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Chen, S

Publications and source records attributed to Chen, S.

At least 19 records

SU-C-202-03: A Tool for Automatic Calculation of Delivered Dose Variation for Off-Line Adaptive Therapy Using Cone Beam CT

Purpose: Monitoring the delivered dose is an important task for the adaptive radiotherapy (ART) and for determining time to re-plan. A software tool which enables automatic delivered dose calculation using cone-beam CT (CBCT) has been developed and tested. Methods: The tool consists of four components: a CBCT Colleting Module (CCM), a Plan Registration Moduel (PRM), a Dose Calculation Module (DCM), and an Evaluation and Action Module (EAM). The CCM is triggered periodically (e.g. every 1:00 AM) to search for newly acquired CBCTs of patients of interest and then export the DICOM files of the images and related registrations defined in ARIA followed by triggering the PRM. The PRM imports the DICOM images and registrations, links the CBCTs to the related treatment plan of the patient in the planning system (RayStation V4.5, RaySearch, Stockholm, Sweden). A pre-determined CT-to-density table is automatically generated for dose calculation. Current version of the DCM uses a rigid registration which regards the treatment isocenter of the CBCT to be the isocenter of the treatment plan. Then it starts the dose calculation automatically. The AEM evaluates the plan using pre-determined plan evaluation parameters: PTV dose-volume metrics and critical organ doses. The tool has been tested for 10 patients. Results: Automatic plans are generated and saved in the order of the treatment dates of the Adaptive Planning module of the RayStation planning system, without any manual intervention. Once the CTV dose deviates more than 3%, both email and page alerts are sent to the physician and the physicist of the patient so that one can look the case closely. Conclusion: The tool is capable to perform automatic dose tracking and to alert clinicians when an action is needed. It is clinically useful for off-line adaptive therapy to catch any gross error. Practical way of determining alarming level for OAR is under development.

60 APPLIED LIFE SCIENCES↗

SU-F-J-59: Assessment of Dose Response Distribution in Individual Human Tumor

Purpose: To fulfill precision radiotherapy via adaptive dose painting by number, voxel-by-voxel dose response or radio-sensitivity in individual human tumor needs to be determined in early treatment to guide treatment adaptation. In this study, multiple FDG PET images obtained pre- and weekly during the treatment course were utilized to determine the distribution/spectrum of dose response parameters in individual human tumors. Methods: FDG PET/CT images of 18 HN cancer patients were used in the study. Spatial parametric image of tumor metabolic ratio (dSUV) was created following voxel by voxel deformable image registration. Each voxel value in dSUV was a function of pre-treatment baseline SUV and treatment delivered dose, and used as a surrogate of tumor survival fraction (SF). Regression fitting with break points was performed using the LQ-model with tumor proliferation for the control and failure group of tumors separately. The distribution and spectrum of radiation sensitivity and growth in individual tumors were determined and evaluated. Results: Spectrum of tumor dose-sensitivity and proliferation in the controlled group was broad with α in tumor survival LQ-model from 0.17 to 0.8. It was proportional to the baseline SUV. Tlag was about 21∼25 days, and Tpot about 0.56∼1.67 days respectively. Commonly tumor voxels with high radio-sensitivity or larger α had small Tlag and Tpot. For the failure group, the radio-sensitivity α was low within 0.05 to 0.3, but did not show clear Tlag. In addition, tumor voxel radio-sensitivity could be estimated during the early treatment weeks. Conclusion: Dose response distribution with respect to radio-sensitivity and growth in individual human tumor can be determined using FDG PET imaging based tumor metabolic ratio measured in early treatment course. The discover is critical and provides a potential quantitative objective to implement tumor specific precision radiotherapy via adaptive dose painting by number.

60 APPLIED LIFE SCIENCES↗

SU-F-J-86: Method to Include Tissue Dose Response Effect in Deformable Image Registration

Purpose: Organ changes shape and size during radiation treatment due to both mechanical stress and radiation dose response. However, the dose response induced deformation has not been considered in conventional deformable image registration (DIR). A novel DIR approach is proposed to include both tissue elasticity and radiation dose induced organ deformation. Methods: Assuming that organ sub-volume shrinkage was proportional to the radiation dose induced cell killing/absorption, the dose induced organ volume change was simulated applying virtual temperature on each sub-volume. Hence, both stress and heterogeneity temperature induced organ deformation. Thermal stress finite element method with organ surface boundary condition was used to solve deformation. Initial boundary correspondence on organ surface was created from conventional DIR. Boundary condition was updated by an iterative optimization scheme to minimize elastic deformation energy. The registration was validated on a numerical phantom. Treatment dose was constructed applying both the conventional DIR and the proposed method using daily CBCT image obtained from HN treatment. Results: Phantom study showed 2.7% maximal discrepancy with respect to the actual displacement. Compared with conventional DIR, subvolume displacement difference in a right parotid had the mean±SD (Min, Max) to be 1.1±0.9(−0.4∼4.8), −0.1±0.9(−2.9∼2.4) and −0.1±0.9(−3.4∼1.9)mm in RL/PA/SI directions respectively. Mean parotid dose and V30 constructed including the dose response induced shrinkage were 6.3% and 12.0% higher than those from the conventional DIR. Conclusion: Heterogeneous dose distribution in normal organ causes non-uniform sub-volume shrinkage. Sub-volume in high dose region has a larger shrinkage than the one in low dose region, therefore causing more sub-volumes to move into the high dose area during the treatment course. This leads to an unfavorable dose-volume relationship for the normal organ. Without including this effect in DIR, treatment dose in normal organ could be underestimated affecting treatment evaluation and planning modification. Acknowledgement: Partially Supported by Elekta Research Grant.

60 APPLIED LIFE SCIENCES↗

SU-F-J-88: Comparison of Two Deformable Image Registration Algorithms for CT-To-CT Contour Propagation

Purpose: To compare the contour propagation accuracy of two deformable image registration (DIR) algorithms in the Raystation treatment planning system – the “Hybrid” algorithm based on image intensities and anatomical information; and the “Biomechanical” algorithm based on linear anatomical elasticity and finite element modeling. Methods: Both DIR algorithms were used for CT-to-CT deformation for 20 lung radiation therapy patients that underwent treatment plan revisions. Deformation accuracy was evaluated using landmark tracking to measure the target registration error (TRE) and inverse consistency error (ICE). The deformed contours were also evaluated against physician drawn contours using Dice similarity coefficients (DSC). Contour propagation was qualitatively assessed using a visual quality score assigned by physicians, and a refinement quality score (0 0.9 for lungs, > 0.85 for heart, > 0.8 for liver) and similar qualitative assessments (VQS < 0.35, RQS > 0.75 for lungs). When anatomical structures were used to control the deformation, the DSC improved more significantly for the biomechanical DIR compared to the hybrid DIR, while the VQS and RQS improved only for the controlling structures. However, while the inclusion of controlling structures improved the TRE for the hybrid DIR, it increased the TRE for the biomechanical DIR. Conclusion: The hybrid DIR was found to perform slightly better than the biomechanical DIR based on lower TRE while the DSC, VQS, and RQS studies yielded comparable results for both. The use of controlling structures showed considerable improvement in the hybrid DIR results and is recommended for clinical use in contour propagation.

60 APPLIED LIFE SCIENCES↗

SU-F-T-519: Is Geometry Based Setup Sufficient for All of the Head and Neck Treatment Cases?: A Feasibility Study Towards the Dose Based Setup

Purpose: This study compares the geometric-based setup (GBS) which is currently used in the clinic to a novel concept of dose-based setup (DBS) of head and neck (H&N) patients using cone beam CT (CBCT) of the day; and evaluates the clinical advantages. Methods: Ten H&N patients who underwent re-simulation and re-plan due to noticeable anatomic changes during the course of the treatments were retrospectively reviewed on dosimetric changes in the assumption of no plan modification was performed. RayStation planning system (RaySearch Laboratories AB, Sweden) was used to match (ROI fusion module) between prescribed isodoseline (IDL) in the CBCT imported along with ROIs from re-planned CT and the IDL of original plan (Dose-based setup: DBS). Then, the CBCT plan based on daily setup using the GBS (previously used for a patient) and the DBS CBCT plan recalculated in RayStation compared against the original CT-sim plan. Results: Most of patients’ tumor coverage and OAR doses got generally worsen when the CBCT plans were compared with original CT-sim plan with GBS. However, when DBS intervened, the OAR dose and tumor coverage was better than the GBS. For example, one of patients’ daily average doses of right parotid and oral cavity increased to 26% and 36%, respectively from the original plan to the GBS planning. However, it only increased by 13% and 24%, respectively with DBS. GTV D95 coverage also decreased by 16% with GBS, but only 2% decreased with DBS. Conclusion: DBS method is superior to GBS to prevent any abrupt dose changes to OARs as well as PTV/CTV or GTV at least for some H&N cases. Since it is not known when the DBS is beneficial to the GBS, a system which enables the on-line DBS may be helpful for better treatment of H&N.

60 APPLIED LIFE SCIENCES↗

SU-G-TeP4-11: Implementation of a Non-Measurement-Based Patient-Specific IMRT QA Program

Purpose: To implement a comprehensive non-measurement-based verification program for patient-specific IMRT QA Methods: Based on published guidelines, a robust IMRT QA program should assess the following components: 1) accuracy of dose calculation, 2) accuracy of data transfer from the treatment planning system (TPS) to the record-and-verify (RV) system, 3) treatment plan deliverability, and 4) accuracy of plan delivery. Results: We have implemented an IMRT QA program that consist of four components: 1) an independent re-calculation of the dose distribution in the patient anatomy with a commercial secondary dose calculation program: Mobius3D (Mobius Medical Systems, Houston, TX), with dose accuracy evaluation using gamma analysis, PTV mean dose, PTV coverage to 95%, and organ-at-risk mean dose; 2) an automated in-house-developed plan comparison system that compares all relevant plan parameters such as MU, MLC position, beam iso-center position, collimator, gantry, couch, field size settings, and bolus placement, etc. between the plan and the RV system; 3) use of the RV system to check the plan deliverability and further confirm using “mode-up” function on treatment console for plans receiving warning; and 4) implementation of a comprehensive weekly MLC QA, in addition to routine accelerator monthly and daily QA. Among 1200 verifications, there were 9 cases of suspicious calculations, 5 cases of delivery failure, no data transfer errors, and no failure of weekly MLC QA. These 9 suspicious cases were due to the PTV extending to the skin or to heterogeneity correction effects, which would not have been caught using phantom measurement-based QA. The delivery failure was due to the rounding variation of MLC position between the planning system and RV system. Conclusion: A very efficient, yet comprehensive, non-measurement-based patient-specific QA program has been implemented and used clinically for about 18 months with excellent results.

60 APPLIED LIFE SCIENCES↗

WE-H-207A-05: Spatial Co-Localization of F-18 NaF Vs. F-18 FDG Defined Disease Volumes

Purpose: Both [F-18]NaF and [F-18]FDG show promise for quantitative PET/CT assessment in metastatic prostate cancer to bone. Broad agreement between the tracers has been shown but voxel-wise correspondence has not been explored in depth. This study evaluates the spatial co-localization of [F-18]NaF PET and [F-18]FDG PET in bone lesions. Methods: Seventy-three lesion contours were identified in six patients receiving dynamic NaF PET/CT and FDG PET/CT scans two hours apart using identical fields-of-view. Tracer uptake (SUV) reflecting 60 minutes post-injection was modeled from kinetic parameters. Lesions were segmented by a physician separately on NaF PET and FDG PET. PET images were rigidly aligned using skeletal references on CT images. Lesion size, degree of overlap, voxel-wise tracer uptake values (SUV), and CT density distributions were compared using Dice coefficient, Positive Predictive Value (PPV), and Spearman rank correlation tests. Results: Across all patients, 42 lesions were identified on NaF PET (median 1.4 cm{sup 3}, range <1–204 cm{sup 3}) compared to 31 using FDG PET (median 1.8 cm{sup 3}, range <1–244 cm{sup 3}). Spatial cooccurrence was found in 25 lesion pairs. Lesions on NaF PET had PPV of 0.91 and on FDG a PPV of 0.65. Overall, NaF-defined lesions were 47% (±24%) larger by volume with moderate overlap to FDG, resulting in mean Dice coefficient of 34% (±22%). In areas of overlap, voxel-wise correlation of NaF and FDG SUV was moderate (ρ=0.56). Expanding to regions of non-spatial overlap, voxels contained in FDG-only contours were almost exclusively low HU (median 118), compared to dense regions of NaF-only voxels (median 250). In sclerotic sub-volumes (HU > 300) NaF-defined contours encompassed 83% of total FDG volume. Conclusion: Moderate voxel-wise correlation of FDG and NaF PET/CT uptake was observed. Spatial discrepancies in FDG and NaF PET/CT imaging of boney metastases could be influenced by poor sensitivity of FDG PET/CT in sclerotic regions. Funded by Prostate Cancer Foundation.

60 APPLIED LIFE SCIENCES↗

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

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

60 APPLIED LIFE SCIENCES↗

TH-EF-BRA-04: Individually Optimized Contrast-Enhanced 4D-CT for Radiotherapy Simulation in Pancreatic Ductal Adenocarcinoma

Purpose: To develop an individually optimized contrast-enhanced (CE) 4D-CT for radiotherapy simulation in pancreatic ductal adenocarcinomas (PDA). Methods: Ten PDA patients were enrolled. Each underwent 3 CT scans: a 4D-CT immediately following a CE 3D-CT and an individually optimized CE 4D-CT using test injection. Three physicians contoured the tumor and pancreatic tissues. We compared image quality scores, tumor volume, motion, tumor-to-pancreas contrast, and contrast-to-noise ratio (CNR) in the 3 CTs. We also evaluated interobserver variations in contouring the tumor using simultaneous truth and performance level estimation (STAPLE). Results: Average image quality scores for CE 3DCT and CE 4D-CT were comparable (4.0 and 3.8, respectively; P=0.47), and both were significantly better than that for 4D-CT (2.6, P<0.001). Tumor-to-pancreas contrast results were comparable in CE 3D-CT and CE 4D-CT (15.5 and 16.7 HU, respectively; P=0.71), and the latter was significantly higher than in 4D-CT (9.2 HU, P=0.03). Image noise in CE 3D-CT (12.5 HU) was significantly lower than in CE 4D-CT (22.1 HU, P<0.001) and 4D-CT (19.4 HU, P=0.005). CNRs were comparable in CE 3D-CT and CE 4DCT (1.4 and 0.8, respectively; P=0.23), and the former was significantly better than in 4D-CT (0.6, P = 0.04). Mean tumor volumes were smaller in CE 3D-CT (29.8 cm{sup 3}) and CE 4D-CT (22.8 cm{sup 3}) than in 4D-CT (42.0 cm{sup 3}), although these differences were not statistically significant. Mean tumor motion was comparable in 4D-CT and CE 4D-CT (7.2 and 6.2 mm, P=0.23). Interobserver variations were comparable in CE 3D-CT and CE 4D-CT (Jaccard index 66.0% and 61.9%, respectively) and were worse for 4D-CT (55.6%) than CE 3D-CT. Conclusion: CE 4D-CT demonstrated characteristics comparable to CE 3D-CT, with high potential for simultaneously delineating the tumor and quantifying tumor motion with a single scan. Supported in part by Philips Healthcare.

60 APPLIED LIFE SCIENCES↗

Experimental stand for studying the impact of laser-accelerated protons on biological objects

An original experimental stand is presented, aimed at studying the impact of high-energy protons, produced by the laser-plasma interaction at a petawatt power level, on biological objects. In the course of pilot experiments with the energy of laser-accelerated protons up to 25 MeV, the possibility is demonstrated of transferring doses up to 10 Gy to the object of study in a single shot with the magnetic separation of protons from parasitic X-ray radiation and fast electrons. The technique of irradiating the cell culture HeLa Kyoto and measuring the fraction of survived cells is developed. The ways of optimising the parameters of proton beams and the suitable methods of their separation with respect to energy and transporting to the studied living objects are discussed. The construction of the stand is intended for the improvement of laser technologies for hadron therapy of malignant neoplasms. (extreme laser radiation: physics and fundamental applications)

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-J-72: Dosimetric Study of Cone-Beam CT-Based Radiation Treatment Planning Using a Patient-Specific Stepwise CT-Density Table

Purpose: To assess dose calculation accuracy of cone-beam CT (CBCT) based treatment plans using a patient-specific stepwise CT-density conversion table in comparison to conventional CT-based treatment plans. Methods: Unlike CT-based treatment planning which use fixed CT-density table, this study used patient-specific CT-density table to minimize the errors in reconstructed mass densities due to the effects of CBCT Hounsfield unit (HU) uncertainties. The patient-specific CT-density table was a stepwise function which maps HUs to only 6 classes of materials with different mass densities: air (0.00121g/cm3), lung (0.26g/cm3), adipose (0.95g/cm3), tissue (1.05 g/cm3), cartilage/bone (1.6g/cm3), and other (3g/cm3). HU thresholds to define different materials were adjusted for each CBCT via best match with the known tissue types in these images. Dose distributions were compared between CT-based plans and CBCT-based plans (IMRT/VMAT) for four types of treatment sites: head and neck (HN), lung, pancreas, and pelvis. For dosimetric comparison, PTV mean dose in both plans were compared. A gamma analysis was also performed to directly compare dosimetry in the two plans. Results: Compared to CT-based plans, the differences for PTV mean dose were 0.1% for pelvis, 1.1% for pancreas, 1.8% for lung, and −2.5% for HN in CBCT-based plans. The gamma passing rate was 99.8% for pelvis, 99.6% for pancreas, and 99.3% for lung with 3%/3mm criteria, and 80.5% for head and neck with 5%/3mm criteria. Different dosimetry accuracy level was observed: 1% for pelvis, 3% for lung and pancreas, and 5% for head and neck. Conclusion: By converting CBCT data to 6 classes of materials for dose calculation, 3% of dose calculation accuracy can be achieved for anatomical sites studied here, except HN which had a 5% accuracy. CBCT-based treatment planning using a patient-specific stepwise CT-density table can facilitate the evaluation of dosimetry changes resulting from variation in patient anatomy.

60 APPLIED LIFE SCIENCES↗

SU-E-J-76: CBCT Reconstruction of a Full Couch Using Rigid Registration and Pre-Scanned Couch Image and Its Clinical Application

Purpose: Only a part of a treatment couch is reconstructed in CBCT due to the limited field of view (FOV). This often generates inaccurate results in the delivered dose evaluation with CBCT and more noise in the CBCT reconstruction. Full reconstruction of the couch at treatment setup can be used for more accurate exit beam dosimetry. The goal of this study is to develop a method to reconstruct a full treatment couch using a pre-scanned couch image and rigid registration. Methods: A full couch (Exact Couch, Varian) model image was reconstructed by rigidly registering and combining two sets of partial CBCT images. The full couch model includes three parts: two side rails and a couch top. A patient CBCT was reconstructed with reconstruction grid size larger than the physical field of view to include the full couch. The image quality of the couch is not good due to data truncation, but good enough to allow rigid registration of the couch. A composite CBCT image of the patient plus couch has been generated from the original reconstruction by replacing couch portion with the pre-acquired model couch, rigidly registered to the original scan. We evaluated the clinical usefulness of this method by comparing treatment plans generated on the original and on the modified scans. Results: The full couch model could be attached to a patient CBCT image set via rigid image registration. Plan DVHs showed 1∼2% difference between plans with and without full couch modeling. Conclusion: The proposed method generated a full treatment couch CBCT model, which can be successfully registered to the original patient image. This method was also shown to be useful in generating more accurate dose distributions, by lowering 1∼2% dose in PTV and a few other critical organs. Part of this study is supported by NIH R01CA133539.

60 APPLIED LIFE SCIENCES↗

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

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

60 APPLIED LIFE SCIENCES↗

SU-E-T-39: A Logistic Function-Based Model to Predict Organ-At-Risk (OAR) DVH in IMRT Treatment Planning

Purpose: To investigate the feasibility of a logistic function-based model to predict organ-at-risk (OAR) DVH for IMRT planning. The predicted DVHs are compared to achieved DVHs by expert treatment planners. Methods: A logistic function is used to model the OAR dose-gradient function. This function describes the percentage of the prescription dose as a function of the normal distance to PTV surface. The slope of dose-gradient function is function of relative spatial orientation of the PTV and OARs. The OAR DVH is calculated using the OAR dose-gradient function assuming that the dose is same for voxels with same normal distance to PTV. Ten previously planned prostate IMRT plans were selected to build the model, and the following plan parameters were calculated as possible features to the model: the PTV maximum/minimum dose, PTV volume, bladder/rectum volume in the radiation field, percentage of bladder/rectum overlapping with PTV, and the distance between the bladder/rectum centroid and PTV. The bladder/rectum dose-gradient function was modeled and applied on 10 additional test cases, and the predicted and achieved clinical bladder/rectum DVHs were compared: V70 (percentage of volume receiving 70Gy and above), V65, V60, V55, V50, V45, V40. Results: The following parameters were selected as model features: PTV volume, and distance of centroid of rectum/bladder to PTV. The model was tested with 10 additional patients. For bladder, the absolute difference (mean±standard deviation) between predicted and clinical DVHs is V70=−0.3±3.2, V65=−0.8±3.9, V60=1.5±4.3, V55=1.7±5.3, V50=−0.6±6.4, V45=0.6±6.5, and V40=0.9±5.7, the correlation coefficient is 0.96; for rectum, the difference is V70=1.5±3.8, V65=1.2±4.2, V60=−0.1±5.3, V55=1.0±6.6, V50=1.6±8.7, V45=1.9±9.8, and V40=1.5±10.1, and the correlation coefficient is 0.87. Conclusion: The OAR DVH can be accurately predicted using the OAR dose-gradient function in IMRT plans. This approach may be used as a quality control tool and aid less experienced planners determine benchmarks for plan quality.

60 APPLIED LIFE SCIENCES↗

SU-E-T-182: Clinical Implementation of TG71-Based Electron MU Calculation and Comparison with a Commercial Secondary Calculation

Purpose: The TG-71 report was published in 2014 to present standardized methodologies for MU calculations and determination of dosimetric quantities. This work explores the clinical implementation of a TG71-based electron MU calculation algorithm and compares it with a recently released commercial secondary calculation program–Mobius3D (Mobius Medical System, LP). Methods: TG-71 electron dosimetry data were acquired, and MU calculations were performed based on the recently published TG-71 report. The formalism in the report for extended SSD using air-gap corrections was used. The dosimetric quantities, such PDD, output factor, and f-air factors were incorporated into an organized databook that facilitates data access and subsequent computation. The Mobius3D program utilizes a pencil beam redefinition algorithm. To verify the accuracy of calculations, five customized rectangular cutouts of different sizes–6×12, 4×12, 6×8, 4×8, 3×6 cm{sup 2}–were made. Calculations were compared to each other and to point dose measurements for electron beams of energy 6, 9, 12, 16, 20 MeV. Each calculation / measurement point was at the depth of maximum dose for each cutout in a 10×10 cm{sup 2} or 15×15cm{sup 2} applicator with SSDs 100cm and 110cm. Validation measurements were made with a CC04 ion chamber in a solid water phantom for electron beams of energy 9 and 16 MeV. Results: Differences between the TG-71 and the commercial system relative to measurements were within 3% for most combinations of electron energy, cutout size, and SSD. A 5.6% difference between the two calculation methods was found only for the 6MeV electron beam with 3×6 cm{sup 2}cutout in the 10×10{sup 2}cm applicator at 110cm SSD. Both the TG-71 and the commercial calculations show good consistency with chamber measurements: for 5 cutouts, <1% difference for 100cm SSD, and 0.5–2.7% for 110cm SSD. Conclusions: Based on comparisons with measurements, a TG71-based computation method and a Mobius3D program produce reasonably accurate MU calculations for electron-beam therapy.

60 APPLIED LIFE SCIENCES↗

SU-E-T-192: Commissioning of a Commercial 3D Dose Calculation Program

Purpose: To commission a commercial software package (CSP) that is used as secondary dose calculation check. The CSP uses an independent golden data beam model. However, some parameters can be modified to generate a customer specific model. Plan comparisons and point dose measurements were performed to test if and to what extent the beam model needed adjustment to optimize results. Methods: Beam parameter configurations were compared between the CSP and both TPS. Twelve phantom test plans ranging from simple to complex were generated in two treatment planning systems (TPS). Tests included small field, off axis, EDW, IMRT and VMAT plans. For each plan a point dose was measured to establish ground truth. Lastly, patient plans were compared for both TPS systems and the CSP. Results: Beam parameters agreed within 2%. The output factors for small fields were changed for the 15 MV beam by 2 and 1.5 % for the 1 cm and 2 cm field sizes, respectively. For the 6 MV beam output factors were adjusted by 3−0.8% for field sizes ranging from 1 to 5 cm. The MLC dynamic leaf gap was adjusted by 1.5 mm for 18 MV beam. Differences between the CSP and the TPS were noted in the built-up region. These differences affected the gamma pass rate in the surface region, however this effect is reduced with increasing number of beam angles and does not affect point dose calculations at depth. All IMRT and VMAT plans agreed with the CSP using a gamma pass rate of 95% (3%, 3mm). Conclusion: The CSP is used to verify point doses for all 3D plans generated in our clinic for the last 6 months. No point dose mismatches were encountered since the CSP was implemented. Next, the CSP will be adapted for secondary checks of all IMRT plans. KL had a beta tester agreement with Mobius Medical for an in-kind equipment and software loan.

60 APPLIED LIFE SCIENCES↗