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At least 307 records · Page 17

Dentalmaps: Automatic Dental Delineation for Radiotherapy Planning in Head-and-Neck Cancer

Purpose: To propose an automatic atlas-based segmentation framework of the dental structures, called Dentalmaps, and to assess its accuracy and relevance to guide dental care in the context of intensity-modulated radiotherapy. Methods and Materials: A multi-atlas-based segmentation, less sensitive to artifacts than previously published head-and-neck segmentation methods, was used. The manual segmentations of a 21-patient database were first deformed onto the query using nonlinear registrations with the training images and then fused to estimate the consensus segmentation of the query. Results: The framework was evaluated with a leave-one-out protocol. The maximum doses estimated using manual contours were considered as ground truth and compared with the maximum doses estimated using automatic contours. The dose estimation error was within 2-Gy accuracy in 75% of cases (with a median of 0.9 Gy), whereas it was within 2-Gy accuracy in 30% of cases only with the visual estimation method without any contour, which is the routine practice procedure. Conclusions: Dose estimates using this framework were more accurate than visual estimates without dental contour. Dentalmaps represents a useful documentation and communication tool between radiation oncologists and dentists in routine practice. Prospective multicenter assessment is underway on patients extrinsic to the database.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the Postoperative Treatment of Pancreatic Head Cancer

Purpose: To develop contouring guidelines to be used in the Radiation Therapy Oncology Group protocol 0848, a Phase III randomized trial evaluating the benefit of adjuvant chemoradiation in patients with resected head of pancreas cancer. Methods and Materials: A consensus committee of six radiation oncologists with expertise in gastrointestinal radiotherapy developed stepwise contouring guidelines and an atlas for the delineation of the clinical target volume (CTV) in the postoperative treatment of pancreas cancer, based on identifiable regions of interest and margin expansions. Areas at risk for subclinical disease to be included in the CTV were defined, including nodal regions, anastomoses, and the preoperative primary tumor location. Regions of interest that could be reproducibly contoured on postoperative imaging after a pancreaticoduodenectomy were identified. Standardized expansion margins to encompass areas at risk were developed after multiple iterations to determine the optimal margin expansions. Results: New contouring recommendations based on CT anatomy were established. Written guidelines for the delineation of the postoperative CTV and normal tissues, as well as a Web-based atlas, were developed. Conclusions: The postoperative abdomen has been a difficult area for effective radiotherapy. These new guidelines will help physicians create fields that better encompass areas at risk and minimize dose to normal tissues.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Insight into SEI Growth in Li-Ion Batteries using Molecular Dynamics and Accelerated Chemical Reactions

The performance of lithium-ion batteries (LIB) using organic electrolytes strongly depends on the formation of a stable solid electrolyte interphase (SEI) film. Elucidating the dynamic evolution and spatial composition of the SEI can be very useful to study the stability of SEI components and help optimize the formation cycles of LIB. We propose a classical molecular dynamics simulation protocol for predicting the first stages of SEI formation using a reaction method involving the decomposition of EC and LiPF 6 molecules in the electrolyte. We accelerate the formation of SEI components near the anode surface by increasing the probability of reactions, implemented through a geometry matching scheme, followed by a force-field reconfiguration. We observe the formation of gases (C 2 H 4 ), inorganic (Li 2 CO 3 and LiF) and organic (LEDC) components. Finally, this protocol shows promise to be able to evaluate the effects of varying electrolyte compositions and additives on SEI layer structure and composition.

25 ENERGY STORAGE↗

Accelerated Carbon and Water Cycles in the Amazon and Congo Basins Revealed From TRENDY Models and Remote Sensing Products

Tropical forests play a vital role in the global carbon cycle and land–atmosphere interactions. Estimating tropical forest carbon–water dynamics is challenging due to observational and modeling uncertainties. This study leverages the “Trends and drivers of the regional scale terrestrial sources and sinks of carbon dioxide” (TRENDY) project models and satellite observations to assess changes (2003–2021) in vegetation carbon, gross primary production (GPP), evapotranspiration (ET), and net biosphere production (NBP) in the Amazon and Congo. Atmospheric CO 2 , climate variability, and land use and land cover changes constrain these variables between 1700 and 2021 with the overall increasing trends of carbon stock and fluxes. The models overestimate vegetation carbon and GPP, while ET and NBP are consistent with observations. Fire-activated models predict lower values for vegetation carbon and GPP, ET, and NBP, aligning more closely with observations. The higher ET from fire-activated models may result from enhanced soil evaporation due to increased canopy openings. Fire-inactivated models could well estimate the magnitudes of NBP. The high vegetation carbon in nitrogen-enabled models points to simulation uncertainties and imbalance in model numbers regarding the nitrogen cycle. Although the nitrogen cycle enhances water use efficiency in both the Amazon and Congo, the models show a higher sensitivity to the nitrogen cycle in the Congo. This study highlights the challenges in accurately representing tropical biogeochemical cycles and the values of satellite products in model evaluations, underscoring the need for standard modeling protocols that address biogeochemical components (e.g., nutrient cycles) to better resolve process-based representations.

Shi, Mingjie [Pacific Northwest National Laborator↗

Toward an AI-Powered Software Pipeline for Real-Time Tracking and Analysis of Wildfire and Smoke

Real-time tracking of wildfires and smoke is crucial for effective response, minimizing damage, protecting lives, and efficiently managing resources during fire emergencies. We develop a web-based AI-powered pipeline that detects wildfires in aerial video and estimates deployment-relevant behavior metrics, including cumulative burned area, burned-area growth rate, fire spread direction, and smoke dispersion. The system combines a YOLO-based detector with YCbCr-based fire segmentation, HSV-based smoke segmentation, Farneback optical flow, and centroid-based spatiotemporal tracking. Using ground sampling distance (GSD), pixel-level fire masks are converted to physical burned-area measurements by correlating fire pixel counts with camera altitude and tilt angle. We benchmark YOLO variants and non-YOLO baselines (GoogLeNet, CNN, DBN, Autoencoder, U-Net, and AlexNet) on the IEEE FLAME dataset and a newly created aerial frame dataset, Wildfire-DB. Cross-dataset evaluation uses a strict threshold-transfer protocol: decision thresholds are selected on FLAME validation and transferred unchanged to Wildfire-DB to quantify generalization under domain shift. YOLOv6 achieves the strongest cross-dataset frame-level fire detection on Wildfire-DB (ROC-AUC 0.8200, PR-AUC 0.8044, and transferred-threshold F1 0.7596). For tracking-oriented deployment requiring oriented localization, YOLO11-OBB provides the most reliable cross-dataset behavior among OBB-capable models while remaining computationally feasible. To analyze the feasibility of UAV deployment, we further measure inference efficiency using synchronized GPU and CPU power logs on a fixed workload of 1569 frames. YOLO-family models process the video in 5.73–12.47 seconds with net energy of 1247.28–1775.39 J, substantially lower latency and energy than heavier classification and reconstruction baselines. Overall, model optimality depends on operational objectives: YOLOv6 is best for cross-dataset detection robustness, whereas YOL...

Color segmentation↗

Omics-Lethal Human Viruses, MERS-CoV Experiment MCL003

The purpose of this experiment was to evaluate the human host response to wild-type icMERS-CoV virus infection and mockulum. Sample data was obtained from human lung adenocarcinoma cells (Calu-3) for proteome, metabolome, and lipidome expression analysis. Resulting quantitative data profiles were evaluated for extreme outlier behavior using MPLEX protocol. Secondary host-associated viral dataset downloads contain one or more statistically processed (normalization data transformation) quantitative dataset collections resulting in qualitative expression analyses of primary host-pathogen experimental study designs. Leveraging unique high-resolution Omics capabilities for proteomics, metabolomics, and lipidomics dataset download each have a direct relationship to a primary sample submission corresponding to a specific MERS-CoV virus infection.

59 BASIC BIOLOGICAL SCIENCES↗

Advancing Development of Emissions Detection (Final Report)

This document is the final report to the U.S. Department of Energy (DOE for contract DE-FE0031873) awarded to Colorado State University (CSU). CSU and partners at Harrisburg University of Science and Technology, University of Texas Arlington, and University of Texas at Austin organized several testing rounds to provide knowledge focused on advancing the detection capabilities of emissions monitoring devices. With this funding opportunity the research group began by establishing the Advancing the Development of Emission Detection (ADED) program, with the goal focused on enhancing the accuracy, reliability, and field applicability of methane detection technologies. This effort aimed to address the critical challenges of identifying and quantifying methane emissions while enabling industry stakeholders to meet regulatory compliance and environmental sustainability goals. The program engaged with industry, government, and technology stakeholders to promote adoption and consensus on testing techniques for methane detection solutions. Methane, a potent greenhouse gas, contributes significantly to global warming, and the oil and natural gas (O&G) sector is a primary source of methane emissions. Regulatory measures such as leak detection and repair (LDAR) programs have been implemented to address emissions. However, traditional LDAR approaches, reliant on handheld and component-level measurements, are resource-intensive. To address these limitations and move with evolving regulations, advanced methane technologies are emerging. These solutions include ground-based sensors, mobile systems (e.g., drones, vehicles, and aircraft), and satellite-based platforms. They offer innovative capabilities for autonomous monitoring, larger spatial coverage, and emission quantification using methods such as tracer gas techniques and inverse modeling with Gaussian plume analysis. The ADED program began with creating protocols for methane controlled release (CR) testing these continuous monitoring (CM) and survey technologies that detect and monitor methane emissions at O&G facilities. The protocols were then implemented throughout testing of CM and survey devices at CSU’s Methane Emissions Technology Evaluation Center (METEC) facility from 2021 through 2024. As apart of the protocol, solutions that tested under the ADED program installed their solutions at METEC, documented their system under test, and provided detection reports to the METEC team for analysis. The METEC team would provide the solutions with analyzed reports of their emissions and ground truth data of the releases conducted during their testing session. Under the ADED program, CMs were also tested at O&G facilities for a six week test run of challenge release (ChR) releases. The findings from the ADED program underscore the critical role of collaborative research and innovation in tackling methane emissions, offering a pathway for the oil and gas sector to achieve significant environmental and economic benefits. Results from METEC testing saw improvement of performance and accuracy across all solutions over the extent of the ADED experiments. The results also showed a variance in CM solution performance between CRs and ChRs. That variance pushed the team to further analyze the differences between CR testing environments and field conditions. With the drive from regulations and that variance in field conditions, the ADED team began designing a new CR testing protocol and additions to the METEC testing facility. The METEC team is furthering the progress made through the ADED program with awarded funding from DE-FE0032276. This funding pushes the development of METEC’s addition with new equipment, allowing for an updated facility layout. METEC still facilitates for traditional facilities, with a legacy pad, while expanding an new design based on how O&G infrastructure has Final Report - Contract Number: DE-FE0031873 been changed over the last decade. Throughout the ADED program the team has also been working with international partners to ensure staying in the trend globally. International partners have been essential in moving the new protocol forward to implement into CR testing at the METEC facility in Spring 2025.

42 ENGINEERING↗

Towards philosophical reasoning with agentic LLMs: Socratic method for scientific assistance

As large language models (LLMs) become central tools in science, improving their reasoning capabilities is critical for meaningful and trustworthy applications. We introduce a Socratic agent for scientific reasoning, implemented through a structured system prompt that guides LLMs via classical principles of inquiry. Unlike typical prompt engineering or retrieval-based methods, our approach leverages definition, analogy, hypothesis elimination, and other Socratic techniques to generate more coherent, critical, and domain-aware responses. We evaluate the agent across diverse scientific domains and benchmark it on the abstraction and reasoning corpus challenge dataset, achieving 97.15% under a fixed prompting protocol and without fine-tuning or external tools. Expert evaluation shows improved reasoning depth, clarity, and adaptability over conventional LLM outputs, suggesting that structured prompting rooted in philosophical reasoning can improve the scientific utility of language models.

LLM reasoning↗

Field Validation of Thermoelectric Generation System at Holcim Cement Plant in Alpena, Michigan

Executive Summary Project Background The Industrial Technology Validation (ITV) program aims to identify and demonstrate the performance of new, emerging, and underutilized energy-saving technologies in the industrial sector to help inform decisions to help accelerate their commercialization and deployment, as well as to help make industries more competitive. This ITV demonstration evaluated a thermoelectric generation (TEG) technology at a cement plant, aiming to reduce energy demand in the cement industry. A median cement plant consumes 5.73 million British thermal units per ton of clinker production (resulting in 0.838 metric tons of carbon dioxide [CO₂] emissions per ton of clinker) (Boyd and Zhang 2011, EPA 2021), equivalent to approximately 6.9 trillion British thermal units (TBtu) per year in energy consumption at a cement plant producing 3,300 tons of clinker per day.¹ Collaborating with Holcim, Advanced Thermovoltaic Systems (ATS) developed and deployed a pilot-scale thermoelectric power system to efficiently capture and convert waste heat to electricity. The system leverages the Seebeck effect to convert temperature differences on two sides of semiconductor cartridges into electrical power (ScienceDirect, n.d.). This generation is realized with minimal moving parts compared to existing waste-heat-to-generation solutions and allows capture from heat sources with temperatures as low as 150°C. This project aimed to validate a scalable solution applicable for capturing medium-temperature waste heat, including ambient losses from other high-temperature processes, and high-temperature sources less suitable for other waste-heat-to-power solutions. By recovering this otherwise wasted heat, this project intends to validate improvements to overall process efficiency through reduction in purchased electricity, thereby reducing operational costs while enhancing resiliency and competitiveness. Description and Scope This study evaluated the performance of a TEG system from ATS as a solution to convert waste heat into useful power at a Holcim cement plant in Alpena, Michigan. This plant is a fully integrated cement plant that has been operating since 1907. The facility operates continuously (24/7/365) with approximately 250 employees and five long dry kilns, yielding a total production capacity of 7,852 tons of cement per day (EPA 2023). Currently, the Alpena plant uses waste heat boilers to convert waste heat from the exhaust of each kiln into steam, which drives steam turbine generators. The ATS TEG is being evaluated for its potential to supplement the steam turbines by capturing the remaining lower grade heat. This technology is also being considered for other Holcim plants where steam turbines are not a viable option. ATS installed a pilot-scale TEG unit with an array of 582 individual thermoelectric semiconductor cartridges, of which 573 were operational. The cartridges are sandwiched between 48 hot plates and 49 cold plates. Each cartridge is designed to generate 20 watts (W) of gross power at a hot-side temperature of 240°C and cold-side temperature of 20°C. As such, the total gross generation capacity of the installed system is 11.5 kilowatts (kW) at design conditions. The system configuration for the evaluation was designed to prioritize convenience of installation and minimize disruption to production at the site, while ensuring that the heat required can be obtained for evaluating the TEG system at various operational conditions. To accomplish this, a portion of the steam supplied to Alpena’s steam turbine generation system was diverted to be used as the heat source for the TEG system, while water was supplied to the cold side of the system from nearby Lake Huron. This configuration was designed for the evaluation of the pilot-scale system to assess the performance at different conditions. A commercial-scale system will likely vary from the pilot system depending on typical configurations, including both scale and application. Future commercial applications of the ATS system would involve integrating the system into the exhaust from kiln preheaters, clinker coolers, or radiant heat capture from kiln shells for the heat source. For the cold source, a range of cooling solutions can be considered, including a mechanical cooling system, depending on the location and the application. To increase the generation capacity for commercial applications, the technology provider is working toward developing a commercial-scale TEG system, which would combine multiple TEG units (each similar in design to the pilot system) together. The scope of this evaluation includes the pilot-scale TEG system and all impacted equipment including pumps, controllers, and power handling equipment. Study Objectives The evaluation's goal was to assess the potential of the ATS TEG system to generate useful electrical power by capturing waste heat from cement production kilns. The objectives of this study are to evaluate and verify the following claims made by ATS regarding the pilot-scale system installed at the Holcim Alpena plant. The following design parameters and claims are also outlined in Table ES- 1 and Table ES- 2: • Gross Power: The thermoelectric system converts heat into power to create gross power, the total measured power generated by the system. The 573 active cartridge pilot-scale system is expected to generate 11.5 kW of gross power at the designed hot-side temperature of 240°C and cold-side temperature of 20°C. Power production is dependent on the temperature difference between the heat source (ultimately from the waste heat) and cold temperature supply source. • Net Power: The net power is the total usable power provided to the site by the TEG system after deducting parasitic power loads from the gross generated power. Supplementary equipment is required to operate the TEG system including pumps, controllers, and, in certain anticipated applications, mechanical cooling, which introduce parasitic loads to system operation. After deducting the parasitic loads from the gross power generation, ATS anticipates achieving a net power generation of 7.5 kW from the pilot-scale system. • Thermal Efficiency: The thermal efficiency is the percent of the total heat transferred to the TEG system that is converted to gross power. Historically, TEGs have a thermal efficiency of 2%–5% (DOE 2008). Prior industrial-scale TEG systems, such as the E1 TEG offered by Alphabet Energy, operated at an efficiency of 2.5% (Lamonica, 2014). ATS anticipates achieving an average efficiency of 4.8% or higher in converting heat energy to usable electricity. • Cartridge Performance: The TEG system comprises 573 active individual semiconductor cartridges, each of which generates a portion of the total power. Cartridge optimization and selection is an important design consideration for potential future TEG system design performance. Therefore, understanding the distribution of gross power and efficiency within the pilot system is vital to understanding what is achievable. At a design hot-side temperature of 240°C and cold-side temperature of 20°C, ATS anticipates a cartridge performance of 20 W of gross power per cartridge at an efficiency of 4.8% per cartridge. In addition to evaluating the claimed performance of the TEG pilot-scale unit, the study estimated the potential annual impacts of a scaled-up commercial system used to capture kiln waste heat over annual operations. The evaluation estimated the gross and net annual electric generation achievable by capturing heat from the two proposed tap-in points: the kiln exhaust and the clinker cooler exhaust; see Section 2.1 for details. Two use cases were examined: • Holcim Alpena: The Holcim Alpena site consists of long dry kilns with superheater boilers, which differs from the rest of Holcim’s cement plant portfolio and results in lower waste heat temperatures. The study estimates gross and net annual generation using the superheater boiler exhaust and clinker cooler exhaust, based on 2023 operational data. • Typical Installation: Common cement plants have preheater kilns with higher exhaust temperatures than Holcim Alpena across a range of production rates. The study estimates gross and net annual generation using the preheater exhaust and clinker cooler exhaust, with a sensitivity analysis to account for the typical range of preheater exhaust temperatures, clinker cooler exhaust temperatures, and clinker production rates. Methodology The evaluation methodology followed a measurement and verification (M&V) strategy based on the International Performance Measurement and Verification Protocol Option B through comprehensive measurements and analyses of the affected systems. Evaluation data was collected from March 9 to March 11, 2024, the test period of the pilot TEG system. During the test period, in coordination with the ITV team, the ATS team adjusted system operations to capture the range of variability expected for each of the variables pertinent to performance of the system. The methodology consisted of two parts: evaluating the performance of the pilot unit's TEG system and estimating the annual TEG impact in terms of gross and net power based on a given waste heat profile. First, the evaluation of the thermoelectric generation performance of the pilot unit relative to the claims was performed by analyzing the collected test data. Gross power of the pilot TEG system was directly measured. Net power was determined by deducting the measured parasitic power from the gross power. The gross power generation was compared to heat transferred to the system by the working fluid (which was heated by steam generated from the kiln waste heat) to calculate the thermal efficiency achieved by the system. Performance of individual semiconductor cartridges within the pilot array was also assessed in terms of measured gross cartridge power and calculated cartridge thermal efficiency. The second part of the evaluation estimated the annual TEG impacts in terms of gross power and net power (calculated from the difference between gross power and parasitic power). This analysis comprised development of mathematical regression models for gross power and parasitic power, with assessment of each model’s goodness-of-fit characteristics to ensure satisfaction of statistical requirements. The models predicted the gross power generation, the parasitic load based on the temperature difference between the hot working fluid and the cold-side fluid (cold water from Lake Huron) entering the system, the volumetric flow rate of the cold-side fluid at the inlet, and the volumetric flow rate of the hot working fluid at the inlet. The annual impact analysis considered a theoretical commercial-scale system sized to capture the available waste heat at a cement plant, consisting of linked pilot-scale units that receive heat from a theoretical gas-to-working-fluid heat exchanger. To estimate annual impacts at the Alpena plant, the gross power and parasitic power regression models were applied to the arrays in the theoretical commercial-scale system. The heat supplied to the unit was calculated based on the kiln run time, annual production, kiln exhaust waste heat, and clinker cooler waste heat derived from 2023 Holcim Alpena kiln operational data. Net power impacts were calculated by deducting the resulting parasitic power from the estimated gross power. Inputs for the model were generated from a combination of hourly data, assumed design considerations for TEG system scale-up from the pilot-scale unit, and assumptions regarding TEG system operations. This analysis was then used as the basis for estimating annual impacts of typical TEG installation at cement plants, by applying sensitivity analyses to key kiln operational characteristics including kiln preheater exhaust temperatures, cooler clinker exhaust temperatures, and plant daily production rates across a range of expected values. Project Results/Findings Table ES- 2 and Table ES- 2 provide a summary of the operating conditions and evaluation results compared to the stated claims from the technology provider. Key takeaways include: • Gross Power: The peak gross power achieved during the testing period was 10.0 kW, compared to the 11.5 kW expected for 573 active cartridges. The claimed gross power was associated with a target hot side of 240°C; however, the system only received a maximum hot-side mean plate temperature of 212°C during the testing period. • Net Power: The pilot-scale unit exceeded the claims for net power, achieving a peak of 7.7 kW net compared to a claim of 7.5 kW. One factor contributing to the higher achieved net power is the relatively high water pressure available through Lake Huron. The pilot TEG system did not require cold-side pumps during the test, whereas most installations would. This reduced the parasitic loads on the system, ultimately contributing to higher net power relative to the gross power. • Thermal Efficiency: The pilot-scale unit outperformed the claimed efficiency, achieving a peak system efficiency of 5.0% thermal efficiency compared to the stated 4.8%. • Cartridge Performance: To compare cartridge performance against claims, the study focused on the third day of testing, which aimed for conditions closest to the design specifications, with a hot side of 240°C and cold-side exit temperature of 6.4°–30°C. On this day, the mean gross power observed in the cartridges within the TEG array was 18.1 W/cartridge, and the peak performance was 34.7 W/cartridge. The estimated mean cartridge efficiency was 5.2%, and the estimated efficiency at peak gross cartridge power was 10%. The regression models developed for gross power generation and parasitic loads were used to estimate the generation impact for given heat input to the TEG from the working fluid (captured from the waste heat) and from the cold loop (Lake Huron) on an hourly basis for a year of operation. Based on this analysis, installation of a commercial-scale TEG system at the Holcim cement plant in Alpena, Michigan, with a waste heat exchanger of 0.85 effectiveness, would generate up to 391 kW of net power, translating to between 920,000 and 1,800,000 kilowatt-hours (kWh) in net electricity per year. Based on typical grid emissions for Alpena, this would avoid estimated net emissions by 752 metric tons of CO₂ annually.² The sensitivity analysis estimated that typical TEG system installations at cement plants could generate an average of 56–1,040 kW of net power, or between 488,000 and 9,110,000 kWh of net energy. This generation potential is most significantly affected by plant production rates and also influenced by preheater and clinker cooler exhaust temperatures. Applying the national average emission rate, typical commercial-scale installations at Holcim plants are projected to avoid between 182 and 3,401 metric tons of CO₂ annually per site. Table ES- 3 shows a summary of the estimated annual impacts.³ While parasitic loads are significant and vary by application, this analysis assumed the use of heating loop pumps and access to Lake Huron as a cold sink. This setup assumed no need for cooling loop pumps due to the available water pressure at the test site. Applications that require cooling towers or additional equipment are likely to experience higher parasitic loads. Therefore, the study’s estimates are most applicable to scenarios with similar parasitic load configurations—namely, access to a high-pressure cold sink. Applicability to other locations may be limited, as differing conditions could necessitate additional pumps and cooling systems, potentially impacting performance significantly.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

TU-E-201-03: Eye Lens Dosimetry in Radiotherapy Using Contact Lens-Shaped Applicator

Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on awareness can lead to avoidance or even prevention. Learning Objectives: To understand recent changes in eye lens dose limits and thresholds for tissue reactions To understand different approaches to dose estimation for eye lens To learn about challenges in eye lens opacities among staff in interventional fluoroscopy Di Zhang, Toshiba America Medical Systems, Tustin, CA, USA Eye lens radiation dose from brain perfusion CT exams CT perfusion imaging requires repeatedly exposing one location of the head to monitor the uptake and washout of iodinated contrast. The accumulated radiation dose to the eye lens can be high, leading to concerns about potential radiation injury from these scans. CTDIvol assumes continuous z coverage and can overestimate eye lens dose in CT perfusion scans where the table do not increment. The radiation dose to the eye lens from clinical CT brain perfusion studies can be estimated using Monte Carlo simulation methods on voxelized patient models. MDCT scanners from four major manufacturers were simulated and the eye lens doses were estimated using the AAPM posted clinical protocols. They were also compared to CTDIvol values to evaluate the overestimation from CTDIvol. The efficacy of eye lens dose reduction techniques such as tilting the gantry and moving the scan location away from the eyelens were also investigated. Eye lens dose ranged from 81 mGy to 279 mGy, depending on the scanner and protocol used. It is between 59% and 63% of the CTDIvol values reported by the scanners. The eye lens dose is significantly reduced when the eye lenses were not directly irradiated. CTDIvol should not be interpreted as patient dose; this study has shown it to overestimate dose to the eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy. Learning Objectives: To become familiar with method of eye dose estimation for patient in specific situation of brain perfusion CT To become familiar with level of eye lens radiation doses in patients undergoing brain perfusion MDCT To understand methods for reducing eye lens dose to patient Jong Min Park, Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea Eye lens dosimetry in radiotherapy using contact lens-shaped applicator Dose calculation accuracy of commercial treatment planning systems is relatively low at shallow depths. Therefore, in-vivo measurements are often performed in the clinic to verify delivered doses to eye lens which are located at shallow depth. Current in-vivo dosimetry for eye lens during radiotherapy is generally performed with small in-vivo dosimeters on the surface of patient eyelid. Since this procedure potentially contains considerable uncertainty, a contact lens-shaped applicator made of acrylic (lens applicator) was developed for in-vivo measurements of eye lens dose during radiotherapy to reduce uncertainty. The lens applicator allows the insertion of commercially available metal oxide semiconductor field effect transistor (MOSFET) dosimeters. Computed tomography (CT) images of an anthropomorphic phantom with and without the lens applicator were acquired. A total of 20 VMAT plans were delivered to an anthropomorphic phantom and the doses with the lens applicator and the doses at the surface of the eyelid were measured using both micro and standard MOSFET dosimeters. The differences in measured dose at the surface of the eyelid from the calculated lens dose were acquired. The differences between the measured and the calculated doses at the lens applicator, as well as the differences between the measured and the calculated doses at the surface of the eyelid were acquired. The statistical significance of the differences was analyzed. The average difference between the measured and the calculated dose with the lens applicator was 16.8 % ± 10.4 % with a micro MOSFET dosimeter and 16.6 % ± 10.9% with a standard MOSFET dosimeter. The average difference without the lens applicator was 35.9% ± 41.5% with micro MOSFET dosimeter and 42.9% ± 52.2% with standard MOSFET dosimeter. The maximum difference with micro MOSFET dosimeter was 46% with the applicator and 188.4% without the applicator. For the standard MOSFET dosimeter, the maximum difference was 44.4% with the applicator and 246.4% without the applicator. The lens applicator allowed reduction of the differences between the calculated and the measured dose during in-vivo measurement for the eye lens as compared to in-vivo measurement at the surface of the eyelid. Learning Objectives: To understand limitations of dose calculation with commercial treatment planning system for eye lens during radiotherapy To learn about current in-vivo dosimetry methods for eye lens in the clinic To understand limitations of in-vivo dosimetry for eye lens during radiotherapy Di Zhang is an employee of Toshiba America Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-E-201-00: Eye Lens Dosimetry for Patients and Staff

Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on awareness can lead to avoidance or even prevention. Learning Objectives: To understand recent changes in eye lens dose limits and thresholds for tissue reactions To understand different approaches to dose estimation for eye lens To learn about challenges in eye lens opacities among staff in interventional fluoroscopy Di Zhang, Toshiba America Medical Systems, Tustin, CA, USA Eye lens radiation dose from brain perfusion CT exams CT perfusion imaging requires repeatedly exposing one location of the head to monitor the uptake and washout of iodinated contrast. The accumulated radiation dose to the eye lens can be high, leading to concerns about potential radiation injury from these scans. CTDIvol assumes continuous z coverage and can overestimate eye lens dose in CT perfusion scans where the table do not increment. The radiation dose to the eye lens from clinical CT brain perfusion studies can be estimated using Monte Carlo simulation methods on voxelized patient models. MDCT scanners from four major manufacturers were simulated and the eye lens doses were estimated using the AAPM posted clinical protocols. They were also compared to CTDIvol values to evaluate the overestimation from CTDIvol. The efficacy of eye lens dose reduction techniques such as tilting the gantry and moving the scan location away from the eyelens were also investigated. Eye lens dose ranged from 81 mGy to 279 mGy, depending on the scanner and protocol used. It is between 59% and 63% of the CTDIvol values reported by the scanners. The eye lens dose is significantly reduced when the eye lenses were not directly irradiated. CTDIvol should not be interpreted as patient dose; this study has shown it to overestimate dose to the eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy. Learning Objectives: To become familiar with method of eye dose estimation for patient in specific situation of brain perfusion CT To become familiar with level of eye lens radiation doses in patients undergoing brain perfusion MDCT To understand methods for reducing eye lens dose to patient Jong Min Park, Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea Eye lens dosimetry in radiotherapy using contact lens-shaped applicator Dose calculation accuracy of commercial treatment planning systems is relatively low at shallow depths. Therefore, in-vivo measurements are often performed in the clinic to verify delivered doses to eye lens which are located at shallow depth. Current in-vivo dosimetry for eye lens during radiotherapy is generally performed with small in-vivo dosimeters on the surface of patient eyelid. Since this procedure potentially contains considerable uncertainty, a contact lens-shaped applicator made of acrylic (lens applicator) was developed for in-vivo measurements of eye lens dose during radiotherapy to reduce uncertainty. The lens applicator allows the insertion of commercially available metal oxide semiconductor field effect transistor (MOSFET) dosimeters. Computed tomography (CT) images of an anthropomorphic phantom with and without the lens applicator were acquired. A total of 20 VMAT plans were delivered to an anthropomorphic phantom and the doses with the lens applicator and the doses at the surface of the eyelid were measured using both micro and standard MOSFET dosimeters. The differences in measured dose at the surface of the eyelid from the calculated lens dose were acquired. The differences between the measured and the calculated doses at the lens applicator, as well as the differences between the measured and the calculated doses at the surface of the eyelid were acquired. The statistical significance of the differences was analyzed. The average difference between the measured and the calculated dose with the lens applicator was 16.8 % ± 10.4 % with a micro MOSFET dosimeter and 16.6 % ± 10.9% with a standard MOSFET dosimeter. The average difference without the lens applicator was 35.9% ± 41.5% with micro MOSFET dosimeter and 42.9% ± 52.2% with standard MOSFET dosimeter. The maximum difference with micro MOSFET dosimeter was 46% with the applicator and 188.4% without the applicator. For the standard MOSFET dosimeter, the maximum difference was 44.4% with the applicator and 246.4% without the applicator. The lens applicator allowed reduction of the differences between the calculated and the measured dose during in-vivo measurement for the eye lens as compared to in-vivo measurement at the surface of the eyelid. Learning Objectives: To understand limitations of dose calculation with commercial treatment planning system for eye lens during radiotherapy To learn about current in-vivo dosimetry methods for eye lens in the clinic To understand limitations of in-vivo dosimetry for eye lens during radiotherapy Di Zhang is an employee of Toshiba America Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-E-201-01: Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionists

Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on awareness can lead to avoidance or even prevention. Learning Objectives: To understand recent changes in eye lens dose limits and thresholds for tissue reactions To understand different approaches to dose estimation for eye lens To learn about challenges in eye lens opacities among staff in interventional fluoroscopy Di Zhang, Toshiba America Medical Systems, Tustin, CA, USA Eye lens radiation dose from brain perfusion CT exams CT perfusion imaging requires repeatedly exposing one location of the head to monitor the uptake and washout of iodinated contrast. The accumulated radiation dose to the eye lens can be high, leading to concerns about potential radiation injury from these scans. CTDIvol assumes continuous z coverage and can overestimate eye lens dose in CT perfusion scans where the table do not increment. The radiation dose to the eye lens from clinical CT brain perfusion studies can be estimated using Monte Carlo simulation methods on voxelized patient models. MDCT scanners from four major manufacturers were simulated and the eye lens doses were estimated using the AAPM posted clinical protocols. They were also compared to CTDIvol values to evaluate the overestimation from CTDIvol. The efficacy of eye lens dose reduction techniques such as tilting the gantry and moving the scan location away from the eyelens were also investigated. Eye lens dose ranged from 81 mGy to 279 mGy, depending on the scanner and protocol used. It is between 59% and 63% of the CTDIvol values reported by the scanners. The eye lens dose is significantly reduced when the eye lenses were not directly irradiated. CTDIvol should not be interpreted as patient dose; this study has shown it to overestimate dose to the eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy. Learning Objectives: To become familiar with method of eye dose estimation for patient in specific situation of brain perfusion CT To become familiar with level of eye lens radiation doses in patients undergoing brain perfusion MDCT To understand methods for reducing eye lens dose to patient Jong Min Park, Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea Eye lens dosimetry in radiotherapy using contact lens-shaped applicator Dose calculation accuracy of commercial treatment planning systems is relatively low at shallow depths. Therefore, in-vivo measurements are often performed in the clinic to verify delivered doses to eye lens which are located at shallow depth. Current in-vivo dosimetry for eye lens during radiotherapy is generally performed with small in-vivo dosimeters on the surface of patient eyelid. Since this procedure potentially contains considerable uncertainty, a contact lens-shaped applicator made of acrylic (lens applicator) was developed for in-vivo measurements of eye lens dose during radiotherapy to reduce uncertainty. The lens applicator allows the insertion of commercially available metal oxide semiconductor field effect transistor (MOSFET) dosimeters. Computed tomography (CT) images of an anthropomorphic phantom with and without the lens applicator were acquired. A total of 20 VMAT plans were delivered to an anthropomorphic phantom and the doses with the lens applicator and the doses at the surface of the eyelid were measured using both micro and standard MOSFET dosimeters. The differences in measured dose at the surface of the eyelid from the calculated lens dose were acquired. The differences between the measured and the calculated doses at the lens applicator, as well as the differences between the measured and the calculated doses at the surface of the eyelid were acquired. The statistical significance of the differences was analyzed. The average difference between the measured and the calculated dose with the lens applicator was 16.8 % ± 10.4 % with a micro MOSFET dosimeter and 16.6 % ± 10.9% with a standard MOSFET dosimeter. The average difference without the lens applicator was 35.9% ± 41.5% with micro MOSFET dosimeter and 42.9% ± 52.2% with standard MOSFET dosimeter. The maximum difference with micro MOSFET dosimeter was 46% with the applicator and 188.4% without the applicator. For the standard MOSFET dosimeter, the maximum difference was 44.4% with the applicator and 246.4% without the applicator. The lens applicator allowed reduction of the differences between the calculated and the measured dose during in-vivo measurement for the eye lens as compared to in-vivo measurement at the surface of the eyelid. Learning Objectives: To understand limitations of dose calculation with commercial treatment planning system for eye lens during radiotherapy To learn about current in-vivo dosimetry methods for eye lens in the clinic To understand limitations of in-vivo dosimetry for eye lens during radiotherapy Di Zhang is an employee of Toshiba America Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-E-201-02: Eye Lens Dosimetry From CT Perfusion Studies

Madan M. Rehani, Massachusetts General Hospital and Harvard Medical School, Boston Methods for Eye Lens Dosimetry and Studies On Lens Opacities with Interventionalists Radiation induced cataract is a major threat among staff working in interventional suites. Nearly 16 million interventional procedures are performed annually in USA. Recent studies by the principal investigator’s group, primarily among interventional cardiologists, on behalf of the International Atomic Energy Agency, show posterior subcapsular (PSC) changes in the eye lens in 38–53% of main operators and 21–45% of support staff. These changes have potential to lead to cataract in future years, as per information from A-Bomb survivors. The International Commission on Radiological Protection has reduced dose limit for staff by a factor of 7.5 (from 150 mSv/y to 20 mSv/y). With increasing emphasis on radiation induced cataracts and reduction in threshold dose for eye lens, there is a need to implement strategies for estimating eye lens dose. Unfortunately eye lens dosimetry is at infancy when it comes to routine application. Various approaches are being tried namely direct measurement using active or passive dosimeters kept close to eyes, retrospective estimations and lastly correlating patient dose in interventional procedures with staff eye dose. The talk will review all approaches available and ongoing active research in this area, as well as data from surveys done in Europe on status of eye dose monitoring in interventional radiology and nuclear medicine. The talk will provide update on how good is Hp(10) against Hp(3), estimations from CTDI values, Monte Carlo based simulations and current status of eye lens dosimetry in USA and Europe. The cataract risk among patients is in CT examinations of the head. Since radiation induced cataract predominantly occurs in posterior sub-capsular (PSC) region and is thus distinguishable from age or drug related cataracts and is also preventable, actions on awareness can lead to avoidance or even prevention. Learning Objectives: To understand recent changes in eye lens dose limits and thresholds for tissue reactions To understand different approaches to dose estimation for eye lens To learn about challenges in eye lens opacities among staff in interventional fluoroscopy Di Zhang, Toshiba America Medical Systems, Tustin, CA, USA Eye lens radiation dose from brain perfusion CT exams CT perfusion imaging requires repeatedly exposing one location of the head to monitor the uptake and washout of iodinated contrast. The accumulated radiation dose to the eye lens can be high, leading to concerns about potential radiation injury from these scans. CTDIvol assumes continuous z coverage and can overestimate eye lens dose in CT perfusion scans where the table do not increment. The radiation dose to the eye lens from clinical CT brain perfusion studies can be estimated using Monte Carlo simulation methods on voxelized patient models. MDCT scanners from four major manufacturers were simulated and the eye lens doses were estimated using the AAPM posted clinical protocols. They were also compared to CTDIvol values to evaluate the overestimation from CTDIvol. The efficacy of eye lens dose reduction techniques such as tilting the gantry and moving the scan location away from the eyelens were also investigated. Eye lens dose ranged from 81 mGy to 279 mGy, depending on the scanner and protocol used. It is between 59% and 63% of the CTDIvol values reported by the scanners. The eye lens dose is significantly reduced when the eye lenses were not directly irradiated. CTDIvol should not be interpreted as patient dose; this study has shown it to overestimate dose to the eye lens. These results may be used to provide more accurate estimates of actual dose to ensure that protocols are operated safely below thresholds. Tilting the gantry or moving the scanning region further away from the eyes are effective for reducing lens dose in clinical practice. These actions should be considered when they are consistent with the clinical task and patient anatomy. Learning Objectives: To become familiar with method of eye dose estimation for patient in specific situation of brain perfusion CT To become familiar with level of eye lens radiation doses in patients undergoing brain perfusion MDCT To understand methods for reducing eye lens dose to patient Jong Min Park, Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea Eye lens dosimetry in radiotherapy using contact lens-shaped applicator Dose calculation accuracy of commercial treatment planning systems is relatively low at shallow depths. Therefore, in-vivo measurements are often performed in the clinic to verify delivered doses to eye lens which are located at shallow depth. Current in-vivo dosimetry for eye lens during radiotherapy is generally performed with small in-vivo dosimeters on the surface of patient eyelid. Since this procedure potentially contains considerable uncertainty, a contact lens-shaped applicator made of acrylic (lens applicator) was developed for in-vivo measurements of eye lens dose during radiotherapy to reduce uncertainty. The lens applicator allows the insertion of commercially available metal oxide semiconductor field effect transistor (MOSFET) dosimeters. Computed tomography (CT) images of an anthropomorphic phantom with and without the lens applicator were acquired. A total of 20 VMAT plans were delivered to an anthropomorphic phantom and the doses with the lens applicator and the doses at the surface of the eyelid were measured using both micro and standard MOSFET dosimeters. The differences in measured dose at the surface of the eyelid from the calculated lens dose were acquired. The differences between the measured and the calculated doses at the lens applicator, as well as the differences between the measured and the calculated doses at the surface of the eyelid were acquired. The statistical significance of the differences was analyzed. The average difference between the measured and the calculated dose with the lens applicator was 16.8 % ± 10.4 % with a micro MOSFET dosimeter and 16.6 % ± 10.9% with a standard MOSFET dosimeter. The average difference without the lens applicator was 35.9% ± 41.5% with micro MOSFET dosimeter and 42.9% ± 52.2% with standard MOSFET dosimeter. The maximum difference with micro MOSFET dosimeter was 46% with the applicator and 188.4% without the applicator. For the standard MOSFET dosimeter, the maximum difference was 44.4% with the applicator and 246.4% without the applicator. The lens applicator allowed reduction of the differences between the calculated and the measured dose during in-vivo measurement for the eye lens as compared to in-vivo measurement at the surface of the eyelid. Learning Objectives: To understand limitations of dose calculation with commercial treatment planning system for eye lens during radiotherapy To learn about current in-vivo dosimetry methods for eye lens in the clinic To understand limitations of in-vivo dosimetry for eye lens during radiotherapy Di Zhang is an employee of Toshiba America Medical Systems.

60 APPLIED LIFE SCIENCES↗

Practical Use of the Extended No Action Level (eNAL) Correction Protocol for Breast Cancer Patients With Implanted Surgical Clips

Purpose: To describe the practical use of the extended No Action Level (eNAL) setup correction protocol for breast cancer patients with surgical clips and evaluate its impact on the setup accuracy of both tumor bed and whole breast during simultaneously integrated boost treatments. Methods and Materials: For 80 patients, two orthogonal planar kilovoltage images and one megavoltage image (for the mediolateral beam) were acquired per fraction throughout the radiotherapy course. For setup correction, the eNAL protocol was applied, based on registration of surgical clips in the lumpectomy cavity. Differences with respect to application of a No Action Level (NAL) protocol or no protocol were quantified for tumor bed and whole breast. The correlation between clip migration during the fractionated treatment and either the method of surgery or the time elapsed from last surgery was investigated. Results: The distance of the clips to their center of mass (COM), averaged over all clips and patients, was reduced by 0.9 {+-} 1.2 mm (mean {+-} 1 SD). Clip migration was similar between the group of patients starting treatment within 100 days after surgery (median, 53 days) and the group starting afterward (median, 163 days) (p = 0.20). Clip migration after conventional breast surgery (closing the breast superficially) or after lumpectomy with partial breast reconstructive techniques (sutured cavity). was not significantly different either (p = 0.22). Application of eNAL on clips resulted in residual systematic errors for the clips' COM of less than 1 mm in each direction, whereas the setup of the breast was within about 2 mm of accuracy. Conclusions: Surgical clips can be safely used for high-accuracy position verification and correction. Given compensation for time trends in the clips' COM throughout the treatment course, eNAL resulted in better setup accuracies for both tumor bed and whole breast than NAL.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Dosimetric and geometric evaluation of a novel stereotactic radiotherapy device for breast cancer: The GammaPod Trade-Mark-Sign

Purpose: A dedicated stereotactic gamma irradiation device, the GammaPod Trade-Mark-Sign from Xcision Medical Systems, was developed specifically to treat small breast cancers. This study presents the first evaluation of dosimetric and geometric characteristics from the initial prototype installed at University of Maryland Radiation Oncology Department. Methods: The GammaPod Trade-Mark-Sign stereotactic radiotherapy device is an assembly of a hemi-spherical source carrier containing 36 {sup 60}Co sources, a tungsten collimator, a dynamically controlled patient support table, and the breast immobilization system which also functions as a stereotactic frame. The source carrier contains the sources in six columns spaced longitudinally at 60 Degree-Sign intervals and it rotates together with the variable-size collimator to form 36 noncoplanar, concentric arcs focused at the isocenter. The patient support table enables motion in three dimensions to position the patient tumor at the focal point of the irradiation. The table moves continuously in three cardinal dimensions during treatment to provide dynamic shaping of the dose distribution. The breast is immobilized using a breast cup applying a small negative pressure, where the immobilization cup is embedded with fiducials also functioning as the stereotactic frame for the breast. Geometric and dosimetric evaluations of the system as well as a protocol for absorbed dose calibration are provided. Dosimetric verifications of dynamically delivered patient plans are performed for seven patients using radiochromic films in hypothetical preop, postop, and target-in-target treatment scenarios. Results: Loaded with 36 {sup 60}Co sources with cumulative activity of 4320 Ci, the prototype GammaPod Trade-Mark-Sign unit delivers 5.31 Gy/min at the isocenter using the largest 2.5 cm diameter collimator. Due to the noncoplanar beam arrangement and dynamic dose shaping features, the GammaPod Trade-Mark-Sign device is found to deliver uniform doses to targets with good conformity. The spatial accuracy of the device to locate the radiation isocenter is determined to be less than 1 mm. Single shot profiles with 2.5 cm collimator are measured with radiochromic film and found to be in good agreement with respect to the Monte Carlo based calculations (congruence of FWHM less than 1 mm). Dosimetric verifications corresponding to all hypothetical treatment plans corresponding to three target scenarios for each of the seven patients demonstrated good agreement with gamma index pass rates of better than 97% (99.0%{+-} 0.7%). Conclusions: Dosimetric evaluation of the first GammaPod Trade-Mark-Sign stereotactic breast radiotherapy unit was performed and the dosimetric and spatial accuracy of this novel technology is found to be feasible with respect to clinical radiotherapy standards. The observed level of agreement between the treatment planning system calculations and dosimetric measurements has confirmed that the system can deliver highly complex treatment plans with remarkable geometric and dosimetric accuracy.

60 APPLIED LIFE SCIENCES↗

WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical.

07 ISOTOPE AND RADIATION SOURCES↗

Standardizing Naming Conventions in Radiation Oncology

Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were satisfactorily identified using this nomenclature. Conclusions: Use of standardized naming conventions is important to facilitate comparison of dosimetry across patient datasets. The guidelines presented here will facilitate international acceptance across a wide range of efforts, including groups organizing clinical trials, Radiation Oncology Institute, Dutch Radiation Oncology Society, Integrating the Healthcare Enterprise, Radiation Oncology domain (IHE-RO), and Digital Imaging and Communication in Medicine (DICOM).

62 RADIOLOGY AND NUCLEAR MEDICINE↗