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At least 649 records · Page 36
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-T-35: Optimization of Bladder and Rectal Doses Using a Multi-Lumen Intracavitary Applicator for Gynecological Brachytherapy

Purpose: Radiation dose delivery for endometrial cancer using HDR techniques is limited by dose to bladder and rectum. A dosimetric study was performed using Varian Capri vaginal brachytherapy applicator to determine the optimal channel configuration which minimizes dose to bladder and rectum, while providing good target coverage. Methods: A total of 17 patients, 63 plans clinically delivered, and 252 simulated plans using Varian BrachyVision planning system were generated to investigate optimal channel configuration which results in minimum dose to bladder and rectum while providing adequate target coverage. The Capri applicator consists of 13 lumens arranged in two concentric rings, one central lumen and six lumens per ring. Manual dose shaping is invariably required to lower the dose to critical organs. Three-dimensional plans were simulated for 4 channel arrangements, all 13 channels, channel 12 o’clock (close to bladder) and 6 o’clock (close to rectum) deactivated, central channel deactivated, and central channel in addition to 12 o’clock and 6 o’clock deactivated. A relationship between V100, the volume that receives the prescribed dose, and the amount of curie-seconds required to deliver it, was established. Results: Using all 13 channels results in maximum dose to bladder and rectum. Deactivating central channel in addition to 12 o’clock and 6 o’clock resulted in minimizing bladder and rectum doses but compromised target coverage. The relationship between V100, the volume that receives the prescribed dose, and the curie seconds was found to be linear. Conclusion: Deactivating channels 12 o’clock and 6 o’clock was shown to be the optimal configuration leading to minimum dose to bladder and rectum without compromising target coverage. The linear relationship between V100 and the curie- seconds can be used as a verification parameter.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-51: Investigating the Effect of Eye Size and Eccentricity On Normal Tissue Doses From Eye Plaque Brachytherapy

Purpose: This study investigates the effect of eye size and eccentricity on doses to critical tissues by simulating doses in the Plaque Simulator (v. 6.3.1) software. Present OHSU plaque brachytherapy treatment focuses on delivering radiation to the tumor measured with ocular ultrasound plus a small margin and assumes the orbit has the dimensions of a “standard eye.” Accurately modeling the dimensions of the orbit requires a high resolution ocular CT. This study quantifies how standard differences in equatorial diameters and eccentricity affect calculated doses to critical structures in order to query the justification of the additional CT scan to the treatment planning process. Methods: Tumors of 10 mm × 10 mm × 5 mm were modeled at the 12:00:00 hour with a latitude of 45 degrees. Right eyes were modeled at a number of equatorial diameters from 17.5 to 28 mm for each of the standard non-notched COMS plaques with silastic inserts. The COMS plaques were fully loaded with uniform activity, centered on the tumor, and prescribed to a common tumor dose (85 Gy/100 hours). Variations in the calculated doses to normal structures were examined to see if the changes were significant. Results: The calculated dose to normal structures show a marked dependence on eye geometry. This is exemplified by fovea dose which more than doubled in the smaller eyes and nearly halved in the larger model. Additional significant dependence was found in plaque size on the calculated dose in spite of all plaques giving the same dose to the prescription point. Conclusion: The variation in dose with eye dimension fully justifies the addition of a high resolution ocular CT to the planning technique. Additional attention must be made to plaque size beyond simply covering the tumor when considering normal tissue dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-106: A Dosimetric Study of Intensity Modulated Radiation Therapy to Decrease Radiation Dose to the Thoracic Vertebral Bodies in Patients Receiving Concurrent Chemoradiation for Lung Cancer

Purpose: Recent clinical studies have shown a correlation between radiation dose to the thoracic vertebral bodies (TVB) and the development of hematologic toxicity (HT) in patients receiving chemoradiation (CRT) for lung cancer (LuCa). The feasibility of a bone-marrow sparing (BMS) approach in this group of patients is unknown. We hypothesized that radiation dose to the TVB can be reduced with an intensity modulated radiation therapy(IMRT)/volumetric modulated arc radiotherapy(VMAT) without affecting plan quality. Methods: We identified LuCa cases treated with curative intent CRT using IMRT/VMAT from 4/2009 to 2/2015. The TVBs from T1–T10 were retrospectively contoured. No constraints were placed on the TVB structure initially. A subset were re-planned with BMS-IMRT/VMAT with an objective or reducing the mean TVB dose to <23 Gy. The following data were collected on the initial and BMS plans: mean dose to planning target volume (PTV), lungs-PTV, esophagus, heart; lung V20; cord max dose. Pairwise comparisons were performed using the signed rank test. Results: 94 cases received CRT with IMRT/VMAT. We selected 11 cases (7 IMRT, 4 VMAT) with a range of initial mean TVB doses (median 35.7 Gy, range 18.9–41.4 Gy). Median prescription dose was 60 Gy. BMS-IMRT/VMAT significantly reduced the mean TVB dose by a median of 10.2 Gy (range, 1.0–16.7 Gy, p=0.001) and reduced the cord max dose by 2.9 Gy (p=0.014). BMS-IMRT/VMAT had no impact on lung mean (median +17 cGy, p=0.700), lung V20 (median +0.5%, p=0.898), esophagus mean (median +13 cGy, p=1.000) or heart mean (median +16 cGy, p=0.365). PTV-mean dose was not affected by BMS-IMRT/VMAT (median +13 cGy, p=0.653). Conclusion: BMS-IMRT/VMAT was able to significantly reduce radiation dose to the TVB without compromising plan quality. Prospective evaluation of BMS-IMRT/VMAT in patients receiving CRT for LuCa is warranted to determine if this approach results in clinically significant reductions in HT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-373: Monte Carlo Versus Pencil Beam Dose Calculation for Spine SBRT Treatments Using HybridARC and Sliding Windows IMRT

Purpose: The purpose of this work was to quantify the dosimetric impact of Monte Carlo (MC) dose calculation algorithm compared to Pencil Beam (PB) on Spine SBRT with HybridARC (HA) and sliding windows IMRT (dMLC) treatment modality. Methods: A 6MV beam (1000MU/min) produced by a Novalis TX (BrainLAB-Varian) equipped with HDMLC was used. HA uses 1 arc plus 8 IMRT beams (arc weight between 60–40%) and dIMRT 15 beams. Plans were calculated using iPlan v.4.5.3 (BrainLAB) and the treatment dose prescription was 27Gy in 3 fractions. Dose calculation was done by PB (4mm spatial resolution) with heterogeneity correction and MC dose to water (4mm spatial resolution and 4% mean variance). PTV and spinal cord dose comparison were done. Study was done on 12 patients. IROC Spine Phantom was used to validate HA and quantify dose variation using PB and MC algorithm. Results: The difference between PB and MC for PTV D98%, D95%, Dmean, D2% were 2.6% [−5.1, 6.8], 0.1% [−4.2, 5.4], 0.9% [−1.5, 3.8] and 2.4% [−0.5, 8.3]. The difference between PB and MC for spinal cord Dmax, D1.2cc and D0.35cc were 5.3% [−6.4, 18.4], 9% [−7.0, 17.0] and 7.6% [−0.6, 14.8] respectively. IROC spine phantom shows PTV TLD dose variation of 0.98% for PB and 1.01% for MC. Axial and sagittal film plane gamma index (5%-3mm) was 95% and 97% for PB and 95% and 99% for MC. Conclusion: PB slightly underestimates the dose for the PTV. For the spinal cord PB underestimates the dose and dose differences could be as high as 18% which could have unexpected clinical impact. CI shows no variation between PB and MC for both treatment modalities Treatment modalities have no impact with the dose calculation algorithms used. Following the IROC pass-fail criteria, treatment acceptance requirement was fulfilled for PB and MC.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-502: FFF Beams, Jaw-Tracking and Treatment Techniques: Out of Field Dose Considerations for Pediatric Radiation Therapy Delivery

Purpose: To compare the extended dose profile delivered by 3DCRT and VMAT techniques for flattened and flattening-filter-free(FFF) photon beams (6X, 6XFFF,10XFFF), with and without jaw-tracking (JT) on Varian TrueBeam linac. The goal is to determine which treatment technique/modality will minimize the peripheral photon dose exposure (and ultimately minimize the risk of second malignant neoplasms (SMN)) in pediatric patients. Methods: 3DCRT, VMAT, and jaw tracking VMAT (JTVMAT) plans with 6X, 6XFFF and 10XFFF x-ray beams were created on a 30×60×22.5cm solid water phantom with a 551 cc PTV. The 3DCRT plans consisted of a 4FLD arrangement. The optimization objectives for the single-arc VMAT plans was V95%Rx=98% to PTV and minimize dose to a 5cm diameter organ at risk (OAR). The OAR to PTV distance varied from 0–30cm along the long axis at 7.5cm depth. The dose to the center of the OAR was measured using a 0.6cc ion chamber. Results: Relative to the 6X flattened beam, the 10XFFF photon beam had the lowest dose in the penumbra and peripheral region (>15 cm) region by up to 20% and 40%, respectively for all modalities (3DCRT, VMAT, JTVMAT). The 6XFFF beams only showed a dose reduction in the peripheral region (by up to 20%). JT did not significantly affect the peripheral dose for all modalities and energies. Conclusion: Treating pediatric patients with a 10XFFF beam is the most effective way to reduce photon scatter dose in both the penumbra and peripheral regions. However, the neutron dose contribution resulting from the 10MV beam still needs to be considered. For all modalities, 6XFFF was the next effective method to reduce peripheral photon doses. 3DCRT beams had the lowest peripheral doses for all energies compared to VMAT and JTVMAT, however previous publications have shown that this comes at the expense of PTV conformity and OAR sparing.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-BRA-12: Development of An Intra-Fractional Motion Tracking and Dose Reconstruction System for Adaptive Stereotactic Body Radiation Therapy in High-Risk Prostate Cancer

Purpose: A clinical trial on stereotactic body radiation therapy (SBRT) for high-risk prostate cancer is undergoing at our institution. In addition to escalating dose to the prostate, we have increased dose to intra-prostatic lesions. Intra-fractional prostate motion deteriorates well planned radiation dose, especially for the small intra-prostatic lesions. To solve this problem, we have developed a motion tracking and 4D dose-reconstruction system to facilitate adaptive re-planning. Methods: Patients in the clinical trial were treated with VMAT using four arcs and 10 FFF beam. KV triggered x-ray projections were taken every 3 sec during delivery to acquire 2D projections of 3D anatomy at the direction orthogonal to the therapeutic beam. Each patient had three implanted prostate markers. Our developed system first determined 2D projection locations of these markers and then 3D prostate translation and rotation via 2D/3D registration of the markers. Using delivery log files, our GPU-based Monte Carlo tool (goMC) reconstructed dose corresponding to each triggered image. The calculated 4D dose distributions were further aggregated to yield the delivered dose. Results: We first tested each module in our system. MC dose engine were commissioned to our treatment planning system with dose difference of <0.5%. For motion tracking, 1789 kV projections from 7 patients were acquired. The 2D marker location error was <1 mm. For 3D motion tracking, root mean square (RMS) errors along LR, AP, and CC directions were 0.26mm, 0.36mm, and 0.01mm respectively in simulation studies and 1.99mm, 1.37mm, and 0.22mm in phantom studies. We also tested the entire system workflow. Our system was able to reconstruct delivered dose. Conclusion: We have developed a functional intra-fractional motion tracking and 4D dose re-construction system to support our clinical trial on adaptive high-risk prostate cancer SBRT. Comprehensive evaluations have shown the capability and accuracy of our system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-206-05: A Comparison of Head Phantoms Used for Dose Determination in Imaging Procedures

Purpose: To determine similarities and differences between various head phantoms that might be used for dose measurements in diagnostic imaging procedures. Methods: We chose four frequently used anthropomorphic head phantoms (SK-150, PBU-50, RS-240T and Alderson Rando), a computational patient phantom (Zubal) and the CTDI head phantom for comparison in our study. We did a CT scan of the head phantoms using the same protocol and compared their dimensions and CT numbers. The scan data was used to calculate dose values for each of the phantoms using EGSnrc Monte Carlo software. An .egsphant file was constructed to describe these phantoms using a Visual C++ program for DOSXYZnrc/EGSnrc simulation. The lens dose was calculated for a simulated CBCT scan using DOSXYZnrc/EGSnrc and the calculated doses were validated with measurements using Gafchromic film and an ionization chamber. Similar calculations and measurements were made for PA radiography to investigate the attenuation and backscatter differences between these phantoms. We used the Zubal phantom as the standard for comparison since it was developed based on a CT scan of a patient. Results: The lens dose for the Alderson Rando phantom is around 9% different than the Zubal phantom, while the lens dose for the PBU-50 phantom was about 50% higher, possibly because its skull thickness and the density of bone and soft tissue are lower than anthropometric values. The lens dose for the CTDI phantom is about 500% higher because of its totally different structure. The entrance dose profiles are similar for the five anthropomorphic phantoms, while that for the CTDI phantom was distinctly different. Conclusion: The CTDI and PBU-50 head phantoms have substantially larger lens dose estimates in CBCT. The other four head phantoms have similar entrance dose with backscatter hence should be preferred for dose measurement in imaging procedures of the head. Partial support from NIH Grant R01-EB002873 and Toshiba Medical Systems Corp.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-TeP1-14: SRS Dose Calculation Accuracy Comparison Between Pencil Beam and Monte Carlo Algorithms

Purpose: Stereotactic radiosurgery (SRS) outcomes are related to the delivered dose to the target and to surrounding tissue. We have commissioned a Monte Carlo based dose calculation algorithm to recalculated the delivered dose planned using pencil beam calculation dose engine. Methods: Twenty consecutive previously treated patients have been selected for this study. All plans were generated using the iPlan treatment planning system (TPS) and calculated using the pencil beam algorithm. Each patient plan consisted of 1 to 3 targets and treated using dynamically conformal arcs or intensity modulated beams. Multi-target treatments were delivered using multiple isocenters, one for each target. These plans were recalculated for the purpose of this study using a single isocenter. The CT image sets along with the plan, doses and structures were DICOM exported to Monaco TPS and the dose was recalculated using the same voxel resolution and monitor units. Benchmark data was also generated prior to patient calculations to assess the accuracy of the two TPS against measurements using a micro ionization chamber in solid water. Results: Good agreement, within −0.4% for Monaco and +2.2% for iPlan were observed for measurements in water phantom. Doses in patient geometry revealed up to 9.6% differences for single target plans and 9.3% for multiple-target-multiple-isocenter plans. The average dose differences for multi-target-single-isocenter plans were approximately 1.4%. Similar differences were observed for the OARs and integral dose. Conclusion: Accuracy of the beam is crucial for the dose calculation especially in the case of small fields such as those used in SRS treatments. A superior dose calculation algorithm such as Monte Carlo, with properly commissioned beam models, which is unaffected by the lack of electronic equilibrium should be preferred for the calculation of small fields to improve accuracy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-IeP2-11: Measurement of Equilibrium Doses in Computed Tomography: Comparative Study of Ionization and Solid-State Dosimeters

Purpose: This study aimed to compare equilibrium doses in computed tomography (CT) obtained from ionization and solid-state dosimeters based on the approach presented in the American Association of Physicists in Medicine Report No. 111. The equilibrium doses were also compared with the CT dose index (CTDI) using a 10-cm pencil-type ionization chamber. Methods: A 0.6-cm{sup 3} ionization chamber (10X6-0.6CT) and a solid-state detector (CT Dose Profiler [CTDP]) were calibrated using 80–130 kVp X-ray beams (44.5–55.8 keV of effective energy) from a radiography X-ray machine against a reference ionization dosimeter. Three 16- or 32-cm diameter polymethyl methacrylate (PMMA) phantoms were assembled consecutively on the CT table to obtain equilibrium doses. The 10X6-0.6CT and CTDP were each placed at the center and peripheral holes (12, 3, 6, and 9 o’clock) of the z-center. Central and mean peripheral equilibrium doses were obtained by scanning with longitudinal translation for a length less than the entire phantom length. CTDIs were also obtained with a 10-cm pencil-type ionization chamber (10X6-0.6CT) by scanning a 16- or 32-cm diameter PMMA phantom with one rotation of the X-ray tube. Results: The difference of calibration coefficients between 80 and 130 kVp was 21.1% for the CTDP and 0.7% for the 10X6-0.6CT. The equilibrium doses were higher than the CTDI. Especially at the peripheral positions and 80 kVp, the 10X6-0.6CT showed higher equilibrium doses than CTDP. However, the relation between the equilibrium dose for the 10X6-0.6CT and the CTDP differed depending on the phantom size, scanner type, measurement position, and selected acquisition parameters. Conclusion: The use of a 10-cm pencil-type ionization chamber causes underestimation of the equilibrium dose. The CTDP has a higher energy dependency than the 10X6-0.6CT. The obtained equilibrium doses are different between the 10X6-0.6CT and the CTDP depending on various conditions. This study was supported by JSPS KAKENHI Grant Number 15K09887.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-D-209-05: Automatic Calculation of Organ and Effective Dose for CBCT and Interventional Fluoroscopic Procedures

Purpose: To compare PCXMC and EGSnrc calculated organ and effective radiation doses from cone-beam computed tomography (CBCT) and interventional fluoroscopically-guided procedures using automatic exposure-event grouping. Methods: For CBCT, we used PCXMC20Rotation.exe to automatically calculate the doses and compared the results to those calculated using EGSnrc with the Zubal patient phantom. For interventional procedures, we use the dose tracking system (DTS) which we previously developed to produce a log file of all geometry and exposure parameters for every x-ray pulse during a procedure, and the data in the log file is input into PCXMC and EGSnrc for dose calculation. A MATLAB program reads data from the log files and groups similar exposures to reduce calculation time. The definition files are then automatically generated in the format used by PCXMC and EGSnrc. Processing is done at the end of the procedure after all exposures are completed. Results: For the Toshiba Infinix CBCT LCI-Middle-Abdominal protocol, most organ doses calculated with PCXMC20Rotation closely matched those calculated with EGSnrc. The effective doses were 33.77 mSv with PCXMC20Rotation and 32.46 mSv with EGSnrc. For a simulated interventional cardiac procedure, similar close agreement in organ dose was obtained between the two codes; the effective doses were 12.02 mSv with PCXMC and 11.35 mSv with EGSnrc. The calculations can be completed on a PC without manual intervention in less than 15 minutes with PCXMC and in about 10 hours with EGSnrc, depending on the level of data grouping and accuracy desired. Conclusion: Effective dose and most organ doses in CBCT and interventional radiology calculated by PCXMC closely match those calculated by EGSnrc. Data grouping, which can be done automatically, makes the calculation time with PCXMC on a standard PC acceptable. This capability expands the dose information that can be provided by the DTS. Partial support from NIH Grant R01-EB002873 and Toshiba Medical Systems Corp.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-H-CAMPUS-TeP3-05: Evaluation of the Microscopic Dose Enhancement in the Nanoparticle-Enhanced Auger Therapy

Purpose: The aim of this study is to apply Monte Carlo simulations to investigate the nanoparticle dose enhancement for Auger therapy. Methods: Two nanoparticle fabrications were considered: nanoshell and nanosphere. In the first step, a single nanoparticle was irradiated with Auger emitters. The electrons were scored in a phase space at the outer surface of the nanoparticle with Geant4-Penelope. In the second step, the previously recorded phase space was used as a source and placed at the center of a cell-size water phantom. The nanoscale dose was evaluated in water around the nanoparticle with Geant4-DNA. The dose enhancement factor (DEF) is defined as the ratio of doses with and without nanoparticles. The nanoparticles were replaced by corresponding water nanoparticle with the same size and volume source which represents typical situation of Auger emitters without nanoparticle. Various sizes/materials of nanoparticles and isotopes were considered. Results: Nanoshell - Microscopic dose was increased up to 130% at 20 – 100 nm distances from the surface of Au-{sup 125}I nanoshell. However, dose at less than 20 nm distance was reduced due to absorbed low energy electrons in gold nanoshell. The amounts and regions of the dose enhancement were dependent on nanoshell size, materials, and isotopes. Nanosphere - The increased amounts of electrons up to 300% and reduced average energy with nanosphere were observed compared with water nanoparticle. We observed localized dose enhancement (up to a factor 3.6) in the immediate vicinity (< 50 nm) of Au-{sup 125} I nanosphere. The dose enhancement patterns vary according to nanosphere sizes and isotopes. Conclusion: We conclude that Auger therapy with nanoparticles can lead to change of electron energy spectrum and dose enhancements at certain range. The dose enhancement patterns vary according to nanoparticle sizes, materials, and isotopes. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP: Ministry of Science, ICT and Future Planning) (No. NRF-2013M2B2B1075776)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-AB-207B-06: Dose and Biological Uncertainties in Sarcoma

Purpose: To understand the clinical impact of key uncertainties in proton therapy potentially affecting the analysis of clinical trials, namely the assumption of using a constant relative biological effectiveness (RBE) of 1.1 compared to variable RBE for proton therapy and the use of analytical dose calculation (ADC) methods. Methods: Proton dose distributions were compared for analytical and Monte Carlo (TOPAS) dose calculations. In addition, differences between using a constant RBE of 1.1 (RBE-constant) were compared with four different RBE models (to assess model variations). 10 patients were selected from an ongoing clinical trial on IMRT versus scanned protons for sarcoma. Comparisons were performed using dosimetric indices based on dose-volume histogram analyses and γ-index analyses. Results: For three of the RBE-models the mean dose, D95, D50 and D02 (dose values covering 95%, 50% and 2% of the target volume, respectively) were up to 5% lower than for RBE-constant. The dosimetric indices for one of the RBE-models were around 9% lower than for the RBE-constant model. The differences for V90 (the percentage of the target volume covered by 90% of the prescription dose) were up to 40% for three RBE-models, whereas for one the difference was around 95%. All ADC dosimetric indices were up to 5% larger than for RBE-constant. The γ-index passing rate for the target volume with a 3%/3mm criterion was above 97% for all models except for one, which was below 24%. Conclusion: Interpretation of clinical trials on sarcoma may depend on dose calculation uncertainties (as assessed by Monte Carlo). In addition, the biological dose distribution depends notably on which RBE model is utilized. The current practice of using a constant RBE of 1.1 may overestimate the target dose by as much as 5% for biological dose calculations. Performing an RBE uncertainty analysis is recommended for trial analysis. U19 projects - U19 CA 021239. PI: Delaney.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TH-AB-207A-06: The Use of Realistic Phantoms to Predict CT Dose to Pediatric Patients

Purpose: To predict pediatric patient dose from diagnostic CT scans using Monte Carlo simulation of realistic reference phantoms of various ages, weights, and heights. Methods: A series of deformable pediatric reference phantoms using Non-Uniform Rational B-Splines (NURBS) was developed for a large range of ages, percentiles, and reference anatomy. Individual bones were modeled using age-dependent factors, and red marrow was modeled as functions of age and spatial distribution based on Cristy1. Organ and effective doses for the phantom series were calculated using Monte Carlo simulation of chest, abdominopelvic, and chest-abdomen-pelvis CT exams. Non-linear regression was performed to determine the relationship between dose-length-product (DLP)-normalized organ and effective doses and phantom diameter. Patient-specific voxel computational phantoms were also created by manual segmentation of previously acquired CT images for 40 pediatric patients (0.7 to 17 years). Organ and effective doses were determined by Monte Carlo simulation of these patient-specific phantoms. Each patient was matched to the closest pediatric reference phantom based primarily on age and diameter for all major organs within the torso. Results: A total of 80 NURBS phantoms were created ranging from newborn to 15 years with height/weight percentiles from 10 to 90%. Organ and effective dose normalized by DLP correlated strongly with exponentially decreasing average phantom diameter (R{sup 2} > 0.95 for most organs). A similar relationship was determined for the patient-specific voxel phantoms. Differences between patient-phantom matched organ-dose values ranged from 0.37 to 2.39 mGy (2.87% to 22.1%). Conclusion: Dose estimation using NURBS-based pediatric reference phantoms offers the ability to predict patient dose before and after CT examinations, and physicians and scientists can use this information in their analysis of dose prescriptions for particular subjects and study types. This may lead to practices that minimize radiation dose while still achieving high quality images and, ultimately, improved patient care. NIH/NCI 1 R01 CA155400-01A1.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Poster - 36: Effect of Planning Target Volume Coverage on the Dose Delivered in Lung Radiotherapy

Purpose: In lung radiotherapy, breathing motion may be encompassed by contouring the internal target volume (ITV). Remaining uncertainties are included in a geometrical expansion to the planning target volume (PTV). In IMRT, the treatment is then optimized until a desired PTV fraction is covered by the appropriate dose. The resulting beams often carry high fluence in the PTV margin to overcome low lung density and to generate steep dose gradients. During treatment, the high density tumour can enter the PTV margin, potentially increasing target dose. Thus, planning lung IMRT with a reduced PTV dose may still achieve the desired ITV dose during treatment. Methods: A retrospective analysis was carried out with 25 IMRT plans prescribed to 63 Gy in 30 fractions. The plans were re-normalized to cover various fractions of the PTV by different isodose lines. For each case, the isocentre was moved using 125 shifts derived from all 3D combinations of 0 mm, (PTV margin - 1 mm), and PTV margin. After each shift, the dose was recomputed to approximate the delivered dose. Results and Conclusion: Our plans typically cover 95% of the PTV by 95% of the dose. Reducing the PTV covered to 94% did not significantly reduce the delivered ITV doses for (PTV margin - 1 mm) shifts. Target doses were reduced significantly for all other shifts and planning goals studied. Thus, a reduced planning goal will likely deliver the desired target dose as long as the ITV rarely enters the last mm of the PTV margin.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2022

Simulation and Application of Bayesian Dose Uncertainty Modeling for Low-Boom Community Noise Surveys

In dose-response modeling, failing to account for dose uncertainty can cause artificial flattening of the estimated slope of the dose-response curve. Previous analyses of NASA sonic boom community noise survey data utilized a Bayesian multilevel logistic regression model, which did not account for dose uncertainty. The current work extends the model to account for either classical or Berkson dose uncertainty. The extended model is applied to two simulated dose-response datasets to illustrate conditions under which the dose uncertainty term does and does not correct for the artificial flattening introduced by dose uncertainty. Finally, the extended model is applied to two previous NASA sonic boom community noise surveys. The resulting dose-response curve slope for the average participant is 5 to 10% steeper, but the difference in the noise dose that elicits a 5% highly annoyed response is small (less than 1 dB). The difference remains insignificant when producing population summary dose-response curves. Commentary is included on applicability to future X-59 low-boom community noise survey data modeling and analysis.

X-59↗
DOE OSTI2015

Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Electron postmastectomy chest wall plus comprehensive nodal irradiation technique using Electron Monte Carlo dose algorithm

For left-sided postmastectomy patients requiring chest wall plus comprehensive nodal irradiation, sometimes traditional techniques such as partial wide tangents or electron/tangents combination are not feasible due to abnormal chest wall contour or heart position or unusually wide excision scar. We developed electron chest wall irradiation technique using Electron Monte Carlo (EMC) dose algorithm that will achieve heart sparing with acceptable ipsilateral lung dose, minimal contralateral lung, and breast dose. Ten left-sided postmastectomy patients with very challenging anatomy were selected for this dosimetry study. The en face electron fields were designed from a single isocenter and gantry angle with different energy beams using different cutouts that matched on the skin. Smaller energy was used in the central thin chest wall part and higher energy in the medial internal mammary nodes (IMN) area, superior part of the thick chest wall, and/or axillary nodal area. The electron fields were matched to the photon supraclavicular field in the superior region. Daily field junctions were used to feather the match lines between all the fields. Electron field dose calculations were done with Monte Carlo. Five patients' chest wall fields were planned with 6/9MeVcombination, 1 with 6/12 MeV, 2 with 9/12 MeV, 1 with 9/16 MeV, and 1 with 6/9/12 MeV. Institutional criteria of prescription dose of 50 Gy for target volumes and normal tissue dose were met with this technique in spite of the challenging anatomy. Mean heart dose averaged 3.0 Gy ± 0.8 Gy. For ipsilateral lung, V20Gy and V5Gy averaged 33.2% ± 4.5% and 64.6% ± 9.6%, respectively. For contralateral lung, V5Gy averaged 5.1% ± 5.0%. For contralateral breast, V5Gy averaged 3.3% ± 3.1%. The electron chest wall irradiation technique using EMC dose algorithm can provide adequate dose coverage to the chest wall, IMNs, and/or axillary nodes while achieving heart sparing with acceptable ipsilateral lung dose, minimal contralateral lung, and breast dose.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

DeepMC: a deep learning method for efficient Monte Carlo beamlet dose calculation by predictive denoising in magnetic resonance-guided radiotherapy

Abstract Emerging magnetic resonance (MR) guided radiotherapy affords significantly improved anatomy visualization and, subsequently, more effective personalized treatment. The new therapy paradigm imposes significant demands on radiation dose calculation quality and speed, creating an unmet need for the acceleration of Monte Carlo (MC) dose calculation. Existing deep learning approaches to denoise the final plan MC dose fail to achieve the accuracy and speed requirements of large-scale beamlet dose calculation in the presence of a strong magnetic field for online adaptive radiotherapy planning. Our deep learning dose calculation method, DeepMC, addresses these needs by predicting low-noise dose from extremely noisy (but fast) MC-simulated dose and anatomical inputs, thus enabling significant acceleration. DeepMC simultaneously reduces MC sampling noise and predicts corrupted dose buildup at tissue-air material interfaces resulting from MR-field induced electron return effects. Here we demonstrate our model’s ability to accelerate dose calculation for daily treatment planning by a factor of 38 over traditional low-noise MC simulation with clinically meaningful accuracy in deliverable dose and treatment delivery parameters. As a post-processing approach, DeepMC provides compounded acceleration of large-scale dose calculation when used alongside established MC acceleration techniques in variance reduction and graphics processing unit-based MC simulation.

Engineering↗