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At least 523 records · Page 29

SU-E-T-27: A Tool for Routine Quality Assurance of Radiotherapy Dose Calculation Software

Purpose: Dose calculation software is thoroughly evaluated when it is commissioned; however, evaluation of periodic software updates is typically limited in scope due to staffing constraints and the need to quickly return the treatment planning system to clinical service. We developed a tool for quickly and comprehensively testing and documenting dose calculation software against measured data. Methods: A tool was developed using MatLab (The MathWorks, Natick, MA) for evaluation of dose calculation algorithms against measured data. Inputs to the tool are measured data, reference DICOM RT PLAN files describing the measurements, and dose calculations in DICOM format. The tool consists of a collection of extensible modules that can perform analysis of point dose, depth dose curves, and profiles using dose difference, distance-to-agreement, and the gamma-index. Each module generates a report subsection that is incorporated into a master template, which is converted to final form in portable document format (PDF). Results: After each change to the treatment planning system, a report can be generated in approximately 90 minutes. The tool has been in use for more than 5 years, spanning 5 versions of the eMC and 4 versions of the AAA. We have detected changes to the algorithms that affected clinical practice once during this period. Conclusion: Our tool provides an efficient method for quality assurance of dose calculation software, providing a complete set of tests for an update. Future work includes the addition of plan level tests, allowing incorporation of, for example, the TG-119 test suite for IMRT, and integration with the treatment planning system via an application programming interface. Integration with the planning system will permit fully-automated testing and reporting at scheduled intervals.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-48: Automated Quality Assurance for XML Controlled Linacs

Purpose: To automate routine imaging QA procedures so that complying with TG 142 and TG 179 can be efficient and reliable. Methods: Two QA tests for a True Beam Linac were automatized. A Winston Lutz test as described by Lutz et al{sup 1} using the Winston Lutz test kit from BrainLab, Germany and a CBCT Image Quality test as described in TG 179 using the EMMA phantom, Siemens Medical Physics, Germany were performed in our True Beam. For each QA procedure tested, a 3 step paradigm was used. First, the data was automatically acquired using True Beam Developer Mode and XML scripting. Second, the data acquired in the first step was automatically processed using in-home grown Matlab GUIs. Third, Machine Learning algorithms were used to automatically classify the processed data and reports generated. Results: The Winston Luzt test could be performed by an experienced medical physicist in 29.0 ± 8.0 min. The same test, if automated using our paradigm, could be performed in 3.0 ± 0.1 min. In the same lieu, time could be substantially saved for image quality tests. In this case, the amount of time saved will depend on the phantoms used and the initial localization method. Additionally, machine learning algorithms could automatically identify the roots of the problems if any and possibly help reduce machine down time. Conclusion: Modern linear accelerators are equipped with advanced 2D and 3D imaging that are used for patient alignment substantially improving IGRT protocols. However, this extra complexity exponentially increases the number of QA tests needed. Using the new paradigm described above, not only bare minimum but best practice QA programs could be implemented with the same manpower. This work is supported by Varian, Palo Alto, CA.

60 APPLIED LIFE SCIENCES↗

SU-E-T-50: Automatic Validation of Megavoltage Beams Modeled for Clinical Use in Radiation Therapy

Purpose: To automatically validate megavoltage beams modeled in XiO™ 4.50 (Elekta, Stockholm, Sweden) and Varian Eclipse™ Treatment Planning Systems (TPS) (Varian Associates, Palo Alto, CA, USA), reducing validation time before beam-on for clinical use. Methods: A software application that can automatically read and analyze DICOM RT Dose and W2CAD files was developed using MatLab integrated development environment.TPS calculated dose distributions, in DICOM RT Dose format, and dose values measured in different Varian Clinac beams, in W2CAD format, were compared. Experimental beam data used were those acquired for beam commissioning, collected on a water phantom with a 2D automatic beam scanning system.Two methods were chosen to evaluate dose distributions fitting: gamma analysis and point tests described in Appendix E of IAEA TECDOC-1583. Depth dose curves and beam profiles were evaluated for both open and wedged beams. Tolerance parameters chosen for gamma analysis are 3% and 3 mm dose and distance, respectively.Absolute dose was measured independently at points proposed in Appendix E of TECDOC-1583 to validate software results. Results: TPS calculated depth dose distributions agree with measured beam data under fixed precision values at all depths analyzed. Measured beam dose profiles match TPS calculated doses with high accuracy in both open and wedged beams. Depth and profile dose distributions fitting analysis show gamma values < 1. Relative errors at points proposed in Appendix E of TECDOC-1583 meet therein recommended tolerances.Independent absolute dose measurements at points proposed in Appendix E of TECDOC-1583 confirm software results. Conclusion: Automatic validation of megavoltage beams modeled for their use in the clinic was accomplished. The software tool developed proved efficient, giving users a convenient and reliable environment to decide whether to accept or not a beam model for clinical use. Validation time before beam-on for clinical use was reduced to a few hours.

60 APPLIED LIFE SCIENCES↗

SU-E-T-194: From Dicom-RT to Radiobiological Dose Metrics in 5 Minutes

Purpose: To develop a flexible and standalone framework for batch calculation of radiobiological dose metrics from Dicom-RT. Methods: Software has been developed which allows (1) The calculation of DVH data from DICOM dose and structure files (DVHgenerator), (2) Calculation of a wide range of radiobiological metrics from this data (CompPlanGui). Both these tools are run via graphical user interface (GUI), making them fast and simple. Part 1 is a new tool which has not previously been published, whilst part 2 is a GUI overlay for the previously published software ‘Comp-Plan’ (Holloway et. al., Medical Dosimetry, 2012), previously reliant on command line interface. The time taken for an experienced user to evaluate a test case of 6 plans with and without CompPlanGUI was quantified. Results: The DVH-generator has been found to be faster, more robust and require far less physical memory then using alternative software solutions for the same purpose. The Comp Plan GUI significantly reduces the amount of time required to set up a base directory, eliminates code crashes arising from typographical errors, and renders the code far more accessible to non-expert users. It took an experienced user of the code around 3 minutes to set up a base directory of 6 plans compared around 8 minutes without, indicating that using CompPlanGUI reduced setup time by over 50%. Conclusion: A standalone GUI based framework has developed which allows for the batch calculation of radiobiological dose metrics directly from Dicom-RT files. As with the original code, this work will be made freely available on request, as well as via matlab file exchange.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-206: Improving Radiotherapy Toxicity Based On Artificial Neural Network (ANN) for Head and Neck Cancer Patients

Purpose/Objective(s): The aim of this study is to build the estimator of toxicity using artificial neural network (ANN) for head and neck cancer patients Materials/Methods: An ANN can combine variables into a predictive model during training and considered all possible correlations of variables. We constructed an ANN based on the data from 73 patients with advanced H and N cancer treated with external beam radiotherapy and/or chemotherapy at our institution. For the toxicity estimator we defined input data including age, sex, site, stage, pathology, status of chemo, technique of external beam radiation therapy (EBRT), length of treatment, dose of EBRT, status of post operation, length of follow-up, the status of local recurrences and distant metastasis. These data were digitized based on the significance and fed to the ANN as input nodes. We used 20 hidden nodes (for the 13 input nodes) to take care of the correlations of input nodes. For training ANN, we divided data into three subsets such as training set, validation set and test set. Finally, we built the estimator for the toxicity from ANN output. Results: We used 13 input variables including the status of local recurrences and distant metastasis and 20 hidden nodes for correlations. 59 patients for training set, 7 patients for validation set and 7 patients for test set and fed the inputs to Matlab neural network fitting tool. We trained the data within 15% of errors of outcome. In the end we have the toxicity estimation with 74% of accuracy. Conclusion: We proved in principle that ANN can be a very useful tool for predicting the RT outcomes for high risk H and N patients. Currently we are improving the results using cross validation.

60 APPLIED LIFE SCIENCES↗

SU-E-T-214: Intensity Modulated Proton Therapy (IMPT) Based On Passively Scattered Protons and Multi-Leaf Collimation: Prototype TPS and Dosimetry Study

Purpose. Intensity-modulated proton therapy is usually implemented with multi-field optimization of pencil-beam scanning (PBS) proton fields. However, at the view of the experience with photon-IMRT, proton facilities equipped with double-scattering (DS) delivery and multi-leaf collimation (MLC) could produce highly conformal dose distributions (and possibly eliminate the need for patient-specific compensators) with a clever use of their MLC field shaping, provided that an optimal inverse TPS is developed. Methods. A prototype TPS was developed in MATLAB. The dose calculation process was based on a fluence-dose algorithm on an adaptive divergent grid. A database of dose kernels was precalculated in order to allow for fast variations of the field range and modulation during optimization. The inverse planning process was based on the adaptive simulated annealing approach, with direct aperture optimization of the MLC leaves. A dosimetry study was performed on a phantom formed by three concentrical semicylinders separated by 5 mm, of which the inner-most and outer-most were regarded as organs at risk (OARs), and the middle one as the PTV. We chose a concave target (which is not treatable with conventional DS fields) to show the potential of our technique. The optimizer was configured to minimize the mean dose to the OARs while keeping a good coverage of the target. Results. The plan produced by the prototype TPS achieved a conformity index of 1.34, with the mean doses to the OARs below 78% of the prescribed dose. This Result is hardly achievable with traditional conformal DS technique with compensators, and it compares to what can be obtained with PBS. Conclusion. It is certainly feasible to produce IMPT fields with MLC passive scattering fields. With a fully developed treatment planning system, the produced plans can be superior to traditional DS plans in terms of plan conformity and dose to organs at risk.

60 APPLIED LIFE SCIENCES↗

SU-E-T-252: On the Evaluation of Patient Specific IMRT QA Using EPID, Dynalog Files and Patient Anatomy

Purpose: This research, investigates the viability of using the Electronic portal imaging device (EPID) coupled with the treatment planning system (TPS), to calculate the doses delivered and verify agreement with the treatment plan. The results of QA analysis using the EPID, Delta4 and fluence calculations using the multi-leaf collimator (MLC) dynalog files on 10 IMRT patients are presented in this study. Methods: EPID Fluence Images in integrated mode and Dynalog files for each field were acquired for 10 IMRT (6MV) patients and processed through an in house MatLab program to create an opening density matrix (ODM) which was used as the input fluence for dose calculation with the TPS (Pinnacle3, Philips). The EPID used in this study was the aSi1000 Varian on a Novalis TX linac equipped with high definition MLC. The resulting dose distributions were then exported to VeriSoft (PTW) where a 3D gamma was calculated using 3mm-3% criteria. The Scandidos Delta4 phantom was also used to measure a 2D dose distribution for all 10 patients and a 2D gamma was calculated for each patient using the Delta4 software. Results: The average 3D gamma for all 10 patients using the EPID images was 98.2% ± 2.6%. The average 3D gamma using the dynalog files was 94.6% ± 4.9%. The average 2D gamma from the Delta4 was 98.1% ± 2.5%. The minimum 3D gamma for the EPID and dynalog reconstructed dose distributions was found on the same patient which had a very large PTV, requiring the jaws to open to the maximum field size. Conclusion: Use of the EPID, combined with a TPS is a viable method for QA of IMRT plans. A larger ODM size can be implemented to accommodate larger field sizes. An adaptation of this process to Volumetric Arc Therapy (VMAT) is currently under way.

60 APPLIED LIFE SCIENCES↗

SU-E-T-274: Radiation Therapy with Very High-Energy Electron (VHEE) Beams in the Presence of Metal Implants

Purpose: To evaluate the effect of metal implants on treatment plans for radiation therapy with very high-energy electron (VHEE) beams. Methods: The DOSXYZnrc/BEAMnrc Monte Carlo (MC) codes were used to simulate 50–150MeV VHEE beam dose deposition and its effects on steel and titanium (Ti) heterogeneities in a water phantom. Heterogeneities of thicknesses ranging from 0.5cm to 2cm were placed at 10cm depth. MC was also used to calculate electron and photon spectra generated by the VHEE beams' interaction with metal heterogeneities. The original VMAT patient dose calculation was planned in Eclipse. Patient dose calculations with MC-generated beamlets were planned using a Matlab GUI and research version of RayStation. VHEE MC treatment planning was performed on water-only geometry and water with segmented prostheses (steel and Ti) geometries with 100MeV and 150MeV beams. Results: 100MeV PDD 5cm behind steel/Ti heterogeneity was 51% less than in the water-only phantom. For some cases, dose enhancement lateral to the borders of the phantom increased the dose by up to 22% in steel and 18% in Ti heterogeneities. The dose immediately behind steel heterogeneity decreased by an average of 6%, although for 150MeV, the steel heterogeneity created a 23% increase in dose directly behind it. The average dose immediately behind Ti heterogeneities increased 10%. The prostate VHEE plans resulted in mean dose decrease to the bowel (20%), bladder (7%), and the urethra (5%) compared to the 15MV VMAT plan. The average dose to the body with prosthetic implants was 5% higher than to the body without implants. Conclusion: Based on MC simulations, metallic implants introduce dose perturbations to VHEE beams from lateral scatter and backscatter. However, when performing clinical planning on a prostate case, the use of multiple beams and inverse planning still produces VHEE plans that are dosimetrically superior to photon VMAT plans. BW Loo and P Maxim received research support from RaySearch laboratories; B Hardemark and E Hynning are employees of RaySearch.

60 APPLIED LIFE SCIENCES↗

SU-E-T-294: Simulations to Investigate the Feasibility of ‘dry’ Optical-CT Imaging for 3D Dosimetry

Purpose: To perform simulations investigating the feasibility of “dry” optical-CT, and determine optimal design and scanning parameters for a novel dry tank telecentric optical-CT 3D dosimetry system. Such a system would have important advantages in terms of practical convenience and reduced cost. Methods: A Matlab based ray-tracing simulation platform, ScanSim, was used to model a telecentric system with a polyurethane dry tank, cylindrical dosimeter, and surrounding fluid. This program's capabilities were expanded for the geometry and physics of dry scanning. To categorize the effects of refractive index (RI) mismatches, simulations were run for several dosimeter (RI = 1.5−1.48) and fluid (RI = 1.55−1.33) combinations. Additional simulations examined the effect of increasing gap size (1–5mm) between the dosimeter and tank wall, and of changing the telecentric lens tolerance (0.5°−5°). The evaluation metric is the usable radius; the distance from the dosimeter center where the measured and true doses differ by less than 2%. Results: As the tank/dosimeter RI mismatch increases from 0–0.02, the usable radius decreases from 97.6% to 50.2%. The fluid RI for matching is lower than either the tank or dosimeter RI. Changing gap sizes has drastic effects on the usable radius, requiring more closely matched fluid at large gap sizes. Increasing the telecentric tolerance through a range from 0.5°–5.0° improved the usable radius for every combination of media. Conclusion: Dry optical-CT with telecentric lenses is feasible when the dosimeter and tank RIs are closely matched (<0.01 difference), or when data in the periphery is not required. The ScanSim tool proved very useful in situations when the tank and dosimeter have slight differences in RI by enabling estimation of the optimal choice of RI of the small amount of fluid still required. Some spoiling of the telecentric beam and increasing the tolerance helps recover the usable radius.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-296: Single Field Per Day Vs. Multiple Fields Per Day and the Impact On BED in Proton Therapy Treatment

Purpose: A common practice, in proton therapy, is to deliver a rotating subset of fields from the treatment plan for the daily fractions. This study compares the impact this practice has on the biological effective dose (BED) versus delivering all planned fields daily. Methods: For two scenarios (a phantom with a geometry approximating the anatomy of a prostate treatment with opposing lateral beams, and a clinical 3-field brain treatment), treatment plans were produced in Eclipse (Varian) to simulate delivery of one, two, and three fields per fraction. The RT-Dose file, structure set, and α/β ratios were processed using in-house MATLAB code to return a new RT-Dose file containing the BED (including a proton RBE of 1.1) which was imported back into Eclipse for analysis. Results: For targets and regions of field overlap in the treatment plan, BED is not affected by delivery regimen. In the phantom, BED in the femoral heads showed increased by 20% when a single field was used rather than two fields. In the brain treatment, the minimum BED to the left optic nerve and the pituitary gland increased by 13% and 10% respectively, for a one-field regime compared to three-fields per fraction. Comparing the two-field and threefield regimes, the optic nerve BED was not significantly affected and the minimum pituitary BED was 4% higher for two fields per day. Conclusion: Hypo-fractionation effects, in regions of non-overlap of fields, significantly increase the BED to the involved tissues by as much as 20%. Care should be taken to avoid inadvertently sacrificing plan effectiveness in the interest of reduced treatment time.

60 APPLIED LIFE SCIENCES↗

SU-E-T-322: The Evaluation of the Gafchromic EBT3 Film in Low Dose 6 MV X-Ray Beams with Different Scanning Modes

Purpose: We have evaluated the response of the Gafchromic EBT3 film in low dose for 6 MV x-ray beams with two scanning modes, the reflection scanning mode and the transmission scanning mode. Methods: We irradiated the Gafcromic EBT3 film using a 60 degree enhanced dynamic wedge (EDW) with 6 MV x-ray beams from Clinac iX Linear accelerator (Varian Medical Systems, Palo Alto, CA). The irradiated Gafchromic EBT3 film was scanned with different scanning modes, the reflection scanning mode and the transmission scanning mode. The scanned Gafchromic EBT3 film was analyzed with MATLAB. Results: When 7.2 cGy was irradiated to the Gafchromic EBT3 film, the uncertainty was 0.54 cGy with reflection scanning mode and was 0.88 cGy with transmission scanning mode. When 24 cGy was irradiated to the Gafchromic EBT3 film, the uncertainty was similar to the case of 7.2 cGy irradiation showing 0.51 cGy of uncertainty with reflection scanning mode and 0.87 cGy of uncertainty with transmission scanning mode. The result suggests that the reflection mode should be used in Gafchromic EBT3 film for low irradiation. Conclusion: The result suggests that the reflection mode should be used in Gafchromic EBT3 film for low irradiation.

60 APPLIED LIFE SCIENCES↗

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↗

SU-E-T-473: A Patient-Specific QC Paradigm Based On Trajectory Log Files and DICOM Plan Files

Purpose: To evaluate a remote QC tool for monitoring treatment machine parameters and treatment workflow. Methods: The Varian TrueBeamTM linear accelerator is a digital machine that records machine axis parameters and MLC leaf positions as a function of delivered monitor unit or control point. This information is saved to a binary trajectory log file for every treatment or imaging field in the patient treatment session. A MATLAB analysis routine was developed to parse the trajectory log files for a given patient, compare the expected versus actual machine and MLC positions as well as perform a cross-comparison with the DICOM-RT plan file exported from the treatment planning system. The parsing routine sorts the trajectory log files based on the time and date stamp and generates a sequential report file listing treatment parameters and provides a match relative to the DICOM-RT plan file. Results: The trajectory log parsing-routine was compared against a standard record and verify listing for patients undergoing initial IMRT dosimetry verification and weekly and final chart QC. The complete treatment course was independently verified for 10 patients of varying treatment site and a total of 1267 treatment fields were evaluated including pre-treatment imaging fields where applicable. In the context of IMRT plan verification, eight prostate SBRT plans with 4-arcs per plan were evaluated based on expected versus actual machine axis parameters. The average value for the maximum RMS MLC error was 0.067±0.001mm and 0.066±0.002mm for leaf bank A and B respectively. Conclusion: A real-time QC analysis program was tested using trajectory log files and DICOM-RT plan files. The parsing routine is efficient and able to evaluate all relevant machine axis parameters during a patient treatment course including MLC leaf positions and table positions at time of image acquisition and during treatment.

60 APPLIED LIFE SCIENCES↗

SU-E-T-497: Semi-Automated in Vivo Radiochromic Film Dosimetry Using a Novel Image Processing Algorithm

Purpose: To validate an automated image processing algorithm designed to detect the center of radiochromic film used for in vivo film dosimetry against the current gold standard of manual selection. Methods: An image processing algorithm was developed to automatically select the region of interest (ROI) in *.tiff images that contain multiple pieces of radiochromic film (0.5x1.3cm{sup 2}). After a user has linked a calibration file to the processing algorithm and selected a *.tiff file for processing, an ROI is automatically detected for all films by a combination of thresholding and erosion, which removes edges and any additional markings for orientation. Calibration is applied to the mean pixel values from the ROIs and a *.tiff image is output displaying the original image with an overlay of the ROIs and the measured doses. Validation of the algorithm was determined by comparing in vivo dose determined using the current gold standard (manually drawn ROIs) versus automated ROIs for n=420 scanned films. Bland-Altman analysis, paired t-test, and linear regression were performed to demonstrate agreement between the processes. Results: The measured doses ranged from 0.2-886.6cGy. Bland-Altman analysis of the two techniques (automatic minus manual) revealed a bias of -0.28cGy and a 95% confidence interval of (5.5cGy,-6.1cGy). These values demonstrate excellent agreement between the two techniques. Paired t-test results showed no statistical differences between the two techniques, p=0.98. Linear regression with a forced zero intercept demonstrated that Automatic=0.997*Manual, with a Pearson correlation coefficient of 0.999. The minimal differences between the two techniques may be explained by the fact that the hand drawn ROIs were not identical to the automatically selected ones. The average processing time was 6.7seconds in Matlab on an IntelCore2Duo processor. Conclusion: An automated image processing algorithm has been developed and validated, which will help minimize user interaction and processing time of radiochromic film used for in vivo dosimetry.

60 APPLIED LIFE SCIENCES↗

SU-E-T-510: Mathematical Analysis of Approximate Biological Effective Dose (BED) Calculation for Multi-Phase Radiotherapy Treatment Plans

Purpose: There is growing interest about biological effective dose (BED) and its application in treatment plan evaluation due to its stronger correlation with treatment outcome. An approximate biological effective dose (BEDA) equation was introduced to simplify BED calculations by treatment planning systems in multi-phase treatments. The purpose of this work is to reveal its mathematical properties relative to the true, multi-phase BED (BEDT) equation. Methods: The BEDT equation was derived and used to reveal the mathematical properties of BEDA. MATLAB (MathWorks, Natick, MA) was used to simulate and analyze common and extreme clinical multi-phase cases. In those cases, percent error (Perror) and Bland-Altman analysis were used to study the significance of the inaccuracies of BEDA for different combinations of total doses, numbers of fractions, doses per fractions and α over β values. All the calculations were performed on a voxel-basis in order to study how dose distributions would affect the accuracy of BEDA. Results: When the voxel dose-per-fractions (DPF) delivered by both phases are equal, BEDA and BEDT are equal. In heterogeneous dose distributions, which significantly vary between the phases, there are fewer occurrences of equal DPFs and hence the imprecision of BEDA is greater. It was shown that as the α over β ratio increased the accuracy of BEDA would improve. Examining twenty-four cases, it was shown that the range of DPF ratios for a 3 Perror varied from 0.32 to 7.50Gy, whereas for Perror of 1 the range varied from 0.50 to 2.96Gy. Conclusion: The DPF between the different phases should be equal in order to render BEDA accurate. OARs typically receive heterogeneous dose distributions hence the probability of equal DPFs is low. Consequently, the BEDA equation should only be used for targets or OARs that receive uniform or very similar dose distributions by the different treatment phases.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-514: Simultaneously Determination of Radiation Isocentricity of Gantry, Collimator and Couch Using a Commercial Three-Dimensional Dosimetry QA Apparatus

Purpose: Radiation isocentricity is an important benchmark for a LINAC and is typically determined by 3 separate film star-shots. We developed a technique to simultaneously determine the radiation isocenter of gantry, collimator and couch with a commercial 3D QA apparatus. Methods: The ArcCHECK from SunNuclear was used on two LINACs. It was aligned with room lasers. For gantry rotation, collimator and couch were set to zero and gantry was placed to 0, 49, 213 and 311 degrees. Similarly, a set of collimator/couch angles were chosen with the other two axes at neutral positions. The measured dose matrices were analyzed by an in-house MATLAB program. For each shot, the central axis was determined by computing the FWHM of the diode arrays. The largest inscribed circle from these central axis lines was used to determine isocenter: the radius as the benchmark of isocentricity and the coordinates of the center as the discrepancy of radiation isocenter to the origin defined by lasers. To validate the method, the couch was shifted by ~5 mm in all three directions and measurements were repeated. Results: The radius of the largest inscribed circle for gantry, collimator and couch are (0.3, 0.5, 0.2) mm for one LINAC and (0.2, 0.3, 0.1) mm for the other, in agreement with the film star-shots at annual QA. The discrepancies of radiation isocenter are generally within 1 mm, except gantry rotation on one LINAC due to the drift of foot laser. The differences in positions detected are consistent with the intentional predefined shift. Conclusion: We have demonstrated a technique for the simultaneous measurement of gantry, collimator, and couch isocentricity with a set of carefully chosen irradiation parameters based on the specific construction geometry of the 3D detector ArcCheck. This can replace the standard film star-shots. The future work includes improving operation efficiency.

60 APPLIED LIFE SCIENCES↗

SU-E-T-555: A Protontherapy Inverse Treatment Planning System Prototype with Linear Energy Transfer (LET) Optimization

Purpose: Develop and benchmark an inverse treatment planning system (TPS) for proton radiotherapy integrating fast analytical dose and LET calculations in patient geometries and a dual objective function with both dose and LET components, enabling us to apply optimization techniques to improve the predicted outcome of treatments based on radiobiological models. Methods: The software package was developed in MATLAB and implements a fluence-dose calculation technique based on a pencil beam model for dose calculations and a 3D LET model based on the extension of the LET in the radial direction as a function of the predicted radiological pathway. Both models were benchmarked against commissioning data from our institution, dose calculations performed with a commercial treatment planning system and Monte Carlo simulations. The optimization is based on the adaptive simulated annealing approach . Results: The dose and LET calculations were tested in a water phantom and several real patient treatments. The pass rate for the gamma index analysis (3%/3mm) test was above 90% for all test cases analyzed, and the calculation time was of the order of seconds. The inverse planning module produced plans with a significantly higher mean LET in the target compared to traditional plans, without any loss of target coverage. The clinical relevance of this improvement is under consideration . Conclusion: The developed treatment planning system is a valuable clinical and research tool that enables us to incorporate LET effects into proton radiotherapy planning in a streamlined fashion.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-QI-03: Compartment Modeling of Dynamic Brain PET - The Effect of Scatter and Random Corrections On Parameter Errors

Purpose: To investigate the effects of corrections for random and scattered coincidences on kinetic parameters in brain tumors, by using ten Monte Carlo (MC) simulated dynamic FLT-PET brain scans. Methods: The GATE MC software was used to simulate ten repetitions of a 1 hour dynamic FLT-PET scan of a voxelized head phantom. The phantom comprised six normal head tissues, plus inserted regions for blood and tumor tissue. Different time-activity-curves (TACs) for all eight tissue types were used in the simulation and were generated in Matlab using a 2-tissue model with preset parameter values (K1,k2,k3,k4,Va,Ki). The PET data was reconstructed into 28 frames by both ordered-subset expectation maximization (OSEM) and 3D filtered back-projection (3DFBP). Five image sets were reconstructed, all with normalization and different additional corrections C (A=attenuation, R=random, S=scatter): Trues (AC), trues+randoms (ARC), trues+scatters (ASC), total counts (ARSC) and total counts (AC). Corrections for randoms and scatters were based on real random and scatter sinograms that were back-projected, blurred and then forward projected and scaled to match the real counts. Weighted non-linearleast- squares fitting of TACs from the blood and tumor regions was used to obtain parameter estimates. Results: The bias was not significantly different for trues (AC), trues+randoms (ARC), trues+scatters (ASC) and total counts (ARSC) for either 3DFBP or OSEM (p<0.05). Total counts with only AC stood out however, with an up to 160% larger bias. In general, there was no difference in bias found between 3DFBP and OSEM, except in parameter Va and Ki. Conclusion: According to our results, the methodology of correcting the PET data for randoms and scatters performed well for the dynamic images where frames have much lower counts compared to static images. Generally, no bias was introduced by the corrections and their importance was emphasized since omitting them increased bias extensively.

60 APPLIED LIFE SCIENCES↗