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SU-D-12A-05: Iterative Reconstruction Techniques to Enable Intrinsic Respiratory Gated CT in Mice

Purpose: Longitudinal studies of lung function in mice need the ability to image different phases of ventilation in free-breathing mice using retrospective gating. However, retrospective gating often produces under-sampled and uneven angular samples, resulting in severe reconstruction artifacts when using traditional FDK based reconstruction algorithms. We wanted to demonstrate the utility of iterative reconstruction method to enable intrinsic respiratory gating in small-animal CT. Methods: Free-breathing mice were imaged using a Siemens Inveon PET/micro-CT system. Evenly distributed projection images were acquired at 360 angles. Retrospective respiratory gating was performed using an intrinsic marker based on the average intensity in a region covering the diaphragm. Projections were classified into 4 and 6 phases (finer temporal resolution) resulting in 138 and 67 projections respectively. Reconstruction was carried out using 3 Methods: conventional FDK, iterative penalized least-square (PWLS) with total variation (TV), and PWLS with edge-preserving penalty. The performance of the methods was compared using contrast-to-noise (CNR) in a region of interest (ROI). Line profile through a specific region was plotted to evaluate the preserving of edges. Results: In both the cases with 4 and 6 phases, inadequate and non-uniform angular sampling results in artifacts using conventional FDK. However, such artifacts are minimized using both the iterative methods. Using both 4 and 6 phases, the iterative techniques outperformed FDK in terms of CNR and maintaining sharp edges. This is further evidenced especially with increased artifacts using FDK for 6 phases. Conclusion: This work indicates fewer artifacts and better image details can be achieved with iterative reconstruction methods in non-uniform under-sampled reconstruction. Using iterative methods can enable free-breathing intrinsic respiratory gating in small-animal CT. Further studies are needed to compare the computational complexity for large datasets.

60 APPLIED LIFE SCIENCES↗

SU-E-I-41: Non-Cartesian MR Image Reconstruction with Integrated Gradient Non-Linearity Correction

Purpose: Nonlinearities in the spatial encoding gradients of MRI systems cause geometric distortion in images. Typically, this is retrospectively corrected via image-domain interpolation (a.k.a., “gradwarp”) albeit with a loss of spatial resolution. For non-Cartesian MRI, the latter problem is exaggerated by noise and undersampling artifact. In this study, we describe a novel correction strategy that accounts for gradient nonlinearities during — rather than after — non-Cartesian MRI reconstruction, and demonstrate that this approach mitigates the resolution loss that can occur with standard methods. Methods: To test the proposed method, the American College of Radiology (ACR) quality control phantom was scanned on at 1.5 T (General Electric, v16.0, “zoom” gradient) using a 1.6x undersampled 3D non- Cartesian Shells trajectory (GRE, FOV=24 cm3, 120 shells, 16552 shots, 512 readout, matrix=2403). Image reconstruction was first performed via standard k-space density-compensated gridding and retrospectively corrected via cubic spline interpolation. Image reconstruction was then separately performed using a k-space and image-domain densitycompensated type-3 non-uniform fast Fourier transform (NUFFT), which provides a direct mapping between non-Cartesian k-space samples and warped image space voxel locations. Thus, no separate distortion correction procedure is needed for the proposed approach. The gradient distortion field was determined using vendor provided calibration data. Results: Phantom scan results show that both processing approaches successfully correct geometric distortion. However, visual inspection of the ACR phantom spatial resolution inserts shows that the proposed strategy preserves the resolution of the nominal (uncorrected) reconstruction while “gradwarp” imparts marked spatial blurring (especially for the 1.0 and 1.1 mm inserts) and thus resolution loss. Conclusion: We've presented a novel reconstruction strategy for non-Cartesian MRI that corrects for gradient nonlinearities during — rather than after — reconstruction, and thus better preserves image resolution than traditional interpolation-based methods. This approach is expected to be especially advantageous when imaging with non-standard magnet geometries. NIH RR018898; NIH EB10065.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-I-87: Automated Liver Segmentation Method for CBCT Dataset by Combining Sparse Shape Composition and Probabilistic Atlas Construction

Purpose: The aiming of this study was to extract liver structures for daily Cone beam CT (CBCT) images automatically. Methods: Datasets were collected from 50 intravenous contrast planning CT images, which were regarded as training dataset for probabilistic atlas and shape prior model construction. Firstly, probabilistic atlas and shape prior model based on sparse shape composition (SSC) were constructed by iterative deformable registration. Secondly, the artifacts and noise were removed from the daily CBCT image by an edge-preserving filtering using total variation with L1 norm (TV-L1). Furthermore, the initial liver region was obtained by registering the incoming CBCT image with the atlas utilizing edge-preserving deformable registration with multi-scale strategy, and then the initial liver region was converted to surface meshing which was registered with the shape model where the major variation of specific patient was modeled by sparse vectors. At the last stage, the shape and intensity information were incorporated into joint probabilistic model, and finally the liver structure was extracted by maximum a posteriori segmentation.Regarding the construction process, firstly the manually segmented contours were converted into meshes, and then arbitrary patient data was chosen as reference image to register with the rest of training datasets by deformable registration algorithm for constructing probabilistic atlas and prior shape model. To improve the efficiency of proposed method, the initial probabilistic atlas was used as reference image to register with other patient data for iterative construction for removing bias caused by arbitrary selection. Results: The experiment validated the accuracy of the segmentation results quantitatively by comparing with the manually ones. The volumetric overlap percentage between the automatically generated liver contours and the ground truth were on an average 88%–95% for CBCT images. Conclusion: The experiment demonstrated that liver structures of CBCT with artifacts can be extracted accurately for following adaptive radiation therapy. This work is supported by National Natural Science Foundation of China (No. 61201441), Research Fund for Excellent Young and Middle-aged Scientists of Shandong Province (No. BS2012DX038), Project of Shandong Province Higher Educational Science and Technology Program (No. J12LN23), Jinan youth science and technology star (No.20120109)

60 APPLIED LIFE SCIENCES↗

SU-F-18C-14: Hessian-Based Norm Penalty for Weighted Least-Square CBCT Reconstruction

Purpose: To develop a Hessian-based norm penalty for cone-beam CT (CBCT) reconstruction that has a similar ability in suppressing noise as the total variation (TV) penalty while avoiding the staircase effect and better preserving low-contrast objects. Methods: We extended the TV penalty to a Hessian-based norm penalty based on the Frobenius norm of the Hessian matrix of an image for CBCT reconstruction. The objective function was constructed using the penalized weighted least-square (PWLS) principle. An effective algorithm was developed to minimize the objective function using a majorization-minimization (MM) approach. We evaluated and compared the proposed penalty with the TV penalty on a CatPhan 600 phantom and an anthropomorphic head phantom, each acquired at a low-dose protocol (10mA/10ms) and a high-dose protocol (80mA/12ms). For both penalties, contrast-to-noise (CNR) in four low-contrast regions-of-interest (ROIs) and the full-width-at-half-maximum (FWHM) of two point-like objects in constructed images were calculated and compared. Results: In the experiment of CatPhan 600 phantom, the Hessian-based norm penalty has slightly higher CNRs and approximately equivalent FWHM values compared with the TV penalty. In the experiment of the anthropomorphic head phantom at the low-dose protocol, the TV penalty result has several artificial piece-wise constant areas known as the staircase effect while in the Hessian-based norm penalty the image appears smoother and more similar to that of the FDK result using the high-dose protocol. Conclusion: The proposed Hessian-based norm penalty has a similar performance in suppressing noise to the TV penalty, but has a potential advantage in suppressing the staircase effect and preserving low-contrast objects. This work was supported in part by National Natural Science Foundation of China (NNSFC), under Grant Nos. 60971112 and 61375018, and Fundamental Research Funds for the Central Universities, under Grant No. 2012QN086.

60 APPLIED LIFE SCIENCES↗

TU-F-18A-06: Dual Energy CT Using One Full Scan and a Second Scan with Very Few Projections

Purpose: The conventional dual energy CT (DECT) requires two full CT scans at different energy levels, resulting in dose increase as well as imaging errors from patient motion between the two scans. To shorten the scan time of DECT and thus overcome these drawbacks, we propose a new DECT algorithm using one full scan and a second scan with very few projections by preserving structural information. Methods: We first reconstruct a CT image on the full scan using a standard filtered-backprojection (FBP) algorithm. We then use a compressed sensing (CS) based iterative algorithm on the second scan for reconstruction from very few projections. The edges extracted from the first scan are used as weights in the Objectives: function of the CS-based reconstruction to substantially improve the image quality of CT reconstruction. The basis material images are then obtained by an iterative image-domain decomposition method and an electron density map is finally calculated. The proposed method is evaluated on phantoms. Results: On the Catphan 600 phantom, the CT reconstruction mean error using the proposed method on 20 and 5 projections are 4.76% and 5.02%, respectively. Compared with conventional iterative reconstruction, the proposed edge weighting preserves object structures and achieves a better spatial resolution. With basis materials of Iodine and Teflon, our method on 20 projections obtains similar quality of decomposed material images compared with FBP on a full scan and the mean error of electron density in the selected regions of interest is 0.29%. Conclusion: We propose an effective method for reducing projections and therefore scan time in DECT. We show that a full scan plus a 20-projection scan are sufficient to provide DECT images and electron density with similar quality compared with two full scans. Our future work includes more phantom studies to validate the performance of our method.

60 APPLIED LIFE SCIENCES↗

WE-G-18A-06: Sinogram Restoration in Helical Cone-Beam CT

Purpose: To extend CT sinogram restoration, which has been shown in 2D to reduce noise and to correct for geometric effects and other degradations at a low computational cost, from 2D to a 3D helical cone-beam geometry. Methods: A method for calculating sinogram degradation coefficients for a helical cone-beam geometry was proposed. These values were used to perform penalized-likelihood sinogram restoration on simulated data that were generated from the FORBILD thorax phantom. Sinogram restorations were performed using both a quadratic penalty and the edge-preserving Huber penalty. After sinogram restoration, Fourier-based analytical methods were used to obtain reconstructions. Resolution-variance trade-offs were investigated for several locations within the reconstructions for the purpose of comparing sinogram restoration to no restoration. In order to compare potential differences, reconstructions were performed using different groups of neighbors in the penalty, two analytical reconstruction methods (Katsevich and single-slice rebinning), and differing helical pitches. Results: The resolution-variance properties of reconstructions restored using sinogram restoration with a Huber penalty outperformed those of reconstructions with no restoration. However, the use of a quadratic sinogram restoration penalty did not lead to an improvement over performing no restoration at the outer regions of the phantom. Application of the Huber penalty to neighbors both within a view and across views did not perform as well as only applying the penalty to neighbors within a view. General improvements in resolution-variance properties using sinogram restoration with the Huber penalty were not dependent on the reconstruction method used or the magnitude of the helical pitch. Conclusion: Sinogram restoration for noise and degradation effects for helical cone-beam CT is feasible and should be able to be applied to clinical data. When applied with the edge-preserving Huber penalty, sinogram restoration leads to an improvement in resolution-variance tradeoffs.

60 APPLIED LIFE SCIENCES↗

TH-C-BRE-01: IGART: Fast On-Line Planning for IGART

Cone beam CT IGRT provides on-line anatomical data of the patient at the treatment couch while new hybrid MRI radiotherapy systems promise to provide this data during the actual radiation delivery itself. To exploit these data, and account for tissue rotations, deformations and tumor regression during radiation therapy delivery, fast, on-line IMRT (re)planning is required.On-line IMRT re-planning needs to re-generate a similar patient specific dose distribution as done in the pre-treatment planning but then for the new state of the anatomy. For this the pre-treatment information has to be propagated to the actual treatment. A fast dose engine is required, which may be, in the case of MRI based IGRT, Monte Carlo based in order to account for the magnetic field induced dose effects. Then robust re-planning methods or class solutions should be available that account efficiently for both rigid and non-rigid anatomical changes while preserving the patient specific pre-treatment dose considerations. Preferably this is all fully automatic, but also fast interactive re-planning is an option, especially in hypo-fractionated (boost) radiotherapy. Learning Objectives: Preservation of pre-treatment prescriptions in the on-line IMRT re-planning Fast re-planning techniques and speed limitations for dose engines Pros and cons of interactive versus automatic re-planning.

60 APPLIED LIFE SCIENCES↗

Toward a clinical application of ex situ boron neutron capture therapy for lung tumors at the RA-3 reactor in Argentina

Purpose: Many types of lung tumors have a very poor prognosis due to their spread in the whole organ volume. The fact that boron neutron capture therapy (BNCT) would allow for selective targeting of all the nodules regardless of their position, prompted a preclinical feasibility study of ex situ BNCT at the thermal neutron facility of RA-3 reactor in the province of Buenos Aires, Argentina. (L)-4p-dihydroxy-borylphenylalanine fructose complex (BPA-F) biodistribution studies in an adult sheep model and computational dosimetry for a human explanted lung were performed to evaluate the feasibility and the therapeutic potential of ex situ BNCT. Methods: Two kinds of boron biodistribution studies were carried out in the healthy sheep: a set of pharmacokinetic studies without lung excision, and a set that consisted of evaluation of boron concentration in the explanted and perfused lung. In order to assess the feasibility of the clinical application of ex situ BNCT at RA-3, a case of multiple lung metastases was analyzed. A detailed computational representation of the geometry of the lung was built based on a real collapsed human lung. Dosimetric calculations and dose limiting considerations were based on the experimental results from the adult sheep, and on the most suitable information published in the literature. In addition, a workable treatment plan was considered to assess the clinical application in a realistic scenario. Results: Concentration-time profiles for the normal sheep showed that the boron kinetics in blood, lung, and skin would adequately represent the boron behavior and absolute uptake expected in human tissues. Results strongly suggest that the distribution of the boron compound is spatially homogeneous in the lung. A constant lung-to-blood ratio of 1.3 ± 0.1 was observed from 80 min after the end of BPA-F infusion. The fact that this ratio remains constant during time would allow the blood boron concentration to be used as a surrogate and indirect quantification of the estimated value in the explanted healthy lung. The proposed preclinical animal model allowed for the study of the explanted lung. As expected, the boron concentration values fell as a result of the application of the preservation protocol required to preserve the lung function. The distribution of the boron concentration retention factor was obtained for healthy lung, with a mean value of 0.46 ± 0.14 consistent with that reported for metastatic colon carcinoma model in rat perfused lung. Considering the human lung model and suitable tumor control probability for lung cancer, a promising average fraction of controlled lesions higher than 85% was obtained even for a low tumor-to-normal boron concentration ratio of 2. Conclusions: This work reports for the first time data supporting the validity of the ovine model as an adequate human surrogate in terms of boron kinetics and uptake in clinically relevant tissues. Collectively, the results and analysis presented would strongly suggest that ex situ whole lung BNCT irradiation is a feasible and highly promising technique that could greatly contribute to the treatment of metastatic lung disease in those patients without extrapulmonary spread, increasing not only the expected overall survival but also the resulting quality of life.

60 APPLIED LIFE SCIENCES↗

TU-EF-304-11: Therapeutic Benefits of Collimation in Spot Scanning Proton Therapy in the Treatment of Brain Cancer

Purpose: A dynamic collimation system (DCS) based on two orthogonal pairs of mobile trimmer blades has recently been proposed to reduce the lateral penumbra in spot scanning proton therapy (SSPT). The purpose of this work is to quantify the therapeutic benefit of using the DCS for SSPT of brain cancer by comparing un-collimated and collimated treatment plans. Methods: Un-collimated and collimated brain treatment plans were created for five patients, previously treated with SSPT, using an in-house treatment planning system capable of modeling collimated and un-collimated beamlets. Un-collimated plans reproduced the clinically delivered plans in terms of target coverage and organ-at-risk (OAR) sparing, whereas collimated plans were re-optimized to improve the organ-at-risk sparing while maintaining target coverage. Physical and biological comparison metrics such as dose distribution conformity, mean and maximum doses, normal tissue complication probability (NTCP) and risk of secondary brain cancer were used to evaluate the plans. Results: The DCS systematically improved the dose distribution conformity while preserving the target coverage. The average reduction of the mean dose to the 10-mm ring surrounding the target and the healthy brain were 7.1% (95% CI: 4.2%–9.9%; p<0.01) and 14.3% (95% CI: 7.8%–20.8%; p<0.01), respectively. This yielded an average reduction of 12.0% (95% CI: 8.2%–15.7%; p<0.01) for the brain necrosis NTCP using the Flickinger model, and 14.2% (95% CI: 7.7%–20.8%; p<0.01) for the risk of secondary brain cancer. The average maximum dose reductions for the brainstem, chiasm, optic nerves, cochleae and pituitary gland when comparing un-collimated and collimated plans were 14.3%, 10.4%, 11.2%, 13.0%, 12.9% and 3.4%, respectively. Evaluating individual plans using the Lyman-Kutcher-Burman NTCP model also yielded improvements. Conclusion: The lateral penumbra reduction performed by the DCS increases the normal tissue sparing capabilities of SSPT for brain tumor treatment while preserving the target coverage. This research was financially supported by Ion Beam Applications S.A. (IBA, Louvain-La-Neuve, Belgium)

60 APPLIED LIFE SCIENCES↗

Accelerated fast iterative shrinkage thresholding algorithms for sparsity-regularized cone-beam CT image reconstruction

Purpose: The development of iterative image reconstruction algorithms for cone-beam computed tomography (CBCT) remains an active and important research area. Even with hardware acceleration, the overwhelming majority of the available 3D iterative algorithms that implement nonsmooth regularizers remain computationally burdensome and have not been translated for routine use in time-sensitive applications such as image-guided radiation therapy (IGRT). In this work, two variants of the fast iterative shrinkage thresholding algorithm (FISTA) are proposed and investigated for accelerated iterative image reconstruction in CBCT. Methods: Algorithm acceleration was achieved by replacing the original gradient-descent step in the FISTAs by a subproblem that is solved by use of the ordered subset simultaneous algebraic reconstruction technique (OS-SART). Due to the preconditioning matrix adopted in the OS-SART method, two new weighted proximal problems were introduced and corresponding fast gradient projection-type algorithms were developed for solving them. We also provided efficient numerical implementations of the proposed algorithms that exploit the massive data parallelism of multiple graphics processing units. Results: The improved rates of convergence of the proposed algorithms were quantified in computer-simulation studies and by use of clinical projection data corresponding to an IGRT study. The accelerated FISTAs were shown to possess dramatically improved convergence properties as compared to the standard FISTAs. For example, the number of iterations to achieve a specified reconstruction error could be reduced by an order of magnitude. Volumetric images reconstructed from clinical data were produced in under 4 min. Conclusions: The FISTA achieves a quadratic convergence rate and can therefore potentially reduce the number of iterations required to produce an image of a specified image quality as compared to first-order methods. We have proposed and investigated accelerated FISTAs for use with two nonsmooth penalty functions that will lead to further reductions in image reconstruction times while preserving image quality. Moreover, with the help of a mixed sparsity-regularization, better preservation of soft-tissue structures can be potentially obtained. The algorithms were systematically evaluated by use of computer-simulated and clinical data sets.

60 APPLIED LIFE SCIENCES↗

Anatomical pulmonary magnetic resonance imaging segmentation for regional structure-function measurements of asthma

Purpose: Pulmonary magnetic-resonance-imaging (MRI) and x-ray computed-tomography have provided strong evidence of spatially and temporally persistent lung structure-function abnormalities in asthmatics. This has generated a shift in their understanding of lung disease and supports the use of imaging biomarkers as intermediate endpoints of asthma severity and control. In particular, pulmonary {sup 1}H MRI can be used to provide quantitative lung structure-function measurements longitudinally and in response to treatment. However, to translate such biomarkers of asthma, robust methods are required to segment the lung from pulmonary {sup 1}H MRI. Therefore, their objective was to develop a pulmonary {sup 1}H MRI segmentation algorithm to provide regional measurements with the precision and speed required to support clinical studies. Methods: The authors developed a method to segment the left and right lung from {sup 1}H MRI acquired in 20 asthmatics including five well-controlled and 15 severe poorly controlled participants who provided written informed consent to a study protocol approved by Health Canada. Same-day spirometry and plethysmography measurements of lung function and volume were acquired as well as {sup 1}H MRI using a whole-body radiofrequency coil and fast spoiled gradient-recalled echo sequence at a fixed lung volume (functional residual capacity + 1 l). We incorporated the left-to-right lung volume proportion prior based on the Potts model and derived a volume-proportion preserved Potts model, which was approximated through convex relaxation and further represented by a dual volume-proportion preserved max-flow model. The max-flow model led to a linear problem with convex and linear equality constraints that implicitly encoded the proportion prior. To implement the algorithm, {sup 1}H MRI was resampled into ∼3 × 3 × 3 mm{sup 3} isotropic voxel space. Two observers placed seeds on each lung and on the background of 20 pulmonary {sup 1}H MR images in a randomized dataset, on five occasions, five consecutive days in a row. Segmentation accuracy was evaluated using the Dice-similarity-coefficient (DSC) of the segmented thoracic cavity with comparison to five-rounds of manual segmentation by an expert observer. The authors also evaluated the root-mean-squared-error (RMSE) of the Euclidean distance between lung surfaces, the absolute, and percent volume error. Reproducibility was measured using the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) for two observers who repeated segmentation measurements five-times. Results: For five well-controlled asthmatics, forced expiratory volume in 1 s (FEV{sub 1})/forced vital capacity (FVC) was 83% ± 7% and FEV{sub 1} was 86 ± 9%{sub pred}. For 15 severe, poorly controlled asthmatics, FEV{sub 1}/FV C = 66% ± 17% and FEV{sub 1} = 72 ± 27%{sub pred}. The DSC for algorithm and manual segmentation was 91% ± 3%, 92% ± 2% and 91% ± 2% for the left, right, and whole lung, respectively. RMSE was 4.0 ± 1.0 mm for each of the left, right, and whole lung. The absolute (percent) volume errors were 0.1 l (∼6%) for each of right and left lung and ∼0.2 l (∼6%) for whole lung. Intra- and inter-CoV (ICC) were <0.5% (>0.91%) for DSC and <4.5% (>0.93%) for RMSE. While segmentation required 10 s including ∼6 s for user interaction, the smallest detectable difference was 0.24 l for algorithm measurements which was similar to manual measurements. Conclusions: This lung segmentation approach provided the necessary and sufficient precision and accuracy required for research and clinical studies.

60 APPLIED LIFE SCIENCES↗

Iterative metal artifact reduction for x-ray computed tomography using unmatched projector/backprojector pairs

Purpose: Metal artifact reduction (MAR) is a major problem and a challenging issue in x-ray computed tomography (CT) examinations. Iterative reconstruction from sinograms unaffected by metals shows promising potential in detail recovery. This reconstruction has been the subject of much research in recent years. However, conventional iterative reconstruction methods easily introduce new artifacts around metal implants because of incomplete data reconstruction and inconsistencies in practical data acquisition. Hence, this work aims at developing a method to suppress newly introduced artifacts and improve the image quality around metal implants for the iterative MAR scheme. Methods: The proposed method consists of two steps based on the general iterative MAR framework. An uncorrected image is initially reconstructed, and the corresponding metal trace is obtained. The iterative reconstruction method is then used to reconstruct images from the unaffected sinogram. In the reconstruction step of this work, an iterative strategy utilizing unmatched projector/backprojector pairs is used. A ramp filter is introduced into the back-projection procedure to restrain the inconsistency components in low frequencies and generate more reliable images of the regions around metals. Furthermore, a constrained total variation (TV) minimization model is also incorporated to enhance efficiency. The proposed strategy is implemented based on an iterative FBP and an alternating direction minimization (ADM) scheme, respectively. The developed algorithms are referred to as “iFBP-TV” and “TV-FADM,” respectively. Two projection-completion-based MAR methods and three iterative MAR methods are performed simultaneously for comparison. Results: The proposed method performs reasonably on both simulation and real CT-scanned datasets. This approach could reduce streak metal artifacts effectively and avoid the mentioned effects in the vicinity of the metals. The improvements are evaluated by inspecting regions of interest and by comparing the root-mean-square errors, normalized mean absolute distance, and universal quality index metrics of the images. Both iFBP-TV and TV-FADM methods outperform other counterparts in all cases. Unlike the conventional iterative methods, the proposed strategy utilizing unmatched projector/backprojector pairs shows excellent performance in detail preservation and prevention of the introduction of new artifacts. Conclusions: Qualitative and quantitative evaluations of experimental results indicate that the developed method outperforms classical MAR algorithms in suppressing streak artifacts and preserving the edge structural information of the object. In particular, structures lying close to metals can be gradually recovered because of the reduction of artifacts caused by inconsistency effects.

60 APPLIED LIFE SCIENCES↗

SU-F-T-592: A Delivery QA-Free Approach for Adaptive Therapy of Prostate Cancer with Static Intensity Modulated Radiotherapy

Purpose: Clinical implementations of adaptive radiotherapy (ART) are limited mainly by the requirement of delivery QA (DQA) prior to the treatment. Small segment size and small segment MU are two dominant factors causing failures of DQA. The aim of this project is to explore the feasibility of ART treatment without DQA by using a partial optimization approach. Methods: A retrospective simulation study was performed on two prostate cancer patients treated with SMLC-IMRT. The prescription was 180cGx25 fractions with daily CT-on-rail imaging for target alignment. For each patient, seven daily CTs were selected randomly across treatment course. The contours were deformablely transferred from the simulation CT onto the daily CTs and modified appropriately. For each selected treatment, dose distributions from original beams were calculated on the daily treatment CTs (DCT plan). An ART plan was also created by optimizing the segmental MU only, while the segment shapes were preserved and the minimum MU constraint was respected. The overlaps, between PTV and the rectum, between PTV and the bladder, were normalized by the PTV volume. This ratio was used to characterize the difficulty of organs-at-risk (OAR) sparing. Results: Comparing to the original plan, PTV coverage was compromised significantly in DCT plans (82% ± 7%) while all ART plans preserved PTV coverage. ART plans showed similar OAR sparing as the original plan, such as V40Gy=11.2cc (ART) vs 11.4cc (original) for the rectum and D10cc=4580cGy vs 4605cGy for the bladder. The sparing of the rectum/bladder depends on overlap ratios. The sparing in ART was either similar or improved when overlap ratios in treatment CTs were smaller than those in original plan. Conclusion: A partial optimization method is developed that may make the real-time ART feasible on selected patients. Future research is warranted to quantify the applicability of the proposed method.

60 APPLIED LIFE SCIENCES↗

WE-H-204-00: History Committee Symposium

“William D. Coolidge, Inventor of the Modern X-ray Tube” David J. Allard, M.S., CHP - Director, PA DEP Bureau of Radiation Protection William David Coolidge 1873–1975 was a research scientist and inventor of the modern X-ray tube. Besides Roentgen, with his 1895 discovery and subsequent studies of X-rays, perhaps no other individual contributed more to the advancement of X-ray technology than did Coolidge. He was born in Hudson, MA and received his Bachelor of Science degree from MIT in 1896. That same year he went to Europe to study under renowned physicists of the time. Coolidge received his Ph.D. summa cum laude from the University of Leipzig in 1899 and soon after joined the staff of MIT. While studying at Leipzig, he met Roentgen. In 1905 he was asked to join the newly established General Electric Research Laboratory in Schenectady, NY. He promptly began fundamental work on the production of ductile tungsten filaments as a replacement for fragile carbon filaments used in incandescent light bulbs. This improved light bulb was brought to market by GE in 1911. It was subsequent application of his tungsten work that led Coolidge to his studies in X ray production. Circa 1910, the state-of-the-art X-ray tube was a “gas tube” or “cold cathode” type tube. These crude X-ray tubes relied on residual gas molecules as a source of electrons for bombardment of low to medium atomic number metal targets. In 1912 Coolidge described the use of tungsten as an improved anode target material for X-ray tubes. Shortly after in 1913 he published a paper in Physical Review describing “A Powerful Roentgen Ray Tube With a Pure Electron Discharge.” This tube used a tungsten filament as a thermionic source of electrons under high vacuum to bombard a tungsten anode target. Great improvements in X-ray tube stability, output and performance were obtained with the “hot cathode” or “Coolidge tube.” With some variation in filament and target geometry, this 100 year old invention is the same basic X-ray tube used today in medicine, research and industry. In 1932 Coolidge became Director of the GE Laboratory, then in 1940 Vice-President and Director of Research. In 1941 he was a member of a small committee, appointed by President Franklin D. Roosevelt, to evaluate the military importance of research on uranium. This committee’s report led to the establishment of the Manhattan Engineering District for nuclear weapons development during WWII. Coolidge lived to be over 100 years old, he had 83 patents to his credit, numerous awards and honorary degrees, and in 1975 was elected to the National Inventor’s Hall of Fame. At the time he was the only inventor to receive this honor in his lifetime. Dr. Coolidge was also the first recipient of the AAPM’s highest science award - named in his honor. From notes of a day-long interview with Coolidge’s son Lawrence in the mid-1990s, previous biographies, publications, books, GE literature, historic photographs, e.g., a wonderful 1874 photo stereoview card with 1 year old baby “Willie Coolidge”, and other artifacts in the author’s collection, this presentation will review Dr. Coolidge’s amazing life, work, accomplishments and awards. “History and Archives Resources at AIP for AAPM and its Members” Gregory A. Good, Ph.D. - Director, AIP Center for History of Physics Melanie J. Mueller, MLIS - Acting Director, AIP Niels Bohr Library & Archives The American Institute of Physics established the Center for History of Physics and the Niels Bohr Library & Archives in the 1960s. Our shared mission is: To preserve and make known the history of the physical sciences. This talk will explore the many ways that AIP’s two history programs support the historical and archival activities of AAPM. Topics will include our ongoing oral history program, web outreach through exhibits and teaching guides, and archiving for AAPM and other Member Societies. We will focus in particular on materials in our collections related to the history of medical physics and to the history of AAPM. We will unveil and demonstrate a new “Archives Portal” that we are designing specifically to be useful to AAPM and its members. Learning Objectives: Study the background of the medical physicist - William David Coolidge Examine the time-line for his success Review the publications conceptualizing his works and progressions Realize what he invented Evaluate the importance of the invention Relate the success to national prominence Uncover how he influenced medical physicists today Find out how he was celebrated by the AAPM View the AIP established Center for History of Physics Consider the significant efforts and vision to preserve the history of medical physics Learn about the Niels Bohr Library & Archives Look back in time at medical physics in the 1960s Unveil and demonstrate a new “Archives Portal” that will be useful to AAPM.

61 RADIATION PROTECTION AND DOSIMETRY↗

WE-H-204-01: William D. Coolidge, Inventor of the Modern X-Ray Tube

“William D. Coolidge, Inventor of the Modern X-ray Tube” David J. Allard, M.S., CHP - Director, PA DEP Bureau of Radiation Protection William David Coolidge 1873–1975 was a research scientist and inventor of the modern X-ray tube. Besides Roentgen, with his 1895 discovery and subsequent studies of X-rays, perhaps no other individual contributed more to the advancement of X-ray technology than did Coolidge. He was born in Hudson, MA and received his Bachelor of Science degree from MIT in 1896. That same year he went to Europe to study under renowned physicists of the time. Coolidge received his Ph.D. summa cum laude from the University of Leipzig in 1899 and soon after joined the staff of MIT. While studying at Leipzig, he met Roentgen. In 1905 he was asked to join the newly established General Electric Research Laboratory in Schenectady, NY. He promptly began fundamental work on the production of ductile tungsten filaments as a replacement for fragile carbon filaments used in incandescent light bulbs. This improved light bulb was brought to market by GE in 1911. It was subsequent application of his tungsten work that led Coolidge to his studies in X ray production. Circa 1910, the state-of-the-art X-ray tube was a “gas tube” or “cold cathode” type tube. These crude X-ray tubes relied on residual gas molecules as a source of electrons for bombardment of low to medium atomic number metal targets. In 1912 Coolidge described the use of tungsten as an improved anode target material for X-ray tubes. Shortly after in 1913 he published a paper in Physical Review describing “A Powerful Roentgen Ray Tube With a Pure Electron Discharge.” This tube used a tungsten filament as a thermionic source of electrons under high vacuum to bombard a tungsten anode target. Great improvements in X-ray tube stability, output and performance were obtained with the “hot cathode” or “Coolidge tube.” With some variation in filament and target geometry, this 100 year old invention is the same basic X-ray tube used today in medicine, research and industry. In 1932 Coolidge became Director of the GE Laboratory, then in 1940 Vice-President and Director of Research. In 1941 he was a member of a small committee, appointed by President Franklin D. Roosevelt, to evaluate the military importance of research on uranium. This committee’s report led to the establishment of the Manhattan Engineering District for nuclear weapons development during WWII. Coolidge lived to be over 100 years old, he had 83 patents to his credit, numerous awards and honorary degrees, and in 1975 was elected to the National Inventor’s Hall of Fame. At the time he was the only inventor to receive this honor in his lifetime. Dr. Coolidge was also the first recipient of the AAPM’s highest science award - named in his honor. From notes of a day-long interview with Coolidge’s son Lawrence in the mid-1990s, previous biographies, publications, books, GE literature, historic photographs, e.g., a wonderful 1874 photo stereoview card with 1 year old baby “Willie Coolidge”, and other artifacts in the author’s collection, this presentation will review Dr. Coolidge’s amazing life, work, accomplishments and awards. “History and Archives Resources at AIP for AAPM and its Members” Gregory A. Good, Ph.D. - Director, AIP Center for History of Physics Melanie J. Mueller, MLIS - Acting Director, AIP Niels Bohr Library & Archives The American Institute of Physics established the Center for History of Physics and the Niels Bohr Library & Archives in the 1960s. Our shared mission is: To preserve and make known the history of the physical sciences. This talk will explore the many ways that AIP’s two history programs support the historical and archival activities of AAPM. Topics will include our ongoing oral history program, web outreach through exhibits and teaching guides, and archiving for AAPM and other Member Societies. We will focus in particular on materials in our collections related to the history of medical physics and to the history of AAPM. We will unveil and demonstrate a new “Archives Portal” that we are designing specifically to be useful to AAPM and its members. Learning Objectives: Study the background of the medical physicist - William David Coolidge Examine the time-line for his success Review the publications conceptualizing his works and progressions Realize what he invented Evaluate the importance of the invention Relate the success to national prominence Uncover how he influenced medical physicists today Find out how he was celebrated by the AAPM View the AIP established Center for History of Physics Consider the significant efforts and vision to preserve the history of medical physics Learn about the Niels Bohr Library & Archives Look back in time at medical physics in the 1960s Unveil and demonstrate a new “Archives Portal” that will be useful to AAPM.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

WE-H-204-02: Part 1: History and Archives Resources at AIP for AAPM and Its Members

“William D. Coolidge, Inventor of the Modern X-ray Tube” David J. Allard, M.S., CHP - Director, PA DEP Bureau of Radiation Protection William David Coolidge 1873–1975 was a research scientist and inventor of the modern X-ray tube. Besides Roentgen, with his 1895 discovery and subsequent studies of X-rays, perhaps no other individual contributed more to the advancement of X-ray technology than did Coolidge. He was born in Hudson, MA and received his Bachelor of Science degree from MIT in 1896. That same year he went to Europe to study under renowned physicists of the time. Coolidge received his Ph.D. summa cum laude from the University of Leipzig in 1899 and soon after joined the staff of MIT. While studying at Leipzig, he met Roentgen. In 1905 he was asked to join the newly established General Electric Research Laboratory in Schenectady, NY. He promptly began fundamental work on the production of ductile tungsten filaments as a replacement for fragile carbon filaments used in incandescent light bulbs. This improved light bulb was brought to market by GE in 1911. It was subsequent application of his tungsten work that led Coolidge to his studies in X ray production. Circa 1910, the state-of-the-art X-ray tube was a “gas tube” or “cold cathode” type tube. These crude X-ray tubes relied on residual gas molecules as a source of electrons for bombardment of low to medium atomic number metal targets. In 1912 Coolidge described the use of tungsten as an improved anode target material for X-ray tubes. Shortly after in 1913 he published a paper in Physical Review describing “A Powerful Roentgen Ray Tube With a Pure Electron Discharge.” This tube used a tungsten filament as a thermionic source of electrons under high vacuum to bombard a tungsten anode target. Great improvements in X-ray tube stability, output and performance were obtained with the “hot cathode” or “Coolidge tube.” With some variation in filament and target geometry, this 100 year old invention is the same basic X-ray tube used today in medicine, research and industry. In 1932 Coolidge became Director of the GE Laboratory, then in 1940 Vice-President and Director of Research. In 1941 he was a member of a small committee, appointed by President Franklin D. Roosevelt, to evaluate the military importance of research on uranium. This committee’s report led to the establishment of the Manhattan Engineering District for nuclear weapons development during WWII. Coolidge lived to be over 100 years old, he had 83 patents to his credit, numerous awards and honorary degrees, and in 1975 was elected to the National Inventor’s Hall of Fame. At the time he was the only inventor to receive this honor in his lifetime. Dr. Coolidge was also the first recipient of the AAPM’s highest science award - named in his honor. From notes of a day-long interview with Coolidge’s son Lawrence in the mid-1990s, previous biographies, publications, books, GE literature, historic photographs, e.g., a wonderful 1874 photo stereoview card with 1 year old baby “Willie Coolidge”, and other artifacts in the author’s collection, this presentation will review Dr. Coolidge’s amazing life, work, accomplishments and awards. “History and Archives Resources at AIP for AAPM and its Members” Gregory A. Good, Ph.D. - Director, AIP Center for History of Physics Melanie J. Mueller, MLIS - Acting Director, AIP Niels Bohr Library & Archives The American Institute of Physics established the Center for History of Physics and the Niels Bohr Library & Archives in the 1960s. Our shared mission is: To preserve and make known the history of the physical sciences. This talk will explore the many ways that AIP’s two history programs support the historical and archival activities of AAPM. Topics will include our ongoing oral history program, web outreach through exhibits and teaching guides, and archiving for AAPM and other Member Societies. We will focus in particular on materials in our collections related to the history of medical physics and to the history of AAPM. We will unveil and demonstrate a new “Archives Portal” that we are designing specifically to be useful to AAPM and its members. Learning Objectives: Study the background of the medical physicist - William David Coolidge Examine the time-line for his success Review the publications conceptualizing his works and progressions Realize what he invented Evaluate the importance of the invention Relate the success to national prominence Uncover how he influenced medical physicists today Find out how he was celebrated by the AAPM View the AIP established Center for History of Physics Consider the significant efforts and vision to preserve the history of medical physics Learn about the Niels Bohr Library & Archives Look back in time at medical physics in the 1960s Unveil and demonstrate a new “Archives Portal” that will be useful to AAPM.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

WE-H-204-03: Part 2: History and Archives Resources at AIP for AAPM and Its Members

“William D. Coolidge, Inventor of the Modern X-ray Tube” David J. Allard, M.S., CHP - Director, PA DEP Bureau of Radiation Protection William David Coolidge 1873–1975 was a research scientist and inventor of the modern X-ray tube. Besides Roentgen, with his 1895 discovery and subsequent studies of X-rays, perhaps no other individual contributed more to the advancement of X-ray technology than did Coolidge. He was born in Hudson, MA and received his Bachelor of Science degree from MIT in 1896. That same year he went to Europe to study under renowned physicists of the time. Coolidge received his Ph.D. summa cum laude from the University of Leipzig in 1899 and soon after joined the staff of MIT. While studying at Leipzig, he met Roentgen. In 1905 he was asked to join the newly established General Electric Research Laboratory in Schenectady, NY. He promptly began fundamental work on the production of ductile tungsten filaments as a replacement for fragile carbon filaments used in incandescent light bulbs. This improved light bulb was brought to market by GE in 1911. It was subsequent application of his tungsten work that led Coolidge to his studies in X ray production. Circa 1910, the state-of-the-art X-ray tube was a “gas tube” or “cold cathode” type tube. These crude X-ray tubes relied on residual gas molecules as a source of electrons for bombardment of low to medium atomic number metal targets. In 1912 Coolidge described the use of tungsten as an improved anode target material for X-ray tubes. Shortly after in 1913 he published a paper in Physical Review describing “A Powerful Roentgen Ray Tube With a Pure Electron Discharge.” This tube used a tungsten filament as a thermionic source of electrons under high vacuum to bombard a tungsten anode target. Great improvements in X-ray tube stability, output and performance were obtained with the “hot cathode” or “Coolidge tube.” With some variation in filament and target geometry, this 100 year old invention is the same basic X-ray tube used today in medicine, research and industry. In 1932 Coolidge became Director of the GE Laboratory, then in 1940 Vice-President and Director of Research. In 1941 he was a member of a small committee, appointed by President Franklin D. Roosevelt, to evaluate the military importance of research on uranium. This committee’s report led to the establishment of the Manhattan Engineering District for nuclear weapons development during WWII. Coolidge lived to be over 100 years old, he had 83 patents to his credit, numerous awards and honorary degrees, and in 1975 was elected to the National Inventor’s Hall of Fame. At the time he was the only inventor to receive this honor in his lifetime. Dr. Coolidge was also the first recipient of the AAPM’s highest science award - named in his honor. From notes of a day-long interview with Coolidge’s son Lawrence in the mid-1990s, previous biographies, publications, books, GE literature, historic photographs, e.g., a wonderful 1874 photo stereoview card with 1 year old baby “Willie Coolidge”, and other artifacts in the author’s collection, this presentation will review Dr. Coolidge’s amazing life, work, accomplishments and awards. “History and Archives Resources at AIP for AAPM and its Members” Gregory A. Good, Ph.D. - Director, AIP Center for History of Physics Melanie J. Mueller, MLIS - Acting Director, AIP Niels Bohr Library & Archives The American Institute of Physics established the Center for History of Physics and the Niels Bohr Library & Archives in the 1960s. Our shared mission is: To preserve and make known the history of the physical sciences. This talk will explore the many ways that AIP’s two history programs support the historical and archival activities of AAPM. Topics will include our ongoing oral history program, web outreach through exhibits and teaching guides, and archiving for AAPM and other Member Societies. We will focus in particular on materials in our collections related to the history of medical physics and to the history of AAPM. We will unveil and demonstrate a new “Archives Portal” that we are designing specifically to be useful to AAPM and its members. Learning Objectives: Study the background of the medical physicist - William David Coolidge Examine the time-line for his success Review the publications conceptualizing his works and progressions Realize what he invented Evaluate the importance of the invention Relate the success to national prominence Uncover how he influenced medical physicists today Find out how he was celebrated by the AAPM View the AIP established Center for History of Physics Consider the significant efforts and vision to preserve the history of medical physics Learn about the Niels Bohr Library & Archives Look back in time at medical physics in the 1960s Unveil and demonstrate a new “Archives Portal” that will be useful to AAPM.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TH-AB-209-09: Quantitative Imaging of Electrical Conductivity by VHF-Induced Thermoacoustics

Purpose: To demonstrate that very high frequency (VHF) induced thermoacoustics has the potential to provide quantitative images of electrical conductivity in Siemens/meter, much as shear wave elastography provides tissue stiffness in kPa. Quantitatively imaging a large organ requires exciting thermoacoustic pulses throughout the volume and broadband detection of those pulses because tomographic image reconstruction preserves frequency content. Applying the half-wavelength limit to a 200-micron inclusion inside a 7.5 cm diameter organ requires measurement sensitivity to frequencies ranging from 4 MHz down to 10 kHz, respectively. VHF irradiation provides superior depth penetration over near infrared used in photoacoustics. Additionally, VHF signal production is proportional to electrical conductivity, and prostate cancer is known to suppress electrical conductivity of prostatic fluid. Methods: A dual-transducer system utilizing a P4-1 array connected to a Verasonics V1 system augmented by a lower frequency focused single element transducer was developed. Simultaneous acquisition of VHF-induced thermoacoustic pulses by both transducers enabled comparison of transducer performance. Data from the clinical array generated a stack of 96-images with separation of 0.3 mm, whereas the single element transducer imaged only in a single plane. In-plane resolution and quantitative accuracy were measured at isocenter. Results: The array provided volumetric imaging capability with superior resolution whereas the single element transducer provided superior quantitative accuracy. Combining axial images from both transducers preserved resolution of the P4-1 array and improved image contrast. Neither transducer was sensitive to frequencies below 50 kHz, resulting in a DC offset and low-frequency shading over fields of view exceeding 15 mm. Fresh human prostates were imaged ex vivo and volumetric reconstructions reveal structures rarely seen in diagnostic images. Conclusion: Quantitative whole-organ thermoacoustic tomography will be feasible by sparsely interspersing transducer elements sensitive to the low end of the ultrasonic range.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗