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MO-B-BRB-04: 3D Dosimetry in End-To-End Dosimetry QA

Full three-dimensional (3D) dosimetry using volumetric chemical dosimeters probed by 3D imaging systems has long been a promising technique for the radiation therapy clinic, since it provides a unique methodology for dose measurements in the volume irradiated using complex conformal delivery techniques such as IMRT and VMAT. To date true 3D dosimetry is still not widely practiced in the community; it has been confined to centres of specialized expertise especially for quality assurance or commissioning roles where other dosimetry techniques are difficult to implement. The potential for improved clinical applicability has been advanced considerably in the last decade by the development of improved 3D dosimeters (e.g., radiochromic plastics, radiochromic gel dosimeters and normoxic polymer gel systems) and by improved readout protocols using optical computed tomography or magnetic resonance imaging. In this session, established users of some current 3D chemical dosimeters will briefly review the current status of 3D dosimetry, describe several dosimeters and their appropriate imaging for dose readout, present workflow procedures required for good dosimetry, and analyze some limitations for applications in select settings. We will review the application of 3D dosimetry to various clinical situations describing how 3D approaches can complement other dose delivery validation approaches already available in the clinic. The applications presented will be selected to inform attendees of the unique features provided by full 3D techniques. Learning Objectives: L. John Schreiner: Background and Motivation Understand recent developments enabling clinically practical 3D dosimetry, Appreciate 3D dosimetry workflow and dosimetry procedures, and Observe select examples from the clinic. Sofie Ceberg: Application to dynamic radiotherapy Observe full dosimetry under dynamic radiotherapy during respiratory motion, and Understand how the measurement of high resolution dose data in an irradiated volume can help understand interplay effects during TomoTherapy or VMAT. Titania Juang: Special techniques in the clinic and research Understand the potential for 3D dosimetry in validating dose accumulation in deformable systems, and Observe the benefits of high resolution measurements for precision therapy in SRS and in MicroSBRT for small animal irradiators Geoffrey S. Ibbott: 3D Dosimetry in end-to-end dosimetry QA Understand the potential for 3D dosimetry for end-to-end radiation therapy process validation in the in-house and external credentialing setting. Canadian Institutes of Health Research; L. Schreiner, Modus QA, London, ON, Canada; T. Juang, NIH R01CA100835.

60 APPLIED LIFE SCIENCES↗

Shared Dosimetry Error in Epidemiological Dose-Response Analyses

Radiation dose reconstruction systems for large-scale epidemiological studies are sophisticated both in providing estimates of dose and in representing dosimetry uncertainty. For example, a computer program was used by the Hanford Thyroid Disease Study to provide 100 realizations of possible dose to study participants. The variation in realizations reflected the range of possible dose for each cohort member consistent with the data on dose determinates in the cohort. Another example is the Mayak Worker Dosimetry System 2013 which estimates both external and internal exposures and provides multiple realizations of "possible" dose history to workers given dose determinants. This paper takes up the problem of dealing with complex dosimetry systems that provide multiple realizations of dose in an epidemiologic analysis. In this paper we derive expected scores and the information matrix for a model used widely in radiation epidemiology, namely the linear excess relative risk (ERR) model that allows for a linear dose response (risk in relation to radiation) and distinguishes between modifiers of background rates and of the excess risk due to exposure. We show that treating the mean dose for each individual (calculated by averaging over the realizations) as if it was true dose (ignoring both shared and unshared dosimetry errors) gives asymptotically unbiased estimates (i.e. the score has expectation zero) and valid tests of the null hypothesis that the ERR slope β is zero. Although the score is unbiased the information matrix (and hence the standard errors of the estimate of β) is biased for β≠0 when ignoring errors in dose estimates, and we show how to adjust the information matrix to remove this bias, using the multiple realizations of dose. Use of these methods for several studies, including the Mayak Worker Cohort and the U.S. Atomic Veterans Study, is discussed.

epidemiological analysis↗

SU-G-TeP2-03: Comparison of Standard Dosimetry Protocol in Japan and AAPM TG-51 Addendum in Order to Establish Optimal Dosimetry for FFF Beam

Purpose: Japan Standard Dosimetry of Absorbed dose to water in external beam radiotherapy (JSDP12) is widely used to measure radiation dose in radiotherapy. However, JSDP12 does not take flattening-filter-free (FFF) beam into consideration. In addition, JSDP12 applied TPR20,10 for dose quality index for photon beam. The purpose of this study is to compare JSDP12 with AAPM TG-51 addendum in order to establish optimal dosimetry procedure for FFF beam. Method: We evaluated the ion-recombination factor (ks) and the correction factor of radial beam profile (Prp) in FFF beam dosimetry. The ks was introduced by 2 voltages method and verified by Jaffe’s plot. The Prp was given by both film measurement and calculation of treatment planning system, and compared them. Next, we compared the dose quality indexes (kQ) between TPR20,10 method and PDD(10)x method. Finally we considered optimal dosimetry protocol for FFF photon beam using JSDP12 with referring TG-51 addendum protocols. The FFF photon beams of 6 MV (6X-FFF) and 10 MV (10X-FFF) from TrueBeam were investigated in this study. Results: The ks for 6X-FFF and 10X-FFF beams were 1.005 and 1.010, respectively. The Prp of 0.6 cc ionization chamber for 6X-FFF and 10X-FFF beams (Film, TPS) were (1.004, 1.008) and (1.005, 1.008), respectively. The kQ for 6X-FFF and 10X-FFF beams (JSDP12, TG-51 addendum) were (0.9950, 0.9947) and (0.9851, 0.9845), respectively. The most effective factor for uncertainty in FFF photon beam measurement was Prp for JSDP12 formalism. Total dosimetric differences between JSDP12 and TG-51 addendum for 6X-FFF and 10X-FFF were -0.47% and -0.73%, respectively. Conclusion: The total dosimetric difference between JSDP12 and TG-51 addendum was within 1%. The introduction of kQ given by JSDP is feasible for FFF photon beam dosimetry. However, we think Prp should be considered for optimal dosimetry procedure even if JSDP12 is used for FFF photon beam dosimetry.

61 RADIATION PROTECTION AND DOSIMETRY↗

Overcoming Barriers to Radiopharmaceutical Therapy (RPT): An Overview From the NRG-NCI Working Group on Dosimetry of Radiopharmaceutical Therapy

Radiopharmaceutical therapy (RPT) continues to demonstrate tremendous potential in improving the therapeutic gains in radiation therapy by specifically delivering radiation to tumors that can be well assessed in terms of dosimetry and imaging. Dosimetry in external beam radiation therapy is standard practice. This is not the case, however, in RPT. This NRG (acronym formed from the first letter of the 3 original groups: National Surgical Adjuvant Breast and Bowel Project, the Radiation Therapy Oncology Group, and the Gynecologic Oncology Group)-National Cancer Institute Working Group review describes some of the challenges to improving RPT. The main priorities for advancing the field include (1) developing and adopting best practice guidelines for incorporating patient-specific dosimetry for RPT that can be used at both large clinics with substantial resources and more modest clinics that have limited resources, (2) establishing and improving strategies for introducing new radiopharmaceuticals for clinical investigation, (3) developing approaches to address the radiophobia that is associated with the administration of radioactivity for cancer therapy, and (4) solving the financial and logistical issues of expertise and training in the developing field of RPT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

High-precision γ -ray spectroscopy of the cardiac PET imaging isotope Rb 82 and its impact on dosimetry

82 Rb is a positron-emitting isotope used in cardiac positron emission tomography (PET) imaging which has been reported to deliver a significantly lower effective radiation dose than analogous imaging isotopes like 201 Tl and 99m Tc sestamibi. High-quality β-decay data are essential to accurately appraise the total dose received by the patients. A source of 82 Sr was produced at the Brookhaven Linac Isotope Producer (BLIP), transported to Argonne National Laboratory, and studied with the Gammasphere facility. Significant revisions have been made to the level scheme of 82 Kr including 12 new levels, 50 new γ-ray transitions, and the determination of many new spin assignments through angular correlations. Lastly, these new high-quality data allow a precise reappraisal of the β-decay strength function and thus the consequent dose received by patients.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

SU-F-T-421: Dosimetry Change During Radiotherapy and Dosimetry Difference for Rigid and Deformed Registration in the Mid-Thoracic Esophageal Carcinoma

Purpose: This study aimed to analyze dosimetry changes during radiotherapy for the mid-thoracic esophageal carcinoma, and investigate dosimetry difference between rigid and deformed registration. Methods: Twelve patients with primary middle thoracic esophageal carcinoma were selected randomly. Based on first CT scanning of each patient, plans-o were generated by experience physicists. After 20 fractions treatment, the corresponding plans-re were created with second CT scanning. And then, these two CT images were rigid and deformed registration respectively, and the dose was accumulated plan-o with plan-re. The dosimetry variation of these plans (plan-o: with 30 fractions, plan-rig: the accumulated dose with rigid registration and plan-def: the accumulated dose with deformed registration) were evaluated by paired T-test. Results: The V20 value of total lung were 32.68%, 30.3% and 29.71% for plan-o, plan-rig and plan-def respectively. The mean dose of total lung was 17.19 Gy, 16.67 Gy and 16.51 Gy for plan-o plan-rig and plan-def respectively. There were significant differences between plan-o and plan-rig or plan-def for both V20 and mean dose of total lung (with p= 0.003, p= 0.000 for V20 and p=0.008, p= 0.000 for mean dose respectively). There was no significant difference between plan-rig and plan-def (with p=0.118 for V20 and p=0.384 for mean dose). The max dose of spinal-cord was 41.95 Gy, 41.48 Gy and 41.4 Gy for plan-o, plan-rig and plan-def respectively. There were no significant differences for the max dose of spinal-cord between these plans. Conclusion: The target volume changes and anatomic position displacement of mid-thoracic esophageal carcinoma should not be neglected in clinics. These changes would cause overdose in normal tissue. Therefore, it is necessary to have another CT scanning and re-plan during the mid-thoracic esophageal carcinoma radiotherapy. And the dosimetry difference between rigid and deformed fusions was not found in this study.

60 APPLIED LIFE SCIENCES↗

Sci-Sat AM: Radiation Dosimetry and Practical Therapy Solutions - 03: Energy dependence of a clinical probe-format calorimeter and its pertinence to absolute photon and electron beam dosimetry

Purpose: To evaluate the intrinsic and absorbed-dose energy dependence of a small-scale graphite calorimeter probe (GPC) developed for use as a routine clinical dosimeter. The influence of charge deposition on the response of the GPC was also assessed by performing absolute dosimetry in clinical linac-based electron beams. Methods: Intrinsic energy dependence was determined by performing constant-temperature calorimetry dose measurements in a water-equivalent solid phantom, under otherwise reference conditions, in five high-energy photon (63.5 < %dd(10){sub X} < 76.3), and five electron (2.3 cm < R{sub 50} < 8.3 cm) beams. Reference dosimetry was performed for all beams in question using an Exradin A19 ion chamber with a calibration traceable to national standards. The absorbed-dose component of the overall energy dependence was calculated using the EGSnrc egs-chamber user code. Results: A total of 72 measurements were performed with the GPC, resulting in a standard error on the mean absorbed dose of better than 0.3 % for all ten beams. For both the photon and electron beams, no statistically-significant energy dependence was observed experimentally. Peak-to-peak, variations in the relative response of the GPC across all beam qualities of a given radiation type were on the order of 1 %. No effects, either transient or permanent, were attributable to the charge deposited by the electron beams. Conclusions: The GPC’s apparent energy-independence, combined with its well-established linearity and dose rate independence, make it a potentially useful dosimetry system capable measuring photon and electron doses in absolute terms at the clinical level.

61 RADIATION PROTECTION AND DOSIMETRY↗

Stochastic parametric skeletal dosimetry model for humans: Pediatric and adult computational skeleton phantoms for internal bone marrow dosimetry

Currently, computational phantoms that simulate skeletal tissues are used in active red bone marrow (AM) internal dosimetry. Up-to-date reference computational phantoms recommended by the ICRP are based on the analysis of CT-images of cadavers. Such phantoms have significant disadvantages. One disadvantage is that the assessment of uncertainty due to the population variability of skeleton dimensions and microstructure results from the limited availability of autopsy material. Another disadvantage is the simplified modelling of cortical layer and bone microarchitecture. A method of stochastic parametric skeletal dosimetry modelling of the bone structures – SPSD modelling – has been developed as an alternative to the ICRP reference phantoms. In the framework of this approach, skeletal phantom parameters are evaluated based on extensively reviewed results of published measurements of real bones. The SPSD approach allows for the assessment of both population-average values and their variability. SPSD-phantoms of the skeleton are modelled in voxel representation. They consist of smaller phantoms of the bone sites – segments – described by simple geometric shapes with uniform microarchitecture parameters. Such segmentation makes it possible to account for non-homogeneous skeletal microarchitecture and to model the bone structure with the required voxel resolution to elaborate suitable skeletal phantoms. The current study presents the parameters of the SPSD skeletal phantoms for the following age-groups: newborn, 1-year-old, 5-year-old, 10-year-old, 15-year-old (male and female), and adult (male and female). This skeletal phantom can be used for dosimetry as an alternative to available reference phantoms for bone-seeking radionuclides. The above-mentioned age- and sex-specific skeletal phantoms are comprised of 289 unique segments. The characteristics of the SPSD phantoms do not contradict published data and are in good agreement with the measurement results of real bones.

Science & Technology - Other Topics↗

Implementation of IMRT and VMAT using Delta4 phantom and portal dosimetry as dosimetry verification tools

In this study we analyzed and compared the dose distribution of different IMRT and VMAT plans with the intent to provide pre-treatment quality assurance using two different tools. Materials/Methods: We have used the electronic portal imaging device EPID after calibration to dose and correction for the background offset signal and also the Delta4 phantom after en evaluation of angular sensitivity. The Delta4 phantom has a two-dimensional array with ionization chambers. We analyzed three plans for each anatomical site calculated by Eclipse treatment planning system. The measurements were analyzed using γ-evaluation method with passing criteria 3% absolute dose and 3 mm distance to agreement (DTA). For all the plans the range of score has been from 97% to 99% for gantry fixed at 0° while for rotational planes there was a slightly decreased pass rates and above 95%. Point measurement with a ionization chamber were done in additional to see the accuracy of portal dosimetry and to evaluate the Delta4 device to various dose rates. Conclusions: Both Delt4 and Portal dosimetry shows good results between the measured and calculated doses. While Delta4 is more accurate in measurements EPID is more time efficient. We have decided to use both methods in the first steps of IMRT and VMAT implementation and later on to decide which of the tools to use depending on the complexity of plans, how much accurate we want to be and the time we have on the machine.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Efficient bi-directional coupling of 3D computational fluid-particle dynamics and 1D Multiple Path Particle Dosimetry lung models for multiscale modeling of aerosol dosimetry

The development of predictive aerosol dosimetry models has been a major focus of environmental toxicology and pharmaceutical health research for decades. One-dimensional (1D) models successfully predict overall deposition averages but fail to accurately predict local deposition. Computational fluid-particle dynamics (CFPD) models provide site-specific predictions but at a computational cost that prohibits whole lung predictions. Thus, there is a need for developing multiscale strategies to provide a realistic subject-specific picture of the fate of inhaled aerosol in the lungs. CT-based 3D/CFPD models of the large airways were bidirectionally coupled with individualized 1D Navier-Stokes airflow and particle transport based upon the widely used Multiple Path Particle Dosimetry Model (MPPD). Distribution of airflows among lobes was adjusted by measured lobar volume changes observed in CT images between FRC and FRC + 1.5 L. Additionally, as a test of the effectiveness of the coupling procedures, deposition modeling of previous 1 µm aerosol exposure studies was performed. The complete coupled model was run for 3 breaths, with the computation-intense portion being the 3D CFD Lagrangian particle tracking calculation. The average deposition per breath was 11% in the combined multiscale model with site-specific doses available in the CFPD portion of the model and airway- or region-specific deposition available for the MPPD portion. In conclusion, the key methods developed in this study enable predictions of ventilation heterogeneities and aerosol deposition across the lungs that are not captured by 3D or 1D models alone. Overall, these methods can be used as the foundation for multi-scale modeling of the full respiratory system.

60 APPLIED LIFE SCIENCES↗

Respiratory Tract Lung Geometry and Dosimetry Model for Male Sprague-Dawley Rats

While inhalation toxicological studies of various compounds have been conducted using a number of different strains of rats, mechanistic dosimetry models have only had tracheobronchial (TB) structural data for Long-Evans rats, detailed morphometric data on the alveolar region of Sprague-Dawley rats and limited alveolar data on other strains. Based upon CT imaging data for two male Sprague-Dawley rats, a 15-generation, symmetric typical path model was developed for the TB region. Literature data for the alveolar region of Sprague-Dawley rats were analyzed to develop an eight-generation model, and the two regions were joined to provide a complete lower respiratory tract model for Sprague-Dawley rats. The resulting lung model was used to examine particle deposition in Sprague-Dawley rats and to compare these results with predicted deposition in Long-Evans rats. Relationships of various physiologic variables and lung volumes were either developed in this study or extracted from the literature to provide the necessary input data for examining particle deposition. While the lengths, diameters and branching angles of the TB airways differed between the two Sprague-Dawley rats, the predicted deposition patterns in the three major respiratory tract regions were very similar. Between Sprague-Dawley and Long-Evans rats, significant differences in TB and alveolar predicted deposition fractions were observed over a wide range of particle sizes, with TB deposition fractions being up to 3- to 4-fold greater in Sprague-Dawley rats and alveolar deposition being significantly greater in Long-Evans rats. Thus, strain-specific lung geometry models should be used for particle deposition calculations and interspecies dose comparisons.

Miller, Frederick J.↗

A complete dosimetry experimental program in support to the core characterization and to the power calibration of the CABRI reactor. A complete dosimetry experimental program in support of the core characterization and of the power calibration of the CABRI reactor

CABRI is an experimental pulse reactor operated by CEA at the Cadarache research center. Since 1978 the experimental programs have aimed at studying the fuel behavior under Reactivity Initiated Accident (RIA) conditions. Since 2003, it has been refurbished in order to be able to provide RIA and LOCA (Loss Of Coolant Accident) experiments in prototypical PWR conditions (155 bar, 300 deg. C). This project is part of a broader scope including an overall facility refurbishment and a safety review. The global modification is conducted by the CEA project team. It is funded by IRSN, which is conducting the CIP experimental program, in the framework of the OECD/NEA project CIP. It is financed in the framework of an international collaboration. During the reactor restart, commissioning tests are realized for all equipment, systems and circuits of the reactor. In particular neutronics and power commissioning tests will be performed respectively in 2015 and 2016. This paper focuses on the design of a complete and original dosimetry program that was built in support to the CABRI core characterization and to the power calibration. Each one of the above experimental goals will be fully described, as well as the target uncertainties and the forecasted experimental techniques and data treatment. (authors)

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

The Mayak Worker Dosimetry System (MWDS-2013): Internal Dosimetry Results

The distribution of calculated internal doses was determined for 8043 Mayak Production Associate (Mayak PA) workers according to the epidemiological cohorts and groups of raw data used as well as the type of industrial compounds of inhaled aerosols. Statistical characteristics of point estimates of accumulated doses to 17 different tissues and organs and the uncertainty ranges were calculated. Under the MWDS-2013 dosimetry system, the mean accumulated lung dose was 185585 mGy, with a median value of 31 mGy and a maximum of 8980 mGy maximum. The ranges of relative standard uncertainty were: from 40 to 2200% for accumulated lung dose, from 25-90% to 2600-3000% for accumulated dose to different regions of respiratory tract, from 13-18% to 2300-2500% for systemic organs and tissues. The Mayak PA workers accumulated internal plutonium lung dose is shown to be close to lognormal. The accumulated internal plutonium dose to systemic organs was close to a log-triangle. The dependency of uncertainty of accumulated absorbed lung and liver doses on the dose estimates itself is also shown. The accumulated absorbed doses to lung, alveolar-interstitial region, liver, bone surface cells and red bone marrow, calculated both with MWDS-2013 and MWDS-2008 have been compared. In general, the accumulated lung doses increased by a factor of 1.8 in median value, while the accumulated doses to systemic organs decreased by factor of 1.3-1.4 in median value. For the cases with identical initial data, accumulated lung doses increased by a factor of 2.1 in median value, while accumulated doses to systemic organs decreased by 8-13% in median value. For the cases with both identical initial data and all of plutonium activity in urine measurements above the decision threshold, accumulated lung doses increased by a factor of 2.8 in median value, while accumulated doses to systemic organs increased by 6-12% in median value.

dose reconstruction↗

Advanced Test Reactor Neutron Dosimetry Report - Cycle 175C: Results of Neutron Dosimetry Measurements for the Advanced Test Reactor Cycle 175C

Results of neutron dosimetry measurements in ATR for cycle 175C are presented. A single set of cobalt and nickel wires were installed in numerous irradiation locations for the duration of the cycle. The specific activity of these wire segments can be used in conjunction with the presented cycle history information to determine the thermal- and fast-neutron fluence rates for each irradiation position during the cycle using the referenced standard test methods.

73 - NUCLEAR PHYSICS AND RADIATION PHYSICS↗

THE MAYAK WORKER DOSIMETRY SYSTEM (MWDS-2016): INTERNAL DOSIMETRY RESULTS AND COMPARISON WITH MWDS-2013

Abstract Differences in results from the new Mayak Worker Dosimetry System (MWDS-2016) vs the previous MWDS-2013 are described. Statistical characteristics are shown for the distribution of accumulated absorbed doses to organs for 8340 workers with bioassay data. Differences in mean values of accumulated doses and their relative standard uncertainties calculated by MWDS-2016 and MWDS-2013 were analysed separately for various types of industrial compounds of plutonium, specifically nitrates, mixtures and oxides. Within the range of accumulated doses >1 mGy, lung doses for nitrates and mixtures decreased by 41 and 15%, respectively, and remained at the same level for oxides. Accumulated liver doses within the range >1 mGy increased for nitrates and mixtures by 13 and 8%, respectively, and decreased for oxides by 7%.

Vostrotin, Vadim V.↗

Sci-Sat AM: Radiation Dosimetry and Practical Therapy Solutions - 01: Optimization of an organic field effect transistor for radiation dosimetry measurements

Purpose: To use Monte Carlo simulations to optimize the design of an organic field effect transistor (OFET) to maximize water-equivalence across the diagnostic and therapeutic photon energy ranges. Methods: DOSXYZnrc was used to simulate transport of mono-energetic photon beams through OFETs. Dose was scored in the dielectric region of devices and used for evaluating the response of the device relative to water. Two designs were considered: 1. a bottom-gate device on a substrate of polyethylene terephthalate (PET) with an aluminum gate, a dielectric layer of either PMMA or CYTOP (a fluorocarbon) and an organic semiconductor (pentacene). 2. a symmetric bilayer design was employed in which two polymer layers (PET and CYTOP) were deposited both below the gate and above the semiconductor to improve water-equivalence and reduce directional dependence. The relative thickness of the layers was optimized to maximize water-equivalence. Results: Without the bilayer, water-equivalence was diminished relative to OFETs with the symmetric bilayer at low photon energies (below 80 keV). The bilayer’s composition was designed to have one layer with an effective atomic number larger than that of water and the other with an effective atomic number lower than that of water. For the particular materials used in this study, a PET layer 0.1mm thick coupled with a CYTOP layer of 900 nm provided a device with a water-equivalence within 3% between 20 keV and 5 MeV. Conclusions: organic electronic devices hold tremendous potential as water-equivalent dosimeters that could be used in a wide range of applications without recalibration.

60 APPLIED LIFE SCIENCES↗