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All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

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

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

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

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

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

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2012

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

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

79 ASTRONOMY AND ASTROPHYSICS↗
NASA NTRS1987

Use of maximum entropy method with parallel processing machine

The maximum entropy method (MEM) and balanced correlation method were used to reconstruct the images of low-intensity X-ray objects obtained experimentally by means of a uniformly redundant array coded aperture system. The reconstructed images from MEM are clearly superior. However, the MEM algorithm is computationally more time-consuming because of its iterative nature. On the other hand, both the inherently two-dimensional character of images and the iterative computations of MEM suggest the use of parallel processing machines. Accordingly, computations were carried out on the massively parallel processor at Goddard Space Flight Center as well as on the serial processing machine VAX 8600, and the results are compared.

Yin, Lo I.↗
DOE OSTI2016

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

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

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

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

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

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

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

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

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

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

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

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

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-D-210-06: Feasibility for Monitoring the Head of the Pancreas Motion Through a Surrogate Using Ultrasound During Radiation Therapy Delivery

Purpose: Substantial target motion during the delivery of radiation therapy (RT) for pancreatic cancer is well recognized as a major limiting factor on RT effectiveness. The aim of this work is to monitor intra-fractional motion of the pancreas using ultrasound during RT delivery. Methods: Transabdominal Ultrasound B-mode images were collected from 5 volunteers using a research version of the Clarity Autoscan System (Elekta). The autoscan transducer with center frequency of 5 MHz was utilized for the scans. Imaging parameters were adjusted to acquire images at the desired depth with good contrast and a wide sweep angle. Since well-defined boundaries of the pancreas can be difficult to find on ultrasound B-mode images, the portal vein was selected as a surrogate for motion estimation of the head of the pancreas. The selection was due to its anatomical location posterior to the neck of the pancreas and close proximity to the pancreas head. The portal vein was contoured on the ultrasound images acquired during simulation using the Clarity Research AFC Workstation software. Volunteers were set up in a similar manner to the simulation for their monitoring session and the ultrasound transducer was mounted on an arm fixed to the couch. A video segment of the portal vein motion was captured. Results: The portal vein was visualized and segmented. Successful monitoring sessions of the portal vein were observed. In addition, our results showed that the ultrasound transducer itself reduces breathing related motion. This is analogous to the use of a compression plate to suppress respiration motion during thorax or abdominal irradiation. Conclusion: We demonstrate the feasibility of tracking the pancreas through the localization of the portal vein using abdominal ultrasound. This will allow for real-time tracking of the intra-fractional motion to justify PTV-margin and to account for unusual motions, thus, improving normal tissue sparing. This research was funding in part by Elekta Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

STUDY OF THE RECURRING DIMMING REGION DETECTED AT AR 11305 USING THE CORONAL DIMMING TRACKER (CoDiT)

We present a new approach to coronal dimming detection using the COronal DImming Tracker tool (CODIT), which was found to be successful in locating and tracking multiple dimming regions. This tool, an extension of a previously developed coronal hole tracking software, allows us to study the properties and the spatial evolution of dimming regions at high temporal and spatial cadence from the time of their appearance to their disappearance. We use Solar Dynamics Observatory/Atmospheric Imaging Assembly 193 A wavelength observations and Helioseismic and Magnetic Imager magnetograms to study dimmings. As a demonstration of the detection technique we analyzed six recurrences of a dimming observed near AR 11305 between 2011 September 29 and October 2. The dimming repeatedly appeared and formed in a similar way, first expanding then shrinking and occasionally stabilizing in the same location until the next eruption. The dimming areas were studied in conjunction with the corresponding flare magnitudes and coronal mass ejection (CME) masses. These properties were found to follow a similar trend during the observation period, which is consistent with the idea that the magnitude of the eruption and the CME mass affect the relative sizes of the consecutive dimmings. We also present a hypothesis to explain the evolution of the recurrent single dimming through interchange reconnection. This process would accommodate the relocation of quasi-open magnetic field lines and hence allow the CME flux rope footpoint (the dimming) to expand into quiet-Sun regions. By relating the properties of dimmings, flares, and CMEs we improve our understanding of the magnetic field reconfiguration caused by reconnection.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2014

SU-E-T-204: Improving Multiple Isocenter Coincidence: Elekta Beam Modulator with HexaPOD Six Degrees Couchtop

Purpose: With evolution from frame-based to image-guided SRS/SRT technique, the coincidence of multiple isocenters must be within a tight tolerance: MV, kV, table mechanical, and, in this case, HexaPOD 6° patient positioning system. Reported here is a method for improving the effectiveness of an isocenter alignment procedure which ultimately led to isocenter coincidence on an Elekta Beam Modulator LINAC equipped with 4 mm MLC leaves and a fixed secondary jaw to within a radius of 1mm. Methods: Utilizing a self-leveling laser, the Elekta ball (BB) bearing phantom (8mm steel ball), the Modus QA Isocenter Cube software, and a colleague-provided isocenter alignment method, the kV, table mechanical, and HexaPOD isocenters were localized to the MV isocenter. Isocenter coincidence was tested using the Isocenter Cube from Modus QA, brought to kV isocenter using CBCT and the HexaPOD system. MV images were taken at various gantry, collimator, and couch angles and then analyzed with the aforementioned software to determine coincidence of the 5mm steel ball at cube center with MV isocenter. To improve overall coincidence, two errors were addressed iteratively: (1) LINAC mechanical and radiation isocenter coincidence allowing each isocenter volume to have similar variations during gantry and collimator rotation and (2) collimator rotational walkout which reduced the size of both mechanical and radiation isocenters. Beam steering was performed to bring MV isocenter closer to mechanical and collimator walkout was adjusted by physically shifting the MLC bank. Initial procedures were repeated to align all isocenters and perform regular checks for consistency. Results: Post-initial alignment revealed a maximum diameter of 1.8mm for MV isocenter and maximum isocenter alignment error of up to 1.22mm radius which improved to roughly 1.0mm MV isocenter diameter and <0.71mm radius alignment error with a consistency within 0.25mm. Conclusion: With the methods described, all isocenters were brought into alignment within a radius of 1mm.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-435: Development and Commissioning of a Complete System for In-Vivo Dosimetry and Range Verification in Proton Therapy

Purpose: In-vivo dose and beam range verification in proton therapy could play significant roles in proton treatment validation and improvements. Invivo beam range verification, in particular, could enable new treatment techniques one of which, for example, could be the use of anterior fields for prostate treatment instead of opposed lateral fields as in current practice. We have developed and commissioned an integrated system with hardware, software and workflow protocols, to provide a complete solution, simultaneously for both in-vivo dosimetry and range verification for proton therapy. Methods: The system uses a matrix of diodes, up to 12 in total, but separable into three groups for flexibility in application. A special amplifier was developed to capture extremely small signals from very low proton beam current. The software was developed within iMagX, a general platform for image processing in radiation therapy applications. The range determination exploits the inherent relationship between the internal range modulation clock of the proton therapy system and the radiological depth at the point of measurement. The commissioning of the system, for in-vivo dosimetry and for range verification was separately conducted using anthropomorphic phantom. EBT films and TLDs were used for dose comparisons and range scan of the beam distal fall-off was used as ground truth for range verification. Results: For in-vivo dose measurement, the results were in agreement with TLD and EBT films and were within 3% from treatment planning calculations. For range verification, a precision of 0.5mm is achieved in homogeneous phantoms, and a precision of 2mm for anthropomorphic pelvic phantom, except at points with significant range mixing. Conclusion: We completed the commissioning of our system for in-vivo dosimetry and range verification in proton therapy. The results suggest that the system is ready for clinical trials on patient.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-J-11: A New Optical Method to Register Patient External Motion

Purpose: To devise and implement a new system to measure and register the patient motion during radiotherapy treatments. Methods: The system can obtain the position of several points in the 3D-space, through their projections in the 2D-images recorded by two cameras. The algorithm needs a series of constants, that are obtained using the images of a calibrated phantom.To test the system, some adhesive labels were placed on the surface of an object. Two cameras recorded the moving object over time. An in-house developed software localized the labels in each image. In the first pair of images, the program used a first approximation given by the user. In the subsequent images, it used the last position as an approximate location. The final exact coordinates of the point were obtained in a two-step process using the contrast of the images. From the 2D-positions of the point in each frame, the 3D-trajectories of each of these marks were obtained.The system was tested with linear displacements, oscillations of a mechanical oscillator, circular trajectories of a rotating disk, and with respiratory motion of a volunteer. Results: Trajectories of several points were reproduced with sub-millimeter accuracy in the three directions of the space. The system was able to follow periodic motion with amplitudes lower than 0.5mm; and trajectories of rotating points at speeds up to 200mm/s. The software could also track accurately the respiration motion of a person. Conclusion: A new, inexpensive optical tracking system for patient motion has been demonstrated. The system detects motion with high accuracy. Installation and calibration of the system is simple and quick. Data collection is not expected to involve any discomfort for the patient, nor any delay for the treatment. The system could be also used as a method of warning for patient movements, and for gating. We acknowledge financial support from Fundacion Mutua Madrilena, Madrid, Spain.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-T-490: Independent Three-Dimensional (3D) Dose Verification of VMAT/SBRT Using EPID and Cloud Computing

Purpose: Dosimetric verification of VMAT/SBRT is currently performed on one or two planes in a phantom with either film or array detectors. A robust and easy-to-use 3D dosimetric tool has been sought since the advent of conformal radiation therapy. Here we present such a strategy for independent 3D VMAT/SBRT plan verification system by a combined use of EPID and cloud-based Monte Carlo (MC) dose calculation. Methods: The 3D dosimetric verification proceeds in two steps. First, the plan was delivered with a high resolution portable EPID mounted on the gantry, and the EPID-captured gantry-angle-resolved VMAT/SBRT field images were converted into fluence by using the EPID pixel response function derived from MC simulations. The fluence was resampled and used as the input for an in-house developed Amazon cloud-based MC software to reconstruct the 3D dose distribution. The accuracy of the developed 3D dosimetric tool was assessed using a Delta4 phantom with various field sizes (square, circular, rectangular, and irregular MLC fields) and different patient cases. The method was applied to validate VMAT/SBRT plans using WFF and FFF photon beams (Varian TrueBeam STX). Results: It was found that the proposed method yielded results consistent with the Delta4 measurements. For points on the two detector planes, a good agreement within 1.5% were found for all the testing fields. Patient VMAT/SBRT plan studies revealed similar level of accuracy: an average γ-index passing rate of 99.2± 0.6% (3mm/3%), 97.4± 2.4% (2mm/2%), and 72.6± 8.4 % ( 1mm/1%). Conclusion: A valuable 3D dosimetric verification strategy has been developed for VMAT/SBRT plan validation. The technique provides a viable solution for a number of intractable dosimetry problems, such as small fields and plans with high dose gradient.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-AB-202-03: Prediction of PET Transfer Uncertainty by DIR Error Estimating Software, AUTODIRECT

Purpose: Deformable image registration (DIR) is a powerful tool, but DIR errors can adversely affect its clinical applications. To estimate voxel-specific DIR uncertainty, a software tool, called AUTODIRECT (automated DIR evaluation of confidence tool), has been developed and validated. This work tests the ability of this software to predict uncertainty for the transfer of standard uptake values (SUV) from positron-emission tomography (PET) with DIR. Methods: Virtual phantoms are used for this study. Each phantom has a planning computed tomography (CT) image and a diagnostic PET-CT image set. A deformation was digitally applied to the diagnostic CT to create the planning CT image and establish a known deformation between the images. One lung and three rectum patient datasets were employed to create the virtual phantoms. Both of these sites have difficult deformation scenarios associated with them, which can affect DIR accuracy (lung tissue sliding and changes in rectal filling). The virtual phantoms were created to simulate these scenarios by introducing discontinuities in the deformation field at the lung rectum border. The DIR algorithm from Plastimatch software was applied to these phantoms. The SUV mapping errors from the DIR were then compared to that predicted by AUTODIRECT. Results: The SUV error distributions closely followed the AUTODIRECT predicted error distribution for the 4 test cases. The minimum and maximum PET SUVs were produced from AUTODIRECT at 95% confidence interval before applying gradient-based SUV segmentation for each of these volumes. Notably, 93.5% of the target volume warped by the true deformation was included within the AUTODIRECT-predicted maximum SUV volume after the segmentation, while 78.9% of the target volume was within the target volume warped by Plastimatch. Conclusion: The AUTODIRECT framework is able to predict PET transfer uncertainty caused by DIR, which enables an understanding of the associated target volume uncertainty.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-348: Effect of Treatment Table and Immobilization Devices On Surface Dose When Using a GRID Technique

Purpose: To determine the increase of surface dose of MLC-designed GRID therapy in the presence of immobilization devices and treatment table. Methods: To create a GRID field, our facility utilizes an MLC consisting of four millimeter wide leaves. The field is designed to have aperture sizes of 0.8 cm X 0.8 cm with inter-aperture distance of 3.2 cm. Gafchromic EBT3 film was placed between the surface of a solid water phantom and the immobilization device. The treatment table was also present within the beam path. The devices consist of carbon fiber exterior shell. A piece of film was also placed at maximal depth for the photon energy of 10 MV. Image files were converted to dose per a calibration curve based on the selected red channel. The surface dose to maximum dose was established by comparing the ratio of seven centrally located aperture regions-of-interest and four adjacent inter-aperture regions-of-interest were measured with the available software tools. Results: With no devices present in beam path, the ratio of surface dose to maximum dose was 11.5% ± 0.3% for aperture region and 7.0% ± 0.1% for inter-aperture region. When devices are present, the ratio of surface dose to maximum dose was 45.2% ± 0.5% and 33.8% ± 1.1%, respectively. Due to the presence of devices, the surface dose increases in aperture region by 3.8 times or in the inter-aperture region by 4.7 times. Conclusion: The purpose of using GRID technique is to deliver a single fractional dose in range of 15–20 Gy to a bulky lesion while also preserving skin tolerance. The increase of surface dose due to devices placed in beam path may increase the chance of skin toxicity in GRID therapy. Care should be used to determine best manageable patient immobilization while considering skin dose especially for posteriorly located lesions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-195: Gantry Angle Dependency of MLC Leaf Position Error

Purpose: The aim of this study was to investigate the gantry angle dependency of the multileaf collimator (MLC) leaf position error. Methods: An automatic MLC quality assurance system (AutoMLCQA) was developed to evaluate the gantry angle dependency of the MLC leaf position error using an electronic portal imaging device (EPID). To eliminate the EPID position error due to gantry rotation, we designed a reference maker (RM) that could be inserted into the wedge mount. After setting up the EPID, a reference image was taken of the RM using an open field. Next, an EPID-based picket-fence test (PFT) was performed without the RM. These procedures were repeated at every 45° intervals of the gantry angle. A total of eight reference images and PFT image sets were analyzed using in-house software. The average MLC leaf position error was calculated at five pickets (-10, -5, 0, 5, and 10 cm) in accordance with general PFT guidelines using in-house software. This test was carried out for four linear accelerators. Results: The average MLC leaf position errors were within the set criterion of <1 mm (actual errors ranged from -0.7 to 0.8 mm) for all gantry angles, but significant gantry angle dependency was observed in all machines. The error was smaller at a gantry angle of 0° but increased toward the positive direction with gantry angle increments in the clockwise direction. The error reached a maximum value at a gantry angle of 90° and then gradually decreased until 180°. In the counter-clockwise rotation of the gantry, the same pattern of error was observed but the error increased in the negative direction. Conclusion: The AutoMLCQA system was useful to evaluate the MLC leaf position error for various gantry angles without the EPID position error. The Gantry angle dependency should be considered during MLC leaf position error analysis.

07 ISOTOPE AND RADIATION SOURCES↗