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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 343 records · Page 19
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-T-380: Comparing the Effect of Respiration On Dose Distribution Between Conventional Tangent Pair and IMRT Techniques for Adjuvant Radiotherapy in Early Stage Breast Cancer

Purpose: In this project, we compared the conventional tangent pair technique to IMRT technique by analyzing the dose distribution. We also investigated the effect of respiration on planning target volume (PTV) dose coverage in both techniques. Methods: In order to implement IMRT technique a template based planning protocol, dose constrains and treatment process was developed. Two open fields with optimized field weights were combined with two beamlet optimization fields in IMRT plans. We compared the dose distribution between standard tangential pair and IMRT. The improvement in dose distribution was measured by parameters such as conformity index, homogeneity index and coverage index. Another end point was the IMRT technique will reduce the planning time for staff. The effect of patient’s respiration on dose distribution was also estimated. The four dimensional computed tomography (4DCT) for different phase of breathing cycle was used to evaluate the effect of respiration on IMRT planned dose distribution. Results: We have accumulated 10 patients that acquired 4DCT and planned by both techniques. Based on the preliminary analysis, the dose distribution in IMRT technique was better than conventional tangent pair technique. Furthermore, the effect of respiration in IMRT plan was not significant as evident from the 95% isodose line coverage of PTV drawn on all phases of 4DCT. Conclusion: Based on the 4DCT images, the breathing effect on dose distribution was smaller than what we expected. We suspect that there are two reasons. First, the PTV movement due to respiration was not significant. It might be because we used a tilted breast board to setup patients. Second, the open fields with optimized field weights in IMRT technique might reduce the breathing effect on dose distribution. A further investigation is necessary.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-442: Dose Distribution Comparison for Post-Laryngectomy Stoma Area Between Conventional AP and VMAT Plans with Or Without Bolus

Purpose: To compare dose distributions of conventional AP vs. VMAT treatment plans with or without bolus around post-laryngectomy stoma. Methods: Radiation dose coverage for post-laryngectomy stoma was analyzed using a set of real-case CT-simulation images. After meticulous contouring of the catheter cuff, stoma lumen, peri-stoma skin and subclinical tumor bed at the larynx, the resulting dosimetry plans were analyzed with or without a 5 mm bolus placement. Wet gauze was used to minimize the effect of any air gap. Four plans were generated: AP superclavicular (SCV) plan with or without bolus, and VMAT plan with or without bolus. A dose of 60Gy in 30 fractions was prescribed at 3 cm depth for AP SCV plan, and to 95% of the PTV volume for VMAT plan. Results: For the conventional AP SCV plan, the peri-stoma skin dose is sensitive to bolus placement as well as air gap compensation by wetted gauze (V95% of 20.7%, 33.0% and 94.8% for no bolus, bolus without and with air gap compensation, respectively). For stoma lumen, the dose drops off rapidly in depth. The catheter cuff may have certain dose-buildup effect, but air gap around it and under the bolus placed can pose a more serious problem. The dose distributions of the two VMAT plans are moderately different for peri-stoma skin (V95% of 95.0% with bolus and air gap compensation, and 82.3% without bolus), but nearly identical for stoma lumen (V95% of 91.5% and 92.0%, respectively). VMAT allows beamlets with different angles of incidence that helped achieve such dose distribution around the stoma even without bolus placement. Conclusion: Overall, the dose coverage around the stoma in the VMAT plan is better than the conventional AP SCV plan. To achieve optimal dose distribution, it is still recommended to place physical bolus and reduce the air gaps.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-549: Validation of a Method for in Vivo 3D Dose Reconstruction for SBRT Using a New Transmission Detector

Purpose: Recently, there has been increased clinical use of stereotactic body radiation therapy (SBRT). SBRT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. In vivo dose measurements, a commercially available quality assurance platform which is able to correlate the delivered dose to the patient’s anatomy and take into account tissue inhomogeneity, is the COMPASS system (IBA Dosimetry, Germany) using a new transmission detector (Dolphin, IBA Dosimetry). In this work, we evaluate a method for in vivo 3D dose reconstruction for SBRT using a new transmission detector, which was developed for in vivo dose verification for intensity-modulated radiation therapy (IMRT). Methods: We evaluated the accuracy of measurement for SBRT using simple small fields (2×2−10×10 cm2), a multileaf collimator (MLC) test pattern, and clinical cases. The dose distributions from the COMPASS were compared with those of EDR2 films (Kodak, USA) and the Monte Carlo simulations (MC). For clinical cases, we compared MC using dose-volume-histograms (DVHs) and dose profiles. Results: The dose profiles from the COMPASS for small fields and the complicated MLC test pattern agreed with those of EDR2 films, and MC within 3%. This showed the COMPASS with Dolphin system showed good spatial resolution and can measure small fields which are required for SBRT. Those results also suggest that COMPASS with Dolphin is able to detect MLC leaf position errors for SBRT. In clinical cases, the COMPASS with Dolphin agreed well with MC. The Dolphin detector, which consists of ionization chambers, provided stable measurement. Conclusion: COMPASS with Dolphin detector showed a useful in vivo 3D dose reconstruction for SBRT. The accuracy of the results indicates that this approach is suitable for clinical implementation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-620: Development of a Convolution/Superposition Dose Engine for CyberKnife System

Purpose: Current CyberKnife treatment planning system (TPS) provided two dose calculation algorithms: Ray-tracing and Monte Carlo. Ray-tracing algorithm is fast, but less accurate, and also can’t handle irregular fields since a multi-leaf collimator system was recently introduced to CyberKnife M6 system. Monte Carlo method has well-known accuracy, but the current version still takes a long time to finish dose calculations. The purpose of this paper is to develop a GPU-based fast C/S dose engine for CyberKnife system to achieve both accuracy and efficiency. Methods: The TERMA distribution from a poly-energetic source was calculated based on beam’s eye view coordinate system, which is GPU friendly and has linear complexity. The dose distribution was then computed by inversely collecting the energy depositions from all TERMA points along 192 collapsed-cone directions. EGSnrc user code was used to pre-calculate energy deposition kernels (EDKs) for a series of mono-energy photons The energy spectrum was reconstructed based on measured tissue maximum ratio (TMR) curve, the TERMA averaged cumulative kernels was then calculated. Beam hardening parameters and intensity profiles were optimized based on measurement data from CyberKnife system. Results: The difference between measured and calculated TMR are less than 1% for all collimators except in the build-up regions. The calculated profiles also showed good agreements with the measured doses within 1% except in the penumbra regions. The developed C/S dose engine was also used to evaluate four clinical CyberKnife treatment plans, the results showed a better dose calculation accuracy than Ray-tracing algorithm compared with Monte Carlo method for heterogeneous cases. For the dose calculation time, it takes about several seconds for one beam depends on collimator size and dose calculation grids. Conclusion: A GPU-based C/S dose engine has been developed for CyberKnife system, which was proven to be efficient and accurate for clinical purpose, and can be easily implemented in TPS.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-621: Impact of Vacuum and Treatment Couch On Surface Dose in Stereotactic Body Radiation Therapy With and Without a Flattening Filter

Purpose: When treating lung cancer patients with stereotactic body radiation therapy (SBRT), better immobilization is needed for accurate delivery of high-dose radiation. However, using a treatment couch (TrueBeamTM) and vacuum bag (BlueBAGTM) may increase the surface dose and skin toxicity. This study investigated the influence of couch and vacuum bag on the surface dose. Methods: The relative surface dose (D{sub 0}/DMAX) was measured in an ion-chamber (Markus-type PTW, 0.05cm{sup 3}) with a solid water phantom and SSD to 100 cm. A comprehensive comparison of different parameter settings, including the different energies (6MV-FFF, 10MV-FF, and 10MV-FFF), field sizes (3 X 3 cm{sup 2}, 5 × 5 cm{sup 2}, 8 × x cm{sup 2} , 10 × 10 cm{sup 2}, and 15 × 15 cm{sup 2}), thickness of the vacuum bag (5mm, 15mm, 30mm, 39mm and 55mm), and couch (with and without), was performed. Results: The FFF increases the surface dose as compared to FF mode. In a similar setting with field of 10 × 10 cm{sup 2}, FFF mode increases the surface dose from 26.0% to 32.8% for 6 MV, and 17.4% to 21.5% for 10 MV. When the beam passes through the couch, the surface dose increases to 3.6, 4.6, 2.9, and 3.7 times for 6 MV-FF, 10 MV-FF, 6 MV-FFF, and 10 MV-FFF, respectively. At the same energy, the surface dose increases to 3.93, 4.11, 4.23, 4.16 and 4.24 times at 5 mm, 15 mm, 30 mm, 39 mm and 55 mm thickness of the vacuum, respectively. Conclusion: Using a couch and vacuum significantly increases the surface dose. For SBRT with a superficial target close to the couch and immobilization vacuum, reduction of vacuum thickness and careful attention to skin dose in planning would be helpful in avoiding severe skin toxicity.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-667: Development and Validation of Dose Calculation for An Open-Source KV Treatment Planning System for Small Animal Radiotherapy

Purpose: An open-source, convolution/superposition based kV-treatment planning system(TPS) was developed for small animal radiotherapy from previously existed in-house MV-TPS. It is flexible and applicable to both step and shoot and helical tomotherapy treatment delivery. For initial commissioning process, the dose calculation from kV-TPS was compared with measurements and Monte Carlo(MC) simulations. Methods: High resolution, low energy kernels were simulated using EGSnrc user code EDKnrc, which was used as an input in kV-TPS together with MC-simulated x-ray beam spectrum. The Blue Water™ homogeneous phantom (with film inserts) and heterogeneous phantom (with film and TLD inserts) were fabricated. Phantom was placed at 100cm SSD, and was irradiated with 250 kVp beam for 10mins with 1.1cm × 1.1cm open field (at 100cm) created by newly designed binary micro-MLC assembly positioned at 90cm SSD. Gafchromic™ EBT3 film was calibrated in-phantom following AAPM TG-61 guidelines, and were used for measurement at 5 different depths in phantom. Calibrated TLD-100s were obtained from ADCL. EGS and MNCP5 simulation were used to model experimental irradiation set up calculation of dose in phantom. Results: Using the homogeneous phantom, dose difference between film and kV-TPS was calculated: mean(x)=0.9%; maximum difference(MD)=3.1%; standard deviation(σ)=1.1%. Dose difference between MCNP5 and kV-TPS was: x=1.5%; MD=4.6%; σ=1.9%. Dose difference between EGS and kV-TPS was: x=0.8%; MD=1.9%; σ=0.8%. Using the heterogeneous phantom, dose difference between film and kV-TPS was: x=2.6%; MD=3%; σ=1.1%; and dose difference between TLD and kV-TPS was: x=2.9%; MD=6.4%; σ=2.5%. Conclusion: The inhouse, open-source kV-TPS dose calculation system was comparable within 5% of measurements and MC simulations in both homogeneous and heterogeneous phantoms. The dose calculation system of the kV-TPS is validated as a part of initial commissioning process for small animal radiotherapy. The kV-TPS has the potential for accurate dose calculation for any kV treatment or imaging modalities.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-206-15: Effects of Dose Reduction On Emphysema Score

Purpose: The purpose of this study was to investigate the effects of reducing radiation dose levels on emphysema scores from lung cancer screening CT exams. Methods: 52 cases were selected from the National Lung Screening Trial (NLST) patients for which we had both the image series and the raw CT data. All scans were acquired with fixed effective mAs (25 for standard-sized patients, 40 for large patients) on a 64-slice scanner (Sensation 64, Siemens Healthcare) using 120kV, 64×0.6mm collimation and pitch 1.0. All images were reconstructed with 1mm slice thickness, B50 kernel. Based on a previously-published technique, we added noise to the raw data to simulate reduced-dose versions at 50% and 25% of the original dose (approximately 1.0- and 0.5-mGy CTDIvol). Lung segmentations were obtained via region growing from manual seed point at a threshold of 600HU followed by manual removal of trachea and major airways. Lung segmentations were only performed on original dose scans, and mapped to simulated reduced-dose scans. Emphysema scores based on relative area of lung with attenuation values lower than −950HU (RA950) were computed for all cases. Results: Average RA950 of all 50 cases were 31.6 (±5.5), 32.5 (±4.9) and 32.8 (±4.6) for 100%, 50% and 25% dose level respectively. The average absolute difference in RA950 between simulated and original dose scans were 1.0 (±0.7) and 1.4 (±1.1) for 50% and 25% dose level respectively. Conclusion: RA950 is relatively robust to dose level, with a difference of no more than 5 from the original dose scans. The average RA950 of this population was high for a two reasons: This was a high risk population of patients with substantial smoking history; The use of B50 kernel, which may be biased towards high emphysema scores. Further exploration with smoother kernels will be conducted in the future. Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics; NIH grant support from U01 CA181156.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

MO-FG-CAMPUS-TeP1-04: Pseudo-In-Vivo Dose Verification of a New Mono-Isocentric Technique for the Treatment of Multiple Brain Metastases

Purpose: To validate dose calculation and delivery accuracy of a recently introduced mono-isocentric technique for the treatment of multiple brain metastases in a realistic clinical case. Methods: Anonymized CT scans of a patient were used to model a hollow phantom that duplicates anatomy of the skull. A 3D printer was used to construct the phantom of a radiologically bone-equivalent material. The hollow phantom was subsequently filled with a polymer gel 3D dosimeter which also acted as a water-equivalent material. Irradiation plan consisted of 5 targets and was identical to the one delivered to the specific patient except for the prescription dose which was optimized to match the gel dose-response characteristics. Dose delivery was performed using a single setup isocenter dynamic conformal arcs technique. Gel dose read-out was carried out by a 1.5 T MRI scanner. All steps of the corresponding patient’s treatment protocol were strictly followed providing an end-to-end quality assurance test. Pseudo-in-vivo measured 3D dose distribution and calculated one were compared in terms of spatial agreement, dose profiles, 3D gamma indices (5%/2mm, 20% dose threshold), DVHs and DVH metrics. Results: MR-identified polymerized areas and calculated high dose regions were found to agree within 1.5 mm for all targets, taking into account all sources of spatial uncertainties involved (i.e., set-up errors, MR-related geometric distortions and registration inaccuracies). Good dosimetric agreement was observed in the vast majority of the examined profiles. 3D gamma index passing rate reached 91%. DVH and corresponding metrics comparison resulted in a satisfying agreement between measured and calculated datasets within targets and selected organs-at-risk. Conclusion: A novel, pseudo-in-vivo QA test was implemented to validate spatial and dosimetric accuracy in treatment of multiple metastases. End-to-end testing demonstrated that our gel dosimetry phantom is suited for such QA procedures, allowing for 3D analysis of both targeting placement and dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

MO-FG-CAMPUS-IeP2-03: Validation of an SSDE-To-Organ-Dose Calculation Methodology Developed for Pediatric CT in An Adult Population

Purpose: To discover if a previously published methodology for estimating patient-specific organ dose in a pediatric population (5–55kg) is translatable to the adult sized patient population (> 55 kg). Methods: An adult male anthropomorphic phantom was scanned with metal oxide semiconductor field effect transistor (MOSFET) dosimeters placed at 23 organ locations in the chest and abdominopelvic regions to determine absolute organ dose. Organ-dose-to-SSDE correlation factors were developed by dividing individual phantom organ doses by SSDE of the phantom; where SSDE was calculated at the center of the scan volume of the chest and abdomen/pelvis separately. Organ dose correlation factors developed in phantom were multiplied by 28 chest and 22 abdominopelvic patient SSDE values to estimate organ dose. The median patient weight from the CT examinations was 68.9 kg (range 57–87 kg) and median age was 17 years (range 13–28 years). Calculated organ dose estimates were compared to published Monte Carlo simulated patient and phantom results. Results: Organ-dose-to-SSDE correlation was determined for a total of 23 organs in the chest and abdominopelvic regions. For organs fully covered by the scan volume, correlation in the chest (median 1.3; range 1.1–1.5) and abdominopelvic (median 0.9; range 0.7–1.0) was 1.0 ± 10%. For organs that extended beyond the scan volume (i.e. skin bone marrow and bone surface) correlation was determined to be a median of 0.3 (range 0.1–0.4). Calculated patient organ dose using patient SSDE agreed to better than 6% (chest) and 15% (abdominopelvic) to published values. Conclusion: This study demonstrated that our previous published methodology for calculating organ dose using patient-specific SSDE for the chest and abdominopelvic regions is translatable to adult sized patients for organs fully covered by the scan volume.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-AB-BRC-02: Accuracy Evaluation of GPU-Based OpenCL Carbon Monte Carlo Package (goCMC) in Biological Dose and Microdosimetry in Comparison to FLUKA Simulations

Purpose: One of the most accurate methods for radiation transport is Monte Carlo (MC) simulation. Long computation time prevents its wide applications in clinic. We have recently developed a fast MC code for carbon ion therapy called GPU-based OpenCL Carbon Monte Carlo (goCMC) and its accuracy in physical dose has been established. Since radiobiology is an indispensible aspect of carbon ion therapy, this study evaluates accuracy of goCMC in biological dose and microdosimetry by benchmarking it with FLUKA. Methods: We performed simulations of a carbon pencil beam with 150, 300 and 450 MeV/u in a homogeneous water phantom using goCMC and FLUKA. Dose and energy spectra for primary and secondary ions on the central beam axis were recorded. Repair-misrepair-fixation model was employed to calculate Relative Biological Effectiveness (RBE). Monte Carlo Damage Simulation (MCDS) tool was used to calculate microdosimetry parameters. Results: Physical dose differences on the central axis were <1.6% of the maximum value. Before the Bragg peak, differences in RBE and RBE-weighted dose were <2% and <1%. At the Bragg peak, the differences were 12.5% caused by small range discrepancy and sensitivity of RBE to beam spectra. Consequently, RBE-weighted dose difference was 11%. Beyond the peak, RBE differences were <20% and primarily caused by differences in the Helium-4 spectrum. However, the RBE-weighted dose agreed within 1% due to the low physical dose. Differences in microdosimetric quantities were small except at the Bragg peak. The simulation time per source particle with FLUKA was 0.08 sec, while goCMC was approximately 1000 times faster. Conclusion: Physical doses computed by FLUKA and goCMC were in good agreement. Although relatively large RBE differences were observed at and beyond the Bragg peak, the RBE-weighted dose differences were considered to be acceptable.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-D-209-06: Head and Neck Tissue Dose From X-Ray Scatter to Physicians Performing Cardiovascular Procedures

Purpose: The purpose of this work was to characterize the spatial distribution of scatter radiation to the head and neck of a physician performing an x-ray interventional procedure and assess brain, eye lens, and carotid artery dose. Methods: Radiographic x-ray beams were tuned to match the peak energy (56 to 106 keV) and HVL (3.5 to 6.5 mm Al) of x-ray scatter originating from a patient during a fluoroscopic procedure. The radiographic beam was directed upon a Rando phantom from an inferior-left location to mimic a typical patient-operator geometric relationship. A lead-equivalent protective garment was secured to the phantom. Direct exposure Gafchromic film (XRQA2) was placed between the transverse plane layers of the head and neck region of the phantom and exposed with 4 scatter-equivalent radiographic beams. A 3×3 cm{sup 2} film placed at the left collar of the phantom was used to monitor incident dose in the position of a radiation monitoring badge. The films were converted to 2D dose distribution maps using FilmQA Pro software and an Epson 11000-XL scanner. The 2D dose distributions maps were normalized by the left collar dose and the percent of left collar dose (%LCD) was calculated for select tissues. Results: The dose maps had high dynamic range (10{sub 4}) and spatial detail. Considering all transverse planes and 4 scatter beam qualities, the median %LCD values were: whole brain 8.5%, left brain 13%, right brain 5.4%, left eye lens 67%, right eye lens 25%, left carotid artery 72%, and right carotid artery 28%. Conclusion: Scatter radiation dose to an operator can be simulated using a tuned radiographic beam and used to expose a phantom and Gafchromic film, thereby creating detailed 2D dose distribution maps. This work facilitates individualized estimation of dose to select head and neck tissues based on an operator’s radiation monitoring badge value.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-H-CAMPUS-IeP1-04: Combined Organ Dose for Digital Subtraction Angiography and Computed Tomography Using Monte Carlo Simulation

Purpose: The purpose of this study was to evaluate the combined organ dose of digital subtraction angiography (DSA) and computed tomography (CT) using a Monte Carlo (MC) simulation on the abdominal intervention. Methods: The organ doses for DSA and CT were obtained with MC simulation and actual measurements using fluorescent-glass dosimeters at 7 abdominal portions in an Alderson-Rando phantom. DSA was performed from three directions: posterior anterior (PA), right anterior oblique (RAO), and left anterior oblique (LAO). The organ dose with MC simulation was compared with actual radiation dose measurements. Calculations for the MC simulation were carried out with the GMctdospp (IMPS, Germany) software based on the EGSnrc MC code. Finally, the combined organ dose for DSA and CT was calculated from the MC simulation using the X-ray conditions of a patient with a diagnosis of hepatocellular carcinoma. Results: For DSA from the PA direction, the organ doses for the actual measurements and MC simulation were 2.2 and 2.4 mGy/100 mAs at the liver, respectively, and 3.0 and 3.1 mGy/100 mAs at the spinal cord, while for CT, the organ doses were 15.2 and 15.1 mGy/100 mAs at the liver, and 14.6 and 13.5 mGy/100 mAs at the spinal cord. The maximum difference in organ dose between the actual measurements and the MC simulation was 11.0% of the spleen at PA, 8.2% of the spinal cord at RAO, and 6.1% of left kidney at LAO with DSA and 9.3% of the stomach with CT. The combined organ dose (4 DSAs and 6 CT scans) with the use of actual patient conditions was found to be 197.4 mGy for the liver and 205.1 mGy for the spinal cord. Conclusion: Our method makes it possible to accurately assess the organ dose to patients for abdominal intervention with combined DSA and CT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-AB-207A-01: Contrast-Enhanced CT: Correlation of Radiation Dose and Biological Effect

Purpose: The potential risk from CT is generally characterized in terms of radiation dose. The presence of iodinated-contrast medium increases radiation dose. However, it is unclear how much of this increase is biologically relevant. The purpose of this study was to establish the contribution of dose increase from iodine to biological effect. Methods: Radiation organ dose was estimated in 58 human (XCAT) phantoms “undergoing” chest CT examination (120 kVp, 9 mGy CTDI) on a simulated CT system (Definition Flash, Siemens) with and without iodinated-contrast agent (62.5 mL of iodine per subject). The dose without and with the presence of iodine was compared to the increase in foci per cell (a surrogate of DNA damage) measured before and after similar CT exams without and with contrast agent (Piechowiak et al. 2015). The data were analyzed to ascertain how the enhancement in biological effect in contrast-enhanced CTs correlated with the increase in dose due to the presence of iodine. Results: The presence of iodinated-contrast in CT increased the organ doses by 2% to 50% on average. Typical values were heart (50%±7%), kidney (19%±7%), and liver (2%±3%). The corresponding increase in the average foci per cell was 107%±19%, indicating biological effect of iodine was greater than what would be anticipated from the iodine-initiated increase in radiation dose alone. Conclusion: Mean foci per cell and organ dose both increase in the presence of contrast agent. The former, however, is at least twice as large as the latter, indicating that iodine contributes to an increase in the probability of DNA damage not only as a consequence of increased x-ray energy deposition but also from other mechanisms. Hence iodine radiation dose, while relevant to be included in estimating the risk associated with contrast-enhanced CT, still can underestimate the biological effects.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-AB-207A-03: Skin Dose to Patients Receiving Multiple CTA and CT Exams of the Head

Purpose: To measure patient skin dose from CT angiography (CTA) and CT exams of the head, and determine if patients having multiple exams could receive cumulative doses that approach or exceed deterministic thresholds. Methods: This study was HIPAA compliant and conducted with IRB approval. Patient skin doses were measured over a 4 month period using nanoDot OSL dosimeters placed on the head of 52 patients for two CT scanners. On each scanner, 26 patients received CT exams (scanner 1: 10 females, 16 males, mean age 64.2 years; scanner 2: 18 females, 8 males, mean age 61.2 years). CT exam dose metrics, CTDIvol and dose-length product (DLP) were recorded for each exam. Additionally, skin dose was measured on an acrylic skull phantom in each scanner and on a neuro-interventional imaging system using clinical protocols. Measured dose data was used to estimate peak skin dose (PSD) for 4 patients receiving multiple exams including CTA, head CT, and cerebral angiography. Results: For scanner 1, the mean PSD for CTA exams (98.9 ± 5.3 mGy) and for routine head CT exams (39.2 ± 3.7 mGy) agreed reasonably well with the PSD measured on the phantom, 105.4 mGy and 40.0 mGy, respectively. Similarly for scanner 2, the mean PSD for CTA exams (98.8 ± 7.4 mGy) and for routine head CT exams (42.9 ± 9.4 mGy) compared well with phantom measurements, 95.2 mGy and 37.6 mGy, respectively. In addition, the mean PSD was comparable between scanners for corresponding patient exams, CTA and routine head CT respectively. PSD estimates ranged from 1.9 – 4.5 Gy among 4 patients receiving multiple exams. Conclusion: Patients having several exams including both CTA and routine head CT may receive cumulative doses approaching or exceeding the threshold for single dose deterministic effects.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-AB-207A-04: Assessment of Patients’ Cumulative Effective Dose From CT Examinations

Purpose: The Joint Commission requires institutions to consider patient’s age and recent imaging exams when deciding on the most appropriate type of imaging exam. Additionally, knowing patient’s imaging history can help prevent duplicate scans. Radiation dose management software affords new opportunities to identify and utilize patients with high cumulative doses as one proxy for subsequent review of imaging history and opportunities in avoiding redundant exams. Methods: Using dose management software (Radimetrics, Bayer Healthcare) a total of 72073 CT examinations performed from Jan 2015 to Jan 2016 were examined to categorize patients with a cumulative effective dose of 100 mSv and above. This threshold was selected based on epidemiological studies on populations exposed to radiation, which demonstrate a statistical increase of cancer risk at doses above 100 mSv. Histories of patients with highest cumulative dose and highest number of exams were further investigated by a Radiologist for appropriateness of recurrent studies and potential opportunities for reduction. Results: Out of 34762 patients, 927 (2.7%) were identified with a cumulative dose of 100 mSv and above. The highest cumulative dose (842 mSv) belonged to an oncology patient who underwent 2 diagnostic exams and 9 interventional ablative CT guided procedures. The patient with highest number of exams (56 counts) and cumulative dose of 170 mSv was a 17 year old trauma patient. An imaging history review of these two patients did not suggest any superfluous scans. Conclusion: Our limited pilot study suggests that recurrent CT exams for patients with oncologic or severe trauma history may be warranted and appropriate. As a result, for future studies we will be focusing on high dose patient cohorts not associated with oncology or severe trauma. Additionally, the review process itself has suggested areas for potential improvement in patient care, including improved documentation and Radiologist involvement in patient management. Dr. McNitt-Gray’s disclosures: Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2000

Effects of pH and dose on nasal absorption of scopolamine hydrobromide in human subjects

PURPOSE: The present study was conducted to evaluate the effects of formulation pH and dose on nasal absorption of scopolamine hydrobromide, the single most effective drug available for the prevention of nausea and vomiting induced by motion sickness. METHODS: Human subjects received scopolamine nasally at a dose of 0.2 mg/0.05 mL or 0.4 mg/0.10 mL, blood samples were collected at different time points, and plasma scopolamine concentrations were determined by LC-MS/MS. RESULTS: Following administration of a 0.2 mg dose, the average Cmax values were found to be 262+/-118, 419+/-161, and 488+/-331 pg/ mL for pH 4.0, 7.0, and 9.0 formulations, respectively. At the 0.4 mg dose the average Cmax values were found to be 503+/-199, 933+/-449, and 1,308+/-473 pg/mL for pH 4.0, 7.0, and 9.0 formulations, respectively. At a 0.2 mg dose, the AUC values were found to be 23,208+/-6,824, 29,145+/-9,225, and 25,721+/-5,294 pg x min/mL for formulation pH 4.0, 7.0, and 9.0, respectively. At a 0.4 mg dose, the average AUC value was found to be high for pH 9.0 formulation (70,740+/-29,381 pg x min/mL) as compared to those of pH 4.0 (59,573+/-13,700 pg x min/mL) and pH 7.0 (55,298+/-17,305 pg x min/mL) formulations. Both the Cmax and AUC values were almost doubled with doubling the dose. On the other hand, the average Tmax, values decreased linearly with a decrease in formulation pH at both doses. For example, at a 0.4 mg dose, the average Tmax values were 26.7+/-5.8, 15.0+/-10.0, and 8.8+/-2.5 minutes at formulation pH 4.0, 7.0, and 9.0, respectively. CONCLUSIONS: Nasal absorption of scopolamine hydrobromide in human subjects increased substantially with increases in formulation pH and dose.

Controlled Clinical Trial↗
NASA NTRS2004

Effect of high-dose irradiation on the optically stimulated luminescence of Al2O3:C

This paper examines the effect of high-dose irradiation on the optically stimulated luminescence (OSL) of Al2O3:C, principally on the shape of the OSL decay curve and on the OSL sensitivity. The effect of the degree of deep trap filling on the OSL was also studied by monitoring the sensitivity changes after doses of beta irradiation and after step-annealing of samples previously irradiated with high doses. The OSL response to dose shows a linear-supralinear-saturation behavior, with a decrease in the response for doses higher than those required for saturation. This behavior correlates with the sensitivity changes observed in the samples annealed only to 773 K, which show sensitization for doses up to 20-50 Gy and desensitization for higher doses. Data from the step-annealing study leads to the suggestion that the sensitization is caused by the filling of deep electron traps, which become thermally unstable at 1100-1200 K, whereas the desensitization is caused by the filling of deep hole traps, which become thermally unstable at 800-875 K, along with a concomitant decrease in the concentration of recombination centers (F+ -centers). Changes in the shape of the OSL decay curves are also observed at high doses, the decay becoming faster as the dose increases. These changes in the OSL decay curves are discussed in terms of multiple overlapping components, each characterized by different photoionization cross-sections. However, using numerical solutions of the rate equations for a simple model consisting of a main trap and a recombination center, it is shown that the kinetics of OSL process may also be partially responsible for the changes in the OSL curves at high doses in Al2O3:C. Finally, the implication of these results for the dosimetry of heavy charged particles is discussed. c2004 Elsevier Ltd. All rights reserved.

Heavy Ions↗
NASA NTRSDate not supplied

Dose-Response Data Considerations for the NASA Quesst Community Test Campaign

Key outcomes for NASA's Quesst mission are noise dose and perceptual response data to inform regulators on their decisions regarding noise certification standards for the future of overland commercial supersonic flight. Dose-response curves are commonly utilized in community noise studies to describe the annoyance of a community to a particular noise source. The X-59 aircraft utilizes shaped-boom technology to demonstrate low noise supersonic flight. For X-59 community studies, the sound level from X-59 overflights constitutes the dose, while the response is an annoyance rating selected from a verbal scale, e.g., “slightly annoyed” and “very annoyed.” Dose-response data will be collected from individual flyovers (single event dose) and an overall response to the accumulation of single events at the end of the day (cumulative dose). There are quantifiable sources of error in the noise dose due to uncertainty in microphone measurements of the sonic thumps and uncertainty in predicted noise levels at survey participant locations. Assessing and accounting for error in the noise dose is essential to obtain an accurate dose-response model. There is also a potential for error in the perceptual response. This error is due to the ability of participants to provide their response in a timely manner and participant fatigue after responding to up to one hundred surveys over the course of a month. This talk outlines various challenges in estimating noise dose and perceptual response and the methods considered in preparation for X-59 community tests.

dose-response↗