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At least 667 records · Page 37
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-594: Out-Of-Field Neutron and Gamma Dose Estimated Using TLD-600/700 Pairs in the Wobbling Proton Therapy System

Purpose: Secondary fast neutrons and gamma rays are mainly produced due to the interaction of the primary proton beam with the beam delivery nozzle. These secondary radiation dose to patients and radiation workers are unwanted. The purpose of this study is to estimate the neutron and gamma dose equivalent out of the treatment volume during the wobbling proton therapy system. Methods: Two types of thermoluminescent (TL) dosimeters, TLD-600 ({sup 6}LiF: Mg, Ti) and TLD-700 ({sup 7}LiF: Mg, Ti) were used in this study. They were calibrated in the standard neutron and gamma sources at National Standards Laboratory. Annealing procedure is 400°C for 1 hour, 100°C for 2 hours and spontaneously cooling down to the room temperature in a programmable oven. Two-peak method (a kind of glow curve analysis technique) was used to evaluate the TL response corresponding to the neutron and gamma dose. The TLD pairs were placed outside the treatment field at the neutron-gamma mixed field with 190-MeV proton beam produced by the wobbling system through the polyethylene plate phantom. The results of TLD measurement were compared to the Monte Carlo simulation. Results: The initial experiment results of calculated dose equivalents are 0.63, 0.38, 0.21 and 0.13 mSv per Gy outside the field at the distance of 50, 100, 150 and 200 cm. Conclusion: The TLD-600 and TLD-700 pairs are convenient to estimate neutron and gamma dosimetry during proton therapy. However, an accurate and suitable glow curve analysis technique is necessary. During the wobbling system proton therapy, our results showed that the neutron and gamma doses outside the treatment field are noticeable. This study was supported by the grants from the Chang Gung Memorial Hospital (CMRPD1C0682)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Uncertainty Quantification for Monte Carlo simulations - Paper 18

Uncertainty quantification (UQ) generally speaking refers to a wide variety of specific problems, also pertaining different scientific areas: then studies on Uncertainty Quantification involve many different methodologies, techniques and even terminologies: to be specific we are interested in studying how uncertainties on input physical data needed for Monte Carlo simulations transfer into uncertainties on the physical output of the simulation. We mention that other sources of uncertainty are be present in a simulation environment: they can be ascribed either to model inadequacy (for instance when one neglects atomic lattice at very low energies) or to the numerical procedure involved: for the case of MC simulation the latter corresponds to the statistical error affecting the simulation itself. So in general parameter uncertainties are mixed with other kind of uncertainties. The problem then remains seemingly quite complicated, even in this more specific domain: moreover we should better specify the meaning of the rather undetermined words physical data needed for Monte Carlo simulation. In fact they may refer both those data needed to specify the experimental setup that is going to be simulated - like, e.g., geometrical or composition data, but including also some external conditions applied to the system, like temperature, pressure, electromagnetic fields and so on - and physical data - cross sections or often physical models - required to describe particle transport. All these data are generally affected by uncertainties, which through the process of simulation transfer into uncertainty on its physical outcome. Then, from the MC user's own perspective, input data refers both to those that are under his direct experimental control and to many others, whose values and uncertainties will affect the result of the simulation. In this contribution we will summarize previous results, together with some new ones. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2019

The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas

Purpose: To evaluate the effect of size and central location of the tumor on safety and efficacy of percutaneous CEUS- and CT-guided MWA in biopsy-proven renal cell carcinomas (RCCs). Materials and methods: In this IRB-approved retrospective study, 69 biopsy-proven renal tumors in 56 patients, who underwent MWA in our institution from January 2013 to March 2017, were evaluated. Data collection included demographics, tumor characteristics, procedural protocols, and follow-up visits within 6 months post procedure. Primary outcomes were assessed by technical success (TS), local tumor progression (LTP), and complications. The Kaplan–Meier analysis was used for survival rate. Results: Overall technical success was achieved for all 69 lesions (92.8% primary TS, 100% overall). Median nephrometry score was 8 (4–11) and median tumor size was 2.5 cm (0.8–7). Five lesions which required second ablation had significantly higher median tumor size 4 cm (P = 0.039) with the same nephrometry score. Renal function remained stable with no significant change in eGFR before or after ablation. The LTP rate was 5.8%. The most recurrent tumors were clear cell (50%) followed by papillary tumors (25%). The complication rate was 5.8% with minor complications (hematoma and pain) and no major issues. There was no significant association between nephrometry score and technical success, recurrence, or complication rates. Overall and tumor-specific survival rates were 96.7% and 100% at 11.9 months. Conclusions: Image-guided MWA appears to be a safe and effective treatment regardless of nephrometry score and tumor location with high technical success, low recurrence, and complication rates.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Irreversible Electroporation (IRE) Fails to Demonstrate Efficacy in a Prospective Multicenter Phase II Trial on Lung Malignancies: The ALICE Trial

PurposeTo assess safety and efficacy of irreversible electroporation (IRE) of lung malignancies.Materials and MethodsPatients with primary and secondary lung malignancies and preserved lung function were included in this prospective single arm trial. Primary and secondary endpoints were safety and efficacy. Recruitment goal was 36 subjects in 2 centers. Patients underwent IRE under general anesthesia with probe placement performed in Fluoroscopy-CT. The IRE system employed was NanoKnife{sup ®} (Angiodynamics). System settings for the ablation procedure followed the manufacturer’s recommendations. The Mann–Whitney U test was used to evaluate the correlation of nine technical parameters with local tumor control. Median follow up was 12 months.ResultsThe expected efficacy was not met at interim analysis and the trial was stopped prematurely after inclusion of 23 patients (13/10 between both centers). The dominant tumor entity was colorectal (n = 13). The median tumor diameter was 16 mm (8–27 mm). Pneumothoraces were observed in 11 of 23 patients with chest tubes required in 8 (35 %). Frequently observed alveolar hemorrhage never led to significant hemoptysis. 14/23 showed progressive disease (61 %). Stable disease was found in 1 (4 %), partial remission in 1 (4 %) and complete remission in 7 (30 %) patients. The relative increase of the current during ablation was significantly higher in the group treated successfully as compared to the group presenting local recurrence (p < 0.05). Needle tract seeding was found in three cases (13 %).ConclusionsIRE is not effective for the treatment of lung malignancies. We hypothesize that the energy deposition with current IRE probes is highly sensitive to air exposure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Liquid-liquid interfacial properties of a symmetrical Lennard-Jones binary mixture

We determine the interfacial properties of a symmetrical binary mixture of equal-sized spherical Lennard-Jones molecules, σ{sub 11} = σ{sub 22}, with the same dispersive energy between like species, ϵ{sub 11} = ϵ{sub 22}, but different dispersive energies between unlike species low enough to induce phase separation. We use the extensions of the improved version of the inhomogeneous long-range corrections of Janecek [J. Phys. Chem. B 110, 6264 (2006)], presented recently by MacDowell and Blas [J. Chem. Phys. 131, 074705 (2009)] and Martínez-Ruiz et al. [J. Chem. Phys. 141, 184701 (2014)], to deal with the interaction energy and microscopic components of the pressure tensor. We perform Monte Carlo simulations in the canonical ensemble to obtain the interfacial properties of the symmetrical mixture with different cut-off distances r{sub c} and in combination with the inhomogeneous long-range corrections. The pressure tensor is obtained using the mechanical (virial) and thermodynamic route. The liquid-liquid interfacial tension is also evaluated using three different procedures, the Irving-Kirkwood method, the difference between the macroscopic components of the pressure tensor, and the test-area methodology. This allows to check the validity of the recent extensions presented to deal with the contributions due to long-range corrections for intermolecular energy and pressure tensor in the case of binary mixtures that exhibit liquid-liquid immiscibility. In addition to the pressure tensor and the surface tension, we also obtain density profiles and coexistence densities and compositions as functions of pressure, at a given temperature. According to our results, the main effect of increasing the cut-off distance r{sub c} is to sharpen the liquid-liquid interface and to increase the width of the biphasic coexistence region. Particularly interesting is the presence of a relative minimum in the total density profiles of the symmetrical mixture. This minimum is related with a desorption of the molecules at the interface, a direct consequence of a combination of the weak dispersive interactions between unlike species of the symmetrical binary mixture, and the presence of an interfacial region separating the two immiscible liquid phases in coexistence.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2012

A DATA-DRIVEN MODEL FOR SPECTRA: FINDING DOUBLE REDSHIFTS IN THE SLOAN DIGITAL SKY SURVEY

We present a data-driven method-heteroscedastic matrix factorization, a kind of probabilistic factor analysis-for modeling or performing dimensionality reduction on observed spectra or other high-dimensional data with known but non-uniform observational uncertainties. The method uses an iterative inverse-variance-weighted least-squares minimization procedure to generate a best set of basis functions. The method is similar to principal components analysis (PCA), but with the substantial advantage that it uses measurement uncertainties in a responsible way and accounts naturally for poorly measured and missing data; it models the variance in the noise-deconvolved data space. A regularization can be applied, in the form of a smoothness prior (inspired by Gaussian processes) or a non-negative constraint, without making the method prohibitively slow. Because the method optimizes a justified scalar (related to the likelihood), the basis provides a better fit to the data in a probabilistic sense than any PCA basis. We test the method on Sloan Digital Sky Survey (SDSS) spectra, concentrating on spectra known to contain two redshift components: these are spectra of gravitational lens candidates and massive black hole binaries. We apply a hypothesis test to compare one-redshift and two-redshift models for these spectra, utilizing the data-driven model trained on a random subset of all SDSS spectra. This test confirms 129 of the 131 lens candidates in our sample and all of the known binary candidates, and turns up very few false positives.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2014

Development and characterization of a three-dimensional radiochromic film stack dosimeter for megavoltage photon beam dosimetry

Purpose: Three-dimensional (3D) dosimeters are particularly useful for verifying the commissioning of treatment planning and delivery systems, especially with the ever-increasing implementation of complex and conformal radiotherapy techniques such as volumetric modulated arc therapy. However, currently available 3D dosimeters require extensive experience to prepare and analyze, and are subject to large measurement uncertainties. This work aims to provide a more readily implementable 3D dosimeter with the development and characterization of a radiochromic film stack dosimeter for megavoltage photon beam dosimetry. Methods: A film stack dosimeter was developed using Gafchromic{sup ®} EBT2 films. The dosimeter consists of 22 films separated by 1 mm-thick spacers. A Virtual Water™ phantom was created that maintains the radial film alignment within a maximum uncertainty of 0.3 mm. The film stack dosimeter was characterized using simulations and measurements of 6 MV fields. The absorbed-dose energy dependence and orientation dependence of the film stack dosimeter were investigated using Monte Carlo simulations. The water equivalence of the dosimeter was determined by comparing percentage-depth-dose (PDD) profiles measured with the film stack dosimeter and simulated using Monte Carlo methods. Film stack dosimeter measurements were verified with thermoluminescent dosimeter (TLD) microcube measurements. The film stack dosimeter was also used to verify the delivery of an intensity-modulated radiation therapy (IMRT) procedure. Results: The absorbed-dose energy response of EBT2 film differs less than 1.5% between the calibration and film stack dosimeter geometries for a 6 MV spectrum. Over a series of beam angles ranging from normal incidence to parallel incidence, the overall variation in the response of the film stack dosimeter is within a range of 2.5%. Relative to the response to a normally incident beam, the film stack dosimeter exhibits a 1% under-response when the beam axis is parallel to the film planes. Measured and simulated PDD profiles agree within a root-mean-square difference of 1.3%. In-field film stack dosimeter and TLD measurements agree within 5%, and measurements in the field penumbra agree within 0.5 mm. Film stack dosimeter and TLD measurements have expanded (k = 2) overall measurement uncertainties of 6.2% and 5.8%, respectively. Film stack dosimeter measurements of an IMRT dose distribution have 98% agreement with the treatment planning system dose calculation, using gamma criteria of 3% and 2 mm. Conclusions: The film stack dosimeter is capable of high-resolution, low-uncertainty 3D dose measurements, and can be readily incorporated into an existing film dosimetry program.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

A VLT/FLAMES STUDY OF THE PECULIAR INTERMEDIATE-AGE LARGE MAGELLANIC CLOUD STAR CLUSTER NGC 1846. I. KINEMATICS

In this paper we present high-resolution VLT/FLAMES observations of red giant stars in the massive intermediate-age Large Magellanic Cloud star cluster NGC 1846, which, on the basis of its extended main-sequence turnoff (EMSTO), possesses an internal age spread of Almost-Equal-To 300 Myr. We describe in detail our target selection and data reduction procedures, and construct a sample of 21 stars possessing radial velocities indicating their membership of NGC 1846 at high confidence. We consider high-resolution spectra of the planetary nebula Mo-17, and conclude that this object is also a member of the cluster. Our measured radial velocities allow us to conduct a detailed investigation of the internal kinematics of NGC 1846, the first time this has been done for an EMSTO system. The key result of this work is that the cluster exhibits a significant degree of systemic rotation, of a magnitude comparable to the mean velocity dispersion. Using an extensive suite of Monte Carlo models we demonstrate that, despite our relatively small sample size and the substantial fraction of unresolved binary stars in the cluster, the rotation signal we detect is very likely to be genuine. Our observations are in qualitative agreement with the predictions of simulations modeling the formation of multiple populations of stars in globular clusters, where a dynamically cold, rapidly rotating second generation is a common feature. NGC 1846 is less than one relaxation time old, so any dynamical signatures encoded during its formation ought to remain present.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2015

A new cubic phantom for PET/CT dosimetry: Experimental and Monte Carlo characterization

In recent years, positron emission tomography (PET) associated with multidetector computed tomography (MDCT) has become a diagnostic technique widely disseminated to evaluate various malignant tumors and other diseases. However, during PET/CT examinations, the doses of ionizing radiation experienced by the internal organs of patients may be substantial. To study the doses involved in PET/CT procedures, a new cubic phantom of overlapping acrylic plates was developed and characterized. This phantom has a deposit for the placement of the fluorine-18 fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) solution. There are also small holes near the faces for the insertion of optically stimulated luminescence dosimeters (OSLD). The holes for OSLD are positioned at different distances from the {sup 18}F-FDG deposit. The experimental results were obtained in two PET/CT devices operating with different parameters. Differences in the absorbed doses were observed in OSLD measurements due to the non-orthogonal positioning of the detectors inside the phantom. This phantom was also evaluated using Monte Carlo simulations, with the MCNPX code. The phantom and the geometrical characteristics of the equipment were carefully modeled in the MCNPX code, in order to develop a new methodology form comparison of experimental and simulated results, as well as to allow the characterization of PET/CT equipments in Monte Carlo simulations. All results showed good agreement, proving that this new phantom may be applied for these experiments. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?

AimTo compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.Materials and MethodsPatients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10–20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.ResultsForty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = −9.45, t = −3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).ConclusionCBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

THE RADIO SURFACE-BRIGHTNESS-TO-DIAMETER RELATION FOR GALACTIC SUPERNOVA REMNANTS: SAMPLE SELECTION AND ROBUST ANALYSIS WITH VARIOUS FITTING OFFSETS

In this paper, we present new empirical radio surface-brightness-to-diameter ({Sigma}-D) relations for supernova remnants (SNRs) in our Galaxy. We also present new theoretical derivations of the {Sigma}-D relation based on equipartition or on a constant ratio between cosmic rays and magnetic field energy. A new calibration sample of 60 Galactic SNRs with independently determined distances is created. Instead of (standard) vertical regression, used in previous papers, different fitting procedures are applied to the calibration sample in the log {Sigma}-log D plane. Non-standard regressions are used to satisfy the requirement that values of parameters obtained from the fitting of {Sigma}-D and D-{Sigma} relations should be invariant within estimated uncertainties. We impose symmetry between {Sigma}-D and D-{Sigma} due to the existence of large scatter in both D and {Sigma}. Using four fitting methods that treat {Sigma} and D symmetrically, different {Sigma}-D slopes {beta} are obtained for the calibration sample. Monte Carlo simulations verify that the slopes of the empirical {Sigma}-D relation should be determined by using orthogonal regression because of its good performance in data sets with severe scatter. The slope derived here ({beta} = 4.8) is significantly steeper than those derived in previous studies. This new slope is closer to the updated theoretically predicted surface-brightness-diameter slope in the radio range of the Sedov phase. We also analyze the empirical {Sigma}-D relations for SNRs in a dense environment of molecular clouds and for SNRs evolving in the lower-density interstellar medium. Applying new empirical relations to estimate distances of Galactic SNRs results in a dramatically changed distance scale.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2015

SU-E-J-73: Extension of a Clinical OIS/EMR/R&V System to Deliver Safe and Efficient Adaptive Plan-Of-The-Day Treatments Using a Fully Customizable Plan-Library-Based Workflow

Purpose: To extend a clinical Record and Verify (R&V) system to enable a safe and fast workflow for Plan-of-the-Day (PotD) adaptive treatments based on patient-specific plan libraries. Methods: Plan libraries for PotD adaptive treatments contain for each patient several pre-treatment generated treatment plans. They may be generated for various patient anatomies or CTV-PTV margins. For each fraction, a Cone Beam CT scan is acquired to support the selection of the plan that best fits the patient’s anatomy-of-the-day. To date, there are no commercial R&V systems that support PotD delivery strategies. Consequently, the clinical workflow requires many manual interventions. Moreover, multiple scheduled plans have a high risk of excessive dose delivery. In this work we extended a commercial R&V system (MOSAIQ) to support PotD workflows using IQ-scripting. The PotD workflow was designed after extensive risk analysis of the manual procedure, and all identified risks were incorporated as logical checks. Results: All manual PotD activities were automated. The workflow first identifies if the patient is scheduled for PotD, then performs safety checks, and continues to treatment plan selection only if no issues were found. The user selects the plan to deliver from a list of candidate plans. After plan selection, the workflow makes the treatment fields of the selected plan available for delivery by adding them to the treatment calendar. Finally, control is returned to the R&V system to commence treatment. Additional logic was added to incorporate off-line changes such as updating the plan library. After extensive testing including treatment fraction interrupts and plan-library updates during the treatment course, the workflow is running successfully in a clinical pilot, in which 35 patients have been treated since October 2014. Conclusion: We have extended a commercial R&V system for improved safety and efficiency in library-based adaptive strategies enabling a wide-spread implementation of those strategies. This work was in part funded by a research grant of Elekta AB, Stockholm, Sweden.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2017

Early implementation of digital upgrades on simulators - 347

An important aspect of successful Nuclear Power Plant (NPP) digital control system upgrade projects is to upgrade the Operator Training Simulator (OTS) or a related Engineering Simulator (ES), prior to installation of the Distributed Control System (DCS) on the plant allowing for early testing of the digital controls/HMI and for early training of the plant operators while maintaining OTS configuration management (i.e. OTS in sync with the plant's current design). Experience has shown that early implementation of digital upgrades on the OTS and/or an ES can reduce plant startup duration (related to digital systems commissioning) and ensure operators are proficient with the new digital systems to ensure safe and reliable plant operation. Including simulators in the design process offers many benefits including early identification of design deficiencies, testing deficiency fixes, developing and validating plant procedures and supporting human factors engineering, to name a few. Implementing digital upgrades on the OTS is also a regulatory requirement driven by the ANSI/ANS-3.5-2009 standard (Nuclear Power Plant Simulators for Use in Operator Training and Examination) if the new DCS affects actions to be taken by the plant operator in the main control room. This paper presents the benefits of implementing digital upgrades on the OTS and/or ES prior to plant implementation. The various simulator implementation strategies (stimulation, emulation, simulation or a hybrid solution) and selection factors are discussed. The paper also covers four (4) case studies demonstrating how digital upgrades can be implemented on simulators. The first case study covers the implementation of a Siemens offgas Programmable Logic Controller (PLC) system on the Enrico Fermi OTS (Michigan). The second case study covers the implementation of a GE main generator excitation system on the Cernavoda OTS (Romania). The third case study covers the implementation of a Siemens main feedwater control system on the Callaway OTS and ES (Missouri). The final case study covers the implementation of the non-safety related and safety related DCS on the Nuclear New Build (NNB) Hongyanhe Phase I dual-purpose OTS/ES (China). (authors)

22 GENERAL STUDIES OF NUCLEAR REACTORS↗
DOE OSTI2016

SU-F-J-69: The Dosimetric Impact of Interfraction Anorectum and Bladder Variability in Prostate Radiation Therapy

Purpose: In the era of dose escalation and numerous protocols evaluating radiation delivery to the prostate, it is imperative to achieve accurate and standardized daily set up. At the Sylvester Comprehensive Cancer Center, patients are instructed to drink 8 ounces of water 30 minutes prior to RT and follow a low residue diet to ensure that the anorectum is not distended and the bladder is adequately filled. If daily CBCT imaging shows any variation, the patient is removed from the table and drinks water or evacuates their rectum prior to a repeat CBCT. Here we attempt to quantify the efficacy of this procedure. Methods: CBCTs were collected for 5 patients receiving 40 fractions of definitive treatment for prostate cancer. CBCTs were imported into MIM (v6.5.7, Cleveland OH) and the bladder, anorectum, and prostate were contoured. Using the daily registration reviewed by the attending physician, the planning dose was rigidly transferred to the daily CBCT. On days that multiple CBCTs were performed due to inadequate anorectum or bladder preparation, the repeated and final CBCTs were evaluated for variations in V40Gy and V65Gy to both the anorectum and bladder. Results: A high level of variability in doses to the anorectum and bladder was found in the scans that were not utilized for treatment. The aggregate lower quartile for the unused versus used CBCTs was 27.2% vs. 16.83% for V40Gy and 8.53% vs. 5.66% for V65Gy bladder. The upper quartiles showed to be 48.88% vs. 41.92% and 21.05% vs. 20.55%. The combined lower quartile for the unused vs. used CBCTs was 8.24% vs. 5.49% for V40Gy and 0.57% vs. 0.0% for V65Gy anorectum. The upper quartiles were 34.35% vs. 33.25% and 18.37% vs. 16.11%. Conclusion: This study shows that daily imaging is insufficient and that proper bladder and anorectum preparation are essential to deliver proper treatment.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2019

Characterization of Calibrated Gelatin Sponge Particles in a Rabbit Renal Embolization Model

Purpose: To evaluate the level of artery occlusion, degradation periods, tissue response and vessel recanalization of calibrated gelatin sponge particles after segmental renal artery embolization. Materials and Methods: Superselective embolization of 14 adult rabbits was performed with calibrated gelatin sponge particles (150–350 μm). Two rabbits were killed immediately after the procedure (day 0). One pair of rabbits was killed on each of the following days: 1, 3, 7, 14, 28 and 56. One rabbit from each pair underwent CT angiography before embolization and killing. The pathologic changes of the embolized renal parenchyma and embolic characteristics of calibrated gelatin sponge particles were evaluated histologically and angiographically. Results: Calibrated gelatin sponge particles were distally located in interlobular artery with a dense packing on day 0. The level of occlusion paralleled the size of the particles. Partial degradation of the particles was observed on day 3, and complete degradation was observed on day 14. Vessel recanalization was observed through both CTA and histological analysis starting on day 3. Vascular inflammation responding to gelatin sponge particles was mild and subsided with the degradation of the particles. On day 28 and day 56, attenuation of embolized vessels occurred due to marked intimal proliferation, and vascular occlusion developed. Conclusions: Gelatin sponge particles of 150–350 μm produced dense and distal embolization, and were resorbed before day 14 with a mild tissue reaction. Vessel recanalization occurred secondary to the resorption of gelatin sponge particles, but permanent vascular occlusion developed due to marked intimal hyperplasia after day 28.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-D-207-06: Clinical Validations of Shading Correction for Cone-Beam CT Using Planning CT as a Prior

Purpose: Current cone-beam CT (CBCT) images contain severe shading artifacts mainly due to scatter, hindering their quantitative use in current radiation therapy. We have previously proposed an effective shading correction method for CBCT using planning CT (pCT) as prior knowledge. In this work, we investigate the method robustness via statistical analyses on studies of a large patient group and compare the performance with that of a state-of-the-art method implemented on the current commercial radiation therapy machine -- the Varian Truebeam system. Methods: Since radiotherapy patients routinely undergo multiple-detector CT (MDCT) scans in the planning procedure, we use the high-quality pCT as “free” prior knowledge for CBCT image improvement. The CBCT image with no correction is first spatially registered with the pCT. Primary CBCT projections are estimated via forward projections of the registered image. The low frequency errors in the projections, which stem from mainly scatter, are estimated by filtering the difference between original line integral and the estimated scatter projections. The corrected CBCT image is then reconstructed from the scatter corrected projections. The proposed method is evaluated on 40 cancer patients. Results: On all patient images, we compare errors on CT number, spatial non-uniformity (SNU) and image contrast, using pCT as the ground truth. T-tests show that our algorithm improves over the Varian method on CBCT accuracies of CT number and SNU with 90% confident. The average CT number error is reduced from 54.8 HU on the Varian method to 40.9 HU, and the SNU error is reduced from 7.7% to 3.8%. There is no obvious improvement on image contrast. Conclusion: Large-group patient studies show that the proposed pCT-based algorithm outperforms the Varian method of the Truebeam system on CBCT shading correction, by providing CBCT images with higher CT number accuracy and greater image uniformity.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Effect of dispersive long-range corrections to the pressure tensor: The vapour-liquid interfacial properties of the Lennard-Jones system revisited

We propose an extension of the improved version of the inhomogeneous long-range corrections of Janeček [J. Phys. Chem. B 110, 6264–6269 (2006)], presented recently by MacDowell and Blas [J. Chem. Phys. 131, 074705 (2009)] to account for the intermolecular potential energy of spherical, rigid, and flexible molecular systems, to deal with the contributions to the microscopic components of the pressure tensor due to the dispersive long-range corrections. We have performed Monte Carlo simulations in the canonical ensemble to obtain the interfacial properties of spherical Lennard-Jones molecules with different cutoff distances, r{sub c} = 2.5, 3, 4, and 5σ. In addition, we have also considered cutoff distances r{sub c} = 2.5 and 3σ in combination with the inhomogeneous long-range corrections proposed in this work. The normal and tangential microscopic components of the pressure tensor are obtained using the mechanical or virial route in combination with the recipe of Irving and Kirkwood, while the macroscopic components are calculated using the Volume Perturbation thermodynamic route proposed by de Miguel and Jackson [J. Chem. Phys. 125, 164109 (2006)]. The vapour-liquid interfacial tension is evaluated using three different procedures, the Irving-Kirkwood method, the difference between the macroscopic components of the pressure tensor, and the Test-Area methodology. In addition to the pressure tensor and the surface tension, we also obtain density profiles, coexistence densities, vapour pressure, critical temperature and density, and interfacial thickness as functions of temperature, paying particular attention to the effect of the cutoff distance and the long-range corrections on these properties. According to our results, the main effect of increasing the cutoff distance (at fixed temperature) is to sharpen the vapour-liquid interface, to decrease the vapour pressure, and to increase the width of the biphasic coexistence region. As a result, the interfacial thickness decreases, the width of the tangential microscopic component of the pressure tensor profile increases, and the surface tension increases as the cutoff distance is larger. We have also checked the effect of the impulsive contribution to the pressure due to the discontinuity of the intermolecular interaction potential when it is cut. If this contribution is not accounted for in the calculation of the microscopic components of the pressure tensor, incorrect values of both components as well as a wrong structure along the vapour-liquid interface are obtained.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗