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Calibration of imaging plates to electrons between 40 and 180 MeV

This paper presents the response calibration of Imaging Plates (IPs) for electrons in the 40-180 MeV range using laser-accelerated electrons at Laboratoire d’Optique Appliquée (LOA), Palaiseau, France. In the calibration process, the energy spectrum and charge of electron beams are measured by an independent system composed of a magnetic spectrometer and a Lanex scintillator screen used as a calibrated reference detector. It is possible to insert IPs of different types or stacks of IPs in this spectrometer in order to detect dispersed electrons simultaneously. The response values are inferred from the signal on the IPs, due to an appropriate charge calibration of the reference detector. The effect of thin layers of tungsten in front and/or behind IPs is studied in detail. GEANT4 simulations are used in order to analyze our measurements.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

A method for evaluating image quality of monochrome and color displays based on luminance by use of a commercially available color digital camera

Purpose: The aim of this study is to propose a method for the quantitative evaluation of image quality of both monochrome and color liquid-crystal displays (LCDs) using a commercially available color digital camera. Methods: The intensities of the unprocessed red (R), green (G), and blue (B) signals of a camera vary depending on the spectral sensitivity of the image sensor used in the camera. For consistent evaluation of image quality for both monochrome and color LCDs, the unprocessed RGB signals of the camera were converted into gray scale signals that corresponded to the luminance of the LCD. Gray scale signals for the monochrome LCD were evaluated by using only the green channel signals of the camera. For the color LCD, the RGB signals of the camera were converted into gray scale signals by employing weighting factors (WFs) for each RGB channel. A line image displayed on the color LCD was simulated on the monochrome LCD by using a software application for subpixel driving in order to verify the WF-based conversion method. Furthermore, the results obtained by different types of commercially available color cameras and a photometric camera were compared to examine the consistency of the authors’ method. Finally, image quality for both the monochrome and color LCDs was assessed by measuring modulation transfer functions (MTFs) and Wiener spectra (WS). Results: The authors’ results demonstrated that the proposed method for calibrating the spectral sensitivity of the camera resulted in a consistent and reliable evaluation of the luminance of monochrome and color LCDs. The MTFs and WS showed different characteristics for the two LCD types owing to difference in the subpixel structure. The MTF in the vertical direction of the color LCD was superior to that of the monochrome LCD, although the WS in the vertical direction of the color LCD was inferior to that of the monochrome LCD as a result of luminance fluctuations in RGB subpixels. Conclusions: The authors’ method based on the use of a commercially available color camera is useful to evaluate and understand the display performances of both monochrome and color LCDs in radiology departments.

60 APPLIED LIFE SCIENCES↗

SU-E-J-27: Appropriateness Criteria for Deformable Image Registration and Dose Propagation

Purpose: Several commercial software packages have been recently released that allow the user to apply deformable registration algorithms (DRA) for image fusion and dose propagation. Although the idea of anatomically tracking the daily patient dose in the context of adaptive radiotherapy or merely adding the dose from prior treatment to the current one is very intuitive, the accuracy and applicability of such algorithms needs to be investigated as it remains somewhat subjective. In our study, we used true anatomical data where we introduced changes in the density, volume and location of segmented structures to test the DRA for its sensitivity and accuracy. Methods: The CT scan of a prostate patient was selected for this study. The CT images were first segmented to define structure such as the PTV, bladder, rectum, intestines and pelvic bone anatomy. To perform our study, we introduced anatomical changes in the reference patient image set in three different ways: (i) we kept the segmented volumes constant and changed the density of rectum and bladder in increments of 5% (ii) we changed the volume of rectum and bladder in increments of 5% and (iii) we kept the segmented volumes constant but changed their location by moving their COM in increments of 3mm. Using the Velocity software, we evaluated the accuracy of the DRA for each incremental change in all three scenarios. Results: The DRA performs reasonably well when the differential density difference against the background is more than 5%. For the volume change study, the DRA results became unreliable for relative volume changes greater than 10%. Finally for the location study, the DRA performance was acceptable for shifts below 9mm. Conclusion: Site specific and patient specific QA for DRA is an important step to evaluate such algorithms prior to their use for dose propagation.

60 APPLIED LIFE SCIENCES↗

TU-PIS-Exhibit Hall-3: Under the hood of Deformable Image Registration: Similarity Functions and Regularization

Brachytherapy devices and software are designed to last for a certain period of time. Due to a number of considerations, such as material factors, wear-and-tear, backwards compatibility, and others, they all reach a date when they are no longer supported by the manufacturer. Most of these products have a limited duration for their use, and the information is provided to the user at time of purchase. Because of issues or concerns determined by the manufacturer, certain products are retired sooner than the anticipated date, and the user is immediately notified. In these situations, the institution is facing some difficult choices: remove these products from the clinic or perform tests and continue their usage. Both of these choices come with a financial burden: replacing the product or assuming a potential medicolegal liability. This session will provide attendees with the knowledge and tools to make better decisions when facing these issues. Learning Objectives: Understand the meaning of “end-of-life or “life expectancy” for brachytherapy devices and software Review items (devices and software) affected by “end-of-life” restrictions Learn how to effectively formulate “end-of-life” policies at your institution Learn about possible implications of “end-of-life” policy Review other possible approaches to “end-of-life” issue.

60 APPLIED LIFE SCIENCES↗

TU-PIS-Exhibit Hall-1: Therapy: Deformable Image Registration, Contour Propagation, and Dose Mapping

Brachytherapy devices and software are designed to last for a certain period of time. Due to a number of considerations, such as material factors, wear-and-tear, backwards compatibility, and others, they all reach a date when they are no longer supported by the manufacturer. Most of these products have a limited duration for their use, and the information is provided to the user at time of purchase. Because of issues or concerns determined by the manufacturer, certain products are retired sooner than the anticipated date, and the user is immediately notified. In these situations, the institution is facing some difficult choices: remove these products from the clinic or perform tests and continue their usage. Both of these choices come with a financial burden: replacing the product or assuming a potential medicolegal liability. This session will provide attendees with the knowledge and tools to make better decisions when facing these issues. Learning Objectives: Understand the meaning of “end-of-life or “life expectancy” for brachytherapy devices and software Review items (devices and software) affected by “end-of-life” restrictions Learn how to effectively formulate “end-of-life” policies at your institution Learn about possible implications of “end-of-life” policy Review other possible approaches to “end-of-life” issue.

60 APPLIED LIFE SCIENCES↗

TU-PIS-Exhibit Hall-2: Deformable Image Registration, Contour Propagation, and Dose Mapping inMIM Maestro - MIM Software

Brachytherapy devices and software are designed to last for a certain period of time. Due to a number of considerations, such as material factors, wear-and-tear, backwards compatibility, and others, they all reach a date when they are no longer supported by the manufacturer. Most of these products have a limited duration for their use, and the information is provided to the user at time of purchase. Because of issues or concerns determined by the manufacturer, certain products are retired sooner than the anticipated date, and the user is immediately notified. In these situations, the institution is facing some difficult choices: remove these products from the clinic or perform tests and continue their usage. Both of these choices come with a financial burden: replacing the product or assuming a potential medicolegal liability. This session will provide attendees with the knowledge and tools to make better decisions when facing these issues. Learning Objectives: Understand the meaning of “end-of-life or “life expectancy” for brachytherapy devices and software Review items (devices and software) affected by “end-of-life” restrictions Learn how to effectively formulate “end-of-life” policies at your institution Learn about possible implications of “end-of-life” policy Review other possible approaches to “end-of-life” issue.

60 APPLIED LIFE SCIENCES↗

SU-E-J-146: A Research of PET-CT SUV Range for the Online Dose Verification in Carbon Ion Radiation Therapy

Purpose: Positron-emitting isotope distributions can be used for the image fusion of the carbon ion planning CT and online target verification PETCT, after radiation in the same decay period,the relationship between the same target volume and the SUV value of different every single fraction dose can be found,then the range of SUV for the radiation target could be decided.So this online range also can provide reference for the correlation and consistency in planning target dose verification and evaluation for the clinical trial. Methods: The Rando head phantom can be used as real body,the 10cc cube volume target contouring is done,beam ISO Center depth is 7.6cm and the 90 degree fixed carbon ion beams should be delivered in single fraction effective dose of 2.5GyE,5GyE and 8GyE.After irradiation,390 seconds later the 30 minutes PET-CT scanning is performed,parameters are set to 50Kg virtual weight,0.05mCi activity.MIM Maestro is used for the image processing and fusion,five 16mm diameter SUV spheres have been chosen in the different direction in the target.The average SUV in target for different fraction dose can be found by software. Results: For 10cc volume target,390 seconds decay period,the Single fraction effective dose equal to 2.5Gy,Ethe SUV mean value is 3.42,the relative range is 1.72 to 6.83;Equal to 5GyE,SUV mean value is 9.946,the relative range is 7.016 to 12.54;Equal or above to 8GyE,SUV mean value is 20.496,the relative range is 11.16 to 34.73. Conclusion: Making an evaluation for accuracy of the dose distribution using the SUV range which is from the planning CT with after treatment online PET-CT fusion for the normal single fraction carbon ion treatment is available.Even to the plan which single fraction dose is above 2GyE,in the condition of other parameters all the same,the SUV range is linearly dependent with single fraction dose,so this method also can be used in the hyper-fraction treatment plan.

60 APPLIED LIFE SCIENCES↗

Clinical evaluation of a medical high dynamic range display

Purpose: Recent new medical displays do have higher contrast and higher luminance but do not have a High Dynamic Range (HDR). HDR implies a minimum luminance value close to zero. A medical HDR display prototype based on two Liquid Crystal layers has been developed. The goal of this study is to evaluate the potential clinical benefit of such display in comparison with a low dynamic range (LDR) display. Methods: The study evaluated the clinical performance of the displays in a search and detection task. Eight radiologists read chest x-ray images some of which contained simulated lung nodules. The study used a JAFROC (Jacknife Free Receiver Operating Characteristic) approach for analyzing FROC data. The calculated figure of merit (FoM) is the probability that a lesion is rated higher than all rated nonlesions on all images. Time per case and accuracy for locating the center of the nodules were also compared. The nodules were simulated using Samei’s model. 214 CR and DR images [half were “healthy images” (chest nodule-free) and half “diseased images”] were used resulting in a total number of nodules equal to 199 with 25 images with 1 nodule, 51 images with 2 nodules, and 24 images with 3 nodules. A dedicated software interface was designed for visualizing the images for each session. For the JAFROC1 statistical analysis, the study is done per nodule category: all nodules, difficult nodules, and very difficult nodules. Results: For all nodules, the averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 0.09% of difference. For the difficult nodules, the averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 1.38% of difference. The averaged FoM{sub HDR} is slightly higher than FoM{sub LDR} with 0.71% of difference. For the true positive fraction (TPF), both displays (the HDR and the LDR ones) have similar TPF for all nodules, but looking at difficult and very difficult nodules, there are more TP for the HDR display. The true positive fraction has been also computed in function of the local average luminance around the nodules. For the lowest luminance range, there is more than 30% in favor of the HDR display. For the highest luminance range, there is less than 6% in favor of the LDR display. Conclusions: This study shows the potential benefit of using a HDR display in radiology.

60 APPLIED LIFE SCIENCES↗

SU-E-J-262: Variability in Texture Analysis of Gynecological Tumors in the Context of An 18F-FDG PET Adaptive Protocol

Purpose: This study examines the effect on texture analysis due to variable reconstruction of PET images in the context of an adaptive FDG PET protocol for node positive gynecologic cancer patients. By measuring variability in texture features from baseline and intra-treatment PET-CT, we can isolate unreliable texture features due to large variation. Methods: A subset of seven patients with node positive gynecological cancers visible on PET was selected for this study. Prescribed dose varied between 45–50.4Gy, with a 55–70Gy boost to the PET positive nodes. A baseline and intratreatment (between 30–36Gy) PET-CT were obtained on a Siemens Biograph mCT. Each clinical PET image set was reconstructed 6 times using a TrueX+TOF algorithm with varying iterations and Gaussian filter. Baseline and intra-treatment primary GTVs were segmented using PET Edge (MIM Software Inc., Cleveland, OH), a semi-automatic gradient-based algorithm, on the clinical PET and transferred to the other reconstructed sets. Using an in-house MATLAB program, four 3D texture matrices describing relationships between voxel intensities in the GTV were generated: co-occurrence, run length, size zone, and neighborhood difference. From these, 39 textural features characterizing texture were calculated in addition to SUV histogram features. The percent variability among parameters was first calculated. Each reconstructed texture feature from baseline and intra-treatment per patient was normalized to the clinical baseline scan and compared using the Wilcoxon signed-rank test in order to isolate variations due to reconstruction parameters. Results: For the baseline scans, 13 texture features showed a mean range greater than 10%. For the intra scans, 28 texture features showed a mean range greater than 10%. Comparing baseline to intra scans, 25 texture features showed p <0.05. Conclusion: Variability due to different reconstruction parameters increased with treatment, however, the majority of texture features showed significant changes during treatment independent of reconstruction effects.

60 APPLIED LIFE SCIENCES↗

TU-H-BRA-05: A System Design for Integration of An Interior MRI and a Linear Accelerator

Purpose: MRI is a highly desirable modality to guide radiation therapy but it is difficult to combine a conventional MRI scanner directly with a linear accelerator (linac). An interior MRI (iMRI) concept has been proposed to acquire MRI images within a small field of view only covering targets and immediate surrounding tissues. The objective of this project is to design an interior MRI system to work with a linac using a magnet to provide a field around 0.2T in a cube of 20cm per side, and perform image reconstruction with a slightly inhomogeneous static magnetic fields. Methods: All the results are simulated using a commercially available software package, FARADY. In our design, a ring structure holds the iMRI system and also imbeds a linac treatment head. The ring is synchronized to the linac gantry rotation. Half of the ring is made of steel and becomes a magnetic flux return path (yoke) so that a strong magnetic field will be limited inside the iron circuit and fringe fields will be very weak. In order to increase the static magnetic field homogeneity, special steel magnet boots or tips were simulated. Three curved boots were designed based on two-dimensional curves: arc, parabola and hyperbola. Results: Different boot surfaces modify magnetic field distributions differently. With the same pair of neodymium-iron-boron (NdFeB) magnets, the magnetic induction at the centers are 0.217T, 0.201T, 0.204T, and 0.212T for flat, arc, parabola and hyperbola boots, respectively. The hyperbola boots lead to the most homogeneous results, the static magnetic field deviations are within 0.5% in a cube of 20cm, and can be further improved using shimming techniques. Conclusion: This study supports the concept of an iMRI design. Successful development of iMRI will provide crucial information for tumor delineation in radiation therapy.

43 PARTICLE ACCELERATORS↗

SU-E-T-80: Comparison of Fluence-Based RapidArc QAs Using EPID and MapCHECK 2

Purpose: To compare the Varian aS-1000 EPID imager to the isocentrically mounted MapCHECK 2 diode array for RapidArc QAs as a function of photon beam energy. Methods: A Varian TrueBeam STx with an aS-1000 digital imaging panel was used to acquire RapidArc QA images for 13 patient plans; each plan QA was performed at 6, 8, 10 and 15MV energies. The Portal Dose Image Prediction algorithm in the Varian Eclipse treatment planning system (TPS) was used to create the comparison image for the EPID acquisition. A Sun Nuclear MapCHECK 2 diode array on an isocentric mounting fixture with 5 cm water-equivalent buildup was also used for the RapidArc QAs. A composite dose plane was taken from the Eclipse TPS for comparison to the MapCHECK 2 measurements. A gamma test was implemented in the Sun Nuclear Patient software with 10% threshold and absolute comparison for both QA methods. The two-tailed paired t-test was employed to analyze the statistical significance between two methods at the 95% confidence level. Results: The average gamma passing rates were greater than 95% at 3%/3mm using both methods for all four energies. The average passing rates were within 2.5% and 1.1% of each other when analyzed at 2%/2mm and 3%/3mm conditions, respectively. The EPID passing rates were somewhat better than the MapCHECK 2 when analyzed at 1%/1mm condition; this difference decreased with increasing energy (9.1% at 6MV to 2.7% at 15MV). The differences were not statistically significant for all criteria and energies (p-value ã 0.05). Conclusion: EPID-based RapidArc QA results are comparable to MapCHECK 2 when using 3%/3mm criteria at all four energies. EPID-based QA shows potential for being the superior device under strict gamma criteria.

60 APPLIED LIFE SCIENCES↗

SU-D-204-07: Comparison of AAPM TG150 Draft Image Receptor Tests with Vendor Automated QC Tests for Five Mobile DR Units

Purpose: To determine the consistency of digital detector (DR) tests recommended by AAPM TG150 and tests provided by commercially available DirectView Total Quality Tool (TQT). Methods: The DR tests recommended by the TG150 Detector Subgroup[1] were performed on 4 new Carestream DRX-Revolution and one Carestream DRX1C retrofit of a GE AMX-4 that had been in service for three years. After detector calibration, flat-field images plus images of two bar patterns oriented parallel and perpendicular to the A-C axis, were acquired at conditions recommended by TG150. Raw images were harvested and then analyzed using a MATLAB software previously validated[2,3,4]. Data were analyzed using ROIs of two different dimensions: 1) 128 x 128 ROIs matching the detector electronics; and 2) 256 x 256 ROIs, each including 4 adjacent smaller ROIs. TG150 metrics from 128 x 128 ROIs were compared to TQT metrics, which are also obtained from 128 x 128 ROIs[5]. Results: The results show that both TG150 and TQT measurements were consistent among these detectors. Differences between TG150 and TQT values appear systematic. Compared with 128 x 128 ROIs, noise and SNR non-uniformity were lower with 256 x 256 ROIs, although signal non-uniformity was similar, indicating detectors were appropriately calibrated for gain and offset. MTF of the retrofit unit remained essentially the same between 2012 and 2015, but was inferior to the new units. The older generator focal spot is smaller (0.75mm vs. 1.2mm), and the SID for acquisition is 182cm as well, so focal spot dimensions cannot explain the difference. The difference in MTF may be secondary to differences in generator X-ray spectrum or by unannounced changes in detector architecture. Further investigation is needed. Conclusion: The study shows that both TG150 and TQT tests are consistent. The numerical value of some metrics are dependent on ROI size.

60 APPLIED LIFE SCIENCES↗

SU-E-J-272: Auto-Segmentation of Regions with Differentiating CT Numbers for Treatment Response Assessment

Purpose: It has been reported recently that the change of CT number (CTN) during and after radiation therapy (RT) may be used to assess RT response. The purpose of this work is to develop a tool to automatically segment the regions with differentiating CTN and/or with change of CTN in a series of CTs. Methods: A software tool was developed to identify regions with differentiating CTN using K-mean Cluster of CT numbers and to automatically delineate these regions using convex hull enclosing method. Pre- and Post-RT CT, PET, or MRI images acquired for sample lung and pancreatic cancer cases were used to test the software tool. K-mean cluster of CT numbers within the gross tumor volumes (GTVs) delineated based on PET SUV (standard uptake value of fludeoxyglucose) and/or MRI ADC (apparent diffusion coefficient) map was analyzed. The cluster centers with higher value were considered as active tumor volumes (ATV). The convex hull contours enclosing preset clusters were used to delineate these ATVs with color washed displays. The CTN defined ATVs were compared with the SUV- or ADC-defined ATVs. Results: CTN stability of the CT scanner used to acquire the CTs in this work is less than 1.5 Hounsfield Unit (HU) variation annually. K-mean cluster centers in the GTV have difference of ∼20 HU, much larger than variation due to CTN stability, for the lung cancer cases studied. The dice coefficient between the ATVs delineated based on convex hull enclosure of high CTN centers and the PET defined GTVs based on SUV cutoff value of 2.5 was 90(±5)%. Conclusion: A software tool was developed using K-mean cluster and convex hull contour to automatically segment high CTN regions which may not be identifiable using a simple threshold method. These CTN regions were reasonably overlapped with the PET or MRI defined GTVs.

60 APPLIED LIFE SCIENCES↗

Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, less EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose (<20% prescription dose) and high dose regions (>80% prescription dose) was calculated for each frame averaged scenario for each plan. The authors defined their unacceptable loss of accuracy as no more than a ±1% mean dose difference in the high dose region. Optimal frame average numbers were then determined as a function of the Linac’s average gantry speed and the dose per fraction. Results: The authors found that 9 and 11 frame averages were suitable for all VMAT and SBRT-VMAT treatments, respectively. This resulted in no more than a 1% loss to any of the dose region’s mean percentage difference when compared to the single frame reconstruction. The optimized number was dependent on the treatment’s dose per fraction and was determined to be as high as 14 for 12 Gy/fraction (fx), 15 for 8 Gy/fx, 11 for 6 Gy/fx, and 9 for 2 Gy/fx. Conclusions: The authors have determined an optimal EPID frame averaging number for multiple VMAT-type treatments. These are given as a function of the dose per fraction and average gantry speed. These optimized values are now used in the authors’ clinical, 3D, in vivo patient dosimetry program. This provides a reduction in calculation time while maintaining the authors’ required level of accuracy in the dose reconstruction.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-F-T-47: MRI T2 Exclusive Based Planning Using the Endocavitary/interstitial Gynecological Benidorm Applicator: A Proposed TPS Library and Preplan Efficient Methodology

Purpose: ABS and GEC-ESTRO have recommended MRI T2 for image guided brachytherapy. Recently, a new applicator (Benidorm Template, TB) has been developed in our Department (Rodriguez et al 2015). TB is fully MRI compatible because the Titanium needles and it allows the use of intrauterine tandem. Currently, TPS applicators library are not currently available for non-rigid applicators in case of interstitial component as the TB.The purpose of this work is to present the development of a library for the TB, together with its use on a pre-planning technique. Both new goals allow a very efficient and exclusive T2 MRI based planning clinical TB implementation. Methods: The developed library has been implemented in Oncentra Brachytherapy TPS, version 4.3.0 (Elekta) and now is being implemented on Sagiplan v 2.0 TPS (Eckert&Ziegler BEBIG). To model the TB, free and open software named FreeCAD and MeshLab have been used. The reconstruction process is based on three inserted A-vitamin pellets together with the data provided by the free length. The implemented preplanning procedure is as follow: 1) A MRI T2 acquisition is performed with the template in place just with the vaginal cylinder (no uterine tube nor needles). 2) The CTV is drawn and the required needles are selected using a developed Java based application and 3) A post-implant MRI T2 is performed. Results: This library procedure has been successfully applied by now in 25 patients. In this work the use of the developed library will be illustrated with clinical examples. The preplanning procedure has been applied by now in 6 patients, having significant advantages: needle depth estimation, needle positions and number are optimized a priori, time saving, etc Conclusion: TB library and pre-plan techniques are feasible and very efficient and their use will be illustrated in this work.

60 APPLIED LIFE SCIENCES↗

SU-F-BRF-04: Evaluation of Five Commercially-Available Algorithms for Deformable Image Registration

Purpose: Deformable image registration (DIR) is increasingly being used in various clinical applications. Although there are several DIR packages all making successful attempts at modeling complex anatomical changes using even more complex mathematical approximations, they are all subject to various uncertainties. Many studies have attempted to quantify the spatial uncertainty with DIR. This is the first study to compare the uncertainty for interfraction DIR for 5 different commercially-available algorithms. The aim of this study was to benchmark the performance of the most commonlyused DIR algorithms offered through these 5 software packages: Eclipse, MIM, Pinnacle, RaySearch, and Velocity. Methods: A set of 10 virtual H'N phantoms [Pukala et al. MedPhys. 40(11) 2013] with known deformations were used to determine the spatial errors that might be seen when performing DIR. The “ground-truth” deformation vector field (DVF) was compared to the DVF output of the 5 commercially-available algorithms in order to evaluate spatial errors for six regions of interest (ROIs): brainstem, cord, mandible, left parotid, right parotid, and the external body contour. Results: We found that each software package had varying uncertainties with the various ROIs, but were generally all comparable to one another – with mean spatial errors for each algorithm below 3.5 mm for each ROI (averaged across all phantoms). We also found that no single algorithm was the clear winner over the other 4 algorithms. However, at times, we found huge maximum errors in our results (e.g. phantom #9 maximum errors: right parotid = 22.9 mm, external contour = 30.5mm) with the varying DIR algorithms. Conclusion: Although our evaluation was limited to H'N patients, we show that our methods are a single-assessment analysis tool that could be used by any physicist, within any type of facility, to compare their DIR software before initiating widespread use within their daily radiotherapy practice.

60 APPLIED LIFE SCIENCES↗

SU-D-18A-02: Towards Real-Time On-Board Volumetric Image Reconstruction for Intrafraction Target Verification in Radiation Therapy

Purpose: To expedite on-board volumetric image reconstruction from limited-angle kV—MV projections for intrafraction verification. Methods: A limited-angle intrafraction verification (LIVE) system has recently been developed for real-time volumetric verification of moving targets, using limited-angle kV—MV projections. Currently, it is challenged by the intensive computational load of the prior-knowledge-based reconstruction method. To accelerate LIVE, we restructure the software pipeline to make it adaptable to model and algorithm parameter changes, while enabling efficient utilization of rapidly advancing, modern computer architectures. In particular, an innovative two-level parallelization scheme has been designed: At the macroscopic level, data and operations are adaptively partitioned, taking into account algorithmic parameters and the processing capacity or constraints of underlying hardware. The control and data flows of the pipeline are scheduled in such a way as to maximize operation concurrency and minimize total processing time. At the microscopic level, the partitioned functions act as independent modules, operating on data partitions in parallel. Each module is pre-parallelized and optimized for multi-core processors (CPUs) and graphics processing units (GPUs). Results: We present results from a parallel prototype, where most of the controls and module parallelization are carried out via Matlab and its Parallel Computing Toolbox. The reconstruction is 5 times faster on a data-set of twice the size, compared to recently reported results, without compromising on algorithmic optimization control. Conclusion: The prototype implementation and its results have served to assess the efficacy of our system concept. While a production implementation will yield much higher processing rates by approaching full-capacity utilization of CPUs and GPUs, some mutual constraints between algorithmic flow and architecture specifics remain. Based on a careful analysis of the prototype performance, it will be feasible to resolve such issues through appropriate algorithmic modifications or special-purpose hardware, thus enabling target verification in seconds with the LIVE system. This work was partially supported by a research grant from Varian Medical Systems.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TU-CD-BRA-04: Evaluation of An Atlas-Based Segmentation Method for Prostate and Peripheral Zone Regions On MRI

Purpose: Prostate MRI plays an important role in diagnosis, biopsy guidance, and therapy planning for prostate cancer. Prostate MRI contours can be used to aid in image fusion for ultrasound biopsy guidance and delivery of radiation. Our goal in this study is to evaluate an automatic atlas-based segmentation method for generating prostate and peripheral zone (PZ) contours on MRI. Methods: T2-weighted MRIs were acquired on 3T-Discovery MR750 System (GE, Milwaukee). The Volumes of Interest (VOIs): prostate and PZ were outlined by an expert radiation oncologist and used to create an atlas library for atlas-based segmentation. The atlas-segmentation accuracy was evaluated using a leave-one-out analysis. The method involved automatically finding the atlas subject that best matched the test subject followed by a normalized intensity-based free-form deformable registration of the atlas subject to the test subject. The prostate and PZ contours were transformed to the test subject using the same deformation. For each test subject the three best matches were used and the final contour was combined using Majority Vote. The atlas-segmentation process was fully automatic. Dice similarity coefficients (DSC) and mean Hausdorff values were used for comparison. Results: VOIs contours were available for 28 subjects. For the prostate, the atlas-based segmentation method resulted in an average DSC of 0.88+/−0.08 and a mean Hausdorff distance of 1.1+/−0.9mm. The number of patients (#) in DSC ranges are as follows: 0.60–0.69(1), 0.70–0.79(2), 0.80–0.89(13), >0.89(11). For the PZ, the average DSC was 0.72+/−0.17 and average Hausdorff of 0.9+/−0.9mm. The number of patients (#) in DSC ranges are as follows: <0.60(4), 0.60–0.69(6), 0.70–0.79(7), 0.80–0.89(9), >0.89(1). Conclusion: The MRI atlas-based segmentation method achieved good results for both the whole prostate and PZ compared to expert defined VOIs. The technique is fast, fully automatic, and has the potential to provide significant time savings for prostate VOI definition. AS Nelson and J Piper are partial owners of MIM Software, Inc. AS Nelson, J Piper, K Curry, and A Swallen are current employees at MIM Software, Inc.

60 APPLIED LIFE SCIENCES↗