Results for “NSF” — Page 8

DOE OSTI2014

SU-E-T-303: Spot Scanning Dose Delivery with Rapid Cycling Proton Beams From RCMS

Purpose: A rapid cycling proton beam has several distinct characteristics superior to a slow extraction synchrotron: The beam energy and energy spread, beam intensity and spot size can be varied spot by spot. The feasibility of using a spot scanning beam from a rapidc-ycling-medical-synchrotron (RCMS) at 10 Hz repetition frequency is investigated in this study for its application in proton therapy. Methods: The versatility of the beam is illustrated by two examples in water phantoms: (1) a cylindrical PTV irradiated by a single field and (2) a spherical PTV irradiated by two parallel opposed fields. A uniform dose distribution is to be delivered to the volumes. Geant4 Monte Carlo code is used to validate the dose distributions in each example. Results: Transverse algorithms are developed to produce uniform distributions in each transverseplane in the two examples with a cylindrical and a spherical PTV respectively. Longitudinally, different proton energies are used in successive transverse planes toproduce the SOBP required to cover the PTVs. In general, uniformity of dosedistribution within 3% is obtained for the cylinder and 3.5% for the sphere. The transversealgorithms requires only few hundred beam spots for each plane The algorithms may beapplied to larger volumes by increasing the intensity spot by spot for the same deliverytime of the same dose. The treatment time can be shorter than 1 minute for any fieldconfiguration and tumor shape. Conclusion: The unique beam characteristics of a spot scanning beam from a RCMS at 10 Hz repetitionfrequency are used to design transverse and longitudinal algorithms to produce uniformdistribution for any arbitrary shape and size of targets. The proposed spot scanning beam ismore versatile than existing spot scanning beams in proton therapy with better beamcontrol and lower neutron dose. This work is supported in part by grants from the US Department of Energy under contract; DE-FG02-12ER41800 and the National Science Foundation NSF PHY-1205431.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2014

MO-G-BRF-07: Anomalously Fast Diffusion of Carbon Nanotubes Carriers in 3D Tissue Model

Purpose: We aim to investigate and understand diffusion process of carbon nanotubes (CNTs) and other nanoscale particles in tissue and organs. Methods: In this research, we utilized a 3D model tissue of hepatocellular carcinoma (HCC)cultured in inverted colloidal crystal (ICC) scaffolds to compare the diffusivity of CNTs with small molecules such as Rhodamine and FITC in vitro, and further investigated the transportation of CNTs with and without targeting ligand, TGFβ1. The real-time permeation profiles of CNTs in HCC tissue model with high temporal and spatial resolution was demonstrated by using standard confocal microscopy. Quantitative analysis of the diffusion process in 3D was carried out using luminescence intensity in a series of Z-stack images obtained for different time points of the diffusion process after initial addition of CNTs or small molecules to the cell culture and the image data was analyzed by software ImageJ and Mathematica. Results: CNTs display diffusion rate in model tissues substantially faster than small molecules of the similar charge such as FITC, and the diffusion rate of CNTs are significantly enhanced with targeting ligand, TGFβ1. Conclusion: In terms of the advantages of in-vitro model, we were able to have access to measuring the rate of CNT penetration at designed conditions with variable parameters. And the findings by using this model, changed our understanding about advantages of CNTs as nanoscale drug carriers and provides design principles for making new drug carriers for both treatment and diagnostics. Additionally the fast diffusion opens the discussion of the best possible drug carriers to reach deep parts of cancerous tissues, which is often a prerequisite for successful cancer treatment. This work was supported by the Center for Photonic and Multiscale Nanomaterials funded by National Science Foundation Materials Research Science and Engineering Center program DMR 1120923. The work was also partially supported by NSF grant ECS-0601345; EFRI-BSBA 0938019; CBET 0933384; CBET 0932823; CBET 1036672, AFOSR MURI 444286-P061716 and NIH 1R21CA121841-01A2.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

TU-F-18C-05: Evaluation of a Method to Calculate Patient-Oriented MGD Coefficients Using Estimates of Glandular Tissue Distribution

Purpose: Evaluate mammographic mean glandular dose (MGD) coefficients for particular known tissue distributions using a novel formalism that incorporates the effect of the heterogeneous glandular tissue distribution, by comparing them with MGD coefficients derived from the corresponding anthropomorphic computer breast phantom. Methods: MGD coefficients were obtained using MCNP5 simulations with the currently used homogeneous assumption and the heterogeneously-layered breast (HLB) geometry and compared against those from the computer phantom (ground truth). The tissue distribution for the HLB geometry was estimated using glandularity map image pairs corrected for the presence of non-glandular fibrous tissue. Heterogeneity of tissue distribution was quantified using the glandular tissue distribution index, Idist. The phantom had 5 cm compressed breast thickness (MLO and CC views) and 29% whole breast glandular percentage. Results: Differences as high as 116% were found between the MGD coefficients with the homogeneous breast core assumption and those from the corresponding ground truth. Higher differences were found for cases with more heterogeneous distribution of glandular tissue. The Idist for all cases was in the [−0.8{sup −}+0.3] range. The use of the methods presented in this work results in better agreement with ground truth with an improvement as high as 105 pp. The decrease in difference across all phantom cases was in the [9{sup −}105] pp range, dependent on the distribution of glandular tissue and was larger for the cases with the highest Idist values. Conclusion: Our results suggest that the use of corrected glandularity image pairs, as well as the HLB geometry, improves the estimates of MGD conversion coefficients by accounting for the distribution of glandular tissue within the breast. The accuracy of this approach with respect to ground truth is highly dependent on the particular glandular tissue distribution studied. Predrag Bakic discloses current funding from NIH, NSF, and DoD, former funding from Real Time Tomography, LLC and a current research collaboration with Barco and Hologic.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

TH-A-9A-06: Inverse Planning of Gamma Knife Radiosurgery Using Natural Physical Models

Purpose: Treatment-planning systems rely on computer intensive optimization algorithms in order to provide radiation dose localization. We are investigating a new optimization paradigm based on natural physical modeling and simulations, which tend to evolve in time and find the minimum energy state. In our research, we aim to match physical models with radiation therapy inverse planning problems, where the minimum energy state coincides with the optimal solution. As a prototype study, we have modeled the inverse planning of Gamma Knife radiosurgery using the dynamic interactions between charged particles and demonstrate the potential of the paradigm. Methods: For inverse planning of Gamma Knife radiosurgery: (1) positive charges are uniformly placed on the surface of tumors and critical structures. (2) The Gamma Knife dose kernels of 4mm, 8mm and 16mm radii are modeled as geometric objects with variable charges. (3) The number of shots per each kernel radii is obtained by solving a constrained integer-linear problem. (4) The shots are placed into the tumor volume and move under electrostatic forces. The simulation is performed until internal forces are zero or maximum iterations are reached. (5) Finally, non-negative least squares (NNLS) is used to calculate the beam-on times for each shot. Results: A 3D C-shaped tumor surrounding a spherical critical structure was used for testing the new optimization paradigm. These tests showed that charges spread out evenly covering the tumor while keeping distance from the critical structure, resulting in a high quality plan. Conclusion: We have developed a new paradigm for dose optimization based on the simulation of physical models. As prototype studies, we applied electrostatic models to Gamma Knife radiosurgery and demonstrated the potential of the new paradigm. Further research and fine-tuning of the model are underway. NSF CBET-0853157.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-D-BRB-06: Treating Glioblastoma Multiforme (GBM) as a Chronic Disease: Implication of Temporal-Spatial Dose Fractionation Optimization Including Cancer Stem Cell Dynamics

Purpose: To explore the feasibility of improving GBM treatment outcome with temporal-spatial dose optimization of an ordinary differential equation (ODE) that models the differentiation and distinct radiosensitivity between cancer stem cells (CSC) and differentiated cancer cells (DCC). Methods: The ODE was formulated into a non-convex optimization problem with the objective to minimize remaining total cancer cells 500 days from the onset of radiotherapy when the total cancer cell number was 3.5×10{sup 7}, while maintaining normal tissue biological effective dose (BED) of 100Gy resulted from standard prescription of 2Gyx30. Assuming spatially separated CSC and DCC, optimization was also performed to explore the potential benefit from dose-painting the two compartments. Dose escalation to a sub-cell-population in the GTV was also examined assuming that a 2 cm margin around the GTV allows sufficient dose drop-off to 100Gy BED. The recurrence time was determined as the time at which the total cancer cell number regrows to 10{sup 9} cells. Results: The recurrence time with variable fractional doses administered once per week, bi-week and month for one year were found to be 615, 593 and 570 days, superior to the standard-prescription recurrence time of 418 days. The optimal dose-fraction size progression for both uniform and dose-painting to the tumor is low and relatively constant in the beginning and gradually increases to more aggressive fractions at end of the treatment course. Dose escalation to BED of 200Gy to the whole tumor alongside with protracted weekly treatment was found to further delay recurrence to 733 days. Dose-painting of 200 and 500Gy BED to CSC on a year-long weekly schedule further extended recurrence to 736 and 1076 days, respectively. Conclusion: GBM treatment outcome can possibly be improved with a chronic treatment approach. Further dose escalation to the entire tumor or CSC targeted killing is needed to achieve total tumor control. This work is supported by the NSF Graduate Research Fellowship (DGE-1144087)

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-I-90: Characterizing Small Animal Lung Properties Using Speckle Observed with An In-Line X-Ray Phase Contrast Benchtop System

Purpose: We demonstrate a novel X-ray phase-contrast (XPC) method for lung imaging representing a paradigm shift in the way small animal functional imaging is performed. In our method, information regarding airway microstructure that is encoded within speckle texture of a single XPC radiograph is decoded to produce 2D parametric images that will spatially resolve changes in lung properties such as microstructure sizes and air volumes. Such information cannot be derived from conventional lung radiography or any other 2D imaging modality. By computing these images at different points within a breathing cycle, dynamic functional imaging will be readily achieved without the need for tomography. Methods: XPC mouse lung radiographs acquired in situ with an in-line X-ray phase contrast benchtop system. The lung air volume is varied and controlled with a small animal ventilator. XPC radiographs will be acquired for various lung air volume levels representing different phases of the respiratory cycle. Similar data will be acquired of microsphere-based lung phantoms containing hollow glass spheres with known distributions of diameters. Image texture analysis is applied to the data to investigate relationships between texture characteristics and airspace/microsphere physical properties. Results: Correlations between Fourier-based texture descriptors (FBTDs) and regional lung air volume indicate that the texture features in 2D radiographs reveal information on 3D properties of the lungs. For example, we find for a 350 × 350 πm2 lung ROI a linear relationship between injected air volume and FBTD value with slope and intercept of 8.9×10{sup 5} and 7.5, respectively. Conclusion: We demonstrate specific image texture measures related to lung speckle features are correlated with physical characteristics of refracting elements (i.e. lung air spaces). Furthermore, we present results indicating the feasibility of implementing the technique with a simple imaging system design, short exposures, and low dose which provides potential for widespread use in laboratory settings for in vivo studies. This research was supported in part by NSF Award CBET1263988.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-516: Investigation of a Novel Radiochromic Radiation Reporting System Utilizing the Reduction of Ferric Ion

Purpose To introduce and characterize a new “reverse-Fricke” radiation reporting system utilizing the reduction of ferric ions (Fe{sup 3+}) to ferrous ions (Fe{sup 2+}). Methods Two formulations of the radiochromic reporting system, referred to as A and B, were prepared for investigation. Formulation-A consisted of 14 mM 1,10-phenanthroline, 42 mM ethanol, and 57 mM ammonium ferric oxalate in water. Formulation-B consisted of 27 mM 1,10-phenanthroline, 42 mM ethanol, and 28 mM ammonium ferric oxalate in water. Solutions were prepared immediately prior to irradiation with a Cobalt-60 unit with radiation doses of 0, 1, 5, 10, 15, 20, and 25 Gy. The change in optical density over the visible range of 450–650 nm was measured using a spectrophotometer immediately after irradiation. The effective atomic numbers of the formulations were calculated using Mayneord’s formula. Results Ionizing radiation energy absorbed in the solutions causes the reduction of ferric ions (Fe{sup 3+}) into ferrous ions (Fe{sup 2+}), which then forms a 1:3 red colored complex with 1,10-phenanthroline ([(C{sub 1} {sub 2}H{sub 8}N{sup 2}){sub 3}Fe]{sup 2+}) that can be measured spectrophotometrically. The absorbance spectra of the resulting complex displayed a peak maximum at 512 nm with a greater change in absorbance for Formulation-B after receiving comparable radiation doses. The change in absorbance relative to dose exhibited a linear response up to 25 Gy for both Formulation-A (R{sup 2} = 0.98) and Formulation-B (R{sup 2} = 0.97). The novel formulations were also nearly water equivalent (Zeff = 7.42) with effective atomic numbers of 7.65 and 7.52 and mass densities within 0.2% of water. Conclusion Both formulations displayed visible Fe{sup 2+} complex formation with 1,10-phenanthroline after irradiation using a Cobalt-60 source. The higher sensitivity measured for Formulation-B is attributed to the increase in 1,10-phenanthroline concentration and the increase in the 1,10-phenanthroline to ammonium ferric oxalate ratio. Further investigation of this radiation reporting system in a 3D matrix material is encouraged. NSF GRFP Grant Award #LH-102SPS.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-CD-304-05: 4Ï€ Non-Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation

Purpose: To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non-coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing. Methods: A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients. Results: Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion. Conclusion: The mathematical modeling utilized in 4π is accurate to create and guide highly complex non-coplanar IMRT treatments that consistently and significantly outperform human-operator-created plans. Deliverability of such plans is clinically demonstrated. This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE-1144087.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-F-CAMPUS-J-05: Effect of Uncorrelated Noise Texture On Computed Tomography Quantitative Image Features

Purpose: To investigate the relationship between quantitative image features (i.e. radiomics) and statistical fluctuations (i.e. electronic noise) in clinical Computed Tomography (CT) using the standardized American College of Radiology (ACR) CT accreditation phantom and patient images. Methods: Three levels of uncorrelated Gaussian noise were added to CT images of phantom and patients (20) acquired in static mode and respiratory tracking mode. We calculated the noise-power spectrum (NPS) of the original CT images of the phantom, and of the phantom images with added Gaussian noise with means of 50, 80, and 120 HU. Concurrently, on patient images (original and noise-added images), image features were calculated: 14 shape, 19 intensity (1st order statistics from intensity volume histograms), 18 GLCM features (2nd order statistics from grey level co-occurrence matrices) and 11 RLM features (2nd order statistics from run-length matrices). These features provide the underlying structural information of the images. GLCM (size 128x128) was calculated with a step size of 1 voxel in 13 directions and averaged. RLM feature calculation was performed in 13 directions with grey levels binning into 128 levels. Results: Adding the electronic noise to the images modified the quality of the NPS, shifting the noise from mostly correlated to mostly uncorrelated voxels. The dramatic increase in noise texture did not affect image structure/contours significantly for patient images. However, it did affect the image features and textures significantly as demonstrated by GLCM differences. Conclusion: Image features are sensitive to acquisition factors (simulated by adding uncorrelated Gaussian noise). We speculate that image features will be more difficult to detect in the presence of electronic noise (an uncorrelated noise contributor) or, for that matter, any other highly correlated image noise. This work focuses on the effect of electronic, uncorrelated, noise and future work shall examine the influence of changes in quantum noise on the features. J. Oliver was supported by NSF FGLSAMP BD award HRD #1139850 and the McKnight Doctoral Fellowship.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-127: Charged Particle Transport in Condensed Media

Purpose: Provide quality interaction cross sections for charged particle Monte Carlo (MC) track structure codes and evaluate low energy electron transport in condensed media. Methods: MC methods and codes are often used to model or simulate charged particle radiation transport in matter. Detailed (or event-by-event) track structure simulations are of special interest for the modeling of the physical and chemical stages of radiation action with matter and the initial radiation damage to biological systems. They require reliable interaction cross sections of all radiation qualities considered (e.g., electrons, protons, alpha particles, light and heavy ions) with the target material under consideration, mainly in the condensed phase, including liquids and solids. Interaction cross sections are calculated using the dielectric formalism, a mixture of first principles, theoretical modeling and experimental information for bulk and surface transport and implemented into MC track structure codes. Secondary electron emission yields from amorphous solid water (ASW) and thin metal foils (copper and gold) after fast proton impact are simulated and measured experimentally. Results: After considering different transport models for bulk and surface transport and a careful modeling of the experimental geometry, simulated secondary electron emission yields follow the trends of experimental data well. Furthermore, yields for electron emissions below 50 eV are sensitive to differential elastic scattering cross sections. Conclusion: Low-energy electron transport in condensed media is still a challenge for detailed track structure simulation codes. Interaction cross-sections, transport models, and target geometry need to be considered adequately. The research was funded in part by NSF Major Research Instrumentation Program 2009, Award Number: 0923270 and by NIH/NCI R01 CA93351.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

MO-FG-209-02: Development of a Virtual Breast Phantom From a Multi-Modality Perspective

This symposium will review recent advances in the simulation methods for evaluation of novel breast imaging systems – the subject of AAPM Task Group TG234. Our focus will be on the various approaches to development and validation of software anthropomorphic phantoms and their use in the statistical assessment of novel imaging systems using such phantoms along with computational models for the x-ray image formation process. Due to the dynamic development and complex design of modern medical imaging systems, the simulation of anatomical structures, image acquisition modalities, and the image perception and analysis offers substantial benefits of reduced cost, duration, and radiation exposure, as well as the known ground-truth and wide variability in simulated anatomies. For these reasons, Virtual Clinical Trials (VCTs) have been increasingly accepted as a viable tool for preclinical assessment of x-ray and other breast imaging methods. Activities of TG234 have encompassed the optimization of protocols for simulation studies, including phantom specifications, the simulated data representation, models of the imaging process, and statistical assessment of simulated images. The symposium will discuss the state-of-the-science of VCTs for novel breast imaging systems, emphasizing recent developments and future directions. Presentations will discuss virtual phantoms for intermodality breast imaging performance comparisons, extension of the breast anatomy simulation to the cellular level, optimized integration of the simulated imaging chain, and the novel directions in the observer models design. Learning Objectives: Review novel results in developing and applying virtual phantoms for inter-modality breast imaging performance comparisons; Discuss the efforts to extend the computer simulation of breast anatomy and pathology to the cellular level; Summarize the state of the science in optimized integration of modules in the simulated imaging chain; Compare novel directions in the design of observer models for task based validation of imaging systems. PB: Research funding support from the NIH, NSF, and Komen for the Cure; NIH funded collaboration with Barco, Inc. and Hologic, Inc.; Consultant to Delaware State Univ. and NCCPM, UK. AA: Employed at Barco Healthcare.; P. Bakic, NIH: (NIGMS P20 #GM103446, NCI R01 #CA154444); M. Das, NIH Research grants.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

MO-FG-209-05: Towards a Feature-Based Anthropomorphic Model Observer

This symposium will review recent advances in the simulation methods for evaluation of novel breast imaging systems – the subject of AAPM Task Group TG234. Our focus will be on the various approaches to development and validation of software anthropomorphic phantoms and their use in the statistical assessment of novel imaging systems using such phantoms along with computational models for the x-ray image formation process. Due to the dynamic development and complex design of modern medical imaging systems, the simulation of anatomical structures, image acquisition modalities, and the image perception and analysis offers substantial benefits of reduced cost, duration, and radiation exposure, as well as the known ground-truth and wide variability in simulated anatomies. For these reasons, Virtual Clinical Trials (VCTs) have been increasingly accepted as a viable tool for preclinical assessment of x-ray and other breast imaging methods. Activities of TG234 have encompassed the optimization of protocols for simulation studies, including phantom specifications, the simulated data representation, models of the imaging process, and statistical assessment of simulated images. The symposium will discuss the state-of-the-science of VCTs for novel breast imaging systems, emphasizing recent developments and future directions. Presentations will discuss virtual phantoms for intermodality breast imaging performance comparisons, extension of the breast anatomy simulation to the cellular level, optimized integration of the simulated imaging chain, and the novel directions in the observer models design. Learning Objectives: Review novel results in developing and applying virtual phantoms for inter-modality breast imaging performance comparisons; Discuss the efforts to extend the computer simulation of breast anatomy and pathology to the cellular level; Summarize the state of the science in optimized integration of modules in the simulated imaging chain; Compare novel directions in the design of observer models for task based validation of imaging systems. PB: Research funding support from the NIH, NSF, and Komen for the Cure; NIH funded collaboration with Barco, Inc. and Hologic, Inc.; Consultant to Delaware State Univ. and NCCPM, UK. AA: Employed at Barco Healthcare.; P. Bakic, NIH: (NIGMS P20 #GM103446, NCI R01 #CA154444); M. Das, NIH Research grants.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-00: Research Opportunities with Digital Linear Accelerators

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-01: Trajectory Modulated Arc Therapy: Application to Partial Breast Irradiation

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-02: ET-Reloaded

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-03: 4n Radiotherapy

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-04: Quality Assurance for Advanced Digital Linac Implementations

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRB-05: Using a Research Real-Time Control Interface to Go Beyond Dynamic MLC Tracking

Current state-of-the art digital C-arm medical linear accelerators are capable of delivering radiation treatments with high level of automation, which affords coordinated motions of gantry, couch, and multileaf collimator (MLC) with dose rate modulations. The new machine capacity has shown the potential to bring substantially improved radiation dosimetry and/or delivery efficiency to many challenging diseases. Combining an integrated beam orientation optimization algorithm with automated machine navigation, markedly improved dose conformity has been achieved using 4ρ therapy. Trajectory modulated radiation therapy (TMAT) can be used to deliver highly conformal dose to partial breast or to carve complex dose distribution for therapy involving extended volumes such as total marrow and total lymph node treatment. Dynamic electron arc radiotherapy (DEAR) not only overcomes the deficiencies of conventional electron therapy in dose conformity and homogeneity but also achieves so without patient-specific shields. The combination of MLC and couch tracking provides improved motion management of thoracic and abdominal tumors. A substantial body of work has been done in these technological advances for clinical translation. The proposed symposium will provide a timely review of these exciting opportunities. Learning Objectives: Recognize the potential of using digitally controlled linacs for clinically significant improvements in delivered dose distributions for various treatment sites. Identify existing approaches to treatment planning, optimization and delivery for treatment techniques utilizing the advanced functions of digital linacs and venues for further development and improvement. Understand methods for testing and validating delivery system performance. Identify tools available on current delivery systems for implementation and control for such treatments. Obtain the update in clinical applications, trials and regulatory approval. K. Sheng, NIH U19AI067769, NIH R43CA183390, NIH R01CA188300, Varian Medical Systems V. Yu, Varian Medical Systems, AAPM Summer Undergraduate Fellowship, NSF graduate fellowship S. Nill, Elekta AB. Cancer Research UK under Programme C33589/A19727, NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research.

60 APPLIED LIFE SCIENCES↗