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Sci—Fri AM: Mountain — 02: A comparison of dose reduction methods on image quality for cone beam CT

Modern radiotherapy uses highly conformai dose distributions and therefore relies on daily image guidance for accurate patient positioning. Kilovoltage cone beam CT is one technique that is routinely used for patient set-up and results in a high dose to the patient relative to planar imaging techniques. This study uses an Elekta Synergy linac equipped with XVI cone beam CT to investigate the impact of various imaging parameters on dose and image quality. Dose and image quality are assessed as functions of x-ray tube voltage, tube current and the number of projections in the scan. In each case, the dose measurements confirm that as each parameter increases the dose increases. The assessment of high contrast resolution shows little dependence on changes to the image technique. However, low contrast visibility suggests a trade off between dose and image quality. Particularly for changes in tube potential, the dose increases much faster as a function of voltage than the corresponding increase in low contrast image quality. This suggests using moderate values of the peak tube voltage (100 – 120 kVp) since higher values result in significant dose increases with little gain in image quality. Measurements also indicate that increasing tube current achieves the greatest degree of improvement in the low contrast visibility. The results of this study highlight the need to establish careful imaging protocols to limit dose to the patient and to limit changes to the imaging parameters to those cases where there is a clear clinical requirement for improved image quality.

60 APPLIED LIFE SCIENCES↗

Imaging a moving lung tumor with megavoltage cone beam computed tomography

Purpose: Respiratory motion may affect the accuracy of image guidance of radiation treatment of lung cancer. A cone beam computed tomography (CBCT) image spans several breathing cycles, resulting in a blurred object with a theoretical size equal to the sum of tumor size and breathing motion. However, several factors may affect this theoretical relationship. The objective of this study was to analyze the effect of tumor motion on megavoltage (MV)-CBCT images, by comparing target sizes on simulation and pretreatment images of a large cohort of lung cancer patients. Methods: Ninety-three MV-CBCT images from 17 patients were analyzed. Internal target volumes were contoured on each MV-CBCT dataset [internal target volume (ITV{sub CB})]. Their extent in each dimension was compared to that of two volumes contoured on simulation 4-dimensional computed tomography (4D-CT) images: the combination of the tumor contours of each phase of the 4D-CT (ITV{sub 4D}) and the volume contoured on the average CT calculated from the 4D-CT phases (ITV{sub ave}). Tumor size and breathing amplitude were assessed by contouring the tumor on each CBCT raw projection where it could be unambiguously identified. The effect of breathing amplitude on the quality of the MV-CBCT image reconstruction was analyzed. Results: The mean differences between the sizes of ITV{sub CB} and ITV{sub 4D} were −1.6 ± 3.3 mm (p < 0.001), −2.4 ± 3.1 mm (p < 0.001), and −7.2 ± 5.3 mm (p < 0.001) in the anterior/posterior (AP), left/right (LR), and superior/inferior (SI) directions, respectively, showing that MV-CBCT underestimates the full target size. The corresponding mean differences between ITV{sub CB} and ITV{sub ave} were 0.3 ± 2.6 mm (p = 0.307), 0.0 ± 2.4 mm (p = 0.86), and −4.0 ± 4.3 mm (p < 0.001), indicating that the average CT image is more representative of what is visible on MV-CBCT in the AP and LR directions. In the SI directions, differences between ITV{sub CB} and ITV{sub ave} could be separated into two groups based on tumor motion: −3.2 ± 3.2 mm for tumor motion less than 15 mm and −10.9 ± 6.3 mm for tumor motion greater than 15 mm. Deviations of measured target extents from their theoretical values derived from tumor size and motion were correlated with motion amplitude similarly for both MV-CBCT and average CT images, suggesting that the two images were subject to similar motion artifacts for motion less than 15 mm. Conclusions: MV-CBCT images are affected by tumor motion and tend to under-represent the full target volume. For tumor motion up to 15 mm, the volume contoured on average CT is comparable to that contoured on the MV-CBCT. Therefore, the average CT should be used in image registration for localization purposes, and the standard 5 mm PTV margin seems adequate. For tumor motion greater than 15 mm, an additional setup margin may need to be used to account for the increased uncertainty in tumor localization.

60 APPLIED LIFE SCIENCES↗

Characteristic image quality of a third generation dual-source MDCT scanner: Noise, resolution, and detectability

Purpose: The purpose of this work was to assess the inherent image quality characteristics of a new multidetector computed tomography system in terms of noise, resolution, and detectability index as a function of image acquisition and reconstruction for a range of clinically relevant settings. Methods: A multisized image quality phantom (37, 30, 23, 18.5, and 12 cm physical diameter) was imaged on a SOMATOM Force scanner (Siemens Medical Solutions) under variable dose, kVp, and tube current modulation settings. Images were reconstructed with filtered back projection (FBP) and with advanced modeled iterative reconstruction (ADMIRE) with iterative strengths of 3, 4, and 5. Image quality was assessed in terms of the noise power spectrum (NPS), task transfer function (TTF), and detectability index for a range of detection tasks (contrasts of approximately 45, 90, 300, −900, and 1000 HU, and 2–20 mm diameter) based on a non-prewhitening matched filter model observer with eye filter. Results: Image noise magnitude decreased with decreasing phantom size, increasing dose, and increasing ADMIRE strength, offering up to 64% noise reduction relative to FBP. Noise texture in terms of the NPS was similar between FBP and ADMIRE (<5% shift in peak frequency). The resolution, based on the TTF, improved with increased ADMIRE strength by an average of 15% in the TTF 50% frequency for ADMIRE-5. The detectability index increased with increasing dose and ADMIRE strength by an average of 55%, 90%, and 163% for ADMIRE 3, 4, and 5, respectively. Assessing the impact of mA modulation for a fixed average dose over the length of the phantom, detectability was up to 49% lower in smaller phantom sections and up to 26% higher in larger phantom sections for the modulated scan compared to a fixed tube current scan. Overall, the detectability exhibited less variability with phantom size for modulated scans compared to fixed tube current scans. Conclusions: Image quality increased with increasing dose and decreasing phantom size. The CT system exhibited nonlinear noise and resolution properties, especially at very low-doses, large phantom sizes, and for low-contrast objects. Objective image quality metrics generally increased with increasing dose and ADMIRE strength, and with decreasing phantom size. The ADMIRE algorithm could offer comparable image quality at reduced doses or improved image quality at the same dose. The use of tube current modulation resulted in more consistent image quality with changing phantom size.

60 APPLIED LIFE SCIENCES↗

SU-D-207-03: Development of 4D-CBCT Imaging System with Dual Source KV X-Ray Tubes

Purpose: The purposes of this work are to develop 4D-CBCT imaging system with orthogonal dual source kV X-ray tubes, and to determine the imaging doses from 4D-CBCT scans. Methods: Dual source kV X-ray tubes were used for the 4D-CBCT imaging. The maximum CBCT field of view was 200 mm in diameter and 150 mm in length, and the imaging parameters were 110 kV, 160 mA and 5 ms. The rotational angle was 105°, the rotational speed of the gantry was 1.5°/s, the gantry rotation time was 70 s, and the image acquisition interval was 0.3°. The observed amplitude of infrared marker motion during respiration was used to sort each image into eight respiratory phase bins. The EGSnrc/BEAMnrc and EGSnrc/DOSXYZnrc packages were used to simulate kV X-ray dose distributions of 4D-CBCT imaging. The kV X-ray dose distributions were calculated for 9 lung cancer patients based on the planning CT images with dose calculation grid size of 2.5 x 2.5 x 2.5 mm. The dose covering a 2-cc volume of skin (D2cc), defined as the inner 5 mm of the skin surface with the exception of bone structure, was assessed. Results: A moving object was well identified on 4D-CBCT images in a phantom study. Given a gantry rotational angle of 105° and the configuration of kV X-ray imaging subsystems, both kV X-ray fields overlapped at a part of skin surface. The D2cc for the 4D-CBCT scans was in the range 73.8–105.4 mGy. Linear correlation coefficient between the 1000 minus averaged SSD during CBCT scanning and D2cc was −0.65 (with a slope of −0.17) for the 4D-CBCT scans. Conclusion: We have developed 4D-CBCT imaging system with dual source kV X-ray tubes. The total imaging dose with 4D-CBCT scans was up to 105.4 mGy.

60 APPLIED LIFE SCIENCES↗

WE-G-204-09: Medical Physics 2.0 in Practice: Automated QC Assessment of Clinical Chest Images

Purpose: To determine whether a proposed suite of objective image quality metrics for digital chest radiographs is useful for monitoring image quality in our clinical operation. Methods: Seventeen gridless AP Chest radiographs from a GE Optima portable digital radiography (DR) unit (Group 1), seventeen (routine) PA Chest radiographs from a GE Discovery DR unit (Group 2), and sixteen gridless (non-routine) PA Chest radiographs from the same Discovery DR unit (Group 3) were chosen for analysis. Groups were selected to represent “sub-standard” (Group 1), “standard-of-care” (Group 2), and images with a gross technical error (Group 3). Group 1 images were acquired with lower kVp (90 vs. 125), shorter source-to-image distance (127cm vs 183cm) and were expected to have lower quality than images in Group 2. Group 3 was expected to have degraded contrast versus Group 2.This evaluation was approved by the institutional Quality Improvement Assurance Board (QIAB). Images were anonymized and securely transferred to the Duke University Clinical Imaging Physics Group for analysis using software previously described{sup 1} and validated{sup 2}. Image quality for individual images was reported in terms of lung grey level(Lgl); lung noise(Ln); rib-lung contrast(RLc); rib sharpness(Rs); mediastinum detail(Md), noise(Mn), and alignment(Ma); subdiaphragm-lung contrast(SLc); and subdiaphragm area(Sa). Metrics were compared across groups. Results: Metrics agreed with published Quality Consistency Ranges with three exceptions: higher Lgl, lower RLc, and SDc. Higher bit depth (16 vs 12) accounted for higher Lgl values in our images. Values were most internally consistent for Group 2. The most sensitive metric for distinguishing between groups was Mn followed closely by Ln. The least sensitive metrics were Md and RLc. Conclusion: The software appears promising for objectively and automatically identifying substandard images in our operation. The results can be used to establish local quality consistency ranges and action limits per facility preferences.

60 APPLIED LIFE SCIENCES↗

A Monte Carlo study on {sup 223}Ra imaging for unsealed radionuclide therapy

Purpose: Radium-223 ({sup 223}Ra), an α-emitting radionuclide, is used in unsealed radionuclide therapy for metastatic bone tumors. The demand for qualitative {sup 223}Ra imaging is growing to optimize dosimetry. The authors simulated {sup 223}Ra imaging using an in-house Monte Carlo simulation code and investigated the feasibility and utility of {sup 223}Ra imaging. Methods: The Monte Carlo code comprises two modules, HEXAGON and NAI. The HEXAGON code simulates the photon and electron interactions in the tissues and collimator, and the NAI code simulates the response of the NaI detector system. A 3D numeric phantom created using computed tomography images of a chest phantom was installed in the HEXAGON code. {sup 223}Ra accumulated in a part of the spine, and three x-rays and 19 γ rays between 80 and 450 keV were selected as the emitted photons. To evaluate the quality of the {sup 223}Ra imaging, the authors also simulated technetium-99m ({sup 99m}Tc) imaging under the same conditions and compared the results. Results: The sensitivities of the three photopeaks were 147 counts per unit of source activity (cps MBq{sup −1}; photopeak: 84 keV, full width of energy window: 20%), 166 cps MBq{sup −1} (154 keV, 15%), and 158 cps MBq{sup −1} (270 keV, 10%) for a low-energy general-purpose (LEGP) collimator, and those for the medium-energy general-purpose (MEGP) collimator were 33, 13, and 8.0 cps MBq{sup −1}, respectively. In the case of {sup 99m}Tc, the sensitivity was 55 cps MBq{sup −1} (141 keV, 20%) for LEGP and 52 cps MBq{sup −1} for MEGP. The fractions of unscattered photons of the total photons reflecting the image quality were 0.09 (84 keV), 0.03 (154 keV), and 0.02 (270 keV) for the LEGP collimator and 0.41, 0.25, and 0.50 for the MEGP collimator, respectively. Conversely, this fraction was approximately 0.65 for the simulated {sup 99m}Tc imaging. The sensitivity with the LEGP collimator appeared very high. However, almost all of the counts were because of photons that penetrated or were scattered in the collimator; therefore, the proportions of unscattered photons were small. Conclusions: Their simulation study revealed that the most promising scheme for {sup 223}Ra imaging is an 84-keV window using an MEGP collimator. The sensitivity of the photopeaks above 100 keV is too low for {sup 223}Ra imaging. A comparison of the fractions of unscattered photons reveals that the sensitivity and image quality are approximately two-thirds of those for {sup 99m}Tc imaging.

60 APPLIED LIFE SCIENCES↗

MO-DE-202-01: Image-Guided Focused Ultrasound Surgery and Therapy

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.

60 APPLIED LIFE SCIENCES↗

MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.

60 APPLIED LIFE SCIENCES↗

MO-FG-CAMPUS-JeP1-03: Luminescence Imaging of Water During Proton Beam Irradiation for Range Estimation

Purpose: Since proton therapy has the ability to selectively deliver a dose to a target tumor, the dose distribution should be accurately measured. A precise and efficient method to evaluate the dose distribution is desired. We found that luminescence was emitted from water during proton irradiation and thought this phenomenon could be used for estimating the dose distribution. Methods: For this purpose, we placed water phantoms set on a table with a spot-scanning proton-therapy system, and luminescence images of these phantoms were measured with a high-sensitivity cooled charge coupled device (CCD) camera during proton-beam irradiation. We also conducted the imaging of phantoms of pure-water, fluorescein solution and acrylic block. We made three dimensional images from the projection data. Results: The luminescence images of water phantoms during the proton-beam irradiations showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. The image of the pure-water phantom also showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had 14.5% shorter proton range than that of water; the proton range in the acrylic phantom was relatively matched with the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 sec. Three dimensional images were successfully obtained which have more quantitative information. Conclusion: Luminescence imaging during proton-beam irradiation has the potential to be a new method for range estimations in proton therapy.

60 APPLIED LIFE SCIENCES↗

TU-FG-BRB-11: Design and Evaluation of a Robotic C-Arm CBCT System for Image-Guided Proton Therapy

Purpose: To describe the design and performance of a ceiling-mounted robotic C-arm CBCT system for image-guided proton therapy. Methods: Uniquely different from traditional C-arm CBCT used in interventional radiology, the imaging system was designed to provide volumetric image guidance for patients treated on a 190-degree proton gantry system and a 6 degree-of-freedom (DOF) robotic patient positioner. The mounting of robotic arms to the ceiling rails, rather than gantry or nozzle, provides the flexibility in imaging locations (isocenter, iso+27cm in X, iso+100cm in Y) in the room and easier upgrade as technology advances. A kV X-ray tube and a 43×43cm flat panel imager were mounted to a rotating C-ring (87cm diameter), which is coupled to the C-arm concentrically. Both C-arm and the robotic arm remain stationary during imaging to maintain high position accuracy. Source-to-axis distance and source-to-imager distance are 100 and 150cm, respectively. A 14:1 focused anti-scatter grid and a bowtie filer are used for image acquisition. A unique automatic collimator device of 4 independent blades for adjusting field of view and reducing patient dose has also been developed. Results: Sub-millimeter position accuracy and repeatability of the robotic C-arm were measured with a laser tracker. High quality CBCT images for positioning can be acquired with a weighted CTDI of 3.6mGy (head in 200° full fan mode: 100kV, 20mA, 20ms, 10fps)-8.7 mGy (pelvis in 360° half fan mode: 125kV, 42mA, 20ms, 10fps). Image guidance accuracy achieved <1mm (3D vector) with automatic 3D-3D registration for anthropomorphic head and pelvis phantoms. Since November 2015, 22 proton therapy patients have undergone daily CBCT imaging for 6 DOF positioning. Conclusion: Decoupled from gantry and nozzle, this CBCT system provides a unique solution for volumetric image guidance with half/partial proton gantry systems. We demonstrated that daily CBCT can be integrated into proton therapy for pre-treatment position verification.

60 APPLIED LIFE SCIENCES↗

TH-E-202-01: Pitfalls and Remedies in PET/CT Imaging for RT Planning

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy. The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.

60 APPLIED LIFE SCIENCES↗

TH-E-202-02: The Use of Hypoxia PET Imaging for Radiotherapy

PET/CT is a very important imaging tool in the management of oncology patients. PET/CT has been applied for treatment planning and response evaluation in radiation therapy. This educational session will discuss: Pitfalls and remedies in PET/CT imaging for RT planning The use of hypoxia PET imaging for radiotherapy PET for tumor response evaluation The first presentation will address the issue of mis-registration between the CT and PET images in the thorax and the abdomen. We will discuss the challenges of respiratory gating and introduce an average CT technique to improve the registration for dose calculation and image-guidance in radiation therapy. The second presentation will discuss the use of hypoxia PET Imaging for radiation therapy. We will discuss various hypoxia radiotracers, the choice of clinical acquisition protocol (in particular a single late static acquisition versus a dynamic acquisition), and the compartmental modeling with different transfer rate constants explained. We will demonstrate applications of hypoxia imaging for dose escalation/de-escalation in clinical trials. The last presentation will discuss the use of PET/CT for tumor response evaluation. We will discuss anatomic response assessment vs. metabolic response assessment, visual evaluation and semi-quantitative evaluation, and limitations of current PET/CT assessment. We will summarize clinical trials using PET response in guiding adaptive radiotherapy. Finally, we will summarize recent advancements in PET/CT radiomics and non-FDG PET tracers for response assessment. Learning Objectives: Identify the causes of mis-registration of CT and PET images in PET/CT, and review the strategies to remedy the issue. Understand the basics of PET imaging of tumor hypoxia (radiotracers, how PET measures the hypoxia selective uptake, imaging protocols, applications in chemo-radiation therapy). Understand the basics of dynamic PET imaging, compartmental modeling and parametric images. Understand the basics of using FDG PET/CT for tumor response evaluation. Learn about recent advancement in PET/CT radiomics and non-FDG PET tracers for response assessment. This work was supported in part by the National Cancer Institute Grants R01CA172638.; W. Lu, This work was supported in part by the National Cancer Institute Grants R01CA172638.

60 APPLIED LIFE SCIENCES↗

Deep machine learning-assisted multiphoton microscopy to reduce light exposure and expedite imaging

Two-photon excitation fluorescence (2PEF) allows imaging of tissue up to about one millimeter in thickness. Typically, reducing fluorescence excitation exposure reduces the quality of the image. However, using deep learning super resolution techniques, these low-resolution images can be converted to high-resolution images. This work explores improving human tissue imaging by applying deep learning to maximize image quality while reducing fluorescence excitation exposure. We analyze two methods: a method based on U-Net, and a patch-based regression method. Both methods are evaluated on a skin dataset and an eye dataset. The eye dataset includes 1200 paired high power and low power images of retinal organoids. The skin dataset contains multiple frames of each sample of human skin. High-resolution images were formed by averaging 70 frames for each sample and low-resolution images were formed by averaging the first 7 and 15 frames for each sample. The skin dataset includes 550 images for each of the resolution levels. We track two measures of performance for the two methods: mean squared error (MSE) and structural similarity index measure (SSIM). For the eye dataset, the patches method achieves an average MSE of 27,611 compared to 146,855 for the U-Net method, and an average SSIM of 0.636 compared to 0.607 for the U-Net method. For the skin dataset, the patches method achieves an average MSE of 3.768 compared to 4.032 for the U-Net method, and an average SSIM of 0.824 compared to 0.783 for the U-Net method. Despite better performance on image quality, the patches method is worse than the U-Net method when comparing the speed of prediction, taking 303 seconds to predict one image compared to less than one second for the U-Net method.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Neutron Transmission Imaging with a Portable D-T Neutron Generator

Fast-neutron transmission imaging provides complementary information to x-ray transmission imaging. While fast neutron imaging resolution is generally below x-ray imaging, 14-MeV neutrons have an advantage over portable x-ray systems. Neutrons have higher transmission through high-Z materials due to a more uniform attenuation as a function of material atomic number Z compared to X-rays, and can therefore image low-Z materials inside high-Z materials. As a result, portable neutron transmission imaging has many applications, including inspection of concrete and welds for corrosion in vehicles, bridges, and other infrastructure, measurement of material levels in containers, and inspection of suspicious packages. Fast-neutron imaging is also more practical for field use than thermal-neutron imaging due to the size and shielding requirements typical of thermal-imaging systems compared to the availability of small 14.1 MeV D-T neutron generators. However, there are limitations in portable fast-neutron imaging systems, including limited neutron output, limited light produced by neutron scintillators, and lower resolution due to neutron source spot size and 2-3 mm scintillator thickness. In addition, digital-panel dark-noise is roughly 100x higher than neutron scintillator light, and variations in noise across the panel and in time is comparable to the imaging signal. Here we discuss recent efforts in developing a portable fast-neutron radiography system, including an improved neutron scintillator, mitigation of panel noise, and new commercial portable D-T neutron generators. We also present MCNP efforts to model neutron imaging, including scintillator resolution and the effects of neutron scattering from the object and surrounding materials.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Bayesian Spatially Varying Multi-Regularization Image Deblurring

Many scientific experiments such as those found in astronomy, geology, microbiology, and X-ray radiography require the use of high-energy instruments to capture images. Since blur and noise are inevitably present in any imaging system, the images must be \deblurred" to extract the full information content. Mathematically, image deblurring is an ill-posed inverse problem that requires regularization. The regularization, in turn, has a large effect on the deblurred image: different regularization strengths, and types, lead to drastically different reconstructions. Moreover, many images contain a mixture of smooth and sharp features which suggests the use of multi-regularization, i.e., varying the type of regularization (e.g. Tikhonov or total variation) across the image. We address these issues by formulating the image deblurring problem within a hierarchical Bayesian framework in which we spatially adapt the strength of the regularization and also vary the regularization type across the image. In this way, the image itself, along with corresponding regularization strength at each pixel, are described jointly by a posterior distribution which we can sample by Markov chain Monte Carlo (MCMC) methods. We illustrate our techniques on simplified test problems and apply them to high-energy X-ray images taken at the Nevada National Security Site. Numerical tests show that our new method is robustly applicable and increases the quality of the image reconstruction when compared to other (Bayesian) methods.

97 MATHEMATICS AND COMPUTING↗

The Role of Quantum Science Concepts in Enhancing Sensing and Imaging Technologies: Applications for Biology: Proceedings of a Workshop

Quantum concepts hold the potential to enable significant advances in sensing and imaging technologies that could be vital to the study of biological systems. The workshop Quantum Science Concepts in Enhancing Sensing and Imaging Technologies: Applications for Biology, held online March 8–10, 2021, was organized to examine the research and development needs to advance biological applications of quantum technology. Hosted by the National Academies of Sciences, Engineering, and Medicine, the event brought together experts working on state-of-the-art, quantum-enabled technologies and scientists who are interested in applying these technologies to biological systems. Through talks, panels, and discussions, the workshop facilitated a better understanding of the current and future biological applications of quantum-enabled technologies in fields such as microbiology, molecular biology, cell biology, plant science, mycology, and many others. The workshop was organized around three main themes. The first, quantum in biology, examined quantum concepts that are hypothesized to be important for life processes and that researchers are working to observe through biological imaging and sensing. The second, quantum for biology, addressed ways to use quantum concepts to enhance technologies for biological imaging and sensing. The third, biology for quantum, offered a wider discussion of how the frontiers of biological imaging and sensing could enable future study using quantum concepts, tools, or technologies. Throughout the workshop, participants identified a wide range of emerging approaches and opportunities at the intersection of quantum physics and biological sensing and imaging. During the workshop, there were some differences in how each speaker defined the term quantum. During one of the panels, Prem Kumar offered thoughts on what phenomena are classical versus quantum, explaining that techniques get progressively more quantum as you move from just having superposition to having superposition with measurement and entanglement. Another explanation from Clarice Aiello delineates the definition into several levels. This includes a base level of “quantum-ness,” which reflects that all matter is made of atoms, and when these particles are isolated they behave based on quantum mechanical principles. A second level is related to quantum coherence, where a single quantum object might be found in a coherent superposition state. A final level, which she described as the quantum-entangled level, involves multiple quantum systems which are entangled among themselves. Overall, the workshop touched on concepts such as superposition, entanglement, and squeezing and their potential implications for communication, computing, and simulation, in addition to the workshop’s main focal area, biological sensing and imaging. At the opening of the workshop, Thorsten Ritz of the University of California, Irvine, identified two questions at the heart of quantum biology: Is the machinery of life quantum mechanical, and can quantum mechanics be used to study the machinery of life in new ways? Participants highlighted systems in which researchers have explored these questions, from the vast array of molecular interactions involved in biological processes such as photosynthesis, to the mechanics involved in cellular functions such as differentiation and aggregation, to the role of oscillating magnetic fields in flight orientation among birds. Sensing and imaging technologies are crucial to biological research; these technologies could both enhance the study of quantum effects and be enhanced by quantum concepts. A critical challenge in biological research is to develop imaging and sensing tools that do not damage or interfere with the often fragile and fleeting systems being studied. Attendees discussed a variety of established and emerging technologies that could enhance noninvasive biological imaging, including single- and two-photon spectroscopy, single-molecule spectroscopy, quantum illumination, ghost imaging, and cryo-electron microscopy. One example came from Marlan Scully who gave a keynote address on the first day of the workshop. Scully emphasized the use of different laser technologies, which exhibit coherence and other quantum properties, in moving toward real-world biological applications, such as the detection of SARS-CoV-2. Both tools and theory will play an important role in advancing quantum biology research and applications. Several participants suggested theorists and experimentalists should work in tandem to understand and model biological processes. While physics often reduces systems to their simplest forms for fundamental insights, participants also noted the value of observing and understanding biological systems in all their “messiness,” capturing both the inner workings of biological systems and the complex interactions that occur within and between organisms. In discussions among participants, several attendees stressed the need to match emerging tools with the right scientific questions. Rather than developing quantum technologies as “a hammer looking for a nail,” participants emphasized a focus on exploring the problems these technologies are best suited to address. For example, it is important to consider the size of the phenomenon being studied, the timescales that are important in answering the scientific question, and other relevant considerations. Every tool along the spectrum from classical to quantum involves its own set of trade-offs. For example, Ted Laurence of the Lawrence Livermore National Laboratory said that quantum measurements, such as single photon counting, fluorescence transitions, and lasers, can take longer to produce the same results as classical measurements. These quantum measurements, however, do not require calibration and can enable new research questions to be answered. Prem Kumar, Northwestern University, noted that, despite their promise, quantum approaches should not be used simply for the sake of using quantum, especially in situations where classical approaches better meet the needs of the researcher. Understanding and applying quantum concepts could enable advances in a wide range of application areas including energy, synthetic biology, medicine, and sustainability. For example, Michelle O’Malley, University of California, Santa Barbara, described how improved noninvasive imaging approaches could help capture the complex interactions and functions involved in the breakdown of organic matter by microbial communities and lead to new technologies for capturing valuable products from plant waste. Several other participants discussed needs in tracking the movement of metabolites and molecules in microbial communities for insights into nutrient cycling in environments such as soil. Margaret Ahmad, Sorbonne University, discussed potential opportunities to leverage the magnetic properties of cryptochromes to advance new treatment approaches for diseases such as COVID-19 and cancer. Looking toward the future development of the field, participants discussed challenges to advancing quantum biology that arise from disciplinary disconnects between physicists and biologists. The siloing of academic research disciplines represents a significant barrier to progress. Disconnects in terminology, motivations and priorities, and structural barriers to collaborative work underscore the need for concerted efforts to bridge these divides. Attendees and speakers offered suggestions for resolving these divergences, establishing a shared language, moving the field forward, and fostering meaningful feedback between disciplines. Overall, participants stressed a need for balance, open communication, collaboration, unity, and clear dialogue on trade-offs between quantum and classical approaches. Keiko Torii, The University of Texas at Austin, said that the best collaborations happen when the project provides mutual advantages that can show off everyone’s talents, each team finds the work interesting, and partners develop a camaraderie to pursue new knowledge. To enable near- and long-term opportunities in this space, participants suggested that exploratory, high-risk funding could improve existing instrumentation to explore quantum enhancement collaboratively. They also emphasized the need for collaboration between quantum physicists and sensing/imaging scientists, which could be advanced through a dedicated quantum biology investigator program. People, even more than technology, will be crucial to the future of quantum biology. Participants explored training, education, and workforce needs to further develop this burgeoning field and cultivate the next generation of scientists. While many programs are still in their nascent stages, participants highlighted examples of approaches and programs being developed at various types of institutions to engage students and professional scientists in quantum biology research. Several participants stressed the need for an inclusive approach, spanning disciplines as well as communities to foster a diverse field fueled by the intellectual contributions of a wide range of people, including historically under-resourced schools and students. To increase awareness and excitement about quantum physics and related areas of biology, attendees suggested capitalizing on the “buzz” around quantum. Several participants emphasized the need to start early, introducing students to quantum concepts and their appealing “weirdness” in K–12 education. Engaging students early—before they become entrenched in traditional disciplinary siloes as typically happens in graduate school—could help to galvanize interest in the area and foster a generation of scientists with the interdisciplinary mindset and skills needed to advance this interdisciplinary field. While these efforts could be advanced at many levels and across multiple sectors, several participants suggested a national quantum biology center could be a valuable hub to coordinate and support quantum biology education and workforce development across academia, industry, and government.

59 BASIC BIOLOGICAL SCIENCES↗

A highly sensitive x-ray imaging modality for hepatocellular carcinoma detection in vitro

Innovations that improve sensitivity and reduce cost are of paramount importance in diagnostic imaging. The novel x-ray imaging modality called Spatial Frequency Heterodyne Imaging (SFHI) is based on a linear arrangement of x-ray source, tissue, and x-ray detector, much like that of a conventional x-ray imaging apparatus. However, SFHI rests on a complete paradigm reversal compared to conventional x-ray absorption-based radiology: while scattered x-rays are carefully rejected in absorption-based x-ray radiology to enhance the image contrast, SFHI forms images exclusively from x-rays scattered by the tissue. Here in this study we use numerical processing to produce x-ray scatter images of Hepatocellular Carcinoma (HCC) labeled with a nanoparticle contrast agent. We subsequently compare the sensitivity of SFHI in this application to that of both conventional x-ray imaging and Magnetic Resonance Imaging (MRI). Although SFHI is still in the early stages of its development, our results show that the sensitivity of SFHI is an order of magnitude greater than that of absorption-based x-ray imaging and approximately equal to that of MRI. Lastly, as x-ray imaging modalities typically have lower installation and service costs compared to MRI, SFHI could become a cost effective alternative to MRI, particularly in areas of the world with inadequate availability of MRI facilities.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Accuracy of volume measurement using 3D ultrasound and development of CT-3D US image fusion algorithm for prostate cancer radiotherapy

Purpose: To evaluate the accuracy of measuring volumes using three-dimensional ultrasound (3D US), and to verify the feasibility of the replacement of CT-MR fusion images with CT-3D US in radiotherapy treatment planning. Methods: Phantoms, consisting of water, contrast agent, and agarose, were manufactured. The volume was measured using 3D US, CT, and MR devices. A CT-3D US and MR-3D US image fusion software was developed using the Insight Toolkit library in order to acquire three-dimensional fusion images. The quality of the image fusion was evaluated using metric value and fusion images. Results: Volume measurement, using 3D US, shows a 2.8 {+-} 1.5% error, 4.4 {+-} 3.0% error for CT, and 3.1 {+-} 2.0% error for MR. The results imply that volume measurement using the 3D US devices has a similar accuracy level to that of CT and MR. Three-dimensional image fusion of CT-3D US and MR-3D US was successfully performed using phantom images. Moreover, MR-3D US image fusion was performed using human bladder images. Conclusions: 3D US could be used in the volume measurement of human bladders and prostates. CT-3D US image fusion could be used in monitoring the target position in each fraction of external beam radiation therapy. Moreover, the feasibility of replacing the CT-MR image fusion to the CT-3D US in radiotherapy treatment planning was verified.

62 RADIOLOGY AND NUCLEAR MEDICINE↗