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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↗

WE-A-17A-07: Evaluation of a Grid-Based Boltzmann Solver for Nuclear Medicine Voxel-Based Dose Calculations

Purpose: Grid-based Boltzmann solvers (GBBS) have been successfully implemented in radiation oncology clinics as dose calculations for e×ternal photon beams and 192Ir sealed-source brachytherapy. We report on the evaluation of a GBBS for nuclear medicine vo×el-based absorbed doses. Methods: Vo×el-S-values were calculated for monoenergetic betas and photons (1, 0.1, 0.01 MeV), 90Y, and 131I for 3 mm vo×el sizes using Monte Carlo (DOS×YZnrc) and GBBS (Attila 8.1-beta5, Transpire). The source distribution was uniform throughout a single vo×el. The material was an infinite 1.04 g/cc soft tissue slab. To e×plore convergence properties of the GBBS 3 tetrahedral meshes, 3 energy group structures, 3 different square Chebyschev-Legendre quadrature set orders (Sn), and 4×2013;7 spherical harmonic e×pansion terms (Pn) were investigated for a total of 168 discretizations per source. The mesh, energy group, and quadrature sets are 8×, 3×, and 16×, respectively, finer than the corresponding coarse discretization. GBBS cross sections were generated with full electronphoton-coupling using the vendors e×tended CEP×S code. For accuracy, percent differences (%Δ) in source vo×el absorbed doses between MC and GBBS are reported for the coarsest and finest discretization. For convergence, ratios of the two finest discretization solutions are reported along each variable. Results: For 1 MeV, 0.1 MeV, 0.01 MeV, Y90, and I-131 beta sources the %Δ in the source vo×el for (coarsest,finest) discretization were (+2.0,−6.4), (−8.0, −7.5), (−13.8, −13.4), (+0.9,−5.5), and (− 10.1,−9.0) respectively. The corresponding %Δ for photons were (+33.7,−7.1), (−9.4, −9.8), (−17.4, −15.2), and (−1.7,−7.7), respectively. For betas, the convergence ratio of mesh, energy, Sn, and Pn ranged from 0.991–1.000. For gammas, the convergence ratio of mesh, Sn, and Pn ranged from 0.998–1.003 while the ratio for energy ranged from 0.964–1.001. Conclusions: GBBS is promising for nuclear medicine vo×el-based dose calculations. Ongoing work includes evaluating GBBS in bone, lung, and realistic clinical PET/SPECT-based activity distributions. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA138986. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

07 ISOTOPE AND RADIATION SOURCES↗

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↗

Development of a golden beam data set for the commissioning of a proton double-scattering system in a pencil-beam dose calculation algorithm

Purpose: The purpose of this investigation is to determine if a single set of beam data, described by a minimal set of equations and fitting variables, can be used to commission different installations of a proton double-scattering system in a commercial pencil-beam dose calculation algorithm. Methods: The beam model parameters required to commission the pencil-beam dose calculation algorithm (virtual and effective SAD, effective source size, and pristine-peak energy spread) are determined for a commercial double-scattering system. These parameters are measured in a first room and parameterized as function of proton energy and nozzle settings by fitting four analytical equations to the measured data. The combination of these equations and fitting values constitutes the golden beam data (GBD). To determine the variation in dose delivery between installations, the same dosimetric properties are measured in two additional rooms at the same facility, as well as in a single room at another facility. The difference between the room-specific measurements and the GBD is evaluated against tolerances that guarantee the 3D dose distribution in each of the rooms matches the GBD-based dose distribution within clinically reasonable limits. The pencil-beam treatment-planning algorithm is commissioned with the GBD. The three-dimensional dose distribution in water is evaluated in the four treatment rooms and compared to the treatment-planning calculated dose distribution. Results: The virtual and effective SAD measurements fall between 226 and 257 cm. The effective source size varies between 2.4 and 6.2 cm for the large-field options, and 1.0 and 2.0 cm for the small-field options. The pristine-peak energy spread decreases from 1.05% at the lowest range to 0.6% at the highest. The virtual SAD as well as the effective source size can be accurately described by a linear relationship as function of the inverse of the residual energy. An additional linear correction term as function of RM-step thickness is required for accurate parameterization of the effective SAD. The GBD energy spread is given by a linear function of the exponential of the beam energy. Except for a few outliers, the measured parameters match the GBD within the specified tolerances in all of the four rooms investigated. For a SOBP field with a range of 15 g/cm{sup 2} and an air gap of 25 cm, the maximum difference in the 80%–20% lateral penumbra between the GBD-commissioned treatment-planning system and measurements in any of the four rooms is 0.5 mm. Conclusions: The beam model parameters of the double-scattering system can be parameterized with a limited set of equations and parameters. This GBD closely matches the measured dosimetric properties in four different rooms.

43 PARTICLE ACCELERATORS↗

SU-C-BRB-06: Utilizing 3D Scanner and Printer for Dummy Eye-Shield: Artifact-Free CT Images of Tungsten Eye-Shield for Accurate Dose Calculation

Purpose: To evaluate the effect of a tungsten eye-shield on the dose distribution of a patient. Methods: A 3D scanner was used to extract the dimension and shape of a tungsten eye-shield in the STL format. Scanned data was transferred into a 3D printer. A dummy eye shield was then produced using bio-resin (3D systems, VisiJet M3 Proplast). For a patient with mucinous carcinoma, the planning CT was obtained with the dummy eye-shield placed on the patient’s right eye. Field shaping of 6 MeV was performed using a patient-specific cerrobend block on the 15 x 15 cm{sup 2} applicator. The gantry angle was 330° to cover the planning target volume near by the lens. EGS4/BEAMnrc was commissioned from our measurement data from a Varian 21EX. For the CT-based dose calculation using EGS4/DOSXYZnrc, the CT images were converted to a phantom file through the ctcreate program. The phantom file had the same resolution as the planning CT images. By assigning the CT numbers of the dummy eye-shield region to 17000, the real dose distributions below the tungsten eye-shield were calculated in EGS4/DOSXYZnrc. In the TPS, the CT number of the dummy eye-shield region was assigned to the maximum allowable CT number (3000). Results: As compared to the maximum dose, the MC dose on the right lens or below the eye shield area was less than 2%, while the corresponding RTP calculated dose was an unrealistic value of approximately 50%. Conclusion: Utilizing a 3D scanner and a 3D printer, a dummy eye-shield for electron treatment can be easily produced. The artifact-free CT images were successfully incorporated into the CT-based Monte Carlo simulations. The developed method was useful in predicting the realistic dose distributions around the lens blocked with the tungsten shield.

60 APPLIED LIFE SCIENCES↗

SU-E-J-115: Correlation of Displacement Vector Fields Calculated by Deformable Image Registration Algorithms with Motion Parameters of CT Images with Well-Defined Targets and Controlled-Motion

Purpose: To investigate correlation of displacement vector fields (DVF) calculated by deformable image registration algorithms with motion parameters in helical axial and cone-beam CT images with motion artifacts. Methods: A mobile thorax phantom with well-known targets with different sizes that were made from water-equivalent material and inserted in foam to simulate lung lesions. The thorax phantom was imaged with helical, axial and cone-beam CT. The phantom was moved with a cyclic motion with different motion amplitudes and frequencies along the superior-inferior direction. Different deformable image registration algorithms including demons, fast demons, Horn-Shunck and iterative-optical-flow from the DIRART software were used to deform CT images for the phantom with different motion patterns. The CT images of the mobile phantom were deformed to CT images of the stationary phantom. Results: The values of displacement vectors calculated by deformable image registration algorithm correlated strongly with motion amplitude where large displacement vectors were calculated for CT images with large motion amplitudes. For example, the maximal displacement vectors were nearly equal to the motion amplitudes (5mm, 10mm or 20mm) at interfaces between the mobile targets lung tissue, while the minimal displacement vectors were nearly equal to negative the motion amplitudes. The maximal and minimal displacement vectors matched with edges of the blurred targets along the Z-axis (motion-direction), while DVF’s were small in the other directions. This indicates that the blurred edges by phantom motion were shifted largely to match with the actual target edge. These shifts were nearly equal to the motion amplitude. Conclusions: The DVF from deformable-image registration algorithms correlated well with motion amplitude of well-defined mobile targets. This can be used to extract motion parameters such as amplitude. However, as motion amplitudes increased, image artifacts increased significantly and that limited image quality and poor correlation between the motion amplitude and DVF was obtained.

60 APPLIED LIFE SCIENCES↗

SU-E-J-136: Investigation Into Robustness of Stopping Power Calculated by DECT and SECT for Proton Therapy Treatment Planning

Purpose: To investigate the robustness of dual energy CT (DECT) and single energy CT (SECT) proton stopping power calibration techniques and quantify the associated errors when imaging a phantom differing in chemical composition to that used during stopping power calibration. Methods: The CIRS tissue substitute phantom was scanned in a CT-simulator at 90kV and 140kV. This image set was used to generate a DECT proton SPR calibration based on a relationship between effective atomic number and mean excitation energy. A SECT proton SPR calibration based only on Hounsfield units (HUs) was also generated. DECT and SECT scans of a second phantom of known density and chemical composition were performed. The SPR of the second phantom was calculated with the DECT approach (SPR-DECT),the SECT approach (SPR-SECT) and finally the known density and chemical composition of the phantom (SPR-ref). The DECT and SECT image sets were imported into the Pinnacle{sup 3} research release of proton therapy treatment planning. The difference in dose when exposed to a common pencil beam distribution was investigated. Results: SPR-DECT was found to be in better agreement with SPR-ref than SPR- SECT. The mean difference in SPR for all materials was 0.51% for DECT and 6.89% for SECT. With the exception of Teflon, SPR-DECT was found to agree with SPR-ref to within 1%. Significant differences in calculated dose were found when using the DECT image set or the SECT image set. Conclusion: The DECT calibration technique was found to be more robust to situations in which the physical properties of the test materials differed from the materials used during SPR calibration. Furthermore, it was demonstrated that the DECT and SECT SPR calibration techniques can Result in significantly different calculated dose distributions.

60 APPLIED LIFE SCIENCES↗

SU-E-T-22: A Deterministic Solver of the Boltzmann-Fokker-Planck Equation for Dose Calculation

Purpose: The Boltzmann-Fokker-Planck equation (BFPE) accurately models the migration of photons/charged particles in tissues. While the Monte Carlo (MC) method is popular for solving BFPE in a statistical manner, we aim to develop a deterministic BFPE solver based on various state-of-art numerical acceleration techniques for rapid and accurate dose calculation. Methods: Our BFPE solver is based on the structured grid that is maximally parallelizable, with the discretization in energy, angle and space, and its cross section coefficients are derived or directly imported from the Geant4 database. The physical processes that are taken into account are Compton scattering, photoelectric effect, pair production for photons, and elastic scattering, ionization and bremsstrahlung for charged particles.While the spatial discretization is based on the diamond scheme, the angular discretization synergizes finite element method (FEM) and spherical harmonics (SH). Thus, SH is used to globally expand the scattering kernel and FFM is used to locally discretize the angular sphere. As a Result, this hybrid method (FEM-SH) is both accurate in dealing with forward-peaking scattering via FEM, and efficient for multi-energy-group computation via SH. In addition, FEM-SH enables the analytical integration in energy variable of delta scattering kernel for elastic scattering with reduced truncation error from the numerical integration based on the classic SH-based multi-energy-group method. Results: The accuracy of the proposed BFPE solver was benchmarked against Geant4 for photon dose calculation. In particular, FEM-SH had improved accuracy compared to FEM, while both were within 2% of the results obtained with Geant4. Conclusion: A deterministic solver of the Boltzmann-Fokker-Planck equation is developed for dose calculation, and benchmarked against Geant4. Xiang Hong and Hao Gao were partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000) and the Shanghai Pujiang Talent Program (#14PJ1404500)

60 APPLIED LIFE SCIENCES↗

SU-E-T-91: Accuracy of Dose Calculation Algorithms for Patients Undergoing Stereotactic Ablative Radiotherapy

Purpose: The purpose of this study was to investigate and quantify the variation in dose distributions in small field lung cancer radiotherapy using seven different dose calculation algorithms. Methods: The study was performed in 21 lung cancer patients who underwent Stereotactic Ablative Body Radiotherapy (SABR). Two different methods (i) Same dose coverage to the target volume (named as same dose method) (ii) Same monitor units in all algorithms (named as same monitor units) were used for studying the performance of seven different dose calculation algorithms in XiO and Eclipse treatment planning systems. The seven dose calculation algorithms include Superposition, Fast superposition, Fast Fourier Transform ( FFT) Convolution, Clarkson, Anisotropic Analytic Algorithm (AAA), Acurous XB and pencil beam (PB) algorithms. Prior to this, a phantom study was performed to assess the accuracy of these algorithms. Superposition algorithm was used as a reference algorithm in this study. The treatment plans were compared using different dosimetric parameters including conformity, heterogeneity and dose fall off index. In addition to this, the dose to critical structures like lungs, heart, oesophagus and spinal cord were also studied. Statistical analysis was performed using Prism software. Results: The mean±stdev with conformity index for Superposition, Fast superposition, Clarkson and FFT convolution algorithms were 1.29±0.13, 1.31±0.16, 2.2±0.7 and 2.17±0.59 respectively whereas for AAA, pencil beam and Acurous XB were 1.4±0.27, 1.66±0.27 and 1.35±0.24 respectively. Conclusion: Our study showed significant variations among the seven different algorithms. Superposition and AcurosXB algorithms showed similar values for most of the dosimetric parameters. Clarkson, FFT convolution and pencil beam algorithms showed large differences as compared to superposition algorithms. Based on our study, we recommend Superposition and AcurosXB algorithms as the first choice of algorithms in lung cancer radiotherapy involving small fields. However, further investigation by Monte Carlo simulation is required to confirm our results.

60 APPLIED LIFE SCIENCES↗

SU-E-T-135: Assessing the Clinical Impact of Approximations in Analytical Dose Calculations for Proton Therapy

Purpose: To estimate the clinical relevance of approximations made in analytical dose calculation methods (ADCs) used for treatment planning on tumor coverage and tumor control probability (TCP) in proton therapy. Methods: We compared dose distributions planned with ADC to delivered dose distributions (as determined by TOPAS Monte Carlo (MC) simulations). We investigated 10 patients per site for 5 treatment sites (head-and-neck, lung, breast, prostate, liver). We evaluated differences between the two dose distributions analyzing dosimetric indices based on the dose-volume-histograms, the γ-index and the TCP. The normal tissue complication probability (NTCP) was estimated for the bladder and anterior rectum for the prostate patients. Results: We find that the target doses are overestimated by the ADC by 1–2% on average for all patients considered. All dosimetric indices (the mean dose, D95, D50 and D02, the dose values covering 95%, 50% and 2% of the target volume, respectively) are predicted within 5% of the delivered dose. A γ-index with a 3%/3mm criteria had a passing rate for target volumes above 96% for all patients. The TCP predicted by the two algorithms was up to 2%, 2.5%, 6%, 6.5%, and 11% for liver and breast, prostate, head-and-neck and lung patients, respectively. Differences in NTCP for anterior-rectum and bladder for prostate patients were less than 3%. Conclusion: We show that ADC provide adequate dose distributions for most patients, however, they can Result in underdosage of the target by as much as 5%. The TCP was found to be up to 11% lower than predicted. Advanced dose-calculation methods like MC simulations may be necessary in proton therapy to ensure target coverage for heterogeneous patient geometries, in clinical trials comparing proton therapy to conventional radiotherapy to avoid biases due to systematic discrepancies in calculated dose distributions, and, if tighter range margins are considered. Fully funded by NIH grants.

60 APPLIED LIFE SCIENCES↗

SU-E-T-252: Developing a Pencil Beam Dose Calculation Algorithm for CyberKnife System

Purpose: Currently there are two dose calculation algorithms available in the Cyberknife planning system: ray-tracing and Monte Carlo, which is either not accurate or time-consuming for irregular field shaped by the MLC that was recently introduced. The purpose of this study is to develop a fast and accurate pencil beam dose calculation algorithm which can handle irregular field. Methods: A pencil beam dose calculation algorithm widely used in Linac system is modified. The algorithm models both primary (short range) and scatter (long range) components with a single input parameter: TPR{sub 20}/{sub 10}. The TPR{sub 20}/{sub 20}/{sub 10} value was first estimated to derive an initial set of pencil beam model parameters (PBMP). The agreement between predicted and measured TPRs for all cones were evaluated using the root mean square of the difference (RMSTPR), which was then minimized by adjusting PBMPs. PBMPs are further tuned to minimize OCR RMS (RMSocr) by focusing at the outfield region. Finally, an arbitrary intensity profile is optimized by minimizing RMSocr difference at infield region. To test model validity, the PBMPs were obtained by fitting to only a subset of cones (4) and applied to all cones (12) for evaluation. Results: With RMS values normalized to the dmax and all cones combined, the average RMSTPR at build-up and descending region is 2.3% and 0.4%, respectively. The RMSocr at infield, penumbra and outfield region is 1.5%, 7.8% and 0.6%, respectively. Average DTA in penumbra region is 0.5mm. There is no trend found in TPR or OCR agreement among cones or depths. Conclusion: We have developed a pencil beam algorithm for Cyberknife system. The prediction agrees well with commissioning data. Only a subset of measurements is needed to derive the model. Further improvements are needed for TPR buildup region and OCR penumbra. Experimental validations on MLC shaped irregular field needs to be performed. This work was partially supported by the National Natural Science Foundation of China (61171005) and the China Scholarship Council (CSC)

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-06: Robust Dose Calculation in Intensity Modulated Proton Therapy

Purpose: Commissioning data for intensity modulated proton therapy (IMPT) must be post-processed by fits to ad-hoc functions to derive the dose calculation kernel parameters in a treatment planning system (TPS). Whether from experimental measurement or Monte Carlo simulation, the limited and noisy nature of such data makes this task very challenging. We present a method to improve the modeling of the lateral dose distribution of clinical energy proton beams in water to commission an in-house IMPT dose calculation engine. Methods: A linear sum of three Gaussian distribution functions was fitted to the lateral dose data in logarithmic scale. Starting values of fitting solutions were determined from the Generalized Highland Approximation. We exhaustively optimized the combinations of data weights with upper bounds of the fitting solutions to minimize confidence intervals of the fitting solutions while maintaining the coefficient of determination (R{sup 2}). Results: Across all energies, average confidence bounds improved 72.88% [Max: 88.28%, Min: 55.05%] for small angle coulomb scattering, 114.25% [409.13%, 66.72%,] for nuclear scattering, and 68.66% [141.09%, 33.27%] for large angle coulomb scattering, while the coefficients of determination of the fits (R{sup 2}) remained comparable. On average R {sup 2} only changed 0.18% and were very close to 1 (approx. 0.999). Wilcoxon signed rank tests comparing unweighted/unbounded fits with weighted/bounded fits averaged 0.0146 (Max: 0.177, Min: 7.05×10−{sup 7}) for small angle Coulomb, 0.0903 (0.945, 7.05×10−{sup 7}) for nuclear, and 0.254 (0.871, 1.86×10−{sup 6}) for large angle Coulomb scattering. This allows rejection of the null hypothesis for small angle Coulomb scattering at the 0.015 level and nuclear interaction at the 0.1 level. Conclusion: Optimal weights assigned to IMPT lateral dose data minimized fitting to stochastic noise in the tail region. Optimizing the upper bounds of fitting parameters improved the robustness of fitting solutions. Both led to a more physically meaningful dose calculation kernel for the TPS. NIH/NCI K25CA168984, Eagles Cancer Research Career Development, The Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, Mayo ASU Seed Grant, and The Kemper Marley Foundation.

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-09: A Random Walk Model Algorithm for Proton Dose Calculation

Purpose: To develop a random walk model algorithm for calculating proton dose with balanced computation burden and accuracy. Methods: Random walk (RW) model is sometimes referred to as a density Monte Carlo (MC) simulation. In MC proton dose calculation, the use of Gaussian angular distribution of protons due to multiple Coulomb scatter (MCS) is convenient, but in RW the use of Gaussian angular distribution requires an extremely large computation and memory. Thus, our RW model adopts spatial distribution from the angular one to accelerate the computation and to decrease the memory usage. From the physics and comparison with the MC simulations, we have determined and analytically expressed those critical variables affecting the dose accuracy in our RW model. Results: Besides those variables such as MCS, stopping power, energy spectrum after energy absorption etc., which have been extensively discussed in literature, the following variables were found to be critical in our RW model: (1) inverse squared law that can significantly reduce the computation burden and memory, (2) non-Gaussian spatial distribution after MCS, and (3) the mean direction of scatters at each voxel. In comparison to MC results, taken as reference, for a water phantom irradiated by mono-energetic proton beams from 75 MeV to 221.28 MeV, the gamma test pass rate was 100% for the 2%/2mm/10% criterion. For a highly heterogeneous phantom consisting of water embedded by a 10 cm cortical bone and a 10 cm lung in the Bragg peak region of the proton beam, the gamma test pass rate was greater than 98% for the 3%/3mm/10% criterion. Conclusion: We have determined key variables in our RW model for proton dose calculation. Compared with commercial pencil beam algorithms, our RW model much improves the dose accuracy in heterogeneous regions, and is about 10 times faster than MC simulations.

60 APPLIED LIFE SCIENCES↗

Improved tissue assignment using dual-energy computed tomography in low-dose rate prostate brachytherapy for Monte Carlo dose calculation

Purpose: An improvement in tissue assignment for low-dose rate brachytherapy (LDRB) patients using more accurate Monte Carlo (MC) dose calculation was accomplished with a metallic artifact reduction (MAR) method specific to dual-energy computed tomography (DECT). Methods: The proposed MAR algorithm followed a four-step procedure. The first step involved applying a weighted blend of both DECT scans (I {sub H/L}) to generate a new image (I {sub Mix}). This action minimized Hounsfield unit (HU) variations surrounding the brachytherapy seeds. In the second step, the mean HU of the prostate in I {sub Mix} was calculated and shifted toward the mean HU of the two original DECT images (I {sub H/L}). The third step involved smoothing the newly shifted I {sub Mix} and the two original I {sub H/L}, followed by a subtraction of both, generating an image that represented the metallic artifact (I {sub A,(H/L)}) of reduced noise levels. The final step consisted of subtracting the original I {sub H/L} from the newly generated I {sub A,(H/L)} and obtaining a final image corrected for metallic artifacts. Following the completion of the algorithm, a DECT stoichiometric method was used to extract the relative electronic density (ρ{sub e}) and effective atomic number (Z {sub eff}) at each voxel of the corrected scans. Tissue assignment could then be determined with these two newly acquired physical parameters. Each voxel was assigned the tissue bearing the closest resemblance in terms of ρ{sub e} and Z {sub eff}, comparing with values from the ICRU 42 database. A MC study was then performed to compare the dosimetric impacts of alternative MAR algorithms. Results: An improvement in tissue assignment was observed with the DECT MAR algorithm, compared to the single-energy computed tomography (SECT) approach. In a phantom study, tissue misassignment was found to reach 0.05% of voxels using the DECT approach, compared with 0.40% using the SECT method. Comparison of the DECT and SECT D {sub 90} dose parameter (volume receiving 90% of the dose) indicated that D {sub 90} could be underestimated by up to 2.3% using the SECT method. Conclusions: The DECT MAR approach is a simple alternative to reduce metallic artifacts found in LDRB patient scans. Images can be processed quickly and do not require the determination of x-ray spectra. Substantial information on density and atomic number can also be obtained. Furthermore, calcifications within the prostate are detected by the tissue assignment algorithm. This enables more accurate, patient-specific MC dose calculations.

60 APPLIED LIFE SCIENCES↗

A GPU-accelerated Monte Carlo dose calculation platform and its application toward validating an MRI-guided radiation therapy beam model

Purpose: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on PENELOPE and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. Methods: PENELOPE was first translated from FORTRAN to C++ and the result was confirmed to produce equivalent results to the original code. The C++ code was then adapted to CUDA in a workflow optimized for GPU architecture. The original code was expanded to include voxelized transport with Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gPENELOPE highly user-friendly. Moreover, the vendor-provided MRIdian head model was incorporated into the code in an effort to apply gPENELOPE as both an accurate and rapid dose validation system. A set of experimental measurements were performed on the MRIdian system to examine the accuracy of both the head model and gPENELOPE. Ultimately, gPENELOPE was applied toward independent validation of patient doses calculated by MRIdian’s KMC. Results: An acceleration factor of 152 was achieved in comparison to the original single-thread FORTRAN implementation with the original accuracy being preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen(1), mediastinum (1), and breast (1), the MRIdian dose calculation engine agrees with gPENELOPE with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). Conclusions: A Monte Carlo simulation platform was developed based on a GPU- accelerated version of PENELOPE. This platform was used to validate that both the vendor-provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems.

60 APPLIED LIFE SCIENCES↗

SU-C-204-06: Monte Carlo Dose Calculation for Kilovoltage X-Ray-Psoralen Activated Cancer Therapy (X-PACT): Preliminary Results

Purpose: X-PACT is an experimental cancer therapy where kV x-rays are used to photo-activate anti-cancer therapeutics through phosphor intermediaries (phosphors that absorb x-rays and re-radiate as UV light). Clinical trials in pet dogs are currently underway (NC State College of Veterinary Medicine) and an essential component is the ability to model the kV dose in these dogs. Here we report the commissioning and characterization of a Monte Carlo (MC) treatment planning simulation tool to calculate X-PACT radiation doses in canine trials. Methods: FLUKA multi-particle MC simulation package was used to simulate a standard X-PACT radiation treatment beam of 80kVp with the Varian OBI x-ray source geometry. The beam quality was verified by comparing measured and simulated attenuation of the beam by various thicknesses of aluminum (2–4.6 mm) under narrow beam conditions (HVL). The beam parameters at commissioning were then corroborated using MC, characterized and verified with empirically collected commissioning data, including: percent depth dose curves (PDD), back-scatter factors (BSF), collimator scatter factor(s), and heel effect, etc. All simulations were conducted for N=30M histories at M=100 iterations. Results: HVL and PDD simulation data agreed with an average percent error of 2.42%±0.33 and 6.03%±1.58, respectively. The mean square error (MSE) values for HVL and PDD (0.07% and 0.50%) were low, as expected; however, longer simulations are required to validate convergence to the expected values. Qualitatively, pre- and post-filtration source spectra matched well with 80kVp references generated via SPEKTR software. Further validation of commissioning data simulation is underway in preparation for first-time 3D dose calculations with canine CBCT data. Conclusion: We have prepared a Monte Carlo simulation capable of accurate dose calculation for use with ongoing X-PACT canine clinical trials. Preliminary results show good agreement with measured data and hold promise for accurate quantification of dose for this novel psoralen X-ray therapy. Funding Support, Disclosures, & Conflict of Interest: The Monte Carlo simulation work was not funded; Drs. Adamson & Oldham have received funding from Immunolight LLC for X-PACT research.

60 APPLIED LIFE SCIENCES↗

SU-F-SPS-01: Accuracy of the Small Field Dosimetry Using Acuros XB and AAA Dose Calculation Algorithms of Eclipse Treatment Planning System Within and Beyond Heterogeneous Media for Trubeam 2.0 Unit

Purpose: In this study, the comparison of dosimetric accuracy of Acuros XB and AAA algorithms were investigated for small radiation fields incident on homogeneous and heterogeneous geometries Methods: Small open fields of Truebeam 2.0 unit (1×1, 2×2, 3×3, 4×4 fields) were used for this study. The fields were incident on homogeneous phantom and in house phantom containing lung, air, and bone inhomogeneities. Using the same film batch, the net OD to dose calibration curve was obtaine dusing Trubeam 2.0 for 6 MV, 6 FFF, 10 MV, 10 FFF, 15 MV energies by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. The dosimetric accuracy of Acuros XB and AAA algorithms in the presence of the inhomogeneities was compared against EBT3 film dosimetry Results: Open field tests in a homogeneous phantom showed good agreement betweent wo algorithms and measurement. For Acuros XB, minimum gamma analysis passin grates between measured and calculated dose distributions were 99.3% and 98.1% for homogeneousand inhomogeneous fields in thecase of lung and bone respectively. For AAA, minimum gamma analysis passingrates were 99.1% and 96.5% for homogeneous and inhomogeneous fields respectively for all used energies and field sizes.In the case of the air heterogeneity, the differences were larger for both calculations algorithms. Over all, when compared to measurement, theAcuros XB had beter agreement than AAA. Conclusion: The Acuros XB calculation algorithm in the TPS is an improvemen tover theexisting AAA algorithm. Dose discrepancies were observed for in the presence of air inhomogeneities.

60 APPLIED LIFE SCIENCES↗

SU-F-T-54: Determination of the AAPM TG-43 Brachytherapy Dosimetry Parameters for A New Titanium-Encapsulated Yb-169 Source by Monte Carlo Calculations

Purpose: To determine the AAPM TG-43 brachytherapy dosimetry parameters of a new titanium-encapsulated Yb-169 source designed to maximize the dose enhancement during gold nanoparticle-aided radiation therapy (GNRT). Methods: An existing Monte Carlo (MC) model of the titanium-encapsulated Yb-169 source, which was described in the current investigators’ published MC optimization study, was modified based on the source manufacturer’s detailed specifications, resulting in an accurate model of the titanium-encapsulated Yb-169 source that was actually manufactured. MC calculations were then performed using the MCNP5 code system and the modified source model, in order to obtain a complete set of the AAPM TG-43 parameters for the new Yb-169 source. Results: The MC-calculated dose rate constant for the new titanium-encapsulated Yb-169 source was 1.05 ± 0.03 cGy per hr U, indicating about 10% decrease from the values reported for the conventional stainless steel-encapsulated Yb-169 sources. The source anisotropy and radial dose function for the new source were found similar to those reported for the conventional Yb-169 sources. Conclusion: In this study, the AAPM TG-43 brachytherapy dosimetry parameters of a new titanium-encapsulated Yb-169 source were determined by MC calculations. The current results suggested that the use of titanium, instead of stainless steel, to encapsulate the Yb-169 core would not lead to any major change in the dosimetric characteristics of the Yb-169 source, while it would allow more low energy photons being transmitted through the source filter thereby leading to an increased dose enhancement during GNRT. Supported by DOD/PCRP grant W81XWH-12-1-0198 This investigation was supported by DOD/PCRP grant W81XWH-12-1- 0198.

60 APPLIED LIFE SCIENCES↗