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All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

SU-E-T-237: Deformable Image Registration and Deformed Dose Composite for Volumetric Evaluation of Multimodal Gynecological Cancer Treatments

Purpose: Radiotherapy plans for patients with cervical cancer treated with EBRT followed by HDR brachytherapy are optimized by constraining dose to organs at risk (OARs). Risk of treatment related toxicities is estimated based on the dose received to the hottest 2cc (D2cc) of the bladder, bowel, rectum, and sigmoid. To account for intrafractional variation in OAR volume and positioning, a dose deformation method is proposed for more accurate evaluation of dose distribution for these patients. Methods: Radiotherapy plans from five patients who received 50.4Gy pelvic EBRT followed by 30Gy in five fractions of HDR brachytherapy, using split-ring and tandem applicators, were retrospectively evaluated using MIM Software version 6.0. Dose accumulation workflows were used for initial deformation of EBRT and HDR planning CTs onto a common HDR planning CT. The Reg Refine tool was applied with user-specified local alignments to refine the deformation. Doses from the deformed images were transferred to the common planning CT. Deformed doses were scaled to the EQD2, following the linear-quadratic BED model (considered α/β ratio for tumor as 10, and 3 for rest of the tissues), and then combined to create the dose composite. MIM composite doses were compared to the clinically-reported plan assessments based upon the American Brachytherapy Society (ABS) guidelines for cervical HDR brachytherapy treatment. Results: Bladder D2cc exhibited significant reduction (−11.4%±3.85%, p< 0.02) when evaluated using MIM deformable dose composition. Differences observed for bowel, rectum, and sigmoid D2cc were not significant (−0.58±7.37%, −4.13%±13.7%, and 8.58%±4.71%, respectively and p>0.05 for all) relative to the calculated values used clinically. Conclusion: Application of deformable dose composite techniques may lead to more accurate total dose reporting and can allow for elevated dose to target structures with the assurance of not exceeding dose to OARs. Further study into deformable dose composition and correlation with clinical outcomes is warranted.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Dose-Dependent Cortical Thinning After Partial Brain Irradiation in High-Grade Glioma

Purpose: Radiation-induced cognitive deficits may be mediated by tissue damage to cortical regions. Volumetric changes in cortex can be reliably measured using high-resolution magnetic resonance imaging (MRI). We used these methods to study the association between radiation therapy (RT) dose and change in cortical thickness in high-grade glioma (HGG) patients. Methods and Materials: We performed a voxel-wise analysis of MRI from 15 HGG patients who underwent fractionated partial brain RT. Three-dimensional MRI was acquired pre- and 1 year post RT. Cortex was parceled with well-validated segmentation software. Surgical cavities were censored. Each cortical voxel was assigned a change in cortical thickness between time points, RT dose value, and neuroanatomic label by lobe. Effects of dose, neuroanatomic location, age, and chemotherapy on cortical thickness were tested using linear mixed effects (LME) modeling. Results: Cortical atrophy was seen after 1 year post RT with greater effects at higher doses. Estimates from LME modeling showed that cortical thickness decreased by −0.0033 mm (P<.001) for every 1-Gy increase in RT dose. Temporal and limbic cortex exhibited the largest changes in cortical thickness per Gy compared to that in other regions (P<.001). Age and chemotherapy were not significantly associated with change in cortical thickness. Conclusions: We found dose-dependent thinning of the cerebral cortex, with varying neuroanatomical regional sensitivity, 1 year after fractionated partial brain RT. The magnitude of thinning parallels 1-year atrophy rates seen in neurodegenerative diseases and may contribute to cognitive decline following high-dose RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
NASA NTRS1992

LDEF: Dosimetric measurement results (AO 138-7 experiment)

One of the objectives of the AO 138-7 experiment on board the LDEF was a total dose measurement with Thermo Luminescent Detectors (TLD 100). Two identical cases, both including 5 TLDs inside various aluminum shields, are exposed to the space environment in order to obtain the absorbed dose profile induced. Radiation fluence received during the total mission length was computed, taking into account the trapped particles (solar maximum and solar minimum periods) and the cosmic rays; due to the magnetospheric shielding, the solar proton fluences are negligible on the LDEF orbit. The total dose induced by these radiations inside a semi-infinite plane shield of Al are computed with radiation transport codes. TLD reading are performed after flight; due to the mission duration increase, a post-flight calibration was necessary in order to cover the range of the flight induced dose. The results obtained, similar (+ or - 30 pct.) in both cases, are compared with the dose profile computation. In practice, these LDEF results, with less than a factor 1.4 between measurements and forecasts, reinforce the validity of the computation methods and models used for the long term evaluation of space radiation intensity on low inclination Earth orbits.

Bourrieau, J.↗
DOE OSTI2014

SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy

Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TEM Video Compressive Sensing

One of the main limitations of imaging at high spatial and temporal resolution during in-situ TEM experiments is the frame rate of the camera being used to image the dynamic process. While the recent development of direct detectors has provided the hardware to achieve frame rates approaching 0.1ms, the cameras are expensive and must replace existing detectors. In this paper, we examine the use of coded aperture compressive sensing methods [1, 2, 3, 4] to increase the framerate of any camera with simple, low-cost hardware modifications. The coded aperture approach allows multiple sub-frames to be coded and integrated into a single camera frame during the acquisition process, and then extracted upon readout using statistical compressive sensing inversion. Our simulations show that it should be possible to increase the speed of any camera by at least an order of magnitude. Compressive Sensing (CS) combines sensing and compression in one operation, and thus provides an approach that could further improve the temporal resolution while correspondingly reducing the electron dose rate. Because the signal is measured in a compressive manner, fewer total measurements are required. When applied to TEM video capture, compressive imaging couled improve acquisition speed and reduce the electron dose rate. CS is a recent concept, and has come to the forefront due the seminal work of Candès [5]. Since the publication of Candès, there has been enormous growth in the application of CS and development of CS variants. For electron microscopy applications, the concept of CS has also been recently applied to electron tomography [6], and reduction of electron dose in scanning transmission electron microscopy (STEM) imaging [7]. To demonstrate the applicability of coded aperture CS video reconstruction for atomic level imaging, we simulate compressive sensing on observations of Pd nanoparticles and Ag nanoparticles during exposure to high temperatures and other environmental conditions. Figure 1 highlights the results from the Pd nanoparticle experiment. On the left, 10 frames are reconstructed from a single coded frame—the original frames are shown for comparison. On the right a selection of three frames are shown from reconstructions at compression levels 10,20,30. The reconstructions, which are not post-processed, are true to the original and degrade in a straightforward manner. The final choice of compression level will obviously depend on both the temporal and spatial resolution required for a specific imaging task, but the results indicate that an increase in speed of better than an order of magnitude should be possible for all experiments. References: [1] P Llull, X Liao, X Yuan et al. Optics express 21(9), (2013), p. 10526. [2] J Yang, X Yuan, X Liao et al. Image Processing, IEEE Trans 23(11), (2014), p. 4863. [3] X Yuan, J Yang, P Llull et al. In ICIP 2013 (IEEE), p. 14. [4] X Yuan, P Llull, X Liao et al. In CVPR 2014. p. 3318. [5] EJ Candès, J Romberg and T Tao. Information Theory, IEEE Trans 52(2), (2006), p. 489. [6] P Binev, W Dahmen, R DeVore et al. In Modeling Nanoscale Imaging in Electron Microscopy, eds. T Vogt, W Dahmen and P Binev (Springer US), Nanostructure Science and Technology (2012). p. 73. [7] A Stevens, H Yang, L Carin et al. Microscopy 63(1), (2014), pp. 41.

Stevens, Andrew↗
DOE OSTI2023

Deoptimization of FMDV P1 Region Results in Robust Serotype-Independent Viral Attenuation

Foot-and-mouth disease (FMD), caused by the FMD virus (FMDV), is a highly contagious disease of cloven-hoofed livestock that can have severe economic impacts. Control and prevention strategies, including the development of improved vaccines, are urgently needed to effectively control FMD outbreaks in endemic settings. Previously, we employed two distinct strategies (codon pair bias deoptimization (CPD) and codon bias deoptimization (CD)) to deoptimize various regions of the FMDV serotype A subtype A12 genome, which resulted in the development of an attenuated virus in vitro and in vivo, inducing varying levels of humoral responses. In the current study, we examined the versatility of the system by using CPD applied to the P1 capsid coding region of FMDV serotype A subtype, A24, and another serotype, Asia1. Viruses carrying recoded P1 (A24-P1Deopt or Asia1-P1Deopt) exhibited different degrees of attenuation (i.e., delayed viral growth kinetics and replication) in cultured cells. Studies in vivo using a mouse model of FMD demonstrated that inoculation with the A24-P1Deopt and Asia1-P1Deopt strains elicited a strong humoral immune response capable of offering protection against challenge with homologous wildtype (WT) viruses. However, different results were obtained in pigs. While clear attenuation was detected for both the A24-P1Deopt and Asia1-P1Deopt strains, only a limited induction of adaptive immunity and protection against challenge was detected, depending on the inoculated dose and serotype deoptimized. Our work demonstrates that while CPD of the P1 coding region attenuates viral strains of multiple FMDV serotypes/subtypes, a thorough assessment of virulence and induction of adaptive immunity in the natural host is required in each case in order to finely adjust the degree of deoptimization required for attenuation without affecting the induction of protective adaptive immune responses.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-416: Dosimetric Comparison of Coplanar and Non-Coplanar IMRT Plans for Peripheral Lung Lesion

Purpose: The purpose of this study was to compare dosimetric parameters of treatment plans between coplanar and non-coplanar techniques for treating peripheral lung lesions. Methods: The planning CT scans of 6 patients in supine positions were used in this study. The size of the PTV ranges from 163 c.c. to 782 c.c.. The locations of PTV are mostly at the peripheral of Lung, some spreading to the mediastinum. For each patient, we generated two IMRT plans, one with and the other without non-coplanar beams. The non-coplanar beams were carefully selected so that the beams would never exit patient bodies through the contralateral lung. The IMRT plans were generated with Pinnacle 9.8 treatment planning software. The IMRT optimization objectives were kept the same for the corresponding pairs of plans. All plans were normalized such that 95% of PTV receives the prescription dose (full dose). Results: The conformity index (mean±standard deviation of the mean) is 1.49±0.14 and 1.58±0.23 for the coplanar and noncoplanar plans, respectively. The heterogeneity index (mean±standard deviation of the mean) is 7.74 ±2.33 and 6.34±1.40 for the coplanar and non-coplanar plans, respectively. The maximum heart dose is 60.94±6.22 and 60.42±7.21 Gy, and mean heart dose is 10.22 ±7.57, 9.07 ±6.32 Gy, for the coplanar and non-coplanar plans, respectively. The ipsilateral lung V20 is 48.0%±2.4% and 47.5%±3.3%, and V5 is 68.2%±10.0% and 69.1%±7.3%, for the coplanar and noncoplanar plans, respectively. Furthermore, with the non-coplanar beam arrangement, the contralateral lung V20 was reduced from 3.3%±3.7% to 1.3%±0.8%, and the contralateral Lung V5 is reduced significantly from 65.6%±9.3% to 33.5%±20.9% (p value =0.008). Conclusion: The IMRT plans with non-coplanar beam arrangement could reduce the exit dose to the contralateral lung, and therefore reduce the contralateral lung V5 significantly. This method is especially helpful while the lung lesion doesn’t have a symmetric shape.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2010

Know your dose: RADDOSE

The program RADDOSE computes the dose absorbed by a macromolecular crystal and here a guide is provided to help to ensure the proper use of the program. In the new version (v.3) described here, modifications to include the energy deposited owing to Compton scattering have been made. The program RADDOSE is widely used to compute the dose absorbed by a macromolecular crystal during an X-ray diffraction experiment. A number of factors affect the absorbed dose, including the incident X-ray flux density, the photon energy and the composition of the macromolecule and of the buffer in the crystal. An experimental dose limit for macromolecular crystallography (MX) of 30 MGy at 100 K has been reported, beyond which the biological information obtained may be compromised. Thus, for the planning of an optimized diffraction experiment the estimation of dose has become an additional tool. A number of approximations were made in the original version of RADDOSE. Recently, the code has been modified in order to take into account fluorescent X-ray escape from the crystal (version 2) and the inclusion of incoherent (Compton) scattering into the dose calculation is now reported (version 3). The Compton cross-section, although negligible at the energies currently commonly used in MX, should be considered in dose calculations for incident energies above 20 keV. Calculations using version 3 of RADDOSE reinforce previous studies that predict a reduction in the absorbed dose when data are collected at higher energies compared with data collected at 12.4 keV. Hence, a longer irradiation lifetime for the sample can be achieved at these higher energies but this is at the cost of lower diffraction intensities. The parameter ‘diffraction-dose efficiency’, which is the diffracted intensity per absorbed dose, is revisited in an attempt to investigate the benefits and pitfalls of data collection using higher and lower energy radiation, particularly for thin crystals.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗
DOE OSTI2011

Organ doses for reference adult male and female undergoing computed tomography estimated by Monte Carlo simulations

Purpose: To develop a computed tomography (CT) organ dose estimation method designed to readily provide organ doses in a reference adult male and female for different scan ranges to investigate the degree to which existing commercial programs can reasonably match organ doses defined in these more anatomically realistic adult hybrid phantomsMethods: The x-ray fan beam in the SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code MCNPX2.6. The simulated CT scanner model was validated through comparison with experimentally measured lateral free-in-air dose profiles and computed tomography dose index (CTDI) values. The reference adult male and female hybrid phantoms were coupled with the established CT scanner model following arm removal to simulate clinical head and other body region scans. A set of organ dose matrices were calculated for a series of consecutive axial scans ranging from the top of the head to the bottom of the phantoms with a beam thickness of 10 mm and the tube potentials of 80, 100, and 120 kVp. The organ doses for head, chest, and abdomen/pelvis examinations were calculated based on the organ dose matrices and compared to those obtained from two commercial programs, CT-EXPO and CTDOSIMETRY. Organ dose calculations were repeated for an adult stylized phantom by using the same simulation method used for the adult hybrid phantom. Results: Comparisons of both lateral free-in-air dose profiles and CTDI values through experimental measurement with the Monte Carlo simulations showed good agreement to within 9%. Organ doses for head, chest, and abdomen/pelvis scans reported in the commercial programs exceeded those from the Monte Carlo calculations in both the hybrid and stylized phantoms in this study, sometimes by orders of magnitude. Conclusions: The organ dose estimation method and dose matrices established in this study readily provides organ doses for a reference adult male and female for different CT scan ranges and technical parameters. Organ doses from existing commercial programs do not reasonably match organ doses calculated for the hybrid phantoms due to differences in phantom anatomy, as well as differences in organ dose scaling parameters. The organ dose matrices developed in this study will be extended to cover different technical parameters, CT scanner models, and various age groups.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

An evaluation of health risk to the public as a consequence of in situ uranium mining in Wyoming, USA

In the United States there is considerable public concern regarding the health effects of in situ recovery uranium mining. These concerns focus principally on exposure to contaminants mobilized in groundwater by the mining process. However, the risk arising as a result of mining must be viewed in light of the presence of naturally occurring uranium ore and other constituents which comprise a latent hazard. The United States Environmental Protection Agency recently proposed new guidelines for successful restoration of an in situ uranium mine by limiting concentrations of thirteen groundwater constituents: arsenic, barium, cadmium, chromium, lead, mercury, selenium, silver, nitrate (as nitrogen), molybdenum, radium, total uranium, and gross α activity. We investigated the changes occurring to these constituents at an ISR uranium mine in Wyoming, USA by comparing groundwater quality at baseline measurement to that at stability (post-restoration) testing. Of the groundwater constituents considered, only uranium and radium-226 showed significant (p < 0.05) deviation from site-wide baseline conditions in matched-wells. Uranium concentrations increased by a factor of 5.6 (95% CI 3.6–8.9 times greater) while radium-226 decreased by a factor of about one half (95% CI 0.42–0.75 times less). Change in risk was calculated using the RESRAD (onsite) code for an individual exposed as a resident-farmer; total radiation dose to a resident farmer decreased from pre-to post-mining by about 5.2 mSv y –1 . As a result, higher concentrations of uranium correspond to increased biomarkers of nephrotoxicity, however the clinical significance of this increase is unclear.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2014

SU-E-T-448: On the Perturbation Factor P-cav of the Markus Parallel Plate Ion Chambers in Clinical Electron Beams, Monte Carlo Based Reintegration of An Historical Experiment

Purpose: All present dosimetry protocols recommend well-guarded parallel-plate ion chambers for electron dosimetry. For the guard-less Markus chamber an energy dependent fluence perturbation correction pcav is given. This perturbation correction was experimentally determined by van der Plaetsen by comparison of the read-out of a Markus and a NACP chamber, which was assumed to be “perturbation-free”. Aim of the present study is a Monte Carlo based reiteration of this experiment. Methods: Detailed models of four parallel-plate chambers (Roos, Markus, NACP and Advanced Markus) were designed using the Monte Carlo code EGSnrc and placed in a water phantom. For all chambers the dose to the active volume filled with low density water was calculated for 13 clinical electron spectra (E{sub 0}=6-21 MeV) at the depth of maximum and at the reference depth under reference conditions. In all cases the chamber's reference point was positioned at the depth of measurement. Moreover, the dose to water DW was calculated in a small water voxel positioned at the same depth. Results: The calculated dose ratio D{sub NACP}/D{sub Markus}, which according to van der Plaetsen reflects the fluence perturbation correction of the Markus chamber, deviates less from unity than the values given by van der Plaetsen's but exhibits a similar energy dependence. The same holds for the dose ratios of the other well guarded chambers. But, in comparison to water, the Markus chamber reveals the smallest overall perturbation correction which is nearly energy independent at both investigated depths. Conclusion: The simulations principally confirm the energy dependence of the dose ratio D{sub NACP}/D{sub Markus} as published by van der Plaetsen. But, as shown by our simulations of the ratio D{sub W}/D{sub Markus}, the conclusion drawn in all dosimetry protocols is questionable: in contrast to all well-guarded chambers the guard-less Markus chamber reveals the smallest overall perturbation correction and also the smallest energy dependence.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

TU-C-17A-12: Towards a Passively Optimized Phase-Space Monte Carlo (POPMC) Treatment Planning Method: A Proof of Principle

Purpose: The advent of on-line/off-line adaptive, and biologically-conformal radiation therapy has led to a need for treatment planning solutions that utilize voxel-specific penalties, requiring optimization over a large solution space that is performed quickly, and the dose in each voxel calculated accurately. This work proposes a “passive” optimization framework, which is executed concurrently during Monte Carlo dose calculation, evaluating the cost/benefit of each history during transport, and creates a passively optimized fluence map. Methods: The Monte Carlo code Geant4 v9.6 was used for this study. The standard voxel geometry implementation was modified to support the passive optimization framework, with voxel-specific optimization parameters. Dose-benefit functions, which will increase a particle history’s weight upon dose deposition, were defined in a central collection of voxels to effectively create target structures. Histories that deposit energy to voxels are reweighted based on a voxel’s dose multiplied by its cost/benefit value. Upon full termination of each history, the dose contributions of that history are reweighted to reflect a contribution proportional to the history’s final weight. A parallel-planar 1.25 MeV photon fluence is transported through the geometry, and re-weighted at each dose deposition step. The resulting weight is tallied with the incident spatial and directional coordinates in a phase-space distribution. Results: A uniform incident fluence was reweighted during MC dose calculations to create an optimized fluence map which would generate dose profiles in target volumes that exhibit the same dose characteristics as the prescribed optimization parameters. An optimized dose profile, calculated concurrently with the phase-space, reflects the resulting dose distribution. Conclusion: This study demonstrated the feasibility of passively optimizing an incident fluence map during Monte Carlo dose calculations. The flexibility of the voxel-specific optimization framework allows a variety and combination of optimization parameters to be calculated for each voxel at every transportation step. This work is partially supported by Varian. This work is partially supported by the NIH.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

MO-D-213-04: The Proximity to the Skin of PTV Affects PTV Coverage and Skin Dose for TomoTherapy

Purpose: The proximity to the skin surface of the PTV for the patients with skin disease could be a concern in terms of the PTV coverage and actual surface dose (SD). IMRT optimization algorithms increase the beam intensity close to the skin in order to compensate for lack of scattering material, leading to enhanced SD but potential hot spots. This study aims to investigate the effect of PTV proximity to the skin on planning and measured SD Methods: All measurements were done for 6 MV X-ray beam of Helical TomoTherapy. An anthropomorphic phantom was scanned in a CT simulator in a routine manner with thermoplastic mask immobilization. PTVs were created with varying distances to the skin of 0 mm -(PTV1), 1 mm- (PTV2), 2 mm-(PTV3) and 3 mm-(PTV4). Also, a 5 mm bolus was used with PTV1 (PTV5). All planning constraints were kept the same in all studies (hard constraint: 95% of the prescription dose covered 95% of the PTV). Gafchromic film (EBT3) was placed under the mask on the phantom surface, and the resulting dose was estimated using RIT software. Results: Optimizing the dose using different PTVs lead to average planned target doses of 10.8, 10.3, 10.2, 10.3 and 10.0 Gy, with maximum doses 12.2, 11.2, 11.1, 11.1 and 10.0 Gy for PTV1, PTV2, PTV3, PTV4 and PTV5, respectively. EBT3 measurements indicated a significant decrease of SD with skin distance by 12.7% (PTV1), 21.9% (PTV2), 24.8% (PTV3) and 28.4% (PTV4) comparing to prescription dose. Placement of a 5 mm bolus on the phantom surface resulted in a SD close to prescribed (+0.5%). Conclusion: This work provides a clear demonstration of the relationship between the skin dose and the PTV to the skin distance. The results indicate the necessity of a bolus even for TomoTherapy when high skin dose is required.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, less EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose (<20% prescription dose) and high dose regions (>80% prescription dose) was calculated for each frame averaged scenario for each plan. The authors defined their unacceptable loss of accuracy as no more than a ±1% mean dose difference in the high dose region. Optimal frame average numbers were then determined as a function of the Linac’s average gantry speed and the dose per fraction. Results: The authors found that 9 and 11 frame averages were suitable for all VMAT and SBRT-VMAT treatments, respectively. This resulted in no more than a 1% loss to any of the dose region’s mean percentage difference when compared to the single frame reconstruction. The optimized number was dependent on the treatment’s dose per fraction and was determined to be as high as 14 for 12 Gy/fraction (fx), 15 for 8 Gy/fx, 11 for 6 Gy/fx, and 9 for 2 Gy/fx. Conclusions: The authors have determined an optimal EPID frame averaging number for multiple VMAT-type treatments. These are given as a function of the dose per fraction and average gantry speed. These optimized values are now used in the authors’ clinical, 3D, in vivo patient dosimetry program. This provides a reduction in calculation time while maintaining the authors’ required level of accuracy in the dose reconstruction.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-218: Validation of An In-Vivo Proton Range Verification Method for Reducing the Risk of Permanent Alopecia in the Treatment of Pediatric Medulloblastoma

Purpose: The clinical commissioning of a workflow for pre-treatment range verification/adjustment for the head treatment of pediatric medulloblastoma patients, including dose monitoring during treatment. Methods: An array of Si-diodes (DIODES Incorporated) is placed on the patient skin on the opposite side to the beam entrance. A “scout” SOBP beam, with a longer beam range to cover the diodes in its plateau, is delivered; the measured signal is analyzed and the extracted water equivalent path lengths (WEPL) are compared to the expected values, revealing if a range correction is needed. Diodes stay in place during treatment to measure dose. The workflow was tested in solid water and head phantoms and validated against independent WEPL measurements. Both measured WEPL and skin doses were compared to computed values from the TPS (XiO); a Markus chamber was used for reference dose measurements. Results: The WEPL accuracy of the method was verified by comparing it with the dose extinction method. It resulted, for both solid water and head phantom, in the sub-millimeter range, with a deviation less than 1% to the value extracted from the TPS. The accuracy of dose measurements in the fall-off part of the dose profile was validated against the Markus chamber. The entire range verification workflow was successfully tested for the mock-treatment of head phantom with the standard delivery of 90 cGy per field per fraction. The WEPL measurement revealed no need for range correction. The dose measurements agreed to better than 4% with the prescription dose. The robustness of the method and workflow, including detector array, hardware set and software functions, was successfully stress-tested with multiple repetitions. Conclusion: The performance of the in-vivo range verification system and related workflow meet the clinical requirements in terms of the needed WEPL accuracy for pretreatment range verification with acceptable dose to the patient.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Neutron-Irradiated Samples as Test Materials for MPEX

Plasma Material Interaction (PMI) is a major concern in fusion reactor design and analysis. The Material-Plasma Exposure eXperiment (MPEX) will explore PMI under fusion reactor plasma conditions. Samples with accumulated displacements per atom (DPA) damage produced by fast neutron irradiations in the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory (ORNL) will be studied in the MPEX facility. This paper presents assessments of the calculated induced radioactivity and resulting radiation dose rates of a variety of potential fusion reactor plasma-facing materials (such as tungsten). The scientific code packages MCNP and SCALE were used to simulate irradiation of the samples in HFIR including the generation and depletion of nuclides in the material and the subsequent composition, activity levels, gamma radiation fields, and resultant dose rates as a function of cooling time. A challenge of the MPEX project is to minimize the radioactive inventory in the preparation of the samples and the sample dose rates for inclusion in the MPEX facility.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗
DOE OSTI2023

A fast Monte Carlo cell-by-cell simulation for radiobiological effects in targeted radionuclide therapy using pre-calculated single-particle track standard DNA damage data

Introduction: We developed a new method that drastically speeds up radiobiological Monte Carlo radiation-track-structure (MC-RTS) calculations on a cell-by-cell basis. Methods: The technique is based on random sampling and superposition of single-particle track (SPT) standard DNA damage (SDD) files from a “pre-calculated” data library, constructed using the RTS code TOPAS-nBio, with “time stamps” manually added to incorporate dose-rate effects. This time-stamped SDD file can then be input into MEDRAS, a mechanistic kinetic model that calculates various radiation-induced biological endpoints, such as DNA double-strand breaks (DSBs), misrepairs and chromosomal aberrations, and cell death. As a benchmark validation of the approach, we calculated the predicted energy-dependent DSB yield and the ratio of direct-to-total DNA damage, both of which agreed with published in vitro experimental data. We subsequently applied the method to perform a superfast cell-by-cell simulation of an experimental in vitro system consisting of neuroendocrine tumor cells uniformly incubated with 177 Lu. Results and discussion: The results for residual DSBs, both at 24 and 48 h post-irradiation, are in line with the published literature values. Our work serves as a proof-of-concept demonstration of the feasibility of a cost-effective “in silico clonogenic cell survival assay” for the computational design and development of radiopharmaceuticals and novel radiotherapy treatments more generally.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
NASA NTRS1992

Galactic cosmic ray transport methods and radiation quality issues

An overview of galactic cosmic ray (GCR) interaction and transport methods, as implemented in the Langley Research Center GCR transport code, is presented. Representative results for solar minimum, exo-magnetospheric GCR dose equivalents in water are presented on a component by component basis for various thicknesses of aluminum shielding. The impact of proposed changes to the currently used quality factors on exposure estimates and shielding requirements are quantified. Using the cellular track model of Katz, estimates of relative biological effectiveness (RBE) for the mixed GCR radiation fields are also made.

Townsend, L. W.↗