Engineering topics

Mutic, S

Publications and source records attributed to Mutic, S.

At least 37 records · Page 2

DOE OSTI2016

TH-AB-BRA-06: MOSFET-Based Dosimetry in An MR Image-Guided Radiation Therapy System: Comparison with and Without a Static 0.3T Magnetic Field

Purpose: To compare depth-dose and surface-dose measurements without and with the magnetic field in a 0.3T MR image-guided Co-60 treatment unit using MOSFET dosimeters. Methods: MOSFET dosimeters (Best Medical Canada, model TN-502RDH-10) were placed in a solid water phantom at 5cm depth with 8cm backscatter (with the MOSFET wires in different orientations to the couch long axis) and also on the surface of an 8cm solid water phantom. The phantoms were placed in an MR image-guided Co-60 treatment machine at an SAD of 105cm to the MOSFETs. Dose measurements were performed between 50 and 200cGy at 5cm depth in a 10.5cm × 10.5cm radiation field without the magnetic field (during a machine maintenance period) and with the nominal magnetic field of 0.3T. The dose linearity was measured at 5cm depth with an orthogonal field and the angular dose dependence was measured on the surface with an orthogonal field and oblique fields at +60 degrees and −60 degrees. Results: The measured MOSFET readings at 5cm depth were linear with dose with slopes of (2.97 +/− 0.01) mV/cGy and (3.01 +/− 0.02) mV/cGy without and with the magnetic field, respectively. No statistically significant difference was found. The surface dose measurements, however, were lower by 6.4% for the AP field (2.3 σ) with magnetic field, 4.9% for the −60 degree field (1.4 σ), and 0.4% different for the +60 degree field (0.2 σ). Conclusion: There is no statistically significant difference in the dose at depth without and with the magnetic field and different orientations of the MOSFET wires. There is a statistically significant difference for the surface dose due to the influence of the magnetic field on secondary electrons from head-scatter and the build-up region in certain field orientations. Clinical surface-dose dosimetry in a magnetic field should apply asymmetric angle-dependent corrections.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRA-07: PENELOPE-Based GPU-Accelerated Dose Calculation System Applied to MRI-Guided Radiation Therapy

Purpose: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on PENELOPE and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. Methods: We first translated PENELOPE from FORTRAN to C++ and validated that the translation produced equivalent results. Then we adapted the C++ code to CUDA in a workflow optimized for GPU architecture. We expanded upon the original code to include voxelized transport boosted by Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gPENELOPE highly user-friendly. Moreover, we incorporated the vendor-provided MRIdian head model into the code. We performed a set of experimental measurements on MRIdian to examine the accuracy of both the head model and gPENELOPE, and then applied gPENELOPE toward independent validation of patient doses calculated by MRIdian’s KMC. Results: We achieve an average acceleration factor of 152 compared to the original single-thread FORTRAN implementation with the original accuracy preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen (1), mediastinum (1) and breast (1), the MRIdian dose calculation engine agrees with gPENELOPE with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). Conclusions: We developed a Monte Carlo simulation platform based on a GPU-accelerated version of PENELOPE. We validated that both the vendor provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-CD-201-10: Highly Efficient Synchronized High-Speed Scintillation Camera System for Measuring Proton Range, SOBP and Dose Distributions in a 2D-Plane

Purpose: Proton therapy (PT) delivery is complex and extremely dynamic. Therefore, quality assurance testing is vital, but highly time-consuming. We have developed a High-Speed Scintillation-Camera-System (HS-SCS) for simultaneously measuring multiple beam characteristics. Methods: High-speed camera was placed in a light-tight housing and dual-layer neutron shield. HS-SCS is synchronized with a synchrocyclotron to capture individual proton-beam-pulses (PBPs) at ∼504 frames/sec. The PBPs from synchrocyclotron trigger the HS-SCS to open its shutter for programmed exposure-time. Light emissions within 30×30×5cm3 plastic-scintillator (BC-408) were captured by a CCD-camera as individual images revealing dose-deposition in a 2D-plane with a resolution of 0.7mm for range and SOBP measurements and 1.67mm for profiles. The CCD response as well as signal to noise ratio (SNR) was characterized for varying exposure times, gains for different light intensities using a TV-Optoliner system. Software tools were developed to analyze ∼5000 images to extract different beam parameters. Quenching correction-factors were established by comparing scintillation Bragg-Peaks with water scanned ionization-chamber measurements. Quenching corrected Bragg-peaks were integrated to ascertain proton-beam range (PBR), width of Spared-Out-Bragg-Peak (MOD) and distal.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2016

TH-CD-BRA-02: 3D Remote Dosimetry for MRI-Guided Radiation Therapy: A Hybrid Approach

Purpose: To validate the dosimetric accuracy of a commercially available MR-IGRT system using a combination of 3D dosimetry measurements (with PRESAGE(R) radiochromic plastic and optical-CT readout) and an in-house developed GPU-accelerated PENELOPE Monte-Carlo dose calculation system. Methods: {sup 60}Co IMRT subject to a 0.35T lateral magnetic field has recently been commissioned in our institution following AAPM’s TG-119 recommendations. We performed PRESAGE(R) sensitivity studies in 4ml cuvettes to verify linearity, MR-compatibility, and energy-independence. Using 10cm diameter PRESAGE(R), we delivered an open calibration field to examine the percent depth dose and a symmetrical 3-field plan with three adjacent regions of varying dose to determine uniformity within the dosimeter under a magnetic field. After initial testing, TG-119 plans were created in the TPS and then delivered to 14.5cm 2kg PRESAGE(R) dosimeters. Dose readout was performed via optical-CT at a second institution specializing in remote 3D dosimetry. Absolute dose was measured using an IBA CC01 ion chamber and the institution standard patient-specific QA methods were used to validate plan delivery. Calculated TG-119 plans were then compared with an independent Monte Carlo dose calculation (gPENELOPE). Results: PRESAGE(R) responds linearly (R{sup 2}=0.9996) to {sup 60}Co irradiation, in the presence of a 0.35T magnetic field, with a sensitivity of 0.0305(±0.003)cm{sup −1}Gy{sup −1}, within 1% of a 6MV non-MR linac irradiation (R{sup 2}=0.9991) with a sensitivity of 0.0302(±0.003)cm{sup −1}Gy{sup −1}. Analysis of TG-119 clinical plans using 3D-gamma (3%/3mm, 10% threshold) give passing rates of: HN 99.1%, prostate 98.0%, C-shape 90.8%, and multi-target 98.5%. The TPS agreed with gPENELOPE with a mean gamma passing rate of 98.4±1.5% (2%/2mm) with the z-score distributions following a standard normal distribution. Conclusion: We demonstrate for the first time that 3D remote dosimetry using both experimental and computational methods is a feasible and reliable approach to commissioning MR-IMRT, which is particularly useful for less specialized clinics in adopting this new treatment modality.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-CD-BRA-06: Magnetic Field Effects On Gafchromic-Film Response in MR-IGRT

Purpose: To investigate the effects of magnetic fields in radiochromic films (RCF). Magnetokinetic changes may affect crystal orientation and polymerization within active layer of RCF, these effects are investigated in Magnetic Resonance Image-guided Radiotherapy (MR-IGRT). Methods: Gafchromic EBT2 RCF were irradiated in a 30×30×30 cm{sup 3} solid water phantom using a ViewRay MRIdian Co-60 MRI guided radiotherapy system (B=0.35 T). Fifteen 20.3×25.4 cm{sup 2} EBT2 film sheets were placed at three different depths (d=0.5, 5 and 10 cm) and irradiated using 5 different treatment plans. The plans were computed using the MRIdian treatment planning system to deliver 2, 4, 6, 8, and 10 Gy at a depth of 10 cm. The films were scanned using an Epson Expression 10000 XL flat-bed document scanner in transmission mode. Films were processed before and after irradiation to obtain a net optical density (netOD) for each color channel separately. Scanning electron microscope (SEM) images were obtained to compare the active layer of selected samples. Results: The results show the red channel netOD decreases between 1.3–12.3 % (average of 5.95 %) for doses above 2.8 Gy, with a linear increase in this effect for higher doses. Green channel netOD showed similar results with a decrease between 1.2–10.5 % (average of 4.09 %) for doses above 3.5 Gy. Blue channel showed the weakest effect between 1.3–2.9 % (average of 1.94 %) for doses above 8.0 Gy. SEM images show changes in crystal orientation within active layer in RCF exposed in a magnetic field. Conclusion: The presence of a magnetic field affects crystal orientation and polymerization during irradiation, decreasing netOD by an average of 5.95 % in the red channel. The under response is dependent on dose and differs by up to 12.3 % at 17.6 Gy. The results show that magnetokinetic effects should be carefully considered in MR-IGRT.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-CD-202-01: BEST IN PHYSICS (JOINT IMAGING-THERAPY): Evaluation of the Use of Direct Electron Density CT Images in Radiation Therapy

Purpose: The current standard for calculation of photon and electron dose requires conversion of Hounsfield Units (HU) to Electron Density (ED) by applying a calibration curve specifically constructed for the corresponding CT tube voltage. This practice limits the use of the CT scanner to a single tube voltage and hinders the freedom in the selection of optimal tube voltage for better image quality. The objective of this study is to report a prototype CT reconstruction algorithm that provides direct ED images from the raw CT data independently of tube voltages used during acquisition. Methods: A tissue substitute phantom was scanned for Stoichiometric CT calibrations at tube voltages of 70kV, 80kV, 100kV, 120kV and 140kV respectively. HU images and direct ED images were acquired sequentially on a thoracic anthropomorphic phantom at the same tube voltages. Electron densities converted from the HU images were compared to ED obtained from the direct ED images. A 7-field treatment plan was made on all HU and ED images. Gamma analysis was performed to demonstrate quantitatively dosimetric change from the two schemes in acquiring ED. Results: The average deviation of EDs obtained from the direct ED images was −1.5%±2.1% from the EDs from HU images with the corresponding CT calibration curves applied. Gamma analysis on dose calculated on the direct ED images and the HU images acquired at the same tube voltage indicated negligible difference with lowest passing rate at 99.9%. Conclusion: Direct ED images require no CT calibration while demonstrate equivalent dosimetry compared to that obtained from standard HU images. The ability of acquiring direct ED images simplifies the current practice at a safer level by eliminating CT calibration and HU conversion from commissioning and treatment planning respectively. Furthermore, it unlocks a wider range of tube voltages in CT scanner for better imaging quality while maintaining similar dosimetric accuracy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-CD-202-02: A Preliminary Study Evaluating Beam-Hardening Artifact Reduction On CT Direct Electron-Density Images

Purpose: A prototype reconstruction algorithm that can provide direct electron density (ED) images from single energy CT scans is being currently developed by Siemens Healthcare GmbH. This feature can eliminate the need for kV specific calibration curve for radiation treatemnt planning. An added benefit is that beam-hardening artifacts are also reduced on direct-ED images due to the underlying material decomposition. This study is to quantitatively analyze the reduction of beam-hardening artifacts on direct-ED images and suggest additional clinical usages. Methods: HU and direct-ED images were reconstructed on a head phantom scanned on a Siemens Definition AS CT scanner at five tube potentials of 70kV, 80kV, 100kV, 120kV and 140kV respectively. From these images, mean, standard deviation (SD), and local NPS were calculated for regions of interest (ROI) of same locations and sizes. A complete analysis of beam-hardening artifact reduction and image quality improvement was conducted. Results: Along with the increase of tube potentials, ROI means and SDs decrease on both HU and direct-ED images. The mean value differences between HU and direct-ED images are up to 8% with absolute value of 2.9. Compared to that on HU images, the SDs are lower on direct-ED images, and the differences are up to 26%. Interestingly, the local NPS calculated from direct-ED images shows consistent values in the low spatial frequency domain for images acquired from all tube potential settings, while varied dramatically on HU images. This also confirms the beam -hardening artifact reduction on ED images. Conclusions: The low SDs on direct-ED images and relative consistent NPS values in the low spatial frequency domain indicate a reduction of beam-hardening artifacts. The direct-ED image has the potential to assist in more accurate organ contouring, and is a better fit for the desired purpose of CT simulations for radiotherapy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-CD-202-07: A Methodology for Generating Numerical Phantoms for Radiation Therapy Using Geometric Attribute Distribution Models

Purpose: A persistent challenge for the quality assessment of radiation therapy treatments (e.g. contouring accuracy) is the absence of the known, ground truth for patient data. Moreover, assessment results are often patient-dependent. Computer simulation studies utilizing numerical phantoms can be performed for quality assessment with a known ground truth. However, previously reported numerical phantoms do not include the statistical properties of inter-patient variations, as their models are based on only one patient. In addition, these models do not incorporate tumor data. In this study, a methodology was developed for generating numerical phantoms which encapsulate the statistical variations of patients within radiation therapy, including tumors. Methods: Based on previous work in contouring assessment, geometric attribute distribution (GAD) models were employed to model both the deterministic and stochastic properties of individual organs via principle component analysis. Using pre-existing radiation therapy contour data, the GAD models are trained to model the shape and centroid distributions of each organ. Then, organs with different shapes and positions can be generated by assigning statistically sound weights to the GAD model parameters. Organ contour data from 20 retrospective prostate patient cases were manually extracted and utilized to train the GAD models. As a demonstration, computer-simulated CT images of generated numerical phantoms were calculated and assessed subjectively and objectively for realism. Results: A cohort of numerical phantoms of the male human pelvis was generated. CT images were deemed realistic both subjectively and objectively in terms of image noise power spectrum. Conclusion: A methodology has been developed to generate realistic numerical anthropomorphic phantoms using pre-existing radiation therapy data. The GAD models guarantee that generated organs span the statistical distribution of observed radiation therapy patients, according to the training dataset. The methodology enables radiation therapy treatment assessment with multi-modality imaging and a known ground truth, and without patient-dependent bias.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-C-304-02: Robust and Efficient Process for Acceptance Testing of Varian TrueBeam Linacs Using An Electronic Portal Imaging Device (EPID)

Purpose: The purpose of this project was to develop a process that utilizes the onboard kV and MV electronic portal imaging devices (EPIDs) to perform rapid acceptance testing (AT) of linacs in order to improve efficiency and standardize AT equipment and processes. Methods: In this study a Varian TrueBeam linac equipped with an amorphous silicon based EPID (aSi1000) was used. The conventional set of AT tests and tolerances was used as a baseline guide, and a novel methodology was developed to perform as many tests as possible using EPID exclusively. The developer mode on Varian TrueBeam linac was used to automate the process. In the current AT process there are about 45 tests that call for customer demos. Many of the geometric tests such as jaw alignment and MLC positioning are performed with highly manual methods, such as using graph paper. The goal of the new methodology was to achieve quantitative testing while reducing variability in data acquisition, analysis and interpretation of the results. The developed process was validated on two machines at two different institutions. Results: At least 25 of the 45 (56%) tests which required customer demo can be streamlined and performed using EPIDs. More than half of the AT tests can be fully automated using the developer mode, while others still require some user interaction. Overall, the preliminary data shows that EPID-based linac AT can be performed in less than a day, compared to 2–3 days using conventional methods. Conclusions: Our preliminary results show that performance of onboard imagers is quite suitable for both geometric and dosimetric testing of TrueBeam systems. A standardized AT process can tremendously improve efficiency, and minimize the variability related to third party quality assurance (QA) equipment and the available onsite expertise. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

SU-C-304-04: A Compact Modular Computational Platform for Automated On-Board Imager Quality Assurance

Purpose: Traditionally, the assessment of X-ray tube output and detector positioning accuracy of on-board imagers (OBI) has been performed manually and subjectively with rulers and dosimeters, and typically takes hours to complete. In this study, we have designed a compact modular computational platform to automatically analyze OBI images acquired with in-house designed phantoms as an efficient and robust surrogate. Methods: The platform was developed as an integrated and automated image analysis-based platform using MATLAB for easy modification and maintenance. Given a set of images acquired with the in-house designed phantoms, the X-ray output accuracy was examined via cross-validation of the uniqueness and integration minimization of important image quality assessment metrics, while machine geometric and positioning accuracy were validated by utilizing pattern-recognition based image analysis techniques. Results: The platform input was a set of images of an in-house designed phantom. The total processing time is about 1–2 minutes. Based on the data acquired from three Varian Truebeam machines over the course of 3 months, the designed test validation strategy achieved higher accuracy than traditional methods. The kVp output accuracy can be verified within +/−2 kVp, the exposure accuracy within 2%, and exposure linearity with a coefficient of variation (CV) of 0.1. Sub-millimeter position accuracy was achieved for the lateral and longitudinal positioning tests, while vertical positioning accuracy within +/−2 mm was achieved. Conclusion: This new platform delivers to the radiotherapy field an automated, efficient, and stable image analysis-based procedure, for the first time, acting as a surrogate for traditional tests for LINAC OBI systems. It has great potential to facilitate OBI quality assurance (QA) with the assistance of advanced image processing techniques. In addition, it provides flexible integration of additional tests for expediting other OBI quality assurance tests, such as 2D/3D image quality, making completely automated QA possible. Research Funding from Varian Medical Systems Inc. . Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-C-210-07: Assessment of Intra-/Inter-Fractional Internal Tumor and Organ Movement in Radiotherapy of Head and Neck Cancer Using On-Board Cine MRI

Purpose: Head and neck (H&N) internal organ motion has previously been determined with low frequency and temporary nature based on population-based pre- and post-treatment studies. Using immobilization masks and adding a 4–6 mm planning-tumor-volume margin, geometric uncertainties of patients are routinely considered clinically inconsequential in H&N radiotherapy. Using the first commercially-available MR-IGRT system, we conducted the first quantitative study on inter-patient, intra- and inter-fractional H&N internal motion patterns to evaluate the necessity of individualized asymmetric internal margins. Methods: Ninety cine sagittal MR image sequences were acquired during the entire treatment course (6–7 weeks) of three H&N cancer patients using the ViewRay™ MR-IGRT system. The images were 5 mm thick and acquired at 4 frames/per second. One of the patients had a tracheostomy tube. The cross-sectional H&N airway (nasopharynx, oropharynx, and laryngopharynx portions) movement was analyzed comprehensively using in-house developed motion detection software. Results: Large inter-patient variations of swallowing frequency (0–1 times/per fraction), swallowing duration (1–3 seconds), and pharyngeal cross-sectional area (238–2516 mm2) were observed. Extensive pharyngeal motion occurred during swallowing, while nonzero and periodic change of airway geometry was observed in resting. For patient 1 with tracheostomy tube replacement, 30.3%, 30.0%, 48.7% and 0.3% of total frames showed ≥ 4 mm displacements in the anterior, posterior, inferior, and superior airway boundaries, respectively; similarly, (5.7%, 0.0%, 0.0%, 0.3%) and (23.3%, 0.0%, 35.7%, 1.7%) occurred for patients 2 and 3. Area overlapping coefficients with respect to the first frame were 76.3+/−6.4%, 90.3+/−0.6%, and 92.3+/−1.2% for the three patients, respectively. Conclusion: Both the resting and swallowing motions varied in frequency and amplitude among the patients and across fractions of a patient’s treatment. Patients receiving surgery that alters their respiratory and swallowing behavior can have significant intra-fractional internal motion. Patient-specific organ/tumor motion analysis may yield individualized asymmetric internal margins and improve the therapeutic ratio.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-J-204: Can a Commercial System for MR-IGRT Be Used to Treat Patients Without Acquiring a CT Scan?

Patients treated using a magnetic-resonance image guided radiation therapy (MR-IGRT) system received both CT and MR simulations. During planning, the CT is used to determine relative electron density (RED) using a calibration table. This study aims to investigate the feasibility of MR-only treatments by comparing CT-computed dose distributions to those computed with combinations of water (1.0), lung (0.26), tissue (1.02), and bone (1.12) bulk RED overrides, and to identify the effects of the magnetic field on the RED-overridden doses. Methods: Four patients who received treatment using a commercial MR-IGRT system were analyzed (1 lung, 2 abdomen, and 1 pelvis). The clinical plans were computed using the first fraction MRI as primary, and the simulation CT as secondary for REDs. Plans were reoptimized using default bulk RED overrides (water/lung and tissue/lung for the lung patient, water/bone, tissue/bone, water only, and tissue only for the abdomen and pelvis patients). Additionally, each plan was re-optimized to include the static magnetic field. All plans were normalized to the same PTV coverage as the clinical plan. Dose-difference volumes and DVHs were computed for bulk density override plans, and 3D gamma analyses between each plan and its accompanying magnetic field plan were performed using 3%/3 mm dose difference and distance-to-agreement criteria using the PTV and Skin as masking structures. Results: The average differences in PTV and organs-at-risk mean dose for all RED combinations tested were −0.19 Gy (−0.62 – 0.06 Gy) and −0.34 Gy (−1.76 – 0.33 Gy), respectively. The average PTV and Skin gamma pass rates for all RED combinations tested were 99.88% (99.5% – 100%) and 98. 35% (96.3% – 99.6%). No systematic differences in DVHs or isodoses were observed. Conclusions: It is likely that that a commercial MR-IGRT system may produce high quality treatment plans without the need for CT scans. Authors of this abstract are members of the Washington University Radiation Oncology department, which has a research agreement with ViewRay, Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-36: A GPU-Accelerated Monte-Carlo Dose Calculation Platform and Its Application Toward Validating a ViewRay Beam Model

Purpose: To build a fast, accurate and easily-deployable research platform for Monte-Carlo dose calculations. We port the dose calculation engine PENELOPE to C++, and accelerate calculations using GPU acceleration. Simulations of a Co-60 beam model provided by ViewRay demonstrate the capabilities of the platform. Methods: We built software that incorporates a beam model interface, CT-phantom model, GPU-accelerated PENELOPE engine, and GUI front-end. We rewrote the PENELOPE kernel in C++ (from Fortran) and accelerated the code on a GPU. We seamlessly integrated a Co-60 beam model (obtained from ViewRay) into our platform. Simulations of various field sizes and SSDs using a homogeneous water phantom generated PDDs, dose profiles, and output factors that were compared to experiment data. Results: With GPU acceleration using a dated graphics card (Nvidia Tesla C2050), a highly accurate simulation – including 100*100*100 grid, 3×3×3 mm3 voxels, <1% uncertainty, and 4.2×4.2 cm2 field size – runs 24 times faster (20 minutes versus 8 hours) than when parallelizing on 8 threads across a new CPU (Intel i7-4770). Simulated PDDs, profiles and output ratios for the commercial system agree well with experiment data measured using radiographic film or ionization chamber. Based on our analysis, this beam model is precise enough for general applications. Conclusions: Using a beam model for a Co-60 system provided by ViewRay, we evaluate a dose calculation platform that we developed. Comparison to measurements demonstrates the promise of our software for use as a research platform for dose calculations, with applications including quality assurance and treatment plan verification.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-249: Determining the Sensitivity of Beam Profile Parameters for Detecting Energy Changes in Flattening Filter-Free Beams

Purpose: To identify the beam profile parameters that can be used to detect energy changes in a flattening filter-free photon beams. Methods: Flattening filter-free beam profiles (inline, crossline, and diagonals) were measured for multiple field sizes (25×25cm and 10×10cm) at 6MV on a clinical system (Truebeam, Varian Medical Systems Palo Alto CA). Profiles were acquired for baseline energy and detuned beams by changing the bending magnet current (BMC), above and below baseline. The following profile parameters were measured: flatness (off-axis ratio at 80% of field size), symmetry, uniformity, slope, and the off-axis ratio (OAR) at several off-axis distances. Tolerance values were determined from repeated measurements. Each parameter was evaluated for sensitivity to the induced beam changes, and the minimum detectable BMC change was calculated for each parameter by calculating the change in BMC that would Result in a change in the parameter above the measurement tolerance. Results: Tolerance values for the parameters were-Flatness≤0.1%; Symmetry≤0.4%; Uniformity≤0.01%; Slope≤ 0.001%/mm. The measurements made with a field size of 25cm and a depth of d=1.5cm showed the greatest sensitivity to bending magnet current variations. Uniformity had the highest sensitivity, able to detect a change in BMC of BMC=0.02A. The OARs and slope were sensitive to the magnitude and direction of BMC change. The sensitivity in the flatness parameter was BMC=0.04A; slope was sensitive to BMC=0.05A. The sensitivity decreased for OARs measured closer to central axis-BMC(8cm)=0.23A; BMC(5cm)=0.47A; BMC(2cm)=1.35A. Symmetry was not sensitive to changes in BMC. Conclusion: These tests allow for better QA of FFF beams by setting tolerance levels to beam parameter baseline values which reflect variations in machine calibration. Uniformity is most sensitive to BMC changes, while OARs provide information about magnitude and direction of miscalibration. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-269: Differential Hazard Analysis For Conventional And New Linac Acceptance Testing Procedures

Purpose: New techniques and materials have recently been developed to expedite the conventional Linac Acceptance Testing Procedure (ATP). The new ATP method uses the Electronic Portal Imaging Device (EPID) for data collection and is presented separately. This new procedure is meant to be more efficient then conventional methods. While not clinically implemented yet, a prospective risk assessment is warranted for any new techniques. The purpose of this work is to investigate the risks and establish the pros and cons between the conventional approach and the new ATP method. Methods: ATP tests that were modified and performed with the EPID were analyzed. Five domain experts (Medical Physicists) comprised the core analysis team. Ranking scales were adopted from previous publications related to TG 100. The number of failure pathways for each ATP test procedure were compared as well as the number of risk priority numbers (RPN’s) greater than 100 were compared. Results: There were fewer failure pathways with the new ATP compared to the conventional, 262 and 556, respectively. There were fewer RPN’s > 100 in the new ATP compared to the conventional, 41 and 115. Failure pathways and RPN’s > 100 for individual ATP tests on average were 2 and 3.5 times higher in the conventional ATP compared to the new, respectively. The pixel sensitivity map of the EPID was identified as a key hazard to the new ATP procedure with an RPN of 288 for verifying beam parameters. Conclusion: The significant decrease in failure pathways and RPN’s >100 for the new ATP mitigates the possibilities of a catastrophic error occurring. The Pixel Sensitivity Map determining the response and inherent characteristics of the EPID is crucial as all data and hence results are dependent on that process. Grant from Varian Medical Systems Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-775: Use of Electronic Portal Imaging Device (EPID) for Quality Assurance (QA) of Electron Beams On Varian Truebeam System

Purpose: In a previous study we have demonstrated the feasibility of using EPID to QA electron beam parameters on a single Varian TrueBeam LINAC. This study aims to provide further investigation on (1) reproducibility of using EPID to detect electron beam energy changes on multiple machines and (2) evaluation of appropriate calibration methods to compare results from different EPIDs. Methods: Ad-hoc mode electron beam images were acquired in developer mode with XML code. Electron beam data were collected on a total of six machines from four institutions. A custom-designed double-wedge phantom was placed on the EPID detector. Two calibration methods - Pixel Sensitivity Map (PSM) and Large Source-to-Imager Distance Flood Field (LSID-FF) - were used. To test the sensitivity of EPID in detecting energy drifts, Bending Magnet Current (BMC) was detuned to invoke energy changes corresponding to ∼±1.5 mm change in R50% of PDD on two machines from two institutions. Percent depth ionization (PDI) curves were then analyzed and compared with the respective baseline images using LSID-FF calibration. For reproducibility testing, open field EPID images and images with a standard testing phantom were collected on multiple machines. Images with and without PSM correction for same energies on different machines were overlaid and compared. Results: Two pixel shifts were observed in PDI curve when energy changes exceeded the TG142 tolerance. PSM showed the potential to correct the differences in pixel response of different imagers. With PSM correction, the histogram of images differences obtained from different machines showed narrower distributions than those images without PSM correction. Conclusion: EPID is sensitive for electron energy changes and the results are reproducible on different machines. When overlaying images from different machines, PSM showed the ability to partially eliminate the intrinsic variation of various imagers. Research Funding from Varian Medical Systems Inc.Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-781: Using An Electronic Portal Imaging Device (EPID) for Correlating Linac Photon Beam Energies

Purpose: Electronic portal imaging devices (EPIDs) have proven to be useful for measuring several parameters of interest in linear accelerator (linac) quality assurance (QA). The purpose of this project was to evaluate the feasibility of using EPIDs for determining linac photon beam energies. Methods: Two non-clinical Varian TrueBeam linacs (Varian Medical Systems, Palo Alto, CA) with 6MV and 10MV photon beams were used to perform the measurements. The linacs were equipped with an amorphous silicon based EPIDs (aSi1000) that were used for the measurements. We compared the use of flatness versus percent depth dose (PDD) for predicting changes in linac photon beam energy. PDD was measured in 1D water tank (Sun Nuclear Corporation, Melbourne FL) and the profiles were measured using 2D ion-chamber array (IC-Profiler, Sun Nuclear) and the EPID. Energy changes were accomplished by varying the bending magnet current (BMC). The evaluated energies conformed with the AAPM TG142 tolerance of ±1% change in PDD. Results: BMC changes correlating with a ±1% change in PDD corresponded with a change in flatness of ∼1% to 2% from baseline values on the EPID. IC Profiler flatness values had the same correlation. We observed a similar trend for the 10MV beam energy changes. Our measurements indicated a strong correlation between changes in linac photon beam energy and changes in flatness. For all machines and energies, beam energy changes produced change in the uniformity (AAPM TG-142), varying from ∼1% to 2.5%. Conclusions: EPID image analysis of beam profiles can be used to determine linac photon beam energy changes. Flatness-based metrics or uniformity as defined by AAPM TG-142 were found to be more sensitive to linac photon beam energy changes than PDD. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2015

SU-F-303-11: Implementation and Applications of Rapid, SIFT-Based Cine MR Image Binning and Region Tracking

Purpose: To develop a novel and rapid, SIFT-based algorithm for assessing feature motion on cine MR images acquired during MRI-guided radiotherapy treatments. In particular, we apply SIFT descriptors toward both partitioning cine images into respiratory states and tracking regions across frames. Methods: Among a training set of images acquired during a fraction, we densely assign SIFT descriptors to pixels within the images. We cluster these descriptors across all frames in order to produce a dictionary of trackable features. Associating the best-matching descriptors at every frame among the training images to these features, we construct motion traces for the features. We use these traces to define respiratory bins for sorting images in order to facilitate robust pixel-by-pixel tracking. Instead of applying conventional methods for identifying pixel correspondences across frames we utilize a recently-developed algorithm that derives correspondences via a matching objective for SIFT descriptors. Results: We apply these methods to a collection of lung, abdominal, and breast patients. We evaluate the procedure for respiratory binning using target sites exhibiting high-amplitude motion among 20 lung and abdominal patients. In particular, we investigate whether these methods yield minimal variation between images within a bin by perturbing the resulting image distributions among bins. Moreover, we compare the motion between averaged images across respiratory states to 4DCT data for these patients. We evaluate the algorithm for obtaining pixel correspondences between frames by tracking contours among a set of breast patients. As an initial case, we track easily-identifiable edges of lumpectomy cavities that show minimal motion over treatment. Conclusions: These SIFT-based methods reliably extract motion information from cine MR images acquired during patient treatments. While we performed our analysis retrospectively, the algorithm lends itself to prospective motion assessment. Applications of these methods include motion assessment, identifying treatment windows for gating, and determining optimal margins for treatment.

60 APPLIED LIFE SCIENCES↗