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Lee, Se Byeong

Publications and source records attributed to Lee, Se Byeong.

Sparse-view proton computed tomography using modulated proton beams

Purpose: Proton imaging that uses a modulated proton beam and an intensity detector allows a relatively fast image acquisition compared to the imaging approach based on a trajectory tracking detector. In addition, it requires a relatively simple implementation in a conventional proton therapy equipment. The model of geometric straight ray assumed in conventional computed tomography (CT) image reconstruction is however challenged by multiple-Coulomb scattering and energy straggling in the proton imaging. Radiation dose to the patient is another important issue that has to be taken care of for practical applications. In this work, the authors have investigated iterative image reconstructions after a deconvolution of the sparsely view-sampled data to address these issues in proton CT. Methods: Proton projection images were acquired using the modulated proton beams and the EBT2 film as an intensity detector. Four electron-density cylinders representing normal soft tissues and bone were used as imaged object and scanned at 40 views that are equally separated over 360°. Digitized film images were converted to water-equivalent thickness by use of an empirically derived conversion curve. For improving the image quality, a deconvolution-based image deblurring with an empirically acquired point spread function was employed. They have implemented iterative image reconstruction algorithms such as adaptive steepest descent-projection onto convex sets (ASD-POCS), superiorization method–projection onto convex sets (SM-POCS), superiorization method–expectation maximization (SM-EM), and expectation maximization-total variation minimization (EM-TV). Performance of the four image reconstruction algorithms was analyzed and compared quantitatively via contrast-to-noise ratio (CNR) and root-mean-square-error (RMSE). Results: Objects of higher electron density have been reconstructed more accurately than those of lower density objects. The bone, for example, has been reconstructed within 1% error. EM-based algorithms produced an increased image noise and RMSE as the iteration reaches about 20, while the POCS-based algorithms showed a monotonic convergence with iterations. The ASD-POCS algorithm outperformed the others in terms of CNR, RMSE, and the accuracy of the reconstructed relative stopping power in the region of lung and soft tissues. Conclusions: The four iterative algorithms, i.e., ASD-POCS, SM-POCS, SM-EM, and EM-TV, have been developed and applied for proton CT image reconstruction. Although it still seems that the images need to be improved for practical applications to the treatment planning, proton CT imaging by use of the modulated beams in sparse-view sampling has demonstrated its feasibility.

60 APPLIED LIFE SCIENCES↗

New Technique for Developing a Proton Range Compensator With Use of a 3-Dimensional Printer

Purpose: A new system for manufacturing a proton range compensator (RC) was developed by using a 3-dimensional printer (3DP). The physical accuracy and dosimetric characteristics of the new RC manufactured by 3DP (RC{sub 3}DP) were compared with those of a conventional RC (RC{sub C}MM) manufactured by a computerized milling machine (CMM). Methods and Materials: An RC for brain tumor treatment with a scattered proton beam was calculated with a treatment planning system, and the resulting data were converted into a new format for 3DP using in-house software. The RC{sub 3}DP was printed with ultraviolet curable acrylic plastic, and an RC{sub C}MM was milled into polymethylmethacrylate using a CMM. The inner shape of both RCs was scanned by using a 3D scanner and compared with TPS data by applying composite analysis (CA; with 1-mm depth difference and 1 mm distance-to-agreement criteria) to verify their geometric accuracy. The position and distal penumbra of distal dose falloff at the central axis and field width of the dose profile at the midline depth of spread-out Bragg peak were measured for the 2 RCs to evaluate their dosimetric characteristics. Both RCs were imaged on a computed tomography scanner to evaluate uniformity of internal density. The manufacturing times for both RCs were compared to evaluate the production efficiency. Results: The pass rates for the CA test were 99.5% and 92.5% for RC{sub 3}DP and RC{sub C}MM, respectively. There was no significant difference in dosimetric characteristics and uniformity of internal density between the 2 RCs. The net fabrication times of RC{sub 3}DP and RC{sub C}MM were about 18 and 3 hours, respectively. Conclusions: The physical accuracy and dosimetric characteristics of RC{sub 3}DP were comparable with those of the conventional RC{sub C}MM, and significant system minimization was provided.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Feasibility Study of Glass Dosimeter for In Vivo Measurement: Dosimetric Characterization and Clinical Application in Proton Beams

Purpose: To evaluate the suitability of the GD-301 glass dosimeter for in vivo dose verification in proton therapy. Methods and Materials: The glass dosimeter was analyzed for its dosimetrics characteristic in proton beam. Dosimeters were calibrated in a water phantom using a stairlike holder specially designed for this study. To determine the accuracy of the glass dosimeter in proton dose measurements, we compared the glass dosimeter and thermoluminescent dosimeter (TLD) dose measurements using a cylindrical phantom. We investigated the feasibility of the glass dosimeter for the measurement of dose distributions near the superficial region for proton therapy plans with a varying separation between the target volume and the surface of 6 patients. Results and Discussion: Uniformity was within 1.5%. The dose-response has good linearity. Dose-rate, fading, and energy dependence were found to be within 3%. The beam profile measured using the glass dosimeter was in good agreement with the profile obtained from the ionization chamber. Depth-dose distributions in nonmodulated and modulated proton beams obtained with the glass dosimeter were estimated to be within 3%, which was lower than those with the ionization chamber. In the phantom study, the difference of isocenter dose between the delivery dose calculated by the treatment planning system and that measured by the glass dosimeter was within 5%. With in vivo dosimetry, the calculated surface doses overestimated measurements by 4%-16% using glass dosimeter and TLD. Conclusion: It is recommended that bolus be added for these clinical cases. We also believe that the glass dosimeter has considerable potential for use with in vivo patient proton dosimetry.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Eye tracking and gating system for proton therapy of orbital tumors

Purpose: A new motion-based gated proton therapy for the treatment of orbital tumors using real-time eye-tracking system was designed and evaluated. Methods: We developed our system by image-pattern matching, using a normalized cross-correlation technique with LabVIEW 8.6 and Vision Assistant 8.6 (National Instruments, Austin, TX). To measure the pixel spacing of an image consistently, four different calibration modes such as the point-detection, the edge-detection, the line-measurement, and the manual measurement mode were suggested and used. After these methods were applied to proton therapy, gating was performed, and radiation dose distributions were evaluated. Results: Moving phantom verification measurements resulted in errors of less than 0.1 mm for given ranges of translation. Dosimetric evaluation of the beam-gating system versus nongated treatment delivery with a moving phantom shows that while there was only 0.83 mm growth in lateral penumbra for gated radiotherapy, there was 4.95 mm growth in lateral penumbra in case of nongated exposure. The analysis from clinical results suggests that the average of eye movements depends distinctively on each patient by showing 0.44 mm, 0.45 mm, and 0.86 mm for three patients, respectively. Conclusions: The developed automatic eye-tracking based beam-gating system enabled us to perform high-precision proton radiotherapy of orbital tumors.

60 APPLIED LIFE SCIENCES↗

Development of array-type prompt gamma measurement system for in vivo range verification in proton therapy

Purpose: In vivo range verification is one of the most important parts of proton therapy to fully utilize its benefits delivering high radiation dose to tumor, while sparing the normal tissue with the so-called Bragg peak. Currently, however, range verification method is not used in clinics. The purpose of the present study is to optimize and evaluate the configuration of an array-type prompt gamma measurement system on determining distal dose edge for in vivo range verification of proton therapy. Methods: To effectively measure the prompt gammas against the background gammas, the Monte Carlo simulations with the MCNPX code were employed in optimizing the configuration of the measurement system, and the Monte Carlo method was also used to understand the effect of the background gammas, mainly neutron capture gammas, in the measured gamma distribution. To reduce the effect of the background gammas, the optimized energy window of 4-10 MeV in measuring the prompt gammas was employed. A parameterized source was used to maximize computation speed in the optimization study. A simplified test measurement system, using only one detector moving from one measurement location to the next, was constructed and applied to therapeutic proton beams of 80-220 MeV. For accurate determination of the distal dose edge, the sigmoidal curve-fitting method was applied to the measured distributions of the prompt gammas, and then, the location of the half-value between the maximum and minimum value in the curve-fitting was determined as the distal dose edge and compared with the beam range assessed by the proton dose distribution. Results: The parameterized source term employed in optimization process improved the calculation speed by up to {approx}300 times. The optimization study indicates that an array-type measurement system with 3, 2, 2, and 150 mm for scintillator thickness, slit width, septal thickness, and slit length, respectively, can effectively measure the prompt gamma distributions minimizing the contribution of background gammas. The present results show that a few hundred counts of prompt gammas can be easily obtained by measuring 10 s at each measurement location for proton beams of {approx}4 nA. The distal dose edges determined by the prompt gamma distribution are 5.45, 14.73, and 27.74 cm for proton beams of 5.17 (80 MeV), 14.99 (150 MeV), and 27.38 (220 MeV) cm, respectively. Conclusions: The results show that the array-type measurement system can measure prompt gamma distributions from a therapeutic proton beam within a short measurement time, and that the distal dose edge can be determined within a few millimeters of error without using any sophisticated analysis.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Craniospinal Irradiation Techniques: A Dosimetric Comparison of Proton Beams With Standard and Advanced Photon Radiotherapy

Purpose: To evaluate the dosimetric benefits of advanced radiotherapy techniques for craniospinal irradiation in cancer in children. Methods and Materials: Craniospinal irradiation (CSI) using three-dimensional conformal radiotherapy (3D-CRT), tomotherapy (TOMO), and proton beam treatment (PBT) in the scattering mode was planned for each of 10 patients at our institution. Dosimetric benefits and organ-specific radiation-induced cancer risks were based on comparisons of dose-volume histograms (DVHs) and on the application of organ equivalent doses (OEDs), respectively. Results: When we analyzed the organ-at-risk volumes that received 30%, 60%, and 90% of the prescribed dose (PD), we found that PBT was superior to TOMO and 3D-CRT. On average, the doses delivered by PBT to the esophagus, stomach, liver, lung, pancreas, and kidney were 19.4 Gy, 0.6 Gy, 0.3 Gy, 2.5 Gy, 0.2 Gy, and 2.2 Gy for the PD of 36 Gy, respectively, which were significantly lower than the doses delivered by TOMO (22.9 Gy, 4.5 Gy, 6.1 Gy, 4.0 Gy, 13.3 Gy, and 4.9 Gy, respectively) and 3D-CRT (34.6 Gy, 3.6 Gy, 8.0 Gy, 4.6 Gy, 22.9 Gy, and 4.3 Gy, respectively). Although the average doses delivered by PBT to the chest and abdomen were significantly lower than those of 3D-CRT or TOMO, these differences were reduced in the head-and-neck region. OED calculations showed that the risk of secondary cancers in organs such as the stomach, lungs, thyroid, and pancreas was much higher when 3D-CRT or TOMO was used than when PBT was used. Conclusions: Compared with photon techniques, PBT showed improvements in most dosimetric parameters for CSI patients, with lower OEDs to organs at risk.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Proton Range Uncertainty Due to Bone Cement Injected Into the Vertebra in Radiation Therapy Planning

We wanted to evaluate the influence of bone cement on the proton range and to derive a conversion factor predicting the range shift by correcting distorted computed tomography (CT) data as a reference to determine whether the correction is needed. Two CT datasets were obtained with and without a bone cement disk placed in a water phantom. Treatment planning was performed on a set of uncorrected CT images with the bone cement disk, and the verification plan was applied to the same set of CT images with an effective CT number for the bone cement disk. The effective CT number was determined by measuring the actual proton range with the bone cement disk. The effects of CT number, thicknesses, and position of bone cement on the proton range were evaluated in the treatment planning system (TPS) to draw a conversion factor predicting the range shift by correcting the CT number of bone cement. The effective CT number of bone cement was 260 Hounsfield units (HU). The calculated proton range for native CT data was significantly shorter than the measured proton range. However, the calculated range for the corrected CT data with the effective CT number coincided exactly with the measured range. The conversion factor was 209.6 [HU . cm/mm] for bone cement and predicted the range shift by approximately correcting the CT number. We found that the heterogeneity of bone cement could cause incorrect proton ranges in treatment plans using CT images. With an effective CT number of bone cement derived from the proton range and relative stopping power, a more actual proton range could be calculated in the TPS. The conversion factor could predict the necessity for CT data correction with sufficient accuracy.

61 RADIATION PROTECTION AND DOSIMETRY↗