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Kavanaugh, J

Publications and source records attributed to Kavanaugh, J.

TU-FG-201-01: 18-Month Clinical Experience of a Linac Daily Quality Assurance (QA) Solution Using Only EPID and OBI

Purpose: To describe the clinical use of a Linear Accelerator (Linac) DailyQA system with only EPID and OBI. To assess the reliability over an 18-month period and improve the robustness of this system based on QA failure analysis. Methods: A DailyQA solution utilizing an in-house designed phantom, combined EPID and OBI image acquisitions, and a web-based data analysis and reporting system was commissioned and used in our clinic to measure geometric, dosimetry and imaging components of a Varian Truebeam Linac. During an 18-month period (335 working days), the Daily QA results, including the output constancy, beam flatness and symmetry, uniformity, TPR20/10, MV and KV imaging quality, were collected and analyzed. For output constancy measurement, an independent monthly QA system with an ionization chamber (IC) and annual/incidental TG51 measurements with ADCL IC were performed and cross-compared to Daily QA system. Thorough analyses were performed on the recorded QA failures to evaluate the machine performance, optimize the data analysis algorithm, adjust the tolerance setting and improve the training procedure to prevent future failures. Results: A clinical workflow including beam delivery, data analysis, QA report generation and physics approval was established and optimized to suit daily clinical operation. The output tests over the 335 working day period cross-correlated with the monthly QA system within 1.3% and TG51 results within 1%. QA passed with one attempt on 236 days out of 335 days. Based on the QA failures analysis, the Gamma criteria is revised from (1%, 1mm) to (2%, 1mm) considering both QA accuracy and efficiency. Data analysis algorithm is improved to handle multiple entries for a repeating test. Conclusion: We described our 18-month clinical experience on a novel DailyQA system using only EPID and OBI. The long term data presented demonstrated the system is suitable and reliable for Linac daily QA.

60 APPLIED LIFE SCIENCES↗

TU-C-17A-03: An Integrated Contour Evaluation Software Tool Using Supervised Pattern Recognition for Radiotherapy

Purpose: Radiotherapy (RT) contours delineated either manually or semiautomatically require verification before clinical usage. Manual evaluation is very time consuming. A new integrated software tool using supervised pattern contour recognition was thus developed to facilitate this process. Methods: The contouring tool was developed using an object-oriented programming language C# and application programming interfaces, e.g. visualization toolkit (VTK). The C# language served as the tool design basis. The Accord.Net scientific computing libraries were utilized for the required statistical data processing and pattern recognition, while the VTK was used to build and render 3-D mesh models from critical RT structures in real-time and 360° visualization. Principal component analysis (PCA) was used for system self-updating geometry variations of normal structures based on physician-approved RT contours as a training dataset. The inhouse design of supervised PCA-based contour recognition method was used for automatically evaluating contour normality/abnormality. The function for reporting the contour evaluation results was implemented by using C# and Windows Form Designer. Results: The software input was RT simulation images and RT structures from commercial clinical treatment planning systems. Several abilities were demonstrated: automatic assessment of RT contours, file loading/saving of various modality medical images and RT contours, and generation/visualization of 3-D images and anatomical models. Moreover, it supported the 360° rendering of the RT structures in a multi-slice view, which allows physicians to visually check and edit abnormally contoured structures. Conclusion: This new software integrates the supervised learning framework with image processing and graphical visualization modules for RT contour verification. This tool has great potential for facilitating treatment planning with the assistance of an automatic contour evaluation module in avoiding unnecessary manual verification for physicians/dosimetrists. In addition, its nature as a compact and stand-alone tool allows for future extensibility to include additional functions for physicians’ clinical needs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

TU-C-17A-04: BEST IN PHYSICS (THERAPY) - A Supervised Framework for Automatic Contour Assessment for Radiotherapy Planning of Head- Neck Cancer

Purpose: Precise contour delineation of tumor targets and critical structures from CT simulations is essential for accurate radiotherapy (RT) treatment planning. However, manual and automatic delineation processes can be error prone due to limitations in imaging techniques and individual anatomic variability. Tedious and laborious manual verification is hence needed. This study develops a general framework for automatically assessing RT contours for head-neck cancer patients using geometric attribute distribution models (GADMs). Methods: Geometric attributes (centroid and volume) were computed from physician-approved RT contours of 29 head-neck patients. Considering anatomical correlation between neighboring structures, the GADM for each attribute was trained to characterize intra- and interpatient structure variations using principal component analysis. Each trained GADM was scalable and deformable, but constrained by the principal attribute variations of the training contours. A new hierarchical model adaptation algorithm was utilized to assess the RT contour correctness for a given patient. Receiver operating characteristic (ROC) curves were employed to evaluate and tune system parameters for the training models. Results: Experiments utilizing training and non-training data sets with simulated contouring errors were conducted to validate the framework performance. Promising assessment results of contour normality/abnormality for the training contour-based data were achieved with excellent accuracy (0.99), precision (0.99), recall (0.83), and F-score (0.97), while corresponding values of 0.84, 0.96, 0.83, and 0.9 were achieved for the non-training data. Furthermore, the areas under the ROC curves were above 0.9, validating the accuracy of this test. Conclusion: The proposed framework can reliably identify contour normality/abnormality based upon intra- and inter-structure constraints derived from clinically-approved contours. It also allows physicians to analytically determine the system parameters to fit various clinic requirements (e.g. as-low-as-possible false positives). It has great potential for improving RT work flow. More geometric attributes and training sets will be investigated to improve framework performance in the future.

60 APPLIED LIFE SCIENCES↗