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At least 163 records · Page 9
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

Implementation of spot scanning dose optimization and dose calculation for helium ions in Hyperion

Purpose: Helium ions ({sup 4}He) may supplement current particle beam therapy strategies as they possess advantages in physical dose distribution over protons. To assess potential clinical advantages, a dose calculation module accounting for relative biological effectiveness (RBE) was developed and integrated into the treatment planning system Hyperion. Methods: Current knowledge on RBE of {sup 4}He together with linear energy transfer considerations motivated an empirical depth-dependent “zonal” RBE model. In the plateau region, a RBE of 1.0 was assumed, followed by an increasing RBE up to 2.8 at the Bragg-peak region, which was then kept constant over the fragmentation tail. To account for a variable proton RBE, the same model concept was also applied to protons with a maximum RBE of 1.6. Both RBE models were added to a previously developed pencil beam algorithm for physical dose calculation and included into the treatment planning system Hyperion. The implementation was validated against Monte Carlo simulations within a water phantom using γ-index evaluation. The potential benefits of {sup 4}He based treatment plans were explored in a preliminary treatment planning comparison (against protons) for four treatment sites, i.e., a prostate, a base-of-skull, a pediatric, and a head-and-neck tumor case. Separate treatment plans taking into account physical dose calculation only or using biological modeling were created for protons and {sup 4}He. Results: Comparison of Monte Carlo and Hyperion calculated doses resulted in a γ{sub mean} of 0.3, with 3.4% of the values above 1 and γ{sub 1%} of 1.5 and better. Treatment plan evaluation showed comparable planning target volume coverage for both particles, with slightly increased coverage for {sup 4}He. Organ at risk (OAR) doses were generally reduced using {sup 4}He, some by more than to 30%. Improvements of {sup 4}He over protons were more pronounced for treatment plans taking biological effects into account. All OAR doses were within tolerances specified in the QUANTEC report. Conclusions: The biological {sup 4}He model proposed above is a first approach matching biological data published so far. The advantage of {sup 4}He seems to lie in the reduction of dose to surrounding tissue and to OARs. Nevertheless, additional biological experiments and treatment planning studies with larger patient numbers and more tumor indications are necessary to study the possible benefits of helium ion beam therapy in detail.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-IeP3-05: Effects of Image Receptor Technology and Dose Reduction Software On Radiation Dose Estimates for Fluoroscopically-Guided Interventional (FGI) Procedures

Purpose: To investigate the effects of image receptor technology and dose reduction software on radiation dose estimates for most frequently performed fluoroscopically-guided interventional (FGI) procedures at a tertiary health care center. Methods: IRB approval was obtained for retrospective analysis of FGI procedures performed in the interventional radiology suites between January-2011 and December-2015. This included procedures performed using image-intensifier (II) based systems which were subsequently replaced, flat-panel-detector (FPD) based systems which were later upgraded with ClarityIQ dose reduction software (Philips Healthcare) and relatively new FPD system already equipped with ClarityIQ. Post procedure, technologists entered system-reported cumulative air kerma (CAK) and kerma-area product (KAP; only KAP for II based systems) in RIS; these values were analyzed. Data pre-processing included correcting typographical errors and cross-verifying CAK and KAP. The most frequent high and low dose FGI procedures were identified and corresponding CAK and KAP values were compared. Results: Out of 27,251 procedures within this time period, most frequent high and low dose procedures were chemo/immuno-embolization (n=1967) and abscess drainage (n=1821). Mean KAP for embolization and abscess drainage procedures were 260,657, 310,304 and 94,908 mGycm{sup 2}, and 14,497, 15,040 and 6307 mGycm{sup 2} using II-, FPD- and FPD with ClarityIQ- based systems, respectively. Statistically significant differences were observed in KAP values for embolization procedures with respect to different systems but for abscess drainage procedures significant differences were only noted between systems with FPD and FPD with ClarityIQ (p<0.05). Mean CAK reduced significantly from 823 to 308 mGy and from 43 to 21 mGy for embolization and abscess drainage procedures, respectively, in transitioning to FPD systems with ClarityIQ (p<0.05). Conclusion: While transitioning from II- to FPD- based systems was not associated with dose reduction for the most frequently performed FGI procedures, substantial dose reduction was noted with relatively newer systems and dose reduction software.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

MO-FG-BRA-05: Dosimetric and Radiobiological Validation of Respiratory Gating in Conventional and Hypofractionated Radiotherapy of the Lung: Effect of Dose, Dose Rate, Gating Window and Breathing Pattern

Purpose: to evaluate the dosimetric and radiobiological consequences from having different gating windows, dose rates, and breathing patterns in gated VMAT lung radiotherapy. Methods: A novel 3D-printed moving phantom with central high and peripheral low tracer uptake regions was 4D FDG-PET/CT-scanned using ideal, patient-specific regular, and irregular breathing patterns. A scan of the stationary phantom was obtained as a reference. Target volumes corresponding to different uptake regions were delineated. Simultaneous integrated boost (SIB) 6 MV VMAT plans were produced for conventional and hypofractionated radiotherapy, using 30–70 and 100% cycle gating scenarios. Prescribed doses were 200 cGy with SIB to 240 cGy to high uptake volume for conventional, and 800 with SIB to 900 cGy for hypofractionated plans. Dose rates of 600 MU/min (conventional and hypofractionated) and flattening filter free 1400 MU/min (hypofractionated) were used. Ion chamber measurements were performed to verify delivered doses. Vials with A549 cells placed in locations matching ion chamber measurements were irradiated using the same plans to measure clonogenic survival. Differences in survival for the different doses, dose rates, gating windows, and breathing patterns were analyzed. Results: Ion chamber measurements agreed within 3% of the planned dose, for all locations, breathing patterns and gating windows. Cell survival depended on dose alone, and not on gating window, breathing pattern, MU rate, or delivery time. The surviving fraction varied from approximately 40% at 2Gy to 1% for 9 Gy and was within statistical uncertainty relative to that observed for the stationary phantom. Conclusions: Use of gated VMAT in PET-driven SIB radiotherapy was validated using ion chamber measurements and cell survival assays for conventional and hypofractionated radiotherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-CD-202-10: Tumor Metabolic Control Probability & Dose Response Mapping for Adaptive Dose Painting by Number

Purpose: Adaptive dose-painting-by-number (DPbN) requires a dose-response-mapping (DRM) obtained early in the treatment course. To obtain DRM, voxel-by-voxel tumor dose response needs to be quantified. Our recent study has demonstrated that voxel-by-voxel radio-sensitivity of patient tumor can be determined using tumor-metabolic-ratio measured early during the treatment using FDG-PET images. In this study, the measurements were utilized to construct tumor metabolic control probability (TMCP) and DRM for DPbN. Methods: FDG-PET/CT images of 18 HN cancer patients obtained pre- and weekly during the treatment were used. Spatial parametric images of tumor-metabolic-ratio (dSUV) were constructed following voxel-by-voxel deformable image registration. Each voxel value in dSUV was a function of baseline SUV and delivered dose. Utilizing all values of dSUV in the controlled tumor group at the last treatment week, a cut-off function between the baseline SUV and dSUV was formed, and applied in early treatment days on dSUV of all tumors to model the TMCP. At the treatment week k, TMCP was constructed with respect to the tumor voxel dSUV appeared at the week using the maximum likelihood estimation for all dose levels, and used for DRM construction. Results: TMCPs estimated in the week 2 & 3 have D{sub 50}=11.1∼47.6Gy; γ{sub 50}=0.55∼0.92 respectively with respect to dSUV=0.3∼1.2. The corresponding DRM between tumor voxel dSUV and the expected treatment dose has sigmoid shape. The expected treatment dose are 26∼40Gy (for 95% TMCP) for high sensitive tumor voxels with dSUV=0.3∼0.5; and 65∼110Gy for low sensitive tumor voxels with the dSUV>1.0 depending on the time of the estimation. Conclusion: TMCP can be constructed voxel-by-voxel in human tumor using multiple FDG-PET imaging obtained in early treatment days. TMCP provides a potential quantitative objective of tumor DRM for DPbN to plan the best dose, escalate or de-escalate, in tumor adaptively based on its own radio-sensitivity.

60 APPLIED LIFE SCIENCES↗
NASA NTRSDate not supplied

Dose Error Correction Using Simulation Extrapolation for Community Noise Dose-Response Modeling

The objective of this work is to provide a framework to account and correct for dose error in dose-response modeling due to measurement uncertainty. Error in noise measurements, especially in the case of limited monitoring locations in a community, can lead to an attenuation or misestimation of parameters in dose-response models. This error can result in overpredicted annoyance at lower doses and underpredicted annoyance at higher doses. Simulated data in the present work are based on previous NASA community studies and incorporate a notional design for future studies with the X-59 aircraft. Several populations of different annoyance response sensitivities are included. Simulation extrapolation (SIMEX, Cook and Stefanski 1994) is used to correct for the dose error in a simple, fully pooled logistic regression. Results indicate the negative impact of attenuation is greatly diminished for all amounts of dose error considered, regardless of a population’s annoyance sensitivity. Therefore, SIMEX can help produce a more accurate dose-response relationship.

SIMEX↗
DOE OSTI2015

Impact of x-ray dose on track formation and data analysis for CR-39-based proton diagnostics

The nuclear track detector CR-39 is used extensively for charged particle diagnosis, in particular proton spectroscopy, at inertial confinement fusion facilities. These detectors can absorb x-ray doses from the experiments in the order of 1–100 Gy, the effects of which are not accounted for in the previous detector calibrations. X-ray dose absorbed in the CR-39 has previously been shown to affect the track size of alpha particles in the detector, primarily due to a measured reduction in the material bulk etch rate [Rojas-Herrera et al., Rev. Sci. Instrum. 86, 033501 (2015)]. Similar to the previous findings for alpha particles, protons with energies in the range 0.5–9.1 MeV are shown to produce tracks that are systematically smaller as a function of the absorbed x-ray dose in the CR-39. The reduction of track size due to x-ray dose is found to diminish with time between exposure and etching if the CR-39 is stored at ambient temperature, and complete recovery is observed after two weeks. Lastly, the impact of this effect on the analysis of data from existing CR-39-based proton diagnostics on OMEGA and the National Ignition Facility is evaluated and best practices are proposed for cases in which the effect of x rays is significant.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗
DOE OSTI2014

Independent dose per monitor unit review of eight U.S.A. proton treatment facilities

Purpose: Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Methods: Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Results: Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 N{sub D,w} based method gave results approximately 3% higher than both the ICRU 59 N{sub X} and ICRU 78 (TRS-398) N{sub D,w} based methods. Conclusions: Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 N{sub X} based and ICRU 78 (TRS-398) N{sub D,w} based methods but use of the ICRU 59 N{sub D,w} based method should not be allowed simultaneously with the other two until the difference is resolved.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Analysis Approach and Data Package for Mayak Public Doses: Data Supporting the Calculation of Representative Doses to Members of the Public from Airborne Releases of 131 I at the Mayak Production Association from 1948 through 1972

Historical activities at facilities producing nuclear materials for weapons released radioactivity into the air and water. Past studies in the United States have evaluated the release, atmospheric transport and environmental accumulation of 131 I from the nuclear facilities at Hanford in Washington State and the resulting dose to members of the public (Farris et al. 1994). A multi-year dose reconstruction effort (Mokrov et al. 2004) is also being conducted to produce representative dose estimates for members of the public living near Mayak, Russia, from atmospheric releases of 131 I at the facilities of the Mayak Production Association. The approach to calculating individual doses to members of the public from historical releases of airborne 131 I has the following general steps: • Construct estimates of releases 131 I to the air from production facilities. • Model the transport of 131 I in the air and subsequent deposition on the ground and vegetation. • Model the accumulation of 131 I in soil, water and food products (environmental media). • Calculate the dose for an individual by matching the appropriate lifestyle and consumption data for the individual to the concentrations of 131 I in environmental media at their residence location. A number of computer codes were developed to facilitate the study of airborne 131 I emissions at Hanford. Of particular interest is DESCARTES code that modeled accumulation of 131 I in environmental media (Miley et al. 1994). In addition, the CIDER computer code estimated annual doses to individuals (Eslinger et al. 1994) using the equations and parameters specific to Hanford (Snyder et al. 1994). Several of the computer codes developed to model 131 I releases from Hanford are general enough to be used for other facilities. Additional codes have been developed, including the new individual dose code CiderF (Eslinger and Napier 2013), and applied to historical releases of 131 I from Mayak. This document provides a data package that identifies computer code runs and associated input and output files prepared for the purpose of calculating doses to members of the public from atmospheric releases of 131 I at the Mayak Production Association for the time period 1948 through 1972.

Mayak↗
DOE OSTI2025

Total Effective Dose from Radiologic Emissions from INL Facilities for Calculation of Population Dose for the INL 2024 Annual Site Environmental Report

Total effective radiation dose from airborne releases was calculated using air dispersion modeling performed by the National Oceanic and Atmospheric Administration (NOAA) Idaho Falls Office using their HYSPLIT computer model (Stein et al. 2015; Draxler et al. 2013), and the Dose Multi-Media (DOSEMM) dose assessment model (Rood 2019) . The objective of these calculations was to provide a grid of total effective dose across a model domain that encompasses a 50-mile (80-km) radius from any Idaho National Laboratory (INL) Site source. In addition to INL Site sources, releases from the Radiological and Environmental Sciences Laboratory (RESL) (IF-683) and IF-603 located at the INL Research Center (IRC) within the Idaho Falls city limits were also included. Due to tracking limitations, radionuclides released from IF-611 and IF-603 are modeled as released from IF-603. The dose results will be combined with GIS software to compute a total population dose for the calendar year (CY) 2024 and will be reported in the INL Annual Site Environmental Report (ASER). This report does not cover the population dose calculation and only documents generation of the gridded dose file.

42 - ENGINEERING↗
DOE OSTI2013

Is There a Dose-Response Relationship for Heart Disease With Low-Dose Radiation Therapy?

Purpose: To quantify cardiac radiation therapy (RT) exposure using sensitive measures of cardiac dysfunction; and to correlate dysfunction with heart doses, in the setting of adjuvant RT for left-sided breast cancer. Methods and Materials: On a randomized trial, 32 women with node-positive left-sided breast cancer underwent pre-RT stress single photon emission computed tomography (SPECT-CT) myocardial perfusion scans. Patients received RT to the breast/chest wall and regional lymph nodes to doses of 50 to 52.2 Gy. Repeat SPECT-CT scans were performed 1 year after RT. Perfusion defects (PD), summed stress defects scores (SSS), and ejection fractions (EF) were evaluated. Doses to the heart and coronary arteries were quantified. Results: The mean difference in pre- and post-RT PD was −0.38% ± 3.20% (P=.68), with no clinically significant defects. To assess for subclinical effects, PD were also examined using a 1.5-SD below the normal mean threshold, with a mean difference of 2.53% ± 12.57% (P=.38). The mean differences in SSS and EF before and after RT were 0.78% ± 2.50% (P=.08) and 1.75% ± 7.29% (P=.39), respectively. The average heart Dmean and D95 were 2.82 Gy (range, 1.11-6.06 Gy) and 0.90 Gy (range, 0.13-2.17 Gy), respectively. The average Dmean and D95 to the left anterior descending artery were 7.22 Gy (range, 2.58-18.05 Gy) and 3.22 Gy (range, 1.23-6.86 Gy), respectively. No correlations were found between cardiac doses and changes in PD, SSS, and EF. Conclusions: Using sensitive measures of cardiac function, no clinically significant defects were found after RT, with the average heart Dmean <5 Gy. Although a dose response may exist for measures of cardiac dysfunction at higher doses, no correlation was found in the present study for low doses delivered to cardiac structures and perfusion, SSS, or EF.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-D-BRE-04: Evaluating the Dose Accuracy of a 2D Ion Chamber Array in High Dose Rate Pencil Beam Scanning Proton Beam

Purpose: To evaluate the absolute dose accuracy of the PTW Octavius 729 XDR 2D ion chamber array at a high dose rate pencil beam scanning proton therapy facility. Methods: A set of 18 plans were created in our treatment planning system, each of which comprising a unique combination of field sizes (FS), length of spread out of Bragg peaks (SOBP) and depths. The parameters used were: FS of 5×5cm{sup 2}, 10×10cm{sup 2} and 15×15cm{sup 2}; flat SOBP of 5cm and 10cm; and isocenter depths of 10cm, 15cm and 20cm, which coincides with the center of the SOBP. The 2D array detector was positioned at the machine isocenter and the appropriate amount of solid water was used to match the planned depths of 10, 15 and 20 cm water equivalent depth. Subsequently, we measured the absolute dose at isocenter using a CC04 ion chamber in a 1D water tank. Both 2D array and CC04 were previously cross calibrated. We also collected the MU rates used by our proton machine from the log files. Results: The relative differences between the CC04 and the 2D array can be summarized into two groups, one with 5 cm SOBP and another with 10 cm SOBP. Plotting these datasets against FS shows that the 2D array response for high dose rate fields (FS of 5×5cm{sup 2} and 5cm SOBP) can be up to 2% lower. Similarly, plotting them against isocenter depths reveals the detector's response can be up to 2% lower for higher energy beams (about 200MeV nominal). The MU rate found in the machine log files for 5cm SOBP's were as high as twice the MU rate for the 10cm SOBP. Conclusion: The 2D array dose response showed a dose rate effect in scanning pencil beam delivery, which needs to be corrected to achieve a better dose accuracy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

ITAR: A modified TAR method to determine depth dose distribution for an ophthalmic device that performs kilovoltage x-ray pencil-beam stereotaxy

Purpose: New technology has been developed to treat age-related macular degeneration (AMD) using 100 kVp pencil-beams that enter the patient through the radio-resistant sclera with a depth of interest between 1.6 and 2.6 cm. Measurement of reference and relative dose in a kilovoltage x-ray beam with a 0.42 cm diameter field size and a 15 cm source to axis distance (SAD) is a challenge that is not fully addressed in current guidelines to medical physicists. AAPM's TG-61 gives dosimetry recommendations for low and medium energy x-rays, but not all of them are feasible to follow for this modality. Methods: An investigation was conducted to select appropriate equipment for the application. PTW's Type 34013 Soft X-Ray Chamber (Freiburg, Germany) and CIRS's Plastic Water LR (Norfolk, VA) were found to be the best available options. Attenuation curves were measured with minimal scatter contribution and thus called Low Scatter Tissue Air Ratio (LSTAR). A scatter conversion coefficient (C{sub scat}) was derived through Monte Carlo radiation transport simulation using MCNPX (LANL, Los Alamos, NM) to quantify the difference between a traditional TAR curve and the LSTAR curve. A material conversion coefficient (C{sub mat}) was determined through experimentation to evaluate the difference in attenuation properties between water and Plastic Water LR. Validity of performing direct dosimetry measurements with a source to detector distance other than the treatment distance, and therefore a different field size due to a fixed collimator, was explored. A method—Integrated Tissue Air Ratio (ITAR)—has been developed that isolates each of the three main radiological effects (distance from source, attenuation, and scatter) during measurement, and integrates them to determine the dose rate to the macula during treatment. Results: LSTAR curves were determined to be field size independent within the range explored, indicating that direct dosimetry measurements may be performed with a source to detector distance of 20 cm even though the SAD is 15 cm during treatment. C{sub scat} varied from 1.102 to 1.106 within the range of depths of interest. The experimental variance among repeated measurements of C{sub mat} was larger than depth dependence, so C{sub mat} was estimated as1.019 for all depths of interest. Conclusions: Equipment selection, measurement techniques, and formalism for the determination of dose rate to the macula during stereotaxy for AMD have been determined and are strongly recommended by the authors of this paper to be used by clinical medical physicists.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2017

Hippocampal dose from stereotactic radiosurgery for 4 to 10 brain metastases: Risk factors, feasibility of dose reduction via re-optimization, and patient outcomes

This study aimed to report hippocampal dose from single-fraction stereotactic radiosurgery (SRS) for 4 to 10 brain metastases and determine feasibility of hippocampal-sparing SRS. Patients with 4 to 10 brain metastases receiving single-isocenter, multi-target single-fraction SRS were identified. Hippocampi were contoured using the Radiation Therapy Oncology Group (RTOG) 0933 atlas. RTOG 0933 dose constraints were converted to a biologically effective dose using an alpha/beta of 2 (D{sub 100} 421 cGy, D{sub max} 665 cGy). Number of metastases, total target volume, prescribed dose, and distance of nearest metastasis (dmin) were analyzed as risk factors for exceeding hippocampal constraints. If hippocampi exceeded constraints, the SRS plan was re-optimized. Key dosimetric parameters were compared between original and re-optimized plans. To determine if a single target can exceed constraints, all targets but the closest metastasis were removed from the plan, and dosimetry was compared. Forty plans were identified. Fifteen hippocampi (19%) exceeded constraints in 12 SRS plans. Hippocampal sparing was achieved in 10 of 12 replanned cases (83%). Risk factors associated with exceeding hippocampal constraints were decreasing dmin (24.0 vs 8.0 mm, p = 0.002; odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04 to 1.26) and total target volume (5.46 cm{sup 3}vs 1.98 cm{sup 3}, p = 0.03; OR 1.14, 95% CI 1.00 to 1.32). There was no difference in exceeding constraints for 4 to 5 vs 6 to 10 metastases (27% vs 21%, p = 0.409) or prescribed dose (18 Gy, p = 0.58). For re-optimized plans, there were no significant differences in planning target volume (PTV) coverage (99.6% vs 99.0%, p = 0.17) or conformality index (1.47 vs 1.4, p = 0.78). Six (50%) plans exceeded constraints with a single target. A substantial minority of hippocampi receive high radiation dose from SRS for 4 to 10 brain metastases. Decreasing distance of the closest metastasis and total target volume are associated with exceeding hippocampal constraints. Re-optimizing these plans yielded hippocampal-sparing SRS plans with acceptable dosimetry. Prospective evaluation of the impact of hippocampal dose from SRS on neurocognition merits consideration.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

WE-E-18A-10: Comparison of Patient Dose and Vessel Visibility Between Antiscatter Grid Removal and Lower Angiographic Radiation Dose Settings for Pediatric Imaging: A Preclinical Investigation

Purpose: To define an alternative to antiscatter grid (ASG) removal in angiographic systems which achieves similar patient dose reduction as ASG removal without degrading image quality during pediatric imaging. Methods: This study was approved by the local institution animal care and use committee (IACUC). Six different digital subtraction angiography settings were evaluated that altered the mAs, (100, 70, 50, 35, 25, 17.5% of reference mAs) with and without ASG. Three pigs of 5, 15, and 20 kg (9, 15, and 17 cm abdominal thickness; smaller than a newborn, average 3 yr old, and average 10 year old human abdomen respectively) were imaged using the six dose settings with and without ASG. Image quality was defined as the order of vessel branch that is visible relative to the injected vessel. Five interventional radiologists evaluated all images. Image quality and patient dose were statistically compared using analysis of variance and receiver operating curve (ROC) analysis to define the preferred dose level and use of ASG for a minimum visibility of 2nd or 3rd order branches of vessel visibility. Results: ASG grid removal reduces dose by 26% with reduced image quality. Only with the ASG present can 3rd order branches be visualized; 100% mAs is required for 9 cm pig while 70% mAs is adequate for the larger pigs. 2nd order branches can be visualized with ASG at 17.5% mAs for all three pig sizes. Without the ASG, 50%, 35% and 35% mAs is required for smallest to largest pig. Conclusion: Removing ASG reduces patient dose and image quality. Image quality can be improved with the ASG present while further reducing patient dose if an optimized radiographic technique is used. Rami Nachabe is an employee of Philips Health Care; Keith Strauss is a paid consultant of Philips Health Care.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-30: A Factor for Converting Dose to a Gold Nanoparticle Mixture to a Biologically-Relevant Dose

Purpose: Monte Carlo studies of gold nanoparticle (GNP) dose enhancement on macroscopic scales in radiotherapy have modeled GNPs in tissue as a homogeneous mixture of gold and tissue. Using an explicit model of GNPs randomly positioned in a small volume (1 µm{sup 3}) of tissue, this study aims to quantify the dose to the biologically relevant component of a goldtissue mixture, enabling a conversion from macroscopically-scored dose. Methods: Using the PENELOPE Monte Carlo code with the penEasy package, we modeled a 1 µm{sup 3} volume containing either a tissue-gold mixture or GNPs suspended in ICRU 4-component tissue at various gold concentrations (0, 5, 10, and 15 mg Au/g tissue) and GNP diameters (20, 30, 40, 50 nm). The volume was irradiated with monoenergetic photon and electron beams, ranging from 110 eV to 6 MeV. Interaction forcing was utilized to increase simulation efficiency. Energy deposition was scored in the tissue for each case and was converted to dose. For each scenario, we calculated a conversion factor, the ratio of dose-to-tissue to dose-to-mixture as a function of energy. Results: The conversion factor was plotted as a function of energy for both photons and electrons. For electrons, the conversion factor was relatively unaffected by any of the parameters, including energy, ranging between 0.98–1.02. For photons, the factor was very energy dependent, with a range of 0.49–1.02. The factor was lowest for 10–100 keV photons. The conversion factor generally decreased with increasing GNP concentration and increasing GNP size. Conclusion: With a large variation in the conversion factor with incident energy, dose deposition is dependent on the spectrum incident on a volume. By scoring the energy spectrum in a given volume, one can provide a scenario-specific conversion factor, allowing fast, detailed Monte Carlo simulations without the need for explicit GNP-definition.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-217: Accurate Dose Volume Parameters Calculation for Revealing Rectum Dose-Toxicity Effect Using Deformable Registration in Cervical Cancer Brachytherapy: A Pilot Study

Purpose: To study the feasibility of employing deformable registration methods for accurate rectum dose volume parameters calculation and their potentials in revealing rectum dose-toxicity between complication and non-complication cervical cancer patients with brachytherapy treatment. Method and Materials: Data from 60 patients treated with BT including planning images, treatment plans, and follow-up clinical exam were retrospectively collected. Among them, 12 patients complained about hematochezia were further examined with colonoscopy and scored as Grade 1–3 complication (CP). Meanwhile, another 12 non-complication (NCP) patients were selected as a reference group. To seek for potential gains in rectum toxicity prediction when fractional anatomical deformations are account for, the rectum dose volume parameters D0.1/1/2cc of the selected patients were retrospectively computed by three different approaches: the simple “worstcase scenario” (WS) addition method, an intensity-based deformable image registration (DIR) algorithm-Demons, and a more accurate, recent developed local topology preserved non-rigid point matching algorithm (TOP). Statistical significance of the differences between rectum doses of the CP group and the NCP group were tested by a two-tailed t-test and results were considered to be statistically significant if p < 0.05. Results: For the D0.1cc, no statistical differences are found between the CP and NCP group in all three methods. For the D1cc, dose difference is not detected by the WS method, however, statistical differences between the two groups are observed by both Demons and TOP, and more evident in TOP. For the D2cc, the CP and NCP cases are statistically significance of the difference for all three methods but more pronounced with TOP. Conclusion: In this study, we calculated the rectum D0.1/1/2cc by simple WS addition and two DIR methods and seek for gains in rectum toxicity prediction. The results favor the claim that accurate dose deformation and summation tend to be more sensitive in unveiling the dose-toxicity relationship. This work is supported in part by grant from VARIAN MEDICAL SYSTEMS INC, the National Natural Science Foundation of China (no 81428019 and no 81301940), the Guangdong Natural Science Foundation (2015A030313302)and the 2015 Pearl River S&T Nova Program of Guangzhou (201506010096).

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-130: [18F]-FDG Uptake Dose Response in Lung Correlates Linearly with Proton Therapy Dose

Purpose: Analysis of clinical outcomes in lung cancer patients treated with protons using 18F-FDG uptake in lung as a measure of dose response. Methods: A test case lung cancer patient was selected in an unbiased way. The test patient’s treatment planning and post treatment positron emission tomography (PET) were collected from picture archiving and communication system at the UT M.D. Anderson Cancer Center. Average computerized tomography scan was registered with post PET/CT through both rigid and deformable registrations for selected region of interest (ROI) via VelocityAI imaging informatics software. For the voxels in the ROI, a system that extracts the Standard Uptake Value (SUV) from PET was developed, and the corresponding relative biological effectiveness (RBE) weighted (both variable and constant) dose was computed using the Monte Carlo (MC) methods. The treatment planning system (TPS) dose was also obtained. Using histogram analysis, the voxel average normalized SUV vs. 3 different doses was obtained and linear regression fit was performed. Results: From the registration process, there were some regions that showed significant artifacts near the diaphragm and heart region, which yielded poor r-squared values when the linear regression fit was performed on normalized SUV vs. dose. Excluding these values, TPS fit yielded mean r-squared value of 0.79 (range 0.61–0.95), constant RBE fit yielded 0.79 (range 0.52–0.94), and variable RBE fit yielded 0.80 (range 0.52–0.94). Conclusion: A system that extracts SUV from PET to correlate between normalized SUV and various dose calculations was developed. A linear relation between normalized SUV and all three different doses was found.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

A linear programming model for optimizing HDR brachytherapy dose distributions with respect to mean dose in the DVH-tail

Purpose: Recent research has shown that the optimization model hitherto used in high-dose-rate (HDR) brachytherapy corresponds weakly to the dosimetric indices used to evaluate the quality of a dose distribution. Although alternative models that explicitly include such dosimetric indices have been presented, the inclusion of the dosimetric indices explicitly yields intractable models. The purpose of this paper is to develop a model for optimizing dosimetric indices that is easier to solve than those proposed earlier.Methods: In this paper, the authors present an alternative approach for optimizing dose distributions for HDR brachytherapy where dosimetric indices are taken into account through surrogates based on the conditional value-at-risk concept. This yields a linear optimization model that is easy to solve, and has the advantage that the constraints are easy to interpret and modify to obtain satisfactory dose distributions.Results: The authors show by experimental comparisons, carried out retrospectively for a set of prostate cancer patients, that their proposed model corresponds well with constraining dosimetric indices. All modifications of the parameters in the authors' model yield the expected result. The dose distributions generated are also comparable to those generated by the standard model with respect to the dosimetric indices that are used for evaluating quality.Conclusions: The authors' new model is a viable surrogate to optimizing dosimetric indices and quickly and easily yields high quality dose distributions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗