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At least 1,783 records · Page 99

SU-C-213-07: Fabrication and Testing of a 3D-Printed Small Animal Rectal Cooling Device to Evaluate Local Hypothermia as a Radioprotector During Prostate SBRT

Purpose: The protective effects of induced or even accidental hypothermia on the human body are widespread with several medical uses currently under active research. In vitro experiments using human cell lines have shown hypothermia provides a radioprotective effect that becomes more pronounced at large, single-fraction doses common to SBRT treatments. Relevant to prostate SBRT, this work details the fabrication and testing of a 3D-printed cooling device to facilitate the investigation of the radioprotective effect of local hypothermia on the rat rectum. Methods: A 3cm long, two-channel rectal cooling device was designed in SOLIDWORKS CAD for 3D printing. The water intake nozzle is connected to a 1mm diameter brass pipe from which water flows and circulates back around to the exit nozzle. Both nozzles are connected by plastic tubing to a water chiller pump. Following leak-proof testing, fiber optic temperature probes were used to evaluate the temperature over time when placed adjacent to the cooling device within a rat rectum. MRI thermometry characterized the relative temperature distribution in concentric ROIs surrounding the probe. CBCT images from a small-animal irradiator were evaluated for imaging artifacts which could affect Monte Carlo dose calculations during treatment planning. Results: The rectal temperature adjacent to the cooling device decreased from body temperature (37°C) to 15°C in 10–20 minutes from device insertion. Rectal temperature was maintained at 15±3°C during active cooling. MRI thermometry tests revealed a steep temperature gradient with increasing distance from the cooling device, with the desired temperature range maintained within the surrounding few millimeters. Conclusion: A 3D printed rectal cooling device was fabricated for the purpose of inducing local hypothermia in rat rectums. Rectal cooling capabilities were characterized in-vivo to facilitate an investigation of the radioprotective effect of hypothermia for late rectal toxicity following a single large dose of radiation. Funding support provided by RSNA research seed grant.

60 APPLIED LIFE SCIENCES↗

SU-C-303-04: Evaluation of On- and Off-Line Bioluminescence Tomography System for Focal Irradiation Guidance

Purpose: We have developed offline and on-board bioluminescence tomography(BLT) systems for the small animal radiation research platform(SARRP) for radiation guidance of soft tissue targets. We investigated the effectiveness of offline BLT guidance. Methods: CBCT is equipped on both the offline BLT system and SARRP that are 10 ft. apart. To evaluate the setup error during animal transport between the two systems, we implanted a luminescence source in the abdomen of anesthetized mice. Five mice were studied. After CBCT was acquired on both systems, source centers and correlation coefficients were calculated. CBCT was also used to generate object mesh for BLT reconstruction. To assess target localization, we compared the localization of the luminescence source based on (1)on-board SARRP BLT and CBCT, (2)offline BLT and CBCT, and (3)offline BLT and SARRP CBCT. The 3rd comparison examines if an offline BLT system can be used to guide radiation when there is minimal target contrast in CBCT. Results: Our CBCT results show the offset of the light source center can be maintained within 0.2 mm during animal transport. The center of mass(CoM) of the light source reconstructed by the offline BLT has an offset of 1.0 ± 0.4 mm from the ‘true’ CoM as derived from the SARRP CBCT. The results compare well with the offset of 1.0 ± 0.2 mm using on-line BLT. Conclusion: With CBCT information provided by the SARRP and effective animal immobilization during transport, these findings support the use of offline BLT in close vicinity for accurate soft tissue target localization for irradiation. However, the disadvantage of the off-line system is reduced efficiency as care is required to maintain stable animal transport. We envisage a dual use system where the on-board arrangement allows convenient access to CBCT and avoids disturbance of animal setup. The off-line capability would support standalone longitudinal imaging studies. The work is supported by NIH R01CA158100 and Xstrahl Ltd. Drs. John Wong and Iulian Iordachita receive royalty payment from a licensing agreement between Xstrahl Ltd and Johns Hopkins University. John Wong also has a consultant agreement with Xstrahl Ltd.

60 APPLIED LIFE SCIENCES↗

SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bones from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.

60 APPLIED LIFE SCIENCES↗

SU-E-J-221: A Novel Expansion Method for MRI Based Target Delineation in Prostate Radiotherapy

Purpose: To compare a novel bladder/rectum carveout expansion method on MRI delineated prostate to standard CT and expansion based methods for maintaining prostate coverage while providing superior bladder and rectal sparing. Methods: Ten prostate cases were planned to include four trials: MRI vs CT delineated prostate/proximal seminal vesicles, and each image modality compared to both standard expansions (8mm 3D expansion and 5mm posterior, i.e. ∼8mm) and carveout method expansions (5mm 3D expansion, 4mm posterior for GTV-CTV excluding expansion into bladder/rectum followed by additional 5mm 3D expansion to PTV, i.e. ∼1cm). All trials were planned to total dose 7920 cGy via IMRT. Evaluation and comparison was made using the following criteria: QUANTEC constraints for bladder/rectum including analysis of low dose regions, changes in PTV volume, total control points, and maximum hot spot. Results: ∼8mm MRI expansion consistently produced the most optimal plan with lowest total control points and best bladder/rectum sparing. However, this scheme had the smallest prostate (average 22.9% reduction) and subsequent PTV volume, consistent with prior literature. ∼1cm MRI had an average PTV volume comparable to ∼8mm CT at 3.79% difference. Bladder QUANTEC constraints were on average less for the ∼1cm MRI as compared to the ∼8mm CT and observed as statistically significant with 2.64% reduction in V65. Rectal constraints appeared to follow the same trend. Case-by-case analysis showed variation in rectal V30 with MRI delineated prostate being most favorable regardless of expansion type. ∼1cm MRI and ∼8mm CT had comparable plan quality. Conclusion: MRI delineated prostate with standard expansions had the smallest PTV leading to margins that may be too tight. Bladder/rectum carveout expansion method on MRI delineated prostate was found to be superior to standard CT based methods in terms of bladder and rectal sparing while maintaining prostate coverage. Continued investigation is warranted for further validation.

60 APPLIED LIFE SCIENCES↗

SU-E-T-10: A Clinical Implementation and the Dosimetric Evidence in High Dose Rate Vaginal Multichannel Applicator Brachytherapy

Purpose: The multichannel cylindrical applicator has a distinctive modification of the traditional single channel cylindrical applicator. The novel multichannel applicator has additional peripheral channels that provide more flexibility both in treatment planning process and outcomes. To protect by reducing doses to adjacent organ at risk (OAR) while maintaining target coverage with inverse plan optimization are the goals for such novel Brachytherapy device. Through a series of comparison and analysis of reults in more than forty patients who received HDR Brachytherapy using multichannel vaginal applicator, this procedure has been implemented in our institution. Methods: Multichannel planning was CT image based. The CTV of 5mm vaginal cuff rind with prescribed length was well reconstructed as well as bladder and rectum. At least D95 of CTV coverage is 95% of prescribed dose. Multichannel inverse plan optimization algorithm not only shapes target dose cloud but set dose avoids to OAR’s exclusively. The doses of D2cc, D5cc and D5; volume of V2Gy in OAR’s were selected to compare with single channel results when sole central channel is only possibility. Results: Study demonstrates plan superiorly in OAR’s doe reduction in multi-channel plan. The D2cc of the rectum and bladder were showing a little lower for multichannel vs. single channel. The V2Gy of the rectum was 93.72% vs. 83.79% (p=0.007) for single channel vs. multichannel respectively. Absolute reduced mean dose of D5 by multichannel was 17 cGy (s.d.=6.4) and 44 cGy (s.d.=15.2) in bladder and rectum respectively. Conclusion: The optimization solution in multichannel was to maintain D95 CTV coverage while reducing the dose to OAR’s. Dosimetric advantage in sparing critical organs by using a multichannel applicator in HDR Brachytherapy treatment of the vaginal cuff is so promising and has been implemented clinically.

60 APPLIED LIFE SCIENCES↗

SU-E-T-267: Development of the Compact Graphite Calorimetry System for the High Energy Photon Beam

Purpose: Graphite calorimeter systems are used for the absolute photon dosimetry. But many electronics are demanded in order to measure the tiny temperature changes. Minimizing the control system is needed to make a portable graphite calorimeter. Methods: A Domen-type graphite calorimetry system is constructing to measure the absorbed dose of the high energy photon beam. The graphite calorimeter divided into three parts, Core, Jacket, and Shield. In order to measure the temperature rising of the core due to the radiation accurately, the temperatures of the jacket and the shield should be controlled properly. A commercial temperature controller (Model 350, Lake Shore Cryogenics) was used to minimize the size of control system for making a portable graphite calorimetry system at the cost of the measurement uncertainty. The PID control of the jacket is conducted by the software (LabView) and Model 350 maintain the temperature of shield. Results: Our design value of the heat deposition power in the core is 0.04 mW for the dose rate of 3 Gy/min where the temperature sensitivity of the graphite is 1.4 mK/Gy. While the residuals of the Steinhart-hart equation fitting for the core thermistor were less than 0.1 mK, the temperature resolution of Model 350 is 1 mK. The temperature of the shield was kept within the 5 mK when the room temperature variation was about 0.5 K. Conclusion: The resolution of Model 350 for the temperature measurement and control is not good enough as the control system for the compact graphite calorimetry system. But The performance of Model 350 is good enough to maintain the temperature of the shield constantly. The Model 350 will be replaced by the AC resistance bridge (Model 372, Lake Shore Cryogenics) for the core temperature measurement and the jacket control.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-774: Use of a Scintillator-Mirror-Camera System for the Measurement of MLC Leakage Radiation with the CyberKnife M6 System

Purpose: A technique using a scintillator-mirror-camera system to measure MLC leakage was developed to provide an efficient alternative to film dosimetry while maintaining high spatial resolution. This work describes the technique together with measurement uncertainties. Methods: Leakage measurements were made for the InCise™ MLC using the Logos XRV-2020A device. For each measurement approximately 170 leakage and background images were acquired using optimized camera settings. Average background was subtracted from each leakage frame before filtering the integrated leakage image to replace anomalous pixels. Pixel value to dose conversion was performed using a calibration image. Mean leakage was calculated within an ROI corresponding to the primary beam, and maximum leakage was determined by binning the image into overlapping 1mm x 1mm ROIs. 48 measurements were performed using 3 cameras and multiple MLC-linac combinations in varying beam orientations, with each compared to film dosimetry. Optical and environmental influences were also investigated. Results: Measurement time with the XRV-2020A was 8 minutes vs. 50 minutes using radiochromic film, and results were available immediately. Camera radiation exposure degraded measurement accuracy. With a relatively undamaged camera, mean leakage agreed with film measurement to ≤0.02% in 92% cases, ≤0.03% in 100% (for maximum leakage the values were 88% and 96%) relative to reference open field dose. The estimated camera lifetime over which this agreement is maintained is at least 150 measurements, and can be monitored using reference field exposures. A dependency on camera temperature was identified and a reduction in sensitivity with distance from image center due to optical distortion was characterized. Conclusion: With periodic monitoring of the degree of camera radiation damage, the XRV-2020A system can be used to measure MLC leakage. This represents a significant time saving when compared to the traditional film-based approach without any substantial reduction in accuracy.

60 APPLIED LIFE SCIENCES↗

SU-E-T-804: Verification of the BJR-25 Method of KQ Determination for CyberKnife Absolute Dosimetry

Purpose: Absolute calibration of the CyberKnife is performed using a 6cm-diameter cone defined at 80cm SAD. Since kQ is defined using PDD values determined using 10×10 cm fields at 100cm SSD, the PDD must be corrected in order to correctly apply the quality conversion factor. The accepted method is based on equivalent field-size conversions of PDD values using BJR25. Using the new InCise MLC system, the CK is capable of generating a rectangular field equivalent to 10×10 cm square field. In this study, a comparison is made between kQ values determined using the traditional BJR25 method and the MLC method introduced herein. Methods: First, kQ(BJR) is determined: a PDD is acquired using a 6cm circular field at 100cm SSD, its field size converted to an equivalent square, and PDD converted to a 10×10cm field using the appropriate BJR25 table. Maintaining a consistent setup, the collimator is changed, and the MLC method is used. Finally, kQ is determined using PDDs acquired with a 9.71×10.31cm at 100cm SSD. This field is produced by setting the field to a size of 7.77×8.25cm (since it is defined at 80cm SAD). An exact 10×10cm field since field size is relegated to increments of its leaf width (0.25cm). This comparison is made using an Exradin A1SL, IBA CC08, IBA CC13, and an Exradin A19. For each detector and collimator type, the beam injector was adjusted to give 5 different beam qualities; representing a range of clinical systems. Results: Averaging across all beam qualities, kQ(MLC) differed from kQ(BJR) by less than 0.15%. The difference between the values increased with detector volume. Conclusion: For CK users with standard cone collimators, the BJR25 method has been verified. For CK users the MLC system, a technique is described to determine kQ. Primary author is the President/Owner of Spectrum Medical Physics, LLC, a company which maintains contracts with Siemens Healthcare and Standard Imaging, Inc.

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MO-FG-213-04: Managing the Relationship

Academic-industrial collaborations are playing an increasingly prominent role in medical physics research. Successful partnerships have enabled truly translational, benchtop-to-bedside research that has significantly and positively impacted our field. Given the current flat or depleting trends in federal funding, and the increasing emphasis in the medical physics community on demonstrating translatability, efficacy, and safety prior to widespread clinical use, it is anticipated that such partnerships will become ever more important in advancing our field. In the future, it is likely that neither academia alone, nor industry alone, will be able to bring significant innovation to successfully impact patient care in radiotherapy. Such innovation will require partnership and symbiosis through the lifetime of the project. This symposium is aimed at professionals from academia and the industry who are interested in either initiating new collaborations or maintaining and improving existing partnerships. We will hear from four thought leaders from industry and academia on critical aspects of building and maintaining successful academic-industrial research partnerships. The following topics will be addressed: 1. Motivations: The industry perspective [Kevin Brown, Elekta] What goes into the development of a company’s R&D roadmap What are the motivations and expectations of the industry from academic partners How can academics make a successful pitch by identifying projects aligned with a company’s roadmap Why are some relationships successful and some not Milestones and progress reports - Why do we need them 2. Motivations: The academic perspective [T. Rock Mackie, Univ. of Madison, WI; Tomotherapy] What are the motivations and expectations of academic partners from the industry What are the cultural differences in academia vs industry on sharing information, exchanging ideas Partnership or entrepreneurship? When does each option make sense 3. Industrial Grants and Research Contracts – a Primer [Norbert Pelc; Stanford University] What topics are suited to industrial grants vs. academic grants How do resources (personnel effort, tuition) get allocated and charged in academia What are reasonable resource and timeline requests for small and big projects; from small and big companies “Fair market value” considerations Sections of a research agreement (IP including software confidential information, publications, data, exclusivity, support) 4. Managing the relationship [John Wong, Johns Hopkins University] How to effectively collaborate with each other How to adapt to changes in the relationship How to renew funding with the industry Moderated Panel Discussion [All speakers + moderators] Learning Objectives: 1. Understand the motivations of each partner 2. Elements that contribute to a successful partnership 3. Avoiding pitfalls - Challenges on either side that may derail a project 4. How to frame a research grant and agreement 5. How to sustain the collaborative relationship Amit Sawant: Funding from: NIH. Varian, Elekta and VisionRT; Michelle Svatos: Employee and shareholder: Varian, Board Member, TopasMC; Kevin Brown: Employee, Elekta; T. Rock Mackie: Consultant, Accuray; Norbert Pelc: Research support: Philips Healthcare, GE Healthcare; John Wong: Funding from NIH, Xstrahl and Elekta. Co-founder and advisor for JPLC Associates, LLC.

07 ISOTOPE AND RADIATION SOURCES↗

TU-CD-304-07: Intensity Modulated Electron Beam Therapy Employing Small Fields in Virtual Scanning Mode

Purpose: Dynamic electron radiation therapies such as dynamic electron arc radiotherapy (DEAR) utilize small fields to provide target conformity and fluence modulation. The purpose of this study is to demonstrate the feasibility of virtual scanning mode using small fields. Methods: Monte Carlo simulations (EGSnrc/BEAMnrc/DOSXYZnrc) were performed using validated Varian TrueBeam phase space files for electron beam energies of 6, 9, 12, and 16 MeV and square/circular fields (1×1/1, 2×2/2, 3×3/3, 4×4/4, 5×5/5 cm{sup 2}/cm diameter). Resulting dose distributions (kernels) were used for subsequent calculations. The following analyses were performed: (1) Comparison of composite square fields and reference 10×10 cm{sup 2} dose distributions and (2) Scanning beam deliveries for square and circular fields realized as the convolution of kernels and scanning pattern. Preliminary beam weight and pattern optimization were also performed. Two linear scans of 10 cm with/without overlap were modeled. Comparison metrics included depth and orthogonal profiles at dmax. Results: (1) Composite fields regained reference depth dose profiles for most energies and fields within 5%. Smaller kernels and higher energies increased dose in the build-up and Bremsstrahlung region (30%, 16MeV and 1×1 cm{sup 2}), while reference dmax was maintained for all energies and composite fields. Smaller kernels (<2×2 cm{sup 2}) maintained penumbra and field size within 0.2 cm, and flatness within 2%. Deterioration of penumbra for larger kernels (5×5 cm{sup 2}) were observed. Balancing desirable dosimetry and efficiencies suggests that smaller kernels are used at edges and larger kernels in the center of the target. (2) Beam weight optimization improved cross-plane penumbra (0.2 cm) and increased the field size (0.4 cm) on average. In-plane penumbra and field size remained unchanged. Overlap depended on kernel size and optimal overlap resulted in flatness ±2%. Conclusion: Dynamic electron beam therapy in virtual scanning mode is feasible by employing small fields to achieve desired dose distributions and acceptable efficiencies.

60 APPLIED LIFE SCIENCES↗

TU-CD-207-08: Intrinsic Image Quality Comparison of Synthesized 2-D and FFDM Images

Purpose: With the combined interest of managing patient dose, maintaining or improving image quality, and maintaining or improving the diagnostic utility of mammographic data, this study aims to compare the intrinsic image quality of Hologic’s synthesized 2-D (C-View) and 2-D FFDM images in terms of resolution, contrast, and noise. Methods: This study utilized a novel 3-D printed anthropomorphic breast phantom in addition to the American College of Radiology (ACR) mammography accreditation phantom. Analysis of the 3-D anthropomorphic phantom included visual assessment of resolution and analysis of the normalized noise power spectrum. Analysis of the ACR phantom included both visual inspection and objective automated analysis using in-house software. The software incorporates image- and object-specific CNR visibility thresholds which account for image characteristics such as noise texture which affect object visualization. T- test statistical analysis was also performed on ACR phantom scores. Results: The spatial resolution of C-View images is markedly lower (at least 50% worse) than that of FFDM. And while this is generally associated with the benefit of reduced relative noise magnitude, the noise in C-View images tends to have a more mottled (predominantly low-frequency) texture. In general, for high contrast objects, C-View provides superior visualization over FFDM; however this benefit diminishes for low contrast objects and is applicable only to objects that are sufficiently larger than the spatial resolution threshold. Based on both observer and automated ACR phantom analysis, between 50–70% of C-View images failed to meet ACR minimum accreditation requirements – primarily due to insufficient (unbroken) fiber visibility. Conclusion: Compared to FFDM, C-View offers better depiction of objects of certain size and contrast, but provides poorer overall resolution and noise properties. Based on these findings, the utilization of C-View images in the clinical setting requires careful consideration, especially if considering the discontinuation of FFDM imaging.

60 APPLIED LIFE SCIENCES↗

Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study

Purpose: To evaluate the potential of low tube voltage dual source (DS) single energy (SE) and dual energy (DE) computed tomography (CT) to reduce contrast media (CM) dose in adult abdominal examinations of various sizes while maintaining soft tissue and iodine contrast-to-noise ratio (CNR). Methods: Four abdominal phantoms simulating a body mass index of 16 to 35 kg/m{sup 2} with four inserted syringes of 0, 2, 4, and 8 mgI/ml CM were scanned using a 64-slice DS-CT scanner. Six imaging protocols were used; one single source (SS) reference protocol (120 kV, 180 reference mAs), four low kV SE protocols (70 and 80 kV using both SS and DS), and one DE protocol at 80/140 kV. Potential CM reduction with unchanged CNRs relative to the 120 kV protocol was calculated along with the corresponding increase in radiation dose. Results: The potential contrast media reductions were determined to be approximately 53% for DS 70 kV, 51% for SS 70 kV, 44% for DS 80 kV, 40% for SS 80 kV, and 20% for DE (all differences were significant, P < 0.05). Constant CNR could be achieved by using DS 70 kV for small to medium phantom sizes (16–26 kg/m{sup 2}) and for all sizes (16–35 kg/m{sup 2}) when using DS 80 kV and DE. Corresponding radiation doses increased by 60%–107%, 23%–83%, and 6%–12%, respectively. Conclusions: DS single energy CT can be used to reduce CM dose by 44%–53% with maintained CNR in adult abdominal examinations at the cost of an increased radiation dose. DS dual-energy CT allows reduction of CM dose by 20% at similar radiation dose as compared to a standard 120 kV single source.

60 APPLIED LIFE SCIENCES↗

Improved accuracy of quantitative parameter estimates in dynamic contrast-enhanced CT study with low temporal resolution

Purpose: A previously proposed method to reduce radiation dose to patient in dynamic contrast-enhanced (DCE) CT is enhanced by principal component analysis (PCA) filtering which improves the signal-to-noise ratio (SNR) of time-concentration curves in the DCE-CT study. The efficacy of the combined method to maintain the accuracy of kinetic parameter estimates at low temporal resolution is investigated with pixel-by-pixel kinetic analysis of DCE-CT data. Methods: The method is based on DCE-CT scanning performed with low temporal resolution to reduce the radiation dose to the patient. The arterial input function (AIF) with high temporal resolution can be generated with a coarsely sampled AIF through a previously published method of AIF estimation. To increase the SNR of time-concentration curves (tissue curves), first, a region-of-interest is segmented into squares composed of 3 × 3 pixels in size. Subsequently, the PCA filtering combined with a fraction of residual information criterion is applied to all the segmented squares for further improvement of their SNRs. The proposed method was applied to each DCE-CT data set of a cohort of 14 patients at varying levels of down-sampling. The kinetic analyses using the modified Tofts’ model and singular value decomposition method, then, were carried out for each of the down-sampling schemes between the intervals from 2 to 15 s. The results were compared with analyses done with the measured data in high temporal resolution (i.e., original scanning frequency) as the reference. Results: The patients’ AIFs were estimated to high accuracy based on the 11 orthonormal bases of arterial impulse responses established in the previous paper. In addition, noise in the images was effectively reduced by using five principal components of the tissue curves for filtering. Kinetic analyses using the proposed method showed superior results compared to those with down-sampling alone; they were able to maintain the accuracy in the quantitative histogram parameters of volume transfer constant [standard deviation (SD), 98th percentile, and range], rate constant (SD), blood volume fraction (mean, SD, 98th percentile, and range), and blood flow (mean, SD, median, 98th percentile, and range) for sampling intervals between 10 and 15 s. Conclusions: The proposed method of PCA filtering combined with the AIF estimation technique allows low frequency scanning for DCE-CT study to reduce patient radiation dose. The results indicate that the method is useful in pixel-by-pixel kinetic analysis of DCE-CT data for patients with cervical cancer.

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Evaluation of a silicon photomultiplier PET insert for simultaneous PET and MR imaging

Purpose: In this study, the authors present a silicon photomultiplier (SiPM)-based positron emission tomography (PET) insert dedicated to small animal imaging with high system performance and robustness to temperature change. Methods: The insert consists of 64 LYSO-SiPM detector blocks arranged in 4 rings of 16 detector blocks to yield a ring diameter of 64 mm and axial field of view of 55 mm. Each detector block consists of a 9 × 9 array of LYSO crystals (1.2 × 1.2 × 10 mm{sup 3}) and a monolithic 4 × 4 SiPM array. The temperature of each monolithic SiPM is monitored, and the proper bias voltage is applied according to the temperature reading in real time to maintain uniform performance. The performance of this PET insert was characterized using National Electrical Manufacturers Association NU 4-2008 standards, and its feasibility was evaluated through in vivo mouse imaging studies. Results: The PET insert had a peak sensitivity of 3.4% and volumetric spatial resolutions of 1.92 (filtered back projection) and 0.53 (ordered subset expectation maximization) mm{sup 3} at center. The peak noise equivalent count rate and scatter fraction were 42.4 kcps at 15.08 MBq and 16.5%, respectively. By applying the real-time bias voltage adjustment, an energy resolution of 14.2% ± 0.3% was maintained and the count rate varied ≤1.2%, despite severe temperature changes (10–30 °C). The mouse imaging studies demonstrate that this PET insert can produce high-quality images useful for imaging studies on the small animals. Conclusions: The developed MR-compatible PET insert is designed for insertion into a narrow-bore magnetic resonance imaging scanner, and it provides excellent imaging performance for PET/MR preclinical studies.

61 RADIATION PROTECTION AND DOSIMETRY↗

Commissioning optically stimulated luminescence in vivo dosimeters for fast neutron therapy

Purpose: Clinical in vivo dosimeters intended for use with photon and electron therapies have not been utilized for fast neutron therapy because they are highly susceptible to neutron damage. The objective of this work was to determine if a commercial optically stimulated luminescence (OSL) in vivo dosimetry system could be adapted for use in fast neutron therapy. Methods: A 50.5 MeV fast neutron beam generated by a clinical neutron therapy cyclotron was used to irradiate carbon doped aluminum oxide (Al{sub 2}O{sub 3}:C) optically simulated luminescence dosimeters (OSLDs) in a solid water phantom under standard calibration conditions, 150 cm SAD, 1.7 cm depth, and 10.3 × 10.0 cm field size. OSLD fading and electron trap depletion studies were performed with the OSLDs irradiated with 20 and 50 cGy and monitored over a 24-h period to determine the optimal time for reading the dosimeters during calibration. Four OSLDs per group were calibrated over a clinical dose range of 0–150 cGy. Results: OSLD measurement uncertainties were lowered to within ±2%–3% of the expected dose by minimizing the effect of transient fading that occurs with neutron irradiation and maintaining individual calibration factors for each dosimeter. Dose dependent luminescence fading extended beyond the manufacturer’s recommended 10 min period for irradiation with photon or electron beams. To minimize OSL variances caused by inconsistent fading among dosimeters, the observed optimal time for reading the OSLDs postirradiation was between 30 and 90 min. No field size, wedge factor, or gantry angle dependencies were observed in the OSLDs irradiated by the studied fast neutron beam. Conclusions: Measurements demonstrated that uncertainties less than ±3% were attainable in OSLDs irradiated with fast neutrons under clinical conditions. Accuracy and precision comparable to clinical OSL measurements observed with photons can be achieved by maintaining individual OSLD calibration factors and minimizing transient fading effects.

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SU-D-BRA-02: Motion Assessment During Open Face Mask SRS Using CBCT and Surface Monitoring

Purpose: To assess the robustness of immobilization using open-face mask technology for linac-based stereotactic radiosurgery (SRS) with multiple non-coplanar arcs via repeated CBCT acquisition, with comparison to contemporaneous optical surface tracking data. Methods: 25 patients were treated in open faced masks with cranial SRS using 3–4 non-coplanar arcs. Repeated CBCT imaging was performed to verify the maintenance of proper patient positioning during treatment. Initial patient positioning was performed based on prescribed shifts and optical surface tracking. Positioning refinements employed rigid 3D-matching of the planning CT and CBCT images and were implemented via automated 6DOF couch control. CBCT imaging was repeated following the treatment of all non-transverse beams with associated couch kicks. Detected patient translations and rotations were recorded and automatically corrected. Optical surface tracking was applied throughout the treatments to monitor motion, and this contemporaneous patient positioning data was recorded to compare against CBCT data and 6DOF couch adjustments. Results: Initial patient positions were refined on average by translations of 3±1mm and rotations of ±0.9-degrees. Optical surface tracking corroborated couch corrections to within 1±1mm and ±0.4-degrees. Following treatment of the transverse and subsequent superior-oblique beam, average translations of 0.6±0.4mm and rotations of ±0.4-degrees were reported via CBCT, with optical surface tracking in agreement to within 1.1±0.6mm and ±0.6-degrees. Following treatment of the third beam, CBCT indicated additional translations of 0.4±0.2mm and rotations of ±0.3-degrees. Cumulative couch corrections resulted in 0.7 ± 0.4mm average magnitude translations and rotations of ±0.4-degrees. Conclusion: Based on CBCT measurements of patients during SRS, the open face mask maintained patient positioning to within 1.5mm and 1-degree with >95% confidence. Patient positioning determined by optical surface tracking agreed with CBCT assessment to within 1±1mm and ±0.6-degree rotations. These data support the use of 1–2mm PTV margins and repeated CBCT to maintain stereotactic positioning tolerances.

60 APPLIED LIFE SCIENCES↗

SU-F-J-72: A Clinical Usable Integrated Contouring Quality Evaluation Software for Radiotherapy

Purpose: To introduce the Auto Contour Evaluation (ACE) software, which is the clinical usable, user friendly, efficient and all-in-one toolbox for automatically identify common contouring errors in radiotherapy treatment planning using supervised machine learning techniques. Methods: ACE is developed with C# using Microsoft .Net framework and Windows Presentation Foundation (WPF) for elegant GUI design and smooth GUI transition animations through the integration of graphics engines and high dots per inch (DPI) settings on modern high resolution monitors. The industrial standard software design pattern, Model-View-ViewModel (MVVM) pattern, is chosen to be the major architecture of ACE for neat coding structure, deep modularization, easy maintainability and seamless communication with other clinical software. ACE consists of 1) a patient data importing module integrated with clinical patient database server, 2) a 2D DICOM image and RT structure simultaneously displaying module, 3) a 3D RT structure visualization module using Visualization Toolkit or VTK library and 4) a contour evaluation module using supervised pattern recognition algorithms to detect contouring errors and display detection results. ACE relies on supervised learning algorithms to handle all image processing and data processing jobs. Implementations of related algorithms are powered by Accord.Net scientific computing library for better efficiency and effectiveness. Results: ACE can take patient’s CT images and RT structures from commercial treatment planning software via direct user input or from patients’ database. All functionalities including 2D and 3D image visualization and RT contours error detection have been demonstrated with real clinical patient cases. Conclusion: ACE implements supervised learning algorithms and combines image processing and graphical visualization modules for RT contours verification. ACE has great potential for automated radiotherapy contouring quality verification. Structured with MVVM pattern, it is highly maintainable and extensible, and support smooth connections with other clinical software tools.

60 APPLIED LIFE SCIENCES↗

SU-F-T-346: Dose Mimicking Inverse Planning Based On Helical Delivery Treatment Plans for Head and Neck Patients

Purpose: We aim to evaluate a new commercial dose mimicking inverse-planning application that was designed to provide cross-platform treatment planning, for its dosimetric quality and efficiency. The clinical benefit of this application allows patients treated on O-shaped linac to receive an equivalent plan on conventional L-shaped linac as needed for workflow or machine downtime. Methods: The dose mimicking optimization process seeks to create a similar DVH of an O-shaped linac-based plans with an alternative treatment technique (IMRT or VMAT), by maintaining target conformity, and penalizing dose falloff outside the target. Ten head and neck (HN) helical delivery plans, including simple and complex cases were selected for re-planning with the dose mimicking application. All plans were generated for a 6 MV beam model, using 7-field/ 9-field IMRT and VMAT techniques. PTV coverage (D1, D99 and homogeneity index [HI]), and OARs avoidance (Dmean / Dmax) were compared. Results: The resulting dose mimicked HN plans achieved acceptable PTV coverage for HI (VMAT 7.0±2.3, 7-fld 7.3±2.4, and 9-fld 7.0±2.4), D99 (98.0%±0.7%, 97.8%±0.7%, and 98.0%±0.7%), as well as D1 (106.4%±2.1%, 106.5%±2.2%, and 106.4%±2.1%), respectively. The OAR dose discrepancy varied: brainstem (2% to 4%), cord (3% to 6%), esophagus (−4% to −8%), larynx (−4% to 2%), and parotid (4% to 14%). Mimicked plans would typically be needed for 1–5 fractions of a treatment course, and we estimate <1% variance would be introduced in target coverage while maintaining comparable low dose to OARs. All mimicked plans were approved by independent physician and passed patient specific QA within our established tolerance. Conclusion: Dose mimicked plans provide a practical alternative for responding to clinical workflow issues, and provide reliability for patient treatment. The quality of dose mimicking for HN patients highly depends on the delivery technique, field numbers and angles, as well as user selection of structures.

60 APPLIED LIFE SCIENCES↗