Engineering topics

Mutic, S

Publications and source records attributed to Mutic, S.

At least 19 records

DOE OSTI2016

SU-D-207A-04: Use of Gradient Echo Plural Contrast Imaging (GEPCI) in MR-Guided Radiation Therapy: A Feasibility Study Targeting Brain Treatment

Purpose: To implement the Gradient Echo Plural Contrast Imaging(GEPCI) technique in MRI-simulation for radiation therapy and assess the feasibility of using GEPCI images with advanced inhomogeneity correction in MRI-guided radiotherapy for brain treatment. Methods: An optimized multigradient-echo GRE sequence (TR=50ms;TE1=4ms;delta-TE=4ms;flip angle=300,11 Echoes) was developed to generate both structural (T1w and T2*w) and functional MRIs (field and susceptibility maps) from a single acquisition. One healthy subject (Subject1) and one post-surgical brain cancer patient (Subject2) were scanned on a Philips Ingenia 1.5T MRI used for radiation therapy simulation. Another healthy subject (Subject3) was scanned on a 0.35T MRI-guided radiotherapy (MR-IGRT) system (ViewRay). A voxel spread function (VSF) was used to correct the B0 inhomogeneities caused by surgical cavities and edema for Subject2. GEPCI images and standard radiotherapy planning MRIs for this patient were compared focusing the delineation of radiotherapy target region. Results: GEPCI brain images were successfully derived from all three subjects with scan times of <7 minutes. The images derived for Subjects1&2 demonstrated that GEPCI can be applied and combined into radiotherapy MRI simulation. Despite low field, T1-weighted and R2* images were successfully reconstructed for Subject3 and were satisfactory for contour and target delineation. The R2* distribution of grey matter (center=12,FWHM=4.5) and white matter (center=14.6, FWHM=2) demonstrated the feasibility for tissue segmentation and quantification. The voxel spread function(VSF) corrected surgical site related inhomogeneities for Subject2. R2* and quantitative susceptibility map(QSM) images for Subject2 can be used to quantitatively assess the brain structure response to radiation over the treatment course. Conclusion: We implemented the GEPCI technique in MRI-simulation and in MR-IGRT system for radiation therapy. The images demonstrated that it is feasible to adopt this technique in radiotherapy for structural delineation. The preliminary data also enable the opportunity for quantitative assessment of radiation response of the target region and normal tissue.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-72: A Clinical Usable Integrated Contouring Quality Evaluation Software for Radiotherapy

Purpose: To introduce the Auto Contour Evaluation (ACE) software, which is the clinical usable, user friendly, efficient and all-in-one toolbox for automatically identify common contouring errors in radiotherapy treatment planning using supervised machine learning techniques. Methods: ACE is developed with C# using Microsoft .Net framework and Windows Presentation Foundation (WPF) for elegant GUI design and smooth GUI transition animations through the integration of graphics engines and high dots per inch (DPI) settings on modern high resolution monitors. The industrial standard software design pattern, Model-View-ViewModel (MVVM) pattern, is chosen to be the major architecture of ACE for neat coding structure, deep modularization, easy maintainability and seamless communication with other clinical software. ACE consists of 1) a patient data importing module integrated with clinical patient database server, 2) a 2D DICOM image and RT structure simultaneously displaying module, 3) a 3D RT structure visualization module using Visualization Toolkit or VTK library and 4) a contour evaluation module using supervised pattern recognition algorithms to detect contouring errors and display detection results. ACE relies on supervised learning algorithms to handle all image processing and data processing jobs. Implementations of related algorithms are powered by Accord.Net scientific computing library for better efficiency and effectiveness. Results: ACE can take patient’s CT images and RT structures from commercial treatment planning software via direct user input or from patients’ database. All functionalities including 2D and 3D image visualization and RT contours error detection have been demonstrated with real clinical patient cases. Conclusion: ACE implements supervised learning algorithms and combines image processing and graphical visualization modules for RT contours verification. ACE has great potential for automated radiotherapy contouring quality verification. Structured with MVVM pattern, it is highly maintainable and extensible, and support smooth connections with other clinical software tools.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-102: Lower Esophagus Margin Implications Based On Rapid Computational Algorithm for SBRT

Purpose: To quantify inter-fraction esophagus-variation. Methods: Computed tomography and daily on-treatment 0.3-T MRI data sets for 7 patients were analyzed using a novel Matlab-based (Mathworks, Natick, MA) rapid computational method. Rigid registration was performed from the cricoid to the gastro-esophageal junction. CT and MR-based contours were compared at slice intervals of 3mm. Variation was quantified by “expansion,” defined as additional length in any radial direction from CT contour to MR contour. Expansion computations were performed with 360° of freedom in each axial slice. We partitioned expansions into left anterior, right anterior, right posterior, and left posterior quadrants (LA, RA, RP, and LP, respectively). Sample means were compared by analysis of variance (ANOVA) and Fisher’s Protected Least Significant Difference test. Results: Fifteen fractions and 1121 axial slices from 7 patients undergoing SBRT for primary lung cancer (3) and metastatic lung disease (4) were analyzed, generating 41,970 measurements. Mean LA, RA, RP, and LP expansions were 4.30±0.05 mm, 3.71±0.05mm, 3.17±0.07, and 3.98±0.06mm, respectively. 50.13% of all axial slices showed variation > 5 mm in one or more directions. Variation was greatest in lower esophagus with mean LA, RA, RP, and LP expansion (5.98±0.09 mm, 4.59±0.09 mm, 4.04±0.16 mm, and 5.41±0.16 mm, respectively). The difference was significant compared to mid and upper esophagus (p<.0001). The 95th percentiles of expansion for LA, RA, RP, LP were 13.36 mm, 9.97 mm, 11.29 mm, and 12.19 mm, respectively. Conclusion: Analysis of on-treatment MR imaging of the lower esophagus during thoracic SBRT suggests margin expansions of 13.36 mm LA, 9.97 mm RA, 11.29 mm RP, 12.19 mm LP would account for 95% of measurements. Our novel algorithm for rapid assessment of margin expansion for critical structures with 360° of freedom in each axial slice enables continuously adaptive patient-specific margins which may reduce overlap with high-dose regions.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework was developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for incorporation of additional modules to include any aspect of the treatment process, and therefore has great potential for both assessment and optimization within radiation therapy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-194: Development of Dose-Based Image Guided Proton Therapy Workflow

Purpose: To implement image-guided proton therapy (IGPT) based on daily proton dose distribution. Methods: Unlike x-ray therapy, simple alignment based on anatomy cannot ensure proper dose coverage in proton therapy. Anatomy changes along the beam path may lead to underdosing the target, or overdosing the organ-at-risk (OAR). With an in-room mobile computed tomography (CT) system, we are developing a dose-based IGPT software tool that allows patient positioning and treatment adaption based on daily dose distributions. During an IGPT treatment, daily CT images are acquired in treatment position. After initial positioning based on rigid image registration, proton dose distribution is calculated on daily CT images. The target and OARs are automatically delineated via deformable image registration. Dose distributions are evaluated to decide if repositioning or plan adaptation is necessary in order to achieve proper coverage of the target and sparing of OARs. Besides online dose-based image guidance, the software tool can also map daily treatment doses to the treatment planning CT images for offline adaptive treatment. Results: An in-room helical CT system is commissioned for IGPT purposes. It produces accurate CT numbers that allow proton dose calculation. GPU-based deformable image registration algorithms are developed and evaluated for automatic ROI-delineation and dose mapping. The online and offline IGPT functionalities are evaluated with daily CT images of the proton patients. Conclusion: The online and offline IGPT software tool may improve the safety and quality of proton treatment by allowing dose-based IGPT and adaptive proton treatments. Research is partially supported by Mevion Medical Systems.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-135: A Retrospective Analysis of the Impact of Range Uncertainty in Brain Patients

Purpose: We retrospectively evaluate the dosimetric impact of a 3.5% range uncertainty on CTV coverage and normal organ toxicity for a cohort of brain patients. Methods: Twenty treatment plans involving 20 brain cancer patients treated with Mevions S250 were reviewed. Forty uncertain plans were made by changing the ranges in original plans by ±3.5% while keeping all devices unchanged. Fidelity to the original plans was evaluated with gamma index. Changes in generalized equivalent uniform dose (gEUD) were reported for the following structures: CTV coverage, brainstem, optic chiasm, and optic nerves. Comparisons were made by plotting the relevant endpoints from the uncertain plans as a function of the same endpoints from the original clinical plan. Results: Gamma-index analysis resulted in a 50% pass rate of the uncertain plans using a 90% passing rate and 3%/3mm criterion. A 9.5% decrease in the slope of gEUD plot for the CTV was observed for the 3.5% downward range shift. However, the change in slope did not result in a gEUD change greater than 1.1% for the CTV. The slopes of the gEUD plots for normal structures increased by 3.1% 3.9% 2.4% and 0.2% for the chiasm, brainstem, left optic nerve and right optic nerve respectively. The maximum deviation from the gEUD of the clinical plan for normal structures was: 64% in the chiasm, 31% for the brainstem, and 19% for both optic nerves. Conclusion: A retrospective review shows moderate radiobiological impact of range uncertainty in passively scattered proton therapy with sporadic catastrophe. The linear regression analysis on the statistical data indicates a systematic deviation of gEUD from treatment planning in the light of range uncertainty.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-142: An Analytical Model to Correct the Aperture Scattered Dose in Clinical Proton Beams

Purpose: Apertures or collimators are used to laterally shape proton beams in double scattering (DS) delivery and to sharpen the penumbra in pencil beam (PB) delivery. However, aperture-scattered dose is not included in the current dose calculations of treatment planning system (TPS). The purpose of this study is to provide a method to correct the aperture-scattered dose based on an analytical model. Methods: A DS beam with a non-divergent aperture was delivered using a single-room proton machine. Dose profiles were measured with an ion-chamber scanning in water and a 2-D ion chamber matrix with solid-water buildup at various depths. The measured doses were considered as the sum of the non-contaminated dose and the aperture-scattered dose. The non-contaminated dose was calculated by TPS and subtracted from the measured dose. Aperture scattered-dose was modeled as a 1D Gaussian distribution. For 2-D fields, to calculate the scatter-dose from all the edges of aperture, a sum of weighted distance was used in the model based on the distance from calculation point to aperture edge. The gamma index was calculated between the measured and calculated dose with and without scatter correction. Results: For a beam with range of 23 cm and aperture size of 20 cm, the contribution of the scatter horn was ∼8% of the total dose at 4 cm depth and diminished to 0 at 15 cm depth. The amplitude of scatter-dose decreased linearly with the depth increase. The 1D gamma index (2%/2 mm) between the calculated and measured profiles increased from 63% to 98% for 4 cm depth and from 83% to 98% at 13 cm depth. The 2D gamma index (2%/2 mm) at 4 cm depth has improved from 78% to 94%. Conclusion: Using the simple analytical method the discrepancy between the measured and calculated dose has significantly improved.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-275: A Correlation Study On 3D Fluence-Based QA and 2D Dose Measurement-Based QA

Purpose: The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(ά)) to the passing rates of 2D dose measurementbased QA (P(Dm)). Methods: 3D volumetric primary fluencies are calculated by forward-projecting the beam apertures and modulated by beam MU values at all gantry angles. We first introduce simulated machine parameter errors (MU, MLC positions, jaw, gantry and collimator) to the plan. Using passing rates of voxel intensity differences (P(Ir)) and 3D gamma analysis (P(γ)), calculated 3D fluencies, calculated 3D delivered dose, and measured 2D planar dose in phantom from the original plan are then compared with those from corresponding plans with errors, respectively. The correlations of these three groups of resultant passing rates, i.e. 3D fluence-based QA (P(ά,Ir) and P(ά,γ)), calculated 3D dose (P(Dc,Ir) and P(Dc,γ)), and 2D dose measurement-based QA (P(Dm,Ir) and P(Dm,γ)), will be investigated. Results: 20 treatment plans with 5 different types of errors were tested. Spearman’s correlations were found between P(ά,Ir) and P(Dc,Ir), and also between P(ά,γ) and P(Dc,γ), with averaged p-value 0.037, 0.065, and averaged correlation coefficient ρ-value 0.942, 0.871 respectively. Using Matrixx QA for IMRT plans, Spearman’s correlations were also obtained between P(ά,Ir) and P(Dm,Ir) and also between P(ά,γ) and P(Dm,γ), with p-value being 0.048, 0.071 and ρ-value being 0.897, 0.779 respectively. Conclusion: The demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans. Together with advantages of high detection sensitivity and better visualization of machine parameter errors, this study further demonstrates the accuracy and feasibility of 3D fluence based-QA in pre-treatment QA and daily QA. Research reported in this study is supported by the Agency for Healthcare Research and Quality (AHRQ) under award 1R01HS0222888. The senior author received research grants from ViewRay Inc. and Varian Medical System.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-279: Impact of Beam Energy Drifts On IMRT Delivery Accuracy

Purpose: According to TG-40 percent-depth-dose (PDD) tolerance is ±2% but TG-142 is ±1%. Now the question is, which one is relevant in IMRT era? The primary objective of this study is to evaluate dosimetric impact of beam-energy-drifts on IMRT-delivery. Methods: Beam-energy drifts were simulated by adjusting Linac’s bending-magnet-current (BMC) followed by tuning the pulse-forming network and adjusting gun-current. PDD change of −0.6% and +1.2% were tested. Planar-dosimetry measurements were performed using an ionization-chamber-array in solid-water phantoms. Study includes 10-head-and-neck and 3-breast cancer patients. en-face beam-deliveries were also tested at 1.3cm and 5.3cm depths. Composite and single-field dose-distributions were compared against the plans to determine %Gamma pass-rates (%GPRs). For plan dose comparisons, changes in %Gamma pass-rates (cPGPRs) were computed/reported to exclude the differences between dose-computation and delivery. Dose distributions of the drifted-energies were compared against their baseline measurements to determine the% GPRs. A Gamma criteria of 3%/3mm was considered for plan-dose comparisons while 3%/1mm used for measured dose intercomparisons. Results: For composite-dose delivery, average cPGPRs were 0.41%±2.48% and −2.54%±3.65% for low-energy (LE) and high-energy (HE) drifts, respectively. For measured dose inter-comparisons, the average%GPRs were 98.4%±2.2% (LE-drift) and 95.8%±4.0 (HE-drift). The average %GPR of 92.6%±4.3% was noted for the worst-case scenario comparing LE-drift to HE-drift. All en-face beams at 5.3 cm depth have cPGPRs within ±4% of the baseline-energy measurements. However, greater variations were noted for 1.3cm depth. Average %GPRs for drifted energies were >99% at 5.3cm and >97% at 1.3cm depths. However, for the worst-case scenario (LE-drift to HE-drift) these numbers dropped to 95.2% at 5.3cm and 93.1% at 1.3cm depths. Conclusion: The dosimetric impact of beam-energy drifts was found to be within clinically acceptable tolerance. However, this study includes a single energy with limited range of PDD change. Further studies are on going and the results will be presented. Received funding from Varian Medical Systems, Palo Alto, CA.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-472: Validation of Absolute Dose Measurements for MR-IGRT With and Without Magnetic Field

Purpose: To validate absolute dose measurements for a MR-IGRT system without presence of the magnetic field. Methods: The standard method (AAPM’s TG-51) of absolute dose measurement with ionization chambers was tested with and without the presence of the magnetic field for a clinical 0.32-T Co-60 MR-IGRT system. Two ionization chambers were used - the Standard Imaging (Madison, WI) A18 (0.123 cc) and the PTW (Freiburg, Germany). A previously reported Monte Carlo simulation suggested a difference on the order of 0.5% for dose measured with and without the presence of the magnetic field, but testing this was not possible until an engineering solution to allow the radiation system to be used without the nominal magnetic field was found. A previously identified effect of orientation in the magnetic field was also tested by placing the chamber either parallel or perpendicular to the field and irradiating from two opposing angles (90 and 270). Finally, the Imaging and Radiation Oncology Core provided OSLD detectors for five irradiations each with and without the field - with two heads at both 0 and 90 degrees, and one head at 90 degrees only as it doesn’t reach 0 (IEC convention). Results: For the TG-51 comparison, expected dose was obtained by decaying values measured at the time of source installation. The average measured difference was 0.4%±0.12% for A18 and 0.06%±0.15% for Farmer chamber. There was minimal (0.3%) orientation dependence without the magnetic field for the A18 chamber, while previous measurements with the magnetic field had a deviation of 3.2% with chamber perpendicular to magnetic field. Results reported by IROC for the OSLDs with and without the field had a maximum difference of 2%. Conclusion: Accurate absolute dosimetry was verified by measurement under the same conditions with and without the magnetic field for both ionization chambers and independently-verifiable OSLDs.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-AB-202-06: Quantitative Evaluation of Deformable Image Registration in MRI-Guided Adaptive Radiation Therapy

Purpose: To assess the performance of the deformable image registration algorithm used for MRI-guided adaptive radiation therapy using image feature analysis. Methods: MR images were collected from five patients treated on the MRIdian (ViewRay, Inc., Oakwood Village, OH), a three head Cobalt-60 therapy machine with an 0.35 T MR system. The images were acquired immediately prior to treatment with a uniform 1.5 mm resolution. Treatment sites were as follows: head/neck, lung, breast, stomach, and bladder. Deformable image registration was performed using the ViewRay software between the first fraction MRI and the final fraction MRI, and the DICE similarity coefficient (DSC) for the skin contours was reported. The SIFT and Harris feature detection and matching algorithms identified point features in each image separately, then found matching features in the other image. The target registration error (TRE) was defined as the vector distance between matched features on the two image sets. Each deformation was evaluated based on comparison of average TRE and DSC. Results: Image feature analysis produced between 2000–9500 points for evaluation on the patient images. The average (± standard deviation) TRE for all patients was 3.3 mm (±3.1 mm), and the passing rate of TRE<3 mm was 60% on the images. The head/neck patient had the best average TRE (1.9 mm±2.3 mm) and the best passing rate (80%). The lung patient had the worst average TRE (4.8 mm±3.3 mm) and the worst passing rate (37.2%). DSC was not significantly correlated with either TRE (p=0.63) or passing rate (p=0.55). Conclusions: Feature matching provides a quantitative assessment of deformable image registration, with a large number of data points for analysis. The TRE of matched features can be used to evaluate the registration of many objects throughout the volume, whereas DSC mainly provides a measure of gross overlap. We have a research agreement with ViewRay Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

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↗

DOE OSTI2016

TU-H-BRA-01: The Physics of High Power Radiofrequency Isolation in a Novel Compact Linear Accelerator Based MRI Guided Radiation Therapy System

Purpose: To develop a method for isolating the radiofrequency waves emanating from linear accelerator components from the magnetic resonance imaging (MRI) system of an integrated MRI-linac. Methods: An MRI-guided radiation therapy system has been designed that integrates a linear accelerator with simultaneous MR imaging. The radiofrequency waves created by the accelerating process would degrade MR image quality, so a method for containing the radiofrequency waves and isolating the MR imager from them was developed. The linear accelerator radiofrequency modulator was placed outside the room, so a filter was designed to eliminate the radiofrequency corresponding to the proton Larmour frequency of 14.7 MHz. Placing the radiofrequency emitting components in a typical Faraday cage would have reduced the radiofrequency emissions, but the design would be susceptible to small gaps in the shield due to the efficiency of the Faraday cage reflecting internal radiofrequency emissions. To reduce internal radiofrequency reflections, the Faraday cage was lined with carbon fiber sheets. Carbon fiber has the property of attenuating the radiofrequency energy so that the overall radiofrequency field inside the Faraday cage is reduced, decreasing any radiofrequency energy emitted from small gaps in the cage walls. Results: Within a 1.2 MHz band centered on the Larmor frequency, the radiofrequency (RF) leakage from the Faraday cage was measured to be −90 dB with no RF on, −40 dB with the RF on and no shield, returning to −90 dB with the RF on and shields in place. The radiofrequency filter attenuated the linear accelerator modulator emissions in the 14.7 MHz band by 70 dB. Conclusions: One of the major challenges in designing a compact linear accelerator based MRI-guided radiation therapy system, that of isolating the high power RF system from the MRI, has been solved. The measured radiofrequency emissions are sufficiently small to enable system integration. This research was funded by ViewRay, Inc., Oakwood, OH.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-H-BRA-02: The Physics of Magnetic Field Isolation in a Novel Compact Linear Accelerator Based MRI-Guided Radiation Therapy System

Purpose: To develop a method for isolating the MRI magnetic field from field-sensitive linear accelerator components at distances close to isocenter. Methods: A MRI-guided radiation therapy system has been designed that integrates a linear accelerator with simultaneous MR imaging. In order to accomplish this, the magnetron, port circulator, radiofrequency waveguide, gun driver, and linear accelerator needed to be placed in locations with low magnetic fields. The system was also required to be compact, so moving these components far from the main magnetic field and isocenter was not an option. The magnetic field sensitive components (exclusive of the waveguide) were placed in coaxial steel sleeves that were electrically and mechanically isolated and whose thickness and placement were optimized using E&M modeling software. Six sets of sleeves were placed 60° apart, 85 cm from isocenter. The Faraday effect occurs when the direction of propagation is parallel to the magnetic RF field component, rotating the RF polarization, subsequently diminishing RF power. The Faraday effect was avoided by orienting the waveguides such that the magnetic field RF component was parallel to the magnetic field. Results: The magnetic field within the shields was measured to be less than 40 Gauss, significantly below the amount needed for the magnetron and port circulator. Additional mu-metal was employed to reduce the magnetic field at the linear accelerator to less than 1 Gauss. The orientation of the RF waveguides allowed the RT transport with minimal loss and reflection. Conclusion: One of the major challenges in designing a compact linear accelerator based MRI-guided radiation therapy system, that of creating low magnetic field environments for the magnetic-field sensitive components, has been solved. The measured magnetic fields are sufficiently small to enable system integration. This work supported by ViewRay, Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-H-BRA-06: Characterization of a Linear Accelerator Operating in a Compact MRIGuided Radiation Therapy System

Purpose: To describe the performance of a linear accelerator operating in a compact MRI-guided radiation therapy system. Methods: A commercial linear accelerator was placed in an MRI unit that is employed in a commercial MR-based image guided radiation therapy (IGRT) system. The linear accelerator components were placed within magnetic field-reducing hardware that provided magnetic fields of less than 40 G for the magnetron, gun driver, and port circulator, with 1 G for the linear accelerator. The system did not employ a flattening filter. The test linear accelerator was an industrial 4 MV model that was employed to test the ability to run an accelerator in the MR environment. An MR-compatible diode detector array was used to measure the beam profiles with the accelerator outside and inside the MR field and with the gradient coils on and off to examine if there was any effect on the delivered dose distribution. The beam profiles and time characteristics of the beam were measured. Results: The beam profiles exhibited characteristic unflattened Bremsstrahlung features with less than ±1.5% differences in the profile magnitude when the system was outside and inside the magnet and less than 1% differences with the gradient coils on and off. The central axis dose rate fluctuated by less than 1% over a 30 second period when outside and inside the MRI. Conclusion: A linaccompatible MR design has been shown to be effective in not perturbing the operation of a commercial linear accelerator. While the accelerator used in the tests was 4MV, there is nothing fundamentally different with the operation of a 6MV unit, implying that the design will enable operation of the proposed clinical unit. Research funding provided by ViewRay, Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-H-BRA-08: The Design and Characteristics of a Novel Compact Linac-Based MRI Guided Radiation Therapy (MR-IGRT) System

Purpose: To describe the design and characteristics of a novel linac-based MRI guided radiation therapy system that addresses RF and magnetic field interference and that can be housed in conventional radiotherapy vaults. Methods: The MR-IGRT system will provide simultaneous MR imaging combined with both simple (3D) and complex (IMRT, SBRT, SRS) techniques. The system is a combination of a) double-donut split solenoidal superconducting 0.345T MRI; and b) a 90 cm isocenter ring-gantry mounted 6MV, flattening filter-free linac coupled with a stacked doubly-focused multileaf collimator with 4 mm resolution. A novel RF shielding and absorption technology was developed to isolate the beam generating RF emissions from the MR, while a novel magnetic shielding sleeve system was developed to place the magnetic field-sensitive components in low-magnetic field regions. The system design produces high spatial resolution radiation beams with state-of-the art radiation dose characteristics and simultaneous MR imaging. Results: Prototype testing with a spectrum analyzer has demonstrated complete elimination of linac RF inside the treatment room. The magnetic field inside of the magnetic shielding was well below the specification, allowing the linear accelerator to operate normally. A novel on-gantry shimming system maintained < 25 ppm magnetic field homogeneity over a 45 cm spherical field of view for all gantry angles. Conclusion: The system design demonstrates the feasibility coupling a state-of-the art linac system with a 0.345T MRI, enabling highly conformal radiation therapy with simultaneous MR image guidance. S. Mutic’s employer (Washington University) has grant with ViewRay; D. Low is former ViewRay scientific advisory board member (ended October 2015); T. Chmielewski, G. Fought, M. Hernandez, I. Kawrakow, A. Sharma, S. Shvartsman, J. Dempsey are employees of ViewRay with stock options (Dempsey has leadership role and Dempsey/Kawrakow have stock).

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-H-206-04: An Effective Homomorphic Unsharp Mask Filtering Method to Correct Intensity Inhomogeneity in Daily Treatment MR Images

Purpose: The daily treatment MRIs acquired on MR-IGRT systems, like diagnostic MRIs, suffer from intensity inhomogeneity issue, associated with B1 and B0 inhomogeneities. An improved homomorphic unsharp mask (HUM) filtering method, automatic and robust body segmentation, and imaging field-of-view (FOV) detection methods were developed to compute the multiplicative slow-varying correction field and correct the intensity inhomogeneity. The goal is to improve and normalize the voxel intensity so that the images could be processed more accurately by quantitative methods (e.g., segmentation and registration) that require consistent image voxel intensity values. Methods: HUM methods have been widely used for years. A body mask is required, otherwise the body surface in the corrected image would be incorrectly bright due to the sudden intensity transition at the body surface. In this study, we developed an improved HUM-based correction method that includes three main components: 1) Robust body segmentation on the normalized image gradient map, 2) Robust FOV detection (needed for body segmentation) using region growing and morphologic filters, and 3) An effective implementation of HUM using repeated Gaussian convolution. Results: The proposed method was successfully tested on patient images of common anatomical sites (H/N, lung, abdomen and pelvis). Initial qualitative comparisons showed that this improved HUM method outperformed three recently published algorithms (FCM, LEMS, MICO) in both computation speed (by 50+ times) and robustness (in intermediate to severe inhomogeneity situations). Currently implemented in MATLAB, it takes 20 to 25 seconds to process a 3D MRI volume. Conclusion: Compared to more sophisticated MRI inhomogeneity correction algorithms, the improved HUM method is simple and effective. The inhomogeneity correction, body mask, and FOV detection methods developed in this study would be useful as preprocessing tools for many MRI-related research and clinical applications in radiotherapy. Authors have received research grants from ViewRay and Varian.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRA-01: A Novel Doubly-Focused Multileaf Collimator Design for MR-Guided Radiation Therapy

Purpose: To describe the physical and dosimetric properties of a novel double-stack multileaf collimator (MLC). Methods: One of the compromises made in the MLC design has been to employ linear-motion singly-divergent shapes. Because the MLC leading edge moves linearly, it is rounded to provide a consistent, albeit compromised penumbra. The MLC employed in the new linac-based MR-IGRT unit is designed to be doubly focused in that each leaf moves in an arc centered at the source, and the sides of the leaves are machined such that they lie parallel to a line between the leaf edge and the source. The curvature of the MLC keeps motors and encoders in lower magnetic field. However, high spatial-resolution leaves are difficult to manufacture to sufficiently tight tolerances and difficult to move due to restricted space on the gantry. Wider leaves alleviate this problem with less moving parts but the coarse resolution disallows treating very small lesions. This compromise has been overcome by splitting the MLC leaf bank into two sets, stacked one upon the other and offset half of a leaf width. The dosimetry has been simulated using Monte-Carlo and a 6 MV linac in a 0.35 T magnetic field. Results: The combined MLC leaf set has a spatial resolution of effectively half of the leaf width, 4mm here. The dosimetry resolution and conformality are consistent with 4mm wide MLC assisted by inverse fluence modulation. Also, because each leaf junction is backed up by the stacked leaf that lies over the junction, the problem of tongue-and-groove dosimetry has been greatly reduced. The novel MLC design allows the use of more powerful leaf motors than would be otherwise possible if a single MLC bank is employed. Conclusions: The stacked MLC will provide highly conformal dose distributions suitable for stereotactic radiation therapy of small lesions. The research was funded by ViewRay, Inc.

60 APPLIED LIFE SCIENCES↗