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At least 595 records · Page 33

SU-E-T-61: A Practical Process for Fabricating Passive Scatter Proton Beam Modulation Compensation Filters Using 3D Printing

Purpose: The purpose of this project was to devise a practical fabrication process for passive scatter proton beam compensation filters (CF) that is competitive in time, cost and effort using 3D printing. Methods: DICOM compensator filter files for a proton beam were generated by our Eclipse (Varian, Inc.) treatment planning system. The compensator thickness specifications were extracted with in-house software written in Matlab (MathWorks, Inc.) code and written to a text file which could be read by the Rhinoceros 5, computer-aided design (CAD) package (Robert McNeel and Associates), which subsequently generated a smoothed model in a STereoLithographic also known as a Standard Tesselation Language file (STL). The model in the STL file was subsequently refined using Netfabb software and then converted to printing instructions using Cura. version 15.02.1. for our 3D printer. The Airwolf3D, model HD2x, fused filament fabrication (FFF) 3D printer (Airwolf3D.com) was used for our fabrication system with a print speed of 150mm per second. It can print in over 22 different plastic filament materials in a build volume of 11” x 8” x 12”. We choose ABS plastic to print the 3D model of the imprint for our CFs. Results: Prints of the CF could be performed at a print speed of 70mm per second. The time to print the 3D topology for the CF for the 14 cm diameter snout of our Mevion 250 proton accelerator was less than 3 hours. The printed model is intended to subsequently be used as a mold to imprint a molten wax cylindrical to form the compensation after cooling. The whole process should be performed for a typical 3 beam treatment plan within a day. Conclusion: Use of 3D printing is practical and can be used to print a 3D model of a CF within a few hours.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-67: A Quality Assurance Procedure for VMAT Delivery Technique with Multiple Verification Metric Using TG-119 Protocol

Purpose: A successful VMAT plan delivery includes precise modulations of dose rate, gantry rotational and multi-leaf collimator shapes. The purpose of this research is to construct routine QA protocol which focuses on VMAT delivery technique and to obtain a baseline including dose error, fluence distribution and mechanical accuracy during VMAT. Methods: The mock prostate, head and neck (HN) cases supplied from AAPM were used in this study. A VMAT plans were generated in Monaco TPS according to TG-119 protocol. Plans were created using 6 MV and 10 MV photon beams for each case. The phantom based measurement, fluence measurement and log files analysis were performed. The dose measurement was performed using 0.6 cc ion chamber, which located at isocenter. The fluence distribution were acquired using the MapCHECK2 mounted in the MapPHAN. The trajectory log files recorded inner 20 leaf pairs and gantry angle positions at every 0.25 sec interval were exported to in-house software developed by MATLAB and determined those RMS values. Results: The dose difference is expressed as a ratio of the difference between measured and planned doses. The dose difference for 6 MV was 0.91%, for 10 MV was 0.67%. In turn, the fluence distribution using gamma criteria of 2%/2 mm with a 50% minimum dose threshold for 6 MV was 98.8%, for 10 MV was 97.5%, respectively. The RMS values of MLC for 6 MV and 10 MV were 0.32 mm and 0.37 mm, of gantry were 0.33 degree and 0.31 degree. Conclusion: In this study, QA protocol to assess VMAT delivery accuracy is constructed and results acquired in this study are used as a baseline of VMAT delivery performance verification.

60 APPLIED LIFE SCIENCES↗

SU-E-T-142: Automatic Linac Log File: Analysis and Reporting

Purpose: End to end QA for IMRT/VMAT is time consuming. Automated linac log file analysis and recalculation of daily recorded fluence, and hence dose, distribution bring this closer. Methods: Matlab (R2014b, Mathworks) software was written to read in and analyse IMRT/VMAT trajectory log files (TrueBeam 1.5, Varian Medical Systems) overnight, and are archived on a backed-up network drive (figure). A summary report (PDF) is sent by email to the duty linac physicist. A structured summary report (PDF) for each patient is automatically updated for embedding into the R&V system (Mosaiq 2.5, Elekta AG). The report contains cross-referenced hyperlinks to ease navigation between treatment fractions. Gamma analysis can be performed on planned (DICOM RTPlan) and treated (trajectory log) fluence distributions. Trajectory log files can be converted into RTPlan files for dose distribution calculation (Eclipse, AAA10.0.28, VMS). Results: All leaf positions are within +/−0.10mm: 57% within +/−0.01mm; 89% within 0.05mm. Mean leaf position deviation is 0.02mm. Gantry angle variations lie in the range −0.1 to 0.3 degrees, mean 0.04 degrees. Fluence verification shows excellent agreement between planned and treated fluence. Agreement between planned and treated dose distribution, the derived from log files, is very good. Conclusion: Automated log file analysis is a valuable tool for the busy physicist, enabling potential treated fluence distribution errors to be quickly identified. In the near future we will correlate trajectory log analysis with routine IMRT/VMAT QA analysis. This has the potential to reduce, but not eliminate, the QA workload.

60 APPLIED LIFE SCIENCES↗

SU-E-T-149: Brachytherapy Patient Specific Quality Assurance for a HDR Vaginal Cylinder Case

Purpose: Commonly Ir-192 HDR treatment planning system commissioning is only based on a single absolute measurement of source activity supplemented by tabulated parameters for multiple factors without independent verification that the planned distribution corresponds to the actual delivered dose. The purpose on this work is to present a methodology using Gafchromic film with a statistically valid calibration curve that can be used to validate clinical HDR vaginal cylinder cases by comparing the calculated plan dose distribution in a plane with the corresponding measured planar dose. Methods: A vaginal cylinder plan was created with Oncentra treatment planning system. The 3D dose matrix was exported to a Varian Eclipse work station for convenient extraction of a 2D coronal dose plane corresponding to the film position. The plan was delivered with a sheet of Gafchromic EBT3 film positioned 1mm from the catheter using an Ir-192 Nucletron HDR source. The film was then digitized with an Epson 10000 XL color scanner. Film analysis is performed with MatLab imaging toolbox. A density to dose calibration curve was created using TG43 formalism for a single dwell position exposure at over 100 points for statistical accuracy. The plan and measured film dose planes were registered using a known dwell position relative to four film marks. The plan delivered 500 cGy to points 2 cm from the sources. Results: The distance to agreement of the 500 cGy isodose between the plan and film measurement laterally was 0.5 mm but can be as much as 1.5 mm superior and inferior. The difference between the computed plan dose and film measurement was calculated per pixel. The greatest errors up to 50 cGy are near the apex. Conclusion: The methodology presented will be useful to implement more comprehensive quality assurance to verify patient-specific dose distributions.

60 APPLIED LIFE SCIENCES↗

SU-E-T-385: Evaluation of DVH Change for PTV Due to Patient Weight Loss in Prostate VMAT Using Gaussian Error Function

Purpose: We proposed a method to predict the change of dose-volume histogram (DVH) for PTV due to patient weight loss in prostate volumetric modulated arc therapy (VMAT). This method is based on a pre-calculated patient dataset and DVH curve fitting using the Gaussian error function (GEF). Methods: Pre-calculated dose-volume data from patients having weight loss in prostate VMAT was employed to predict the change of PTV coverage due to reduced depth in external contour. The effect of patient weight loss in treatment was described by a prostate dose-volume factor (PDVF), which was evaluated by the prostate PTV. Along with the PDVF, the GEF was used to fit into the DVH curve for the PTV. To predict a new DVH due to weight loss, parameters from the GEF describing the shape of DVH curve were determined. Since the parameters were related to the PDVF as per the specific reduced depth, we could first predict the PDVF at a reduced depth based on the prostate size from the pre-calculated dataset. Then parameters of the GEF could be determined from the PDVF to plot the new DVH for the PTV corresponding to the reduced depth. Results: A MATLAB program was built basing on the patient dataset with different prostate sizes. We input data of the prostate size and reduced depth of the patient into the program. The program then calculated the PDVF and DVH for the PTV considering the patient weight loss. The program was verified by different patient cases with various reduced depths. Conclusion: Our method can estimate the change of DVH for the PTV due to patient weight loss quickly without CT rescan and replan. This would help the radiation staff to predict the change of PTV coverage, when patient’s external contour reduced in prostate VMAT.

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SU-E-T-418: Explore the Sensitive of the Planar Quality Assurance to the MLC Error with Different Beam Complexity in Intensity-Modulate Radiation Therapy

Purpose: The purpose of this study is to investigate the sensitivity of the planar quality assurance to MLC errors with different beam complexities in intensity-modulate radiation therapy. Methods: sixteen patients’ planar quality assurance (QA) plans in our institution were enrolled in this study, including 10 dynamic MLC (DMLC) IMRT plans measured by Portal Dosimetry and 6 static MLC (SMLC) IMRT plans measured by Mapcheck. The gamma pass rate was calculated using vender’s software. The field numbers were 74 and 40 for DMLC and SMLC, respectively. A random error was generated and introduced to these fields. The modified gamma pass rate was calculated by comparing the original measured fluence and modified fields’ fluence. A decreasing gamma pass rate was acquired using the original gamma pass rate minus the modified gamma pass rate. Eight complexity scores were calculated in MATLAB based on the fluence and MLC sequence of these fields. The complexity scores include fractal dimension, monitor unit of field, modulation index, fluence map complexity, weighted average of field area, weighted average of field perimeter, and small aperture ratio ( <5cm{sup 2} and <50cm{sup 2}). The Spearman’s rank correlation coefficient was implemented to analyze the correlation between these scores and decreasing gamma rate. Results: The relation between the decreasing gamma pass rate and field complexity was insignificant for most complexity scores. The most significant complexity score was fluence map complexity for SMLC, which have ρ =0.4274 (p-value=0.0063). For DMLC, the most significant complex score was fractal dimension, which have ρ=−0.3068 (p-value=0.0081). Conclusions: According to the primarily Result of this study, the sensitivity gamma pass rate was not strongly relate to the field complexity.

60 APPLIED LIFE SCIENCES↗

SU-E-T-422: Fast Analytical Beamlet Optimization for Volumetric Intensity-Modulated Arc Therapy

Purpose: To implement a fast optimization algorithm on CPU/GPU heterogeneous computing platform and to obtain an optimal fluence for a given target dose distribution from the pre-calculated beamlets in an analytical approach. Methods: The 2D target dose distribution was modeled as an n-dimensional vector and estimated by a linear combination of independent basis vectors. The basis set was composed of the pre-calculated beamlet dose distributions at every 6 degrees of gantry angle and the cost function was set as the magnitude square of the vector difference between the target and the estimated dose distribution. The optimal weighting of the basis, which corresponds to the optimal fluence, was obtained analytically by the least square method. Those basis vectors with a positive weighting were selected for entering into the next level of optimization. Totally, 7 levels of optimization were implemented in the study.Ten head-and-neck and ten prostate carcinoma cases were selected for the study and mapped to a round water phantom with a diameter of 20cm. The Matlab computation was performed in a heterogeneous programming environment with Intel i7 CPU and NVIDIA Geforce 840M GPU. Results: In all selected cases, the estimated dose distribution was in a good agreement with the given target dose distribution and their correlation coefficients were found to be in the range of 0.9992 to 0.9997. Their root-mean-square error was monotonically decreasing and converging after 7 cycles of optimization. The computation took only about 10 seconds and the optimal fluence maps at each gantry angle throughout an arc were quickly obtained. Conclusion: An analytical approach is derived for finding the optimal fluence for a given target dose distribution and a fast optimization algorithm implemented on the CPU/GPU heterogeneous computing environment greatly reduces the optimization time.

60 APPLIED LIFE SCIENCES↗

SU-E-T-545: MLC Distance Travelled as a Predictor for Motor Failure

Purpose: To study the frequency of Multi-Leaf Collimator (MLC) leaf failures, investigate methods to predict them and reduce linac downtime. Methods: A Varian HD120 MLC was used in our study. The hyperterminal MLC errors logged from 06/2012 to 12/2014 were collected. Along with the hyperterminal errors, the MLC motor changes and all other MLC interventions by the linear accelerator engineer were recorded. The MLC dynalog files were also recorded on a daily basis for each treatment and during linac QA. The dynalog files were analyzed to calculate root mean square errors (RMS) and cumulative MLC travel distance per motor. An in-house MatLab code was used to analyze all dynalog files, record RMS errors and calculate the distance each MLC traveled per day. Results: A total of 269 interventions were recorded over a period of 18 months. Of these, 146 included MLC motor leaf change, 39 T-nut replacements, and 84 MLC cleaning sessions. Leaves close to the middle of each side required the most maintenance. In the A bank, leaves A27 to A40 recorded 73% of all interventions, while the same leaves in the B bank counted for 52% of the interventions. On average, leaves in the middle of the bank had their motors changed approximately every 1500m of travel. Finally, it was found that the number of RMS errors increased prior to an MLC motor change. Conclusion: An MLC dynalog file analysis software was developed that can be used to log daily MLC usage. Our eighteen-month data analysis showed that there is a correlation between the distance an MLC travels, the RMS and the life of the MLC motor. We plan to use this tool to predict MLC motor failures and with proper and timely intervention, reduce the downtime of the linac during clinical hours.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-T-562: Motion Tracking Optimization for Conformal Arc Radiotherapy Plans: A QUASAR Phantom Based Study

Purpose: This study is to use plan parameters optimization (Dose rate, collimator angle, couch angle, initial starting phase) to improve the performance of conformal arc radiotherapy plans with motion tracking by increasing the plan performance score (PPS). Methods: Two types of 3D conformal arc plans were created based on QUASAR respiratory motion phantom with spherical and cylindrical targets. Sinusoidal model was applied to the MLC leaves to generate motion tracking plans. A MATLAB program was developed to calculate PPS of each plan (ranges from 0–1) and optimize plan parameters. We first selected the dose rate for motion tracking plans and then used simulated annealing algorithm to search for the combination of the other parameters that resulted in the plan of the maximal PPS. The optimized motion tracking plan was delivered by Varian Truebeam Linac. In-room cameras and stopwatch were used for starting phase selection and synchronization between phantom motion and plan delivery. Gaf-EBT2 dosimetry films were used to measure the dose delivered to the target in QUASAR phantom. Dose profiles and Truebeam trajectory log files were used for plan delivery performance evaluation. Results: For spherical target, the maximal PPS (PPSsph) of the optimized plan was 0.79: (Dose rate: 500MU/min, Collimator: 90°, Couch: +10°, starting phase: 0.83π). For cylindrical target, the maximal PPScyl was 0.75 (Dose rate: 300MU/min, Collimator: 87°, starting phase: 0.97π) with couch at 0°. Differences of dose profiles between motion tracking plans (with the maximal and the minimal PPS) and 3D conformal plans were as follows: PPSsph=0.79: %ΔFWHM: 8.9%, %Dmax: 3.1%; PPSsph=0.52: %ΔFWHM: 10.4%, %Dmax: 6.1%. PPScyl=0.75: %ΔFWHM: 4.7%, %Dmax: 3.6%; PPScyl=0.42: %ΔFWHM: 12.5%, %Dmax: 9.6%. Conclusion: By achieving high plan performance score through parameters optimization, we can improve target dose conformity of motion tracking plan by decreasing total MLC leaf travel distance and leaf speed.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-644: QuAArC: A 3D VMAT QA System Based On Radiochromic Film and Monte Carlo Simulation of Log Files

Purpose: VMAT involves two main sources of uncertainty: one related to the dose calculation accuracy, and the other linked to the continuous delivery of a discrete calculation. The purpose of this work is to present QuAArC, an alternative VMAT QA system to control and potentially reduce these uncertainties. Methods: An automated MC simulation of log files, recorded during VMAT treatment plans delivery, was implemented in order to simulate the actual treatment parameters. The linac head models and the phase-space data of each Control Point (CP) were simulated using the EGSnrc/BEAMnrc MC code, and the corresponding dose calculation was carried out by means of BEAMDOSE, a DOSXYZnrc code modification. A cylindrical phantom was specifically designed to host films rolled up at different radial distances from the isocenter, for a 3D and continuous dosimetric verification. It also allows axial and/or coronal films and point measurements with several types of ion chambers at different locations. Specific software was developed in MATLAB in order to process and evaluate the dosimetric measurements, which incorporates the analysis of dose distributions, profiles, dose difference maps, and 2D/3D gamma index. It is also possible to obtain the experimental DVH reconstructed on the patient CT, by an optimization method to find the individual contribution corresponding to each CP on the film, taking into account the total measured dose, and the corresponding CP dose calculated by MC. Results: The QuAArC system showed high reproducibility of measurements, and consistency with the results obtained with the commercial system implemented in the verification of the evaluated treatment plans. Conclusion: A VMAT QA system based on MC simulation and high resolution dosimetry with film has been developed for treatment verification. It shows to be useful for the study of the real VMAT capabilities, and also for linac commissioning and evaluation of other verification devices.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-657: Quantitative Assessment of Plan Robustness for Helical Tomotherapy for Head and Neck Cancer Radiotherapy

Introduction: Geometric uncertainties in daily patient setup can lead to variations in the planned dose, especially when using highly conformal techniques such as helical Tomotherapy. To account for the potential effect of geometric uncertainty, our clinical practice is to expand critical structures by 3mm expansion into planning risk volumes (PRV). The PRV concept assumes the spatial dose cloud is insensitive to patient positioning. However, no tools currently exist to determine if a Tomotherapy plan is robust to the effects of daily setup variation. We objectively quantified the impact of geometric uncertainties on the 3D doses to critical normal tissues during helical Tomotherapy. Methods: Using a Matlab-based program created and validated by Accuray (Madison, WI), the planned Tomotherapy delivery sinogram recalculated dose on shifted CT datasets. Ten head and neck patients were selected for analysis. To simulate setup uncertainty, the patient anatomy was shifted ±3mm in the longitudinal, lateral and vertical axes. For each potential shift, the recalculated doses to various critical normal tissues were compared to the doses delivered to the PRV in the original plan Results: 18 shifted scenarios created from Tomotherapy plans for three patients with head and neck cancers were analyzed. For all simulated setup errors, the maximum doses to the brainstem, spinal cord, parotids and cochlea were no greater than 0.6Gy of the respective original PRV maximum. Despite 3mm setup shifts, the minimum dose delivered to 95% of the CTVs and PTVs were always within 0.4Gy of the original plan. Conclusions: For head and neck sites treated with Tomotherapy, the use of a 3mm PRV expansion provide a reasonable estimate of the dosimetric effects of 3mm setup uncertainties. Similarly, target coverage appears minimally effected by a 3mm setup uncertainty. Data from a larger number of patients will be presented. Future work will include other anatomical sites.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice

Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with ALL and SCLC, and we have shown the potential of PCI in select breast cancer patients through a mouse model (manuscript in preparation). We developed a computational model using our experimental results to demonstrate the advantage of treating brain micro-metastases early. Methods: MATLAB was used to develop the computational model of brain metastasis and PCI in mice. The number of metastases per mouse and the volume of metastases from four- and eight-week endpoints were fit to normal and log-normal distributions, respectively. Model input parameters were optimized so that model output would match the experimental number of metastases per mouse. A limiting dilution assay was performed to validate the model. The effect of radiation at different time points was computationally evaluated through the endpoints of incidence, number of metastases, and tumor burden. Results: The correlation between experimental number of metastases per mouse and the Gaussian fit was 87% and 66% at the two endpoints. The experimental volumes and the log-normal fit had correlations of 99% and 97%. In the optimized model, the correlation between number of metastases per mouse and the Gaussian fit was 96% and 98%. The log-normal volume fit and the model agree 100%. The model was validated by a limiting dilution assay, where the correlation was 100%. The model demonstrates that cells are very sensitive to radiation at early time points, and delaying treatment introduces a threshold dose at which point the incidence and number of metastases decline. Conclusion: We have developed a computational model of brain metastasis and PCI in mice that is highly correlated to our experimental data. The model shows that early treatment of subclinical disease is highly advantageous.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-784: Using MLC Log Files for Daily IMRT Delivery Verification

Purpose: To verify daily intensity modulated radiation therapy (IMRT) treatments using multi-leaf collimator (MLC) log files. Methods: The MLC log files from a NovalisTX Varian linear accelerator were used in this study. The MLC files were recorded daily for all patients undergoing IMRT or volumetric modulated arc therapy (VMAT). The first record of each patient was used as reference and all records for subsequent days were compared against the reference. An in house MATLAB software code was used for the comparisons. Each MLC log file was converted to a fluence map (FM) and a gamma index (γ) analysis was used for the evaluation of each daily delivery for every patient. The tolerance for the gamma index was set to 2% dose difference and 2mm distance to agreement while points with signal of 10% or lower of the maximum value were excluded from the comparisons. Results: The γ between each of the reference FMs and the consecutive daily fraction FMs had an average value of 99.1% (ranged from 98.2 to 100.0%). The FM images were reconstructed at various resolutions in order to study the effect of the resolution on the γ and at the same time reduce the time for processing the images. We found that the comparison of images with the highest resolution (768×1024) yielded on average a lower γ (99.1%) than the ones with low resolution (192×256) (γ 99.5%). Conclusion: We developed an in-house software that allows us to monitor the quality of daily IMRT and VMAT treatment deliveries using information from the MLC log files of the linear accelerator. The information can be analyzed and evaluated as early as after the completion of each daily treatment. Such tool can be valuable to assess the effect of MLC positioning on plan quality, especially in the context of adaptive radiotherapy.

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-05: Robustness of Dose Painting by Numbers in Proton Therapy

Purpose: Proton range uncertainties may cause important dose perturbations within the target volume, especially when steep dose gradients are present as in dose painting. The aim of this study is to assess the robustness against setup and range errors for high heterogeneous dose prescriptions (i.e., dose painting by numbers), delivered by proton pencil beam scanning. Methods: An automatic workflow, based on MATLAB functions, was implemented through scripting in RayStation (RaySearch Laboratories). It performs a gradient-based segmentation of the dose painting volume from 18FDG-PET images (GTVPET), and calculates the dose prescription as a linear function of the FDG-uptake value on each voxel. The workflow was applied to two patients with head and neck cancer. Robustness against setup and range errors of the conventional PTV margin strategy (prescription dilated by 2.5 mm) versus CTV-based (minimax) robust optimization (2.5 mm setup, 3% range error) was assessed by comparing the prescription with the planned dose for a set of error scenarios. Results: In order to ensure dose coverage above 95% of the prescribed dose in more than 95% of the GTVPET voxels while compensating for the uncertainties, the plans with a PTV generated a high overdose. For the nominal case, up to 35% of the GTVPET received doses 5% beyond prescription. For the worst of the evaluated error scenarios, the volume with 5% overdose increased to 50%. In contrast, for CTV-based plans this 5% overdose was present only in a small fraction of the GTVPET, which ranged from 7% in the nominal case to 15% in the worst of the evaluated scenarios. Conclusion: The use of a PTV leads to non-robust dose distributions with excessive overdose in the painted volume. In contrast, robust optimization yields robust dose distributions with limited overdose. RaySearch Laboratories is sincerely acknowledged for providing us with RayStation treatment planning system and for the support provided.

60 APPLIED LIFE SCIENCES↗

SU-F-BRA-16: Development of a Radiation Monitoring Device Using a Low-Cost CCD Camera Following Radionuclide Therapy

Purpose: It is now commonplace to handle treatments of hyperthyroidism using iodine-131 as an outpatient procedure due to lower costs and less stringent federal regulations. The Nuclear Regulatory Commission has currently updated release guidelines for these procedures, but there is still a large uncertainty in the dose to the public. Current guidelines to minimize dose to the public require patients to remain isolated after treatment. The purpose of this study was to use a low-cost common device, such as a cell phone, to estimate exposure emitted from a patient to the general public. Methods: Measurements were performed using an Apple iPhone 3GS and a Cs-137 irradiator. The charge-coupled device (CCD) camera on the phone was irradiated to exposure rates ranging from 0.1 mR/hr to 100 mR/hr and 30-sec videos were taken during irradiation with the camera lens covered by electrical tape. Interactions were detected as white pixels on a black background in each video. Both single threshold (ST) and colony counting (CC) methods were performed using MATLAB®. Calibration curves were determined by comparing the total pixel intensity output from each method to the known exposure rate. Results: The calibration curve showed a linear relationship above 5 mR/hr for both analysis techniques. The number of events counted per unit exposure rate within the linear region was 19.5 ± 0.7 events/mR and 8.9 ± 0.4 events/mR for the ST and CC methods respectively. Conclusion: Two algorithms were developed and show a linear relationship between photons detected by a CCD camera and low exposure rates, in the range of 5 mR/hr to 100-mR/hr. Future work aims to refine this model by investigating the dose-rate and energy dependencies of the camera response. This algorithm allows for quantitative monitoring of exposure from patients treated with iodine-131 using a simple device outside of the hospital.

60 APPLIED LIFE SCIENCES↗

MO-DE-BRA-06: MrRSCAL: A Radiological Simulation Tool for Resident Education

Purpose: The goal of this project was to create a readily accessible, comprehensive-yet-flexible interactive MRI simulation tool for use in training and education of radiology residents in particular. This tool was developed to take the place of an MR scanner in laboratory activities, as magnet time has become scarce while hospitals are optimizing clinical scheduling for improved throughput. Methods: MrRSCAL (Magnetic resonance Resident Simulation Console for Active Learning) was programmed and coded using Matlab on a Mac workstation utilizing OS X platform. MR-based brain images were obtained from one of the co-authors and processed to generate parametric maps. Scanner sounds are also generated via mp3 convolution of a single MR gradient slew with a time-profile of gradient waveforms. Results: MrRSCAL facilitates the simulation of multiple MR sequences with the ability to alter MR parameters via an intuitive GUI control panel. The application allows the user to gain real-time understanding of image transformation when varying these said parameters by examining the resulting images. Lab procedures can be loaded and displayed for more directed study. The panel is also configurable, providing a simple interface for elementary labs or a full array of controls for the expert user. Conclusion: Our introduction of MrRSCAL, which is readily available to users with a current laptop or workstation, allows for individual or group study of MR image acquisition with immediate educational feedback as the MR parameters are manipulated. MrRSCAL can be used at any time and any place once installed, offering a new tool for reviewing relaxometric and artifact principles when studying for boards or investigating properties of a pulse sequence. This tool promises to be extremely useful in conveying traditionally difficult and abstract concepts involved with MR to the radiology resident and other medical professionals at large.

60 APPLIED LIFE SCIENCES↗

MO-FG-303-06: Evaluation of the Performance of Very High-Energy Electron (VHEE) Beams in Radiotherapy: Five Clinical Cases

Purpose: To evaluate the performance of 100–120 MeV very-high energy electron (VHEE) scanning pencil beams to radiotherapy by means of Monte Carlo (MC) simulations. Methods: We selected five clinical cases with target sizes of 1.2 cm{sup 3} to 990.4 cm{sup 3}. We calculated VHEE treatment plans using the MC EGSnrc code implemented in a MATLAB-based graphical user interface developed by our group. We generated phase space data for beam energies: 100 and 120 MeV and pencil beam spot sizes of 1, 3, and 5 mm at FWHM. The number of equidistant beams considered in this work was 16 or 32. Dose was calculated and then imported into a research version of RayStation where treatment plan optimization was performed. We compared the VHEE plans with the clinically delivered volumetric modulated arc therapy (VMAT) plan to evaluate VHEE plans performance. Results: VHEE plans provided the same PTV coverage and dose homogeneity than VMAT plans for all the cases. In average, the mean dose to organs at risk (OARs) was 24% lower for the VHEE plans. The structures that benefited the most from using VHEE were: large bowel for the esophagus case, chest wall for the liver case, brainstem for the acoustic case, carina for the lung case, and genitalia for the anal case, with 23.7–34.6% lower dose. VHEE dose distributions were more conformal than VMAT solution as confirmed by conformity indices CI100 and CI50. Integral dose to the body was in average 19.6% (9.2%–36.5%) lower for the VHEE plans. Conclusion: We have shown that VHEE plans resulted in similar or superior dose distributions compared to clinical VMAT plans for five different cases and a wide range of target volumes, including a case with a small target (1.2 cm{sup 3}), which represents a challenge for VMAT planning and might require the use of more complex non-coplanar VMAT plans. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Laboratories AB. E Hynning: Employee, RaySearch Laboratories AB. B Qu: None. B Loo Jr.: Research support, RaySearch, Varian. P Maxim: Research support, RaySearch, Varian.

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