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DOE OSTI2015

MO-E-213-03: Newer Radiation Protection Requirements in Last Decade

The focus of work of medical physicists in 1980’s was on quality control and quality assurance. Radiation safety was important but was dominated by occupational radiation protection. A series of over exposures of patients in radiotherapy, nuclear medicine and observation of skin injuries among patients undergoing interventional procedures in 1990’s started creating the need for focus on patient protection. It gave medical physicists new directions to develop expertise in patient dosimetry and dose management. Publications creating awareness on cancer risks from CT in early part of the current century and over exposures in CT in 2008 brought radiation risks in public domain and created challenging situations for medical physicists. Increasing multiple exposures of individual patient and patient doses of few tens of mSv or exceeding 100 mSv are increasing the role of medical physicists. Expansion of usage of fluoroscopy in the hands of clinical professionals with hardly any training in radiation protection shall require further role for medical physicists. The increasing publications in journals, recent changes in Safety Standards, California law, all increase responsibilities of medical physicists in patient protection. Newer technological developments in dose efficiency and protective devices increase percentage of time devoted by medical physicists on radiation protection activities. Without radiation protection, the roles, responsibilities and day-to-day involvement of medical physicists in diagnostic radiology becomes questionable. In coming years either medical radiation protection may emerge as a specialty or medical physicists will have to keep major part of day-to-day work on radiation protection. Learning Objectives: To understand how radiation protection has been increasing its role in day-to-day activities of medical physicist To be aware about international safety Standards, national and State regulations that require higher attention to radiation protection than in past To be aware about possible emergence of medical radiation protection as a specialty and challenges for medical physicists.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

MO-E-213-01: Increasing Role of Medical Physicist in Radiation Protection

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

SU-E-J-222: Evaluation of Deformable Registration of PET/CT Images for Cervical Cancer Brachytherapy

Purpose: PET/CT provides important functional information for radiotherapy targeting of cervical cancer. However, repeated PET/CT procedures for external beam and subsequent brachytherapy expose patients to additional radiation and are not cost effective. Our goal is to investigate the possibility of propagating PET-active volumes for brachytherapy procedures through deformable image registration (DIR) of earlier PET/CT and ultimately to minimize the number of PET/CT image sessions required. Methods: Nine cervical cancer patients each received their brachytherapy preplanning PET/CT at the end of EBRT with a Syed template in place. The planning PET/CT was acquired on the day of brachytherapy treatment with the actual applicator (Syed or Tandem and Ring) and rigidly registered. The PET/CT images were then deformably registered creating a third (deformed) image set for target prediction. Regions of interest with standardized uptake values (SUV) greater than 65% of maximum SUV were contoured as target volumes in all three sets of PET images. The predictive value of the registered images was evaluated by comparing the preplanning and deformed PET volumes with the planning PET volume using Dice's coefficient (DC) and center-of-mass (COM) displacement. Results: The average DCs were 0.12±0.14 and 0.19±0.16 for rigid and deformable predicted target volumes, respectively. The average COM displacements were 1.9±0.9 cm and 1.7±0.7 cm for rigid and deformable registration, respectively. The DCs were improved by deformable registration, however, both were lower than published data for DIR in other modalities and clinical sites. Anatomical changes caused by different brachytherapy applicators could have posed a challenge to the DIR algorithm. The physiological change from interstitial needle placement may also contribute to lower DC. Conclusion: The clinical use of DIR in PET/CT for cervical cancer brachytherapy appears to be limited by applicator choice and requires further investigation.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-J-23: Characteristics of X-Rays From ExacTrac and Patient Dose From Imaging Procedures

Purpose: The purpose of this investigation is 1) provide the beam characteristics of x-rays produced by a Novalis TX ExacTrac system; 2) present a method to commission such beams, 3) present radiation dose to patients resulting from the imaging procedures. Methods: The Monte Carlo simulations were used to obtain the characteristics of kV beams and validated by measurements. The calculated beam HVLs, profiles and depth-dose curves were benchmarked against measurements. Twelve different image acquisition protocols were studied. The x-ray tube voltage ranges from 70 - 145 kV and milliampere-second (mAs) ranges from 8 - 80 mAs depending on the selection of Cranium, Head & Neck, Thorax or Abdomen imaging protocols. The beam output of each image acquisition protocol was determined by using an ionization chamber. The air kerma calibration factors of the ion chamber were obtained from an Accredited Dosimetry Calibration Laboratory for specified HVLs. Results: The agreements between measured and simulated results were within the uncertainties for HVLs, dose profiles and depth-dose curves. When %dd was normalized at 1 cm depth, its values at depth of 5 cm ranged from 45% to 66% of in water for kV beams range from 70 kVp to 145 kVp respectively. For head images, a typical dose to eye resulting from single projection ranged from 0.008 cGy to 0.025 cGy depending on the cranial image protocols selected. For a single pelvic image the skin dose could reach up to 0.1 cGy from an abdominal protocol. Conclusion: Although multiple pairs of x-ray images are commonly acquired during a daily patient treatment, the imaging doses to patients resulting from the sum of these projected x-rays are generally much less than 0.5 cGy. The knowledge obtained from this investigation can be used to estimate the image dose and optimize the used of the system.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

A new surrogate modeling technique combining Kriging and polynomial chaos expansions – Application to uncertainty analysis in computational dosimetry

In numerical dosimetry, the recent advances in high performance computing led to a strong reduction of the required computational time to assess the specific absorption rate (SAR) characterizing the human exposure to electromagnetic waves. However, this procedure remains time-consuming and a single simulation can request several hours. As a consequence, the influence of uncertain input parameters on the SAR cannot be analyzed using crude Monte Carlo simulation. The solution presented here to perform such an analysis is surrogate modeling. This paper proposes a novel approach to build such a surrogate model from a design of experiments. Considering a sparse representation of the polynomial chaos expansions using least-angle regression as a selection algorithm to retain the most influential polynomials, this paper proposes to use the selected polynomials as regression functions for the universal Kriging model. The leave-one-out cross validation is used to select the optimal number of polynomials in the deterministic part of the Kriging model. The proposed approach, called LARS-Kriging-PC modeling, is applied to three benchmark examples and then to a full-scale metamodeling problem involving the exposure of a numerical fetus model to a femtocell device. The performances of the LARS-Kriging-PC are compared to an ordinary Kriging model and to a classical sparse polynomial chaos expansion. The LARS-Kriging-PC appears to have better performances than the two other approaches. A significant accuracy improvement is observed compared to the ordinary Kriging or to the sparse polynomial chaos depending on the studied case. This approach seems to be an optimal solution between the two other classical approaches. A global sensitivity analysis is finally performed on the LARS-Kriging-PC model of the fetus exposure problem.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2014

Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

SU-F-BRA-04: Prostate HDR Brachytherapy with Multichannel Robotic System

Purpose: High-dose-rate (HDR) brachytherapy is gradually becoming popular in treating patients with prostate cancers. However, placement of the HDR needles at desired locations into the patient is challenging. Application of robotic system may improve the accuracy of the clinical procedure. This experimental study is to evaluate the feasibility of using a multichannel robotic system for prostate HDR brachytherapy. Methods: In this experimental study, the robotic system employed was a 6-DOF Multichannel Image-guided Robotic Assistant for Brachytherapy (MIRAB), which was designed and fabricated for prostate seed implantation. The MIRAB has the provision of rotating 16 needles while inserting them. Ten prostate HDR brachytherapy needles were simultaneously inserted using MIRAB into a commercially available prostate phantom. After inserting the needles into the prostate phantom at desired locations, 2mm thick CT slices were obtained for dosimetric planning. HDR plan was generated using Oncetra planning system with a total prescription dose of 34Gy in 4 fractions. Plan quality was evaluated considering dose coverage to prostate and planning target volume (PTV), with 3mm margin around prostate, as well as the dose limit to the organs at risk (OARs) following the American Brachytherapy Society (ABS) guidelines. Results: From the CT scan, it is observed that the needles were inserted straight into the desired locations and they were adequately spaced and distributed for a clinically acceptable HDR plan. Coverage to PTV and prostate were about 91% (V100= 91%) and 96% (V100=96%), respectively. Dose to 1cc of urethra, rectum, and bladder were within the ABS specified limits. Conclusion: The MIRAB was able to insert multiple needles simultaneously into the prostate precisely. By controlling the MIRAB to insert all the ten utilized needles into the prostate phantom, we could achieve the robotic HDR brachytherapy successfully. Further study for assessing the system’s performance and reliability is in progress.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-AB-BRA-09: Stability Analysis of a Novel Dose Calculation Algorithm for MRI Guided Radiotherapy

Purpose: To determine the iterative deterministic solution stability of the Linear Boltzmann Transport Equation (LBTE) in the presence of magnetic fields. Methods: The LBTE with magnetic fields under investigation is derived using a discrete ordinates approach. The stability analysis is performed using analytical and numerical methods. Analytically, the spectral Fourier analysis is used to obtain the convergence rate of the source iteration procedures based on finding the largest eigenvalue of the iterative operator. This eigenvalue is a function of relevant physical parameters, such as magnetic field strength and material properties, and provides essential information about the domain of applicability required for clinically optimal parameter selection and maximum speed of convergence. The analytical results are reinforced by numerical simulations performed using the same discrete ordinates method in angle, and a discontinuous finite element spatial approach. Results: The spectral radius for the source iteration technique of the time independent transport equation with isotropic and anisotropic scattering centers inside infinite 3D medium is equal to the ratio of differential and total cross sections. The result is confirmed numerically by solving LBTE and is in full agreement with previously published results. The addition of magnetic field reveals that the convergence becomes dependent on the strength of magnetic field, the energy group discretization, and the order of anisotropic expansion. Conclusion: The source iteration technique for solving the LBTE with magnetic fields with the discrete ordinates method leads to divergent solutions in the limiting cases of small energy discretizations and high magnetic field strengths. Future investigations into non-stationary Krylov subspace techniques as an iterative solver will be performed as this has been shown to produce greater stability than source iteration. Furthermore, a stability analysis of a discontinuous finite element space-angle approach (which has been shown to provide the greatest stability) will also be investigated. Dr. B Gino Fallone is a co-founder and CEO of MagnetTx Oncology Solutions (under discussions to license Alberta bi-planar linac MR for commercialization)

60 APPLIED LIFE SCIENCES↗

DOE OSTI2020

Electrolytically Assisted Surface Decontamination (EASD{sup TM}) for POCO Operations - 20282

NNL in collaboration with C-Tech Innovation Ltd and Sellafield Ltd has been exploring innovative technologies to enable a significant reduction of radiological hazards within facilities during the Post Operational Clean Out (POCO) phase of a nuclear plant's life cycle. Reducing the hazard by effectively decontaminating plants in-situ during POCO delivers huge cost reductions for future decommissioning operations. These cost reduction benefits are realized by reducing the number and complexity of remote operations as well as lowering the long-term waste disposal costs. Whilst chemical decontamination can achieve the desired level of decontamination, applying aggressive chemical reagents is hazardous, potentially difficult to control and requires there to be complimentary effluent treatment and waste routes. This work has aimed to develop flexible and controllable decontamination processes which could be operated without the additional complexity and issues associated with chemical decontamination. The processes needed to be relatively fast and effective to minimize the time operators would spend in an active area. In addition, there was a driver to produce decontamination methodologies which generated a secondary waste compatible with current routes and which takes advantage of current waste capacity. The strategy therefore was to come up with a solution that works with, rather than against, the science and engineering behind process plants at Sellafield. Electrolytically Assisted Surface Decontamination (EASD{sup TM}) is an innovative electrochemical decontamination process (developed by NNL and C-Tech Innovation Ltd) that can remove activity from contaminated metal in very short time periods. Application of the patented electric waveform to the surface when treating contaminated metal with nitric acid has been shown to significantly enhance the decontamination performance. When compared to proposed baseline washout procedures at Sellafield, the only change to the process is the applied electrical waveform which is temporary and controllable. The current causes dissolution of the metal surface being decontaminated which leads to activity transferring from the plant item into the nitric acid effluent stream. This innovation has the potential to transform the POCO process and allow a nitric acid based washout approach to deliver POCO quickly and cost effectively within the existing infrastructure. Several devices have now been designed that incorporate this EASD{sup TM} technology and enable the decontamination process to be applied to a range items commonly identified as being contaminated during nuclear decommissioning programmes such as pipework, tanks and hotspots of walls/floors. Inactive and active laboratory-scale testing has been completed using both simulated and 'real-life' contaminated (low level waste) metallic items retrieved from different nuclear sites. Active trials demonstrated that contaminated items could be treated to free release levels within minutes. Engineering scale tests are currently being performed, with guidance from Sellafield's system engineers and plant managers, to provide the necessary re-assurance the designed devices could be successfully deployed in an on-plant scenario. The final stage of this development work is to carry out an active demonstration of the decontamination technology on Thorp at Sellafield. This paper aims to highlight progress made to date with the EASD{sup TM} technology and, more specifically, the development of an in-situ decontamination device for deployment within radioactive pipework. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2015

MO-D-213-08: Remote Dosimetric Credentialing for Clinical Trials with the Virtual EPID Standard Phantom Audit (VESPA)

Purpose: Report on implementation of a Virtual EPID Standard Phantom Audit (VESPA) for IMRT to support credentialing of facilities for clinical trials. Data is acquired by local facility staff and transferred electronically. Analysis is performed centrally. Methods: VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities, provided with web-based comprehensive instructions and CT datasets, create IMRT treatment plans. They deliver the treatments directly to their EPID without phantom or couch in the beam. They also deliver a set of simple calibration fields. Collected EPID images are uploaded electronically. In the analysis, the dose is projected back into a virtual phantom and 3D gamma analysis is performed. 2D dose planes and linear dose profiles can be analysed when needed for clarification. Results: Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Analysis showed agreement comparable to local experience with the method. Advantages of VESPA are (1) fast turnaround mainly driven by the facility’s capability to provide the requested EPID images, (2) the possibility for facilities performing the audit in parallel, as there is no need to wait for a phantom, (3) simple and efficient credentialing for international facilities, (4) a large set of data points, and (5) a reduced impact on resources and environment as there is no need to transport heavy phantoms or audit staff. Limitations of the current implementation of VESPA for trials credentialing are that it does not provide absolute dosimetry, therefore a Level 1 audit still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. Conclusion: The implemented EPID based IMRT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications. VESPA for VMAT will follow soon.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2013

THE FALSE POSITIVE RATE OF KEPLER AND THE OCCURRENCE OF PLANETS

The Kepler mission is uniquely suited to study the frequencies of extrasolar planets. This goal requires knowledge of the incidence of false positives such as eclipsing binaries in the background of the targets, or physically bound to them, which can mimic the photometric signal of a transiting planet. We perform numerical simulations of the Kepler targets and of physical companions or stars in the background to predict the occurrence of astrophysical false positives detectable by the mission. Using real noise level estimates, we compute the number and characteristics of detectable eclipsing pairs involving main-sequence stars and non-main-sequence stars or planets, and we quantify the fraction of those that would pass the Kepler candidate vetting procedure. By comparing their distribution with that of the Kepler Objects of Interest (KOIs) detected during the first six quarters of operation of the spacecraft, we infer the false positive rate of Kepler and study its dependence on spectral type, candidate planet size, and orbital period. We find that the global false positive rate of Kepler is 9.4%, peaking for giant planets (6-22 R{sub Circled-Plus }) at 17.7%, reaching a low of 6.7% for small Neptunes (2-4 R{sub Circled-Plus }), and increasing again for Earth-size planets (0.8-1.25 R{sub Circled-Plus }) to 12.3%. Most importantly, we also quantify and characterize the distribution and rate of occurrence of planets down to Earth size with no prior assumptions on their frequency, by subtracting from the population of actual Kepler candidates our simulated population of astrophysical false positives. We find that 16.5% {+-} 3.6% of main-sequence FGK stars have at least one planet between 0.8 and 1.25 R{sub Circled-Plus} with orbital periods up to 85 days. This result is a significant step toward the determination of eta-earth, the occurrence of Earth-like planets in the habitable zone of their parent stars. There is no significant dependence of the rates of planet occurrence between 0.8 and 4 Earth radii with spectral type. In the process, we also derive a prescription for the signal recovery rate of Kepler that enables a good match to both the KOI size and orbital period distribution, as well as their signal-to-noise distribution.

79 ASTRONOMY AND ASTROPHYSICS↗

DOE OSTI2016

The comparison of 5-field conformal radiotherapy techniques for the treatment of prostate cancer: The best for femoral head sparing

External radiotherapy is a standard treatment procedure for localized prostate cancer. Given the relatively high long term survival treatment complications have been brought in center of attention. In this planning study, between 2012 and 2014, CT simulation data of 90 consecutive high-risk prostate cancer patients were collected. In the first phase, all were planned for whole pelvis irradiation up to 46Gy in 23 daily fractions. In the second phase, only the prostate gland was the target of radiation. Next, the subjects were divided randomly into three groups and each received a unique 5field conformal radiation plan including Plan A (Gantry angle: 0, 60, 120, 240, and 300), Plan B (Gantry angles: 0, 90, 120, 240, and 270) and Plan C (Gantry angles: 0, 60, 90, 270, and 300). The total dose was 70Gy. For each patient, the rectum, bladder, and both femoral heads were contoured as the at risk organs (OAR). From dose volume histograms, the proportional dose of PTV V100, the bladder and rectum V80 and V90 and femoral head V50 and V100 were calculated in all subjects and compared across plans. A statistically significant difference in the femoral head V50 and V100 was found between our studied 5field plans so that in Plan A (beam angles: 0, 60, 120, 240 and 300) less dose was received by both heads of femur. This study suggests that 5 field treatment planning including an anterior, two anterior oblique and two posterior oblique portals to be more proper for 3D conformal radiotherapy in order to spare femoral head with acceptable PTV coverage, and bladder and rectal doses.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2015

TU-AB-201-06: Evaluation of Electromagnetically Guided High- Dose Rate Brachytherapy for Ablative Treatment of Lung Metastases

Purpose: The advent of electromagnetic navigation bronchoscopy has enabled minimally invasive access to peripheral lung tumors previously inaccessible by optical bronchoscopes. As an adjunct to Stereotactic Ablative Radiosurgery (SABR), implantation of HDR catheters can provide focal treatments for multiple metastases and sites of retreatments. The authors evaluate a procedure to deliver ablative doses via Electromagnetically-Guided HDR (EMG-HDR) to lung metastases, quantify the resulting dosimetry, and assess its role in the comprehensive treatment of lung cancer. Methods: A retrospective study was conducted on ten patients, who, from 2009 to 2011, received a hypo-fractionated SABR regimen with 6MV VMAT to lesions in various lobes ranging from 1.5 to 20 cc in volume. A CT visible pathway was delineated for EM guided placement of an HDR applicator (catheter) and dwell times were optimized to ensure at least 98% prescription dose coverage of the GTV. Normal tissue doses were calculated using inhomogeneity corrections via a grid-based Boltzmann solver (Acuros-BV-1.5.0). Results: With EMG-HDR, an average of 83% (+/−9% standard deviation) of each patient’s GTV received over 200% of the prescription dose, as compared to SABR where the patients received an average maximum dose of 125% (+/−5%). EMG-HDR enabled a 59% (+/−12%) decrease in the aorta maximum dose, a 63% (+/−26%) decrease in the spinal cord max dose, and 57% (+/−23%) and 70% (+/−17%) decreases in the volume of the body receiving over 50% and 25% of the prescription dose, respectively. Conclusion: EMG-HDR enables delivery of higher ablative doses to the GTV, while concurrently reducing surrounding normal tissue doses. The single catheter approach shown here is limited to targets smaller than 20 cc. As such, the technique enables ablation of small lesions and a potentially safe and effective retreatment option in situations where external beam utility is limited by normal tissue constraints.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

Effect of annealing on the laser induced damage of polished and CO{sub 2} laser-processed fused silica surfaces

We investigate the effect of different heat treatments on the laser-induced damage probabilities of fused silica samples. Isothermal annealing in a furnace is applied, with different temperatures in the range 700–1100 °C and 12 h annealing time, to super-polished fused silica samples. The surface flatness and laser damage probabilities at 3 ns, 351 nm are measured before and after the different annealing procedures. We have found a significant improvement of the initial laser damage probabilities of the silica surface after annealing at 1050 °C for 12 h. A similar study has been conducted on CO{sub 2} laser-processed sites on the surface of the samples. Before and after annealing, we have studied the morphology of the sites, the evolution of residual stress, and the laser-induced damage threshold measured at 351 nm, 3 ns. In this case, we observe that the laser damage resistance of the laser created craters can reach the damage level of the bare fused silica surface after the annealing process, with a complete stress relieve. The obtained results are then compared to the case of local annealing process by CO{sub 2} laser irradiation during 1 s, and we found similar improvements in both cases. The different results obtained in the study are compared to numerical simulations made with a thermo-mechanical model based on finite-element method that allows the simulation of the isothermal or the local annealing process, the evolution of stress and fictive temperature. The simulation results were found to be very consistent with experimental observations for the stresses evolution after annealing and estimation of the heat affected area during laser-processing based on the density dependence with fictive temperature. Following this work, the temperature for local annealing should reach 1330–1470 °C for an optimized reduction of damage probability and be below the threshold for material removal, whereas furnace annealing should be kept below the annealing point to avoid sample deformation.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2015

SU-F-207-07: Dual-Energy Computed Tomography Detection Limit of Various Radiopaque Contrast Agents That Can Be Infused Within Absorbable Inferior Vena Cava Filters

Purpose: Absorbable IVC filters are shown to be safe and efficacious in preventing pulmonary embolism. These absorbable filters disappear from the body after their required duration, alleviating costly removal procedures and downstream complications. Monitoring the positioning and integrity of absorbable devices using dual-energy computed tomography (DECT) would improve treatment efficacy. The purpose of this study is to determine the limit of detection and the energy dependence of DECT for various contrast agents that may be infused within the IVC filters including gold nanoparticles (AuNP) having diameters of 2 and 4 nm. Methods: All imaging studies were performed on a GE Discovery CT750 system in Gemstone Spectral Imaging (GSI) mode. Plastic vials containing the contrast agent solutions of water and blood were placed in a water bath, and images were acquired with the GSI-5 preset. The images were reformatted into the coronal plane and 5mm diameter ROIs were placed within each solution on a GE Advantage Workstation. Monoenergetic reconstructions were generated from 40 – 140 keV. Results: Mass attenuation (contrast per unit density) for AuNPs was greater than iron, but less than barium and iodine. Contrast was 10.2 (± 3.6) HU for 4 nm AuNP at 0.72 mg/ml and 12.1 (± 4.2) for 2 nm AuNP at 0.31 mg/ml at 70 keV suggesting reasonable chance of visualization at these concentrations for 70 keV reconstruction. The contrast as a function of CT energy is similar in both water and blood. Iodine is most dependent, followed closely by barium and iron, and trailed by a large margin by the AuNP. This was unexpected given Au’s large atomic number and the predominance of photoelectric effect at low energy. Conclusion: Infusion of IVC filters with AuNP is feasible. Discrimination of AuNP-infused IVC filters from surrounding anatomy warrants further investigation.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-I-51: CT/MR Image Deformation: The Clinical Assessment QA in Target Delineation

Purpose: To study the deformation effects in CT/MR image registration of head and neck (HN) cancers. We present a clinical indication in guiding and simplifying registration procedures of this process while CT images possessed artifacts. Methods: CT/MR image fusion provides better soft tissue contrast in intracranial GTV definition with artifacts. However, whether the fusion process should include the deformation process is questionable and not recommended. We performed CT/MR image registration of a HN patient with tonsil GTV and nodes delineation on Varian Velocity™ system. Both rigid transformation and deformable registration of the same CT/MR imaging data were processed separately. Physician’s selection of target delineation was implemented to identify the variations. Transformation matrix was shown with visual identification, as well as the deformation QA numbers and figures were assessed. Results: The deformable CT/MR images were traced with the calculated matrix, both translation and rotational parameters were summarized. In deformable quality QA, the calculated Jacobian matrix was analyzed, which the min/mean/max of 0.73/0/99/1.37, respectively. Jacobian matrix of right neck node was 0.84/1.13/1.41, which present dis-similarity of the nodal area. If Jacobian = 1, the deformation is at the optimum situation. In this case, the deformation results have shown better target delineation for CT/MR deformation than rigid transformation. Though the root-mean-square vector difference is 1.48 mm, with similar rotational components, the cord and vertebrae position were aligned much better in the deformable MR images than the rigid transformation. Conclusion: CT/MR with/without image deformation presents similar image registration matrix; there were significant differentiate the anatomical structures in the region of interest by deformable process. Though vendor suggested only rigid transformation between CT/MR assuming the geometry remain similar, our findings indicated with patient positional variations, deformation registration is needed to generate proper GTV coverage, which will be irradiated more accurately in the following boost phase.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-171: Robust Atlas Based Segmentation of the Prostate and Peripheral Zone Regions On MRI Utilizing Multiple MRI System Vendors

Purpose: Automatically generated prostate MRI contours can be used to aid in image registration with CT or ultrasound and to reduce the burden of contouring for radiation treatment planning. In addition, prostate and zonal contours can assist to automate quantitative imaging features extraction and the analyses of longitudinal MRI studies. These potential gains are limited if the solutions are not compatible across different MRI vendors. The goal of this study is to characterize an atlas based automatic segmentation procedure of the prostate collected on MRI systems from multiple vendors. Methods: The prostate and peripheral zone (PZ) were manually contoured by an expert radiation oncologist on T2-weighted scans acquired on both GE (n=31) and Siemens (n=33) 3T MRI systems. A leave-one-out approach was utilized where the target subject is removed from the atlas before the segmentation algorithm is initiated. The atlas-segmentation method finds the best nine matched atlas subjects and then performs a normalized intensity-based free-form deformable registration of these subjects to the target subject. These nine contours are then merged into a single contour using Simultaneous Truth and Performance Level Estimation (STAPLE). Contour comparisons were made using Dice similarity coefficients (DSC) and Hausdorff distances. Results: Using the T2 FatSat (FS) GE datasets the atlas generated contours resulted in an average DSC of 0.83±0.06 for prostate, 0.57±0.12 for PZ and 0.75±0.09 for CG. Similar results were found when using the Siemens data with a DSC of 0.79±0.14 for prostate, 0.54±0.16 and 0.70±0.9. Contrast between prostate and surrounding anatomy and between the PZ and CG contours for both vendors demonstrated superior contrast separation; significance was found for all comparisons p-value < 0.0001. Conclusion: Atlas-based segmentation yielded promising results for all contours compared to expertly defined contours in both Siemens and GE 3T systems providing fast and automatic segmentation of the prostate. Funding Support, Disclosures, and Conflict of Interest: AS Nelson is a partial owner of MIM Software, Inc. AS Nelson, and A Swallen are current employees at MIM Software, Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

Fully iterative scatter corrected digital breast tomosynthesis using GPU-based fast Monte Carlo simulation and composition ratio update

Purpose: In digital breast tomosynthesis (DBT), scatter correction is highly desirable, as it improves image quality at low doses. Because the DBT detector panel is typically stationary during the source rotation, antiscatter grids are not generally compatible with DBT; thus, a software-based scatter correction is required. This work proposes a fully iterative scatter correction method that uses a novel fast Monte Carlo simulation (MCS) with a tissue-composition ratio estimation technique for DBT imaging. Methods: To apply MCS to scatter estimation, the material composition in each voxel should be known. To overcome the lack of prior accurate knowledge of tissue composition for DBT, a tissue-composition ratio is estimated based on the observation that the breast tissues are principally composed of adipose and glandular tissues. Using this approximation, the composition ratio can be estimated from the reconstructed attenuation coefficients, and the scatter distribution can then be estimated by MCS using the composition ratio. The scatter estimation and image reconstruction procedures can be performed iteratively until an acceptable accuracy is achieved. For practical use, (i) the authors have implemented a fast MCS using a graphics processing unit (GPU), (ii) the MCS is simplified to transport only x-rays in the energy range of 10–50 keV, modeling Rayleigh and Compton scattering and the photoelectric effect using the tissue-composition ratio of adipose and glandular tissues, and (iii) downsampling is used because the scatter distribution varies rather smoothly. Results: The authors have demonstrated that the proposed method can accurately estimate the scatter distribution, and that the contrast-to-noise ratio of the final reconstructed image is significantly improved. The authors validated the performance of the MCS by changing the tissue thickness, composition ratio, and x-ray energy. The authors confirmed that the tissue-composition ratio estimation was quite accurate under a variety of conditions. Our GPU-based fast MCS implementation took approximately 3 s to generate each angular projection for a 6 cm thick breast, which is believed to make this process acceptable for clinical applications. In addition, the clinical preferences of three radiologists were evaluated; the preference for the proposed method compared to the preference for the convolution-based method was statistically meaningful (p < 0.05, McNemar test). Conclusions: The proposed fully iterative scatter correction method and the GPU-based fast MCS using tissue-composition ratio estimation successfully improved the image quality within a reasonable computational time, which may potentially increase the clinical utility of DBT.

60 APPLIED LIFE SCIENCES↗