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Li, Z

Publications and source records attributed to Li, Z.

At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

SU-E-T-08: A Beam Source Model for Monte Carlo Simulations of a Double-Scattering Proton Beam Delivery System Using Beam Current Modulation

Purpose: To reconstruct phase-space information upstream of patient specific collimators for Monte Carlo simulations using only radiotherapy planning system data. Methods: The proton energies are calculated based on residual ranges, e.g., sum of prescribed ranges in a patient and SSD. The Kapchinskij and Vladimirskij (KV) distribution was applied to sample proton’s x-y positions and momentum direction and the beam shape was assumed to be a circle. Free parameters, e.g., the initial energy spread and the emittance of KV distribution were estimated from the benchmarking with commissioning data in a commercial treatment planning system for an operational proton therapy center. The number of histories, which defines the height of individual pristine Bragg peaks (BP) of Spread-out Bragg peak (SOBP), are weighted based on beam current modulation and a correction factor is applied to take into account the fluence reduction as the residual range decreases due to the rotation of the range modulator wheel. The timedependent behaviors, e.g., the changes of the residual range and histories per a pristine BP, are realized by utilizing TOPAS (Tool for Particle Simulation). Results: Benchmarking simulations for selected SOBPs ranging 7.5 cm to 15.5 cm matched within 2 mm in range and up to 5 mm in SOBP width against measurement data in water phantom. We found this model tends to underestimate entrance dose by about 5 % in comparison to measurement. This was attributed to the situation that the energy distribution used in the model was limited in its granularity at the limit of single energy spectrum for the narrow angle modulator steps used in the proximal pull back region of the SOBPs. Conclusion: Within these limitations the source modeling method proved itself an acceptable alternative of a full treatment head simulation when the machine geometry and materials information are not available.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-183: Clinical Quality Assurance Workflow for Dynamic Tumor Tracking Radiation Dose Delivery

Purpose: One of the most important aspects of implementation of new treatment modalities is an ‘end-to-end’ verification of the treatment process. Radiation treatment based on dynamic tracking of a tumor is highly patient-specific, therefore, special attention should be paid to quality assurance of the treatment delivery. Our goal was to design the clinical workflow that ensures accurate delivery of the planned dose using the Dynamic Target Tracking option of VeroTM (BrainLab,MHI) linac. Methods: A patient simulation is designed to include a pre-treatment session to verify whether the system can reliably track the motion of the implanted marker and build the 4D model of the target motion. The external surrogate and target motion patterns are recorded in the ExactracTM log files. In this work, a spectrum of custom marker and external surrogate motion trajectories closely resembling the patient specific motion patterns was used. 1mm thick/11mm long VisicoilTM marker was placed 15 and 20mm from the center of the spherical tissue equivalent target (centroid to centroid distance) in the 4D motion phantom (CIRSTM). 3D conformal (3 mm block margin) SBRT plans were delivered to 2 moving targets in the phantom: 1) 20mm diameter target that allows ion chamber dose measurement and 2) 25mm target that allows using film to measure CAX dose (GafchromicTM EBT3 used). The measured dose was compared to the iPlanTM TPS results using MonteCarlo algorithm (1% variance, Dose-to-water). Results: On average, film shows 98.9% pass using gamma criterion for 2% and 2mm DTA, 94.3% match for 2% and 1 mm DTA, 98% pass for 1% and 2 mm DTA however only 88% points passing for 1% and 1 mm DTA. Ion chamber measurements agreed with the calculation within 1.5%. Conclusion: The clinical QA workflow was designed for SBRT delivery using real-time tumor tracking on VeroTM linac.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-559: Monte Carlo Simulation of Cobalt-60 Teletherapy Unit Modeling In-Field and Out-Of-Field Doses for Applications in Computational Radiation Dosimetry

Purpose: Mean organ doses from structures located in field and outside of field boundaries during radiotherapy treatment must be considered when looking at secondary effects. Treatment planning in patients with 40 years of follow-up does not include 3-D treatment planning images and did not estimate dose to structures out of the direct field. Therefore, it is of interest to correlate actual clinical events with doses received. Methods: Accurate models of radiotherapy machines combined with whole body computational phantoms using Monte Carlo methods allow for dose reconstructions intended for studies on late radiation effects. The Theratron-780 radiotherapy unit and anatomically realistic hybrid computational phantoms are modeled in the Monte Carlo radiation transport code MCNPX. The major components of the machine including the source capsule, lead in the unit-head, collimators (fixed/adjustable), and trimmer bars are simulated. The MCNPX transport code is used to compare calculated values in a water phantom with published data from BJR suppl. 25 for in-field doses and experimental data from AAPM Task Group No. 36 for out-of-field doses. Next, the validated cobalt-60 teletherapy model is combined with the UF/NCI Family of Reference Hybrid Computational Phantoms as a methodology for estimating organ doses. Results: The model of Theratron-780 has shown to be agree with percentage depth dose data within approximately 1% and for out of field doses the machine is shown to agree within 8.8%. Organ doses are reported for reference hybrid phantoms. Conclusion: Combining the UF/NCI Family of Reference Hybrid Computational Phantoms along with a validated model of the Theratron-780 allows for organ dose estimates of both in-field and out-of-field organs. By changing field size, position, and adding patient-specific blocking more complicated treatment set-ups can be recreated for patients treated historically, particularly those who lack both 2D/3D image sets.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-622: Planning Technique for Passively-Scattered Involved-Node Proton Therapy of Mediastinal Lymphoma with Consideration of Cardiac Motion

Purpose: To develop a treatment planning method for passively-scattered involved-node proton therapy of mediastinal lymphoma robust to breathing and cardiac motions. Methods: Beam-specific planning treatment volumes (bsPTV) are calculated for each proton field to incorporate pertinent uncertainties. Geometric margins are added laterally to each beam while margins for range uncertainty due to setup errors, breathing, and calibration curve uncertainties are added along each beam. The calculation of breathing motion and deformation effects on proton range includes all 4DCT phases. The anisotropic water equivalent margins are translated to distances on average 4DCT. Treatment plans are designed so each beam adequately covers the corresponding bsPTV. For targets close to the heart, cardiac motion effects on dosemaps are estimated by using a library of anonymous ECG-gated cardiac CTs (cCT). The cCT, originally contrast-enhanced, are partially overridden to allow meaningful proton dose calculations. Targets similar to the treatment targets are drawn on one or more cCT sets matching the anatomy of the patient. Plans based on the average cCT are calculated on individual phases, then deformed to the average and accumulated. When clinically significant dose discrepancies occur between planned and accumulated doses, the patient plan is modified to reduce the cardiac motion effects. Results: We found that bsPTVs as planning targets create dose distributions similar to the conventional proton planning distributions, while they are a valuable tool for visualization of the uncertainties. For large targets with variability in motion and depth, integral dose was reduced because of the anisotropic margins. In most cases, heart motion has a clinically insignificant effect on target coverage. Conclusion: A treatment planning method was developed and used for proton therapy of mediastinal lymphoma. The technique incorporates bsPTVs compensating for all common sources of uncertainties and estimation of the effects of cardiac motion not commonly performed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Improving the Capacity of Sodium Ion Battery Using a Virus-Templated Nanostructured Composite Cathode

In this work we investigated an energy-efficient biotemplated route to synthesize nanostructured FePO4 for sodium-based batteries. Self-assembled M13 viruses and single wall carbon nanotubes (SWCNTs) have been used as a template to grow amorphous FePO4 nanoparticles at room temperature (the active composite is denoted as Bio-FePO4-CNT) to enhance the electronic conductivity of the active material. Preliminary tests demonstrate a discharge capacity as high as 166 mAh/g at C/10 rate, corresponding to composition Na0.9FePO4, which along with higher C-rate tests show this material to have the highest capacity and power performance reported for amorphous FePO4 electrodes to date.

Moradi, M↗
DOE OSTI2014

TU-F-18A-04: Use of An Image-Based Material-Decomposition Algorithm for Multi-Energy CT to Determine Basis Material Densities

Purpose: Published methods for image-based material decomposition with multi-energy CT images have required the assumption of volume conservation or accurate knowledge of the x-ray spectra and detector response. The purpose of this work was to develop an image-based material-decomposition algorithm that can overcome these limitations. Methods: An image-based material decomposition algorithm was developed that requires only mass conservation (rather than volume conservation). With this method, using multi-energy CT measurements made with n=4 energy bins, the mass density of each basis material and of the mixture can be determined without knowledge of the tube spectra and detector response. A digital phantom containing 12 samples of mixtures from water, calcium, iron, and iodine was used in the simulation (Siemens DRASIM). The calibration was performed by using pure materials at each energy bin. The accuracy of the technique was evaluated in noise-free and noisy data under the assumption of an ideal photon-counting detector. Results: Basis material densities can be estimated accurately by either theoretic calculation or calibration with known pure materials. The calibration approach requires no prior information about the spectra and detector response. Regression analysis of theoretical values versus estimated values results in excellent agreement for both noise-free and noisy data. For the calibration approach, the R-square values are 0.9960+/−0.0025 and 0.9476+/−0.0363 for noise-free and noisy data, respectively. Conclusion: From multi-energy CT images with n=4 energy bins, the developed image-based material decomposition method accurately estimated 4 basis material density (3 without k-edge and 1 with in the range of the simulated energy bins) even without any prior information about spectra and detector response. This method is applicable to mixtures of solutions and dissolvable materials, where volume conservation assumptions do not apply. CHM receives research support from NIH and Siemens Healthcare.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-J-70: Feasibility Study of Dynamic Arc and IMRT Treatment Plans Utilizing Vero Treatment Unit and IPlan Planning Computer for SRS/FSRT Brain Cancer Patients

Purpose: To investigate the feasibility of utilizing Dynamic Arc (DA) and IMRT with 5mm MLC leaf of VERO treatment unit for SRS/FSRT brain cancer patients with non-invasive stereotactic treatments. The DA and IMRT plans using the VERO unit (BrainLab Inc, USA) are compared with cone-based planning and proton plans to evaluate their dosimetric advantages. Methods: The Vero treatment has unique features like no rotational or translational movements of the table during treatments, Dynamic Arc/IMRT, tracking of IR markers, limitation of Ring rotation. Accuracies of the image fusions using CBCT, orthogonal x-rays, and CT are evaluated less than ∼ 0.7mm with a custom-made target phantom with 18 hidden targets. 1mm margin is given to GTV to determine PTV for planning constraints considering all the uncertainties of planning computer and mechanical uncertainties of the treatment unit. Also, double-scattering proton plans with 6F to 9F beams and typical clinical parameters, multiple isocenter plans with 6 to 21 isocenters, and DA/IMRT plans are evaluated to investigate the dosimetric advantages of the DA/IMRT for complex shape of targets. Results: 3 Groups of the patients are divided: (1) Group A (complex target shape), CI's are same for IMRT, and DGI of the proton plan are better by 9.5% than that of the IMRT, (2) Group B, CI of the DA plans (1.91+/−0.4) are better than cone-based plan, while DGI of the DA plan is 4.60+/−1.1 is better than cone-based plan (5.32+/−1.4), (3) Group C (small spherical targets), CI of the DA and cone-based plans are almost the same. Conclusion: For small spherical targets, cone-based plans are superior to other 2 plans: DS proton and DA plans. For complex or irregular plans, dynamic and IMRT plans are comparable to cone-based and proton plans for complex targets.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-156: Preclinical Inverstigation of Dynamic Tumor Tracking Using Vero SBRT Linear Accelerator: Motion Phantom Dosimetry Study

Purpose: Following the ‘end-to-end testing’ paradigm of Dynamic Target Tracking option in our Image-Guided dedicated SBRT VeroTM linac, we verify the capability of the system to deliver planned dose to moving targets in the heterogeneous thorax phantom (CIRSTM). The system includes gimbaled C-band linac head, robotic 6 degree of freedom couch and a tumor tracking method based on predictive modeling of target position using fluoroscopically tracked implanted markers and optically tracked infrared reflecting external markers. Methods: 4DCT scan of the motion phantom with the VisicoilTM implanted marker in the close vicinity of the target was acquired, the ‘exhale’=most prevalent phase was used for planning (iPlan by BrainLabTM). Typical 3D conformal SBRT treatment plans aimed to deliver 6-8Gy/fx to two types of targets: a)solid water-equivalent target 3cm in diameter; b)single VisicoilTM marker inserted within lung equivalent material. The planning GTV/CTV-to-PTV margins were 2mm, the block margins were 3 mm. The dose calculated by MonteCarlo algorithm with 1% variance using option Dose-to-water was compared to the ion chamber (CC01 by IBA Dosimetry) measurements in case (a) and GafchromicTM EBT3 film measurements in case (b). During delivery, the target 6 motion patterns available as a standard on CIRSTM motion phantom were investigated: in case (a), the target was moving along the designated sine or cosine4 3D trajectory; in case (b), the inserted marker was moving sinusoidally in 1D. Results: The ion chamber measurements have shown the agreement with the planned dose within 1% under all the studied motion conditions. The film measurements show 98.1% agreement with the planar calculated dose (gamma criteria: 3%/3mm). Conclusion: We successfully verified the capability of the SBRT VeroTM linac to perform real-time tumor tracking and accurate dose delivery to the target, based on predictive modeling of the correlation between implanted marker motion and external surrogate of breathing motion.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-194: Dynamic Tumor Tracking End-To-End Testing Using a 4D Thorax Phantom and EBT3 Films

Purpose: To quantify the Vero linac dosimetric accuracy of the tumor dynamic tracking treatment using EBT3 film embedded in a 4D thorax phantom. Methods: A dynamic thorax phantom with tissue equivalent materials and a film insert were used in this study. The thorax phantom was scanned in 4DCT mode with a viscoil embedded in its film insert composed of lung equivalent material. Dynamic tracking planning was performed using the 50% phase CT set with 5 conformal beams at gantry angles of 330, 15, 60, 105 and 150 degrees. Each field is a 3cm by 3cm square centered at viscoil since there was no solid mass target. Total 3 different 1–2cos4 motion profiles were used with varied motion magnitude and cycle frequency. Before treatment plan irradiation, a 4D motion model of the target was established using a series of acquired fluoroscopic images and infrared markers motion positions. During irradiation, fluoroscopic image monitoring viscoil motion was performed to verify model validity. The irradiated films were scanned and the dose maps were compared to the planned Monte Carlo dose distributions. Gamma analyses using 3%–3mm, 2%–3mm, 3%–2mm, 2%–2mm criteria were performed and presented. Results: For each motion pattern, a 4D motion model was built successfully and the target tracking performance was verified with fluoroscopic monitoring of the viscoil motion and its model predicted locations. The film gamma analysis showed the average pass rates among the 3 motion profiles are 98.14%, 96.2%, 91.3% and 85.61% for 3%–3mm, 2%–3mm, 3%–2mm, 2%–2mm criteria. Conclusion: Target dynamic tracking was performed using patient-like breathing patterns in a 4D thorax phantom with EBT3 film insert and a viscoil. There was excellent agreement between acquired and planned dose distributions for all three target motion patterns. This study performed end-to-end testing and verified the treatment accuracy of tumor dynamic tracking.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-229: Quantitative Assessment for Timely Adaptive Re-Planning Using Weekly Dose Monitoring for Head and Neck Cancer

Purpose: For patients with head and neck (HN) cancer, mid-course adaptive radiation therapy (ART) is a common practice in our institution to accommodate anatomic changes. The aim of the study is to evaluate whether dose re-calculation on weekly verification images can provide quantitative assessment for timely adaptive re-planning with daily image-guided intensity modulated radiotherapy (IMRT). Methods: We retrospectively selected sixty daily verification images acquired on CT-on-rail/CBCT from ten HN patients. These image sets were typically a week apart. Among these patients, six patients received a mid-course ART. Contours of the tumors and organ-at-risks (OARs) were manually delineated by a physician on each verification CT. After placing the treatment iso-center on the verification CTs according to the recorded clinical shifts, daily dose was re-calculated with the same beam configuration as the original plan. For the purpose of this study, electron densities for both verification CTs and planning CTs were set to 1.0 g/cm3. Results: Two patients had D99 of the CTV < 97% of the planned dose for more than three fractions due to remarkable tumor volume shrinkages. D-max of the spinal cord exceeded a tolerance of 45 Gy for four fractions in additional two patients. D-mean of the parotid increased within 25% of the planned value. D-max of the brainstem and D-mean of the oral cavity did not show significant variation. If the re-planning criteria included D99 of the CTV < 97% of the planned dose and D-max of the spinal cord > 45 Gy, two out ten patients required ART at week 2 and two patients required ART at week 3, respectively. Conclusion: Weekly dose monitoring with re-calculation on verification images can provide quantitative dose guidance for timely adaptive re-planning. Future work will include accumulative dose analysis for the decision of adaptive re-planning. The study is supported in part by Siemens Medical Solutions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-245: Is Off-Line Adaptive Radiotherapy Sufficient for Head and Neck Cancer with IGRT?

Purpose: Radiation doses delivered to patients with head and neck cancer (HN) may deviate from the planned doses because of variations in patient setup and anatomy. This study was to evaluate whether off-line Adaptive Radiotherapy (ART) is sufficient. Methods: Ten HN patients, who received IMRT under daily imaging guidance using CT-on-rail/KV-CBCT, were randomly selected for this study. For each patient, the daily treatment setup was corrected with translational only directions. Sixty weekly verification CTs were retrospectively analyzed. On these weekly verification CTs, the tumor volumes and OAR contours were manually delineated by a physician. With the treatment iso-center placed on the verification CTs, according to the recorded clinical shifts, the treatment beams from the original IMRT plans were then applied to these CTs to calculate the delivered doses. The electron density of the planning CTs and weekly CTs were overridden to 1 g/cm3. Results: Among 60 fractions, D99 of the CTVs in 4 fractions decreased more than 5% of the planned doses. The maximum dose of the spinal cord exceeded 10% of the planned values in 2 fractions. A close examination indicated that the dose discrepancy in these 6 fractions was due to patient rotations, especially shoulder rotations. After registering these 6 CTs with the planning CT allowing six degree of freedoms, the maximum rotations around 3 axes were > 1.5° for these fractions. With rotation setup errors removed, 4 out of 10 patients still required off-line ART to accommodate anatomical changes. Conclusion: A significant shoulder rotations were observed in 10% fractions, requiring patient re-setup. Off-line ART alone is not sufficient to correct for random variations of patient position, although ART is effective to adapt to patients' gradual anatomic changes. Re-setup or on-line ART may be considered for patients with large deviations detected early by daily IGRT images. The study is supported in part by Siemens Medical Solutions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-267: Weekly Volumetric and Dosimetric Changes in Adaptive Conformal Radiotherapy of Non-Small-Cell-Lung Cancer Using 4D CT and Gating

Purpose: This study was to evaluate the significance of weekly imageguided patient setup and to assess the volumetric and dosimetric changes in no-small-cell-lung cancer (NSCLC) patients treated with adaptive conformal radiotherapy (CRT). Methods: 9 NSCLC patients treated with 3D CRT underwent 4D CT-on-rail every five fractions. ITV was generated from three phases of the 4DCT (the end of exhalation, 25% before and after the end of exhalation). The margin of ITV to PTV is 5mm. 6 weekly CTs were acquired for each patient. The weekly CTs were fused with the planning CT by vertebrae. The couch shift was recorded for each weekly CT to evaluate the setup error. The gross tumor volumes (GTVs) were contoured on weekly CT images by a physician. Beams from the original plans were applied to weekly CTs to calculate the delivered doses. All patients underwent replanning after 20 fractions. Results: Among the total 54 CTs, the average setup error was 2.0± 1.7, 2.6± 2.1, 2.7± 2.2 mm in X, Y, and Z direction, respectively. The average volume of the primary GTV was reduced from 42.45 cc to 22.78 cc (47.04%) after 6 weeks. The maximal volume regression occurred between 15 and 20 fractions. Adaptive radiation therapy (ART) reduced the V20 and V5 of the lung by 33.5% and 16.89%, respectively. ART also reduced Dmean and D1/3 of the heart by 31.7% and 32.32%, respectively. Dmax of the spinal cord did not vary much during the treatment course. Conclusion: 5 mm margin is sufficient for 4D weekly CTguided radiotherapy in lung cancer. Tumor regression was observed in the majority of patients. ART significantly reduced the OARs dose. Our preliminary results indicated that an off-line ART approach is appropriate in clinical practice.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-13: A Feasibility Study of the Use of Hybrid Computational Phantoms for Improved Historical Dose Reconstruction in the Study of Late Radiation Effects for Hodgkin's Lymphoma

Purpose: Radiation-induced cancer effects are well-documented following radiotherapy. Further investigation is needed to more accurately determine a dose-response relationship for late radiation effects. Recent dosimetry studies tend to use representative patients (Taylor 2009) or anthropomorphic phantoms (Wirth 2008) for estimating organ mean doses. In this study, we compare hybrid computational phantoms to patient-specific voxel phantoms to test the accuracy of University of Florida Hybrid Phantom Library (UFHP Library) for historical dose reconstructions. Methods: A cohort of 10 patients with CT images was used to reproduce the data that was collected historically for Hodgkin's lymphoma patients (i.e. caliper measurements and photographs). Four types of phantoms were generated to show a range of refinement from reference hybrid-computational phantom to patient-specific phantoms. Each patient is matched to a reference phantom from the UFHP Library based on height and weight. The reference phantom is refined in the anterior/posterior direction to create a ‘caliper-scaled phantom’. A photograph is simulated using a surface rendering from segmented CT images. Further refinement in the lateral direction is performed using ratios from a simulated-photograph to create a ‘photograph and caliper-scaled phantom’; breast size and position is visually adjusted. Patient-specific hybrid phantoms, with matched organ volumes, are generated and show the capabilities of the UF Hybrid Phantom Library. Reference, caliper-scaled, photograph and caliper-scaled, and patient-specific hybrid phantoms are compared with patient-specific voxel phantoms to determine the accuracy of the study. Results: Progression from reference phantom to patient specific hybrid shows good agreement with the patient specific voxel phantoms. Each stage of refinement shows an overall trend of improvement in dose accuracy within the study, which suggests that computational phantoms can show improved accuracy in historical dose estimates. Conclusion: Computational hybrid phantoms show promise for improved accuracy within retrospective studies when CTs and other x-ray images are not available.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-115: Dose Perturbation Study of Self-Expandable Metal and Polyester Esophageal Stents in Proton Therapy Beams

Purpose: This work investigates dose perturbations due to Self-expandable metal and polyester esophageal stents undergoing proton radiotherapy for esophageal cancer. Methods: Five commercially available esophageal stents made of nitinol (Evolution, Wallflex and Ultraflex), stainless steel (Z-Stent) and polyester (Polyflex) were tested. Radiochromic film (GafChromic EBT3 film, Ashland, Covington, KY) wrapped around a stent and a 12cc syringe was irradiated with 2CGE (Cobalt Gray Equivalent) of proton beam in a custom fabricated acrylic phantom. An air-hollow syringe simulates the esophagus. Results: The Z-stent created the largest dose perturbations ranges from -14.5% to 6.1% due to the steel composition. The WallFlex, Evolution and Ultraflex stents produced the dose perturbation ranges of (−9.2%∼8.6%), (−6.8%∼5.7%) and (−6.2%∼6.2%), respectively. The PolyFlex stent contains the radiopaque tungsten markers located top, middle and bottom portions. When the focal cold spots induced by the markers were excluded in the analysis, the dose perturbation range was changed from (−11.6%∼6.4%) to (−0.6%∼5.0%). Conclusion: The magnitude of dose perturbation is related to material of a metallic stent. The non-metallic stent such as PolyFlex shows relatively lower dose perturbation than metallic stents except a radiopaque marker region. Overall Evolution and Ultraflex stent appear to be less dose perturbations. The largest dose perturbations (cold spots) were located at both edges of stents in distal area for the single proton beam irradiation study. The analysis of more than two proton beam which is more typical clinical beam arrangement would be necessary to minimize the doe perturbation effect in proton ratiotherapy.

07 ISOTOPE AND RADIATION SOURCES↗