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SU-E-J-109: Testing the KV Imaging Center Congruence with Radiation Isocenter of Small MLC and SRS Cone Field On Two Machines

Purpose: Orthogonal kV image pairs are used for target localization when fiducial markers are implanted. CBCT is used to verify cone SRS setup. Therefore it is necessary to evaluate the isocenter congruence between radiation fields and kV imaging center. This study used a simple method to evaluate the isocenter congruence, and compared the results for MLC and cone fields on two different Linacs. Methods: Varian OBI block was attached on the couch. It has a central 1mm BB with markers on three surfaces to align with laser. KV and MV images were taken at four cardinal angles. A 3x3cm2 MLC field and a 20mm cone field were irradiated respectively. On each kV image, the distance from BB center to the kV graticule center were measured. On the MV image of MLC field, the center of radiation field was determined manually, while for cone field, the Varian AM maintenance software was used to analyze the distance between BB and radiation field. The subtraction of the two distances gives the discrepancy between kV and radiation centers. Each procedure was repeated on five days at Trilogy and TrueBeam respectively. Results: The maximum discrepancy was found in the longitudinal direction at 180° gantry angel. It was 1.5±0.1mm for Trilogy and 0.6±0.1mm for TrueBeam. For Trilogy, although radiation center wobbled only 0.7mm and image center wobbled 0.8mm, they wobbled to the opposite direction. KV Pair using gantry 180° should be avoided in this case. Cone vs. kV isocenter has less discrepancy than MLC for Trilogy. Conclusion: Radiation isocenter of MLC and cone field is different, so is between Trilogy and TrueBeam. The method is simple and reproducible to check kV and radiation isocenter congruence.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

The art and power of data imaging

Data imaging and visual data assessment are veritable gold mines in the scientist's quest to understand and accurately interpret numerical data. Graphical displays of various aspects of a dataset offer the analyst insight to the data that no mathematical computation or statistic can provide. It is difficult, at best, for even a skilled and observant statistician to understand the underlying structure of a dataset. Often, there is either too little data to get a good 'picture' of the structure that might be present or there is so much data that one cannot readily assimilate it. Of course, the latter problem (too much data) is, in reality, no problem at all given the abilities of modern computers and software systems to manage large amounts of data. Advances in computer technology and the advent of the global positioning satellite system have enabled scientists from many fields of endeavor to collect and view data in its spatial context. Visual images constructed from spatially referenced data reveal the inherent richness and structure in the data and lead to more informed conclusions. So powerful is data collected with spatial context that a relatively new branch of mathematical statistics, geo-spatial statistics, has emerged. Geo-spatial statistics seek to exploit this context rich data form to better understand the spatial and co-relationships that might exist, but would be otherwise hidden in tabular data or obscured with classic statistical approaches. This paper (and accompanying presentation) will show the power that visual data assessment possesses to understand radiological scanning data and to make confident and accurate decisions based on the data images. It will challenge the traditional mathematical concept of detection limits for scanning. It will demonstrate that more data, even if the individual datum comprising the dataset is of 'poorer quality' (i.e., has a larger uncertainty and, thus, a larger calculated minimum detection value), is significantly more powerful than a smaller dataset comprised of higher quality measurements. This presentation will cause the open-minded health physicist to rethink how they prescribe, collect, evaluate, and make decisions based upon radiological scan data. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TU-CD-304-11: Veritas 2.0: A Cloud-Based Tool to Facilitate Research and Innovation

Purpose: We introduce Veritas 2.0, a cloud-based, non-clinical research portal, to facilitate translation of radiotherapy research ideas to new delivery techniques. The ecosystem of research tools includes web apps for a research beam builder for TrueBeam Developer Mode, an image reader for compressed and uncompressed XIM files, and a trajectory log file based QA/beam delivery analyzer. Methods: The research beam builder can generate TrueBeam readable XML file either from scratch or from pre-existing DICOM-RT plans. DICOM-RT plan is first converted to XML format and then researcher can interactively modify or add control points to them. Delivered beam can be verified via reading generated images and analyzing trajectory log files. Image reader can read both uncompressed and HND-compressed XIM images. The trajectory log analyzer lets researchers plot expected vs. actual values and deviations among 30 mechanical axes. The analyzer gives an animated view of MLC patterns for the beam delivery. Veritas 2.0 is freely available and its advantages versus standalone software are i) No software installation or maintenance needed, ii) easy accessibility across all devices iii) seamless upgrades and iv) OS independence. Veritas is written using open-source tools like twitter bootstrap, jQuery, flask, and Python-based modules. Results: In the first experiment, an anonymized 7-beam DICOM-RT IMRT plan was converted to XML beam containing 1400 control points. kV and MV imaging points were inserted into this XML beam. In another experiment, a binary log file was analyzed to compare actual vs expected values and deviations among axes. Conclusions: Veritas 2.0 is a public cloud-based web app that hosts a pool of research tools for facilitating research from conceptualization to verification. It is aimed at providing a platform for facilitating research and collaboration. I am full time employee at Varian Medical systems, Palo Alto.

60 APPLIED LIFE SCIENCES↗

Frameless Angiogram-Based Stereotactic Radiosurgery for Treatment of Arteriovenous Malformations

Purpose: Stereotactic radiosurgery (SRS) is an effective alternative to microsurgical resection or embolization for definitive treatment of arteriovenous malformations (AVMs). Digital subtraction angiography (DSA) is the gold standard for pretreatment diagnosis and characterization of vascular anatomy, but requires rigid frame (skull) immobilization when used in combination with SRS. With the advent of advanced proton and image-guided photon delivery systems, SRS treatment is increasingly migrating to frameless platforms, which are incompatible with frame-based DSA. Without DSA as the primary image, target definition may be less than optimal, in some cases precluding the ability to treat with a frameless system. This article reports a novel solution. Methods and Materials: Fiducial markers are implanted into the patient's skull before angiography. Angiography is performed according to the standard clinical protocol, but, in contrast to the previous practice, without the rigid frame. Separate images of a specially designed localizer box are subsequently obtained. A target volume projected on DSA can be transferred to the localizer system in three dimensions, and in turn be transferred to multiple CT slices using the implanted fiducials. Combined with other imaging modalities, this 'virtual frame' approach yields a highly precise treatment plan that can be delivered by frameless SRS technologies. Results: Phantom measurements for point and volume targets have been performed. The overall uncertainty of placing a point target to CT is 0.4 mm. For volume targets, deviation of the transformed contour from the target CT image is within 0.6 mm. The algorithm and software are robust. The method has been applied clinically, with reliable results. Conclusions: A novel and reproducible method for frameless SRS of AVMs has been developed that enables the use of DSA without the requirement for rigid immobilization. Multiple pairs of DSA can be used for better conformality. Further improvement, including using nonimplanted fiducials, is potentially feasible.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-T-486: A Simple Approach to Performing Light Versus Radiation Field Coincidence Quality Assurance Using An Electronic Portal Imaging Device (EPID)

Purpose: To develop an accurate, straightforward, and user-independent method for performing light versus radiation field coincidence quality assurance utilizing EPID images, a simple phantom made of readily-accessible materials, and a free software program. Methods: A simple phantom consisting of a blocking tray, graph paper, and high-density wire was constructed. The phantom was used to accurately set the size of a desired light field and imaged on the electronic portal imaging device (EPID). A macro written for use in ImageJ, a free image processing software, was then use to determine the radiation field size utilizing the high density wires on the phantom for a pixel to distance calibration. The macro also performs an analysis on the measured radiation field utilizing the tolerances recommended in the AAPM Task Group #142. To verify the accuracy of this method, radiochromic film was used to qualitatively demonstrate agreement between the film and EPID results, and an additional ImageJ macro was used to quantitatively compare the radiation field sizes measured both with the EPID and film images. Results: The results of this technique were benchmarked against film measurements, which have been the gold standard for testing light versus radiation field coincidence. The agreement between this method and film measurements were within 0.5 mm. Conclusion: Due to the operator dependency associated with tracing light fields and measuring radiation fields by hand when using film, this method allows for a more accurate comparison between the light and radiation fields with minimal operator dependency. Removing the need for radiographic or radiochromic film also eliminates a reoccurring cost and increases procedural efficiency.

60 APPLIED LIFE SCIENCES↗

Quantifying deformation during Zry-4 burst testing: a comparison of BISON and a combined in-situ digital image correlation and infrared thermography method

The development and verification of nuclear fuel-cladding performance codes require extensive testing to establish empirical correlations, necessitating more accelerated testing methods that can replace large validation studies. Here, in the present work, a technique was developed and implemented to experimentally quantify the relationship between temperature, cladding internal pressure, and strain in-situ during a burst test, with the specific aim of generating data for code validation and model refinement. Digital image correlation was used to measure hoop, axial, and radial strain, and infrared thermography to quantify axial temperature gradients. Several key experimental modifications to traditional LOCA burst testing were necessary, but are shown to effectively have little impact on burst temperatures. The time/temperature dependent pressure and time/spatially dependent thermal gradient data were used with BISON to simulate cladding burst and strain rates. Although the measured DIC strains reach appreciable amounts at slightly lower temperatures than BISON simulated strains, there is good agreement between the measured and simulated strains in terms of magnitude and rates leading up to burst. However, in the few seconds prior to and during burst, the BISON simulated strains are significantly lower than the measured strains, indicating the potential for model improvement. The combined experiment and simulation technique may be applied to any new cladding concept to accelerate fuel qualification.

36 MATERIALS SCIENCE↗

TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

60 APPLIED LIFE SCIENCES↗

SU-C-18C-03: Dual-Energy X-Ray Fluoroscopy Imaging System

Purpose: This work studies the clinical utility of dual energy (DE) subtraction fluoroscopy for fiducial-free tumor tracking in lung radiation therapy (RT). Improvement in tumor visualization and quantification of tumor shift within a breathing cycle were analyzed. Methods: Twenty subjects who were undergoing RT for lung cancer were recruited following institutional review board approval. The subjects had a range of tumor sizes, locations in the lungs, and body sizes. An x-ray imaging system was setup with the following components: (a) x-ray tube (Varian G-242, Varian Medical Systems (VMS), CA) (b) flat panel detector (4030CB, VMS, CA) and (c) x-ray generator (EPS 50RF, EMD, Canada). Firmware and software modifications were made to the generator to allow 10 x-ray pulse pairs with alternating low/high kV, 100 ms apart for ∼4s (one breathing cycle). Images were obtained at 4 angles: 0°, 45°, 90° and 135°. Weighted subtraction of a kV-pair image set was used to create a “bone-free” image of the lungs. The 2D tumor-shift in each subtracted image and the 3D shift during a breathing cycle was calculated using all views. Results: The subjects enrolled had the following statistics: average age 62.3±7.1 years, 5 female/15 male, 11 had tumors on the right and 9 on the left and the average tumor size was ∼31.4±10.8 mm. X-ray imaging conditions for the pulse pairs were: 70/120 kVp, 280/221 mA and 65/8 ms. For views where these parameters were insufficient 80/130 kVp, 280/221 mA and 60/12 ms was used. Tumor visibility improved for 0°, 45°, 90° and 135° in 100%, 55%, 75% and 80% of the cases respectively. Tumor shift during a breathing cycle was: 2.4±1.0 mm AP, 2.7±1.4 mm LR and 7.6±4.8 mm IS. Conclusion: DE subtraction fluoroscopy allowed improved visualization and quantification of movement of tumors in the lungs during a breathing cycle. This study was entirely funded by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-E-BRB-01: Overview of DIR Advantages/Challenges and Workflow

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

60 APPLIED LIFE SCIENCES↗

TU-E-BRB-02: DIR QA Options and Research Development

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

60 APPLIED LIFE SCIENCES↗

TU-E-BRB-03: Overview of Proposed TG-132 Recommendations

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

60 APPLIED LIFE SCIENCES↗

EXTRAPOLATION OF THE SOLAR CORONAL MAGNETIC FIELD FROM SDO/HMI MAGNETOGRAM BY A CESE-MHD-NLFFF CODE

Due to the absence of direct measurement, the magnetic field in the solar corona is usually extrapolated from the photosphere in a numerical way. At the moment, the nonlinear force-free field (NLFFF) model dominates the physical models for field extrapolation in the low corona. Recently, we have developed a new NLFFF model with MHD relaxation to reconstruct the coronal magnetic field. This method is based on CESE-MHD model with the conservation-element/solution-element (CESE) spacetime scheme. In this paper, we report the application of the CESE-MHD-NLFFF code to Solar Dynamics Observatory/Helioseismic and Magnetic Imager (SDO/HMI) data with magnetograms sampled for two active regions (ARs), NOAA AR 11158 and 11283, both of which were very non-potential, producing X-class flares and eruptions. The raw magnetograms are preprocessed to remove the force and then inputted into the extrapolation code. Qualitative comparison of the results with the SDO/AIA images shows that our code can reconstruct magnetic field lines resembling the EUV-observed coronal loops. Most important structures of the ARs are reproduced excellently, like the highly sheared field lines that suspend filaments in AR 11158 and twisted flux rope which corresponds to a sigmoid in AR 11283. Quantitative assessment of the results shows that the force-free constraint is fulfilled very well in the strong-field regions but apparently not that well in the weak-field regions because of data noise and numerical errors in the small currents.

79 ASTRONOMY AND ASTROPHYSICS↗

SYNMAG PHOTOMETRY: A FAST TOOL FOR CATALOG-LEVEL MATCHED COLORS OF EXTENDED SOURCES

Obtaining reliable, matched photometry for galaxies imaged by different observatories represents a key challenge in the era of wide-field surveys spanning more than several hundred square degrees. Methods such as flux fitting, profile fitting, and PSF homogenization followed by matched-aperture photometry are all computationally expensive. We present an alternative solution called 'synthetic aperture photometry' that exploits galaxy profile fits in one band to efficiently model the observed, point-spread-function-convolved light profile in other bands and predict the flux in arbitrarily sized apertures. Because aperture magnitudes are the most widely tabulated flux measurements in survey catalogs, producing synthetic aperture magnitudes (SYNMAGs) enables very fast matched photometry at the catalog level, without reprocessing imaging data. We make our code public and apply it to obtain matched photometry between Sloan Digital Sky Survey ugriz and UKIDSS YJHK imaging, recovering red-sequence colors and photometric redshifts with a scatter and accuracy as good as if not better than FWHM-homogenized photometry from the GAMA Survey. Finally, we list some specific measurements that upcoming surveys could make available to facilitate and ease the use of SYNMAGs.

79 ASTRONOMY AND ASTROPHYSICS↗

SU-G-IeP4-06: Feasibility of External Beam Treatment Field Verification Using Cherenkov Imaging

Purpose: Cherenkov light emission has been shown to correlate with ionizing radiation (IR) dose delivery in solid tissue. In order to properly correlate Cherenkov light images with real time dose delivery in a patient, we must account for geometric and intensity distortions arising from observation angle, as well as the effect of monitor units (MU) and field size on Cherenkov light emission. To test the feasibility of treatment field verification, we first focused on Cherenkov light emission efficiency based on MU and known field size (FS). Methods: Cherenkov light emission was captured using a PI-MAX4 intensified charge coupled device(ICCD) system (Princeton Instruments), positioned at a fixed angle of 40° relative to the beam central axis. A Varian TrueBeam linear accelerator (linac) was operated at 6MV and 600MU/min to deliver an Anterior-Posterior beam to a 5cm thick block phantom positioned at 100cm Source-to-Surface-Distance(SSD). FS of 10×10, 5×5, and 2×2cm{sup 2} were used. Before beam delivery projected light field images were acquired, ensuring that geometric distortions were consistent when measuring Cherenkov field discrepancies. Cherenkov image acquisition was triggered by linac target current. 500 frames were acquired for each FS. Composite images were created through summation of frames and background subtraction. MU per image was calculated based on linac pulse delay of 2.8ms. Cherenkov and projected light FS were evaluated using ImageJ software. Results: Mean Cherenkov FS discrepancies compared to light field were <0.5cm for 5.6, 2.8, and 8.6 MU for 10×10, 5×5, and 2×2cm{sup 2} FS, respectably. Discrepancies were reduced with increasing field size and MU. We predict a minimum of 100 frames is needed for reliable confirmation of delivered FS. Conclusion: Current discrepancies in Cherenkov field sizes are within a usable range to confirm treatment delivery in standard and respiratory gated clinical scenarios at MU levels appropriate to standard MLC position segments.

60 APPLIED LIFE SCIENCES↗

Patient-specific QA and delivery verification of scanned ion beam at NIRS-HIMAC

Purpose: To evaluate a patient-specific QA program and system for constancy checking of a scanning delivery system developed at the National Institute of Radiological Sciences.Methods: For the patient-specific QA, all the planned beams are recalculated on a water phantom with treatment planning software (TPS). The recalculated dose distributions are compared with the measured distributions using a 2D ionization chamber array at several depths, and evaluated using gamma index analysis with criteria of 3% and 3 mm and a pass rate of 90%. For the constancy check, the authors developed the multiwire proportional chamber (MWPC), which can record the delivered 2D fluence images in a slice-by-slice manner. During irradiation for dosimetric QA with the 2D ionization chamber array and an accordion-type water phantom, the 2D fluence images are recorded using the MWPC in the delivery system. These recorded images are then compared to those taken in the treatment session to check the constancy check. This analysis also employs gamma index analysis using the same criteria as in the patient-specific QA. These patient-specific QA and constancy check evaluations were performed using the data of 122 patients.Results: In the patient-specific QA, the measured dose distributions agreed well with those calculated by the TPS, and the QA criteria were satisfied in all measurements. The additional check of the fluence comparison ensured the constancy of the delivered field during each treatment irradiation.Conclusions: The authors established a patient-specific QA program and additional check of delivery constancy in every treatment session. Fluence comparison is a strong tool for constancy checking of the delivery system.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-F-J-173: Online Replanning for Dose Painting Based On Changing ADC Map of Pancreas Cancer

Purpose: The introduction of MR-guided radiation therapy (RT), e.g., MR-Linac, would allow dose painting to adapt spatial RT response revealed from MRI data during the RT delivery. The purpose of this study is to investigate the use of an online replanning method to adapt dose painting from the MRI Apparent Diffusion Coefficient (ADC) map acquired during the delivery of RT for pancreatic cancers. Methods: Original dose painting plans were created based on multi-parametric simulation MRI including T1, T2 and ADC, using a treatment planning system (MONACO, Elekta) equipped with an online replanning algorithm (WSO, warm start optimization). Multiple GTVs, identified based on various ADC levels were prescribed to different doses ranging from 50–70 Gy with simultaneous integrated boost in 28 fractions. The MRI acquired after RT were used to mimic weekly MRI, on which the changing GTVs, pancreatic head and other organs-at-risk (OAR) (duodenum, stomach, small bowel) were delineated. The adaptive plan was generated by applying WSO algorithm starting from the deformed original plan based on the weekly MRI using a deformable image registration (DIR) software (ADMIRE, Elekta). The online replanning method takes <10 min. including DIR, target delineation, WSO execution and final dose calculation. Standard IGRT repositioning and full-blown reoptimization plans were also generated to compare with the adaptive plans. Results: The online replanning method significantly improved the multiple target coverages and OAR sparing for pancreatic cancers. For example, for a case with two GTVs with prescriptions of 60 and 70 Gy in pancreatic head, V100-GTV70 (the volume covered by 100% of prescription dose for GTV with 70 Gy)/V100-GTV60/V100-CTV50/V45-duodenum were (95.1/22.2/69.5/85.7), (95.0/97.0/98.6/34.3), and (95.0/98.1/100.0/38.7) for the IGRT, adaptive and reoptimization plans, respectively. Conclusion: The introduced online adaptive replanning method can effectively account for interfractional changes including tumor spatial response during MR-guided RT delivery, allowing precise delivery of dose painting. This study was partially supported by Elekta Inc.

60 APPLIED LIFE SCIENCES↗

SU-E-T-646: Quality Assurance of Truebeam Multi-Leaf Collimator Using a MLC QA Phantom

Purpose: To perform a routine quality assurance procedure for Truebeam multi-leaf collimator (MLC) using MLC QA phantom, verify the stability and reliability of MLC during the treatment. Methods: MLC QA phantom is a specialized phantom for MLC quality assurance (QA), and contains five radio-opaque spheres that are embedded in an “L” shape. The phantom was placed isocentrically on the Truebeam treatment couch for the tests. A quality assurance plan was setted up in the Eclipse v10.0, the fields that need to be delivered in order to acquire the necessary images, the MLC shapes can then be obtained by the images. The images acquired by the electronic portal imaging device (EPID), and imported into the PIPSpro software for the analysis. The tests were delivered twelve weeks (once a week) to verify consistency of the delivery, and the images are acquired in the same manner each time. Results: For the Leaf position test, the average position error was 0.23mm±0.02mm (range: 0.18mm∼0.25mm). The Leaf width was measured at the isocenter, the average error was 0.06mm±0.02mm (range: 0.02mm∼0.08mm) for the Leaf width test. Multi-Port test showed the dynamic leaf shift error, the average error was 0.28mm±0.03mm (range: 0.2mm∼0.35mm). For the leaf transmission test, the average inter-leaf leakage value was 1.0%±0.17% (range: 0.8%∼1.3%) and the average inter-bank leakage value was 32.6%±2.1% (range: 30.2%∼36.1%). Conclusion: By the test of 12 weeks, the MLC system of the Truebeam is running in a good condition and the MLC system can be steadily and reliably carried out during the treatment. The MLC QA phantom is a useful test tool for the MLC QA.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A measurement technique to determine the calibration accuracy of an electromagnetic tracking system to radiation isocenter

Purpose: To present and characterize a measurement technique to quantify the calibration accuracy of an electromagnetic tracking system to radiation isocenter.Methods: This technique was developed as a quality assurance method for electromagnetic tracking systems used in a multi-institutional clinical hypofractionated prostate study. In this technique, the electromagnetic tracking system is calibrated to isocenter with the manufacturers recommended technique, using laser-based alignment. A test patient is created with a transponder at isocenter whose position is measured electromagnetically. Four portal images of the transponder are taken with collimator rotations of 45° 135°, 225°, and 315°, at each of four gantry angles (0°, 90°, 180°, 270°) using a 3 × 6 cm{sup 2} radiation field. In each image, the center of the copper-wrapped iron core of the transponder is determined. All measurements are made relative to this transponder position to remove gantry and imager sag effects. For each of the 16 images, the 50% collimation edges are identified and used to find a ray representing the rotational axis of each collimation edge. The 16 collimator rotation rays from four gantry angles pass through and bound the radiation isocenter volume. The center of the bounded region, relative to the transponder, is calculated and then transformed to tracking system coordinates using the transponder position, allowing the tracking system's calibration offset from radiation isocenter to be found. All image analysis and calculations are automated with inhouse software for user-independent accuracy. Three different tracking systems at two different sites were evaluated for this study.Results: The magnitude of the calibration offset was always less than the manufacturer's stated accuracy of 0.2 cm using their standard clinical calibration procedure, and ranged from 0.014 to 0.175 cm. On three systems in clinical use, the magnitude of the offset was found to be 0.053 ± 0.036, 0.121 ± 0.023, and 0.093 ± 0.013 cm.Conclusions: The method presented here provides an independent technique to verify the calibration of an electromagnetic tracking system to radiation isocenter. The calibration accuracy of the system was better than the 0.2 cm accuracy stated by the manufacturer. However, it should not be assumed to be zero, especially for stereotactic radiation therapy treatments where planning target volume margins are very small.

62 RADIOLOGY AND NUCLEAR MEDICINE↗