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Zhu, T

Publications and source records attributed to Zhu, T.

SU-F-I-50: Finite Element-Based Deformable Image Registration of Lung and Heart

Purpose: Photodynamic therapy (PDT) is used after surgical resection to treat the microscopic disease for malignant pleural mesothelioma and to increase survival rates. Although accurate light delivery is imperative to PDT efficacy, the deformation of the pleural volume during the surgery impacts the delivered light dose. To facilitate treatment planning, we use a finite-element-based (FEM) deformable image registration to quantify the anatomical variation of lung and heart volumes between CT pre-(or post-) surgery and surface contours obtained during PDT using an infrared camera-based navigation system (NDI). Methods: NDI is used during PDT to obtain the information of the cumulative light fluence on every cavity surface point that is being treated. A wand, comprised of a modified endotrachial tube filled with Intralipid and an optical fiber inside the tube, is used to deliver the light during PDT. The position of the treatment is tracked using an attachment with nine reflective passive markers that are seen by the NDI system. Then, the position points are plotted as three-dimensional volume of the pleural cavity using Matlab and Meshlab. A series of computed tomography (CT) scans of the lungs and heart, in the same patient, are also acquired before and after the surgery. The NDI and CT contours are imported into COMSOL Multiphysics, where the FEM-based deformable image registration is obtained. The NDI and CT contours acquired during and post-PDT are considered as the reference, and the Pre-PDT CT contours are used as the target, which will be deformed. Results: Anatomical variation of the lung and heart volumes, taken at different times from different imaging devices, was determined by using our model. The resulting three-dimensional deformation map along x, y and z-axes was obtained. Conclusion: Our model fuses images acquired by different modalities and provides insights into the variation in anatomical structures over time.

60 APPLIED LIFE SCIENCES↗

SU-F-J-12: Dosimetrical Characteristics of a 2.5 MV Megavoltage Photon Beam

Purpose: To evaluate the accuracy of modeling scatter factor (SF) and primary off-axis ratio (POAR) for 2.5 MV megavoltage photon beams using an empirical model, which can be used as a dose calculation model for low energy EPID imaging. Methods: Scatter photon parameters were calculated for 2.5 MV photon beam from a Varian TrueBeam by fitting the product of depth dose, PDD, and the phantom scatter factor, Sp, for a range of square field sizes between 2 and 40 cm and depths between 0 and 30 cm. The model is then applied to off-axis profiles measured for a slit field (3cm ×35 cm) for 5 depths: 0.6, 5, 10, and 20, 30 cm. Primary off-axis ratio (POAR) values were determined based on the fitting to data using the empirical model. Results: The fitting to PDD*Sp has a maximum error of 14%, mostly near surface, where backscattering of photons dominate and has a standard deviation of 4.7%. The attenuation coefficient and beam-hardening coefficient of the beam is determined to be 0.095 1/cm and 0.0038 1/cm, respectively. POAR for 2.5 MV has a peak in the center, corresponding to a beam without sufficient material to flatten the beam. Conclusion: This work illustrates a deficiency of the current empirical model to fit SF for a 2.5 MV photon beams. Most of the errors are near the surface region and an improved model that incorporate better modeling of backscattering can be developed to improve the model accuracy.

60 APPLIED LIFE SCIENCES↗

SU-F-J-184: Proton Computed Tomography Using 1D Silicon Diode Array

Purpose: Proton radiography and proton computed tomography (PCT) can be used to measure proton stopping power directly. However, practical and cost effective proton imaging detectors are not widely available. In this study, the authors investigated the feasibility of proton imaging using a silicon diode array. Methods: A one-dimensional silicon-diode detector array (1DSDA) was aligned with the central axis (CAX) of the proton beam. Polymethyl methacrylate (PMMA) slabs were used to find the correspondence between the water equivalent thickness (WET) and 1DSDA channel number. 2D proton radiographs (PR) were obtained by translation and rotation of a phantom relative to CAX while the proton nozzle and 1DSDA were kept stationary. A PCT image of one slice of the phantom was reconstructed using filtered backprojection. Results: PR and PCT images of the PMMA cube were successfully acquired using the 1DSDA. The WET of the phantom was measured using PR data with an accuracy of 4.2% or better. Structures down to 1 mm in size could be resolved. Reconstruction of a PCT image showed very good agreement with simulation. Limitations in spatial resolution are attributed to limited spatial sampling, beam collimation, and proton scatter. Conclusion: The results demonstrate the feasibility of using silicon diode arrays for proton imaging. Such a device can potentially offer fast image acquisition, high spatial and energy resolution for PR and PCT.

60 APPLIED LIFE SCIENCES↗

SU-F-T-66: Characteristics of Electron Beams From Varian Trubeam

Purpose: The purpose of this study was to compare the electron beam data between Truebeam and 2300ix Varian accelerators for percent depth dose for broad beam and small circular cutouts, cone factors, head scatter factor as a function of cone size and SSD, phantom scatter factor, blocking factor, distance factor and virtual source position. Methods: Measurements were performed for Truebeam and 2300ix Varian accelerators. The main energies used were: 6, 9, 12, 16 and 20 MeV. PDD was measured at SSD = 100 cm for open beam and small circular cutouts (r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0 and 6.6cm) for different energies. Measurements to determine the head scatter factor (H) were done as a function of radius for six representative energies and five cone sizes (6, 10, 15, 20 and 25cm2). The phantom scatter factor (PSF) is defined as the ratio of blocking factor in water at reference depth and head scatter factor in air. PSF was measured as a function of radius and electron energy. Distance factor was measured for all energies and cones for three SSD’s (100, 110 and 120cm). Results: The percent depth dose (PDD) was measured for small cutouts of radius r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 and 5.6cm. Blocking factor (BF) was measured for Truebeam and 2300ix accelerators, for different circular cutouts and energies for a 10×10 cone. Cone factors were compared between the two accelerators for different energies and applicator sizes. Conclusion: Cone factors measured for the two accelerator types differ by up to 5% for the largest applicator size. Blocking factors differs by up to 3%, with the largest variation for the smallest field size (0.5cm). Distance factor for different SSD’s differ by up to 4.5%.

43 PARTICLE ACCELERATORS↗

SU-F-T-425: Head-Scatter Off-Axis for FFF Megavoltage Photon Beams

Purpose: Head-scatter photons inside a clinical accelerator cause the output to change with collimator setting. On the central-axis, this contribution is well-described by output factor in air (or head-scatter factor). However, a few studies have examined this component at off-axis points. Methods: We define the head-scatter off-axis ratio, HOA, as the ratio of the water kerma in air due to head-scatter photons at the off-axis position x to the water kerma from direct primary photons on the central axis: HOA(cx,cy,xy) = (Q(cx,cy,x) – QP(cx,cy,x))/QP(cx,cy,0), where Q(cx, cy,x), QP(cx,cy,x) are charges measured by an ionization chamber in a miniphantom for collimator setting cx × cy and cx × 3 cm, respectively, at off-axis point x. “Direct primary” is those photons that come from the source without interactions in the intervening structures. Results: We measured HOA for two energies (6XFFF and 6X) along X and Y jaw directions for various collimator settings. The shape of HOA has well defined penumbra for collimator setting larger than 10 × 10 cm2. Conclusion: The narrow gaussian component is interpreted as the source of photons scattered in the flattening filter and the primary collimator. The broad component is attributed to photons scattered in the secondary (variable) collimators. By a direct comparison between 6X and 6XFFF beams, we can confirm that the second component is indeed coming from collimator jaws and identify the parts coming from the primary collimator and the flattening filter, respectively.

07 ISOTOPE AND RADIATION SOURCES↗

SU-F-T-592: A Delivery QA-Free Approach for Adaptive Therapy of Prostate Cancer with Static Intensity Modulated Radiotherapy

Purpose: Clinical implementations of adaptive radiotherapy (ART) are limited mainly by the requirement of delivery QA (DQA) prior to the treatment. Small segment size and small segment MU are two dominant factors causing failures of DQA. The aim of this project is to explore the feasibility of ART treatment without DQA by using a partial optimization approach. Methods: A retrospective simulation study was performed on two prostate cancer patients treated with SMLC-IMRT. The prescription was 180cGx25 fractions with daily CT-on-rail imaging for target alignment. For each patient, seven daily CTs were selected randomly across treatment course. The contours were deformablely transferred from the simulation CT onto the daily CTs and modified appropriately. For each selected treatment, dose distributions from original beams were calculated on the daily treatment CTs (DCT plan). An ART plan was also created by optimizing the segmental MU only, while the segment shapes were preserved and the minimum MU constraint was respected. The overlaps, between PTV and the rectum, between PTV and the bladder, were normalized by the PTV volume. This ratio was used to characterize the difficulty of organs-at-risk (OAR) sparing. Results: Comparing to the original plan, PTV coverage was compromised significantly in DCT plans (82% ± 7%) while all ART plans preserved PTV coverage. ART plans showed similar OAR sparing as the original plan, such as V40Gy=11.2cc (ART) vs 11.4cc (original) for the rectum and D10cc=4580cGy vs 4605cGy for the bladder. The sparing of the rectum/bladder depends on overlap ratios. The sparing in ART was either similar or improved when overlap ratios in treatment CTs were smaller than those in original plan. Conclusion: A partial optimization method is developed that may make the real-time ART feasible on selected patients. Future research is warranted to quantify the applicability of the proposed method.

60 APPLIED LIFE SCIENCES↗

SU-G-JeP3-10: Update On a Real-Time Treatment Guidance System Using An IR Navigation System for Pleural PDT

Purpose: Photodynamic therapy (PDT) is used in conjunction with surgical debulking of tumorous tissue during treatment for pleural mesothelioma. One of the key components of effective PDT is uniform light distribution. Currently, light is monitored with 8 isotropic light detectors that are placed at specific locations inside the pleural cavity. A tracking system with real-time feedback software can be utilized to improve the uniformity of light in addition to the existing detectors. Methods: An infrared (IR) tracking camera is used to monitor the movement of the light source. The same system determines the pleural geometry of the treatment area. Software upgrades allow visualization of the pleural cavity as a two-dimensional volume. The treatment delivery wand was upgraded for ease of light delivery while incorporating the IR system. Isotropic detector locations are also displayed. Data from the tracking system is used to calculate the light fluence rate delivered. This data is also compared with in vivo data collected via the isotropic detectors. Furthermore, treatment volume information will be used to form light dose volume histograms of the pleural cavity. Results: In a phantom study, the light distribution was improved by using real-time guidance compared to the distribution when using detectors without guidance. With the tracking system, 2D data can be collected regarding light fluence rather than just the 8 discrete locations inside the pleural cavity. Light fluence distribution on the entire cavity can be calculated at every time in the treatment. Conclusion: The IR camera has been used successfully during pleural PDT patient treatment to track the motion of the light source and provide real-time display of 2D light fluence. It is possible to use the feedback system to deliver a more uniform dose of light throughout the pleural cavity.

60 APPLIED LIFE SCIENCES↗

SU-C-303-05: Photosensitizer Determination for PDT Using Interstitial and Surface Measurements of Fluorescence

Purpose: Photosensitizer concentration during photodynamic therapy (PDT) is an important parameter for accurate dosimetry. Fluorescence signal can be used as a measure of photosensitizer concentration. Two methods of data acquisition were compared to an ex vivo study both for in vivo and phantom models. Methods: Fluorescence signal of commonly used photosensitizer benzoporphyrin derivative monoacid ring A (BPD) was obtained in phantoms and mouse tumors using an excitation light of 405 nm. Interstitial fluorescence signal was obtained using a side-cut fiber inserted into the tumor tissue of interest. Using a previously developed multi-fiber probe, tumor surface fluorescence measurements were also collected. Signals were calibrated according to optical phantoms with known sensitizer fluorescence. Optical properties for each sample were determined and the influence of different absorption and scattering properties on the fluorescence signals was investigated. Using single value decomposition of the spectra, the sensitizer concentration was determined using the two different measurement geometries. An ex vivo analysis was also performed for tumor samples to determine the sensitizer concentration. Results: The two fluorescence signals obtained from the surface multi-fiber probe and the interstitial measurements were compared and were corresponding for both phantoms and mouse models. The values obtained were comparable to the ex vivo measurements as well. Despite the difference in geometry, the surface probe measurements can still be used as a metric for determining the presence of sensitizer in small volume tumors. Conclusion: The multi-fiber contact probe can be used as a tool to measure fluorescence at the surface of the treatment area for PDT and predict sensitizer concentration throughout the tumor. This is advantageous in that the measurement does not damage any tissue. Future work will include investigating the dependence of these results on intratumor sensitizer distribution.

60 APPLIED LIFE SCIENCES↗

SU-E-J-111: Finite Element-Based Deformable Image Registration of Pleural Cavity for Photodynamic Therapy

Purpose: The pleural volumes will deform during surgery portion of the pleural photodynamic therapy (PDT) of lung cancer when the pleural cavity is opened. This impact the delivered dose when using highly conformal treatment techniques. In this study, a finite element-based (FEM) deformable image registration is used to quantify the anatomical variation between the contours for the pleural cavities obtained in the operating room and those determined from pre-surgery computed tomography (CT) scans. Methods: An infrared camera-based navigation system (NDI) is used during PDT to track the anatomical changes and contour the lung and chest cavity. A series of CTs of the lungs, in the same patient, are also acquired before the surgery. The structure contour of lung and the CTs are processed and contoured in Matlab and MeshLab. Then, the contours are imported into COMSOL Multiphysics 5.0, where the FEM-based deformable image registration is obtained using the deformed mesh - moving mesh (ALE) model. The NDI acquired lung contour is considered as the reference contour, and the CT contour is used as the target one, which will be deformed. Results: The reconstructed three-dimensional contours from both NDI and CT can be converted to COMSOL so that a three-dimensional ALE model can be developed. The contours can be registered using COMSOL ALE moving mesh model, which takes into account the deformation along x, y and z-axes. The deformed contour has good matches to the reference contour after the dynamic matching process. The resulting 3D deformation map can be used to obtain the locations of other critical anatomic structures, e.g., heart, during surgery. Conclusion: Deformable image registration can fuse images acquired by different modalities. It provides insights into the development of phenomenon and variation in normal anatomical structures over time. The initial assessments of three-dimensional registration show good agreement.

60 APPLIED LIFE SCIENCES↗

SU-E-T-167: Characterization of In-House Plastic Scintillator Detectors Array for Radiation Therapy

Purpose: To characterize basic performance of plastic scintillator detectors (PSD) array designed for dosimetry of radiation therapy. Methods: An in-house PSD array has been developed by placing single point PSD into customized 2D holder. Each point PSD is a plastic scintillating fiber-based detector designed for highly accurate measurement of small radiotherapy fields used in patient plan verification and machine commissioning and QA procedures. A parallel fiber without PSD is used for Cerenkov separation by subtracting from PSD readings. Cerenkov separation was confirmed by optical spectroscopy. Alternative Cerenkov separation approaches are also investigated. The optical signal was converted to electronic signal with a photodiode and then subsequently amplified. We measured its dosimetry performance, including percentage depth dose and output factor, and compared with reference ion chamber measurements. The PSD array is then placed along the radiation beam for multiple point dose measurement, representing subsets of PDD measurements, or perpendicular to the beam for profile measurements. Results: The dosimetry results of PSD point measurements agree well with reference ion chamber measurements. For percentage depth dose, the maximal differences between PSD and ion chamber results are 3.5% and 2.7% for 6MV and 15MV beams, respectively. For the output factors, PSD measurements are within 3% from ion chamber results. PDD and profile measurement with PSD array are also performed. Conclusions: The current design of multichannel PSD array is feasible for the dosimetry measurement in radiation therapy. Dose distribution along or perpendicular to the beam path could be measured. It might as well be used as range verification in proton therapy.A PS hollow fiber detector will be investigated to eliminate the Cerenkov radiation effect so that all 32 channels can be used.

60 APPLIED LIFE SCIENCES↗

SU-E-T-610: Phosphor-Based Fiber Optic Probes for Proton Beam Characterization

Purpose: To investigate feasibility of using fiber optics probes with rare-earth-based phosphor tips for proton beam radiation dosimetry. We designed and fabricated a fiber probe with submillimeter resolution (<0.5 mm3) based on TbF3 phosphors and evaluated its performance for measurement of proton beam including profiles and range. Methods: The fiber optic probe with TbF3 phosphor tip, embedded in tissue-mimicking phantoms was irradiated with double scattering proton beam with energy of 180 MeV. Luminescence spectroscopy was performed by a CCD-coupled spectrograph to analyze the emission spectra of the fiber tip. In order to measure the spatial beam profile and percentage depth dose, we used singular value decomposition method to spectrally separate the phosphors ionoluminescence signal from the background Cerenkov radiation signal. Results: The spectra of the TbF3 fiber probe showed characteristic ionoluminescence emission peaks at 489, 542, 586, and 620 nm. By using singular value decomposition we found the contribution of the ionoluminescence signal to measure the percentage depth dose in phantoms and compared that with measurements performed with ion chamber. We observed quenching effect at the spread out Bragg peak region, manifested as under-responding of the signal, due to the high LET of the beam. However, the beam profiles were not dramatically affected by the quenching effect. Conclusion: We have evaluated the performance of a fiber optic probe with submillimeter resolution for proton beam dosimetry. We demonstrated feasibility of spectral separation of the Cerenkov radiation from the collected signal. Such fiber probes can be used for measurements of proton beams profile and range. The experimental apparatus and spectroscopy method developed in this work provide a robust platform for characterization of proton-irradiated nanophosphor particles for ultralow fluence photodynamic therapy or molecular imaging applications.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TU-CD-BRB-05: Radiation Damage Signature of White Matter Fiber Bundles Using Diffusion Tensor Imaging (DTI)

Purpose: To develop an automated and scalable approach and identify temporal, spatial and dosimetric patterns of radiation damage of white matter (WM) fibers following partial brain irradiation. Methods: An automated and scalable approach was developed to extract DTI features of 22 major WM fibers from 33 patients with low-grade/benign tumors treated by radiation therapy (RT). DTI scans of the patients were performed pre-RT, 3- and 6-week during RT, and 1, 6 and 18 months after RT. The automated tractography analysis was applied to 198 datasets as: (1) intra-subject registration of longitudinal DTI, (2) spatial normalization of individual-patient DTI to the Johns Hopkins WM Atlas, (3) automatic fiber tracking regulated by the WM Atlas, and (4) segmentation of WM into 22 major tract profiles. Longitudinal percentage changes in fractional anisotropy (FA), and mean, axial and radial diffusivity (MD/AD/RD) of each tract from pre-RT were quantified and correlated to 95%, 90% and 80% percentiles of doses and mean doses received by the tract. Heatmaps were used to identify clusters of significant correlation and reveal temporal, spatial and dosimetric signatures of WM damage. A multivariate linear regression was further carried out to determine influence of clinical factors. Results: Of 22 tracts, AD/MD changes in 12 tracts had significant correlation with doses, especially at 6 and 18 months post-RT, indicating progressive radiation damage after RT. Most interestingly, the DTI-index changes in the elongated tracts were associated with received maximum doses, suggesting a serial-structure behavior; while short association fibers were affected by mean doses, indicating a parallel-structure response. Conclusion: Using an automated DTI-tractography analysis of whole brain WM fibers, we reveal complex radiation damage patterns of WM fibers. Damage in WM fibers that play an important role in the neural network could be associated with late neurocognitive function declines after brain irradiation. NIH NS064973.

60 APPLIED LIFE SCIENCES↗