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At least 667 records · Page 37

SU-F-T-366: Dosimetric Parameters Enhancement of 120-Leaf Millennium MLC Using EGSnrc and IAEA Phase-Space Data

Purpose: Recently, the multileaf collimators (MLC) have become an important part of any LINAC collimation systems because they reduce the treatment planning time and improves the conformity. Important factors that affects the MLCs collimation performance are leaves material composition and their thickness. In this study, we investigate the main dosimetric parameters of 120-leaf Millennium MLC including dose in the buildup point, physical penumbra as well as average and end leaf leakages. Effects of the leaves geometry and density on these parameters are evaluated Methods: From EGSnrc Monte Carlo code, BEAMnrc and DOSXYZnrc modules are used to evaluate the dosimetric parameters of a water phantom exposed to a Varian xi for 100cm SSD. Using IAEA phasespace data just above MLC (Z=46cm) and BEAMnrc, for the modified 120-leaf Millennium MLC a new phase space data at Z=52cm is produces. The MLC is modified both in leaf thickness and material composition. EGSgui code generates 521ICRU library for tungsten alloys. DOSXYZnrc with the new phase space evaluates the dose distribution in a water phantom of 60×60×20 cm3 with voxel size of 4×4×2 mm3. Using DOSXYZnrc dose distributions for open beam and closed beam as well as the leakages definition, end leakage, average leakage and physical penumbra are evaluated. Results: A new MLC with improved dosimetric parameters is proposed. The physical penumbra for proposed MLC is 4.7mm compared to 5.16 mm for Millennium. Average leakage in our design is reduced to 1.16% compared to 1.73% for Millennium, the end leaf leakage suggested design is also reduced to 4.86% compared to 7.26% of Millennium. Conclusion: The results show that the proposed MLC with enhanced dosimetric parameters could improve the conformity of treatment planning.

60 APPLIED LIFE SCIENCES↗

Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

Purpose: To compare the dose distributions and late radiation toxicities for {sup 125}I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46 months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-T-53: Treatment Planning with Inhomogeneity Correction for Intraoperative Radiotherapy Using KV X-Ray Beams

Purpose: The current standard in dose calculation for intraoperative radiotherapy (IORT) using the ZEISS Intrabeam 50 kV x-ray system is based on depth dose measurements in water and no heterogeneous tissue effect has been taken into account. We propose an algorithm for pre-treatment planning including inhomogeneity correction based on data of depth dose measurements in various tissue phantoms for kV x-rays. Methods: Direct depth dose measurements were made in air, water, inner bone and cortical bone phantoms for the Intrabeam 50 kV x-rays with a needle applicator. The data were modelled by a function of power law combining exponential with different parameters. Those phantom slabs used in the measurements were scanned to obtain CT numbers. The x-ray beam initiated from the source isocenter is ray-traced through tissues. The corresponding doses will be deposited/assigned at different depths. On the boundary of tissue/organ changes, the x-ray beam will be re-traced in new tissue/organ starting at an equivalent depth with the same dose. In principle, a volumetric dose distribution can be generated if enough directional beams are traced. In practice, a several typical rays traced may be adequate in providing estimates of maximum dose to the organ at risk and minimum dose in the target volume. Results: Depth dose measurements and modeling are shown in Figure 1. The dose versus CT number is shown in Figure 2. A computer program has been written for Kypho-IORT planning using those data. A direct measurement through 2 mm solid water, 2 mm inner bone, and 1 mm solid water yields a dose rate of 7.7 Gy/min. Our calculation shows 8.1±0.4 Gy/min, consistent with the measurement within 5%. Conclusion: The proposed method can be used to more accurately calculate the dose by taking into account the heterogeneous effect. The further validation includes comparison with Monte Carlo simulation.

60 APPLIED LIFE SCIENCES↗

SU-E-T-605: A New Design for a Rotating Gamma Knife. Monte Carlo Simulation

Purpose: to determine the characteristics of the 60Co beam emerging from a new design of a rotating Gamma Knife system and to calculate 3D dose distributions at the isocenter for different source configurations and collimator openings. Methods: We employed the BEAM-Monte Carlo code to realistically model the geometry design, including 30 60Co source capsules, two circular primary collimators (diameter of 6.6mm and 6.1mm) and four different changeable collimators. The shielding of the head design was also simulated. The sources (2.8mm diameter) are distributed in six groups in the spherical geometry. Each source is individually collimated to obtained four different circular fields at the isocenter (3mm, 3.5mm, 6mm and 8mm).The phase-space particles reaching the scoring plane below the primary collimation assembly were recorded and the BEAMDP code was used to determine the fluence and energy spectra of the particles emerging from each source-collimator configuration. The dose distributions at the isocenter plane (397.6mm from the source) were calculated in a spherical component module for the circular field sizes studied. Results: The energy spectra below the head assembly and primary collimators have been obtained, which exhibited the typical 60Co peaks and a small low-energy tail due to scattered photons (from about 200keV to 1MeV). The scattered component of the spectra represents about 8 % of the total number of photons reaching the scoring plane. The radial photon fluence does not vary significantly inside the collimator openings. The spectra of particles from different source groups are compared. Conclusion: The 60Co beam emerging from each source configuration was characterized, which can be used to establish a generic source model for all the sources for fast MC dose calculation. Further investigations are needed to determine the dose variations as a result of partial switching on/off different groups of sources for advanced Gamma Knife SRS/SBRT planning.

07 ISOTOPE AND RADIATION SOURCES↗

Computational Transport Modeling of High-Energy Neutrons Found in the Space Environment

The high charge and high energy (HZE) particle radiation environment in space interacts with spacecraft materials and the human body to create a population of neutrons encompassing a broad kinetic energy spectrum. As an HZE ion penetrates matter, there is an increasing chance of fragmentation as penetration depth increases. When an ion fragments, secondary neutrons are released with velocities up to that of the primary ion, giving some neutrons very long penetration ranges. These secondary neutrons have a high relative biological effectiveness, are difficult to effectively shield, and can cause more biological damage than the primary ions in some scenarios. Ground-based irradiation experiments that simulate the space radiation environment must account for this spectrum of neutrons. Using the Particle and Heavy Ion Transport Code System (PHITS), it is possible to simulate a neutron environment that is characteristic of that found in spaceflight. Considering neutron dosimetry, the focus lies on the broad spectrum of recoil protons that are produced in biological targets. In a biological target, dose at a certain penetration depth is primarily dependent upon recoil proton tracks. The PHITS code can be used to simulate a broad-energy neutron spectrum traversing biological targets, and it account for the recoil particle population. This project focuses on modeling a neutron beamline irradiation scenario for determining dose at increasing depth in water targets. Energy-deposition events and particle fluence can be simulated by establishing cross-sectional scoring routines at different depths in a target. This type of model is useful for correlating theoretical data with actual beamline radiobiology experiments. Other work exposed human fibroblast cells to a high-energy neutron source to study micronuclei induction in cells at increasing depth behind water shielding. Those findings provide supporting data describing dose vs. depth across a water-equivalent medium. This poster presents PHITS data suggesting an increase in dose, up to roughly 10 cm depth, followed by a continual decrease as neutrons come to a stop in the target.

Cox, Brad↗

SU-E-J-86: Functional Conformal Planning for Stereotactic Body Radiation Therapy with CT-Pulmonary Ventilation Imaging

Purpose: To evaluate the functional planning using CT-pulmonary ventilation imaging for conformal SBRT. Methods: The CT-pulmonary ventilation image was generated using the Jacobian metric in the in-house program with the NiftyReg software package. Using the ventilation image, the normal lung was split into three lung regions for functionality (high, moderate and low). The anatomical plan (AP) and functional plan (FP) were made for ten lung SBRT patients. For the AP, the beam angles were optimized with the dose-volume constraints for the normal lung sparing and the PTV coverage. For the FP, the gantry angles were also optimized with the additional constraint for high functional lung. The MLC aperture shapes were adjusted to the PTV with the additional 5 mm margin. The dosimetric parameters for PTV, the functional volumes, spinal cord and so on were compared in both plans. Results: Compared to the AP, the FP showed better dose sparing for high- and moderate-functional lungs with similar PTV coverage while not taking care of the low functional lung (High:−12.9±9.26% Moderate: −2.0±7.09%, Low: +4.1±12.2%). For the other normal organs, the FP and AP showed similar dose sparing in the eight patients. However, the FP showed that the maximum doses for spinal cord were increased with the significant increment of 16.4Gy and 21.0Gy in other two patients, respectively. Because the beam direction optimizer chose the unexpected directions passing through the spinal cord. Conclusion: Even the functional conformal SBRT can selectively reduce high- and moderatefunctional lung while keeping the PTV coverage. However, it would be careful that the optimizer would choose unexpected beam angles and the dose sparing for the other normal organs can be worse. Therefore, the planner needs to control the dose-volume constraints and also limit the beam angles in order to achieve the expected dose sparing and coverage.

60 APPLIED LIFE SCIENCES↗

TU-H-BRC-05: Stereotactic Radiosurgery Optimized with Orthovoltage Beams

Purpose: To achieve improved stereotactic radiosurgery (SRS) dose distributions using orthovoltage energy fluence modulation with inverse planning optimization techniques. Methods: A pencil beam model was used to calculate dose distributions from the institution’s orthovoltage unit at 250 kVp. Kernels for the model were derived using Monte Carlo methods as well as measurements with radiochromic film. The orthovoltage photon spectra, modulated by varying thicknesses of attenuating material, were approximated using open-source software. A genetic algorithm search heuristic routine was used to optimize added tungsten filtration thicknesses to approach rectangular function dose distributions at depth. Optimizations were performed for depths of 2.5, 5.0, and 7.5 cm, with cone sizes of 8, 10, and 12 mm. Results: Circularly-symmetric tungsten filters were designed based on the results of the optimization, to modulate the orthovoltage beam across the aperture of an SRS cone collimator. For each depth and cone size combination examined, the beam flatness and 80–20% and 90–10% penumbrae were calculated for both standard, open cone-collimated beams as well as for the optimized, filtered beams. For all configurations tested, the modulated beams were able to achieve improved penumbra widths and flatness statistics at depth, with flatness improving between 33 and 52%, and penumbrae improving between 18 and 25% for the modulated beams compared to the unmodulated beams. Conclusion: A methodology has been described that may be used to optimize the spatial distribution of added filtration material in an orthovoltage SRS beam to result in dose distributions at depth with improved flatness and penumbrae compared to standard open cones. This work provides the mathematical foundation for a novel, orthovoltage energy fluence-modulated SRS system.

60 APPLIED LIFE SCIENCES↗

Preclinical investigation for developing injectable fiducial markers using a mixture of BaSO{sub 4} and biodegradable polymer for proton therapy

Purpose: The aim of this study is to investigate the use of mixture of BaSO{sub 4} and biodegradable polymer as an injectable nonmetallic fiducial marker to reduce artifacts in x-ray images, decrease the absorbed dose distortion in proton therapy, and replace permanent metal markers. Methods: Two samples were made with 90 wt. % polymer phosphate buffer saline (PBS) and 10 wt. % BaSO{sub 4} (B1) or 20 wt. % BaSO{sub 4} (B2). Two animal models (mice and rats) were used. To test the injectability and in vivo gelation, a volume of 200 μl at a pH 5.8 were injected into the Sprague-Dawley rats. After sacrificing the rats over time, the authors checked the gel morphology. Detectability of the markers in the x-ray images was tested for two sizes (diameters of 1 and 2 mm) for B1 and B2. Four samples were injected into BALB/C mice. The polymer mixed with BaSO{sub 4} transform from SOL at 20 °C with a pH of 6.0 to GEL in the living body at 37 °C with a pH of 7.4, so the size of the fiducial marker could be controlled by adjusting the injected volume. The detectability of the BaSO{sub 4} marker was measured in x-ray images of cone beam CT (CBCT), on-board imager [anterior–posterior (AP), lateral], and fluoroscopy (AP, lateral) using a Novalis-TX (Varian Medical Systems, Palo Alto, CA) repeatedly over 4 months. The volume, HU, and artifacts for the markers were measured in the CBCT images. Artifacts were compared to those of gold marker by analyzing the HU distribution. The dose distortion in proton therapy was computed by using a Monte Carlo (MC) code. A cylindrical shaped marker (diameter: 1 or 2 mm, length: 3 mm) made of gold, stainless-steel [304], titanium, and 20 wt. % BaSO{sub 4} was positioned at the center of the spread-out Bragg peak (SOBP) in parallel or perpendicular to the beam entrance. The dose distortion was measured on the depth dose profile across the markers. Results: Transformation to GEL and the biodegradation were verified. All BaSO{sub 4} markers could be detected in the CBCT. In the OBI and fluoroscopy images, all markers visible in the AP, but only B2(2 mm) could be identified in the lateral images. Changes of BaSO{sub 4} position were not detected in vivo (mice). The volume of the markers decreased by up to 65% and the HU increased by 22%, on average. The mean HU values around the B1, B2, and gold markers were 121.30 [standard deviation (SD): 54.86], 126.31 (SD: 62.13), and 1070.7 (SD: 235.16), respectively. The MC-simulated dose distortion for the BaSO{sub 4} markers was less than that of the commercially used markers. The dose reduction due to the gold marker was largest (15.05%) followed by stainless steel (7.92%) and titanium (6.92%). Dose reduction by B2 (2 mm) was 4.75% and 0.53% in parallel and perpendicular orientations, respectively. Conclusions: BaSO{sub 4} mixed with PBS is a good contrast agent in biodegradable polymer marker because of minimal artifacts in x-ray images and minimal dose reduction in proton therapy. The flexibility of the size is considered to be an advantage of this material over solid type fiducials.

60 APPLIED LIFE SCIENCES↗

Quantifying the performance of in vivo portal dosimetry in detecting four types of treatment parameter variations

Purpose: To quantify the ability of electronic portal imaging device (EPID) dosimetry used during treatment (in vivo) in detecting variations that can occur in the course of patient treatment. Methods: Images of transmitted radiation from in vivo EPID measurements were converted to a 2D planar dose at isocenter and compared to the treatment planning dose using a prototype software system. Using the treatment planning system (TPS), four different types of variability were modeled: overall dose scaling, shifting the positions of the multileaf collimator (MLC) leaves, shifting of the patient position, and changes in the patient body contour. The gamma pass rate was calculated for the modified and unmodified plans and used to construct a receiver operator characteristic (ROC) curve to assess the detectability of the different parameter variations. The detectability is given by the area under the ROC curve (AUC). The TPS was also used to calculate the impact of the variations on the target dose–volume histogram. Results: Nine intensity modulation radiation therapy plans were measured for four different anatomical sites consisting of 70 separate fields. Results show that in vivo EPID dosimetry was most sensitive to variations in the machine output, AUC = 0.70 − 0.94, changes in patient body habitus, AUC = 0.67 − 0.88, and systematic shifts in the MLC bank positions, AUC = 0.59 − 0.82. These deviations are expected to have a relatively small clinical impact [planning target volume (PTV) D{sub 99} change <7%]. Larger variations have even higher detectability. Displacements in the patient’s position and random variations in MLC leaf positions were not readily detectable, AUC < 0.64. The D{sub 99} of the PTV changed by up to 57% for the patient position shifts considered here. Conclusions: In vivo EPID dosimetry is able to detect relatively small variations in overall dose, systematic shifts of the MLC’s, and changes in the patient habitus. Shifts in the patient’s position which can introduce large changes in the target dose coverage were not readily detected.

60 APPLIED LIFE SCIENCES↗

TH-E-209-02: Dose Monitoring and Protocol Optimization: The Pediatric Perspective

Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilities over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.

60 APPLIED LIFE SCIENCES↗

VENTSAR V3.0: A Python GUI for Estimating Contaminant Concentrations on or Near Buildings Due to Building Effects and Plume Rise and For Calculating Inhalation and Plume Shine Doses

VENTSAR: Originated as VENTAX (Smith and Weber 1983) on the IBM Mainframe at the Savannah River Site (SRS) as a Fortran program. Updated to VENTSAR XL V1.0 (Simpkins 1997) as a spreadsheet version using macros created in Microsoft Excel. Later updated to VENTSAR XL V2.0 (Dixon 2018) as a spreadsheet executing a modified version of the original VENTAX Fortran code. Estimates contaminant concentrations on or near a building from a release at a nearby location. Calculates concentrations for a given meteorological exceedance probability or for a given stability and wind speed combination. Can model a single building with or without a penthouse on top or a ground location from either a stack or ground release. Plume rise can be considered. Contaminant releases can be chemical or radioactive with downwind concentrations determined at user-specified distances. Wind passing over and around buildings creates a complicated dispersion pattern. Air-intake vents may be located on building roofs or near the ground downwind of a release source. An estimation of pollutant concentrations on or near a structure is important in determining expected pollutant levels. Meteorological data are selected based on a specific area of the site. Fortran-based VENTAX able to make fast, complex mathematical calculations. Not user-friendly VENTSAR XL V1.0 no longer supported due to obsolete Excel macros. VENTSAR XL V2.0 an interim solution using an Excel spreadsheet to interface with the modified VENTAX Fortran code. Requires user to have Microsoft Excel. Not an intuitive interface for someone unfamiliar with VENTSAR. Does not perform dose calculations. VENTSAR V3.0 goal to combine the strengths of previous versions of VENTSAR into a single, powerful yet user-friendly program with a Graphical User Interface (GUI). Not dependent upon a specific program or plug-ins. Self-contained package to be used on any computer running Microsoft Windows. User-friendly, intuitive GUI created in Python for parameter input. Executes same modified VENTAX Fortran code as VENTSAR XL V2.0. Outputs formatted text file of completed calculations for easy review and dissemination. Performs inhalation and plume shine dose calculations for up to 11 user-selected nuclides from a nuclide dose factor library of almost 500 nuclides. 12 test cases were created for verification of V1.0 and V2.0. Same test cases run in V3.0 to verify correct performance. V3.0 produced similar results to V1.0. Confirmed GUI did not alter calculations in any way. Comparisons of the test case results confirm the V3.0 GUI does not influence the VENTSAR calculations. Simply passes same input parameters to VENTAX Fortran code for execution. Provides end user an easy-to-use, intuitive tool to quickly make building effect and plume rise calculations, as well as, inhalation and plume shine dose calculations. No experience with or working knowledge of Fortran, Excel, command line, or macros required. Self-contained package allows VENTSAR be deployed to any Windows computer without the need for specific programs or plug-ins.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Dose Modeling Evaluations and Technical Support Document For the Authorized Limits Request for the DOE-Owned Property Outside the Limited Area, Paducah Gaseous Diffusion Plant Paducah, Kentucky

Environmental assessments and remediation activities are being conducted by the U.S. Department of Energy (DOE) at the Paducah Gaseous Diffusion Plant (PGDP), Paducah, Kentucky. The Oak Ridge Institute for Science and Education (ORISE), a DOE prime contractor, was contracted by the DOE Portsmouth/Paducah Project Office (DOE-PPPO) to conduct radiation dose modeling analyses and derive single radionuclide soil guidelines (soil guidelines) in support of the derivation of Authorized Limits (ALs) for "DOE-Owned Property Outside the Limited Area"; ("Property") at the PGDP. The ORISE evaluation specifically included the area identified by DOE restricted area postings (public use access restrictions) and areas licensed by DOE to the West Kentucky Wildlife Management Area (WKWMA). The licensed areas are available without restriction to the general public for a variety of (primarily) recreational uses. Relevant receptors impacting current and reasonably anticipated future use activities were evaluated. In support of soil guideline derivation, a Conceptual Site Model (CSM) was developed. The CSM listed radiation and contamination sources, release mechanisms, transport media, representative exposure pathways from residual radioactivity, and a total of three receptors (under present and future use scenarios). Plausible receptors included a Resident Farmer, Recreational User, and Wildlife Worker. single radionuclide soil guidelines (outputs specified by the software modeling code) were generated for three receptors and thirteen targeted radionuclides. These soil guidelines were based on satisfying the project dose constraints. For comparison, soil guidelines applicable to the basic radiation public dose limit of 100 mrem/yr were generated. Single radionuclide soil guidelines from the most limiting (restrictive) receptor based on a target dose constraint of 25 mrem/yr were then rounded and identified as the derived soil guidelines. An additional evaluation using the derived soil guidelines as inputs into the code was also performed to determine the maximum (peak) dose for all receptors. This report contains the technical basis in support of the DOE's derivation of ALs for the "Property"; A complete description of the methodology, including an assessment of the input parameters, model inputs, and results is provided in this report. This report also provides initial recommendations on applying the derived soil guidelines.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Fast optimization and dose calculation in scanned ion beam therapy

Purpose: Particle therapy (PT) has advantages over photon irradiation on static tumors. An increased biological effectiveness and active target conformal dose shaping are strong arguments for PT. However, the sensitivity to changes of internal geometry complicates the use of PT for moving organs. In case of interfractionally moving objects adaptive radiotherapy (ART) concepts known from intensity modulated radiotherapy (IMRT) can be adopted for PT treatments. One ART strategy is to optimize a new treatment plan based on daily image data directly before a radiation fraction is delivered [treatment replanning (TRP)]. Optimizing treatment plans for PT using a scanned beam is a time consuming problem especially for particles other than protons where the biological effective dose has to be calculated. For the purpose of TRP, fast optimization and fast dose calculation have been implemented into the GSI in-house treatment planning system (TPS) TRiP98. Methods: This work reports about the outcome of a code analysis that resulted in optimization of the calculation processes as well as implementation of routines supporting parallel execution of the code. To benchmark the new features, the calculation time for therapy treatment planning has been studied. Results: Compared to the original version of the TPS, calculation times for treatment planning (optimization and dose calculation) have been improved by a factor of 10 with code optimization. The parallelization of the TPS resulted in a speedup factor of 12 and 5.5 for the original version and the code optimized version, respectively. Hence the total speedup of the new implementation of the authors' TPS yielded speedup factors up to 55. Conclusions: The improved TPS is capable of completing treatment planning for ion beam therapy of a prostate irradiation considering organs at risk in this has been overseen in the review process. Also see below 6 min.

60 APPLIED LIFE SCIENCES↗

SU-E-T-125: Dosimetric Comparison of Intensity Modulated Radiation Therapy Using Robotic Versus Traditional Linac Platform in Prostate Cancer

Purpose: Recent development of an MLC for robotic external beam radiotherapy has the potential of new clinical application in conventionally fractionated radiation therapy. This study offers a dosimetric comparison of IMRT plans using Cyberknife with MLC versus conventional linac plans. Methods: Ten prostate cancer patients treated on a traditional linac with IMRT to 7920cGy at 180cGy/fraction were randomly selected. GTVs were defined as prostate plus proximal seminal vesicles. PTVs were defined as GTV+8mm in all directions except 5mm posteriorly. Conventional IMRT planning was performed on Philips Pinnacle and delivered on a standard linac with CBCT and 10mm collimator leaf width. For each case a Cyberknife plan was created using Accuray Multiplan with same CT data set, contours, and dose constraints. All dosimetric data was transferred to third party software for independent computation of contour volumes and DVH. Delivery efficiency was evaluated using total MU, treatment time, number of beams, and number of segments. Results: Evaluation criteria including percent target coverage, homogeneity index, and conformity index were found to be comparable. All dose constraints from QUANTEC were found to be statistically similar except rectum V50Gy and bladder V65Gy. Average rectum V50Gy was lower for robotic IMRT (30.07%±6.57) versus traditional (34.73%±3.62, p=0.0130). Average bladder V65Gy was lower for robotic (17.87%±12.74) versus traditional (21.03%±11.93, p=0.0405). Linac plans utilized 9 coplanar beams, 48.9±3.8 segments, and 19381±2399MU. Robotic plans utilized 38.4±9.0 non-coplanar beams, 85.5±21.0 segments and 42554.71±16381.54 MU. The average treatment was 15.02±0.60 minutes for traditional versus 20.90±2.51 for robotic. Conclusion: The robotic IMRT plans were comparable to the traditional IMRT plans in meeting the target volume dose objectives. Critical structure dose constraints were largely comparable although statistically significant differences were found in favor of the robotic platform in terms of rectum V50Gy and bladder V65Gy at a cost of 25% longer treatment time.

60 APPLIED LIFE SCIENCES↗

SU-E-T-169: Evaluation of Oncentra TPS for Nasopharynx Brachy Using Patient Specific Voxel Phantom and EGSnrc

Purpose: Nasopharnx carcinoma (NPC) treatment is being carried out using Ir-192 HDR seeds in Mehdieh Hospital in Hamadan, Iran. The Oncentra™ TPS is based on optimized TG-43 formalism which disregards heterogeneity in the treatment area. Due to abundant heterogeneity in head and neck, comparison of the Oncentra™ TPS dose evaluation and an accurate dose calculation method in NPC brachytherapy is the objective of this study. Methods: CT DICOMs of a patient with NPC obtained from Mehdieh Hospital used to create 3D voxel phantom with CTCREATE utility of EGSnrc code package. The voxel phantom together with Ir-192 HDR brachytherapy source were the input to DOSXYZnrc to calculate the 3D dose distribution. The sources were incorporate with type 6 source in DOSXYZnrc and their dwell times were taken into account in final dose calculations. Results: The direct comparison between isodoses as well as DVHs for the GTV, PTV and CTV obtained by Oncentra™ and EGSnrc Monte Carlo code are made. EGSnrc results are obtained using 5×10{sup 9} histories to reduce the statistical error below 1% in GTV and 5% in 5% dose areas. The standard ICRP700 cross section library is employed in DOSXYZnrc dose calculation. Conclusion: A direct relationship between increased dose differences and increased material density (hence heterogeneity) is observed when isodoses contours of the TPS and DOSXYZnrc are compared. Regarding the point dose calculations, the differences range from 1.2% in PTV to 5.6% for cavity region and 7.8% for bone regions. While Oncentra™ TPS overestimates the dose in cavities, it tends to underestimate dose depositions within bones.

60 APPLIED LIFE SCIENCES↗

SU-E-T-308: Dosimetric Comparison of SBRT VMAT Treatment Plans Generated for 6 MV, 6 MV FFF, and 10 MV FFF Photon Beams

Purpose: To assess differences in treatment plan quality between VMAT stereotactic body plans generated using the 6 MV, 6 MV FFF, and 10 MV FFF modalities available in our clinic. Plans for lung, spine, and other sites were compared to see if there is any advantage of one modality over the other. Methods: Treatment plans done for actual SBRT patients were selected. Groups of ten lung plans, five spine plans, and five plans from other sites were selected. New treatment plans were generated for each plan using the Varian Eclipse AAA algorithm. The constraints were kept the same as used in the actual plans, but the same version of software was used to generate plans for the three modalities. In addition, because there are natural variations in plans re-done with the same dose constraints, one of the lung plans was repeated ten times to assess those differences. Volumes of the 100%, 90%, 50%, 20% and 10% isodose surfaces were compared. Maximum dose two centimeters from the PTV were compared, as well as the volume of the 105% isodose surface outside of the PTV. In addition, the 20 Gray lung volume was compared for the lung plans. The values of these parameters were divided by the values for the 6 MV plans for comparison. Average and standard deviations were obtained for quantities in each group. The Student t test was done to determine if differences were seen at the 95% confidence level. Results: Comparison of the treatment plans showed no significant differences when assessing these volumes and doses. There were not any trends seen when comparing modalities as a function of PTV volume either. Conclusion: There is no obvious dosimetric advantage in selection of one modality over another for these types of SBRT plans.

60 APPLIED LIFE SCIENCES↗

MO-F-CAMPUS-I-03: GPU Accelerated Monte Carlo Technique for Fast Concurrent Image and Dose Simulation

Purpose: To develop an accurate and fast Monte Carlo (MC) method of simulating CT that is capable of correlating dose with image quality using voxelized phantoms. Methods: A realistic voxelized phantom based on patient CT data, XCAT, was used with a GPU accelerated MC code for helical MDCT. Simulations were done with both uniform density organs and with textured organs. The organ doses were validated using previous experimentally validated simulations of the same phantom under the same conditions. Images acquired by tracking photons through the phantom with MC require lengthy computation times due to the large number of photon histories necessary for accurate representation of noise. A substantial speed up of the process was attained by using a low number of photon histories with kernel denoising of the projections from the scattered photons. These FBP reconstructed images were validated against those that were acquired in simulations using many photon histories by ensuring a minimal normalized root mean square error. Results: Organ doses simulated in the XCAT phantom are within 10% of the reference values. Corresponding images attained using projection kernel smoothing were attained with 3 orders of magnitude less computation time compared to a reference simulation using many photon histories. Conclusion: Combining GPU acceleration with kernel denoising of scattered photon projections in MC simulations allows organ dose and corresponding image quality to be attained with reasonable accuracy and substantially reduced computation time than is possible with standard simulation approaches.

60 APPLIED LIFE SCIENCES↗

TU-H-CAMPUS-JeP2-04: Deriving Delivered Doses to Assess the Viability of 2.5 Mm Margins in Head and Neck SBRT

Purpose: To calculate the delivered dose for head and neck SBRT patients using pre-treatment images. This delivered dose was then used to determine the viability of 2.5 mm margins. Methods: Daily cone beam CTs (CBCTs) were collected for 20 patients along with a planning CT, planned dose, and planning structures. The day 1 CBCT was aligned to the planning CT using the treatment shifts (six degrees of freedom) and then the dose and contours were transferred to the CBCT. The day 1 CBCT becomes the reference image for days 2–5. The day 2–5 CBCTs were also aligned to the planning CT using the treatment shifts given and the dose transferred. The day 2–5 CBCTs were then deformably registered to the day 1 CBCT. The doses delivered on days 2–5 were then deformed to the day 1 CBCT where they could be accumulated. This was achieved with MIM 6.5.1 (MIM Software, Cleveland OH). The accumulated doses for the 20 patients were evaluated against the planned doses using the initial planning criteria as points of comparison. Results: The delivered CTV dose conformed to the planned 98.6% coverage, with an average decrease of 2.6% between planned and delivered coverage. This implies the 2.5 mm margin was sufficient. Larger CTVs correlated to smaller differences between planned and delivered coverage. Delivered dose to critical structures including the spinal cord, mandible, brain, brainstem, and larynx was acceptable, with differences between planned and delivered max dose <5% on average. Similarly for the parotid glands, globes, cochlear, optic nerve, lens, and submandibular glands, differences between planned and delivered doses were generally <5%. Conclusion: The 2.5 mm margin provided acceptable CTV coverage, adequately accounting for setup errors. Organ at risk sparing was also satisfactory. Small tumor volumes (<20 cc) may require a larger margin to treat effectively.

60 APPLIED LIFE SCIENCES↗