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Nurse exposure doses resulted from bone scintigraphy patient

Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It’s general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget’s disease, investigation of loosening and infection in orthopedic implants. It is applied with using {sup 99m}Tc labeled radiopharmaceuticals (e.g {sup 99m} Tc MDP,{sup 99m}Tc HEDP and {sup 99m}Tc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient’s situation is not good, patients are hospitalized until the scanning because of patients’ close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse’s exposure radiations from patient’s routine treatment, examination and emergency station.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evaluating the purity of a {sup 57}Co flood source by PET

Purpose: Flood sources of {sup 57}Co are commonly used for quality control of gamma cameras. Flood uniformity may be affected by the contaminants {sup 56}Co and {sup 58}Co, which emit higher energy photons. Although vendors specify a maximum combined {sup 56}Co and {sup 58}Co activity, a convenient test for flood source purity that is feasible in a clinical environment would be desirable. Methods: Both {sup 56}Co and {sup 58}Co emit positrons with branching 19.6% and 14.9%, respectively. As is known from {sup 90}Y imaging, a positron emission tomography (PET) scanner is capable of quantitatively imaging very weak positron emission in a high single-photon background. To evaluate this approach, two {sup 57}Co flood sources were scanned with a clinical PET/CT multiple times over a period of months. The {sup 56}Co and {sup 58}Co activity was clearly visible in the reconstructed PET images. Total impurity activity was quantified from the PET images after background subtraction of prompt gamma coincidences. Results: Time-of-flight PET reconstruction was highly beneficial for accurate image quantification. Repeated measurements of the positron-emitting impurities showed excellent agreement with an exponential decay model. For both flood sources studied, the fit parameters indicated a zero intercept and a decay half-life consistent with a mixture of {sup 56}Co and {sup 58}Co. The total impurity activity at the reference date was estimated to be 0.06% and 0.07% for the two sources, which was consistent with the vendor’s specification of <0.12%. Conclusions: The robustness of the repeated measurements and a thorough analysis of the detector corrections and physics suggest that the accuracy is acceptable and that the technique is feasible. Further work is needed to validate the accuracy of this technique with a calibrated high resolution gamma spectrometer as a gold standard, which was not available for this study, and for other PET detector models.

07 ISOTOPE AND RADIATION SOURCES↗

GrayQb: A Radiological Contamination Locating and Mapping Tool

Benefits Technology Overview  Easy to operate • Self-contained unit for imaging – no special power, cooling or handling requirements • Standard color camera, easy to use gamma camera and reader • Software automatically processes images, sliders to adjust intensity display • Lightweight – less than 5 lbs. without additional background shielding

Timmons, Daren↗

MO-FG-CAMPUS-JeP1-02: Proton Range Verification of Scanned Pencil Beams Using Prompt Gamma Imaging

Purpose: Prompt gammas are emitted along the proton beam path and have an emission profile correlated with the depth dose profile. In this study, the accuracy of in-vivo proton range verification using a 1-D prompt gamma camera is assessed. Methods: The 1-D camera is comprised of a tungsten slit collimator positioned in front of a linear array of LYSO scintillating crystals coupled to silicon photomultipliers. The imaged gamma profiles of individual pencil beam spots and energy layers were analyzed by determining the relative shifts from the expected gamma profiles based on analytic prediction or reference measurements. The range retrieval precision was evaluated by reproducibility measurements and by irradiation through a heterogeneous phantom composed of materials with known stopping power ratios. The camera was evaluated at clinical doses in pencil beam scanning mode on a head-and-neck phantom (HN). Two scenarios were studied: 5 mm systematic range error; and setup error of 10 mm transverse to the proton beam. Results: The camera range retrieval precision was 2 mm at clinical doses. For the heterogeneous phantom and HN phantom studies, the discrepancies between the analytic model and measurements were less than 2 mm for both spot and iso-energy layer analysis. For the simulated 5 mm range error, the retrieved shifts were 4.3±2.0 mm. For the 10 mm setup error, large shifts (> 4 mm) were observed for some spots due to differences in the irradiated and expected beam path from the measurements without setup error. Conclusion: Our studies demonstrated that in-vivo proton range verification is feasible using a 1D prompt gamma camera with a 2 mm range retrieval precision. Pencil beam spot under or over ranging can be detected via comparison between measured and expected profiles.

60 APPLIED LIFE SCIENCES↗

A line-source method for aligning on-board and other pinhole SPECT systems

Purpose: In order to achieve functional and molecular imaging as patients are in position for radiation therapy, a robotic multipinhole SPECT system is being developed. Alignment of the SPECT system—to the linear accelerator (LINAC) coordinate frame and to the coordinate frames of other on-board imaging systems such as cone-beam CT (CBCT)—is essential for target localization and image reconstruction. An alignment method that utilizes line sources and one pinhole projection is proposed and investigated to achieve this goal. Potentially, this method could also be applied to the calibration of the other pinhole SPECT systems.Methods: An alignment model consisting of multiple alignment parameters was developed which maps line sources in three-dimensional (3D) space to their two-dimensional (2D) projections on the SPECT detector. In a computer-simulation study, 3D coordinates of line-sources were defined in a reference room coordinate frame, such as the LINAC coordinate frame. Corresponding 2D line-source projections were generated by computer simulation that included SPECT blurring and noise effects. The Radon transform was utilized to detect angles (α) and offsets (ρ) of the line-source projections. Alignment parameters were then estimated by a nonlinear least squares method, based on the α and ρ values and the alignment model. Alignment performance was evaluated as a function of number of line sources, Radon transform accuracy, finite line-source width, intrinsic camera resolution, Poisson noise, and acquisition geometry. Experimental evaluations were performed using a physical line-source phantom and a pinhole-collimated gamma camera attached to a robot.Results: In computer-simulation studies, when there was no error in determining angles (α) and offsets (ρ) of the measured projections, six alignment parameters (three translational and three rotational) were estimated perfectly using three line sources. When angles (α) and offsets (ρ) were provided by the Radon transform, estimation accuracy was reduced. The estimation error was associated with rounding errors of Radon transform, finite line-source width, Poisson noise, number of line sources, intrinsic camera resolution, and detector acquisition geometry. Statistically, the estimation accuracy was significantly improved by using four line sources rather than three and by thinner line-source projections (obtained by better intrinsic detector resolution). With five line sources, median errors were 0.2 mm for the detector translations, 0.7 mm for the detector radius of rotation, and less than 0.5° for detector rotation, tilt, and twist. In experimental evaluations, average errors relative to a different, independent registration technique were about 1.8 mm for detector translations, 1.1 mm for the detector radius of rotation (ROR), 0.5° and 0.4° for detector rotation and tilt, respectively, and 1.2° for detector twist.Conclusions: Alignment parameters can be estimated using one pinhole projection of line sources. Alignment errors are largely associated with limited accuracy of the Radon transform in determining angles (α) and offsets (ρ) of the line-source projections. This alignment method may be important for multipinhole SPECT, where relative pinhole alignment may vary during rotation. For pinhole and multipinhole SPECT imaging on-board radiation therapy machines, the method could provide alignment of SPECT coordinates with those of CBCT and the LINAC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-G-IeP4-02: Application of Changs Attenuation Correction Technique for SPECT Partial Angle Acquisition of Jaszczak Phantom

Purpose: Chang’s mathematical formulation is a common method of attenuation correction applied on reconstructed Jaszczak phantom images. Though Chang’s attenuation correction method has been used for 360° angle acquisition, its applicability for 180° angle acquisition remains a question with one vendor’s camera software producing artifacts. The objective of this work is to ensure that Chang’s attenuation correction technique can be applied for reconstructed Jaszczak phantom images acquired in both 360° and 180° mode. Methods: The Jaszczak phantom filled with 20 mCi of diluted Tc-99m was placed on the patient table of Siemens e.cam™ (n = 2) and Siemens Symbia™ (n = 1) dual head gamma cameras centered both in lateral and axial directions. A total of 3 scans were done at 180° and 2 scans at 360° orbit acquisition modes. Thirty two million counts were acquired for both modes. Reconstruction of the projection data was performed using filtered back projection smoothed with pre reconstruction Butterworth filter (order: 6, cutoff: 0.55). Reconstructed transaxial slices were attenuation corrected by Chang’s attenuation correction technique as implemented in the camera software. Corrections were also done using a modified technique where photon path lengths for all possible attenuation paths through a pixel in the image space were added to estimate the corresponding attenuation factor. The inverse of the attenuation factor was utilized to correct the attenuated pixel counts. Results: Comparable uniformity and noise were observed for 360° acquired phantom images attenuation corrected by the vendor technique (28.3% and 7.9%) and the proposed technique (26.8% and 8.4%). The difference in uniformity for 180° acquisition between the proposed technique (22.6% and 6.8%) and the vendor technique (57.6% and 30.1%) was more substantial. Conclusion: Assessment of attenuation correction performance by phantom uniformity analysis illustrated improved uniformity with the proposed algorithm compared to the camera software.

60 APPLIED LIFE SCIENCES↗

Performance of a high-sensitivity dedicated cardiac SPECT scanner for striatal uptake quantification in the brain based on analysis of projection data

Purpose: The authors have previously reported the advantages of high-sensitivity single-photon emission computed tomography (SPECT) systems for imaging structures located deep inside the brain. DaTscan (Isoflupane I-123) is a dopamine transporter (DaT) imaging agent that has shown potential for early detection of Parkinson disease (PD), as well as for monitoring progression of the disease. Realizing the full potential of DaTscan requires efficient estimation of striatal uptake from SPECT images. They have evaluated two SPECT systems, a conventional dual-head gamma camera with low-energy high-resolution collimators (conventional) and a dedicated high-sensitivity multidetector cardiac imaging system (dedicated) for imaging tasks related to PD. Methods: Cramer-Rao bounds (CRB) on precision of estimates of striatal and background activity concentrations were calculated from high-count, separate acquisitions of the compartments (right striata, left striata, background) of a striatal phantom. CRB on striatal and background activity concentration were calculated from essentially noise-free projection datasets, synthesized by scaling and summing the compartment projection datasets, for a range of total detected counts. They also calculated variances of estimates of specific-to-nonspecific binding ratios (BR) and asymmetry indices from these values using propagation of error analysis, as well as the precision of measuring changes in BR on the order of the average annual decline in early PD. Results: Under typical clinical conditions, the conventional camera detected 2 M counts while the dedicated camera detected 12 M counts. Assuming a normal BR of 5, the standard deviation of BR estimates was 0.042 and 0.021 for the conventional and dedicated system, respectively. For an 8% decrease to BR = 4.6, the signal-to-noise ratio were 6.8 (conventional) and 13.3 (dedicated); for a 5% decrease, they were 4.2 (conventional) and 8.3 (dedicated). Conclusions: This implies that PD can be detected earlier with the dedicated system than with the conventional system; therefore, earlier identification of PD progression should be possible with the high-sensitivity dedicated SPECT camera.

60 APPLIED LIFE SCIENCES↗

Failure Evaluation of Savannah River Site High-Level Waste Evaporator 242-25H - Part I - 17366

(25H) in February 2016. Part I discusses the physical investigation to determine the nature and location of the leak site. Part II separately discusses the analytical work to determine the most plausible failure modes. The following investigation methods have been used to aid in determining the leak location: - Remote visual inspection: using remote cameras, inspection of both the inside of the evaporator pot and the evaporator cell, to see if leak locations are visible. Also, inspect the stainless steel insulation jacket for visible leakage. - Leak level check: filling the evaporator pot with flush water to determine at what elevation the pot stops leaking. - Enhanced remote visual inspection: utilizing dye penetrant on the inside of the evaporator pot, attempting to see if any defects in the primary containment are visible. - Grey Qb Gamma camera survey: to look for high radiation areas in the insulation of the evaporator pot. Parallel efforts are underway to develop a strategy for remotely removing the evaporator stainless steel lagging and insulation, locating the specific leak site and developing a repair method; and repairing the leak site if practicable. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Quantitatively accurate activity measurements with a dedicated cardiac SPECT camera: Physical phantom experiments

Purpose: Recently, there has been increased interest in dedicated cardiac single photon emission computed tomography (SPECT) scanners with pinhole collimation and improved detector technology due to their improved count sensitivity and resolution over traditional parallel-hole cameras. With traditional cameras, energy-based approaches are often used in the clinic for scatter compensation because they are fast and easily implemented. Some of the cardiac cameras use cadmium-zinc-telluride (CZT) detectors which can complicate the use of energy-based scatter correction (SC) due to the low-energy tail—an increased number of unscattered photons detected with reduced energy. Modified energy-based scatter correction methods can be implemented, but their level of accuracy is unclear. In this study, the authors validated by physical phantom experiments the quantitative accuracy and reproducibility of easily implemented correction techniques applied to {sup 99m}Tc myocardial imaging with a CZT-detector-based gamma camera with multiple heads, each with a single-pinhole collimator. Methods: Activity in the cardiac compartment of an Anthropomorphic Torso phantom (Data Spectrum Corporation) was measured through 15 {sup 99m}Tc-SPECT acquisitions. The ratio of activity concentrations in organ compartments resembled a clinical {sup 99m}Tc-sestamibi scan and was kept consistent across all experiments (1.2:1 heart to liver and 1.5:1 heart to lung). Two background activity levels were considered: no activity (cold) and an activity concentration 1/10th of the heart (hot). A plastic “lesion” was placed inside of the septal wall of the myocardial insert to simulate the presence of a region without tracer uptake and contrast in this lesion was calculated for all images. The true net activity in each compartment was measured with a dose calibrator (CRC-25R, Capintec, Inc.). A 10 min SPECT image was acquired using a dedicated cardiac camera with CZT detectors (Discovery NM530c, GE Healthcare), followed by a CT scan for attenuation correction (AC). For each experiment, separate images were created including reconstruction with no corrections (NC), with AC, with attenuation and dual-energy window (DEW) scatter correction (ACSC), with attenuation and partial volume correction (PVC) applied (ACPVC), and with attenuation, scatter, and PVC applied (ACSCPVC). The DEW SC method used was modified to account for the presence of the low-energy tail. Results: T-tests showed that the mean error in absolute activity measurement was reduced significantly for AC and ACSC compared to NC for both (hot and cold) datasets (p < 0.001) and that ACSC, ACPVC, and ACSCPVC show significant reductions in mean differences compared to AC (p ≤ 0.001) without increasing the uncertainty (p > 0.4). The effect of SC and PVC was significant in reducing errors over AC in both datasets (p < 0.001 and p < 0.01, respectively), resulting in a mean error of 5% ± 4%. Conclusions: Quantitative measurements of cardiac {sup 99m}Tc activity are achievable using attenuation and scatter corrections, with the authors’ dedicated cardiac SPECT camera. Partial volume corrections offer improvements in measurement accuracy in AC images and ACSC images with elevated background activity; however, these improvements are not significant in ACSC images with low background activity.

61 RADIATION PROTECTION AND DOSIMETRY↗

How Useful Are Imaging and Remote Sensing Technologies in Decontamination and Decommissioning? - 17363

The examples of application of imaging and remote sensing technologies during decontamination and decommissioning works in nuclear environment at Kurchatov Institute site are presented. The systems which realized these technologies are: radiometric system installed on mechanical arm of Brokk remote controlled vehicle, collimated scanning spectrometric system and portable gamma cameras of different types. Objects of application: facilities of research reactors at characterization and under dismantling, temporal radwaste storages during discharge and remediation. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

SU-F-J-08: Quantitative SPECT Imaging of Ra-223 in a Phantom

Purpose: Ra-223 therapy of prostate cancer bone metastases is being used to treat patients routinely. However, the absorbed dose distribution at the macroscopic and microscopic scales remains elusive, due to the inability to image the small activities injected. Accurate activity quantification through imaging is essential to calculate the absorbed dose in organs and sub-units in radiopharmaceutical therapy, enabling personalized absorbed dose-based treatment planning methodologies and more effective and optimal treatments. Methods: A 22 cm diameter by 20 cm long cylindrical phantom, containing a 3.52 cm diameter sphere, was used. A total of 2.01 MBq of Ra-223 was placed in the phantom with 177.6 kBq in the sphere. Images were acquired on a dual-head Siemens Symbia T16 gamma camera using three 20% full-width energy windows and centered at 84, 154, and 269 keV (120 projections, 360° rotation, 45 s per view). We have implemented reconstruction of Ra-223 SPECT projections using OS-EM (up to 20 iterations of 10 subsets) with compensation for attenuation using CT-based attenuation maps, collimator-detector response (CDR) (including septal penetration, scatter and Pb x-ray modeling), and scatter in the patient using the effective source scatter estimation (ESSE) method. The CDR functions and scatter kernels required for ESSE were computed using the SIMIND MC simulation code. All Ra-223 photon emissions as well as gamma rays from the daughters Rn-219 and Bi-211 were modeled. Results: The sensitivity of the camera in the three combined windows was 107.3 cps/MBq. The visual quality of the SPECT images was reasonably good and the activity in the sphere was 27% smaller than the true activity. This underestimation is likely due to partial volume effect. Conclusion: Absolute quantitative Ra-223 SPECT imaging is achievable with careful attention to compensate for image degrading factors and system calibration.

60 APPLIED LIFE SCIENCES↗

SU-F-J-65: Prediction of Patient Setup Errors and Errors in the Calibration Curve from Prompt Gamma Proton Range Measurements

Purpose: To understand the extent to which the prompt gamma camera measurements can be used to predict the residual proton range due to setup errors and errors in the calibration curve. Methods: We generated ten variations on a default calibration curve (CC) and ten corresponding range maps (RM). Starting with the default RM, we chose a square array of N beamlets, which were then rotated by a random angle θ and shifted by a random vector s. We added a 5% distal Gaussian noise to each beamlet in order to introduce discrepancies that exist between the ranges predicted from the prompt gamma measurements and those simulated with Monte Carlo algorithms. For each RM, s, θ, along with an offset u in the CC, were optimized using a simple Euclidian distance between the default ranges and the ranges produced by the given RM. Results: The application of our method lead to the maximal overrange of 2.0mm and underrange of 0.6mm on average. Compared to the situations where s, θ, and u were ignored, these values were larger: 2.1mm and 4.3mm. In order to quantify the need for setup error corrections, we also performed computations in which u was corrected for, but s and θ were not. This yielded: 3.2mm and 3.2mm. The average computation time for 170 beamlets was 65 seconds. Conclusion: These results emphasize the necessity to correct for setup errors and the errors in the calibration curve. The simplicity and speed of our method makes it a good candidate for being implemented as a tool for in-room adaptive therapy. This work also demonstrates that the Prompt gamma range measurements can indeed be useful in the effort to reduce range errors. Given these results, and barring further refinements, this approach is a promising step towards an adaptive proton radiotherapy.

60 APPLIED LIFE SCIENCES↗

Gated SPECT myocardial perfusion imaging with cadmium-zinc-telluride detectors allows real-time assessment of dobutamine-stress-induced wall motion abnormalities

Background: Left ventricular (LV) ejection fraction (EF) during high dobutamine stress (HD) by real-time gated-SPECT myocardial perfusion imaging (MPI) on a cadmium-zinc-telluride (CZT) gamma camera was validated versus cardiac magnetic resonance imaging (CMR). Methods and results: After injecting 99mTc-tetrofosmin (320 MBq) in 50 patients (mean age 64 +/− 11 years), EF at rest and post-stress as well as relevant changes in EF at HD (ΔEF ≥ 5%) were assessed. CZT and CMR rest EF values yielded an excellent correlation and agreement (r = 0.96; P < 0.001; Bland–Altman limits of agreement (BA): + 0 to 14.8%). HD EF acquisition was feasible using CZT and correlated better to HD CMR EF than did post-stress CZT EF (r = 0.85 vs 0.76, respectively, all P < 0.001). Agreement in ΔEF detection between HD CMR and immediate post-stress CZT (reflecting standard acquisition using conventional SPECT camera unable to scan during stress) was 45%, while this increased to 85% with real-time HD CZT scan. Conclusion: Real-time ultrafast dobutamine gated-SPECT MPI with a CZT device is feasible and provides accurate measurements of HD LV performance.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Scintilla European project, the successful research results

The Scintilla FP7 project is ended in December 2014, the fruitful results of 3 years development and tests will be presented. SCINTILLA offers the capacity to finding a reliable alternative to Helium-3 based detection systems since the gas which is predominantly used in nuclear safeguards and security applications has now become very expensive, rare and nearly unavailable. SCINTILLA benchmarks results are based on international standards. Radiation Portal tests were carried out at the Joint Research Centre (JRC) in Ispra (Italy). The scintilla project addresses few mains issues. The first is to develop neutron detectors for Radiation Portal Monitor (RPM) and the second is the need of new wearable integrated solutions for Spectrometric Personal Radiation Monitor (SPRM). The partners which provide technical systems of the scintilla project are INFN-ANSALDO, CEA, SYMETRICA and SAPHYMO. For RPM, the objective is to find reliable alternatives to Helium-3 historical neutron detector and provide technical solutions which cope with tests for reliable mobile and cost effective. For Spectrometric Personal Radiation Monitor (SPRM), SCINTILLA is innovating in technology areas that offer complementary capabilities for detecting and identifying gamma, Two CZT (Cadmium Zinc Telluride) addressing contexts of used by first responder technologies, one is a wearable detector and the second is a gamma camera complemented by advanced image processing technologies. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Activities for the remediation of TEPCO's Fukushima Daiichi nuclear power plant

With the aim of fulfilling recovery work for the Fukushima Daiichi NPP, technological efforts have been made for the development of a survey robot system, adequate communication infrastructure technologies, high radiation environment compatible gamma cameras, heavy machinery-type robots (ASTACO-SoRa), remote decontamination devices (AROUNDER), and contaminated waste water treatment system. We have developed a new type of absorbents which remove cesium (Cs) and strontium (Sr) simultaneously at a high removal rate of 99 % or more. We will provide valuable solutions and rational systems for waste water treatment using this developed adsorbent as well as other various adsorbents for the recovery of Fukushima Daiichi NPP.

54 ENVIRONMENTAL SCIENCES↗

Impact of non-specific normal databases on perfusion quantification of low-dose myocardial SPECT studies

Aim: To evaluate the impact of non-specific normal databases on the percent summed rest score (SR%) and stress score (SS%) from simulated low-dose SPECT studies by shortening the acquisition time/projection. Methods: Forty normal-weight and 40 overweight/obese patients underwent myocardial studies with a conventional gamma-camera (BrightView, Philips) using three different acquisition times/projection: 30, 15, and 8 s (100%-counts, 50%-counts, and 25%-counts scan, respectively) and reconstructed using the iterative algorithm with resolution recovery (IRR) Astonish{sup TM} (Philips). Three sets of normal databases were used: (1) full-counts IRR; (2) half-counts IRR; and (3) full-counts traditional reconstruction algorithm database (TRAD). The impact of these databases and the acquired count statistics on the SR% and SS% was assessed by ANOVA analysis and Tukey test (P < 0.05). Results: Significantly higher SR% and SS% values (> 40%) were found for the full-counts TRAD databases respect to the IRR databases. For overweight/obese patients, significantly higher SS% values for 25%-counts scans (+19%) are confirmed compared to those of 50%-counts scan, independently of using the half-counts or the full-counts IRR databases. Conclusions: Astonish{sup TM} requires the adoption of the own specific normal databases in order to prevent very high overestimation of both stress and rest perfusion scores. Conversely, the count statistics of the normal databases seems not to influence the quantification scores.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-J-176: Results of Images Acquired with Backscattered MV Radiation Using a Pinhole Collimator

Purpose: To ascertain the feasibility of acquiring real time images of small lung tumors from scattered photons while undergoing radiation treatment.There are several methodologies currently used to track tumor location such as MV-cine acquisition and kV fluoroscopy. However, MVcine offers no information parallel to the beam axis while kV fluoroscopy offers little potential for soft tissue discernability while also increasing the patient dose. This study investigates the feasibility of observing an actual simulated tumor while exploring techniques that may improve image quality. Methods: A prototype imager consisting of a gamma camera pinhole collimator and a computed radiography (CR) plate were used in conjunction with a Varian TrueBeam linac. One study consisted of a 2.5 cm diameter solid water cylinder representing a solid tumor imbedded within a lung equivalent material slab. The cylinder with the lung slab was sandwiched between 1 cm lung equivalent slabs and these were sandwiched between 2 slabs of solid water. The top water slab was 1 cm thick. The other imaging study consisted of three different density plugs, 0.46, 1.09, and 1.82 g/cm3 placed on the accelerator couch. The gantry was orientated 70° relative to the CR plate. The slabs and plugs were irradiated with 2000 MU and 500 MU respectively using the 6FFF mode. Results: The solid water plug was visually discernible in the slab phantom. The ratio of the signal coming from the higher density plugs (placed on the treatment couch) to that between the plugs increased from 1.02 to about 3.0 after subtracting the background image acquired with no plugs present. Conclusion: Preliminary results indicate that a lung tumor could be visualized with scattered radiation during treatment. Improvements in discerning an object can be enhanced by filtering out the head leakage and background scattered radiation not emanating from the imaged object.

60 APPLIED LIFE SCIENCES↗

Dosimetric results in treatments of neuroblastoma and neuroendocrine tumors with {sup 131}I-metaiodobenzylguanidine with implications for the activity to administer

Purpose: The aim was to investigate whole-body and red marrow absorbed doses in treatments of neuroblastoma (NB) and adult neuroendocrine tumors (NETs) with {sup 131}I-metaiodobenzylguanidine and to propose a simple method for determining the activity to administer when dosimetric data for the individual patient are not available. Methods: Nine NB patients and six NET patients were included, giving in total 19 treatments as four patients were treated twice. Whole-body absorbed doses were determined from dose-rate measurements and planar gamma-camera imaging. For six NB and five NET treatments, red marrow absorbed doses were also determined using the blood-based method. Results: Dosimetric data from repeated administrations in the same patient were consistent. In groups of NB and NET patients, similar whole-body residence times were obtained, implying that whole-body absorbed dose per unit of administered activity could be reasonably well described as a power function of the patient mass. For NB, this functional form was found to be consistent with dosimetric data from previously published studies. The whole-body to red marrow absorbed dose ratio was similar among patients, with values of 1.4 ± 0.6–1.7 ± 0.7 (1 standard deviation) in NB treatments and between 1.5 ± 0.6 and 1.7 ± 0.7 (1 standard deviation) in NET treatments. Conclusions: The consistency of dosimetric results between administrations for the same patient supports prescription of the activity based on dosimetry performed in pretreatment studies, or during the first administration in a fractionated schedule. The expressions obtained for whole-body absorbed doses per unit of administered activity as a function of patient mass for NB and NET treatments are believed to be a useful tool to estimate the activity to administer at the stage when the individual patient biokinetics has not yet been measured.

60 APPLIED LIFE SCIENCES↗