Engineering Papers⌕ Search

SEARCH · Engineering Papers

Results for “DOSIMETRY”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,387 records · Page 77

MO-DE-210-04: Repositioning and Monitoring of Prostate Cancer Radiotherapy with a New 4D Ultrasound Intra-Modality IGRT Device

Purpose: We report our clinical experience using a non-invasive transperineal (TP) ultrasound (US) probe dedicated to pre-positioning and monitoring of prostate cancer patients. The accuracy of pre-treatment positioning was compared to CBCT for prostate and post-prostatectomy patients. Intrafraction motions were recorded for both localizations. The dosimetric impact of these displacements was finally investigated on prostate patients. Methods: Differences between CBCT/CT and TP-US/TP-US registrations were analyzed on 427 and 453 sessions for 13 prostate and 14 post-prostatectomy patients, respectively. Ten prostate patients’ dosimetries were retrospectively planned using 2 different protocols: 80Gy in 40 fractions and 36.25Gy in 5 fractions with a 5mm CTV- to- PTV margin. The delivery time was measured in order to analyze ranges of intrafraction motions related to each protocol. Mean prostate displacements were calculated for each patient and applied to the treatment isocenter coordinates to evaluate the dosimetric impact of these motions. Results: CBCT and TP-US shifts agreements at ±5mm were 76.6%, 95.1%, 96.3% and 90.3%, 85.0%, 97.6% in anterior- posterior, superior- inferior and left-right directions, for prostate and post-prostatectomy patients, respectively. Intrafraction motions were analyzed considering delivery times of 140 and 290s with an additional time of 120s for patient installation for doses of 2 and 7.25Gy, respectively. Intrafraction motions were patient-dependent and were larger as the irradiation time increased. Larger displacements were observed for prostate compared to post-prostatectomy localizations. Shifts above 3mm were observed on 17.6% and 4.5% of the 2Gy sessions against 30.6% and 7.3% of the 7.25Gy sessions in the anterior-posterior direction for prostate and post-prostatectomy localizations, respectively. Preliminary dosimetric results showed that intrafraction motions mainly impact the PTV coverage. Conclusion: 4D TP-US modality is a promising alternative to irradiating and/or invasive IGRT modalities for both inter and intrafraction motions management. Preliminary dosimetric results show that intrafraction monitoring is mandatory especially for hypofractionated treatments. M Fargier-Voiron was supported by a PhD grant from Elekta.

60 APPLIED LIFE SCIENCES↗

MO-E-213-01: Increasing Role of Medical Physicist in Radiation Protection

The focus of work of medical physicists in 1980’s was on quality control and quality assurance. Radiation safety was important but was dominated by occupational radiation protection. A series of over exposures of patients in radiotherapy, nuclear medicine and observation of skin injuries among patients undergoing interventional procedures in 1990’s started creating the need for focus on patient protection. It gave medical physicists new directions to develop expertise in patient dosimetry and dose management. Publications creating awareness on cancer risks from CT in early part of the current century and over exposures in CT in 2008 brought radiation risks in public domain and created challenging situations for medical physicists. Increasing multiple exposures of individual patient and patient doses of few tens of mSv or exceeding 100 mSv are increasing the role of medical physicists. Expansion of usage of fluoroscopy in the hands of clinical professionals with hardly any training in radiation protection shall require further role for medical physicists. The increasing publications in journals, recent changes in Safety Standards, California law, all increase responsibilities of medical physicists in patient protection. Newer technological developments in dose efficiency and protective devices increase percentage of time devoted by medical physicists on radiation protection activities. Without radiation protection, the roles, responsibilities and day-to-day involvement of medical physicists in diagnostic radiology becomes questionable. In coming years either medical radiation protection may emerge as a specialty or medical physicists will have to keep major part of day-to-day work on radiation protection. Learning Objectives: To understand how radiation protection has been increasing its role in day-to-day activities of medical physicist To be aware about international safety Standards, national and State regulations that require higher attention to radiation protection than in past To be aware about possible emergence of medical radiation protection as a specialty and challenges for medical physicists.

60 APPLIED LIFE SCIENCES↗

MO-E-213-02: Medical Physicist Involvement in Implementing Patient Protection Standards

The focus of work of medical physicists in 1980’s was on quality control and quality assurance. Radiation safety was important but was dominated by occupational radiation protection. A series of over exposures of patients in radiotherapy, nuclear medicine and observation of skin injuries among patients undergoing interventional procedures in 1990’s started creating the need for focus on patient protection. It gave medical physicists new directions to develop expertise in patient dosimetry and dose management. Publications creating awareness on cancer risks from CT in early part of the current century and over exposures in CT in 2008 brought radiation risks in public domain and created challenging situations for medical physicists. Increasing multiple exposures of individual patient and patient doses of few tens of mSv or exceeding 100 mSv are increasing the role of medical physicists. Expansion of usage of fluoroscopy in the hands of clinical professionals with hardly any training in radiation protection shall require further role for medical physicists. The increasing publications in journals, recent changes in Safety Standards, California law, all increase responsibilities of medical physicists in patient protection. Newer technological developments in dose efficiency and protective devices increase percentage of time devoted by medical physicists on radiation protection activities. Without radiation protection, the roles, responsibilities and day-to-day involvement of medical physicists in diagnostic radiology becomes questionable. In coming years either medical radiation protection may emerge as a specialty or medical physicists will have to keep major part of day-to-day work on radiation protection. Learning Objectives: To understand how radiation protection has been increasing its role in day-to-day activities of medical physicist To be aware about international safety Standards, national and State regulations that require higher attention to radiation protection than in past To be aware about possible emergence of medical radiation protection as a specialty and challenges for medical physicists.

60 APPLIED LIFE SCIENCES↗

MO-E-213-03: Newer Radiation Protection Requirements in Last Decade

The focus of work of medical physicists in 1980’s was on quality control and quality assurance. Radiation safety was important but was dominated by occupational radiation protection. A series of over exposures of patients in radiotherapy, nuclear medicine and observation of skin injuries among patients undergoing interventional procedures in 1990’s started creating the need for focus on patient protection. It gave medical physicists new directions to develop expertise in patient dosimetry and dose management. Publications creating awareness on cancer risks from CT in early part of the current century and over exposures in CT in 2008 brought radiation risks in public domain and created challenging situations for medical physicists. Increasing multiple exposures of individual patient and patient doses of few tens of mSv or exceeding 100 mSv are increasing the role of medical physicists. Expansion of usage of fluoroscopy in the hands of clinical professionals with hardly any training in radiation protection shall require further role for medical physicists. The increasing publications in journals, recent changes in Safety Standards, California law, all increase responsibilities of medical physicists in patient protection. Newer technological developments in dose efficiency and protective devices increase percentage of time devoted by medical physicists on radiation protection activities. Without radiation protection, the roles, responsibilities and day-to-day involvement of medical physicists in diagnostic radiology becomes questionable. In coming years either medical radiation protection may emerge as a specialty or medical physicists will have to keep major part of day-to-day work on radiation protection. Learning Objectives: To understand how radiation protection has been increasing its role in day-to-day activities of medical physicist To be aware about international safety Standards, national and State regulations that require higher attention to radiation protection than in past To be aware about possible emergence of medical radiation protection as a specialty and challenges for medical physicists.

60 APPLIED LIFE SCIENCES↗

MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactions with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication between all parties involved in the TP process increasing patient safety.

60 APPLIED LIFE SCIENCES↗

TU-AB-201-05: Automatic Adaptive Per-Operative Re-Planning for HDR Prostate Brachytherapy - a Simulation Study On Errors in Needle Positioning

Purpose: To develop adaptive planning with feedback for MRI-guided focal HDR prostate brachytherapy with a single divergent needle robotic implant device. After each needle insertion, the dwell positions for that needle are calculated and the positioning of remaining needles and dosimetry are both updated based on MR imaging. Methods: Errors in needle positioning may occur due to inaccurate needle insertion (caused by e.g. the needle’s bending) and unpredictable changes in patient anatomy. Consequently, the dose plan quality might dramatically decrease compared to the preplan. In this study, a procedure was developed to re-optimize, after each needle insertion, the remaining needle angulations, source positions and dwell times in order to obtain an optimal coverage (D95% PTV>19 Gy) without exceeding the constraints of the organs at risk (OAR) (D10% urethra<21 Gy, D1cc bladder<12 Gy and D1cc rectum<12 Gy). Complete HDR procedures with 6 needle insertions were simulated for a patient MR-image set with PTV, prostate, urethra, bladder and rectum delineated. Random angulation errors, modeled by a Gaussian distribution (standard deviation of 3 mm at the needle’s tip), were generated for each needle insertion. We compared the final dose parameters for the situations (I) without re-optimization and (II) with the automatic feedback. Results: The computation time of replanning was below 100 seconds on a current desk computer. For the patient tested, a clinically acceptable dose plan was achieved while applying the automatic feedback (median(range) in Gy, D95% PTV: 19.9(19.3–20.3), D10% urethra: 13.4(11.9–18.0), D1cc rectum: 11.0(10.7–11.6), D1cc bladder: 4.9(3.6–6.8)). This was not the case without re-optimization (median(range) in Gy, D95% PTV: 19.4(14.9–21.3), D10% urethra: 12.6(11.0–15.7), D1cc rectum: 10.9(8.9–14.1), D1cc bladder: 4.8(4.4–5.2)). Conclusion: An automatic guidance strategy for HDR prostate brachytherapy was developed to compensate errors in needle positioning and improve the dose distribution. Without re-optimization, target coverage and OAR constraints may not be achieved. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are full-time employees of Philips Medical Systems Nederland B.V.

60 APPLIED LIFE SCIENCES↗

TU-AB-201-06: Evaluation of Electromagnetically Guided High- Dose Rate Brachytherapy for Ablative Treatment of Lung Metastases

Purpose: The advent of electromagnetic navigation bronchoscopy has enabled minimally invasive access to peripheral lung tumors previously inaccessible by optical bronchoscopes. As an adjunct to Stereotactic Ablative Radiosurgery (SABR), implantation of HDR catheters can provide focal treatments for multiple metastases and sites of retreatments. The authors evaluate a procedure to deliver ablative doses via Electromagnetically-Guided HDR (EMG-HDR) to lung metastases, quantify the resulting dosimetry, and assess its role in the comprehensive treatment of lung cancer. Methods: A retrospective study was conducted on ten patients, who, from 2009 to 2011, received a hypo-fractionated SABR regimen with 6MV VMAT to lesions in various lobes ranging from 1.5 to 20 cc in volume. A CT visible pathway was delineated for EM guided placement of an HDR applicator (catheter) and dwell times were optimized to ensure at least 98% prescription dose coverage of the GTV. Normal tissue doses were calculated using inhomogeneity corrections via a grid-based Boltzmann solver (Acuros-BV-1.5.0). Results: With EMG-HDR, an average of 83% (+/−9% standard deviation) of each patient’s GTV received over 200% of the prescription dose, as compared to SABR where the patients received an average maximum dose of 125% (+/−5%). EMG-HDR enabled a 59% (+/−12%) decrease in the aorta maximum dose, a 63% (+/−26%) decrease in the spinal cord max dose, and 57% (+/−23%) and 70% (+/−17%) decreases in the volume of the body receiving over 50% and 25% of the prescription dose, respectively. Conclusion: EMG-HDR enables delivery of higher ablative doses to the GTV, while concurrently reducing surrounding normal tissue doses. The single catheter approach shown here is limited to targets smaller than 20 cc. As such, the technique enables ablation of small lesions and a potentially safe and effective retreatment option in situations where external beam utility is limited by normal tissue constraints.

60 APPLIED LIFE SCIENCES↗

TU-CD-304-08: Feasibility of a VMAT-Based Spatially Fractionated Grid Therapy Technique

Purpose: Grid therapy (GT) uses spatially modulated radiation doses to treat large tumors without significant toxicities. Incorporating 3D conformal-RT or IMRT improved single-field GT by reducing dose to normal tissues spatially through the use of multiple fields. The feasibility of a MLC-based, inverse-planned multi-field GT technique has been demonstrated. Volumetric modulated arc therapy (VMAT) provides conformal dose distributions with the additional potential advantage of reduced treatment times. In this study, we characterize a new VMAT-based GT (VMAT-GT) technique with respect to its deliverability and dosimetric accuracy. Methods: A lattice of 5mm-diameter spheres was created as the boost volume within a large treatment target. A simultaneous boost VMAT (RapidArc) plan with 8Gy to the target and 20Gy to the boost volume was generated using the Eclipse treatment planning system (AAA-v11). The linac utilized HD120 MLC and 6MV flattening-filter free beam. Four non-coplanar arcs, with couch angles at 0, 45, 90 and 317° were used. Collimator angles were at 45 and 315°. The plan was mapped to a phantom. Calibrated Gafchromic EBT3 films were used to measure the delivered dose. Results: The VMAT plan generated a highly spatially modulated dose distribution in the target. D95%, D50%, D5% for the spheres and the targets in Gy were 18.9, 20.6, 23 and 8.0, 9.6, 14.8, respectively. D50% for a 1cm ring 1cm outside the target was 3.0Gy. The peak-to-valley ratio of this technique is comparable to previously proposed techniques, but the MUs were reduced by almost 50%. Film dosimetry showed good agreement between calculated and delivered dose, with an overall gamma passing rate of >98% (3% and 1mm). The point dose differences at sphere centers varied from 2–8%. Conclusion: The deliverability and dose calculation accuracy of the proposed VMAT-GT technique demonstrates that ablative radiation doses are deliverable to large tumors safely and efficiently.

60 APPLIED LIFE SCIENCES↗

TU-CD-207-09: Analysis of the 3-D Shape of Patients’ Breast for Breast Imaging and Surgery Planning

Purpose: Develop a method to accurately capture the 3-D shape of patients’ external breast surface before and during breast compression for mammography/tomosynthesis. Methods: During this IRB-approved, HIPAA-compliant study, 50 women were recruited to undergo 3-D breast surface imaging during breast compression and imaging for the cranio-caudal (CC) view on a digital mammography/breast tomosynthesis system. Digital projectors and cameras mounted on tripods were used to acquire 3-D surface images of the breast, in three conditions: (a) positioned on the support paddle before compression, (b) during compression by the compression paddle and (c) the anterior-posterior view with the breast in its natural, unsupported position. The breast was compressed to standard full compression with the compression paddle and a tomosynthesis image was acquired simultaneously with the 3-D surface. The 3-D surface curvature and deformation with respect to the uncompressed surface was analyzed using contours. The 3-D surfaces were voxelized to capture breast shape in a format that can be manipulated for further analysis. Results: A protocol was developed to accurately capture the 3-D shape of patients’ breast before and during compression for mammography. Using a pair of 3-D scanners, the 50 patient breasts were scanned in three conditions, resulting in accurate representations of the breast surfaces. The surfaces were post processed, analyzed using contours and voxelized, with 1 mm{sup 3} voxels, converting the breast shape into a format that can be easily modified as required. Conclusion: Accurate characterization of the breast curvature and shape for the generation of 3-D models is possible. These models can be used for various applications such as improving breast dosimetry, accurate scatter estimation, conducting virtual clinical trials and validating compression algorithms. Ioannis Sechopoulos is consultant for Fuji Medical Systems USA.

60 APPLIED LIFE SCIENCES↗

TU-EF-304-06: A Comparison of CT Number to Relative Linear Stopping Power Conversion Curves Used by Proton Therapy Centers

Purpose: To compare the CT Number (CTN) to Relative Linear Stopping Power (RLSP) conversion curves used by 14 proton institutions in their dose calculations. Methods: The proton institution’s CTN to RLSP conversion curves were collected by the Imaging and Radiation Oncology Core (IROC) Houston QA Center during its on-site dosimetry review audits. The CTN values were converted to scaled CT Numbers. The scaling assigns a CTN of 0 to air and 1000 to water to allow intercomparison. The conversion curves were compared and the mean curve was calculated based on institutions’ predicted RLSP values for air (CTN 0), lung (CTN 250), fat (CTN 950), water (1000), liver (CTN 1050), and bone (CTN 2000) points. Results: One institution’s curve was found to have a unique curve shape between the scaled CTN of 1025 to 1225. This institution modified its curve based on the findings. Another institution had higher RLSP values than expected for both low and high CTNs. This institution recalibrated their two CT scanners and the new data placed their curve closer to the mean of all institutions. After corrections were made to several conversion curves, four institutions still fall outside 2 standard deviations at very low CTNs (100–200), and two institutions fall outside between CTN 850–900. The largest percent difference in RLSP values between institutions for the specific tissues reviewed was 22% for the lung point. Conclusion: The review and comparison of CTN to RLSP conversion curves allows IROC Houston to identify any outliers and make recommendations for improvement. Several institutions improved their clinical dose calculation accuracy as a Result of this review. There is still area for improvement, particularly in the lung area of the curve. The IROC Houston QA Center is supported by NCI grant CA180803.

60 APPLIED LIFE SCIENCES↗

TU-G-BRD-06: The Imaging and Radiation Oncology Core Houston (IROC Houston) QA Center International Activities Outside North America

Purpose: To describe the extent of IROC Houston’s (formerly the RPC) QA activities and audit results for radiotherapy institutions outside of North America (NA). Methods: The IROC Houston’s QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program provided to international institutions includes: 1) remote TLD/OSLD audit of machine output, 2) credentialing for advanced technologies, and 3) review of patient treatment records. IROC Houston uses the same standards and acceptance criteria for all of its audits whether for North American or international sites. Results: IROC Houston’s QA program has reached out to radiotherapy sites in 43 different countries since 2013 through their participation in clinical trials. In the past two years, 2,778 international megavoltage beam outputs were audited with OSLD/TLD. While the average IROC/Inst ratio is near unity for all sites monitored, there are international regions whose results are significantly different from the NA region. In the past 2 years, 477 and 87 IMRT H&N phantoms were irradiated at NA and international sites, respectively. Regardless of the OSLD beam audit results, the overall pass rate (87 percent) for all international sites (no region separation) is equal to the NA sites. Of the 182 international patient charts reviewed, 10.7 percent of the dose calculation points did not meet our acceptance criterion as compared to 13.6 percent for NA sites. The lower pass rate for NA sites results from a much larger brachytherapy component which has been shown to be more error prone. Conclusion: IROC Houston has expanded its QA services worldwide and continues a long history of improving radiotherapy dose delivery in many countries. Funding received for QA audit services from the Korean GOG, DAHANCA, EORTC, ICON and CMIC Group.

60 APPLIED LIFE SCIENCES↗

TU-F-CAMPUS-I-03: Preliminary Study of Size-Specific Dose Estimates in Adult Abdomenal CT Examinations in Taiwan

Purpose: This study was to investigate size-specific dose estimates (SSDE) for routine adult abdominal CT examinations in Taiwan. Methods: A national survey was conducted in Taiwan in 2014 to investigate SSDEs for routine adult abdominal CT examinations. The hospitals involved in this study provided CT images of their typical patients. The CT image in the level of the middle liver was selected to record the corresponding tube current, slice mAs or effective mAs. The image was also used to estimate the dimensions of patient as measuring the lengths in the anterior to posterior (AP) and lateral (LAT) directions. The effective diameter was then calculated from AP and LAT, and used to look up conversion factors in the AAPM 204 report. The volume CTDI (CTDIvol) for each CT unit was measured on sites using a 32-cm cylindrical standard dose phantom and a calibrated pencil-type ionization chamber. Individual patient’s SSDEs were then calculated from the corresponding SSDE conversion factor and the CTDIvol. Results: The study cohort included 111 CT units. The ratio of turning on automatic tube current modulation (ATCM) or not is 88:23. Effective diameters are 258.7±25.1 mm (167–366 mm). 99.3% of typical patients selected by each hospital have smaller effective diameter than the 32-cm dosimetry phantom. Adult abdomenal SSDE is 17.5 ± 8.8 mGy (1.9-58 mGy). The SSDE seems to decrease as the effective diameter increases as the ATCM turns off, and independent with the effective diameter as the ATCM turns on. Conclusion: The SSDE for typical patients in Taiwan was investigated. We continue to complete this investigation in 2015 to include more valid data to establish SSDE reference level in Taiwan. This study was financially supported by the Atomic Energy Council in Taiwan.

60 APPLIED LIFE SCIENCES↗

WE-B-BRD-00: MRI for Radiation Oncology

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptive QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.

60 APPLIED LIFE SCIENCES↗

WE-B-BRD-01: MR-LINAC

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptive QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.

60 APPLIED LIFE SCIENCES↗

WE-B-BRD-02: MR Simulation for Radiation Therapy

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptive QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.

60 APPLIED LIFE SCIENCES↗

WE-B-BRD-03: MR QA/QC for MRgRT

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptive QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.

60 APPLIED LIFE SCIENCES↗

WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.

60 APPLIED LIFE SCIENCES↗

WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging physics, systems, dosimetry, safety and related problem solving/calculations How to Prepare for Part 3 of the ABR exam by effectively communicating the practice, methods, and significance of clinical diagnostic and/or nuclear medical physics.

60 APPLIED LIFE SCIENCES↗