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Fading study of Harshaw LiF:Mg,Ti thermoluminescence dosimeters exposed to neutron doses

Sensitivity and signal fading were tested in Harshaw LiF:Mg,Ti thermoluminescence dosimeters (TLDs) exposed to neutron and beta/photons doses. A significant difference in the signal fading rate was observed for TLDs exposed to neutrons compared with TLDs exposed to betas. This difference may have been related to differences in glow curves for dosimeters exposed to different beams and to differences in glow curve evolution after exposure. A fading-correction algorithm was developed to correct the cumulative sensitivity + signal fading of TL doses for the fading time t using the formulae: y = 0.147∗exp(-t/4.36) + 0.308∗exp(-t/34.1) + 0.73 for neutrons, and: y = 0.132∗exp(-t/10.72) + 0.174∗exp(-t/31.5) + 0.8 for betas/photons. The formula was validated using the dose recovery test, where the average deviation of fading-corrected doses from delivery doses was within 1%. In conclusion, the proposed fading-correction approaches may significantly improve the accuracy of Harshaw TL dosimetry with LiF:Mg,Ti cards for both neutron and beta/gamma irradiation.

61 RADIATION PROTECTION AND DOSIMETRY↗

An improved Monte Carlo (MC) dose simulation for charged particle cancer therapy

Heavy-particle therapy such as carbon ion therapy are more popular nowadays because of the nature characteristics of charged particle and almost no side effect to patients. An effective treatment is achieved with high precision of dose calculation, in this research work, Geant4 based Monte Carlo simulation method has been used to calculate the radiation transport and dose distribution. The simulation have the same setting with the treatment room in Heavy Ion Medical Accelerator, HIMAC. The carbon ion beam at the isocentric gantry nozzle for the therapeutic energy of 290 MeV/u was simulated, experimental work was carried out in National Institute of Radiological Sciences, NIRS, Chiba, Japan by using the HIMAC to confirm the accuracy and qualities dose distribution by MC methods. The Geant4 based simulated dose distribution were verified with measurements for Bragg peak and spread out Bragg peak (SOBP) respectively. The verification of results shows that the Bragg peak depth-dose and SOBP distributions in simulation has good agreement with measurements. In overall, the study showed that Geant4 based can be fully applied in the heavy-ion therapy field for simulation, further works need to be carry on to refine and improve the Geant4 MC simulations.

61 RADIATION PROTECTION AND DOSIMETRY↗

Study the sensitivity of dose calculation in prism treatment planning system using Monte Carlo simulation of 6 MeV electron beam

Prism is a non-commercial Radiotherapy Treatment Planning System (RTPS) develop by Ira J. Kalet from Washington University. Inhomogeneity factor is included in Prism TPS dose calculation. The aim of this study is to investigate the sensitivity of dose calculation on Prism using Monte Carlo simulation. Phase space source from head linear accelerator (LINAC) for Monte Carlo simulation is implemented. To achieve this aim, Prism dose calculation is compared with EGSnrc Monte Carlo simulation. Percentage depth dose (PDD) and R50 from both calculations are observed. BEAMnrc is simulated electron transport in LINAC head and produced phase space file. This file is used as DOSXYZnrc input to simulated electron transport in phantom. This study is started with commissioning process in water phantom. Commissioning process is adjusted Monte Carlo simulation with Prism RTPS. Commissioning result is used for study of inhomogeneity phantom. Physical parameters of inhomogeneity phantom that varied in this study are: density, location and thickness of tissue. Commissioning result is shown that optimum energy of Monte Carlo simulation for 6 MeV electron beam is 6.8 MeV. This commissioning is used R50 and PDD with Practical length (R{sub p}) as references. From inhomogeneity study, the average deviation for all case on interest region is below 5 %. Based on ICRU recommendations, Prism has good ability to calculate the radiation dose in inhomogeneity tissue.

61 RADIATION PROTECTION AND DOSIMETRY↗

Proton therapy dose distribution comparison between Monte Carlo and a treatment planning system for pediatric patients with ependymoma

Purpose: Compare dose distributions for pediatric patients with ependymoma calculated using a Monte Carlo (MC) system and a clinical treatment planning system (TPS). Methods: Plans from ten pediatric patients with ependymoma treated using double scatter proton therapy were exported from the TPS and calculated in our MC system. A field by field comparison of the distal edge (80% and 20%), distal fall off (80% to 20%), field width (50% to 50%), and penumbra (80% to 20%) were examined. In addition, the target dose for the full plan was compared. Results: For the 32 fields from the 10 patients, the average differences of distal edge at 80% and 20% on central axis between MC and TPS are -1.9 {+-} 1.7 mm (p < 0.001) and -0.6 {+-} 2.3 mm (p= 0.13), respectively. Excluding the fields that ranged out in bone or an air cavity, the 80% difference was -0.9 {+-} 1.7 mm (p= 0.09). The negative value indicates that MC was on average shallower than TPS. The average difference of the 63 field widths of the 10 patients is -0.7 {+-} 1.0 mm (p < 0.001), negative indicating on average the MC had a smaller field width. On average, the difference in the penumbra was 2.3 {+-} 2.1 mm (p < 0.001). The average of the mean clinical target volume dose differences is -1.8% (p= 0.001), negative indicating a lower dose for MC. Conclusions: Overall, the MC system and TPS gave similar results for field width, the 20% distal edge, and the target coverage. For the 80% distal edge and lateral penumbra, there was slight disagreement; however, the difference was less than 2 mm and occurred primarily in highly heterogeneous areas. These differences highlight that the TPS dose calculation cannot be automatically regarded as correct.

60 APPLIED LIFE SCIENCES↗

A real-time in vivo dosimetric verification method for high-dose rate intracavitary brachytherapy of nasopharyngeal carcinoma

Purpose: A real-time in vivo dosimetric verification method using metal-oxide-semiconductor field effect transistor (MOSFET) dosimeters has been developed for patient dosimetry in high-dose rate (HDR) intracavitary brachytherapy of nasopharyngeal carcinoma (NPC). Methods: The necessary calibration and correction factors for MOSFET measurements in {sup 192}Iridium source were determined in a water phantom. With the detector placed inside a custom-made nasopharyngeal applicator, the actual dose delivered to the tumor was measured in vivo and compared to the calculated values using a commercial brachytherapy planning system. Results: Five MOSFETs were independently calibrated with the HDR source, yielding calibration factors of 0.48 {+-} 0.007 cGy/mV. The maximum sensitivity variation was no more than 7% in the clinically relevant distance range of 1-5 cm from the source. A total of 70 in vivo measurements in 11 NPC patients demonstrated good agreement with the treatment planning. The mean differences between the planned and the actually delivered dose within a single treatment fraction were -0.1%{+-} 3.8% and -0.1%{+-} 3.7%, respectively, for right and left side assessments. The maximum dose deviation was less than 8.5%. Conclusions: In vivo measurement using the real-time MOSFET dosimetry system is possible to evaluate the actual dose to the tumor received by the patient during a treatment fraction and thus can offer another line of security to detect and prevent large errors.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Technical Note: Contrast solution density and cross section errors in inhomogeneity-corrected dose calculation for breast balloon brachytherapy

Purpose: Recent recommendations by the American Association of Physicists in Medicine Task Group 186 emphasize the importance of understanding material properties and their effect on inhomogeneity-corrected dose calculation for brachytherapy. Radiographic contrast is normally injected into breast brachytherapy balloons. In this study, the authors independently estimate properties of contrast solution that were expected to be incorrectly specified in a commercial brachytherapy dose calculation algorithm. Methods: The mass density and atomic weight fractions of a clinical formulation of radiographic contrast solution were determined using manufacturers' data. The mass density was verified through measurement and compared with the density obtained by the treatment planning system's CT calibration. The atomic weight fractions were used to determine the photon interaction cross section of the contrast solution for a commercial high-dose-rate (HDR) brachytherapy source and compared with that of muscle. Results: The density of contrast solution was 10% less than that obtained from the CT calibration. The cross section of the contrast solution for the HDR source was 1.2% greater than that of muscle. Both errors could be addressed by overriding the density of the contrast solution in the treatment planning system. Conclusions: The authors estimate the error in mass density and cross section parameters used by a commercial brachytherapy dose calculation algorithm for radiographic contrast used in a clinical breast brachytherapy practice. This approach is adaptable to other clinics seeking to evaluate dose calculation errors and determine appropriate density override values if desired.

60 APPLIED LIFE SCIENCES↗

On the use of a single-fiber multipoint plastic scintillation detector for {sup 192}Ir high-dose-rate brachytherapy

Purpose: The goal of this study was to prove the feasibility of using a single-fiber multipoint plastic scintillation detector (mPSD) as an in vivo verification tool during {sup 192}Ir high-dose-rate brachytherapy treatments.Methods: A three-point detector was built and inserted inside a catheter-positioning template placed in a water phantom. A hyperspectral approach was implemented to discriminate the different optical signals composing the light output at the exit of the single collection optical fiber. The mPSD was tested with different source-to-detector positions, ranging from 1 to 5 cm radially and over 10.5 cm along the longitudinal axis of the detector, and with various integration times. Several strategies for improving the accuracy of the detector were investigated. The device's accuracy in detecting source position was also tested.Results: Good agreement with the expected doses was obtained for all of the scintillating elements, with average relative differences from the expected values of 3.4 {+-} 2.1%, 3.0 {+-} 0.7%, and 4.5 {+-} 1.0% for scintillating elements from the distal to the proximal. A dose threshold of 3 cGy improved the general accuracy of the detector. An integration time of 3 s offered a good trade-off between precision and temporal resolution. Finally, the mPSD measured the radioactive source positioning uncertainty to be no more than 0.32 {+-} 0.06 mm. The accuracy and precision of the detector were improved by a dose-weighted function combining the three measurement points and known details about the geometry of the detector construction.Conclusions: The use of a mPSD for high-dose-rate brachytherapy dosimetry is feasible. This detector shows great promise for development of in vivo applications for real-time verification of treatment delivery.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-35: An Investigation of the Accuracy of Cervical IMRT Dose Distribution Using 2D/3D Ionization Chamber Arrays System and Monte Carlo Simulation

Purpose: The purpose of this work is to compare the verification results of three solutions (2D/3D ionization chamber arrays measurement and Monte Carlo simulation), the results will help make a clinical decision as how to do our cervical IMRT verification. Methods: Seven cervical cases were planned with Pinnacle 8.0m to meet the clinical acceptance criteria. The plans were recalculated in the Matrixx and Delta4 phantom with the accurate plans parameters. The plans were also recalculated by Monte Carlo using leaf sequences and MUs for individual plans of every patient, Matrixx and Delta4 phantom. All plans of Matrixx and Delta4 phantom were delivered and measured. The dose distribution of iso slice, dose profiles, gamma maps of every beam were used to evaluate the agreement. Dose-volume histograms were also compared. Results: The dose distribution of iso slice and dose profiles from Pinnacle calculation were in agreement with the Monte Carlo simulation, Matrixx and Delta4 measurement. A 95.2%/91.3% gamma pass ratio was obtained between the Matrixx/Delta4 measurement and Pinnacle distributions within 3mm/3% gamma criteria. A 96.4%/95.6% gamma pass ratio was obtained between the Matrixx/Delta4 measurement and Monte Carlo simulation within 2mm/2% gamma criteria, almost 100% gamma pass ratio within 3mm/3% gamma criteria. The DVH plot have slightly differences between Pinnacle and Delta4 measurement as well as Pinnacle and Monte Carlo simulation, but have excellent agreement between Delta4 measurement and Monte Carlo simulation. Conclusion: It was shown that Matrixx/Delta4 and Monte Carlo simulation can be used very efficiently to verify cervical IMRT delivery. In terms of Gamma value the pass ratio of Matrixx was little higher, however, Delta4 showed more problem fields. The primary advantage of Delta4 is the fact it can measure true 3D dosimetry while Monte Carlo can simulate in patients CT images but not in phantom.

60 APPLIED LIFE SCIENCES↗

SU-E-T-176: Examination of Surface Dose Enhancement Using Radiochromic EBT3-Films in a Cylindrical Setup

Purpose: This study was undertaken to optimize the measurement techniques with radiochromic EBT3 films to offer accurate surface dose measurements and at the same time high resolution depth dose curves of the backscattering from high Z materials. Methods: Radiochromic EBT3 films (Ashland ISP, Wayne, USA) were wrapped around a PET hollow cylinder with a diameter of 41.5 mm and fixed upon the surface of a lead block. The setup was immersed in water and exposed to a dose of 2 Gy at 6MV acceleration voltage using a Siemens Primus linear accelerator. Water reference measurements were undertaken under equal conditions. An Epson Expression 10000 XL flatbed scanner (Epson, Suwa, Japan) with a preset resolution of 72 dpi was used for digitization. Results: The dose enhancement could be measured with a high resolution of measurement points along the axis normal to the lead surface. A dose enhancement of 70 % was measured at a distance of 134 μm from the lead surface. The data has been compared with results presented by Das et al (Med. Phys. 16(3) (1989)) and is consistent within the uncertainty of the measurements. The results are in consistence with the results from time-tested EBT3 setups, i.e. normal-to-beam EBT3 film stacks and parallel to beam EBT3-films. Conclusion: The cylindrical film setup offers a powerful tool for surface measurements. The advantages of a stacked film setup and a parallel to beam setup could be combined.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-278: Realization of Dose Verification Tool for IMRT Plan Based On DPM

Purpose: To build a Monte Carlo dose verification tool for IMRT Plan by implementing a irradiation source model into DPM code. Extend the ability of DPM to calculate any incident angles and irregular-inhomogeneous fields. Methods: With the virtual source and the energy spectrum which unfolded from the accelerator measurement data,combined with optimized intensity maps to calculate the dose distribution of the irradiation irregular-inhomogeneous field. The irradiation source model of accelerator was substituted by a grid-based surface source. The contour and the intensity distribution of the surface source were optimized by ARTS (Accurate/Advanced Radiotherapy System) optimization module based on the tumor configuration. The weight of the emitter was decided by the grid intensity. The direction of the emitter was decided by the combination of the virtual source and the emitter emitting position. The photon energy spectrum unfolded from the accelerator measurement data was adjusted by compensating the contaminated electron source. For verification, measured data and realistic clinical IMRT plan were compared with DPM dose calculation. Results: The regular field was verified by comparing with the measured data. It was illustrated that the differences were acceptable (<2% inside the field, 2–3mm in the penumbra). The dose calculation of irregular field by DPM simulation was also compared with that of FSPB (Finite Size Pencil Beam) and the passing rate of gamma analysis was 95.1% for peripheral lung cancer. The regular field and the irregular rotational field were all within the range of permitting error. The computing time of regular fields were less than 2h, and the test of peripheral lung cancer was 160min. Through parallel processing, the adapted DPM could complete the calculation of IMRT plan within half an hour. Conclusion: The adapted parallelized DPM code with irradiation source model is faster than classic Monte Carlo codes. Its computational accuracy and speed satisfy the clinical requirement, and it is expectable to be a Monte Carlo dose verification tool for IMRT Plan. Strategic Priority Research Program of the China Academy of Science(XDA03040000); National Natural Science Foundation of China (81101132)

60 APPLIED LIFE SCIENCES↗

SU-E-T-290: Secondary Dose Monitoring Using Scintillating Fibers in Proton Therapy of Prostate Cancer: A Geant4 Monte Carlo Simulation

Purpose: To monitor the secondary dose distribution originating from a water phantom during proton therapy of prostate cancer using scintillating fibers. Methods: The Geant4 Monte Carlo toolkit version 9.6.p02 was used to simulate prostate cancer proton therapy based treatments. Two cases were studied. In the first case, 8 × 8 = 64 equally spaced fibers inside three 4 × 4 × 2.54 cmm{sup 3} DuPont™ Delrin blocks were used to monitor the emission of secondary particles in the transverse (left and right) and distal regions relative to the beam direction. In the second case, a scintillating block with a thickness of 2.54 cm and equal vertical and longitudinal dimensions as the water phantom was used. Geometrical cuts were used to extract the energy deposited in each fiber and the scintillating block. Results: The transverse dose distributions from secondary particles in both cases agree within <5% and with a very good symmetry. The energy deposited not only gradually increases as one moves from the peripheral row fibers towards the center of the block (aligned with the center of the prostate) but also decreases as one goes from the frontal to distal region of the block. The ratio of the doses from the prostate to the ones in the middle two rows of fibers showed a linear relationship with a slope (−3.55±2.26) × 10−5 MeV per treatment Gy. The distal detectors recorded a very small energy deposited due to water attenuation. Conclusion: With a good calibration and the ability to define a good correlation between the dose to the external fibers and the prostate, such fibers can be used for real time dose verification to the target.

60 APPLIED LIFE SCIENCES↗

SU-E-T-416: VMAT Dose Calculations Using Cone Beam CT Images: A Preliminary Study

Purpose: Cone beam CT (CBCT) images have been used routinely for patient positioning throughout the treatment course. However, use of CBCT for dose calculation is still investigational. The purpose of this study is to assess the utility of CBCT images for Volumetric Modulated Arc Therapy (VMAT) plan dose calculation. Methods: A CATPHAN 504 phantom (The Phantom Laboratory, Salem, NY) was used to compare the dosimetric and geometric accuracy between conventional CT and CBCT (in both full and half fan modes). Hounsfield units (HU) profiles at different density areas were evaluated. A C shape target that surrounds a central avoidance structure was created and a VMAT plan was generated on the CT images and copied to the CBCT phantom images. Patient studies included three brain patients, and one head and neck (H'N) patient. VMAT plans generated on the patients treatment planning CT was applied to CBCT images obtained during the first treatment. Isodose distributions and dosevolume- histograms (DVHs) were compared. Results: For the phantom study, the HU difference between CT and CBCT is within 100 (maximum 96 HU for Teflon CBCT images in full fan mode). The impact of these differences on the calculated dose distributions was clinically insignificant. In both phantom and patient studies, target DVHs based on CBCT images were in excellent agreement with those based on planning CT images. Mean, Median, near minimum (D98%), and near maximum (D2%) doses agreed within 0-2.5%. A slightly larger discrepancy is observed in the patient studies compared to that seen in the phantom study, (0-1% vs. 0 - 2.5%). Conclusion: CBCT images can be used to accurately predict dosimetric results, without any HU correction. It is feasible to use CBCT to evaluate the actual dose delivered at each fraction. The dosimetric consequences resulting from tumor response and patient geometry changes could be monitored.

60 APPLIED LIFE SCIENCES↗

SU-E-T-441: Comparison of Dose Distributions for Spot-Scanned Pencil-Beam and Scattered-Beam Proton Treatments of Ocular Tumors

Purpose: To study the cross-field and depth dose profiles of spot-scanned pencil beam configurations for the treatment of ocular tumors and to compare their performance to a simulated scattered beam. Methods: Dose distributions in a cubic water phantom were compared for beams that passed through a final 24mm diameter aperture to deposit maximum dose at 2.4cm depth. The pencil-beam spots formed a hexagonally-packed ring with a center-to-center spacing of 4mm. The protons exited the nozzle with energy 95.5MeV, traversed a 4.5cm water-equivalent range shifter, and travelled either 42.5cm or 100cm to the phantom surface. The aperture-to-phantom distance (APD) was 5.7cm to allow room for eye-tracking hardware. A configuration with APD=0 was also tested. The scattered beam was generated with energy 159MeV, passed through 127mm of Lexan, exited the final aperture, and travelled 5.7cm to the phantom surface. This latter configuration is comparable to the MGH single scattered beamline. All beams were modelled with TOPAS1.0-beta6 compiled with GEANT4.9.6p2. Results: The modeled scattered beam produced a distal fall-off along the central axis of zd90%-zd10%=3.6mm. For the pencil beam, the zd90%-zd10% was 1.6mm in all configurations. The scattered beam's cross-field penumbra at depth of maximum dose was r90%- r10%=1.9mm. For the spot-scanned configuration with the range-shifter-tophantom distance (RsPD) of 100cm, similar cross-field profiles were achieved with r90%-r10%=2.0mm. At shorter RsPD of 42.5cm, the crossfield penumbras were 5.6mm and 7.7mm for APD=0cm and APD=5.7cm, respectively. Conclusion: For proton treatments employing a range shifter, the cross-field and central axis dose profiles depend on the quality of the original beam, the size of the range shifter, the distance from the range shifter exit to the patient, and the distance from the final aperture to the patient. A spot-scanned pencil beam configuration can achieve cross-field penumbras equal to a scattered beam and superior distal gradients.

60 APPLIED LIFE SCIENCES↗

TU-C-17A-05: Dose Domain Optimization of MLC Leaf Patterns for Highly Complicated 4Ï€ IMRT Plans

Purpose: Highly conformal non-coplanar 4π radiotherapy plans typically require more than 20 intensity-modulated fields to deliver. A novel method to calculate multileaf collimator (MLC) leaf patterns is introduced to maximize delivery efficiency, accuracy and plan quality. Methods: 4 GBM patients, with a prescription dose of 59.4 Gy or 60 Gy, were evaluated using the 4π algorithm using 20 beams. The MLC calculation utilized a least square minimization of the dose distribution, with an anisotropic total variation regularization term to encourage piecewise continuity in the fluence maps. Transforming the fluence to the dose domain required multiplying the fluence with a sparse matrix. Exploiting this property made it feasible to solve the problem using CVX, a MATLAB-based convex modeling framework. The fluence was stratified into even step sizes, and the MLC segments, limited to 300, were calculated. The patients studied were replanned using Eclipse with the same beam angles. Results: Compared to the original 4π plan, the stratified 4π plan increased the maximum/mean dose for, in Gy, by 1.0/0.0 (brainstem), 0.5/0.2 (chiasm), 0.0/0.0 (spinal cord), 1.9/0.3 (L eye), 0.7/0.2 (R eye), 0.4/0.4 (L lens), 0.3/0.3 (R lens), 1.0/0.8 (L Optical Nerve), 0.5/0.3 (R Optical Nerve), 0.3/0.2 (L Cochlea), 0.1/0.1 (R Cochlea), 4.6/0.2 (brain), 2.4/0.1 (brain-PTV), 5.1/0.9 (PTV). Compared to Eclipse, which generated an average of 607 segments, the stratified plan reduced (−) or increased (+) the maximum/mean dose, in Gy, by −10.2/−4.1 (brainstem), −10.5/−8.9 (chiasm), +0.0/−0.1 (spinal cord), −4.9/−3.4 (L eye), −4.1/−2.5 (R eye), −2.8/−2.7 (L lens), −2.1/−1.9 (R lens), −7.6/−6.5 (L Optical Nerve), −8.9/−6.1 (R Optical Nerve), −1.3/−1.9 (L Cochlea), −1.8/−1.8 (R Cochlea), +1.7/−2.1 (brain), +3.2/−2.6 (brain-PTV), +1.8/+0.3 Gy (PTV. The stratified plan was also more homogeneous in the PTV. Conclusion: This novel solver can transform complicated fluence maps into significantly fewer deliverable MLC segments than the commercial system while achieving superior dosimetry. Funding support partially contributed by Varian.

60 APPLIED LIFE SCIENCES↗

TH-E-BRE-02: A Forward Scattering Approximation to Dose Calculation Using the Linear Boltzmann Transport Equation

Purpose: To investigate the use of the linear Boltzmann transport equation as a dose calculation tool which can account for interface effects, while still having faster computation times than Monte Carlo methods. In particular, we introduce a forward scattering approximation, in hopes of improving calculation time without a significant hindrance to accuracy. Methods: Two coupled Boltzmann transport equations were constructed, one representing the fluence of photons within the medium, and the other, the fluence of electrons. We neglect the scattering term within the electron transport equation, resulting in an extreme forward scattering approximation to reduce computational complexity. These equations were then solved using a numerical technique for solving partial differential equations, known as a finite difference scheme, where the fluence at each discrete point in space is calculated based on the fluence at the previous point in the particle's path. Using this scheme, it is possible to develop a solution to the Boltzmann transport equations by beginning with boundary conditions and iterating across the entire medium. The fluence of electrons can then be used to find the dose at any point within the medium. Results: Comparisons with Monte Carlo simulations indicate that even simplistic techniques for solving the linear Boltzmann transport equation yield expected interface effects, which many popular dose calculation algorithms are not capable of predicting. Implementation of a forward scattering approximation does not appear to drastically reduce the accuracy of this algorithm. Conclusion: Optimized implementations of this algorithm have been shown to be very accurate when compared with Monte Carlo simulations, even in build up regions where many models fail. Use of a forward scattering approximation could potentially give a reasonably accurate dose distribution in a shorter amount of time for situations where a completely accurate dose distribution is not required, such as in certain optimization algorithms.

97 MATHEMATICS AND COMPUTING↗

A new online detector for estimation of peripheral neutron equivalent dose in organ

Purpose: Peripheral dose in radiotherapy treatments represents a potential source of secondary neoplasic processes. As in the last few years, there has been a fast-growing concern on neutron collateral effects, this work focuses on this component. A previous established methodology to estimate peripheral neutron equivalent doses relied on passive (TLD, CR39) neutron detectors exposed in-phantom, in parallel to an active [static random access memory (SRAMnd)] thermal neutron detector exposed ex-phantom. A newly miniaturized, quick, and reliable active thermal neutron detector (TNRD, Thermal Neutron Rate Detector) was validated for both procedures. This first miniaturized active system eliminates the long postprocessing, required for passive detectors, giving thermal neutron fluences in real time. Methods: To validate TNRD for the established methodology, intrinsic characteristics, characterization of 4 facilities [to correlate monitor value (MU) with risk], and a cohort of 200 real patients (for second cancer risk estimates) were evaluated and compared with the well-established SRAMnd device. Finally, TNRD was compared to TLD pairs for 3 generic radiotherapy treatments through 16 strategic points inside an anthropomorphic phantom. Results: The performed tests indicate similar linear dependence with dose for both detectors, TNRD and SRAMnd, while a slightly better reproducibility has been obtained for TNRD (1.7% vs 2.2%). Risk estimates when delivering 1000 MU are in good agreement between both detectors (mean deviation of TNRD measurements with respect to the ones of SRAMnd is 0.07 cases per 1000, with differences always smaller than 0.08 cases per 1000). As far as the in-phantom measurements are concerned, a mean deviation smaller than 1.7% was obtained. Conclusions: The results obtained indicate that direct evaluation of equivalent dose estimation in organs, both in phantom and patients, is perfectly feasible with this new detector. This will open the door to an easy implementation of specific peripheral neutron dose models for any type of treatment and facility.

60 APPLIED LIFE SCIENCES↗

SU-E-J-122: The CBCT Dose Calculation Using a Patient Specific CBCT Number to Mass Density Conversion Curve Based On a Novel Image Registration and Organ Mapping Method in Head-And-Neck Radiation Therapy

Purpose: To develop a CBCT HU correction method using a patient specific HU to mass density conversion curve based on a novel image registration and organ mapping method for head-and-neck radiation therapy. Methods: There are three steps to generate a patient specific CBCT HU to mass density conversion curve. First, we developed a novel robust image registration method based on sparseness analysis to register the planning CT (PCT) and the CBCT. Second, a novel organ mapping method was developed to transfer the organs at risk (OAR) contours from the PCT to the CBCT and corresponding mean HU values of each OAR were measured in both the PCT and CBCT volumes. Third, a set of PCT and CBCT HU to mass density conversion curves were created based on the mean HU values of OARs and the corresponding mass density of the OAR in the PCT. Then, we compared our proposed conversion curve with the traditional Catphan phantom based CBCT HU to mass density calibration curve. Both curves were input into the treatment planning system (TPS) for dose calculation. Last, the PTV and OAR doses, DVH and dose distributions of CBCT plans are compared to the original treatment plan. Results: One head-and-neck cases which contained a pair of PCT and CBCT was used. The dose differences between the PCT and CBCT plans using the proposed method are −1.33% for the mean PTV, 0.06% for PTV D95%, and −0.56% for the left neck. The dose differences between plans of PCT and CBCT corrected using the CATPhan based method are −4.39% for mean PTV, 4.07% for PTV D95%, and −2.01% for the left neck. Conclusion: The proposed CBCT HU correction method achieves better agreement with the original treatment plan compared to the traditional CATPhan based calibration method.

60 APPLIED LIFE SCIENCES↗

SU-E-T-13: A Comparative Dosimetric Study On Radio-Dynamic Therapy for Pelvic Cancer Treatment: Strategies for Bone Marrow Dose and Volume Reduction

Purpose: Radio-dynamic therapy (RDT) is a potentially effective modality for local and systemic cancer treatment. Using RDT, the administration of a radio-sensitizer enhances the biological effect of high-energy photons. Although the sensitizer uptake ratio of tumor to normal tissue is normally high, one cannot simply neglect its effect on critical structures. In this study, we aim to explore planning strategies to improve bone marrow sparing without compromising the plan quality for RDT treatment of pelvic cancers. Methods: Ten cervical and ten prostate cancer patients who previously received radiotherapy at our institution were selected for this study. For each patient, nine plans were created using the Varian Eclipse treatmentplanning-system (TPS) with 3D-CRT, IMRT, and VMAT delivery techniques containing various gantry angle combinations and optimization parameters (dose constraints to the bone marrow). To evaluate the plans for bone marrow sparing, the dose-volume parameters V5, V10, V15, V20, V30, and V40 for bone marrow were examined. Effective doseenhancement factors for the sensitizer were used to weigh the dose-volume histograms for various tissues from individual fractions. Results: The planning strategies had different impacts on bone marrow sparing for the cervical and prostate cases. For the cervical cases, provided the bone marrow constraints were properly set during optimization, the dose to bone marrow sparing was found to be comparable between different IMRT and VMAT plans regardless of the gantry angle selection. For the prostate cases, however, careful selection of gantry angles could dramatically improve the bone marrow sparing, although the dose distribution in bone marrow was clinically acceptable for all prostate plans that we created. Conclusion: For intensity-modulated RDT planning for cervical cancer, planners should set bone marrow constraints properly to avoid any adverse damage, while for prostate cancer one can carefully select gantry angles to improve bone marrow sparing when necessary.

60 APPLIED LIFE SCIENCES↗