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All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

MO-H-19A-02: Investigation of Modulated Electron Arc (MeArc) Therapy for the Treatment of Scalp Tumors

Purpose: Electron arc therapy has long been proposed as the most suitable technique for the treatment of superficial tumors that follow circularly curved surfaces. However it was challenged by unsuitability of the conventional applicators and the lack of adequate 3-D dose calculation tools for arc electron beams in the treatment planning systems (TPS). Now with the availability of an electron specific multi-leaf collimator (eMLC) and an in-house Monte Carlo (MC) based TPS, we were motivated to investigate more advanced modulated electron arc (MeARC) therapy and its beneficial outcome. Methods: We initiated the study by a film measurement conducted in a head and neck phantom, where we delivered electron arcs in a step and shoot manner using the light field as a guide to avoid fields abutments. This step was done to insure enough clearance for the arcs with eMLC. MCBEAM and MCPLAN MC codes were used for the treatment head simulation and phantom dose calculation, respectively. Treatment plans were generated for targets drawn in real patient CTs and head and neck phantom. We utilized beams eye view available from a commercial planning system to create beamlets having same isocenter and adjoined at the scalp surface. Then dose-deposition coefficients from those beamlets were calculated for all electron energies using MCPLAN. An in-house optimization code was then used to find the optimum weights needed from individual beamlets. Results: MeARC showed a nicely tailored dose distribution around the circular curved target on the scalp. Some hot spots were noticed and could be attributed to fields abutment problem owing to the bulging nature of electron profiles. Brain dose was shown to be at lower levels compared to photon treatment. Conclusion: MeARC was shown to be a promising modality for treating scalp cases and could be beneficial to all superficial tumors with a circular curvature.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-D-213-01: Transparent Photon Detector For The Online Monitoring Of IMRT Beams

Purpose: An innovative Transparent Detector for Radiotherapy (TraDeRa) has been developed. The detector aims at real-time monitoring of modulated beam ahead of the patient during delivery sessions, with a field cover up to 40×40 cm {sup 2}. Methods: TraDeRa consists in a pixelated matrix of ionization chambers with a patented electrodes design. An in-house designed specific integrated circuit allows to extract the signal and provides a real-time map of beam intensity and shape, at the linac pulse-scale. The measurements under irradiation are made with a 6 MV clinical X-Ray beam. Dose calculations are performed with the Monte Carlo code PENELOPE, modeling the full accelerator head and the TraDeRa detector. Results: A 2 % attenuation of the beam was measured in the presence of TraDeRa and the PENELOPE dosimetric study showed no significant modification of the photon beam properties. TraDeRa detects error leaf position as small as 1 mm compared to a reference field, for both static and modulated fields. In addition, measurements are accurate over a large dynamic range from low intensity signals, as inter-leaves leaks, to very high intensities as obtained on the medical line of the European Synchrotron Radiation Facility. The detector is fully operational for conventional and high dose rate beams as FFF modes (up to 2400 MU/min). Conclusion: The current version of TraDeRa shows promising results for IMRT quality assurance (QA), allowing pulse-scale monitoring of the beam and high sensitivity for errors detection. The attenuation is small enough not to hinder the irradiation while keeping the beam upstream of the patient under constant control. A final prototype under development will include 1600 independent electrodes, half of them with a high resolution centered on the beam axis. This compact detector provides an independent set of measurements for a better QA. Funding support : This work was supported by the LABEX PRIMES (ANR-11-LABX-0063) of Universite de Lyon, within the program “Investissements d’Avenir” (ANR-11-IDEX-0007) operated by the French National Research Agency (ANR) and within the project “INSPIRA” operated by the OSEO institution.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2017

Development of the Advanced D1S for Shutdown Dose Rate Calculations in Fusion Reactors

The assessment of the shutdown dose rate due to neutron activation is fundamental for shielding design, materials selection, licensing and planning of maintenance operations in high performances fusion devices. The shutdown dose rate calculations require the combined use of radiation transports and inventory codes. The typical approach consists in a two steps procedure. A pure neutron transport simulation is performed in a first step to calculate the spatial distribution of neutron spectra. The results are used as input for an activation calculation that provides the decay gamma source used in a second step for a pure gamma transport simulation (rigorous-two step, R2S). The Direct 1-Step (D1S) approach has been developed more than ten years ago by ENEA and the ITER team: this technique relies on a coupled neutron-decay gamma transport in a single simulation. It is based on the use of a modified version of the MCNP5 Monte Carlo code with specially tailored nuclear cross-section data for transport and FISPACT inventory code for temporal behaviour. The 'Advanced-D1S' is an improved version of D1S in which additional computational features have been introduced, such as the mesh tally capability and continuous time evolution assessment of the dose rate in single run dose. It has been validated through measurements at JET tokamak and comparison with R2S codes and a future benchmark experiment during next high performance deuterium-tritium campaign is in preparation at JET. It has also been extensively used for ITER calculations and recently applied to DEMO assessment. Present limitations and in progress code improvement strategy are described and discussed in this paper.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-153: Experimental Validation and Calculation Benchmark for a Commercial Monte Carlo Pencil Beam Scanning Proton Therapy Treatment Planning System in Water

Purpose: Eclipse proton Monte Carlo AcurosPT 13.7 was commissioned and experimentally validated for an IBA dedicated PBS nozzle in water. Topas 1.3 was used to isolate the cause of differences in output and penumbra between simulation and experiment. Methods: The spot profiles were measured in air at five locations using Lynx. PTW-34070 Bragg peak chamber (Freiburg, Germany) was used to collect the relative integral Bragg peak for 15 proton energies from 100 MeV to 225 MeV. The phase space parameters (σx, σθ, ρxθ) number of protons per MU, energy spread and calculated mean energy provided by AcurosPT were identically implemented into Topas. The absolute dose, profiles and field size factors measured using ionization chamber arrays were compared with both AcurosPT and Topas. Results: The beam spot size, σx, and the angular spread, σθ, in air were both energy-dependent: in particular, the spot size in air at isocentre ranged from 2.8 to 5.3 mm, and the angular spread ranged from 2.7 mrad to 6 mrad. The number of protons per MU increased from ∼9E7 at 100 MeV to ∼1.5E8 at 225 MeV. Both AcurosPT and TOPAS agree with experiment within 2 mm penumbra difference or 3% dose difference for scenarios including central axis depth dose and profiles at two depths in multi-spot square fields, from 40 to 200 mm, for all the investigated single-energy and multi-energy beams, indicating clinically acceptable source model and radiation transport algorithm in water. Conclusion: By comparing measured data and TOPAS simulation using the same source model, the AcurosPT 13.7 was validated in water within 2 mm penumbra difference or 3% dose difference. Benchmarks versus an independent Monte Carlo code are recommended to study the agreement in output, filed size factors and penumbra differences. This project is partially supported by the Varian grant under the master agreement between University of Pennsylvania and Varian.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

17β-Estradiol regulates cell proliferation, colony formation, migration, invasion and promotes apoptosis by upregulating miR-9 and thus degrades MALAT-1 in osteosarcoma cell MG-63 in an estrogen receptor-independent manner

In bone, different concentration of estrogen leads to various of physiological processes in osteoblast, such as the proliferation, migration, and apoptosis in an estrogen receptor-dependent manner. But little was known about the estrogen effects on osteosarcoma (OS). In this study, OS cell MG-63 was treated with low (1 nM) or high (100 nM) dose of 17β-Estradiol (E2) with the presence or absence of estrogen receptor α (ERα), for evaluating the E2 effects on proliferation, migration, invasion, colony formation and apoptosis. Consistent with a previous study, high dose of E2 treatment dramatically downregulated expressing level of long non-coding RNA metastasis associated lung adenocarcinoma transcript 1 (MALAT-1). The observation of upregulation of miR-9 after a high dose of E2 treatment indicated the cause of MALAT-1 reduction. Downregulation of MALAT-1 promoted the combination of SFPQ/PTBP2 complex. It was also observed that the proliferation, migration, invasion, colony formation and apoptosis of OS cells were remarkably affected by high dose of E2 treatment, but not by low dose, in an ERα independent manner. Furthermore, the abolishment of the effects on these physiological processes caused by ectopic expression of miR-9 ASOs suggested the necessity of miR-9 in MALAT-1 regulation. Here we found that the high dose of E2 treatment upregulated miR-9 thus posttranscriptionally regulated MALAT-1 RNA level in OS cells, and then the downregulation of MALAT-1 inhibited cell proliferation, migration, invasion and epithelial–mesenchymal transition (EMT) processes in the E2-dose dependent and ER-independent ways. - Highlights: • E2 affects osteosarcoma cell MG-63 in an Estrogen receptor-independent way. • High dose of E2 treatment upregulates miR-9 which target to MALAT-1 RNA. • Upregulated miR-9 degrades MALAT-1 and thus affects combination of SFPQ/PTBP2. • E2 treatment block cell proliferation, colony formation, mobility, and enhance apoptosis.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-121: Analyzing the Broadening Effect On the Bragg Peak Due to Heterogeneous Geometries and Implementing User-Routines in the Monte-Carlo Code FLUKA in Order to Reduce Computation Time

Purpose: Aim of this study was to analyze the modulating, broadening effect on the Bragg Peak due to heterogeneous geometries like multi-wire chambers in the beam path of a particle therapy beam line. The effect was described by a mathematical model which was implemented in the Monte-Carlo code FLUKA via user-routines, in order to reduce the computation time for the simulations. Methods: The depth dose curve of 80 MeV/u C12-ions in a water phantom was calculated using the Monte-Carlo code FLUKA (reference curve). The modulating effect on this dose distribution behind eleven mesh-like foils (periodicity ∼80 microns) occurring in a typical set of multi-wire and dose chambers was mathematically described by optimizing a normal distribution so that the reverence curve convoluted with this distribution equals the modulated dose curve. This distribution describes a displacement in water and was transferred in a probability distribution of the thickness of the eleven foils using the water equivalent thickness of the foil’s material. From this distribution the distribution of the thickness of one foil was determined inversely. In FLUKA the heterogeneous foils were replaced by homogeneous foils and a user-routine was programmed that varies the thickness of the homogeneous foils for each simulated particle using this distribution. Results: Using the mathematical model and user-routine in FLUKA the broadening effect could be reproduced exactly when replacing the heterogeneous foils by homogeneous ones. The computation time was reduced by 90 percent. Conclusion: In this study the broadening effect on the Bragg Peak due to heterogeneous structures was analyzed, described by a mathematical model and implemented in FLUKA via user-routines. Applying these routines the computing time was reduced by 90 percent. The developed tool can be used for any heterogeneous structure in the dimensions of microns to millimeters, in principle even for organic materials like lung tissue.

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↗
DOE OSTI2013

Differences in Brainstem Fiber Tract Response to Radiation: A Longitudinal Diffusion Tensor Imaging Study

Purpose: To determine whether radiation-induced changes in white matter tracts are uniform across the brainstem. Methods and Materials: We analyzed serial diffusion tensor imaging data, acquired before radiation therapy and over 48 to 72 months of follow-up, from 42 pediatric patients (age 6-20 years) with medulloblastoma. FSL software (FMRIB, Oxford, UK) was used to calculate fractional anisotropy (FA) and axial, radial, and mean diffusivities. For a consistent identification of volumes of interest (VOIs), the parametric maps of each patient were transformed to a standard brain space (MNI152), on which we identified VOIs including corticospinal tract (CST), medial lemniscus (ML), transverse pontine fiber (TPF), and middle cerebellar peduncle (MCP) at the level of pons. Temporal changes of DTI parameters in VOIs were compared using a linear mixed effect model. Results: Radiation-induced white matter injury was marked by a decline in FA after treatment. The decline was often accompanied by decreased axial diffusivity, increased radial diffusivity, or both. This implied axonal damage and demyelination. We observed that the magnitude of the changes was not always uniform across substructures of the brainstem. Specifically, the changes in DTI parameters for TPF were more pronounced than in other regions (P<.001 for FA) despite similarities in the distribution of dose. We did not find a significant difference among CST, ML, and MCP in these patients (P>.093 for all parameters). Conclusions: Changes in the structural integrity of white matter tracts, assessed by DTI, were not uniform across the brainstem after radiation therapy. These results support a role for tract-based assessment in radiation treatment planning and determination of brainstem tolerance.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

On the feasibility of optical-CT imaging in media of different refractive index

Purpose: Achieving accurate optical-CT 3D dosimetry without the use of viscous refractive index (RI) matching fluids would greatly increase convenience. Methods: Software has been developed to simulate optical-CT 3D dosimetry for a range of scanning configurations including parallel-beam, point, and converging light sources. For each configuration the efficacy of three refractive media was investigated: air, water, a fluid closely matched to PRESAGE{sup Registered-Sign }, and perfect matching (RI = 1.00, 1.33, 1.49, and 1.501 respectively). Reconstructions were performed using both filtered backprojection (FBP) and algebraic reconstruction technique (ART). The efficacy of the three configurations and the two algorithms was evaluated by calculating the usable radius (i.e., the outermost radius where data were accurate to within 2%), and gamma ({Gamma}) analysis. This definition recognizes that for optical-CT imaging, errors are greatest near the edge of the dosimeter, where refraction can be most pronounced. Simulations were performed on three types of dose distribution: uniform, volumetric modulated arc therapy (VMAT), and brachytherapy (Cs-137). Results: For a uniformly irradiated dosimeter the usable radius achieved with filtered backprojection was 68% for water-matching and 31% for dry-scanning in air. Algebraic reconstruction gave usable radii of 99% for both water and air (dry-scanning), indicating greater recovery of useful data for the uniform distribution. FBP and ART performed equally well for a VMAT dose distribution where less dose is delivered near the edge of the dosimeter. In this case, the usable radius was 86% and 53% for scanning in water and air, respectively. For brachytherapy, the usable radius was 99% and 98% for scanning in water and air, respectively using FBP, and a major decrease was seen with ART. Point source geometry provided 1%-2% larger usable radii than parallel geometry. Converging geometry recovered less usable dosimetry data (up to 10% reduced usable radii) than point and parallel geometries. A further disadvantage of converging geometry was an increased requirement on detector size by up to 18 Degree-Sign . Conclusions: For applications where dose information is not required in the periphery of the dosimeter, some dry and low-viscous matching configurations may be feasible. For all three dose distributions (uniform, VMAT, brachytherapy) the point source geometry produced slightly more favorable results (an extra 1%-2% usable radii) than parallel and converging. When dosimetry is required on the periphery, best results were obtained using close refractive matching and ART. A concern for water or dry-scanning is the increase in required detector size, introducing potential cost penalties for manufacturing.

36 MATERIALS SCIENCE↗
DOE OSTI2015

SU-F-BRA-07: Dosimetric Verification of the Valencia Skin Applicator Using Gafchromic EBT3 Film

Purpose: The Valencia applicators have recently been introduced for HDR treatment of small and shallow superficial skin lesions (< 20 mm diameter and 3-mm depth). Per AAPM TG 56, any HDR applicator internal dimensions must be verified prior to clinical use. However radiographic and tomographic imaging to validate the Valencia applicators is impractical due to the Tungsten alloy housing and flattening filter. In this study, we propose to use EBT3 film to indirectly confirm the physical integrity of the Valencia applicators. Methods: Treatment plans were created using the Oncentra MasterPlan TPS v4.5 for the H2 (20-mm dia.) and H3 (30-mm dia.) Valencia Applicators. A virtual CT phantom (2-mm slice thickness) was created with one source position in water. The published effective depth method was used for each applicator to delivery 500 cGy to a 3-mm depth using the TG-43 formalism. Film measurements (n=3) at 3-mm depth and vertical plane in solid water were performed for each applicator to verify the prescribed dose calculated by the TPS. Percent depth dose curves and off-axis profiles (phantom surface and 3-mm depth) were measured and compared to published data. Films were analyzed using an in-house written program and RIT113 v6 software. Film calibration was performed per TG-55 protocol using the Ir-192 source with NIST-traceable calibration. Results: The prescription absolute dose difference was 1% for the Valencia H2 applicator and 4% for the Valencia H3 applicator. The measured percent depth dose curves and off-axis dose profiles measured for the H2 and H2 Valencia applicators are in excellent agreement with the Granero et al. Monte Carlo results{sup 1}. Conclusion: Gafchromic EBT3 film can be used to indirectly verify the internal components of special HDR skin applicators constructed from high Z materials.{sup 1}Granero et al. “Design and evaluation of a HDR skin applicator with flattening filter”, Med. Phys. 35(2), 495–503, 2008.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Scatter factors assessment in microbeam radiation therapy

Purpose: The success of the preclinical studies in Microbeam Radiation Therapy (MRT) paved the way to the clinical trials under preparation at the Biomedical Beamline of the European Synchrotron Radiation Facility. Within this framework, an accurate determination of the deposited dose is crucial. With that aim, the scatter factors, which translate the absolute dose measured in reference conditions (2 x 2 cm{sup 2} field size at 2 cm-depth in water) to peak doses, were assessed. Methods: Monte Carlo (MC) simulations were performed with two different widely used codes, PENELOPE and GEANT4, for the sake of safety. The scatter factors were obtained as the ratio of the doses that are deposited by a microbeam and by a field of reference size, at the reference depth. The calculated values were compared with the experimental data obtained by radiochromic (ISP HD-810) films and a PTW 34070 large area chamber. Results: The scatter factors for different microbeam field sizes assessed by the two MC codes were in agreement and reproduced the experimental data within uncertainty bars. Those correction factors were shown to be non-negligible for the future MRT clinical settings: an average 30% lower dose was deposited by a 50 {mu}m microbeam with respect to the reference conditions. Conclusions: For the first time, the scatter factors in MRT were systematically studied. They constitute an essential key to deposit accurate doses in the forthcoming clinical trials in MRT. The good agreement between the different calculations and the experimental data confirms the reliability of this challenging micrometric dose estimation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Design and implementation of wireless dose logger network for radiological emergency decision support system

A decision support system (DSS) is implemented in Radiological Safety Division, Indira Gandhi Centre for Atomic Research for providing guidance for emergency decision making in case of an inadvertent nuclear accident. Real time gamma dose rate measurement around the stack is used for estimating the radioactive release rate (source term) by using inverse calculation. Wireless gamma dose logging network is designed, implemented, and installed around the Madras Atomic Power Station reactor stack to continuously acquire the environmental gamma dose rate and the details are presented in the paper. The network uses XBee–Pro wireless modules and PSoC controller for wireless interfacing, and the data are logged at the base station. A LabView based program is developed to receive the data, display it on the Google Map, plot the data over the time scale, and register the data in a file to share with DSS software. The DSS at the base station evaluates the real time source term to assess radiation impact.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

TH-EF-BRB-07: Novel Hardware and Software Platform for Intermediate Energy 4π Radiotherapy

Purpose: To develop a robust and efficient platform for the optimization and robotic delivery of highly noncoplanar intensity modulated radiotherapy, which enables significant reduction of normal tissue toxicity and escalation of tumor dose. Methods: An innovative high-output compact 3 MV linac was designed for mounting onto a commercial robotic system in order to access the entire 4π beam solution space without moving the patient couch. The use of intermediate energy X-rays for radiotherapy was evaluated in comparison to clinical plans delivered using 6 MV X-rays and a state-of-the-art delivery system. Monte Carlo simulations of a 3 MV percent depth dose curve were performed for intermediate energy dose calculation. The beam model was used to create a convolution/superposition-based dose calculation engine for 3MV X-rays. The 4π greedy column generation algorithm was used for optimized beam selection and fluence map optimization. Results: A detailed design of the first 3 MV linac capable of producing a competitively high dose rate of >800 cGy/min at 100 cm was completed and verified through extensive simulation. The complete linac head including a multileaf collimator can access most of the 4π solution space including the posterior orientations without changing the couch height. When compared to 6 MV clinical plans, the proposed 3 MV 4π plans demonstrated significantly better dose compactness and normal tissue sparing in brain, prostate, and partial breast treatment plans. Conclusion: We demonstrate the design of a highly versatile radiotherapy machine to natively deliver non-coplanar 4π radiotherapy without the need to move the patient during treatment. This novel platform is efficient and capable of providing dosimetry that is 30–50% more compact than existing therapy platforms. The new system is projected to be cost effective due to improved treatment time and automation. NIH R43CA183390, NIH R01CA188300.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

{sup 103}Pd strings: Monte Carlo assessment of a new approach to brachytherapy source design

Purpose: A new type of{sup 103}Pd source (CivaString and CivaThin by CivaTech Oncology, Inc.) is examined. The source contains {sup 103}Pd and Au radio-opaque marker(s), all contained within low-Z{sub eff} organic polymers that permit source flexibility. The CivaString source is available in lengths L of 10, 20, 30, 40, 50, and 60 mm, and referred to in the current study as CS10–CS60, respectively. A thinner design, CivaThin, has sources designated as CT10–CT60, respectively. The CivaString and CivaThin sources are 0.85 and 0.60 mm in diameter, respectively. The source design is novel and offers an opportunity to examine its interesting dosimetric properties in comparison to conventional {sup 103}Pd seeds. Methods: The MCNP5 radiation transport code was used to estimate air-kerma rate and dose rate distributions with polar and cylindrical coordinate systems. Doses in water and prostate tissue phantoms were compared to determine differences between the TG-43 formalism and realistic clinical circumstances. The influence of Ti encapsulation and 2.7 keV photons was examined. The accuracy of superposition of dose distributions from shorter sources to create longer source dose distributions was also assessed. Results: The normalized air-kerma rate was not highly dependent onL or the polar angle θ, with results being nearly identical between the CivaString and CivaThin sources for common L. The air-kerma strength was also weakly dependent on L. The uncertainty analysis established a standard uncertainty of 1.3% for the dose-rate constant Λ, where the largest contributors were μ{sub en}/ρ and μ/ρ. The Λ values decreased with increasing L, which was largely explained by differences in solid angle. The radial dose function did not substantially vary among the CivaString and CivaThin sources for r ≥ 1 cm. However, behavior for r < 1 cm indicated that the Au marker(s) shielded radiation for the sources having L = 10, 30, and 50 mm. The 2D anisotropy function exhibited peaks and valleys that corresponded to positions adjacent to {sup 103}Pd wells and Au markers, respectively. Dose distributions of both source types had minimal anisotropy in comparison to conventional {sup 103}Pd seeds. Contributions by 2.7 keV photons comprised ≤0.1% of the dose from all photons at positions farther than 0.13 mm from the polymer source surface. Differences between absorbed dose to water and prostate became more substantial as distance from the sources increased, with prostate dose being about 13% lower for r = 5 cm. Using a cylindrical coordinate system, dose superposition of small length sources to replicate the dose distribution for a long length source proved to be a robust technique; a 2.0% tolerance compared with the reference dose distribution did not exceed 0.1 cm{sup 3} for any of the examined source combinations. Conclusions: By design, the CivaString and CivaThin sources have novel dosimetric characteristics in comparison to Ti-encapsulated{sup 103}Pd seeds. The dosimetric characterization has determined the reasons for these differences through analysis using Monte Carlo-based radiation transport simulations.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-T-384: Experimental Verification of a Monte Carlo Linear Accelerator Model Using a Radiochromic Film Stack Dosimeter

Purpose: To experimentally verify a Monte Carlo (MC) linear accelerator model for the simulation of intensity-modulated radiation therapy (IMRT) treatments of moving targets. Methods: A Varian Clinac™ 21EX linear accelerator was modeled using the EGSnrc user code BEAMnrc. The mean energy, radial-intensity distribution, and divergence of the electron beam incident on the bremsstrahlung target were adjusted to achieve agreement between simulated and measured percentage-depth-dose and transverse field profiles for a 6 MV beam. A seven-field step-and-shoot IMRT lung procedure was prepared using Varian Eclipse™ treatment planning software. The plan was delivered using a Clinac™ 21EX linear accelerator and measured with a Gafchromic™ EBT2 film stack dosimeter (FSD) in two separate static geometries: within a cylindrical water-equivalent-plastic phantom and within an anthropomorphic chest phantom. Two measurements were completed in each setup. The dose distribution for each geometry was simulated using the EGSnrc user code DOSXYZnrc. MC geometries of the treatment couch, cylindrical phantom, and chest phantom were developed by thresholding CT data sets using MATLAB™. The FSD was modeled as water. The measured and simulated dose distributions were normalized to the median dose within the FSD. Results: Using an electron beam with a mean energy of 6.05 MeV, a Gaussian radial-intensity distribution with a full width at half maximum of 1.5 mm, and a divergence of 0°, the measured and simulated dose profiles agree within 1.75% and 1 mm. Measured and simulated dose distributions within both the cylindrical and chest phantoms agree within 3% over 94% of the FSD volume. The overall uncertainty in the FSD measurements is 3.1% (k=1). Conclusion: MC simulations agree with FSD measurements within measurement uncertainty, thereby verifying the accuracy of the linear accelerator model for the simulation of IMRT treatments of static geometries. The experimental verification will be extended to treatments of targets undergoing three-dimensional motion.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

GMctdospp: Description and validation of a CT dose calculation system

Purpose: To develop a Monte Carlo (MC)-based computed tomography (CT) dose estimation method with a graphical user interface with options to define almost arbitrary simulation scenarios, to make calculations sufficiently fast for comfortable handling, and to make the software free of charge for general availability to the scientific community. Methods: A framework called GMctdospp was developed to calculate phantom and patient doses with the MC method based on the EGSnrc system. A CT scanner was modeled for testing and was adapted to half-value layer, beam-shaping filter, z-profile, and tube-current modulation (TCM). To validate the implemented variance reduction techniques, depth-dose and cross-profile calculations of a static beam were compared against DOSXYZnrc/EGSnrc. Measurements for beam energies of 80 and 120 kVp at several positions of a CT dose-index (CTDI) standard phantom were compared against calculations of the created CT model. Finally, the efficiency of the adapted code was benchmarked against EGSnrc defaults. Results: The CT scanner could be modeled accurately. The developed TCM scheme was confirmed by the dose measurement. A comparison of calculations to DOSXYZnrc showed no systematic differences. Measurements in a CTDI phantom could be reproduced within 2% average, with a maximal difference of about 6%. Efficiency improvements of about six orders of magnitude were observed for larger organ structures of a chest-examination protocol in a voxelized phantom. In these cases, simulations took 25 s to achieve a statistical uncertainty of ∼0.5%. Conclusions: A fast dose-calculation system for phantoms and patients in a CT examination was developed, successfully validated, and benchmarked. Influences of scan protocols, protection method, and other issues can be easily examined with the developed framework.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2010

Total skin electron therapy (TSET): A reimplementation using radiochromic films and IAEA TRS-398 code of practice

Purpose: The aim of this work is to present an updated implementation of total skin electron therapy (TSET) using IAEA TRS-398 code of practice for absolute dosimetry and taking advantage of the use of radiochromic films. The optimization of quality control tests is also included. Methods: A Varian 2100 C/D linear accelerator equipped with the special procedure HDTSe{sup -} (high dose rate total skin electron mode, E=6 MeV) was employed to perform TSET irradiations using the modified Stanford technique. The commissioning was performed following the AAPM report 23 recommendations. In particular, for dual-field beams irradiation, the optimal tilt angle was investigated and the dose distribution in the treatment plane was measured. For a complete six dual-field beams irradiation, the treatment skin dose on the surface of a cylindrical phantom was evaluated by radiochromic films and the B factor which relates the single dual-field skin dose to the six dual-field skin dose was assessed. Since the TRS-398 reference conditions do not meet the requirements of TSET absolute dosimetry, GafChromic EBT films were also employed to check and validate the application of the protocol. Simplified procedures were studied to verify beam constancy in PMMA phantoms without the more difficult setup of total skin irradiation. Results: The optimized geometrical setup for dual-field beams was: Tilt angle={+-}19 deg., SSD=353 cm, and the beam degrader (200x100x1 cm{sup 3}) placed at 320 cm from the source. As regards to dose homogeneity in the treatment plane, for dual-field beams irradiation, the mean relative dose value was 97%{+-}5% (normalizing to 100% at the calibration point level). For six dual-field beams irradiation, the multiplication factor B was 2.63. In addition, beam quality, dose rate, and bremsstrahlung contribution were also suitable for TSET treatments. The TRS-398 code of practice was used for TSET dosimetry, as dose measurements performed by ionization chamber and radiochromic film agreed within 2.5%. Simplified quality control tests and baseline values were presented in order to check flatness, symmetry, and field size with radiochromic films and output and beam quality constancy with ionization chamber. Short-term reproducibility and MU linearity tests were also included. Conclusions: Commissioning parameters met the requirements of TSET treatments and the matching of AAPM guidelines with the IAEA code of practice was successful. Frequent beam performance controls can be easily performed through the presented quality assurance tests. Radiochromic dosimetry facilitated the TSET commissioning and played a major role to validate the application of TRS-398.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-235: Monte Carlo Analysis of the Dose Enhancement in the Scalp of Patients Due to Titanium Plate Backscatter During Post-Operative Radiotherapy

Purpose: To quantify the clinically observed dose enhancement adjacent to cranial titanium fixation plates during post-operative radiotherapy. Methods: Irradiation of a titanium burr hole cover was simulated using Monte Carlo code MCNPX for a 6 MV photon spectrum to investigate backscatter dose enhancement due to increased production of secondary electrons within the titanium plate. The simulated plate was placed 3 mm deep in a water phantom, and dose deposition was tallied for 0.2 mm thick cells adjacent to the entrance and exit sides of the plate. These results were compared to a simulation excluding the presence of the titanium to calculate relative dose enhancement on the entrance and exit sides of the plate. To verify simulated results, two titanium burr hole covers (Synthes, Inc. and Biomet, Inc.) were irradiated with 6 MV photons in a solid water phantom containing GafChromic MD-55 film. The phantom was irradiated on a Varian 21EX linear accelerator at multiple gantry angles (0–180 degrees) to analyze the angular dependence of the backscattered radiation. Relative dose enhancement was quantified using computer software. Results: Monte Carlo simulations indicate a relative difference of 26.4% and 7.1% on the entrance and exit sides of the plate respectively. Film dosimetry results using a similar geometry indicate a relative difference of 13% and -10% on the entrance and exit sides of the plate respectively. Relative dose enhancement on the entrance side of the plate decreased with increasing gantry angle from 0 to 180 degrees. Conclusion: Film and simulation results demonstrate an increase in dose to structures immediately adjacent to cranial titanium fixation plates. Increased beam obliquity has shown to alleviate dose enhancement to some extent. These results are consistent with clinically observed effects.

60 APPLIED LIFE SCIENCES↗