Feature-Based Statistical Analysis of Combustion Simulation Data
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Visualization and analysis of multivariate data and their uncertainty are top research challenges in data visualization. Constructing fiber surfaces is a popular technique for multivariate data visualization that generalizes the idea of level-set visualization for univariate data to multivariate data. Here, in this paper, we present a statistical framework to quantify positional probabilities of fibers extracted from uncertain bivariate fields. Specifically, we extend the state-of-the-art Gaussian models of uncertainty for bivariate data to other parametric distributions (e.g., uniform and Epanechnikov) and more general nonparametric probability distributions (e.g., histograms and kernel density estimation) and derive corresponding spatial probabilities of fibers. In our proposed framework, we leverage Green's theorem for closed-form computation of fiber probabilities when bivariate data are assumed to have independent parametric and nonparametric noise. Additionally, we present a nonparametric approach combined with numerical integration to study the positional probability of fibers when bivariate data are assumed to have correlated noise. For uncertainty analysis, we visualize the derived probability volumes for fibers via volume rendering and extracting level sets based on probability thresholds. We present the utility of our proposed techniques via experiments on synthetic and simulation datasets.
This paper presents a novel end-to-end framework for closed-form computation and visualization of critical point uncertainty in 2D uncertain scalar fields. Critical points are fundamental topological descriptors used in the visualization and analysis of scalar fields. The uncertainty inherent in data (e.g., observational and experimental data, approximations in simulations, and compression), however, creates uncertainty regarding critical point positions. Uncertainty in critical point positions, therefore, cannot be ignored, given their impact on downstream data analysis tasks. Here, in this work, we study uncertainty in critical points as a function of uncertainty in data modeled with probability distributions. Although Monte Carlo (MC) sampling techniques have been used in prior studies to quantify critical point uncertainty, they are often expensive and are infrequently used in production-quality visualization software. We, therefore, propose a new end-to-end framework to address these challenges that comprises a threefold contribution. First, we derive the critical point uncertainty in closed form, which is more accurate and efficient than the conventional MC sampling methods. Specifically, we provide the closed-form and semianalytical (a mix of closed-form and MC methods) solutions for parametric (e.g., uniform, Epanechnikov) and nonparametric models (e.g., histograms) with finite support. Second, we accelerate critical point probability computations using a parallel implementation with the VTK-m library, which is platform portable. Finally, we demonstrate the integration of our implementation with the ParaView software system to demonstrate near-real-time results for real datasets.
Aim: Primary biodiversity data constitute observations of particular species at given points in space and time. Open-access databases provide unprecedented access to these data, but their utility depends on how complete species inventories are at a given surveying resolution and how uniformly distributed surveys are in space and time. Our aim was to characterize the completeness of freshwater fish data across spatial scales and among habitat types (lotic stream reaches and lentic waterbodies), and assess coverage bias in space and time. Location: Freshwater habitats of the contiguous United States. Methods: We compiled fish occurrence records from the Global Biodiversity Information Facility (GBIF), the Multi-state Aquatic Resources Information Server (MARIS), and three federally-administered surveys (EMAP, NAQWA, NRS). Next, we evaluated survey completeness across seven spatial resolutions representing nested stream catchments, and separately for lotic and lentic habitats. Lastly, we tested for bias in survey coverage along environmental and temporal gradients for each habitat type. Results: A total of 39,855,157 records representing 1925 species were available from 1800 to 2014. The percent of catchments surveyed increased as spatial resolution decreased while the density of occurrence records within surveyed catchments decreased. Species richness also increased with catchment size consistent with putative species–area relationships. Occurrence records were distributed among 72,114 lotic reaches and 3,325 lentic waterbodies throughout the contiguous US. Seven percent (N=5,055) of surveyed lotic reaches and 23% (N=771) of surveyed lentic waterbodies were well-surveyed based on the most conservative thresholds for two completeness indices. Most well-surveyed lotic reaches (95%) and undammed lentic waterbodies (97%) were completed since 1980, and most were surveyed during only one 20-year time interval (83% and 56% for lotic and lentic waterbodies, respectively). Coverage analyses indicated that contemporary and future climates corresponding to regions along the west coast and gulf coast are the most under-represented for both lotic and lentic habitats. Small lentic waterbodies (surface area < 0.1 km2) are also under-represented. Main Conclusions: Contemporary surveys of lotic reaches and, to a lesser extent, lentic waterbodies are plentiful and generally representative of climatic and landscape characteristics. Data compilation efforts should focus on adding historical data to public repositories. Clustering of well-surveyed waterbodies in MARIS-participating states highlights the value of state-agency data and demonstrates the need for dissemination of these data by more state agencies.
An avalanche effect yielding inherent gain can be exploited in thin, single-crystal chemical vapor deposition (scCVD) diamond. It occurs when a high enough bias is applied across the diamond thickness while avoiding breakdown. This charge multiplication effect was studied previously with alpha particles and heavy ions either by using the transient current technique or by measuring the energy spectrum. The measurements we obtained to evaluate the charge multiplication performance of a 10 μm thick scCVD diamond detector used a novel approach—we employed an electrometer to characterize the response of the detector by performing directly coupled current measurements (time-averaged charge, at 1 Hz sampling) when exposed to 14.1 MeV neutrons from deuterium-tritium fusion. We measured both the dark and irradiated currents from the detector over a range of applied displacement field values from 2 to 75 V/μm. A histogram method with central mean and standard deviation width was used to determine the current over each measurement duration typically from 100 to 300 seconds. The dark-subtracted irradiated current (i.e., contrast) was used to evaluate the gain of the detector at each applied displacement field. The contrast at an applied displacement field between 15 and 20 V/μm was higher than the expected linear increase in contrast proportional to the increased applied bias, indicating the possible presence of avalanche events in the diamond. The detector response also indicated possible polarization and charge depletion effects. These results provide an opportunity to further explore the use of thin scCVD diamond as a fast neutron current mode detector with inherent gain.
Coatings of conducting gold-black nano-structures on commercial thin-film amorphous-silicon solar cells enhance the short-circuit current by 20% over a broad spectrum from 400 to 800 nm wavelength. The efficiency, i.e. the ratio of the maximum electrical output power to the incident solar power, is found to increase 7% for initial un-optimized coatings. Metal blacks are produced cheaply and quickly in a low-vacuum process requiring no lithographic patterning. The inherently broad particle-size distribution is responsible for the broad spectrum enhancement in comparison to what has been reported for mono-disperse lithographically deposited or self-assembled metal nano-particles. Photoemission electron microscopy reveals the spatial-spectral distribution of hot-spots for plasmon resonances, where scattering of normally-incident solar flux into the plane increases the effective optical path in the thin film to enhance light harvesting. Efficiency enhancement is correlated with percent coverage and particle size distribution, which are determined from histogram and wavelet analysis of scanning electron microscopy images. Electrodynamic simulations reveal how the gold-black particles scatter the radiation and locally enhance the field strength.
Purpose: AccuBoost is a noninvasive image-guided technique for the delivery of partial breast irradiation to the tumor bed and currently serves as an alternate to conventional electron beam boost. To irradiate the target volume while providing dose sparing to the skin, the round applicator design was augmented through the addition of an internally truncated conical shield and the reduction of the source to skin distance. Methods: Brachytherapy dose distributions for two types of conical applicators were simulated and estimated using Monte Carlo (MC) methods for radiation transport and a conventional treatment planning system (TPS). MC-derived and TPS-generated dose volume histograms (DVHs) and dose distribution data were compared for both the conical and round applicators for benchmarking purposes. Results: Agreement using the gamma-index test was {>=}99.95% for distance to agreement and dose accuracy criteria of 2 mm and 2%, respectively. After observing good agreement, TPS DVHs and dose distributions for the conical and round applicators were obtained and compared. Brachytherapy dose distributions generated using Pinnacle{sup 3} for ten CT data sets showed that the parallel-opposed beams of the conical applicators provided similar PTV coverage to the round applicators and reduced the maximum dose to skin, chest wall, and lung by up to 27%, 42%, and 43%, respectively. Conclusions: Brachytherapy dose distributions for the conical applicators have been generated using MC methods and entered into the Pinnacle{sup 3} TPS via the Tufts technique. Treatment planning metrics for the conical AccuBoost applicators were significantly improved in comparison to those for conventional electron beam breast boost.
Purpose: Focused radiation therapy by direct intratumoral infusion of lipid nanoparticle (liposome)-carried beta-emitting radionuclides has shown promising results in animal model studies; however, little is known about the impact the intratumoral liposomal radionuclide distribution may have on tumor control. The primary objective of this work was to investigate the effects the intratumoral absorbed dose distributions from this cancer therapy modality have on tumor control and treatment planning by combining dosimetric and radiobiological modeling with in vivo imaging data. Methods: {sup 99m}Tc-encapsulated liposomes were intratumorally infused with a single injection location to human head and neck squamous cell carcinoma xenografts in nude rats. High resolution in vivo planar imaging was performed at various time points for quantifying intratumoral retention following infusion. The intratumoral liposomal radioactivity distribution was obtained from 1 mm resolution pinhole collimator SPECT imaging coregistered with CT imaging of excised tumors at 20 h postinfusion. Coregistered images were used for intratumoral dosimetric and radiobiological modeling at a voxel level following extrapolation to the therapeutic analogs, {sup 186}Re/{sup 188}Re liposomes. Effective uniform dose (EUD) and tumor control probability (TCP) were used to assess therapy effectiveness and possible methods of improving upon tumor control with this radiation therapy modality. Results: Dosimetric analysis showed that average tumor absorbed doses of 8.6 Gy/MBq (318.2 Gy/mCi) and 5.7 Gy/MBq (209.1 Gy/mCi) could be delivered with this protocol of radiation delivery for {sup 186}Re/{sup 188}Re liposomes, respectively, and 37-92 MBq (1-2.5 mCi)/g tumor administered activity; however, large intratumoral absorbed dose heterogeneity, as seen in dose-volume histograms, resulted in insignificant values of EUD and TCP for achieving tumor control. It is indicated that the use of liposomes encapsulating radionuclides with higher energy beta emissions, dose escalation through increased specific activity, and increasing the number of direct tumor infusion sites improve tumor control. For larger tumors, the use of multiple infusion locations was modeled to be much more efficient, in terms of activity usage, at improving EUD and TCP to achieve a tumoricidal effect. Conclusions: Direct intratumoral infusion of beta-emitting radionuclide encapsulated liposomes shows promise for cancer therapy by achieving large focally delivered tumor doses. However, the results of this work also indicate that average tumor dose may underestimate tumoricidal effect due to substantial heterogeneity in intratumoral liposomal radionuclide distributions. The resulting intratumoral distribution of liposomes following infusion should be taken into account in treatment planning and evaluation in a clinical setting for an optimal cancer therapy.
Purpose: The purpose of this work was to implement and validate a deformable CT to cone-beam computed tomography (CBCT) image registration method in head-and-neck cancer to eventually facilitate automatic target delineation on CBCT. Methods: Twelve head-and-neck cancer patients underwent a planning CT and weekly CBCT during the 5-7 week treatment period. The 12 planning CT images (moving images) of these patients were registered to their weekly CBCT images (fixed images) via the symmetric force Demons algorithm and using a multiresolution scheme. Histogram matching was used to compensate for the intensity difference between the two types of images. Using nine known anatomic points as registration targets, the accuracy of the registration was evaluated using the target registration error (TRE). In addition, region-of-interest (ROI) contours drawn on the planning CT were morphed to the CBCT images and the volume overlap index (VOI) between registered contours and manually delineated contours was evaluated. Results: The mean TRE value of the nine target points was less than 3.0 mm, the slice thickness of the planning CT. Of the 369 target points evaluated for registration accuracy, the average TRE value was 2.6{+-}0.6 mm. The mean TRE for bony tissue targets was 2.4{+-}0.2 mm, while the mean TRE for soft tissue targets was 2.8{+-}0.2 mm. The average VOI between the registered and manually delineated ROI contours was 76.2{+-}4.6%, which is consistent with that reported in previous studies. Conclusions: The authors have implemented and validated a deformable image registration method to register planning CT images to weekly CBCT images in head-and-neck cancer cases. The accuracy of the TRE values suggests that they can be used as a promising tool for automatic target delineation on CBCT.
Purpose: A method of intensity-based deformable registration of CT and cone-beam CT (CBCT) images is described, in which intensity correction occurs simultaneously within the iterative registration process. The method preserves the speed and simplicity of the popular Demons algorithm while providing robustness and accuracy in the presence of large mismatch between CT and CBCT voxel values (''intensity''). Methods: A variant of the Demons algorithm was developed in which an estimate of the relationship between CT and CBCT intensity values for specific materials in the image is computed at each iteration based on the set of currently overlapping voxels. This tissue-specific intensity correction is then used to estimate the registration output for that iteration and the process is repeated. The robustness of the method was tested in CBCT images of a cadaveric head exhibiting a broad range of simulated intensity variations associated with x-ray scatter, object truncation, and/or errors in the reconstruction algorithm. The accuracy of CT-CBCT registration was also measured in six real cases, exhibiting deformations ranging from simple to complex during surgery or radiotherapy guided by a CBCT-capable C-arm or linear accelerator, respectively. Results: The iterative intensity matching approach was robust against all levels of intensity variation examined, including spatially varying errors in voxel value of a factor of 2 or more, as can be encountered in cases of high x-ray scatter. Registration accuracy without intensity matching degraded severely with increasing magnitude of intensity error and introduced image distortion. A single histogram match performed prior to registration alleviated some of these effects but was also prone to image distortion and was quantifiably less robust and accurate than the iterative approach. Within the six case registration accuracy study, iterative intensity matching Demons reduced mean TRE to (2.5{+-}2.8) mm compared to (3.5{+-}3.0) mm with rigid registration. Conclusions: A method was developed to iteratively correct CT-CBCT intensity disparity during Demons registration, enabling fast, intensity-based registration in CBCT-guided procedures such as surgery and radiotherapy, in which CBCT voxel values may be inaccurate. Accurate CT-CBCT registration in turn facilitates registration of multimodality preoperative image and planning data to intraoperative CBCT by way of the preoperative CT, thereby linking the intraoperative frame of reference to a wealth of preoperative information that could improve interventional guidance.
Purpose: An objective method was proposed and compared with a manual selection method to determine planner-independent skin and rib maximal dose in balloon-based high dose rate (HDR) brachytherapy planning. Methods: The maximal dose to skin and rib was objectively extracted from a dose volume histogram (DVH) of skin and rib volumes. A virtual skin volume was produced by expanding the skin surface in three dimensions (3D) external to the breast with a certain thickness in the planning computed tomography (CT) images. Therefore, the maximal dose to this volume occurs on the skin surface the same with a conventional manual selection method. The rib was also delineated in the planning CT images and its maximal dose was extracted from its DVH. The absolute (Abdiff=|D{sub max}{sup Man}-D{sub max}{sup DVH}|) and relative (Rediff[%]=100x(|D{sub max}{sup Man}-D{sub max}{sup DVH}|)/D{sub max}{sup DVH}) maximal skin and rib dose differences between the manual selection method (D{sub max}{sup Man}) and the objective method (D{sub max}{sup DVH}) were measured for 50 balloon-based HDR (25 MammoSite and 25 Contura) patients. Results: The average{+-}standard deviation of maximal dose difference was 1.67%{+-}1.69% of the prescribed dose (PD). No statistical difference was observed between MammoSite and Contura patients for both Abdiff and Rediff[%] values. However, a statistically significant difference (p value <0.0001) was observed in maximal rib dose difference compared with maximal skin dose difference for both Abdiff (2.30%{+-}1.71% vs 1.05%{+-}1.43%) and Rediff[%] (2.32%{+-}1.79% vs 1.21%{+-}1.41%). In general, rib has a more irregular contour and it is more proximally located to the balloon for 50 HDR patients. Due to the inverse square law factor, more dose difference was observed in higher dose range (D{sub max}>90%) compared with lower dose range (D{sub max}<90%): 2.16%{+-}1.93% vs 1.19%{+-}1.25% with p value of 0.0049. However, the Rediff[%] analysis eliminated the inverse square factor and there was no statistically significant difference (p value=0.8931) between high and low dose ranges. Conclusions: The objective method using volumetric information of skin and rib can determine the planner-independent maximal dose compared with the manual selection method. However, the difference was <2% of PD, on average, if appropriate attention is paid to selecting a manual dose point in 3D planning CT images.
Purpose: To investigate the use of various breast tissue segmentation models in Monte Carlo dose calculations for low-energy brachytherapy. Methods: The EGSnrc user-code BrachyDose is used to perform Monte Carlo simulations of a breast brachytherapy treatment using TheraSeed Pd-103 seeds with various breast tissue segmentation models. Models used include a phantom where voxels are randomly assigned to be gland or adipose (randomly segmented), a phantom where a single tissue of averaged gland and adipose is present (averaged tissue), and a realistically segmented phantom created from previously published numerical phantoms. Radiation transport in averaged tissue while scoring in gland along with other combinations is investigated. The inclusion of calcifications in the breast is also studied in averaged tissue and randomly segmented phantoms. Results: In randomly segmented and averaged tissue phantoms, the photon energy fluence is approximately the same; however, differences occur in the dose volume histograms (DVHs) as a result of scoring in the different tissues (gland and adipose versus averaged tissue), whose mass energy absorption coefficients differ by 30%. A realistically segmented phantom is shown to significantly change the photon energy fluence compared to that in averaged tissue or randomly segmented phantoms. Despite this, resulting DVHs for the entire treatment volume agree reasonably because fluence differences are compensated by dose scoring differences. DVHs for the dose to only the gland voxels in a realistically segmented phantom do not agree with those for dose to gland in an averaged tissue phantom. Calcifications affect photon energy fluence to such a degree that the differences in fluence are not compensated for (as they are in the no calcification case) by dose scoring in averaged tissue phantoms. Conclusions: For low-energy brachytherapy, if photon transport and dose scoring both occur in an averaged tissue, the resulting DVH for the entire treatment volume is reasonably accurate because inaccuracies in photon energy fluence are compensated for by inaccuracies in localized dose scoring. If dose to fibroglandular tissue in the breast is of interest, then the inaccurate photon energy fluence calculated in an averaged tissue phantom will result in inaccurate DVHs and average doses for those tissues. Including calcifications necessitates the use of proper tissue segmentation.
Purpose: In radiation therapy treatment planning, the clinical objectives of uniform high dose to the planning target volume (PTV) and low dose to the organs-at-risk (OARs) are invariably in conflict, often requiring compromises to be made between them when selecting the best treatment plan for a particular patient. In this work, the authors introduce Pareto-Aware Radiotherapy Evolutionary Treatment Optimization (pareto), a multiobjective optimization tool to solve for beam angles and fluence patterns in intensity-modulated radiation therapy (IMRT) treatment planning. Methods: pareto is built around a powerful multiobjective genetic algorithm (GA), which allows us to treat the problem of IMRT treatment plan optimization as a combined monolithic problem, where all beam fluence and angle parameters are treated equally during the optimization. We have employed a simple parameterized beam fluence representation with a realistic dose calculation approach, incorporating patient scatter effects, to demonstrate feasibility of the proposed approach on two phantoms. The first phantom is a simple cylindrical phantom containing a target surrounded by three OARs, while the second phantom is more complex and represents a paraspinal patient. Results: pareto results in a large database of Pareto nondominated solutions that represent the necessary trade-offs between objectives. The solution quality was examined for several PTV and OAR fitness functions. The combination of a conformity-based PTV fitness function and a dose-volume histogram (DVH) or equivalent uniform dose (EUD) -based fitness function for the OAR produced relatively uniform and conformal PTV doses, with well-spaced beams. A penalty function added to the fitness functions eliminates hotspots. Comparison of resulting DVHs to those from treatment plans developed with a single-objective fluence optimizer (from a commercial treatment planning system) showed good correlation. Results also indicated that pareto shows promise in optimizing the number of beams. Conclusions: This initial evaluation of the evolutionary optimization software tool pareto for IMRT treatment planning demonstrates feasibility and provides motivation for continued development. Advantages of this approach over current commercial methods for treatment planning are many, including: (1) fully automated optimization that avoids human controlled iterative optimization and potentially improves overall process efficiency, (2) formulation of the problem as a true multiobjective one, which provides an optimized set of Pareto nondominated solutions refined over hundreds of generations and compiled from thousands of parameter sets explored during the run, and (3) rapid exploration of the final nondominated set accomplished by a graphical interface used to select the best treatment option for the patient.
Purpose: Modern HDR brachytherapy treatment for prostate cancer based on the 3D ultrasound (U/S) plays increasingly important role. The purpose of this study is to investigate possible patient movement and anatomy alteration between the clinical image set acquisition, made after the needle implantation, and the patient irradiation and their influence on the quality of treatment. Methods: The authors used 3D U/S image sets and the corresponding treatment plans based on a 4D-treatment planning procedure: plans of 25 patients are obtained right after the needle implantation (clinical plan is based on this 3D image set) and just before and after the treatment delivery. The authors notice the slight decrease of treatment quality with increase of time gap between the clinical image set acquisition and the patient irradiation. 4D analysis of dose-volume-histograms (DVHs) for prostate: CTV1 = PTV, and urethra, rectum, and bladder as organs at risk (OARs) and conformity index (COIN) is presented, demonstrating the effect of prostate, OARs, and needles displacement. Results: The authors show that in the case that the patient body movement/anatomy alteration takes place, this results in modification of DVHs and radiobiological parameters, hence the plan quality. The observed average displacement of needles (1 mm) and of prostate (0.57 mm) is quite small as compared with the average displacement noted in several other reports [A. A. Martinez et al., Int. J. Radiat. Oncol., Biol., Phys. 49(1), 61-69 (2001); S. J. Damore et al., Int. J. Radiat. Oncol., Biol., Phys. 46(5), 1205-1211 (2000); P. J. Hoskin et al., Radiotherm. Oncol. 68(3), 285-288 (2003); E. Mullokandov et al., Int. J. Radiat. Oncol., Biol., Phys. 58(4), 1063-1071 (2004)] in the literature. Conclusions: Although the decrease of quality of dosimetric and radiobiological parameters occurs, this does not cause clinically unacceptable changes to the 3D dose distribution, according to our clinical protocol.
Purpose: To explore the added value of the shape of renal lesions for classifying renal neoplasms. To investigate the potential of computer-aided analysis of contrast-enhanced computed-tomography (CT) to quantify and classify renal lesions. Methods: A computer-aided clinical tool based on adaptive level sets was employed to analyze 125 renal lesions from contrast-enhanced abdominal CT studies of 43 patients. There were 47 cysts and 78 neoplasms: 22 Von Hippel-Lindau (VHL), 16 Birt-Hogg-Dube (BHD), 19 hereditary papillary renal carcinomas (HPRC), and 21 hereditary leiomyomatosis and renal cell cancers (HLRCC). The technique quantified the three-dimensional size and enhancement of lesions. Intrapatient and interphase registration facilitated the study of lesion serial enhancement. The histograms of curvature-related features were used to classify the lesion types. The areas under the curve (AUC) were calculated for receiver operating characteristic curves. Results: Tumors were robustly segmented with 0.80 overlap (0.98 correlation) between manual and semi-automated quantifications. The method further identified morphological discrepancies between the types of lesions. The classification based on lesion appearance, enhancement and morphology between cysts and cancers showed AUC = 0.98; for BHD + VHL (solid cancers) vs. HPRC + HLRCC AUC = 0.99; for VHL vs. BHD AUC = 0.82; and for HPRC vs. HLRCC AUC = 0.84. All semi-automated classifications were statistically significant (p < 0.05) and superior to the analyses based solely on serial enhancement. Conclusions: The computer-aided clinical tool allowed the accurate quantification of cystic, solid, and mixed renal tumors. Cancer types were classified into four categories using their shape and enhancement. Comprehensive imaging biomarkers of renal neoplasms on abdominal CT may facilitate their noninvasive classification, guide clinical management, and monitor responses to drugs or interventions.
Purpose: Leaf positions for dynamic multileaf collimator (DMLC) intensity modulated radiation therapy must be closely synchronized with MU delivery. For the Varian C3 series MLC controller, if the planned trajectory (leaf position vs. MU) requires velocities exceeding the capability of the MLC, the leaves fall behind the planned positions, causing the controller to momentarily hold the beam and thereby introduce dosimetric errors. We investigated the merits of a new commercial linear accelerator, TrueBeam, that integrates MLC control with prospective dose rate modulation. If treatment is delivered at dose rates so high that leaves would fall behind, the controller reduces the dose rate such that harmony between MU and leaf position is preserved. Methods: For three sets of DMLC leaf trajectories, point doses and two-dimensional dose distributions were measured in phantom using an ionization chamber and film, respectively. The first set, delivered using both a TrueBeam and a conventional C3 controller, comprised a single leaf bank closing at planned velocities of 2.4, 7.1, and 14 cm/s. The maximum achievable leaf velocity for both systems was 3 cm/s. The remaining two sets were derived from clinical fluence maps using a commercial treatment planning system for a range of planned dose rates and were delivered using TrueBeam set to the maximum dose rate, 600 MU/min. Generating trajectories using a planned dose rate that is lower than the delivery dose rate effectively increased the leaf velocity constraint used by the planning system for trajectory calculation. The second set of leaf trajectories was derived from two fluence maps containing regions of zero fluence obtained from representative beams of two different patient treatment plans. The third set was obtained from all nine fields of a head and neck treatment plan. For the head and neck plan, dose-volume histograms of the spinal cord and target for each planned dose rate were obtained. Results: For the single closing leaf bank trajectories, the TrueBeam control system reduced the dose rate such that the leaf velocity was less than the maximum. Dose deviations relative to the 2.4 cm/s trajectory were less than 3%. For the conventional controller, the leaves repeatedly fell behind the planned positions until the beam hold threshold was reached, resulting in deviations of up to 19% relative to the 2.4 cm/s trajectory. For the two clinical fluence maps, reducing the planned dose rate reduced the dose in the zero fluence regions by 15% and 24% and increased the delivery time by 5 s and 14 s. No significant differences were noted in the high and intermediate dose regions measured using film. The DVHs for the head and neck plan showed a 10% reduction in cord dose for 20 MU/min relative to 600 MU/min sequencing dose rate, which was confirmed by measurement. No difference in target DVHs were observed. The reduction in cord dose increased total treatment time by 1.8 min. Conclusions: Leaf sequencing algorithms for integrated control systems should be modified to reflect the reduced importance of maximum leaf velocity for accurate dose delivery.
Purpose: Tumor control and normal tissue toxicity are strongly correlated to the tumor and normal tissue volumes receiving high prescribed dose levels in the course of radiotherapy. Planning target definition is, therefore, crucial to ensure favorable clinical outcomes. This is especially important for stereotactic body radiation therapy of lung cancers, characterized by high fractional doses and steep dose gradients. The shift in recent years from population-based to patient-specific treatment margins, as facilitated by the emergence of 4D medical imaging capabilities, is a major improvement. The commonly used motion-encompassing, or internal-target volume (ITV), target definition approach provides a high likelihood of coverage for the mobile tumor but inevitably exposes healthy tissue to high prescribed dose levels. The goal of this work was to generate an interpolated balanced planning target that takes into account both tumor coverage and normal tissue sparing from high prescribed dose levels, thereby improving on the ITV approach. Methods: For each 4DCT dataset, 4D deformable image registration was used to derive two bounding targets, namely, a 4D-intersection and a 4D-composite target which minimized normal tissue exposure to high prescribed dose levels and maximized tumor coverage, respectively. Through definition of an ''effective overlap volume histogram'' the authors derived an ''interpolated balanced planning target'' intended to balance normal tissue sparing from prescribed doses with tumor coverage. To demonstrate the dosimetric efficacy of the interpolated balanced planning target, the authors performed 4D treatment planning based on deformable image registration of 4D-CT data for five previously treated lung cancer patients. Two 4D plans were generated per patient, one based on the interpolated balanced planning target and the other based on the conventional ITV target. Plans were compared for tumor coverage and the degree of normal tissue sparing resulting from the new approach was quantified. Results: Analysis of the 4D dose distributions from all five patients showed that while achieving tumor coverage comparable to the ITV approach, the new planning target definition resulted in reductions of lung V{sub 10}, V{sub 20}, and V{sub 30} of 6.3% {+-} 1.7%, 10.6% {+-} 3.9%, and 12.9% {+-} 5.5%, respectively, as well as reductions in mean lung dose, mean dose to the GTV-ring and mean heart dose of 8.8% {+-} 2.5%, 7.2% {+-} 2.5%, and 10.6% {+-} 3.6%, respectively. Conclusions: The authors have developed a simple and systematic approach to generate a 4D-interpolated balanced planning target volume that implicitly incorporates the dynamics of respiratory-organ motion without requiring 4D-dose computation or optimization. Preliminary results based on 4D-CT data of five previously treated lung patients showed that this new planning target approach may improve normal tissue sparing without sacrificing tumor coverage.
Purpose: In small animal imaging using a single photon emitting radionuclide, a high resolution gamma camera is required. Recently, position sensitive photomultiplier tubes (PSPMTs) with high quantum efficiency have been developed. By combining these with nonhygroscopic scintillators with a relatively low light output, a high resolution gamma camera can become useful for low energy gamma photons. Therefore, the authors developed a gamma camera by combining a pixelated Ce-doped Gd{sub 2}SiO{sub 5} (GSO) block with a high quantum efficiency PSPMT. Methods: GSO was selected for the scintillator, because it is not hygroscopic and does not contain any natural radioactivity. An array of 1.9 mm x 1.9 mm x 7 mm individual GSO crystal elements was constructed. These GSOs were combined with a 0.1-mm thick reflector to form a 22 x 22 matrix and optically coupled to a high quantum efficiency PSPMT (H8500C-100 MOD8). The GSO gamma camera was encased in a tungsten gamma-ray shield with tungsten pixelated parallel hole collimator, and the basic performance was measured for Co-57 gamma photons (122 keV). Results: In a two-dimensional position histogram, all pixels were clearly resolved. The energy resolution was {approx}15% FWHM. With the 20-mm thick tungsten pixelated collimator, the spatial resolution was 4.4-mm FWHM 40 mm from the collimator surface, and the sensitivity was {approx}0.05%. Phantom and small animal images were successfully obtained with our developed gamma camera. Conclusions: These results confirmed that the developed pixelated GSO gamma camera has potential as an effective instrument for low energy gamma photon imaging.