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Monte Carlo simulation of an x-ray luminescence optical tomography scanner prototype

In this work we report the calculation of the deposited energy distribution produced by an x-ray luminescence optical tomography (XLOT) system in a phantom containing different concentrations of Gd{sub 2}O{sub 2}S:Eu nanoparticles. The calculations were performed via Monte Carlo simulation considering spectra from a W target x-ray tube operating between 30 and 90 kVp, with 1.0 mm Al added filtration. CT and XLOT tomographic images were reconstructed from the same data. The results show that XLOT has better detectability than CT alone, that the dose scales linearly with kVp for a fixed concentration of Gd{sub 2}O{sub 2}S:Eu and air-kerma rate, the scattered radiation contribution to the total dose and signal is about 20% and that the dose ratio for a 3 mm diameter insert containing 10 mg/ml Gd{sub 2}O{sub 2}S embedded in a 30 mm diameter water phantom is 6:1. This ratio drops to less than 2:1 for a 1 mg/ml concentration. Finally we show that the method of conjugate images can be used to correct for artifacts due to attenuation effects in XLOT images.

60 APPLIED LIFE SCIENCES↗

TU-AB-303-01: A Feasibility Study for Dynamic Adaptive Therapy of Non-Small Cell Lung Cancer

Purpose: To compare plans for NSCLC optimized using Dynamic Adaptive Therapy (DAT) with conventional IMRT optimization. DAT adapts plans based on changes in the target volume by using dynamic programing techniques to consider expected changes into the optimization process. Information gathered during treatment, e.g. from CBCT, is incorporated into the optimization. Methods and materials: DAT is formulated using stochastic control formalism, which minimizes the total expected number of tumor cells at the end of a treatment course subject to uncertainty inherent in the tumor response and organs-at-risk (OAR) dose constraints. This formulation allows for non-stationary dose distribution as well as non-stationary fractional dose as needed to achieve a series of optimal plans that are conformal to tumor over time. Sixteen phantom cases with various sizes and locations of tumors, and OAR geometries were generated. Each case was planned with DAT and conventional IMRT (60Gy/30fx). Tumor volume change over time was obtained by using, daily MVCT-based, two-level cell population model. Monte Carlo simulations have been performed for each treatment course to account for uncertainty in tumor response. Same OAR dose constraints were applied for both methods. The frequency of plan modification was varied to 1, 2, 5 (weekly), and 29 (daily). The final average tumor dose and OAR doses have been compared to quantify the potential benefit of DAT. Results: The average tumor max, min, mean, and D95 resulted from DAT were 124.0–125.2%, 102.1–114.7%, 113.7–123.4%, and 102.0–115.9% (range dependent on the frequency of plan modification) of those from conventional IMRT. Cord max, esophagus max, lung mean, heart mean, and unspecified tissue D05 resulted from AT were 84–102.4%, 99.8–106.9%, 66.9–85.6%, 58.2–78.8%, and 85.2–94.0% of those from conventional IMRT. Conclusions: Significant tumor dose increase and OAR dose reduction, especially with parallel OAR with mean or dose-volume constraints, can be achieved using DAT.

60 APPLIED LIFE SCIENCES↗

Radiation Exposure of Abdominal Cone Beam Computed Tomography

PurposeTo evaluate patients radiation exposure of abdominal C-arm cone beam computed tomography (CBCT).MethodsThis prospective study was approved by the institutional review board; written, informed consent was waived. Radiation exposure of abdominal CBCT was evaluated in 40 patients who underwent CBCT during endovascular interventions. Dose area product (DAP) of CBCT was documented and effective dose (ED) was estimated based on organ doses using dedicated Monte Carlo simulation software with consideration of X-ray field location and patients’ individual body weight and height. Weight-dependent ED per DAP conversion factors were calculated. CBCT radiation dose was compared to radiation dose of procedural fluoroscopy. CBCT dose-related risk for cancer was assessed.ResultsMean ED of abdominal CBCT was 4.3 mSv (95 % confidence interval [CI] 3.9; 4.8 mSv, range 1.1–7.4 mSv). ED was significantly higher in the upper than in the lower abdomen (p = 0.003) and increased with patients’ weight (r = 0.55, slope = 0.045 mSv/kg, p < 0.001). Radiation exposure of CBCT corresponded to the radiation exposure of on average 7.2 fluoroscopy minutes (95 % CI 5.5; 8.8 min) in the same region of interest. Lifetime risk of exposure related cancer death was 0.033 % or less depending on age and weight.ConclusionsMean ED of abdominal CBCT was 4.3 mSv depending on X-ray field location and body weight.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-D-206-07: CBCT Scatter Correction Based On Rotating Collimator

Purpose: Scatter correction in cone-beam computed tomography (CBCT) has obvious effect on the removal of image noise, the cup artifact and the increase of image contrast. Several methods using a beam blocker for the estimation and subtraction of scatter have been proposed. However, the inconvenience of mechanics and propensity to residual artifacts limited the further evolution of basic and clinical research. Here, we propose a rotating collimator-based approach, in conjunction with reconstruction based on a discrete Radon transform and Tchebichef moments algorithm, to correct scatter-induced artifacts. Methods: A rotating-collimator, comprising round tungsten alloy strips, was mounted on a linear actuator. The rotating-collimator is divided into 6 portions equally. The round strips space is evenly spaced on each portion but staggered between different portions. A step motor connected to the rotating collimator drove the blocker to around x-ray source during the CBCT acquisition. The CBCT reconstruction based on a discrete Radon transform and Tchebichef moments algorithm is performed. Experimental studies using water phantom and Catphan504 were carried out to evaluate the performance of the proposed scheme. Results: The proposed algorithm was tested on both the Monte Carlo simulation and actual experiments with the Catphan504 phantom. From the simulation result, the mean square error of the reconstruction error decreases from 16% to 1.18%, the cupping (τcup) from 14.005% to 0.66%, and the peak signal-to-noise ratio increase from 16.9594 to 31.45. From the actual experiments, the induced visual artifacts are significantly reduced. Conclusion: We conducted an experiment on CBCT imaging system with a rotating collimator to develop and optimize x-ray scatter control and reduction technique. The proposed method is attractive in applications where a high CBCT image quality is critical, for example, dose calculation in adaptive radiation therapy. We want to thank Dr. Lei Xing and Dr. Yong Yang in the Stanford University School of Medicine for this work. This work was jointly supported by NSFC (61471226), Natural Science Foundation for Distinguished Young Scholars of Shandong Province (JQ201516), and China Postdoctoral Science Foundation (2015T80739, 2014M551949).

60 APPLIED LIFE SCIENCES↗

TH-EF-207A-05: Feasibility of Applying SMEIR Method On Small Animal 4D Cone Beam CT Imaging

Purpose: Small animal cone beam CT imaging has been widely used in preclinical research. Due to the higher respiratory rate and heat beats of small animals, motion blurring is inevitable and needs to be corrected in the reconstruction. Simultaneous motion estimation and image reconstruction (SMEIR) method, which uses projection images of all phases, proved to be effective in motion model estimation and able to reconstruct motion-compensated images. We demonstrate the application of SMEIR for small animal 4D cone beam CT imaging by computer simulations on a digital rat model. Methods: The small animal CBCT imaging system was simulated with the source-to-detector distance of 300 mm and the source-to-object distance of 200 mm. A sequence of rat phantom were generated with 0.4 mm{sup 3} voxel size. The respiratory cycle was taken as 1.0 second and the motions were simulated with a diaphragm motion of 2.4mm and an anterior-posterior expansion of 1.6 mm. The projection images were calculated using a ray-tracing method, and 4D-CBCT were reconstructed using SMEIR and FDK methods. The SMEIR method iterates over two alternating steps: 1) motion-compensated iterative image reconstruction by using projections from all respiration phases and 2) motion model estimation from projections directly through a 2D-3D deformable registration of the image obtained in the first step to projection images of other phases. Results: The images reconstructed using SMEIR method reproduced the features in the original phantom. Projections from the same phase were also reconstructed using FDK method. Compared with the FDK results, the images from SMEIR method substantially improve the image quality with minimum artifacts. Conclusion: We demonstrate that it is viable to apply SMEIR method to reconstruct small animal 4D-CBCT images.

60 APPLIED LIFE SCIENCES↗

Ultra Low Level Environmental Neutron Measurements Using Superheated Droplet Detectors

Through the application of superheated droplet detectors (SDDs), the SIMPLE project for the direct search for dark matter (DM) reached the most restrictive limits on the spin-dependent sector to date. The experiment is based on the detection of recoils following WIMP-nuclei interaction, mimicking those from neutron scattering. The thermodynamic operation conditions yield the SDDs intrinsically insensitive to radiations with linear energy transfer below ∼150 keVμm{sup -1} such as photons, electrons, muons and neutrons with energies below ∼40 keV. Underground facilities are increasingly employed for measurements in a low-level radiation background (DM search, gamma-spectroscopy, intrinsic soft-error rate measurements, etc.), where the rock overburden shields against cosmic radiation. In this environment the SDDs are sensitive only to α-particles and neutrons naturally emitted from the surrounding materials. Recently developed signal analysis techniques allow discrimination between neutron and α-induced signals. SDDs are therefore a promising instrument for low-level neutron and α measurements, namely environmental neutron measurements and α-contamination assays. In this work neutron measurements performed in the challenging conditions of the latest SIMPLE experiment (1500 mwe depth with 50-75 cm water shield) are reported. The results are compared with those obtained by detailed Monte Carlo simulations of the neutron background induced by {sup 238}U and {sup 232}Th traces in the facility, shielding and detector materials. Calculations of the neutron energy distribution yield the following neutron fluence rates (in 10{sup -8} cm{sup -2}s{sup -1}): thermal (<0.5 eV): 2.5; epithermal (0.5 eV-100 keV): 2.2; fast (>1 MeV): 3.9. Signal rates were derived using standard cross sections and codes routinely employed in reactor dosimetry. The measured and calculated neutron count rates per unit of active mass were 0.15 ct/kgd and 0.33 ct/kg-d respectively. As the major signal contribution (98%) originates from radio-impurities in the detector container, alternative materials will be employed in future devices. Latest results regarding the improvement of the detector characterization accuracy towards its application in environmental neutron detection are in progress and will be described. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-D-207-07: Implementation of Full/half Bowtie Filter Model in a Commercial Treatment Planning System for Kilovoltage X-Ray Imaging Dose Estimation

Purpose: To implement full/half bowtie filter models in a commercial treatment planning system (TPS) to calculate kilovoltage (kV) x-ray imaging dose of Varian On-Board Imager (OBI) cone beam CT (CBCT) system. Methods: Full/half bowtie filters of Varian OBI were created as compensator models in Pinnacle TPS (version 9.6) using Matlab software (version 2011a). The profiles of both bowtie filters were acquired from the manufacturer, imported into the Matlab system and hard coded in binary file format. A Pinnacle script was written to import each bowtie filter data into a Pinnacle treatment plan as a compensator. A kV x-ray beam model without including the compensator model was commissioned per each bowtie filter setting based on percent depth dose and lateral profile data acquired from Monte Carlo simulations. To validate the bowtie filter models, a rectangular water phantom was generated in the planning system and an anterior/posterior beam with each bowtie filter was created. Using the Pinnacle script, each bowtie filter compensator was added to the treatment plan. Lateral profile at the depth of 3cm and percent depth dose were measured using an ion chamber and compared with the data extracted from the treatment plans. Results: The kV x-ray beams for both full and half bowtie filter have been modeled in a commercial TPS. The difference of lateral and depth dose profiles between dose calculations and ion chamber measurements were within 6%. Conclusion: Both full/half bowtie filter models provide reasonable results in kV x-ray dose calculations in the water phantom. This study demonstrates the possibility of using a model-based treatment planning system to calculate the kV imaging dose for both full and half bowtie filter modes. Further study is to be performed to evaluate the models in clinical situations.

60 APPLIED LIFE SCIENCES↗

TU-CD-207-11: Patient-Driven Automatic Exposure Control for Dedicated Breast CT

Purpose: To implement automatic exposure control (AEC) in dedicated breast CT (bCT) on a patient-specific basis using only the pre-scan scout views. Methods: Using a large cohort (N=153) of bCT data sets, the breast effective diameter (D) and width in orthogonal planes (Wa,Wb) were calculated from the reconstructed bCT image and pre-scan scout views, respectively. D, Wa, and Wb were measured at the breast center-of-mass (COM), making use of the known geometry of our bCT system. These data were then fit to a second-order polynomial “D=F(Wa,Wb)” in a least squares sense in order to provide a functional form for determining the breast diameter. The coefficient of determination (R{sup 2}) and mean percent error between the measured breast diameter and fit breast diameter were used to evaluate the overall robustness of the polynomial fit. Lastly, previously-reported bCT technique factors derived from Monte Carlo simulations were used to determine the tube current required for each breast diameter in order to match two-view mammographic dose levels. Results: F(Wa,Wb) provided fitted breast diameters in agreement with the measured breast diameters resulting in R{sup 2} values ranging from 0.908 to 0.929 and mean percent errors ranging from 3.2% to 3.7%. For all 153 bCT data sets used in this study, the fitted breast diameters ranged from 7.9 cm to 15.7 cm corresponding to tube current values ranging from 0.6 mA to 4.9 mA in order to deliver the same dose as two-view mammography in a 50% glandular breast with a 80 kV x-ray beam and 16.6 second scan time. Conclusion: The present work provides a robust framework for AEC in dedicated bCT using only the width measurements derived from the two orthogonal pre-scan scout views. Future work will investigate how these automatically chosen exposure levels affect the quality of the reconstructed image.

60 APPLIED LIFE SCIENCES↗

An investigation of kV CBCT image quality and dose reduction for volume-of-interest imaging using dynamic collimation

Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kilovoltage-cone beam CT (CBCT) using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of 1D translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian On-Board Imager system. CBCT and planar image quality were investigated as a function of aperture radius, while maintaining the same dose to the VOI, for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various sizes VOI were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 to 2.4 cm (at isocenter). Depending upon VOI location and size, dose was reduced to 16%–90% of the full-field value along the central axis plane and down to 4% along the axis of rotation, while maintaining the same dose to the VOI compared to full-field techniques. When maintaining constant dose to the VOI, this change in iris diameter corresponds to a factor increase of approximately 1.6 in image contrast and a factor decrease in image noise of approximately 1.2. This results in a measured gain in contrast-to-noise ratio by a factor of approximately 2.0. Conclusions: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.

60 APPLIED LIFE SCIENCES↗

TH-A-18C-11: An Investigation of KV CBCT Image Quality and Dose Reduction for Volume-Of-Interest Imaging Using Dynamic Collimation

Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kV-CBCT using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of one-dimensional translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian OBI system. CBCT and planar image quality was investigated as a function of aperture radius, while maintaining the same dose to the VOI, for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various anatomical sites were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 cm to 2.4 cm (at isocenter). Similarly, this change in iris diameter corresponds to a factor increase of approximately 1.4 and 1.5 in image contrast for CBCT and planar images, respectively, and similarly a factor decrease in image noise of approximately 1.7 and 1.5. This results in a measured gain in contrast-to-noise ratio of a factor of approximately 2.3 for both CBCT and planar images. Depending upon the anatomical site, dose was reduced to 10%–70% of the full field value along the central axis plane and down to 2% along the axial planes, while maintaining the same dose to the VOI compared to full-field techniques. Conclusion: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.

60 APPLIED LIFE SCIENCES↗

Spectra of clinical CT scanners using a portable Compton spectrometer

Purpose: Spectral information of the output of x-ray tubes in (dual source) computer tomography (CT) scanners can be used to improve the conversion of CT numbers to proton stopping power and can be used to advantage in CT scanner quality assurance. The purpose of this study is to design, validate, and apply a compact portable Compton spectrometer that was constructed to accurately measure x-ray spectra of CT scanners. Methods: In the design of the Compton spectrometer, the shielding materials were carefully chosen and positioned to reduce background by x-ray fluorescence from the materials used. The spectrum of Compton scattered x-rays alters from the original source spectrum due to various physical processes. Reconstruction of the original x-ray spectrum from the Compton scattered spectrum is based on Monte Carlo simulations of the processes involved. This reconstruction is validated by comparing directly and indirectly measured spectra of a mobile x-ray tube. The Compton spectrometer is assessed in a clinical setting by measuring x-ray spectra at various tube voltages of three different medical CT scanner x-ray tubes. Results: The directly and indirectly measured spectra are in good agreement (their ratio being 0.99) thereby validating the reconstruction method. The measured spectra of the medical CT scanners are consistent with theoretical spectra and spectra obtained from the x-ray tube manufacturer. Conclusions: A Compton spectrometer has been successfully designed, constructed, validated, and applied in the measurement of x-ray spectra of CT scanners. These measurements show that our compact Compton spectrometer can be rapidly set-up using the alignment lasers of the CT scanner, thereby enabling its use in commissioning, troubleshooting, and, e.g., annual performance check-ups of CT scanners.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-335: Dosimetric Investigation of An Advanced Rotating Gamma Ray System for Imaged Guided Radiation Therapy

Purpose: Co-60 beams have unique dosimetric properties for cranial treatments and thoracic cancers. The conventional concern about the high surface dose is overcome by modern system designs with rotational treatment techniques. This work investigates a novel rotational Gamma ray system for image-guided, external beam radiotherapy. Methods: The CybeRT system (Cyber Medical Corp., China) consists of a ring gantry with either one or two treatment heads containing a Gamma source and a multileaf collimator (MLC). The MLC has 60 paired leaves, and the maximum field size is either 40cmx40cm (40 pairs of 0.5cm central leaves, 20 pairs of 1cm outer leaves), or 22cmx40cm (32 pairs of 0.25cm central leaves, 28 pairs of 0.5cm outer leaves). The treatment head(s) can swing 35° superiorly and 8° inferiorly, allowing a total of 43° non-coplanar beam incident. The treatment couch provides 6-degrees-of-freedom motion compensation and the kV cone-beam CT system has a spatial resolution of 0.4mm. Monte Carlo simulations were used to compute dose distributions and compare with measurements. A retrospective study of 98 previously treated patients was performed to compare CybeRT with existing RT systems. Results: Monte Carlo results confirmed the CybeRT design parameters including output factors and 3D dose distributions. Its beam penumbra/dose gradient was similar to or better than that of 6MV photon beams and its isocenter accuracy is 0.3mm. Co-60 beams produce lower-energy secondary electrons that exhibit better dose properties in low-density lung tissues. Because of their rapid depth dose falloff, Co-60 beams are favorable for peripheral lung tumors with half-arc arrangements to spare the opposite lung and critical structures. Superior dose distributions were obtained for head and neck, breast, spine and lung tumors. Conclusion: Because of its accurate dose delivery and unique dosimetric properties of C-60 sources, CybeRT is ideally suited for advanced SBRT as well as conventional RT. This work was partially supported by Cyber Medical Corp.

60 APPLIED LIFE SCIENCES↗

TU-FG-BRB-09: Thermoacoustic Range Verification with Perfect Co-Registered Overlay of Bragg Peak onto Ultrasound Image

Purpose: The potential of particle therapy has not yet been fully realized due to inaccuracies in range verification. The purpose of this work was to correlate the Bragg peak location with target structure, by overlaying thermoacoustic localization of the Bragg peak onto an ultrasound image. Methods: Pulsed delivery of 50 MeV protons was accomplished by a fast chopper installed between the ion source and the inflector of the 88″ cyclotron at Lawrence Berkeley National Lab. 2 Gy were delivered in 2 µs by a beam with peak current of 2 µA. Thermoacoustic emissions were detected by a cardiac array and Verasonics V1 ultrasound system, which also generated a grayscale ultrasound image. 1024 thermoacoustic pulses were averaged before filtering and one-way beamforming focused signal onto the Bragg peak location with perfect co-registration to the ultrasound images. Data was collected in a room temperature water bath and gelatin phantom with a cavity designed to mimic the intestine, in which gas pockets can displace the Bragg peak. Experiments were performed with the cavity both empty and filled with olive oil. Results: In the waterbath overlays of the Bragg peak agreed with Monte Carlo simulations to within 800±170 µm. Agreement within 1.3 ± 0.2 mm was achieved in the gelatin phantom, although relative stopping powers were estimated only to first order from CT scans. Protoacoustic signals were detected after travel from the Bragg peak through 29 mm and 65 mm of phantom material when the cavity was empty and full of olive oil, respectively. Conclusion: Protoacoustic range verification is feasible with a commercial clinical ultrasound array, but at doses exceeding the clinical realm. Further optimization of both transducer array and injection line chopper is required to enable range verification within a 2 Gy dose limit, which would enable online adaptive treatment. This work was supported in part by a UWM Intramural Instrumentation Grant and by the Director, Office of Science, Office of Nuclear Physics, of the U.S. Department of Energy under Contract No. DE-AC02-05CH11231. YMQ was supported by a UWM-OUR summer fellowship.

60 APPLIED LIFE SCIENCES↗

TH-AB-207A-06: The Use of Realistic Phantoms to Predict CT Dose to Pediatric Patients

Purpose: To predict pediatric patient dose from diagnostic CT scans using Monte Carlo simulation of realistic reference phantoms of various ages, weights, and heights. Methods: A series of deformable pediatric reference phantoms using Non-Uniform Rational B-Splines (NURBS) was developed for a large range of ages, percentiles, and reference anatomy. Individual bones were modeled using age-dependent factors, and red marrow was modeled as functions of age and spatial distribution based on Cristy1. Organ and effective doses for the phantom series were calculated using Monte Carlo simulation of chest, abdominopelvic, and chest-abdomen-pelvis CT exams. Non-linear regression was performed to determine the relationship between dose-length-product (DLP)-normalized organ and effective doses and phantom diameter. Patient-specific voxel computational phantoms were also created by manual segmentation of previously acquired CT images for 40 pediatric patients (0.7 to 17 years). Organ and effective doses were determined by Monte Carlo simulation of these patient-specific phantoms. Each patient was matched to the closest pediatric reference phantom based primarily on age and diameter for all major organs within the torso. Results: A total of 80 NURBS phantoms were created ranging from newborn to 15 years with height/weight percentiles from 10 to 90%. Organ and effective dose normalized by DLP correlated strongly with exponentially decreasing average phantom diameter (R{sup 2} > 0.95 for most organs). A similar relationship was determined for the patient-specific voxel phantoms. Differences between patient-phantom matched organ-dose values ranged from 0.37 to 2.39 mGy (2.87% to 22.1%). Conclusion: Dose estimation using NURBS-based pediatric reference phantoms offers the ability to predict patient dose before and after CT examinations, and physicians and scientists can use this information in their analysis of dose prescriptions for particular subjects and study types. This may lead to practices that minimize radiation dose while still achieving high quality images and, ultimately, improved patient care. NIH/NCI 1 R01 CA155400-01A1.

60 APPLIED LIFE SCIENCES↗

A feasibility study of dynamic adaptive radiotherapy for nonsmall cell lung cancer

Purpose: The final state of the tumor at the end of a radiotherapy course is dependent on the doses given in each fraction during the treatment course. This study investigates the feasibility of using dynamic adaptive radiotherapy (DART) in treating lung cancers assuming CBCT is available to observe midtreatment tumor states. DART adapts treatment plans using a dynamic programming technique to consider the expected changes of the tumor in the optimization process. Methods: DART is constructed using a stochastic control formalism framework. It minimizes the total expected number of tumor cells at the end of a treatment course, which is equivalent to maximizing tumor control probability, subject to the uncertainty inherent in the tumor response. This formulation allows for nonstationary dose distributions as well as nonstationary fractional doses as needed to achieve a series of optimal plans that are conformal to the tumor over time, i.e., spatiotemporally optimal plans. Sixteen phantom cases with various sizes and locations of tumors and organs-at-risk (OAR) were generated using in-house software. Each case was planned with DART and conventional IMRT prescribing 60 Gy in 30 fractions. The observations of the change in the tumor volume over a treatment course were simulated using a two-level cell population model. Monte Carlo simulations of the treatment course for each case were run to account for uncertainty in the tumor response. The same OAR dose constraints were applied for both methods. The frequency of replanning was varied between 1, 2, 5 (weekly), and 29 times (daily). The final average tumor dose and OAR doses have been compared to quantify the potential dosimetric benefits of DART. Results: The average tumor max, min, mean, and D95 doses using DART relative to these using conventional IMRT were 124.0%–125.2%, 102.1%–114.7%, 113.7%–123.4%, and 102.0%–115.9% (range dependent on the frequency of replanning). The average relative maximum doses for the cord and esophagus, mean doses for the heart and lungs, and D05 for the unspecified tissue resulting 84%–102.4%, 99.8%–106.9%, 66.9%–85.6%, 58.2%–78.8%, and 85.2%–94.0%, respectively. Conclusions: It is feasible to apply DART to the treatment of NSCLC using CBCT to observe the midtreatment tumor state. Potential increases in the tumor dose and reductions in the OAR dose, particularly for parallel OARs with mean or dose–volume constraints, could be achieved using DART compared to nonadaptive IMRT.

60 APPLIED LIFE SCIENCES↗

TU-AB-BRC-10: Modeling of Radiotherapy Linac Source Terms Using ARCHER Monte Carlo Code: Performance Comparison of GPU and MIC Computing Accelerators

Purpose: (1) To perform phase space (PS) based source modeling for Tomotherapy and Varian TrueBeam 6 MV Linacs, (2) to examine the accuracy and performance of the ARCHER Monte Carlo code on a heterogeneous computing platform with Many Integrated Core coprocessors (MIC, aka Xeon Phi) and GPUs, and (3) to explore the software micro-optimization methods. Methods: The patient-specific source of Tomotherapy and Varian TrueBeam Linacs was modeled using the PS approach. For the helical Tomotherapy case, the PS data were calculated in our previous study (Su et al. 2014 41(7) Medical Physics). For the single-view Varian TrueBeam case, we analytically derived them from the raw patient-independent PS data in IAEA’s database, partial geometry information of the jaw and MLC as well as the fluence map. The phantom was generated from DICOM images. The Monte Carlo simulation was performed by ARCHER-MIC and GPU codes, which were benchmarked against a modified parallel DPM code. Software micro-optimization was systematically conducted, and was focused on SIMD vectorization of tight for-loops and data prefetch, with the ultimate goal of increasing 512-bit register utilization and reducing memory access latency. Results: Dose calculation was performed for two clinical cases, a Tomotherapy-based prostate cancer treatment and a TrueBeam-based left breast treatment. ARCHER was verified against the DPM code. The statistical uncertainty of the dose to the PTV was less than 1%. Using double-precision, the total wall time of the multithreaded CPU code on a X5650 CPU was 339 seconds for the Tomotherapy case and 131 seconds for the TrueBeam, while on 3 5110P MICs it was reduced to 79 and 59 seconds, respectively. The single-precision GPU code on a K40 GPU took 45 seconds for the Tomotherapy dose calculation. Conclusion: We have extended ARCHER, the MIC and GPU-based Monte Carlo dose engine to Tomotherapy and Truebeam dose calculations.

60 APPLIED LIFE SCIENCES↗

Collimator design for a multipinhole brain SPECT insert for MRI

Purpose: Brain single photon emission computed tomography (SPECT) imaging is an important clinical tool, with unique tracers for studying neurological diseases. Nowadays, most commercial SPECT systems are combined with x-ray computed tomography (CT) in so-called SPECT/CT systems to obtain an anatomical background for the functional information. However, while CT images have a high spatial resolution, they have a low soft-tissue contrast, which is an important disadvantage for brain imaging. Magnetic resonance imaging (MRI), on the other hand, has a very high soft-tissue contrast and does not involve extra ionizing radiation. Therefore, the authors designed a brain SPECT insert that can operate inside a clinical MRI. Methods: The authors designed and simulated a compact stationary multipinhole SPECT insert based on digital silicon photomultiplier detector modules, which have shown to be MR-compatible and have an excellent intrinsic resolution (0.5 mm) when combined with a monolithic 2 mm thick LYSO crystal. First, the authors optimized the different parameters of the SPECT system to maximize sensitivity for a given target resolution of 7.2 mm in the center of the field-of-view, given the spatial constraints of the MR system. Second, the authors performed noiseless simulations of two multipinhole configurations to evaluate sampling and reconstructed resolution. Finally, the authors performed Monte Carlo simulations and compared the SPECT insert with a clinical system with ultrahigh-resolution (UHR) fan beam collimators, based on contrast-to-noise ratio and a visual comparison of a Hoffman phantom with a 9 mm cold lesion. Results: The optimization resulted in a stationary multipinhole system with a collimator radius of 150.2 mm and a detector radius of 172.67 mm, which corresponds to four rings of 34 diSPM detector modules. This allows the authors to include eight rings of 24 pinholes, which results in a system volume sensitivity of 395 cps/MBq. Noiseless simulations show sufficient axial sampling (in a Defrise phantom) and a reconstructed resolution of 5.0 mm (in a cold-rod phantom). The authors compared the 24-pinhole setup with a 34-pinhole system (with the same detector radius but a collimator radius of 156.63 mm) and found that 34 pinholes result in better uniformity but a worse reconstruction of the cold-rod phantom. The authors also compared the 24-pinhole system with a clinical triple-head UHR fan beam system based on contrast-to-noise ratio and found that the 24-pinhole setup performs better for the 6 mm hot and the 16 mm cold lesions and worse for the 8 and 10 mm hot lesions. Finally, the authors reconstructed noisy projection data of a Hoffman phantom with a 9 mm cold lesion and found that the lesion was slightly better visible on the multipinhole image compared to the fan beam image. Conclusions: The authors have optimized a stationary multipinhole SPECT insert for MRI and showed the feasibility of doing brain SPECT imaging inside a MRI with an image quality similar to the best clinical SPECT systems available.

60 APPLIED LIFE SCIENCES↗

SU-F-T-529: Dosimetric Investigation of a Rotating Gamma Ray System for ImagedGuided Modulated Arc Radiotherapy

Purpose: Because of their effectiveness and efficiency, rotational arc radiotherapy (MAT) techniques have been developed on both specialty machines such as Tomotherapy and conventional linear accelerators. This work investigates a new rotating Gamma therapy system for image guided MAT and SBRT of intra/extracranial tumors. Methods: The CyberMAT system (Cyber Medical Corp., China) consists of a ring gantry with a gamma source (effective source size 1cm and 1.7cm respectively), a 120-leaf MLC, a kV CBCT and an EPID. The treatment couch provides 6-degrees-of-freedom motion compensation and the kV CBCT system has a spatial resolution of 0.4mm for target localization. The maximum dose rate is >4.0 Gy/min and the maximum field size is 40cm × 40cm. Monte Carlo simulations were used to compute dose distributions and compare with measurements. A retrospective study of 125 previously treated SBRT patients was performed to evaluate the dosimetric characteristics of CyberMAT in comparison with existing VMAT systems. Results: Monte Carlo results confirmed the CyberMAT design parameters including output factors and 3D dose distributions. Its beam penumbra is 5mm to 10mm for field sizes 1cm to 10cm, respectively and its isocenter accuracy is <0.5mm. Compared to the 6 MV photons of Tomotherapy and conventional linacs, Cobalt beams produce lower-energy secondary electrons that exhibit better dose properties in low-density lung tissues. Cobalt beams are ideal for peripheral lung tumors with half-arc arrangements to spare the opposite lung and other critical structures. Superior dose distributions have been obtained for brain, head and neck, breast, spine and lung tumors with half/full arc arrangements. Conclusion: Because of the unique dosimetric properties of Cobalt sources and its accurate stereotaxy/dose delivery CyberMAT is ideally suited for image guided MAT and SBRT. Full-arc arrangements are superior for brain and H&N treatments while half-arc arrangements produce best dose distributions for thoracic tumors.

60 APPLIED LIFE SCIENCES↗