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DOE OSTI2014

SU-E-T-279: Realization of Three-Dimensional Conformal Dose Planning in Prostate Brachytherapy

Purpose: Successful clinical treatment in prostate brachytherapy is largely dependent on the effectiveness of pre-surgery dose planning. Conventional dose planning method could hardly arrive at a satisfy result. In this abstract, a three-dimensional conformal localized dose planning method is put forward to ensure the accuracy and effectiveness of pre-implantation dose planning. Methods: Using Monte Carlo method, the pre-calculated 3-D dose map for single source is obtained. As for multiple seeds dose distribution, the maps are combined linearly to acquire the 3-D distribution. The 3-D dose distribution is exhibited in the form of isodose surface together with reconstructed 3-D organs group real-timely. Then it is possible to observe the dose exposure to target volume and normal tissues intuitively, thus achieving maximum dose irradiation to treatment target and minimum healthy tissues damage. In addition, the exfoliation display of different isodose surfaces can be realized applying multi-values contour extraction algorithm based on voxels. The needles could be displayed in the system by tracking the position of the implanted seeds in real time to conduct block research in optimizing insertion trajectory. Results: This study extends dose planning from two-dimensional to three-dimensional, realizing the three-dimensional conformal irradiation, which could eliminate the limitations of 2-D images and two-dimensional dose planning. A software platform is developed using VC++ and Visualization Toolkit (VTK) to perform dose planning. The 3-D model reconstruction time is within three seconds (on a Intel Core i5 PC). Block research could be conducted to avoid inaccurate insertion into sensitive organs or internal obstructions. Experiments on eight prostate cancer cases prove that this study could make the dose planning results more reasonable. Conclusion: The three-dimensional conformal dose planning method could improve the rationality of dose planning by safely reducing the large target margin and avoiding dose dead zones for prostate cancer treatment. 1) National Natural Science Foundation of People's Republic of China (No. 51175373); 2) New Century Educational Talents Plan of Chinese Education Ministry (NCET-10-0625); 3) Scientific and Technological Major Project, Tianjin (No. 12ZCDZSY10600)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-289: Scintillating Fiber Based In-Vivo Dose Monitoring System to the Rectum in Proton Therapy of Prostate Cancer: A Geant4 Monte Carlo Simulation

Purpose: To construct a dose monitoring system based on an endorectal balloon coupled to thin scintillating fibers to study the dose delivered to the rectum during prostate cancer proton therapy Methods: The Geant4 Monte Carlo toolkit version 9.6p02 was used to simulate prostate cancer proton therapy treatments of an endorectal balloon (for immobilization of a 2.9 cm diameter prostate gland) and a set of 34 scintillating fibers symmetrically placed around the balloon and perpendicular to the proton beam direction (for dosimetry measurements) Results: A linear response of the fibers to the dose delivered was observed within <2%, a property that makes them good candidates for real time dosimetry. Results obtained show that the closest fiber recorded about 1/3 of the dose to the target with a 1/r{sup 2} decrease in the dose distribution as one goes toward the frontal and distal top fibers. Very low dose was recorded by the bottom fibers (about 45 times comparatively), which is a clear indication that the overall volume of the rectal wall that is exposed to a higher dose is relatively minimized. Further analysis indicated a simple scaling relationship between the dose to the prostate and the dose to the top fibers (a linear fit gave a slope of −0.07±0.07 MeV per treatment Gy) Conclusion: Thin (1 mm × 1 mm × 100 cm) long scintillating fibers were found to be ideal for real time in-vivo dose measurement to the rectum for prostate cancer proton therapy. The linear response of the fibers to the dose delivered makes them good candidates of dosimeters. With thorough calibration and the ability to define a good correlation between the dose to the target and the dose to the fibers, such dosimeters can be used for real time dose verification to the target.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-290: Secondary Dose Monitoring Using Scintillating Fibers in Proton Therapy of Prostate Cancer: A Geant4 Monte Carlo Simulation

Purpose: To monitor the secondary dose distribution originating from a water phantom during proton therapy of prostate cancer using scintillating fibers. Methods: The Geant4 Monte Carlo toolkit version 9.6.p02 was used to simulate prostate cancer proton therapy based treatments. Two cases were studied. In the first case, 8 × 8 = 64 equally spaced fibers inside three 4 × 4 × 2.54 cmm{sup 3} DuPont™ Delrin blocks were used to monitor the emission of secondary particles in the transverse (left and right) and distal regions relative to the beam direction. In the second case, a scintillating block with a thickness of 2.54 cm and equal vertical and longitudinal dimensions as the water phantom was used. Geometrical cuts were used to extract the energy deposited in each fiber and the scintillating block. Results: The transverse dose distributions from secondary particles in both cases agree within <5% and with a very good symmetry. The energy deposited not only gradually increases as one moves from the peripheral row fibers towards the center of the block (aligned with the center of the prostate) but also decreases as one goes from the frontal to distal region of the block. The ratio of the doses from the prostate to the ones in the middle two rows of fibers showed a linear relationship with a slope (−3.55±2.26) × 10−5 MeV per treatment Gy. The distal detectors recorded a very small energy deposited due to water attenuation. Conclusion: With a good calibration and the ability to define a good correlation between the dose to the external fibers and the prostate, such fibers can be used for real time dose verification to the target.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-347: Validation of the Condensed History Algorithm of Geant4 Using the Fano Test

Purpose: To validate the condensed history algorithm and physics of the Geant4 Monte Carlo toolkit for simulations of ionization chambers (ICs). This study is the first step to validate Geant4 for calculations of photon beam quality correction factors under the presence of a strong magnetic field for magnetic resonance guided linac system applications. Methods: The electron transport and boundary crossing algorithms of Geant4 version 9.6.p02 were tested under Fano conditions using the Geant4 example/application FanoCavity. User-defined parameters of the condensed history and multiple scattering algorithms were investigated under Fano test conditions for three scattering models (physics lists): G4UrbanMscModel95 (PhysListEmStandard-option3), G4GoudsmitSaundersonMsc (PhysListEmStandard-GS), and G4WentzelVIModel/G4CoulombScattering (PhysListEmStandard-WVI). Simulations were conducted using monoenergetic photon beams, ranging from 0.5 to 7 MeV and emphasizing energies from 0.8 to 3 MeV. Results: The GS and WVI physics lists provided consistent Fano test results (within ±0.5%) for maximum step sizes under 0.01 mm at 1.25 MeV, with improved performance at 3 MeV (within ±0.25%). The option3 physics list provided consistent Fano test results (within ±0.5%) for maximum step sizes above 1 mm. Optimal parameters for the option3 physics list were 10 km maximum step size with default values for other user-defined parameters: 0.2 dRoverRange, 0.01 mm final range, 0.04 range factor, 2.5 geometrical factor, and 1 skin. Simulations using the option3 physics list were ∼70 – 100 times faster compared to GS and WVI under optimal parameters. Conclusion: This work indicated that the option3 physics list passes the Fano test within ±0.5% when using a maximum step size of 10 km for energies suitable for IC calculations in a 6 MV spectrum without extensive computational times. Optimal user-defined parameters using the option3 physics list will be used in future IC simulations to calculate beam quality correction factors under the presence of a magnetic field. Elekta-MD Anderson Research Agreement.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-T-362: Automatic Catheter Reconstruction of Flap Applicators in HDR Surface Brachytherapy

Purpose: Catheter reconstruction is crucial for the accurate delivery of radiation dose in HDR brachytherapy. The process becomes complicated and time-consuming for large superficial clinical targets with a complex topology. A novel method for the automatic catheter reconstruction of flap applicators is proposed in this study. Methods: We have developed a program package capable of image manipulation, using C++class libraries of The-Visualization-Toolkit(VTK) software system. The workflow for automatic catheter reconstruction is: a)an anchor point is placed in 3D or in the axial view of the first slice at the tip of the first, last and middle points for the curved surface; b)similar points are placed on the last slice of the image set; c)the surface detection algorithm automatically registers the points to the images and applies the surface reconstruction filter; d)then a structured grid surface is generated through the center of the treatment catheters placed at a distance of 5mm from the patient's skin. As a result, a mesh-style plane is generated with the reconstructed catheters placed 10mm apart. To demonstrate automatic catheter reconstruction, we used CT images of patients diagnosed with cutaneous T-cell-lymphoma and imaged with Freiburg-Flap-Applicators (Nucletron™-Elekta, Netherlands). The coordinates for each catheter were generated and compared to the control points selected during the manual reconstruction for 16catheters and 368control point Results: The variation of the catheter tip positions between the automatically and manually reconstructed catheters was 0.17mm(SD=0.23mm). The position difference between the manually selected catheter control points and the corresponding points obtained automatically was 0.17mm in the x-direction (SD=0.23mm), 0.13mm in the y-direction (SD=0.22mm), and 0.14mm in the z-direction (SD=0.24mm). Conclusion: This study shows the feasibility of the automatic catheter reconstruction of flap applicators with a high level of positioning accuracy. Implementation of this technique has potential to decrease the planning time and may improve overall quality in superficial brachytherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-CAMPUS-T-06: Radiochromic Film Analysis Based On Principal Components

Purpose: An algorithm to convert the color image of scanned EBT2 radiochromic film [Ashland, Covington KY] into a dose map was developed based upon a principal component analysis. The sensitive layer of the EBT2 film is colored so that the background streaks arising from variations in thickness and scanning imperfections may be distinguished by color from the dose in the exposed film. Methods: Doses of 0, 0.94, 1.9, 3.8, 7.8, 16, 32 and 64 Gy were delivered to radiochromic films by contact with a calibrated Sr-90/Y-90 source. They were digitized by a transparency scanner. Optical density images were calculated and analyzed by the method of principal components. The eigenimages of the 0.94 Gy film contained predominantly noise, predominantly background streaking, and background streaking plus the source, respectively, in order from the smallest to the largest eigenvalue. Weighting the second and third eigenimages by −0.574 and 0.819 respectively and summing them plus the constant 0.012 yielded a processed optical density image with negligible background streaking. This same weighted sum was transformed to the red, green and blue space of the scanned images and applied to all of the doses. The curve of processed density in the middle of the source versus applied dose was fit by a twophase association curve. A film was sandwiched between two polystyrene blocks and exposed edge-on to a different Y-90 source. This measurement was modeled with the GATE simulation toolkit [Version 6.2, OpenGATE Collaboration], and the on-axis depth-dose curves were compared. Results: The transformation defined using the principal component analysis of the 0.94 Gy film minimized streaking in the backgrounds of all of the films. The depth-dose curves from the film measurement and simulation are indistinguishable. Conclusion: This algorithm accurately converts EBT2 film images to dose images while reducing noise and minimizing background streaking. Supported by a sponsored research agreement from IsoTherapeutics Group, LLC.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-F-18C-09: Assessment of OSL Dosimeter Technology in the Validation of a Monte Carlo Radiation Transport Code for CT Dosimetry

Purpose: To assess the utility of optically stimulated luminescent (OSL) dosimeter technology in calibrating and validating a Monte Carlo radiation transport code for computed tomography (CT). Methods: Exposure data were taken using both a standard CT 100-mm pencil ionization chamber and a series of 150-mm OSL CT dosimeters. Measurements were made at system isocenter in air as well as in standard 16-cm (head) and 32-cm (body) CTDI phantoms at isocenter and at the 12 o'clock positions. Scans were performed on a Philips Brilliance 64 CT scanner for 100 and 120 kVp at 300 mAs with a nominal beam width of 40 mm. A radiation transport code to simulate the CT scanner conditions was developed using the GEANT4 physics toolkit. The imaging geometry and associated parameters were simulated for each ionization chamber and phantom combination. Simulated absorbed doses were compared to both CTDI{sub 100} values determined from the ion chamber and to CTDI{sub 100} values reported from the OSLs. The dose profiles from each simulation were also compared to the physical OSL dose profiles. Results: CTDI{sub 100} values reported by the ion chamber and OSLs are generally in good agreement (average percent difference of 9%), and provide a suitable way to calibrate doses obtained from simulation to real absorbed doses. Simulated and real CTDI{sub 100} values agree to within 10% or less, and the simulated dose profiles also predict the physical profiles reported by the OSLs. Conclusion: Ionization chambers are generally considered the standard for absolute dose measurements. However, OSL dosimeters may also serve as a useful tool with the significant benefit of also assessing the radiation dose profile. This may offer an advantage to those developing simulations for assessing radiation dosimetry such as verification of spatial dose distribution and beam width.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

MO-A-BRD-07: Feasibility of X-Ray Acoustic Computed Tomography as a Tool for Calibration and In Vivo Dosimetry of Radiotherapy Electron and Photon Beams

Purpose: This work simulates radiation-induced acoustic waves to assess the feasibility of x-ray acoustic computed tomography (XACT) as a dosimeter. XACT exploits the phenomenon that acoustic waves with amplitude proportional to the dose deposited are induced following a radiation pulse. After detecting these acoustic waves with an ultrasound transducer, an image of the dose distribution can be reconstructed in realtime. Methods: Monte Carlo was used to simulate the dose distribution for monoenergetic 6 MeV photon and 9 MeV electron beams incident on a water tank. The dose distribution for a prostate patient planned with a photon 4-field box technique was calculated using clinical treatment planning software. All three dose distributions were converted into initial pressure distributions, and transportation of the induced acoustic waves was simulated using an open-source toolkit. Ideal transducers were placed around the circumference of the target to detect the acoustic waves, and a time reversal reconstruction algorithm was used to obtain an XACT image of the dose for each radiation pulse. Results: For the photon water tank relative dosimetry case, it was found that the normalized acoustic signal amplitude agreed with the normalized dose at depths from 0 cm to 10 cm, with an average percent difference of 0.5%. For the reconstructed in-plane dose distribution of an electron water tank irradiation, all pixels passed a 3%–3 mm 2D gamma test. The reconstructed prostate dose distribution closely resembled the plan, with 89% of pixels passing a 3%–3 mm 2D gamma test. For all situations, the amplitude of the induced acoustic waves ranged from 0.01 Pa to 1 Pa. Conclusion: Based on the amplitude of the radiation-induced acoustic waves and accuracy of the reconstructed dose distributions, XACT is a feasible technique for dosimetry in both calibration and in vivo environments for photon and electron beams and merits further investigation. Funding from NSERC, CIHR and McGill University. SH acknowledges partial support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

MO-G-17A-04: Internal Dosimetric Calculations for Pediatric Nuclear Imaging Applications, Using Monte Carlo Simulations and High-Resolution Pediatric Computational Models

Purpose: Our purpose is to evaluate the administered absorbed dose in pediatric, nuclear imaging studies. Monte Carlo simulations with the incorporation of pediatric computational models can serve as reference for the accurate determination of absorbed dose. The procedure of the calculated dosimetric factors is described, while a dataset of reference doses is created. Methods: Realistic simulations were executed using the GATE toolkit and a series of pediatric computational models, developed by the “IT'IS Foundation”. The series of the phantoms used in our work includes 6 models in the range of 5–14 years old (3 boys and 3 girls). Pre-processing techniques were applied to the images, to incorporate the phantoms in GATE simulations. The resolution of the phantoms was set to 2 mm3. The most important organ densities were simulated according to the GATE “Materials Database”. Several used radiopharmaceuticals in SPECT and PET applications are being tested, following the EANM pediatric dosage protocol. The biodistributions of the several isotopes used as activity maps in the simulations, were derived by the literature. Results: Initial results of absorbed dose per organ (mGy) are presented in a 5 years old girl from the whole body exposure to 99mTc - SestaMIBI, 30 minutes after administration. Heart, kidney, liver, ovary, pancreas and brain are the most critical organs, in which the S-factors are calculated. The statistical uncertainty in the simulation procedure was kept lower than 5%. The Sfactors for each target organ are calculated in Gy/(MBq*sec) with highest dose being absorbed in kidneys and pancreas (9.29*10{sup 10} and 0.15*10{sup 10} respectively). Conclusion: An approach for the accurate dosimetry on pediatric models is presented, creating a reference dosage dataset for several radionuclides in children computational models with the advantages of MC techniques. Our study is ongoing, extending our investigation to other reference models and evaluating the results with clinical estimated doses.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TU-C-17A-03: An Integrated Contour Evaluation Software Tool Using Supervised Pattern Recognition for Radiotherapy

Purpose: Radiotherapy (RT) contours delineated either manually or semiautomatically require verification before clinical usage. Manual evaluation is very time consuming. A new integrated software tool using supervised pattern contour recognition was thus developed to facilitate this process. Methods: The contouring tool was developed using an object-oriented programming language C# and application programming interfaces, e.g. visualization toolkit (VTK). The C# language served as the tool design basis. The Accord.Net scientific computing libraries were utilized for the required statistical data processing and pattern recognition, while the VTK was used to build and render 3-D mesh models from critical RT structures in real-time and 360° visualization. Principal component analysis (PCA) was used for system self-updating geometry variations of normal structures based on physician-approved RT contours as a training dataset. The inhouse design of supervised PCA-based contour recognition method was used for automatically evaluating contour normality/abnormality. The function for reporting the contour evaluation results was implemented by using C# and Windows Form Designer. Results: The software input was RT simulation images and RT structures from commercial clinical treatment planning systems. Several abilities were demonstrated: automatic assessment of RT contours, file loading/saving of various modality medical images and RT contours, and generation/visualization of 3-D images and anatomical models. Moreover, it supported the 360° rendering of the RT structures in a multi-slice view, which allows physicians to visually check and edit abnormally contoured structures. Conclusion: This new software integrates the supervised learning framework with image processing and graphical visualization modules for RT contour verification. This tool has great potential for facilitating treatment planning with the assistance of an automatic contour evaluation module in avoiding unnecessary manual verification for physicians/dosimetrists. In addition, its nature as a compact and stand-alone tool allows for future extensibility to include additional functions for physicians’ clinical needs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

TH-A-19A-02: Expanding TOPAS Towards Biological Modeling

Purpose: To expand Monte Carlo simulations of TOPAS to directly calculate radiobiological effects using various biological models. Methods: We use the TOPAS toolkit version beta9 and expand the provided scoring system to directly include scorers for relative biological effect (RBE) modeling. A scorer is a class to record a given physical property in the Monte Carlo simulations. We developed a scorer for the dose averaged linear energy transfer (LETd). This scorer was used to compare RBE weighted dose distributions assuming a constant RBE of 1.1 with the RBE weighted dose using a variable RBE based on a model using LETd and dose as input. Additionally, the local effect model (LEM) was implemented in TOPAS to estimate RBE weighted dose distributions. Survival curves for the LEM were simulated for a monoenergetic proton beams impinging on phantoms and for full patient treatment plans. Results: We have implemented radiobiological effect models in TOPAS, providing users with the possibility to directly obtain parameters related to radiobiological dose and use those as additional information to assess the quality of treatment plans. We applied the scorers to clinical patient treatments and phantom simulations. We find that for the proton therapy plans investigated the regions with the highest LETd are generally outside of the target volume, coinciding with the distal edge of treatment fields. LETd-based variable RBE weighted dose models predict higher doses at the distal edge of over 10% of the prescribed dose than when assuming a constant RBE. Conclusion: By implementing radiobiological effect models into a Monte Carlo simulation package we combine accurate dose calculation with biological modeling. TOPAS thereby provides distributions of multiple physical quantities such as the dose and LETd, and estimates of biological parameters (RBE, survival) thus allowing direct comparison of biological effective dose predictions between different models.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-A-19A-03: Impact of Proton Dose Calculation Method On Delivered Dose to Lung Tumors: Experiments in Thorax Phantom and Planning Study in Patient Cohort

Purpose: Evaluate Monte Carlo (MC) dose calculation and the prediction of the treatment planning system (TPS) in a lung phantom and compare them in a cohort of 20 lung patients treated with protons. Methods: A 2-dimensional array of ionization chambers was used to evaluate the dose across the target in a lung phantom. 20 lung cancer patients on clinical trials were re-simulated using a validated Monte Carlo toolkit (TOPAS) and compared to the TPS. Results: MC increases dose calculation accuracy in lung compared to the clinical TPS significantly and predicts the dose to the target in the phantom within ±2%: the average difference between measured and predicted dose in a plane through the center of the target is 5.6% for the TPS and 1.6% for MC. MC recalculations in patients show a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. The lower dose correlates significantly with aperture size and the distance of the tumor to the chest wall (Spearman's p=0.0002/0.004). For large tumors MC also predicts consistently higher V{sub 5} and V{sub 10} to the normal lung, due to a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target can show large deviations, though this effect is very patient-specific. Conclusion: Advanced dose calculation techniques, such as MC, would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. This would increase the accuracy of the relationships between dose and effect, concerning tumor control as well as normal tissue toxicity. As the role of proton therapy in the treatment of lung cancer continues to be evaluated in clinical trials, this is of ever-increasing importance. This work was supported by National Cancer Institute Grant R01CA111590.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-C-16A-07: Sculpting Isodose Lines: Design of An Internally Shielded Tandem for Cervical Cancer Brachytherapy

Purpose: With the prescription method moving from point A to 3D volume based in cervical cancer HDR brachytherapy, the traditional pear-shaped isodose lines are desired to be sculptured to conform to the irregular shaped target. The standard single channel tandem cannot generate asymmetric isodose lines. Most of the directionally shielded sources proposed in literature are challenging to manufacture and operate. In this study, we proposed a novel internally shielded tandem applicator design which gave users more freedom to manipulate isodose lines while planning. Methods: The proposed tandem design has one centrally located lead cylindrical rod of 8 mm in diameter serving as the internal shield. Multiple source channels with the diameter of 2 mm are evenly spaced and engraved on the central cylindrical rod. The overall diameter of the tandem with polymer encapsulation was kept to be 10 mm. Various number of channels and engraving depths have been tested in the design process. Geant4 Monte Carlo toolkit was used for dose calculation assuming a Varian VS2000 source was placed inside the applicator. A Monte Carlo based planning system has been developed in-house to generate brachytherapy plans. Test plans by using this internally shielded tandem were generated for 3 clinical cases. Results: Water phantom results shown the dose distribution from a VS2000 source in the tandem was strongly distorted towards one direction due to the presence of shielding material. Conformal plans with asymmetric isodose distributions around the tandem can be generated by optimizing dwell times in different channels. Conclusion: An effective and easy-to-use internally shielded tandem was developed. It gave user the freedom to sculpt isodose lines to generate conformal plans for cervical cancer brachytherapy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

Poster — Thur Eve — 46: Monte Carlo model of the Novalis Classic 6MV stereotactic linear accelerator using the GATE simulation platform

Monte Carlo (MC) simulation is accepted as the most accurate method to predict dose deposition when compared to other methods in radiation treatment planning. Current dose calculation algorithms used for treatment planning can become inaccurate when small radiation fields and tissue inhomogeneities are present. At our centre the Novalis Classic linear accelerator (linac) is used for Stereotactic Radiosurgery (SRS). The first MC model to date of the Novalis Classic linac was developed at our centre using the Geant4 Application for Tomographic Emission (GATE) simulation platform. GATE is relatively new, open source MC software built from CERN's Geometry and Tracking 4 (Geant4) toolkit. The linac geometry was modeled using manufacturer specifications, as well as in-house measurements of the micro MLC's. Among multiple model parameters, the initial electron beam was adjusted so that calculated depth dose curves agreed with measured values. Simulations were run on the European Grid Infrastructure through GateLab. Simulation time is approximately 8 hours on GateLab for a complete head model simulation to acquire a phase space file. Current results have a majority of points within 3% of the measured dose values for square field sizes ranging from 6×6 mm{sup 2} to 98×98 mm{sup 2} (maximum field size on the Novalis Classic linac) at 100 cm SSD. The x-ray spectrum was determined from the MC data as well. The model provides an investigation into GATE'S capabilities and has the potential to be used as a research tool and an independent dose calculation engine for clinical treatment plans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Model-based versus specific dosimetry in diagnostic context: Comparison of three dosimetric approaches

Purpose: The dosimetric assessment of novel radiotracers represents a legal requirement in most countries. While the techniques for the computation of internal absorbed dose in a therapeutic context have made huge progresses in recent years, in a diagnostic scenario the absorbed dose is usually extracted from model-based lookup tables, most often derived from International Commission on Radiological Protection (ICRP) or Medical Internal Radiation Dose (MIRD) Committee models. The level of approximation introduced by these models may impact the resulting dosimetry. The aim of this work is to establish whether a more refined approach to dosimetry can be implemented in nuclear medicine diagnostics, by analyzing a specific case. Methods: The authors calculated absorbed doses to various organs in six healthy volunteers administered with flutemetamol ({sup 18}F) injection. Each patient underwent from 8 to 10 whole body 3D PET/CT scans. This dataset was analyzed using a Monte Carlo (MC) application developed in-house using the toolkit GATE that is capable to take into account patient-specific anatomy and radiotracer distribution at the voxel level. They compared the absorbed doses obtained with GATE to those calculated with two commercially available software: OLINDA/EXM and STRATOS implementing a dose voxel kernel convolution approach. Results: Absorbed doses calculated with GATE were higher than those calculated with OLINDA. The average ratio between GATE absorbed doses and OLINDA’s was 1.38 ± 0.34 σ (from 0.93 to 2.23). The discrepancy was particularly high for the thyroid, with an average GATE/OLINDA ratio of 1.97 ± 0.83 σ for the six patients. Differences between STRATOS and GATE were found to be higher. The average ratio between GATE and STRATOS absorbed doses was 2.51 ± 1.21 σ (from 1.09 to 6.06). Conclusions: This study demonstrates how the choice of the absorbed dose calculation algorithm may introduce a bias when gamma radiations are of importance, as is the case in nuclear medicine diagnostics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Technical Note: Improvements in GEANT4 energy-loss model and the effect on low-energy electron transport in liquid water

Purpose: The GEANT4-DNA physics models are upgraded by a more accurate set of electron cross sections for ionization and excitation in liquid water. The impact of the new developments on low-energy electron transport simulations by the GEANT4 Monte Carlo toolkit is examined for improving its performance in dosimetry applications at the subcellular and nanometer level. Methods: The authors provide an algorithm for an improved implementation of the Emfietzoglou model dielectric response function of liquid water used in the GEANT4-DNA existing model. The algorithm redistributes the imaginary part of the dielectric function to ensure a physically motivated behavior at the binding energies, while retaining all the advantages of the original formulation, e.g., the analytic properties and the fulfillment of the f-sum-rule. In addition, refinements in the exchange and perturbation corrections to the Born approximation used in the GEANT4-DNA existing model are also made. Results: The new ionization and excitation cross sections are significantly different from those of the GEANT4-DNA existing model. In particular, excitations are strongly enhanced relative to ionizations, resulting in higher W-values and less diffusive dose-point-kernels at sub-keV electron energies. Conclusions: An improved energy-loss model for the excitation and ionization of liquid water by low-energy electrons has been implemented in GEANT4-DNA. The suspiciously low W-values and the unphysical long tail in the dose-point-kernel have been corrected owing to a different partitioning of the dielectric function.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

Proton dose calculation on scatter-corrected CBCT image: Feasibility study for adaptive proton therapy

Purpose: To demonstrate the feasibility of proton dose calculation on scatter-corrected cone-beam computed tomographic (CBCT) images for the purpose of adaptive proton therapy. Methods: CBCT projection images were acquired from anthropomorphic phantoms and a prostate patient using an on-board imaging system of an Elekta infinity linear accelerator. Two previously introduced techniques were used to correct the scattered x-rays in the raw projection images: uniform scatter correction (CBCT{sub us}) and a priori CT-based scatter correction (CBCT{sub ap}). CBCT images were reconstructed using a standard FDK algorithm and GPU-based reconstruction toolkit. Soft tissue ROI-based HU shifting was used to improve HU accuracy of the uncorrected CBCT images and CBCT{sub us}, while no HU change was applied to the CBCT{sub ap}. The degree of equivalence of the corrected CBCT images with respect to the reference CT image (CT{sub ref}) was evaluated by using angular profiles of water equivalent path length (WEPL) and passively scattered proton treatment plans. The CBCT{sub ap} was further evaluated in more realistic scenarios such as rectal filling and weight loss to assess the effect of mismatched prior information on the corrected images. Results: The uncorrected CBCT and CBCT{sub us} images demonstrated substantial WEPL discrepancies (7.3 ± 5.3 mm and 11.1 ± 6.6 mm, respectively) with respect to the CT{sub ref}, while the CBCT{sub ap} images showed substantially reduced WEPL errors (2.4 ± 2.0 mm). Similarly, the CBCT{sub ap}-based treatment plans demonstrated a high pass rate (96.0% ± 2.5% in 2 mm/2% criteria) in a 3D gamma analysis. Conclusions: A priori CT-based scatter correction technique was shown to be promising for adaptive proton therapy, as it achieved equivalent proton dose distributions and water equivalent path lengths compared to those of a reference CT in a selection of anthropomorphic phantoms.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-C-201-06: Utility of Quantitative 3D SPECT/CT Imaging in Patient Specific Internal Dosimetry of 153-Samarium with GATE Monte Carlo Package

Purpose: Patient-specific 3-dimensional (3D) internal dosimetry in targeted radionuclide therapy is essential for efficient treatment. Two major steps to achieve reliable results are: 1) generating quantitative 3D images of radionuclide distribution and attenuation coefficients and 2) using a reliable method for dose calculation based on activity and attenuation map. In this research, internal dosimetry for 153-Samarium (153-Sm) was done by SPECT-CT images coupled GATE Monte Carlo package for internal dosimetry. Methods: A 50 years old woman with bone metastases from breast cancer was prescribed 153-Sm treatment (Gamma: 103keV and beta: 0.81MeV). A SPECT/CT scan was performed with the Siemens Simbia-T scanner. SPECT and CT images were registered using default registration software. SPECT quantification was achieved by compensating for all image degrading factors including body attenuation, Compton scattering and collimator-detector response (CDR). Triple energy window method was used to estimate and eliminate the scattered photons. Iterative ordered-subsets expectation maximization (OSEM) with correction for attenuation and distance-dependent CDR was used for image reconstruction. Bilinear energy mapping is used to convert Hounsfield units in CT image to attenuation map. Organ borders were defined by the itk-SNAP toolkit segmentation on CT image. GATE was then used for internal dose calculation. The Specific Absorbed Fractions (SAFs) and S-values were reported as MIRD schema. Results: The results showed that the largest SAFs and S-values are in osseous organs as expected. S-value for lung is the highest after spine that can be important in 153-Sm therapy. Conclusion: We presented the utility of SPECT-CT images and Monte Carlo for patient-specific dosimetry as a reliable and accurate method. It has several advantages over template-based methods or simplified dose estimation methods. With advent of high speed computers, Monte Carlo can be used for treatment planning on a day to day basis.

60 APPLIED LIFE SCIENCES↗