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All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

TU-G-BRA-08: BEST IN PHYSICS (JOINT IMAGING-THERAPY): Hybrid PET-MRI Imaging of Acute Radiation Induced Cardiac Toxicity

Purpose: To identify the presence of low-dose radiation induced cardiac toxicity in a canine model using hybrid positron emission tomography (PET) and magnetic resonance imaging (MRI). Methods: Research ethics board approval was obtained for a longitudinal imaging study of 5 canines after cardiac irradiation. Animals were imaged at baseline, 1 week post cardiac irradiation, and 1 month post cardiac irradiation using a hybrid PET- MRI system (Biograph mMR, Siemens Healthcare). The imaging protocol was designed to assess acute changes in myocardial perfusion and inflammation. Myocardial perfusion imaging was performed using N13-ammonia tracer followed by a dynamic PET acquisition scan. A compartmental tracer kinetic model was used for absolute perfusion quantification. Myocardial inflammation imaging was performed using F18-fluorodeoxyglucose (FDG) tracer. The standard uptake value (SUV) over a region encompassing the whole heart was used to compare FDG scans. All animals received a simulation CT scan (GE Medical Systems) for radiation treatment planning. Radiation treatment plans were created using the Pinncale3 treatment planning system (Philips Radiation Oncology Systems) and designed to resemble the typical cardiac exposure during left-sided breast cancer radiotherapy. Cardiac irradiations were performed in a single fraction using a TrueBeam linear accelerator (Varian Medical Systems). Results: The delivered dose (mean ± standard deviation) to heart was 1.8±0.2 Gy. Reductions in myocardial stress perfusion relative to baseline were observed in 2 of the 5 animals 1 month post radiation. A global inflammatory response 1 month post radiation was observed in 4 of the 5 animals. The calculated SUV at 1 month post radiation was significantly higher (p=0.05) than the baseline SUV. Conclusion: Low doses of cardiac irradiation (< 2 Gy) may lead to myocardial perfusion defects and a global inflammatory response that can be detectable as early as 1 month post irradiation using hybrid PET-MRI imaging techniques.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Monte Carlo simulations of the dose from imaging with GE eXplore 120 micro-CT using GATE

Purpose: Small animals are increasingly used as translational models in preclinical imaging studies involving microCT, during which the subjects can be exposed to large amounts of radiation. While the radiation levels are generally sublethal, studies have shown that low-level radiation can change physiological parameters in mice. In order to rule out any influence of radiation on the outcome of such experiments, or resulting deterministic effects in the subjects, the levels of radiation involved need to be addressed. The aim of this study was to investigate the radiation dose delivered by the GE eXplore 120 microCT non-invasively using Monte Carlo simulations in GATE and to compare results to previously obtained experimental values. Methods: Tungsten X-ray spectra were simulated at 70, 80, and 97 kVp using an analytical tool and their half-value layers were simulated for spectra validation against experimentally measured values of the physical X-ray tube. A Monte Carlo model of the microCT system was set up and four protocols that are regularly applied to live animal scanning were implemented. The computed tomography dose index (CTDI) inside a PMMA phantom was derived and multiple field of view acquisitions were simulated using the PMMA phantom, a representative mouse and rat. Results: Simulated half-value layers agreed with experimentally obtained results within a 7% error window. The CTDI ranged from 20 to 56 mGy and closely matched experimental values. Derived organ doses in mice reached 459 mGy in bones and up to 200 mGy in soft tissue organs using the highest energy protocol. Dose levels in rats were lower due to the increased mass of the animal compared to mice. The uncertainty of all dose simulations was below 14%. Conclusions: Monte Carlo simulations proved a valuable tool to investigate the 3D dose distribution in animals from microCT. Small animals, especially mice (due to their small volume), receive large amounts of radiation from the GE eXplore 120 microCT, which might alter physiological parameters in a longitudinal study setup.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Radiation-induced DNA damage and the relative biological effectiveness of 18 F-FDG in wild-type mice

Clinically, the most commonly used positron emission tomography (PET) radiotracer is the glucose analog 2-[ 18 F] fluoro-2-deoxy-d-glucose ( 18 F-FDG), however little research has been conducted on the biological effects of 18 F-FDG injections. The induction and repair of DNA damage and the relative biological effectiveness (RBE) of radiation from 18 F-FDG relative to 662 keV γ-rays were investigated. The study also assessed whether low-dose radiation exposure from 18 F-FDG was capable of inducing an adaptive response. DNA damage to the bone marrow erythroblast population was measured using micronucleus formation and lymphocyte γH2A.X levels. To test the RBE of 18 F-FDG, mice were injected with a range of activities of 18 F-FDG (0–14.80 MBq) or irradiated with Cs-137 γ-rays (0–100 mGy). The adaptive response was investigated 24 h after the 18 F-FDG injection by 1 Gy in vivo challenge doses for micronucleated reticulocyte (MN-RET) formation or 1, 2 and 4 Gy in vitro challenges doses for γH2A.X formation. A significant increase in MN-RET formation above controls occurred following injection activities of 3.70, 7.40 or 14.80 MBq (P < 0.001) which correspond to bone marrow doses of ~35, 75 and 150 mGy, respectively. Per unit dose, the Cs-137 radiation exposure induced significantly more damage than the 18 F-FDG injections (RBE = 0.79 ± 0.04). A 20% reduction in γH2A.X fluorescence was observed in mice injected with a prior adapting low dose of 14.80 MBq 18 F-FDG relative to controls (P < 0.019). A 0.74 MBq 18 F-FDG injection, which gives mice a dose approximately equal to a typical human PET scan, did not cause a significant increase in DNA damage nor did it generate an adaptive response. Typical 18 F-FDG injection activities used in small animal imaging (14.80 MBq) resulted in a decrease in DNA damage, as measured by γH2A.X formation, below spontaneous levels observed in control mice. Lastly, the 18 F-FDG RBE was <1.0, indicating that the mixed radiation quality and/or low dose rate from PET scans is less damaging than equivalent doses of gamma radiation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Low dose dynamic CT myocardial perfusion imaging using a statistical iterative reconstruction method

Purpose: Dynamic CT myocardial perfusion imaging has the potential to provide both functional and anatomical information regarding coronary artery stenosis. However, radiation dose can be potentially high due to repeated scanning of the same region. The purpose of this study is to investigate the use of statistical iterative reconstruction to improve parametric maps of myocardial perfusion derived from a low tube current dynamic CT acquisition. Methods: Four pigs underwent high (500 mA) and low (25 mA) dose dynamic CT myocardial perfusion scans with and without coronary occlusion. To delineate the affected myocardial territory, an N-13 ammonia PET perfusion scan was performed for each animal in each occlusion state. Filtered backprojection (FBP) reconstruction was first applied to all CT data sets. Then, a statistical iterative reconstruction (SIR) method was applied to data sets acquired at low dose. Image voxel noise was matched between the low dose SIR and high dose FBP reconstructions. CT perfusion maps were compared among the low dose FBP, low dose SIR and high dose FBP reconstructions. Numerical simulations of a dynamic CT scan at high and low dose (20:1 ratio) were performed to quantitatively evaluate SIR and FBP performance in terms of flow map accuracy, precision, dose efficiency, and spatial resolution. Results: Forin vivo studies, the 500 mA FBP maps gave −88.4%, −96.0%, −76.7%, and −65.8% flow change in the occluded anterior region compared to the open-coronary scans (four animals). The percent changes in the 25 mA SIR maps were in good agreement, measuring −94.7%, −81.6%, −84.0%, and −72.2%. The 25 mA FBP maps gave unreliable flow measurements due to streaks caused by photon starvation (percent changes of +137.4%, +71.0%, −11.8%, and −3.5%). Agreement between 25 mA SIR and 500 mA FBP global flow was −9.7%, 8.8%, −3.1%, and 26.4%. The average variability of flow measurements in a nonoccluded region was 16.3%, 24.1%, and 937.9% for the 500 mA FBP, 25 mA SIR, and 25 mA FBP, respectively. In numerical simulations, SIR mitigated streak artifacts in the low dose data and yielded flow maps with mean error <7% and standard deviation <9% of mean, for 30×30 pixel ROIs (12.9 × 12.9 mm{sup 2}). In comparison, low dose FBP flow errors were −38% to +258%, and standard deviation was 6%–93%. Additionally, low dose SIR achieved 4.6 times improvement in flow map CNR{sup 2} per unit input dose compared to low dose FBP. Conclusions: SIR reconstruction can reduce image noise and mitigate streaking artifacts caused by photon starvation in dynamic CT myocardial perfusion data sets acquired at low dose (low tube current), and improve perfusion map quality in comparison to FBP reconstruction at the same dose.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Non-radiation risk factors for leukemia: A case-control study among chornobyl cleanup workers in Ukraine

Background: Occupational and environmental exposure to chemicals such as benzene has been linked to increased risk of leukemia. Cigarette smoking and alcohol consumption have also been found to affect leukemia risk. Previous analyses in a large cohort of Chornobyl clean-up workers in Ukraine found significant radiation-related increased risk for all leukemia types. We investigated the potential for additional effects of occupational and lifestyle factors on leukemia risk in this radiation-exposed cohort. Methods: In a case-control study of chronic lymphocytic and other leukemias among Chornobyl cleanup workers, we collected data on a range of non-radiation exposures. We evaluated these and other potential risk factors in analyses adjusting for estimated bone marrow radiation dose. We calculated Odds Ratios and 95% Confidence Intervals in relation to lifestyle factors and occupational hazards. Results: After adjusting for radiation, we found no clear association of leukemia risk with smoking or alcohol but identified a two-fold elevated risk for non-CLL leukemia with occupational exposure to petroleum (OR=2.28; 95% Confidence Interval 1.13, 6.79). Risks were particularly high for myeloid leukemias. No associations with risk factors other than radiation were found for chronic lymphocytic leukemia. Conclusions: These data – the first from a working population in Ukraine – add to evidence from several previous reports of excess leukemia morbidity in groups exposed environmentally or occupationally to petroleum or its products. - Highlights: • A unique population – a cohort of 110,645 Chernobyl clean-up workers from Ukraine. • Followed 1986–2006 for leukemia, interviewed about non-radiation risk factors. • Petroleum exposure increased risk for non-CLL leukemias, particularly CML. • No risk factor other than radiation was found for CLL.

54 ENVIRONMENTAL SCIENCES↗
NASA NTRS2006

Visual Risk Assessment of Space Radiation Exposure for Future Space Exploration Missions

Protecting astronauts from space radiation exposure during an interplanetary mission is an important challenge for mission design and operations. If sufficient protection is not provided near solar maximum, the risk can be significant due to exposure to sporadic solar particle events (SPEs) as well as to the continuous galactic cosmic radiation (GCR). Polyethylene shielded "storm shelters" inside spacecraft have been shown to limit total exposure from a large SPE to a permissible level, preventing acute risks and providing a potential approach to fulfill the ALARA (as low as reasonably achievable) requirement. For accurate predictions of radiation dose to astronauts involved in future space exploration missions, detailed variations of radiation shielding properties are required. Radiation fluences and doses vary considerably across both the spacecraft geometry and the body-shielding distribution. A model using a modern CAD tool ProE(TradeMark), which is the leading engineering design platform at NASA, has been developed to account for these local variations in the radiation distribution. Visual assessment of radiation distribution at different points inside a spacecraft module and in the human body for a given radiation environment are described. Results will ultimately guide in developing requirements for maximal protection for astronauts from space radiation.

Hussein, Hesham F.↗
DOE OSTI2014

TH-C-17A-09: Direct Visualization and Monitoring of Medical Radiation Beams in Air

Purpose: Radiation therapy errors are rare but potentially catastrophic. Recent fatal incidents could have been avoided by utilizing real-time methods of monitoring delivery of radiation during treatment. However, few existing methods are practical enough to be used routinely. The study presents the first experimental demonstration of a novel non-perturbing method of monitoring radiation therapy through the phenomena of air scintillation. Methods: Monitoring of radiation delivery was devised by leveraging the phenomena of nitrogen excitation in air by ionizing radiation. The excitation induced weak luminescence in the 300–400 nm range, a process called air scintillation. An electron-multiplication charge-coupled device camera (f/0.95 lens; 440 nm shortpass) was set-up in a clinical treatment vault and was used to capture air scintillation images of kilovoltage and megavoltage beams. Monte Carlo simulations were performed to determine the correlation of radiation dose to air scintillation. Results: Megavoltage beams from a Varian Clinac 21EX and kilovoltage beams from an orthovoltage unit (50 kVp, 30 mA) were visualized with a relatively short exposure time (10 s). Cherenkov luminescence produced in a plastic transparent phantom did not interfere with detection of air scintillation. The image intensity displayed an inverse intensity falloff (r{sup 2} = 0.89) along the central axis and was proportional to dose rate (r{sup 2} = 0.9998). As beam energy increased, the divergence of the imaged beam decreased. Last, air scintillation was visualized during a simulated total skin irradiation electron treatment. Conclusion: Air scintillation can be clinically detected to monitor a radiation beam in an inexpensive and non-perturbing manner. This new method is advantageous in monitoring for gross delivery and uniquely capable of wide area in a single acquisition, such as the case for online verification of total body / skin / lymphoid irradiation treatments.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Evaluation of Simplified Models for Estimating Public Dose from Spent Nuclear Fuel Shipments

This paper investigates the dose rate as a function of distance from a representative high-capacity SNF rail-type transportation cask. It uses the SCALE suite of radiation transport modeling and simulation codes to determine neutron and gamma radiation dose rates. The SCALE calculated dose rate is compared with simplified analytical methods historically used for these calculations. The SCALE dose rate calculation presented in this paper employs a very detailed transportation cask model (e.g., pin-by-pin modeling of fuel assembly) and a new hybrid computational transport method. Because it includes pin-level heterogeneity and models ample air and soil outside the cask to simulate scattering of gamma and neutron radiation, this detailed SCALE model is expected to yield more accurate results than previously used models which made more simplistic assumptions (e.g., fuel assembly treated as a point or line source, simple 1-D model of environment outside of cask). The results in this paper are preliminary and, as progress is made on developing and validating improved models, results may be subject to change as models and estimates become more refined and better information leads to more accurate assumptions.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-56: A Novel Approach to Computing Expected Value and Variance of Point Dose From Non-Gated Radiotherapy Delivery

Purpose: Randomness in patient internal organ motion phase at the beginning of non-gated radiotherapy delivery may introduce uncertainty to dose received by the patient. Concerns of this dose deviation from the planned one has motivated many researchers to study this phenomenon although unified theoretical framework for computing it is still missing. This study was conducted to develop such framework for analyzing the effect. Methods: Two reasonable assumptions were made: a) patient internal organ motion is stationary and periodic; b) no special arrangement is made to start a non -gated radiotherapy delivery at any specific phase of patient internal organ motion. A statistical ensemble was formed consisting of patient’s non-gated radiotherapy deliveries at all equally possible initial organ motion phases. To characterize the patient received dose, statistical ensemble average method is employed to derive formulae for two variables: expected value and variance of dose received by a patient internal point from a non-gated radiotherapy delivery. Fourier Series was utilized to facilitate our analysis. Results: According to our formulae, the two variables can be computed from non-gated radiotherapy generated dose rate time sequences at the point’s corresponding locations on fixed phase 3D CT images sampled evenly in time over one patient internal organ motion period. The expected value of point dose is simply the average of the doses to the point’s corresponding locations on the fixed phase CT images. The variance can be determined by time integration in terms of Fourier Series coefficients of the dose rate time sequences on the same fixed phase 3D CT images. Conclusion: Given a non-gated radiotherapy delivery plan and patient’s 4D CT study, our novel approach can predict the expected value and variance of patient radiation dose. We expect it to play a significant role in determining both quality and robustness of patient non-gated radiotherapy plan.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2018

Activation in injection area of J-PARC 3-GeV rapid cycling synchrotron and its countermeasures - 25344

The 3-GeV rapid cycling synchrotron in Japan Proton Accelerator Research Complex aims to deliver a 1-MW proton beam to the neutron target and the main ring synchrotron. The existing beam power of the Rapid Cycling Synchrotron is up to 500 kW, and higher radiation doses are concentrated in the injection area. These activations are caused by the interaction between the foil and the beam. To reduce dose exposure to workers near the injection point, we study a new design of the injection scheme to secure sufficient space for radiation shielding and bellows. Experience has shown that eddy currents are generated in the metal flange near the magnet owing to the effect of the pulsed magnetic field used for injection, and the temperature exceeds 100 deg. C. The shield installed in the new injection system needs to have a layer structure, in which an insulator is inserted between iron shields to reduce the eddy current. From the results of the shielding calculation, even if 1 mm of polyethylene was inserted between two 9-mm-thick SUS 316 plates, which serve as shielding material, the shielding performance was reduced only about 5%, and we confirmed that it would function well. (authors)

43 PARTICLE ACCELERATORS↗
DOE OSTI2016

SU-F-J-16: Planar KV Imaging Dose Reduction Study

Purpose: IGRT has become an indispensable tool in modern radiotherapy with kV imaging used in many departments due to superior image quality and lower dose when compared to MV imaging. Many departments use manufacturer supplied protocols for imaging which are not always optimised between image quality and radiation dose (ALARA). Methods: Whole body phantom PBU-50 (Kyoto Kagaku ltd., Japan) for imaging in radiology has been imaged on Varian iX accelerator (Varian Medical Systems, USA) with OBI 1.5 system. Manufacturer’s default protocols were adapted by modifying kV and mAs values when imaging different anatomical regions of the phantom (head, thorax, abdomen, pelvis, extremities). Images with different settings were independently reviewed by two persons and their suitability for IGRT set-up correction protocols were evaluated. The suitable images with the lowest mAs were then selected. The entrance surface dose (ESD) for manufacturer’s default protocols and modified protocols were measured with RTI Black Piranha (RTI Group, Sweden) and compared. Image quality was also measured with kVQC phantom (Standard Imaging, USA) for different protocols. The modified protocols have been applied for clinical work. Results: For most cases optimized protocols reduced the ESD on average by a factor of 3(range 0.9–8.5). Further reduction in ESD has been observed by applying bow-tie filter designed for CBCT. The largest reduction in dose (12.2 times) was observed for Thorax lateral protocol. The dose was slightly increased (by 10%) for large pelvis AP protocol. Conclusion: Manufacturer’s default IGRT protocols could be optimised to reduce the ESD to the patient without losing the necessary image quality for patient set-up correction. For patient set-up with planar kV imaging the bony anatomy is mostly used and optimization should focus on this aspect. Therefore, the current approach with anthropomorphic phantom is more advantageous in optimization over standard kV quality control phantoms and SNR metrics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

MO-FG-CAMPUS-IeP1-01: Alternative K-Edge Filters for Low-Energy Image Acquisition in Contrast Enhanced Spectral Mammography

Purpose: In Contrast Enhanced Spectral Mammography (CESM), Rh filter is often used during low-energy image acquisition. The potential for using Ag, In and Sn filters, which exhibit K-edge closer to, and just below that of Iodine, instead of the Rh filter, was investigated for the low-energy image acquisition. Methods: Analytical computations of the half-value thickness (HVT) and the photon fluence per mAs (photons/mm2/mAs) for 50µm Rh were compared with other potential K-edge filters (Ag, In and Sn), all with K-absorption edge below that of Iodine. Two strategies were investigated: fixed kVp and filter thickness (50µm for all filters) resulting in HVT variation, and fixed kVp and HVT resulting in variation in Ag, In and Sn thickness. Monte Carlo simulations (GEANT4) were conducted to determine if the scatter-to-primary ratio (SPR) and the point spread function of scatter (scatter PSF) differed between Rh and other K-edge filters. Results: Ag, In and Sn filters (50µm thick) increased photon fluence/mAs by 1.3–1.4, 1.8–2, and 1.7–2 at 28-32 kVp compared to 50µm Rh, which could decrease exposure time. Additionally, the fraction of spectra closer to and just below Iodine’s K-edge increased with these filters, which could improve post-subtraction image contrast. For HVT matched to 50µm Rh filtered spectra, the thickness range for Ag, In, and Sn were (41,44)µm, (49,55)µm and (45,53)µm, and increased photon fluence/mAs by 1.5–1.7, 1.6–2, and 1.6–2.2, respectively. Monte Carlo simulations showed that neither the SPR nor the scatter PSF of Ag, In and Sn differed from Rh, indicating no additional detriment due to x-ray scatter. Conclusion: The use of Ag, In and Sn filters for low-energy image acquisition in CESM is potentially feasible and could decrease exposure time and may improve post-subtraction image contrast. Effect of these filters on radiation dose, contrast, noise and associated metrics are being investigated. Funding Support: Supported in part by NIH R01CA195512. The contents are solely the responsibility of the authors and do not reflect the official views of the NIH or NCI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

A dual-view digital tomosynthesis imaging technique for improved chest imaging

Purpose: Digital tomosynthesis (DTS) has been shown to be useful for reducing the overlapping of abnormalities with anatomical structures at various depth levels along the posterior–anterior (PA) direction in chest radiography. However, DTS provides crude three-dimensional (3D) images that have poor resolution in the lateral view and can only be displayed with reasonable quality in the PA view. Furthermore, the spillover of high-contrast objects from off-fulcrum planes generates artifacts that may impede the diagnostic use of the DTS images. In this paper, the authors describe and demonstrate the use of a dual-view DTS technique to improve the accuracy of the reconstructed volume image data for more accurate rendition of the anatomy and slice images with improved resolution and reduced artifacts, thus allowing the 3D image data to be viewed in views other than the PA view. Methods: With the dual-view DTS technique, limited angle scans are performed and projection images are acquired in two orthogonal views: PA and lateral. The dual-view projection data are used together to reconstruct 3D images using the maximum likelihood expectation maximization iterative algorithm. In this study, projection images were simulated or experimentally acquired over 360° using the scanning geometry for cone beam computed tomography (CBCT). While all projections were used to reconstruct CBCT images, selected projections were extracted and used to reconstruct single- and dual-view DTS images for comparison with the CBCT images. For realistic demonstration and comparison, a digital chest phantom derived from clinical CT images was used for the simulation study. An anthropomorphic chest phantom was imaged for the experimental study. The resultant dual-view DTS images were visually compared with the single-view DTS images and CBCT images for the presence of image artifacts and accuracy of CT numbers and anatomy and quantitatively compared with root-mean-square-deviation (RMSD) values computed using the digital chest phantom or the CBCT images as the reference in the simulation and experimental study, respectively. High-contrast wires with vertical, oblique, and horizontal orientations in a PA view plane were also imaged to investigate the spatial resolutions and how the wire signals spread in the PA view and lateral view slice images. Results: Both the digital phantom images (simulated) and the anthropomorphic phantom images (experimentally generated) demonstrated that the dual-view DTS technique resulted in improved spatial resolution in the depth (PA) direction, more accurate representation of the anatomy, and significantly reduced artifacts. The RMSD values corroborate well with visual observations with substantially lower RMSD values measured for the dual-view DTS images as compared to those measured for the single-view DTS images. The imaging experiment with the high-contrast wires shows that while the vertical and oblique wires could be resolved in the lateral view in both single- and dual-view DTS images, the horizontal wire could only be resolved in the dual-view DTS images. This indicates that with single-view DTS, the wire signals spread liberally to off-fulcrum planes and generated wire shadow there. Conclusions: The authors have demonstrated both visually and quantitatively that the dual-view DTS technique can be used to achieve more accurate rendition of the anatomy and to obtain slice images with improved resolution and reduced artifacts as compared to the single-view DTS technique, thus allowing the 3D image data to be viewed in views other than the PA view. These advantages could make the dual-view DTS technique useful in situations where better separation of the objects-of-interest from the off-fulcrum structures or more accurate 3D rendition of the anatomy are required while a regular CT examination is undesirable due to radiation dose considerations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-166: Evaluation of Integral Dose in Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Head and Neck Cancer Patient

Purpose: Volumetric Modulated Arc Therapy (VMAT) usually achieves higher conformity of radiation doses to targets and less delivery time than Intensity Modulated Radiation Therapy (IMRT). We hypothesized that VMAT will increase integral dose (ID) to patients which will decrease the count of white blood count (WBC) lymphocytes, and consequently has a subsequent impact on the immune system. The purpose of this study is to evaluate the ID to patients undergoing IMRT and VMAT for Head and Neck cancers and its impact on the immune system. Methods: As a pilot study, 30 head and neck patients who received 9-fields IMRT or 3-arcs Radip-Arcbased VMAT were included in this study. Ten of these patients who received the VMAT plans were re-planned using IMRT with the same objectives. ID was calculated for all cases. All patients also had a baseline WBC obtained prior to treatment, and 3 sets of labs drawn during the course of radiation treatment. Results: For the 10 re-planned patients, the mean ID was 13.3 Gy/voxel (range 10.2–17.5 Gy/voxel) for the 9-fields IMRT plans, and was 15.9 Gy/voxel (range 12.4-20.9 Gy/voxel) for the 3-Arc VMAT plan (p=0.01). The integral dose was significant correlated with reducing WBC count during RT even when controlling for concurrent chemotherapy (R square =0.56, p=0.008). Conclusion: Although VMAT can deliver higher radiation dose conformality to targets, this benefit is achieved generally at the cost of greater integral doses to normal tissue outside the planning target volume (PTV). Lower WBC counts during RT were associated with higher Integral doses even when controlling for concurrent chemotherapy. This study is ongoing in our Institution to exam the impact of integral doses and WBC on overall survival.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2002

Dose and dose rate effects of whole-body proton-irradiation on lymphocyte blastogenesis and hematological variables: part II

The goal of part II of this study was to evaluate functional characteristics of leukocytes and circulating blood cell parameters after whole-body proton irradiation at varying doses and at low- and high-dose-rates (LDR and HDR, respectively). C57BL/6 mice (n=51) were irradiated and euthanized at 4 days post-exposure for assay. Significant radiation dose- (but not dose-rate-) dependent decreases were observed in splenocyte responses to T and B cell mitogens when compared to sham-irradiated controls (P<0.001). Spontaneous blastogenesis, also significantly dose-dependent, was increased in both blood and spleen (P<0.001). Red blood cell counts, hemoglobin concentration, and hematocrit were decreased in a dose-dependent manner (P<0.05), whereas thrombocyte numbers were only slightly affected. Comparison of proton- and gamma-irradiated groups (both receiving 3 Gy at HDR) showed a higher level of spontaneous blastogenesis in blood leukocytes and a lower splenocyte response to concanavalin A following proton irradiation (P<0.05). There were no dose rate effects. Collectively, the data demonstrate that the measurements in blood and spleen were largely dependent upon the total dose of proton radiation and that an 80-fold difference in the dose rate was not a significant factor. A difference, however, was found between protons and gamma-rays in the degree of change induced in some of the measurements.

Non-NASA Center↗
DOE OSTI2016

SU-G-206-06: Analytic Dose Function for CT Scans in Infinite Cylinders as a Function of Scan Length and Cylinder Radius

Purpose: The radiation dose absorbed at a particular radius ρ within the central plane of a long cylinder following a CT scan is a function of the length of the scan L and the cylinder radius R along with kVp and cylinder composition. An analytic function was created that that not only expresses these dependencies but is integrable in closed form over the area of the central plane. This feature facilitates explicit calculation of the planar average dose. The “approach to equilibrium” h(L) discussed in the TG111 report is seamlessly included in this function. Methods: For a cylindrically symmetric radiation field, Monte Carlo calculations were performed to compute the dose distribution to long polyethylene cylinders for scans of varying L for cylinders ranging in radius from 5 to 20 cm. The function was developed from the resultant Monte Carlo data. In addition, the function was successfully fit to data taken from measurements on the 30 cm diameter ICRU/TG200 phantom using a real-time dosimeter. Results: Symmetry and continuity dictate a local extremum at the center which is a minimum for the larger sizes. There are competing effects as the beam penetrates the cylinder from the outside: attenuation, resulting in a decrease; scatter, abruptly increasing at the circumference. This competition may result in an absolute maximum between the center and outer edge leading to a “gull wing” shape for the radial dependence. For the smallest cylinders, scatter may dominate to the extent that there is an absolute maximum at the center. Conclusion: An integrable, analytic function has been developed that provides the radial dependency of dose for the central plane of a scan of length L for cylinders of varying diameter. Equivalently, we have developed h(L,R,ρ).

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Changes in Imaging and Cognition in Juvenile Rats After Whole-Brain Irradiation

Purpose: In pediatric cancer survivors treated with whole-brain irradiation (WBI), long-term cognitive deficits and morbidity develop that are poorly understood and for which there is no treatment. We describe similar cognitive defects in juvenile WBI rats and correlate them with alterations in diffusion tensor imaging and magnetic resonance spectroscopy (MRS) during brain development. Methods and Materials: Juvenile Fischer rats received clinically relevant fractionated doses of WBI or a high-dose exposure. Diffusion tensor imaging and MRS were performed at the time of WBI and during the subacute (3-month) and late (6-month) phases, before behavioral testing. Results: Fractional anisotropy in the splenium of the corpus callosum increased steadily over the study period, reflecting brain development. WBI did not alter the subacute response, but thereafter there was no further increase in fractional anisotropy, especially in the high-dose group. Similarly, the ratios of various MRS metabolites to creatine increased over the study period, and in general, the most significant changes after WBI were during the late phase and with the higher dose. The most dramatic changes observed were in glutamine-creatine ratios that failed to increase normally between 3 and 6 months after either radiation dose. WBI did not affect the ambulatory response to novel open field testing in the subacute phase, but locomotor habituation was impaired and anxiety-like behaviors increased. As for cognitive measures, the most dramatic impairments were in novel object recognition late after either dose of WBI. Conclusions: The developing brains of juvenile rats given clinically relevant fractionated doses of WBI show few abnormalities in the subacute phase but marked late cognitive alterations that may be linked with perturbed MRS signals measured in the corpus callosum. This pathomimetic phenotype of clinically relevant cranial irradiation effects may be useful for modeling, mechanistic evaluations, and testing of mitigation approaches.

62 RADIOLOGY AND NUCLEAR MEDICINE↗