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At least 1,405 records · Page 78

TH-C-12A-09: Planning and Delivery of the Fully Dynamic Trajectory Modulated Arc Therapy: Application to Accelerated Partial Breast Irradiation

Purpose: A novel trajectory modulated arc therapy (TMAT) system was developed that uses source motion trajectory involving synchronized gantry rotation with translational and rotational couch movement. MLC motion and dose rate were fully optimized for dynamic beam delivery. This work presents a platform for planning deliverable TMAT on a collision free coronal trajectory and evaluates its benefit for accelerated partial breast irradiation (APBI) in a prone position. Methods: The TMAT algorithm was built on VMAT with modifications (physical properties on couch movement were defined) and enhancements (pencil beam dose calculation engine to support extended SSDs) to make it feasible for TMAT delivery. A Matlab software environment for TMAT optimization and dose calculation was created to allow any user specified motion axis. TMAT delivery was implemented on Varian TrueBeamTM STx via XML scripts. 10 prone breast irradiation cases were evaluated in VMAT and compared with a 6- field non-coplanar IMRT plan. Patient selection/exclusion criteria and structure contouring followed the guidelines of NSABP B-39/RTOG 0413 protocol. Results: TMAT delivery time was ∼4.5 minutes. 251.5°±7.88° of non-isocentric couch arc was achieved by the optimized trajectory with 180– 210 control points at 1°–2° couch increments. The improved dose distribution by TMAT was most clearly observed by the marked reduction in the volume of irradiated normal breast tissue in the high dose region. The ratios of the normal breast tissue volume receiving more than 50%, 80% and 100% of the prescription dose for TMAT versus IMRT were: V50%(TMAT/IMRT) = 78.38%±13.03%, V80%(TMAT/IMRT) = 44.19%±9.04% and V100% (TMAT/IMRT) = 9.96%±7.55%, all p≤0.01. Conclusion: The study is the first demonstration of planning and delivery implementation of a fully dynamic APBI TMAT system with continuous couch motion. TMAT achieved significantly improved dosimetry over noncoplanar IMRT on dose volume parameters correlated with toxicity and cosmetic outcome of APBI. This project was supported by Varian Research Grant.

60 APPLIED LIFE SCIENCES↗

Salvage Reirradiaton With Stereotactic Body Radiotherapy for Locally Recurrent Head-and-Neck Tumors

Purpose: In this study, we present our results of reirradiation of locally recurrent head-and-neck cancer with image-guided, fractionated, frameless stereotactic body radiotherapy technique. Methods and Materials: From July 2007 to February 2009, 46 patients were treated using the CyberKnife (Accuray, Sunnyvale, CA) at the Department of Radiation Oncology, Hacettepe University, Ankara, Turkey. All patients had recurrent, unresectable, and previously irradiated head-and-neck cancer. The most prominent site was the nasopharynx (32.6%), and the most common histopathology was epidermoid carcinoma. The planning target volume was defined as the gross tumor volume identified on magnetic resonance imaging and computed tomography. There were 22 female and 24 male patients. Median age was 53 years (range, 19-87 years). The median tumor dose with stereotactic body radiotherapy was 30 Gy (range, 18-35 Gy) in a median of five (range, one to five) fractions. Results: Of 37 patients whose response to therapy was evaluated, 10 patients (27%) had complete tumor regression, 11 (29.8%) had partial response, and 10 (27%) had stable disease. Ultimate local disease control was achieved in 31 patients (83.8%). The overall survival was 11.93 months in median (ranged, 11.4 - 17.4 months), and the median progression free survival was 10.5 months. One-year progression-free survival and overall survival were 41% and 46%, respectively. Grade II or greater long-term complications were observed in 6 (13.3%) patients. On follow-up, 8 (17.3%) patients had carotid blow-out syndrome, and 7 (15.2%) patients died of bleeding from carotid arteries. We discovered that this fatal syndrome occurred only in patients with tumor surrounding carotid arteries and carotid arteries receiving all prescribed dose. Conclusions: Stereotactic body radiotherapy is an appealing treatment option for patients with recurrent head-and-neck cancer previously treated with radiation to high doses. Good local control with considerable 1-year survival is achieved with a relatively high rate of morbidity and related mortality.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Soil gas probes for monitoring trace gas messengers of microbial activity

Abstract Soil microbes vigorously produce and consume gases that reflect active soil biogeochemical processes. Soil gas measurements are therefore a powerful tool to monitor microbial activity. Yet, the majority of soil gases lack non-disruptive subsurface measurement methods at spatiotemporal scales relevant to microbial processes and soil structure. To address this need, we developed a soil gas sampling system that uses novel diffusive soil probes and sample transfer approaches for high-resolution sampling from discrete subsurface regions. Probe sampling requires transferring soil gas samples to above-ground gas analyzers where concentrations and isotopologues are measured. Obtaining representative soil gas samples has historically required balancing disruption to soil gas composition with measurement frequency and analyzer volume demand. These considerations have limited attempts to quantify trace gas spatial concentration gradients and heterogeneity at scales relevant to the soil microbiome. Here, we describe our new flexible diffusive probe sampling system integrated with a modified, reduced volume trace gas analyzer and demonstrate its application for subsurface monitoring of biogeochemical cycling of nitrous oxide (N 2 O) and its site-specific isotopologues, methane, carbon dioxide, and nitric oxide in controlled soil columns. The sampling system observed reproducible responses of soil gas concentrations to manipulations of soil nutrients and redox state, providing a new window into the microbial response to these key environmental forcings. Using site-specific N 2 O isotopologues as indicators of microbial processes, we constrain the dynamics of in situ microbial activity. Unlocking trace gas messengers of microbial activity will complement -omics approaches, challenge subsurface models, and improve understanding of soil heterogeneity to disentangle interactive processes in the subsurface biome.

04 OIL SHALES AND TAR SANDS↗

A carbon nanotube field emission multipixel x-ray array source for microradiotherapy application

The authors report a carbon nanotube (CNT) field emission multipixel x-ray array source for microradiotherapy for cancer research. The developed multipixel x-ray array source has 50 individually controllable pixels and it has several distinct advantages over other irradiation source including high-temporal resolution (millisecond level), the ability to electronically shape the form, and intensity distribution of the radiation fields. The x-ray array was generated by a CNT cathode array (5x10) chip with electron field emission. A dose rate on the order of >1.2 Gy/min per x-ray pixel beam is achieved at the center of the irradiated volume. The measured dose rate is in good agreement with the Monte Carlo simulation result.

43 PARTICLE ACCELERATORS↗

TH-E-17A-04: Geometric Validation of K-Space Self-Gated 4D-MRI Vs. 4D-CT Using A Respiratory Motion Phantom

Purpose: 4D-CT is often limited by motion artifacts, low temporal resolution, and poor phase-based target definition. We recently developed a novel k-space self-gated 4D-MRI technique with high spatial and temporal resolution. The goal here is to geometrically validate 4D-MRI using a MRI-CT compatible respiratory motion phantom and comparison to 4D-CT. Methods: 4D-MRI was acquired using 3T spoiled gradient echo-based 3D projection sequences. Respiratory phases were resolved using self-gated k-space lines as the motion surrogate. Images were reconstructed into 10 temporal bins with 1.56×1.56×1.56mm3. A MRI-CT compatible phantom was designed with a 23mm diameter ball target filled with highconcentration gadolinium(Gd) gel embedded in a 35×40×63mm3 plastic box stabilized with low-concentration Gd gel. The whole phantom was driven by an air pump. Human respiratory motion was mimicked using the controller from a commercial dynamic phantom (RSD). Four breathing settings (rates/depths: 10s/20mm, 6s/15mm, 4s/10mm, 3s/7mm) were scanned with 4D-MRI and 4D-CT (slice thickness 1.25mm). Motion ground-truth was obtained from input signals and real-time video recordings. Reconstructed images were imported into Eclipse(Varian) for target contouring. Volumes and target positions were compared with ground-truth. Initial human study was investigated on a liver patient. Results: 4D-MRI and 4D-CT scans for the different breathing cycles were reconstructed with 10 phases. Target volume in each phase was measured for both 4D-CT and 4D-MRI. Volume percentage difference for the 6.37ml target ranged from 6.67±5.33 to 11.63±5.57 for 4D-CT and from 1.47±0.52 to 2.12±1.60 for 4D-MRI. The Mann-Whitney U-test shows the 4D-MRI is significantly superior to 4D-CT (p=0.021) for phase-based target definition. Centroid motion error ranges were 1.35–1.25mm (4D-CT), and 0.31–0.12mm (4D-MRI). Conclusion: The k-space self-gated 4D-MRI we recently developed can accurately determine phase-based target volume while avoiding typical motion artifacts found in 4D-CT, and is being further studied for use in GI targeting and motion management. This work supported in part by grant 1R03CA173273-01.

60 APPLIED LIFE SCIENCES↗

High-Speed and High-Quality Field Welding Repair Based on Advanced Non-Destructive Evaluation and Numerical Modeling

Creep strength-enhanced ferritic (CSEF) steels such as Grade 91 (9Cr-1Mo-V) and Grade 92 (Fe-9Cr-2W-0.5Mo) steels are widely used in the fossil-fuel-fired and nuclear power plants. The weld integrity of these steels is crucial for power plants' safe and reliable operations. Due to harsh service conditions, the steel weld can become susceptible to environmental degradation. Field welding repair is used to restore the degraded weld’s performance where a controlled temper-bead welding technique is commonly used to temper the freshly formed martensite during welding. However, knowledge of weld repairability is limited and experimental trial and error optimization to achieve desired microstructure and joint properties is expensive and time-consuming. Many existing computational models, e.g., finite element models, are limited to solving heat conduction equation and ignoring convective heat transfer due to molten metal flow. These models can result in over-prediction of peak temperatures of weld pool and heat-affected zone (HAZ), which in turn can affect the accuracy of tempering prediction. Moreover, these finite element models require an input of the deposit profiles in advance and thus limits the usability of these models. Here, a molten pool-based, multi-pass multi-layer model has been developed based on computational fluid dynamics (CFD) approach with the Volume of Fluid (VOF) method. The model calculates the bead formation, thereby eliminating the need for pre-determined bead profiles required by finite element models. For computational efficiency, a coordinate system attached to the moving heat source is utilized. A subroutine is developed to convert the temperature profiles in the reference frame stationary to the heat source to that stationary to the workpiece. The converted thermal cycles are then imported into a microstructure model to compute the tempering kinetics and resultant hardness using a Johnson-Mehl-Avrami-Kolmogorov (JMAK), and modified Grange-Baughman parameter. The modeling approach is first developed and validated on single- and multi-pass deposition of stainless steel filler metal onto a SA-533 high strength steel substrate. The models are then applied to a multi-pass V-groove repair weld of Grade 91 steel plate as well as directed energy deposition of Grade 92 steel. Non-destructive characterization of microstructures was performed on Grade 91 and 92 steel welds. Two welding processes, cold metal transfer (CMT) and flux-cored arc welding (FCAW), were investigated for the Grade 91 steel weld samples. For the Grade 92 weld samples, three different heat inputs (low, medium, and high) of gas tungsten arc welding (GTAW) were utilized to replicate traditional field welding processes. The non-destructive evaluation (NDE) method used for this research was immersion ultrasonic testing (UT) using a micro-resolution ultrasonic imaging methodology specifically designed to operate in the through-transmission configuration operating at 20 MHz of frequency. The system used a focused ultrasonic beam spot size diameter between 250-300 μm, and a 6 μm laser vibrometer spot size for detection, to produce highly defined images with longitudinal and mode-converted shear waves. From the micro-resolution ultrasonic C-scan images, three microstructural regions, i.e., weld metal (WM), HAZ, and base metal (BM), were clearly identifiable. Various levels of ultrasonic amplitudes distributed over the three regions were correlated with electron beam backscattered diffraction (EBSD) images using grain size, grain boundaries, and dislocation densities. The results showed that areas with relatively higher ultrasonic amplitude levels were associated with smaller grains and higher dislocation densities, while areas with lower amplitude levels were associated with larger grains and lower dislocation densities. In addition, ultrasonic velocity data obtained across the three different weld microstructural regions of Grade 91 test samples were correlated with optical metallographic images and hardness measurements. The results showed distinctive decreases in ultrasonic velocity and hardness over the HAZ region, where weld failures often occur during service.

36 MATERIALS SCIENCE↗

Conceptual Design Method Developed for Advanced Propulsion Nozzles

As part of a contract with the NASA Lewis Research Center, a simple, accurate method of predicting the performance characteristics of a nozzle design has been developed for use in conceptual design studies. The Nozzle Performance Analysis Code (NPAC) can predict the on- and off-design performance of axisymmetric or two-dimensional convergent and convergent-divergent nozzle geometries. NPAC accounts for the effects of overexpansion or underexpansion, flow divergence, wall friction, heat transfer, and small mass addition or loss across surfaces when the nozzle gross thrust and gross thrust coefficient are being computed. NPAC can be used to predict the performance of a given nozzle design or to develop a preliminary nozzle system design for subsequent analysis. The input required by NPAC consists of a simple geometry definition of the nozzle surfaces, the location of key nozzle stations (entrance, throat, exit), and the nozzle entrance flow properties. NPAC performs three analysis "passes" on the nozzle geometry. First, an isentropic control volume analysis is performed to determine the gross thrust and gross thrust coefficient of the nozzle. During the second analysis pass, the skin friction and heat transfer losses are computed. The third analysis pass couples the effects of wall shear and heat transfer with the initial internal nozzle flow solutions to produce a system of equations that is solved at steps along the nozzle geometry. Small mass additions or losses, such as those resulting from leakage or bleed flow, can be included in the model at specified geometric sections. A final correction is made to account for divergence losses that are incurred if the nozzle exit flow is not purely axial.

Nadell, Shari-Beth↗

A New Treatment Paradigm: Neoadjuvant Radiosurgery Before Surgical Resection of Brain Metastases With Analysis of Local Tumor Recurrence

Purpose: Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Methods and Materials: Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions were reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Results: Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. Conclusions: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong majority of patients were able to avoid WBRT. NaSRS merits consideration in a multi-institution trial.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

In-situ resource utilization in the design of advanced lunar facilities

Resource utilization will play an important role in the establishment and support of a permanently manned lunar base. At the University of Houston - College of Architecture and the Sasakawa International Center for Space Architecture, a study team recently investigated the potential use of lunar in-situ materials in the design of lunar facilities. The team identified seven potential lunar construction materials; concrete, sulfur concrete, cast basalt, sintered basalt, glass, fiberglass, and metals. Analysis and evaluation of these materials with respect to their physical properties, processes, energy requirements, resource efficiency, and overall advantages and disadvantages lead to the selection of basalt materials as the more likely construction material for initial use on a lunar base. Basalt materials can be formed out of in-situ lunar regolith, with minor material beneficiation, by a simple process of heating and controlled cooling. The team then conceptualized a construction system that combines lunar regolith sintering and casting to make pressurized structures out of lunar resources. The design uses a machine that simultaneously excavates and sinters the lunar regolith to create a cylindrical hole, which is then enclosed with cast basalt slabs, allowing the volume to be pressurized for use as a living or work environment. Cylinder depths of up to 4 to 6 m in the lunar mare or 10 to 12 m in the lunar highlands are possible. Advantages of this construction system include maximum resource utilization, relatively large habitable volumes, interior flexibility, and minimal construction equipment needs. Conclusions of this study indicate that there is significant potential for the use of basalt, a lunar resource derived construction material, as a low cost alternative to Earth-based materials. It remains to be determined when in lunar base phasing this construction method should be implemented.

Source record↗

Mobile platform for radiological characterization of sites under or after decommissioning - 15139

Nowadays, nuclear industry is facing a crucial need in establishing radiological characterization for the assessment and the monitoring of any remediation work. Regarding its experience in this domain, the French Commission for Atomic Energy and Alternative Energies (CEA) of Fontenay-aux-Roses, established an important feedback and developed a sound methodology for radiological characterization. A clean-up project is managed from the initial surface characterization to the final one, once volumes of contaminated soil have been removed. Samples are collected via recognized methods and data is gathered by real-time acquisition with different conveyance such as all-in-vehicles, cart, walking, helicopter or drone. Accurate radiological analyses are performed on site thanks to the mobile laboratories cluster, called SMaRT. It enables to realize long-time gamma spectroscopy, chemical preparation for alpha spectroscopy or beta liquid scintillation counting. Data is processed with geo-statistics via the software Kartotrak, 2D or 3D mapping are created with the associated uncertainty and probability map. Drilling profiles with geological data (layers composition, particles size, etc.) are studied in order to understand the behavior of the contamination in depth. Source term, contaminated volumes and sanitary impact are calculated in order to determine the optimum excavation depth. Finally, data is stored in an online site that insures the traceability of the whole process. This just-in-time production model allows a fast response and control of costs and avoids the disadvantages of radioactive material transport. This whole innovative process, developed inside the mobile platform, requires all these tools that have been used in France and continuously evolving for more than 10 years thanks to a learning organization. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

A Conceptual World Information Library (WIL) and Land Use Information System (LUIS) - 16181

The Organization for Economic Co-operation and Development Nuclear Energy Agency initiative on the Preservation of Records, Knowledge and Memory is addressing the topic of communicating with future generations on the location, specific contents, and potential risks associated with deep geologic nuclear waste repositories. At the Waste Isolation Pilot Plant (WIPP) in the United States, the U.S. Department of Energy (DOE) has committed, prior to the facility closure, to develop a Passive Institutional Controls (PICs) program designed to last as long as practicable. A portion of this PICs program includes development of records packages, selection of data storage materials and methods, and a determination of records retention/storage locations. The approved plan for record retention at WIPP includes the storage of information including hard copies of data, figures and maps in multiple libraries and archive record centers. With this in mind, it is easy to envision reams of various paper documents in a robust physical archive record center similar to one of the museums in Washington D.C., or DOE's Legacy Management facility in Morgantown, West Virginia. While some portion of records for nuclear waste burial sites should be maintained in this fashion for near-term retrieval purposes, it is widely accepted that this is not an efficient way to communicate with future generations even 1,000 years from now. Transmitting large detailed volumes of information to the future should be captured in an electronic format; maintained on computers, translated by computers, and perhaps updated by artificial intelligence as machine and human languages change over the centuries. In addition to a physical records development and storage process for transmittal to future generations, a web-based electronic database system should be developed. A World Electronic Library (WEL) database could be funded from various nations and perhaps sanctioned by the United Nations and/or the IAEA. This WEL could contain information regarding several different subjects with the intent of being a one-stop-information-shop for future generations. This database would require updates and maintenance for as long as there is a recipient. One subset of the WEL would be a spatial database containing all the information available to any set of GPS coordinates, anywhere within the world. This Land Use Information System (LUIS) database would contain information on past and present land use, natural resources, known geology, hydrology and atmospheric conditions, potential warnings, and other pertinent information. The LUIS database is where specific electronic information, a subset of all the records data gathered for a nuclear waste repository, could reside. For not only would LUIS provide the information on a nuclear waste repository when specific GPS coordinates were entered; but a search from the LUIS on 'Nuclear Waste Repositories' could bring up information, including data on location of repositories, radionuclides, operations, D and D, maps, and regulations, plus many other details for locations throughout the world. This tool could be used by future generations for a number of land use or resource exploration decisions. So what can we do now? We can agree to the types of information that should be captured into an electronic database for nuclear waste repositories. We can agree to the levels of detail, the file names and the formats, for ease of combining information sets in the future. Perhaps we can agree to a central electronic data storage site, or sites, where this information will reside for import into a centralized electronic record system, if one is ever developed. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Effect of Radiotherapy Techniques (IMRT vs. 3D-CRT) on Outcome in Patients With Intermediate-Risk Rhabdomyosarcoma Enrolled in COG D9803-A Report From the Children's Oncology Group

Purpose: To compare the dosimetric parameters of intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in patients with intermediate-risk rhabdomyosarcoma and to analyze their effect on locoregional control and failure-free survival (FFS). Methods and Materials: The study population consisted of 375 patients enrolled in the Children's Oncology Group protocol D9803 study, receiving IMRT or 3D-CRT. Dosimetric data were collected from 179 patients with an available composite plan. The chi-square test or Fisher's exact test was used to compare the patient characteristics and radiotherapy parameters between the two groups. The interval-to-event outcomes were estimated using the Kaplan-Meier method and compared using log-rank tests. Cox proportional hazards regression analysis was used to examine the effect of the treatment technique on FFS after adjusting for primary site and risk group. Results: The median follow-up time was 5.7 and 4.2 years for patients receiving 3D-CRT and IMRT, respectively. No differences in the 5-year failure of locoregional control (18% vs. 15%) or FFS (72% vs. 76%) rates were noted between the two groups. Multivariate analysis revealed no association between the two techniques and FFS. Patients with primary tumors in parameningeal sites were more likely to receive IMRT than 3D-CRT. IMRT became more common during the later years of the study. Patients receiving IMRT were more likely to receive >50 Gy, photon energy of {<=}6 MV, and >5 radiation fields than those who received 3D-CRT. The coverage of the IMRT planning target volume by the prescription dose was improved compared with the coverage using 3D-CRT with similar target dose heterogeneity. Conclusions: IMRT improved the target dose coverage compared with 3D-CRT, although an improvement in locoregional control or FFS could not be demonstrated in this population. Future studies comparing the integral dose to nontarget tissue and late radiation toxicity between the two groups are warranted.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Novel tools for stepping source brachytherapy treatment planning: Enhanced geometrical optimization and interactive inverse planning

Purpose: Dose optimization for stepping source brachytherapy can nowadays be performed using automated inverse algorithms. Although much quicker than graphical optimization, an experienced treatment planner is required for both methods. With automated inverse algorithms, the procedure to achieve the desired dose distribution is often based on trial-and-error. Methods: A new approach for stepping source prostate brachytherapy treatment planning was developed as a quick and user-friendly alternative. This approach consists of the combined use of two novel tools: Enhanced geometrical optimization (EGO) and interactive inverse planning (IIP). EGO is an extended version of the common geometrical optimization method and is applied to create a dose distribution as homogeneous as possible. With the second tool, IIP, this dose distribution is tailored to a specific patient anatomy by interactively changing the highest and lowest dose on the contours. Results: The combined use of EGO–IIP was evaluated on 24 prostate cancer patients, by having an inexperienced user create treatment plans, compliant to clinical dose objectives. This user was able to create dose plans of 24 patients in an average time of 4.4 min/patient. An experienced treatment planner without extensive training in EGO–IIP also created 24 plans. The resulting dose-volume histogram parameters were comparable to the clinical plans and showed high conformance to clinical standards. Conclusions: Even for an inexperienced user, treatment planning with EGO–IIP for stepping source prostate brachytherapy is feasible as an alternative to current optimization algorithms, offering speed, simplicity for the user, and local control of the dose levels.

60 APPLIED LIFE SCIENCES↗

Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis

Purpose: To retrospectively analyze the treatment outcomes of particle therapy using protons or carbon ions for unresectable or incompletely resected bone and soft tissue sarcomas (BSTSs) of the pelvis. Methods and Materials: From May 2005 to December 2014, 91 patients with nonmetastatic histologically proven unresectable or incompletely resected pelvic BSTSs underwent particle therapy with curative intent. The particle therapy used protons (52 patients) or carbon ions (39 patients). All patients received a dose of 70.4 Gy (relative biologic effectiveness) in 32 fractions (55 patients) or 16 fractions (36 patients). Results: The median patient age was 67 years (range 18-87). The median planning target volume (PTV) was 455 cm{sup 3} (range 108-1984). The histologic type was chordoma in 53 patients, chondrosarcoma in 14, osteosarcoma in 10, malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma in 5, and other in 9 patients. Of the 91 patients, 82 had a primary tumor and 9 a recurrent tumor. The median follow-up period was 32 months (range 3-112). The 3-year rate of overall survival (OS), progression-free survival (PFS), and local control was 83%, 72%, and 92%, respectively. A Cox proportional hazards model revealed that chordoma histologic features and a PTV of ≤500 cm{sup 3} were significantly associated with better OS, and a primary tumor and PTV of ≤500 cm{sup 3} were significantly associated with better PFS. Ion type and number of fractions were not significantly associated with OS, PFS, or local control. Late grade ≥3 toxicities were observed in 23 patients. Compared with the 32-fraction protocol, the 16-fraction protocol was associated with significantly more frequent late grade ≥3 toxicities (18 of 36 vs 5 of 55; P<.001). Conclusions: Particle therapy using protons or carbon ions was effective for unresectable or incompletely resected pelvic BSTS, and the 32-fraction protocol was effective and relatively less toxic. Nevertheless, a longer follow-up period is needed to confirm these results.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-303-13: Initial Evaluation of Four Dimensional Diffusion- Weighted MRI (4D-DWI) and Its Effect On Apparent Diffusion Coefficient (ADC) Measurement

Purpose: Diffusion-weighted imaging(DWI) has been shown to have superior tumor-to-tissue contrast for cancer detection.This study aims at developing and evaluating a four dimensional DWI(4D-DWI) technique using retrospective sorting method for imaging respiratory motion for radiotherapy planning,and evaluate its effect on Apparent Diffusion Coefficient(ADC) measurement. Materials/Methods: Image acquisition was performed by repeatedly imaging a volume of interest using a multi-slice single-shot 2D-DWI sequence in the axial planes and cine MRI(served as reference) using FIESTA sequence.Each 2D-DWI image were acquired in xyz-diffusion-directions with a high b-value(b=500s/mm2).The respiratory motion was simultaneously recorded using bellows.Retrospective sorting was applied in each direction to reconstruct 4D-DWI.The technique was evaluated using a computer simulated 4D-digital human phantom(XCAT),a motion phantom and a healthy volunteer under an IRB-approved study.Motion trajectories of regions-of-interests(ROI) were extracted from 4D-DWI and compared with reference.The mean motion trajectory amplitude differences(D) between the two was calculated.To quantitatively analyze the motion artifacts,XCAT were controlled to simulate regular motion and the motions of 10 liver cancer patients.4D-DWI,free-breathing DWI(FB- DWI) were reconstructed.Tumor volume difference(VD) of each phase of 4D-DWI and FB-DWI from the input static tumor were calculated.Furthermore, ADC was measured for each phase of 4D-DWI and FB-DWI data,and mean tumor ADC values(M-ADC) were calculated.Mean M-ADC over all 4D-DWI phases was compared with M-ADC calculated from FB-DWI. Results: 4D-DWI of XCAT,the motion phantom and the healthy volunteer demonstrated the respiratory motion clearly.ROI D values were 1.9mm,1.7mm and 2.0mm,respectively.For motion artifacts analysis,XCAT 4D-DWI images show much less motion artifacts compare to FB-DWI.Mean VD for 4D-WDI and FB-DWI were 8.5±1.4% and 108±15%,respectively.Mean M-ADC for ADC measured from 4D-DWI and M-ADC measured from FB-DWI were (2.29±0.04)*0.001*mm2/s and (3.80±0.01)*0.001*mm2/s,respectively.ADC value ground-truth is 2.24*0.001*mm2/s from the input of the simulation. Conclusion: A respiratory correlated 4D-DWI technique has been initially evaluated in phantoms and a human subject.Comparing to free breathing DWI,4D-DWI can lead to more accurate measurement of ADC.

60 APPLIED LIFE SCIENCES↗

Fabricating Composite-Material Structures Containing SMA Ribbons

An improved method of designing and fabricating laminated composite-material (matrix/fiber) structures containing embedded shape-memory-alloy (SMA) actuators has been devised. Structures made by this method have repeatable, predictable properties, and fabrication processes can readily be automated. Such structures, denoted as shape-memory-alloy hybrid composite (SMAHC) structures, have been investigated for their potential to satisfy requirements to control the shapes or thermoelastic responses of themselves or of other structures into which they might be incorporated, or to control noise and vibrations. Much of the prior work on SMAHC structures has involved the use SMA wires embedded within matrices or within sleeves through parent structures. The disadvantages of using SMA wires as the embedded actuators include (1) complexity of fabrication procedures because of the relatively large numbers of actuators usually needed; (2) sensitivity to actuator/ matrix interface flaws because voids can be of significant size, relative to wires; (3) relatively high rates of breakage of actuators during curing of matrix materials because of sensitivity to stress concentrations at mechanical restraints; and (4) difficulty of achieving desirable overall volume fractions of SMA wires when trying to optimize the integration of the wires by placing them in selected layers only.

Turner, Travis L.↗

Dose reduction in LDR brachytherapy by implanted prostate gold fiducial markers

Purpose: The dosimetric impact of gold fiducial markers (FM) implanted prior to external beam radiotherapy of prostate cancer on low dose rate (LDR) brachytherapy seed implants performed in the context of combined therapy was investigated. Methods: A virtual water phantom was designed containing a single FM. Single and multi source scenarios were investigated by performing Monte Carlo dose calculations, along with the influence of varying orientation and distance of the FM with respect to the sources. Three prostate cancer patients treated with LDR brachytherapy for a recurrence following external beam radiotherapy with implanted FM were studied as surrogate cases to combined therapy. FM and brachytherapy seeds were identified on post implant CT scans and Monte Carlo dose calculations were performed with and without FM. The dosimetric impact of the FM was evaluated by quantifying the amplitude of dose shadows and the volume of cold spots. D{sub 90} was reported based on the post implant CT prostate contour. Results: Large shadows are observed in the single source-FM scenarios. As expected from geometric considerations, the shadows are dependent on source-FM distance and orientation. Large dose reductions are observed at the distal side of FM, while at the proximal side a dose enhancement is observed. In multisource scenarios, the importance of shadows appears mitigated, although FM at the periphery of the seed distribution caused underdosage (<prescription dose). In clinical cases, the FM reduced the dose to some voxels by up to 50% and generated shadows with extents of the order of 4 mm. Within the prostate contour, cold spots (<95% prescription dose) of the order of 20 mm{sup 3} were observed. D{sub 90} proved insensitive to the presence of FM for the cases selected. Conclusions: There is a major local impact of FM present in LDR brachytherapy seed implant dose distributions. Therefore, reduced tumor control could be expected from FM implanted in tumors, although our results are too limited to draw conclusions regarding clinical significance.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Stereotactic Body Radiation Therapy in Spinal Metastases

Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

62 RADIOLOGY AND NUCLEAR MEDICINE↗