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At least 559 records · Page 31

Poster — Thur Eve — 25: Sensitivity to inhomogeneities for an in-vivo EPID dosimetry method

Introduction: The electronic portal imaging device (EPID) has the potential to be used for in vivo dosimetry during radiotherapy as an additional dose delivery check. We recently proposed a simple method of using the EPID for 2D-IVD based on correlation ratios. In this work we have investigated the sensitivity of our EPID-IVD to inhomogeneities. Methods: We used slab phantoms that simulate water, bone, and lung, arranged in various geometries. To simulate body contours non-orthogonal to the field, we used a water wedge. CT data of these phantoms was imported into MATLAB, in conjunction with EPID images acquired during irradiation, to calculate dose inside the phantom in isocenter plane. Each phantom was irradiated using a linear accelerator while images were acquired with the EPID (cine mode). Comparisons between EPID-calculated and TPS dose maps were: pixel-by-pixel dose difference, and 3%,3mm gamma evaluation. Results: In the homogeneous case, CAX dose difference was <1%, and 3%,3mm gamma analysis yielded 99% of points with gamma<1. For the inhomogeneous phantoms, agreement decreased with increasing inhomogeneity reaching up to 10% CAX dose difference with 10cm of lung. Results from the water wedge phantom suggest that the EPID-calculated dose can account for surface irregularities of approximately ±3cm. Conclusions: The EPID-based IVD investigated has limitations in the presence of large inhomogeneities. Nonetheless, CAX doses never differed by >15% from the TPS. This suggests that this EPID-IVD is capable of detecting gross dose delivery errors even in the presence of inhomogeneities, supporting its utility as an additional patient safety device.

60 APPLIED LIFE SCIENCES↗

Poster — Thur Eve — 69: Computational Study of DVH-guided Cancer Treatment Planning Optimization Methods

Purpose: To compare methods to incorporate the Dose Volume Histogram (DVH) curves into the treatment planning optimization. Method: The performance of three methods, namely, the conventional Mixed Integer Programming (MIP) model, a convex moment-based constrained optimization approach, and an unconstrained convex moment-based penalty approach, is compared using anonymized data of a prostate cancer patient. Three plans we generated using the corresponding optimization models. Four Organs at Risk (OARs) and one Tumor were involved in the treatment planning. The OARs and Tumor were discretized into total of 50,221 voxels. The number of beamlets was 943. We used commercially available optimization software Gurobi and Matlab to solve the models. Plan comparison was done by recording the model runtime followed by visual inspection of the resulting dose volume histograms. Conclusion: We demonstrate the effectiveness of the moment-based approaches to replicate the set of prescribed DVH curves. The unconstrained convex moment-based penalty approach is concluded to have the greatest potential to reduce the computational effort and holds a promise of substantial computational speed up.

60 APPLIED LIFE SCIENCES↗

Sci—Fri PM: Topics — 05: Experience with linac simulation software in a teaching environment

Medical linear accelerator education is usually restricted to use of academic textbooks and supervised access to accelerators. To facilitate the learning process, simulation software was developed to reproduce the effect of medical linear accelerator beam adjustments on resulting clinical photon beams. The purpose of this report is to briefly describe the method of operation of the software as well as the initial experience with it in a teaching environment. To first and higher orders, all components of medical linear accelerators can be described by analytical solutions. When appropriate calibrations are applied, these analytical solutions can accurately simulate the performance of all linear accelerator sub-components. Grouped together, an overall medical linear accelerator model can be constructed. Fifteen expressions in total were coded using MATLAB v 7.14. The program was called SIMAC. The SIMAC program was used in an accelerator technology course offered at our institution; 14 delegates attended the course. The professional breakdown of the participants was: 5 physics residents, 3 accelerator technologists, 4 regulators and 1 physics associate. The course consisted of didactic lectures supported by labs using SIMAC. At the conclusion of the course, eight of thirteen delegates were able to successfully perform advanced beam adjustments after two days of theory and use of the linac simulator program. We suggest that this demonstrates good proficiency in understanding of the accelerator physics, which we hope will translate to a better ability to understand real world beam adjustments on a functioning medical linear accelerator.

07 ISOTOPE AND RADIATION SOURCES↗

Sci—Thur PM: Planning and Delivery — 02: Treatment planning workflow for very high-energy electron beam radiotherapy

Purpose: To develop treatment planning workflow for rapid radiotherapy delivered with very-high energy electron (VHEE) scanning beam. Methods: VHEE radiotherapy treatment planning was performed by linking Monte Carlo (MC) dose calculations with inverse optimization in a research version of RayStation. In order to study a number of treatment parameters, a Matlab graphical user interface (GUI) for calculation of VHEE beamlet dose was developed. Through the GUI, EGSnrc MC simulations were run for a number of beam energies, number of beams, beamlet spot and grid sizes, and machine bore sizes. VHEE plans for a pediatric patient with a 4.3 cm{sup 3} brain target optimized with spot-scanning algorithm in RayStation were compared to the clinically delivered 6 MV VMAT plan. Results and Discussion: VHEE beam energy had the largest effect on the quality of dose distributions. For the same target dose, the mean doses to critical organs decreased by 10–15% when planned with 100 MeV compared to 60 MeV. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams. While beamlet spacing and bore size had a small effect on VHEE dose distributions, 0.1-3mm beamlet sizes resulted in identical dose distributions. Critical organ doses were by up to 70% lower in the best VHEE plan compared to the clinical 6 MV VMAT plan. Conclusions: We have developed a GUI for MC beamlet generation for treatment planning of VHEE radiotherapy. We have demonstrated that pediatric VHEE plans resulted in significant critical organ dose sparing compared to the clinical VMAT plan.

60 APPLIED LIFE SCIENCES↗

Poster — Thur Eve — 02: Measurement of CT radiation profile width using Fuji CR imaging plate raw data

Measuring the CT collimation width and assessing the shape of the overall profile is a relatively straightforward quality control (QC) measure that impacts both image quality and patient dose, and is often required at acceptance and routine testing. Most CT facilities have access to computed radiography (CR) systems, so performing CT collimation profile assessments using CR plates requires no additional equipment. Previous studies have shown how to effectively use CR plates to measure the radiation profile width. However, a major limitation of the previous work is that the full dynamic range of CR detector plates are not used, since the CR processing technology reduces the dynamic range of the DICOM output to 2{sup 10}, requiring the sensitivity and latitude settings of CR reader to be adjusted to prevent clipping of the CT profile data. Such adjustments to CR readers unnecessarily complicate the QC procedure. These clipping artefacts hinder the ability to accurately assess CT collimation width because the full-width at half maximum value of the penumbras are not properly determined if the maximum dose of the profile is not available. Furthermore, any inconsistencies in the radiation profile shape are lost if the profile plateau is clipped off. In this work we developed an opensource Matlab script for straightforward CT profile width measurements using raw CR data that also allows assessment of the profile shape without clipping, and applied this approach during CT QC.

60 APPLIED LIFE SCIENCES↗

Poster — Thur Eve — 12: Implementation of a Clinical Lung Tumour High Dose Containment Verification Procedure using Respiratory Cone-Beam CT (4DCBCT) on a Varian TrueBeam Linac

Lung tumours move due to respiratory motion. This is managed during planning by acquiring a 4DCT and capturing the excursion of the GTV (gross tumour volume) throughout the breathing cycle within an IGTV (Internal Gross Tumour Volume) contour. Patients undergo a verification cone-beam CT (CBCT) scan immediately prior to treatment. 3D reconstructed images do not consider tumour motion, resulting in image artefacts, such as blurring. This may lead to difficulty in identifying the tumour on reconstructed images. It would be valuable to create a 4DCBCT reconstruction of the tumour motion to confirm that does indeed remain within the planned IGTV. CBCT projections of a Quasar Respiratory Motion Phantom are acquired in Treatment mode (half-fan scan) on a Varian TrueBeam accelerator. This phantom contains a mobile, low-density lung insert with an embedded 3cm diameter tumour object. It is programmed to create a 15s periodic, 2cm (sup/inf) displacement. A Varian Real-time Position Management (RPM) tracking-box is placed on the phantom breathing platform. Breathing phase information is automatically integrated into the projection image files. Using in-house Matlab programs and RTK (Reconstruction Tool Kit) open-source toolboxes, the projections are re-binned into 10 phases and a 4DCBCT scan reconstructed. The planning IGTV is registered to the 4DCBCT and the tumour excursion is verified to remain within the planned contour. This technique successfully reconstructs 4DCBCT images using clinical modes for a breathing phantom. UBC-BCCA ethics approval has been obtained to perform 4DCBCT reconstructions on lung patients (REB#H12-00192). Clinical images will be accrued starting April 2014.

60 APPLIED LIFE SCIENCES↗

Ionoacoustic characterization of the proton Bragg peak with submillimeter accuracy

Purpose: Range verification in ion beam therapy relies to date on nuclear imaging techniques which require complex and costly detector systems. A different approach is the detection of thermoacoustic signals that are generated due to localized energy loss of ion beams in tissue (ionoacoustics). Aim of this work was to study experimentally the achievable position resolution of ionoacoustics under idealized conditions using high frequency ultrasonic transducers and a specifically selected probing beam. Methods: A water phantom was irradiated by a pulsed 20 MeV proton beam with varying pulse intensity and length. The acoustic signal of single proton pulses was measured by different PZT-based ultrasound detectors (3.5 and 10 MHz central frequencies). The proton dose distribution in water was calculated by Geant4 and used as input for simulation of the generated acoustic wave by the matlab toolbox k-WAVE. Results: In measurements from this study, a clear signal of the Bragg peak was observed for an energy deposition as low as 10{sup 12} eV. The signal amplitude showed a linear increase with particle number per pulse and thus, dose. Bragg peak position measurements were reproducible within ±30 μm and agreed with Geant4 simulations to better than 100 μm. The ionoacoustic signal pattern allowed for a detailed analysis of the Bragg peak and could be well reproduced by k-WAVE simulations. Conclusions: The authors have studied the ionoacoustic signal of the Bragg peak in experiments using a 20 MeV proton beam with its correspondingly localized energy deposition, demonstrating submillimeter position resolution and providing a deep insight in the correlation between the acoustic signal and Bragg peak shape. These results, together with earlier experiments and new simulations (including the results in this study) at higher energies, suggest ionoacoustics as a technique for range verification in particle therapy at locations, where the tumor can be localized by ultrasound imaging. This acoustic range verification approach could offer the possibility of combining anatomical ultrasound and Bragg peak imaging, but further studies are required for translation of these findings to clinical application.

07 ISOTOPE AND RADIATION SOURCES↗

Investigations into the feasibility of optical-CT 3D dosimetry with minimal use of refractively matched fluids

Purpose: In optical-CT, the use of a refractively matched polyurethane solid-tank in place of a fluid bath has the potential to greatly increase practical convenience, reduce cost, and possibly improve the efficacy of flood corrections. This work investigates the feasibility of solid-tank optical-CT imaging for 3D dosimetry through computer simulation. Methods: A MATLAB ray-tracing simulation platform, ScanSim, was used to model a parallel-source telecentric optical-CT imaging system through a polyurethane solid-tank containing a central cylindrical hollow into which PRESAGE radiochromic dosimeters can be placed. A small amount of fluid fills the 1–5 mm gap between the dosimeter and the walls of the tank. The use of the solid-tank reduces the required amount of fluid by approximately 97%. To characterize the efficacy of solid-tank, optical-CT scanning simulations investigated sensitivity to refractive index (RI) mismatches between dosimeter, solid-tank, and fluid, for a variety of dosimeter (RI = 1.5–1.47) and fluid (RI = 1.55–1.0) combinations. Efficacy was evaluated through the usable radius (r{sub u}) metric, defined as the fraction of the radius of the dosimeter where measured dose is predicted to be within 2% of the ground truth entered into the simulation. Additional simulations examined the effect of increasing gap size (1–5 mm) between the dosimeter and solid-tank well. The effects of changing the lens tolerance (0.5°–5.0°) were also investigated. Results: As the RI mismatch between the dosimeter and solid-tank increased from 0 to 0.02, the usable radius decreased from 97.6% to 50.2%. The optimal fluid RI decreased nonlinearly from 1.5 to 1.34 as the mismatch increased and was up to 9% lower than the tank. Media mismatches between the dosimeter and solid-tank also exacerbate the effects of changing the gap size, with no easily quantifiable relationship with usable radius. Generally, the optimal fluid RI value increases as gap size increases and is closely matched to the dosimeter at large gap sizes (>3 mm). Increasing the telecentric lens tolerance increases the usable radius for all refractive media combinations and improves the maximum usable radius of mismatched media to that of perfectly matched media for tolerances >5.0°. The maximum usable radius can be improved up to a factor of 2 when lens tolerances are small (<1.0°). Conclusions: Dry solid-tank optical-CT imaging in a telecentric system is feasible if the dosimeter RI is a close match with the solid-tank (<0.01 difference), providing accurate dose measurements within ±2% of true dose to over 80% of the dosimeter volume. In order to achieve accurate measurements over 96% of the dosimeter volume (representing out to 2 mm from the dosimeter edge), the dosimeter-tank RI mismatch must be less than 0.005. Optimal results occur when the RI of the dosimeter and tank is the same, in which case the fluid will have the same RI. If mismatches between the tank and dosimeter RI occur, the RI of the matching fluid needs to be fine tuned to achieve the highest usable radius.

61 RADIATION PROTECTION AND DOSIMETRY↗

Treatment planning for radiotherapy with very high-energy electron beams and comparison of VHEE and VMAT plans

Purpose: The aim of this work was to develop a treatment planning workflow for rapid radiotherapy delivered with very high-energy electron (VHEE) scanning pencil beams of 60–120 MeV and to study VHEE plans as a function of VHEE treatment parameters. Additionally, VHEE plans were compared to clinical state-of-the-art volumetric modulated arc therapy (VMAT) photon plans for three cases. Methods: VHEE radiotherapy treatment planning was performed by linking EGSnrc Monte Carlo (MC) dose calculations with inverse treatment planning in a research version of RayStation. In order to study the effect of VHEE treatment parameters on VHEE dose distributions, a MATLAB graphical user interface (GUI) for calculation of VHEE MC pencil beam doses was developed. Through the GUI, pediatric case MC simulations were run for a number of beam energies (60, 80, 100, and 120 MeV), number of beams (13, 17, and 36), pencil beam spot (0.1, 1.0, and 3.0 mm) and grid (2.0, 2.5, and 3.5 mm) sizes, and source-to-axis distance, SAD (40 and 50 cm). VHEE plans for the pediatric case calculated with the different treatment parameters were optimized and compared. Furthermore, 100 MeV VHEE plans for the pediatric case, a lung, and a prostate case were calculated and compared to the clinically delivered VMAT plans. All plans were normalized such that the 100% isodose line covered 95% of the target volume. Results: VHEE beam energy had the largest effect on the quality of dose distributions of the pediatric case. For the same target dose, the mean doses to organs at risk (OARs) decreased by 5%–16% when planned with 100 MeV compared to 60 MeV, but there was no further improvement in the 120 MeV plan. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams, but to a more modest degree (<8%). While pencil beam spacing and SAD had a small effect on VHEE dose distributions, 0.1–3 mm pencil beam sizes resulted in identical dose distributions. For the 100 MeV VHEE pediatric plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI{sub 100} = 1.09 and CI{sub 50} = 4.07) were better than VMAT conformity indices (CI{sub 100} = 1.30 and CI{sub 50} = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI{sub 100} and CI{sub 50} conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI{sub 100} and CI{sub 50} conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans.

60 APPLIED LIFE SCIENCES↗

Microcalcification detectability using a bench-top prototype photon-counting breast CT based on a Si strip detector

Purpose: To investigate the feasibility of detecting breast microcalcification (μCa) with a dedicated breast computed tomography (CT) system based on energy-resolved photon-counting silicon (Si) strip detectors. Methods: The proposed photon-counting breast CT system and a bench-top prototype photon-counting breast CT system were simulated using a simulation package written in MATLAB to determine the smallest detectable μCa. A 14 cm diameter cylindrical phantom made of breast tissue with 20% glandularity was used to simulate an average-sized breast. Five different size groups of calcium carbonate grains, from 100 to 180 μm in diameter, were simulated inside of the cylindrical phantom. The images were acquired with a mean glandular dose (MGD) in the range of 0.7–8 mGy. A total of 400 images was used to perform a reader study. Another simulation study was performed using a 1.6 cm diameter cylindrical phantom to validate the experimental results from a bench-top prototype breast CT system. In the experimental study, a bench-top prototype CT system was constructed using a tungsten anode x-ray source and a single line 256-pixels Si strip photon-counting detector with a pixel pitch of 100 μm. Calcium carbonate grains, with diameter in the range of 105–215 μm, were embedded in a cylindrical plastic resin phantom to simulate μCas. The physical phantoms were imaged at 65 kVp with an entrance exposure in the range of 0.6–8 mGy. A total of 500 images was used to perform another reader study. The images were displayed in random order to three blinded observers, who were asked to give a 4-point confidence rating on each image regarding the presence of μCa. The μCa detectability for each image was evaluated by using the average area under the receiver operating characteristic curve (AUC) across the readers. Results: The simulation results using a 14 cm diameter breast phantom showed that the proposed photon-counting breast CT system can achieve high detection accuracy with an average AUC greater than 0.89 ± 0.07 for μCas larger than 120 μm in diameter at a MGD of 3 mGy. The experimental results using a 1.6 cm diameter breast phantom showed that the prototype system can achieve an average AUC greater than 0.98 ± 0.01 for μCas larger than 140 μm in diameter using an entrance exposure of 1.2 mGy. Conclusions: The proposed photon-counting breast CT system based on a Si strip detector can potentially offer superior image quality to detect μCa with a lower dose level than a standard two-view mammography.

60 APPLIED LIFE SCIENCES↗

SU-C-304-01: Investigation of Various Detector Response Functions and Their Geometry Dependence in a Novel Method to Address Ion Chamber Volume Averaging Effect

Purpose: A novel convolution-based approach has been proposed to address ion chamber (IC) volume averaging effect (VAE) for the commissioning of commercial treatment planning systems (TPS). We investigate the use of various convolution kernels and its impact on the accuracy of beam models. Methods: Our approach simulates the VAE by iteratively convolving the calculated beam profiles with a detector response function (DRF) while optimizing the beam model. At convergence, the convolved profiles match the measured profiles, indicating the calculated profiles match the “true” beam profiles. To validate the approach, beam profiles of an Elekta LINAC were repeatedly collected with ICs of various volumes (CC04, CC13 and SNC 125) to obtain clinically acceptable beam models. The TPS-calculated profiles were convolved externally with the DRF of respective IC. The beam model parameters were reoptimized using Nelder-Mead method by forcing the convolved profiles to match the measured profiles. We evaluated three types of DRFs (Gaussian, Lorentzian, and parabolic) and the impact of kernel dependence on field geometry (depth and field size). The profiles calculated with beam models were compared with SNC EDGE diode-measured profiles. Results: The method was successfully implemented with Pinnacle Scripting and Matlab. The reoptimization converged in ∼10 minutes. For all tested ICs and DRFs, penumbra widths of the TPS-calculated profiles and diode-measured profiles were within 1.0 mm. Gaussian function had the best performance with mean penumbra width difference within 0.5 mm. The use of geometry dependent DRFs showed marginal improvement, reducing the penumbra width differences to less than 0.3 mm. Significant increase in IMRT QA passing rates was achieved with the optimized beam model. Conclusion: The proposed approach significantly improved the accuracy of the TPS beam model. Gaussian functions as the convolution kernel performed consistently better than Lorentzian and parabolic functions. Further improvement of using geometry-dependent kernels was marginal.

60 APPLIED LIFE SCIENCES↗

SU-C-304-04: A Compact Modular Computational Platform for Automated On-Board Imager Quality Assurance

Purpose: Traditionally, the assessment of X-ray tube output and detector positioning accuracy of on-board imagers (OBI) has been performed manually and subjectively with rulers and dosimeters, and typically takes hours to complete. In this study, we have designed a compact modular computational platform to automatically analyze OBI images acquired with in-house designed phantoms as an efficient and robust surrogate. Methods: The platform was developed as an integrated and automated image analysis-based platform using MATLAB for easy modification and maintenance. Given a set of images acquired with the in-house designed phantoms, the X-ray output accuracy was examined via cross-validation of the uniqueness and integration minimization of important image quality assessment metrics, while machine geometric and positioning accuracy were validated by utilizing pattern-recognition based image analysis techniques. Results: The platform input was a set of images of an in-house designed phantom. The total processing time is about 1–2 minutes. Based on the data acquired from three Varian Truebeam machines over the course of 3 months, the designed test validation strategy achieved higher accuracy than traditional methods. The kVp output accuracy can be verified within +/−2 kVp, the exposure accuracy within 2%, and exposure linearity with a coefficient of variation (CV) of 0.1. Sub-millimeter position accuracy was achieved for the lateral and longitudinal positioning tests, while vertical positioning accuracy within +/−2 mm was achieved. Conclusion: This new platform delivers to the radiotherapy field an automated, efficient, and stable image analysis-based procedure, for the first time, acting as a surrogate for traditional tests for LINAC OBI systems. It has great potential to facilitate OBI quality assurance (QA) with the assistance of advanced image processing techniques. In addition, it provides flexible integration of additional tests for expediting other OBI quality assurance tests, such as 2D/3D image quality, making completely automated QA possible. Research Funding from Varian Medical Systems Inc. . Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

60 APPLIED LIFE SCIENCES↗

SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shielded to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national / international body for the presented work.

60 APPLIED LIFE SCIENCES↗

SU-D-213-04: Accounting for Volume Averaging and Material Composition Effects in An Ionization Chamber Array for Patient Specific QA

Purpose: This study explores novel methods to address two significant challenges affecting measurement of patient-specific quality assurance (QA) with IBA’s Matrixx Evolution™ ionization chamber array. First, dose calculation algorithms often struggle to accurately determine dose to the chamber array due to CT artifact and algorithm limitations. Second, finite chamber size and volume averaging effects cause additional deviation from the calculated dose. Methods: QA measurements were taken with the Matrixx positioned on the treatment table in a solid-water Multi-Cube™ phantom. To reduce the effect of CT artifact, the Matrixx CT image set was masked with appropriate materials and densities. Individual ionization chambers were masked as air, while the high-z electronic backplane and remaining solid-water material were masked as aluminum and water, respectively. Dose calculation was done using Varian’s Acuros XB™ (V11) algorithm, which is capable of predicting dose more accurately in non-biologic materials due to its consideration of each material’s atomic properties. Finally, the exported TPS dose was processed using an in-house algorithm (MATLAB) to assign the volume averaged TPS dose to each element of a corresponding 2-D matrix. This matrix was used for comparison with the measured dose. Square fields at regularly-spaced gantry angles, as well as selected patient plans were analyzed. Results: Analyzed plans showed improved agreement, with the average gamma passing rate increasing from 94 to 98%. Correction factors necessary for chamber angular dependence were reduced by 67% compared to factors measured previously, indicating that previously measured factors corrected for dose calculation errors in addition to true chamber angular dependence. Conclusion: By comparing volume averaged dose, calculated with a capable dose engine, on a phantom masked with correct materials and densities, QA results obtained with the Matrixx Evolution™ can be significantly improved. In addition, necessary correction factors are reduced, allowing for more reliable and meaningful patient-specific QA measurements.

60 APPLIED LIFE SCIENCES↗

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logical hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System.

60 APPLIED LIFE SCIENCES↗

SU-D-204-07: Comparison of AAPM TG150 Draft Image Receptor Tests with Vendor Automated QC Tests for Five Mobile DR Units

Purpose: To determine the consistency of digital detector (DR) tests recommended by AAPM TG150 and tests provided by commercially available DirectView Total Quality Tool (TQT). Methods: The DR tests recommended by the TG150 Detector Subgroup[1] were performed on 4 new Carestream DRX-Revolution and one Carestream DRX1C retrofit of a GE AMX-4 that had been in service for three years. After detector calibration, flat-field images plus images of two bar patterns oriented parallel and perpendicular to the A-C axis, were acquired at conditions recommended by TG150. Raw images were harvested and then analyzed using a MATLAB software previously validated[2,3,4]. Data were analyzed using ROIs of two different dimensions: 1) 128 x 128 ROIs matching the detector electronics; and 2) 256 x 256 ROIs, each including 4 adjacent smaller ROIs. TG150 metrics from 128 x 128 ROIs were compared to TQT metrics, which are also obtained from 128 x 128 ROIs[5]. Results: The results show that both TG150 and TQT measurements were consistent among these detectors. Differences between TG150 and TQT values appear systematic. Compared with 128 x 128 ROIs, noise and SNR non-uniformity were lower with 256 x 256 ROIs, although signal non-uniformity was similar, indicating detectors were appropriately calibrated for gain and offset. MTF of the retrofit unit remained essentially the same between 2012 and 2015, but was inferior to the new units. The older generator focal spot is smaller (0.75mm vs. 1.2mm), and the SID for acquisition is 182cm as well, so focal spot dimensions cannot explain the difference. The difference in MTF may be secondary to differences in generator X-ray spectrum or by unannounced changes in detector architecture. Further investigation is needed. Conclusion: The study shows that both TG150 and TQT tests are consistent. The numerical value of some metrics are dependent on ROI size.

60 APPLIED LIFE SCIENCES↗

SU-D-201-03: Imaging Cellular Pharmacokinetics of 18F-FDG in Inflammatory/Stem Cells

Purpose: Atherosclerosis is a progressive inflammatory condition that underlies coronary artery disease (CAD)—the leading cause of death in the USA. Thus, understating the metabolism of inflammatory cells can be a valuable tool for investigating CAD. To the best of our knowledge, we are the first to successfully investigate the pharmacokinetics of [18F]fluoro-deoxyglucose (18F-FDG) uptake in a single macrophages and compared with induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) with a novel imaging technique, radioluminescence microscopy, initially developed for cancer imaging. Methods: Live cells were cultured sparsely on Matrigel in a glass-bottom dish and starved for 1 hour before incubation with 250 microCi of 18F-FDG for 45 minutes. Excess radiotracer was removed using DMEM medium without glucose. Before imaging, DMEM (1 mL) was added to the cell culture and a 100 microm-thin CdWO4 scintillator plate was placed on top of the cells. Light produced following beta decay was imaged with a highly sensitive inverted microscope (LV200, Olympus) fitted with a 40x/1.3 high-NA oil objective, and an EM-CCD camera. The images were collected over 18,000 frames with 4×4 binning (1200 MHz EM Gain, 300ms exposure). Custom-written software was developed in MATLAB for image processing (Figure 1). For statistical analysis 10 different region-of-interests (ROIs) were selected for each cell type. Results: Figures 2A–2B show bright-field/fusion images for all three different cell types. The relationship between cell-to-cell comparisons was found to be linear for macrophages unlike iPSCs and MSCs, which were best fitted with moving or rolling average (Figure 2C). The average observed decay of 18F-FDG in a single cell of MSCs per second (0.067) was 20% and 36% higher compared to iPSCs (0.054) and macrophages (0.043), respectively (Figure 2D). Conclusion: MSCs was found to be 2–3x more sensitive to glucose molecule despite constant parameters for each cell type examined.

60 APPLIED LIFE SCIENCES↗

SU-D-201-06: Random Walk Algorithm Seed Localization Parameters in Lung Positron Emission Tomography (PET) Images

Purpose: The objective of this study was to find the best seed localization parameters in random walk algorithm application to lung tumor delineation in Positron Emission Tomography (PET) images. Methods: PET images suffer from statistical noise and therefore tumor delineation in these images is a challenging task. Random walk algorithm, a graph based image segmentation technique, has reliable image noise robustness. Also its fast computation and fast editing characteristics make it powerful for clinical purposes. We implemented the random walk algorithm using MATLAB codes. The validation and verification of the algorithm have been done by 4D-NCAT phantom with spherical lung lesions in different diameters from 20 to 90 mm (with incremental steps of 10 mm) and different tumor to background ratios of 4:1 and 8:1. STIR (Software for Tomographic Image Reconstruction) has been applied to reconstruct the phantom PET images with different pixel sizes of 2×2×2 and 4×4×4 mm{sup 3}. For seed localization, we selected pixels with different maximum Standardized Uptake Value (SUVmax) percentages, at least (70%, 80%, 90% and 100%) SUVmax for foreground seeds and up to (20% to 55%, 5% increment) SUVmax for background seeds. Also, for investigation of algorithm performance on clinical data, 19 patients with lung tumor were studied. The resulted contours from algorithm have been compared with nuclear medicine expert manual contouring as ground truth. Results: Phantom and clinical lesion segmentation have shown that the best segmentation results obtained by selecting the pixels with at least 70% SUVmax as foreground seeds and pixels up to 30% SUVmax as background seeds respectively. The mean Dice Similarity Coefficient of 94% ± 5% (83% ± 6%) and mean Hausdorff Distance of 1 (2) pixels have been obtained for phantom (clinical) study. Conclusion: The accurate results of random walk algorithm in PET image segmentation assure its application for radiation treatment planning and diagnosis.

60 APPLIED LIFE SCIENCES↗