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At least 91 records · Page 5
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-T-445: Effect of Triaxial Cables and Microdetectors in Small Field Dosimetry

Purpose: Advances in radiation treatment especially with smaller fields used in SRS, Gamma knife, Tomotherapy, Cyberknife, and IMRT, require a high degree of precision especially with microdetectors for small field dosimetry (Das et al, Med Ph, 35, 206, 2008; Alfonso et al, Med Phys, 35, 5179, 2008). Due to small signal, the triaxial cable becomes critical in terms of signal to noise ratio (SNR) which is studied with microdetectors. Methods: Six high quality triaxial cables, 9.1 meters long from different manufacturers without any defects were acquired along with 5 most popular microdetectors (microdiamond, plastic scintillators, SRS-diode, edge-diode and pinpoint). A dedicated electrometer was used for each combination except W1 which has its own supermax electrometer. A 6MV photon beam from Varian True beam with 100 MU at a 600 MU/min was used. Measurements were made at a depth of 5 cm in water phantom. Field sizes were varied from 0.5 cm to 10 cm square fields. Readings were taken with combination of cables and microdetectors. Results: Signal is dependent on the quality of the connectors, cables and types of microdetector. The readings varied from nC to pC depending on the type of microdetector. The net signal, S, (Sc-Sn), where Sc is signal with chamber and Sn is without chamber is a linear function of sensitive volume, v; (S = α+β•V), where α and β are constants. The standard deviation (SD) in 3 sets of reading with each combination of cable-detector was extremely low <0.02%. As expected the SD is higher in small fields (<3cm). Maximum estimated error was only ±0.2% in cables-detector combinations. Conclusion: The choice of cables has relatively small effect (±0.2%) with microdosimeter and should be accounted in overall error estimation in k value that is needed to convert ratio of reading to dose in small field dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-456: Tomotherapy MLC Synchronization and Leaf Open Time Measurements Using ArcCheck

Purpose: To develop a practical method for routine QA of the MLC of a Tomotherapy unit using ArcCheck. Methods: Two standard test plans were used in this study. One was a helical test, in which the central leaves No. 32 and 33 opened simultaneously for 277.8ms at projections centered at 0°, 120° and 240° gantry angles. The other test plan was a static test with the gantry angle set at 0°, 45°, 90° and 135° respectively and leaves No. 32 and 33 opened sequentially for total 20s which was further divided into eleven or ten segments at each beam angle. The ArcCheck was isocentrically set up and adjusted for couch sag. Movie files which took a snapshot exposure every 50ms were recorded. The start/stop time of leaf open was decided by the ramp-up/ramp-down of the detectors. Results: The percentage differences between measured and planned leaf open time were calculated to be within 0.5% in all the tests. In static test, if leaves are synchronized perfectly, the sum of the two detectors’ signals after normalization should equal one when the leaves are in transition. Our results showed mean values of 0.982, 0.983, 0.978 and 0.995 at static gantry angle 0°, 45°, 90° and 135° respectively. Conclusion: A method for estimating the Tomotherapy binary MLC leaf open time using ArcCheck is proposed and proved to be precise enough to verify the planned leaf open time as small as 277.8ms. This method also makes the observation and quantification of the synchronization of leaves possible.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-457: A Filmless Method for Measurement of Couch Translation Per Gantry Rotation and Couch Speed for Tomotherapy Using ArcCheck

Purpose: To develop a filmless methodology based on an ArcCheck for QA measurement of the couch translation per gantry rotation and couch speed of a Tomotherapy unit. Methods: Two test plans recommended by TG148 were chosen for this study. A helical plan with 1 cm field size opened the leaves for 180 degrees at the 2nd, 7th and 12th of total 13 rotations and was used to verify if the couch travelled the expected distance per gantry rotation. The other test plan was a static plan with the gantry at 0°, 1cm field width and constant couch movement speed of 0.5mm/s. It was used for couch speed measurement. The ArcCheck was isocentrically set up and recorded movie files which took a snapshot exposure every 50ms. Due to the spiral pattern of diodes distribution, when one of the diodes of the ArcCheck located at the beam center, the dose profile as measured by the row of diodes which surrounded the center diode should have a symmetrical pattern. We divided the profile into left half A and right half B. Then a shape parameter was defined as S=Σ|(A−B)|/Σ(A+B). By searching the local minimum of S parameter, the beam center at different time could be located. The machine trajectory log data were also collected and analyzed for comparison. Results: The mean value of measured couch translation and couch speed by ArcCheck had less than 0.05% deviation from the planned values. For couch speed measurement, our result showed a mean value of 0.5002 with an uncertainty ±0.0031, which agreed very well with both the plan setting of 0.5 mm/s and the machine log data of 0.5005 mm/s. Conclusion: Couch translation measured using ArcCheck is accurate and comparable to the film-based measurement. This filmless method also provides a convenient and independent way for measuring couch speed.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-468: Efficient Scanning Data Analysis for TomoTherapy

Purpose: The standard TomoTherapy 2D scanning system requires manual analysis using spreadsheets or similar software. Manual analysis is time consuming and does not allow efficient use of the medical physicist or timely results that may indicate issues during the acquisition of data. The purpose of this study is to determine if an in-house solution can provide timely analysis of TomoTherapy scan data. Methods: A custom MATLAB program utilizing a streamlined graphical interface was developed to interpret the native scanning data acquired by the TomoTherapy Electrometer Measurement System (TEMS). The gold beam data provided by the manufacturer was used as a baseline for the acquired data. Two separate sets of scan data were used including longitudinal, transverse, and percent depth dose (PDD). The scan data were compared visually in an overlay and analytically for each beam width using the full width half max (FWHM) for longitudinal profiles and difference inside the field core for the transverse profiles as recommended by TG-148. A plot of the PDD percent error at each point along the curve was generated to show agreement. The time to analysis was measured on a laptop running an Intel i5 processor with 8GB of RAM. Results: The software program required on average less than 5 seconds to load and analyze the results. No conversion or reformatting of the data was required. This allowed real-time visualization of the comparison to the gold beam data as well as the parameters recommended by TG-148. The average percent difference was 0.3% for the longitudinal profiles and 0.1% for the transverse profiles. All PDD data was less than 1% different beyond dmax. Conclusion: We have developed a tool to analyze TomoTherapy scan data in real-time. This allows an efficient method to perform beam commissioning, annual QA, and adjust the beam parameters if necessary.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-485: Independent Remote Audits for TG51 NonCompliant Photon Beams Performed by the IROC Houston QA Center

Purpose: IROC-H conducts external audits for output check verification of photon and electron beams. Many of these beams can meet the geometric requirements of the TG 51 calibration protocol. For those photon beams that are non TG 51 compliant like Elekta GammaKnife, Accuray CyberKnife and TomoTherapy, IROC-H has specific audit tools to monitor the reference calibration. Methods: IROC-H used its TLD and OSLD remote monitoring systems to verify the output of machines with TG 51 non compliant beams. Acrylic OSLD miniphantoms are used for the CyberKnife. Special TLD phantoms are used for TomoTherapy and GammaKnife machines to accommodate the specific geometry of each machine. These remote audit tools are sent to institutions to be irradiated and returned to IROC-H for analysis. Results: The average IROC-H/institution ratios for 480 GammaKnife, 660 CyberKnife and 907 rotational TomoTherapy beams are 1.000±0.021, 1.008±0.019, 0.974±0.023, respectively. In the particular case of TomoTherapy, the overall ratio is 0.977±0.022 for HD units. The standard deviations of all results are consistent with values determined for TG 51 compliant photon beams. These ratios have shown some changes compared to values presented in 2008. The GammaKnife results were corrected by an experimentally determined scatter factor of 1.025 in 2013. The TomoTherapy helical beam results are now from a rotational beam whereas in 2008 the results were from a static beam. The decision to change modality was based on recommendations from the users. Conclusion: External audits of beam outputs is a valuable tool to confirm the calibrations of photon beams regardless of whether the machine is TG 51 or TG 51 non compliant. The difference found for TomoTherapy units is under investigation. This investigation was supported by IROC grant CA180803 awarded by the NCI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-489: 4-Years Experience of QA in TomoTherapy MVCT: What Do We Look Out For?

Purpose: To evaluate the QA results of TomoTherapy MVCT from March 2012 to February 2016, and to identify issues that may affect consistency in HU numbers and reconstructed treatment dose in MVCT. Methods: Monthly QA was performed on our TomoHD system. Phantom with rod inserts of various mass densities was imaged in MVCT and compared to baseline to evaluate HU number consistency. To evaluate treatment dose reconstructed by delivered sinogram and MVCT, a treatment plan was designed on a humanoid skull phantom. The phantom was imaged with MVCT and treatment plan was delivered to obtain the sinogram. The dose reconstructed with the Planned Adaptive software was compared to the dose in the original plan. The QA tolerance for HU numbers was ±30 HU, and ±2% for discrepancy between original plan dose and reconstructed dose. Tolerances were referenced to AAPM TG148. Results: Several technical modifications or maintenance activities to the system have been identified which affected QA Results: 1) Upgrade in console system software which added a weekly HU calibration procedure; 2) Linac or MLC replacement leading to change in Accelerator Output Machine (AOM) parameters; 3) Upgrade in planning system algorithm affecting MVCT dose reconstruction. These events caused abrupt changes in QA results especially for the reconstructed dose. In the past 9 months, when no such modifications were done to the system, reconstructed dose was consistent with maximum deviation from baseline less than 0.6%. The HU number deviated less than 5HU. Conclusion: Routine QA is essential for MVCT, especially if the MVCT is used for daily dose reconstruction to monitor delivered dose to patients. Several technical events which may affect consistency of this are software changes, linac or MLC replacement. QA results reflected changes which justify re-calibration or system adjustment. In normal circumstances, the system should be relatively stable and quarterly QA may be sufficient.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-529: Dosimetric Investigation of a Rotating Gamma Ray System for ImagedGuided Modulated Arc Radiotherapy

Purpose: Because of their effectiveness and efficiency, rotational arc radiotherapy (MAT) techniques have been developed on both specialty machines such as Tomotherapy and conventional linear accelerators. This work investigates a new rotating Gamma therapy system for image guided MAT and SBRT of intra/extracranial tumors. Methods: The CyberMAT system (Cyber Medical Corp., China) consists of a ring gantry with a gamma source (effective source size 1cm and 1.7cm respectively), a 120-leaf MLC, a kV CBCT and an EPID. The treatment couch provides 6-degrees-of-freedom motion compensation and the kV CBCT system has a spatial resolution of 0.4mm for target localization. The maximum dose rate is >4.0 Gy/min and the maximum field size is 40cm × 40cm. Monte Carlo simulations were used to compute dose distributions and compare with measurements. A retrospective study of 125 previously treated SBRT patients was performed to evaluate the dosimetric characteristics of CyberMAT in comparison with existing VMAT systems. Results: Monte Carlo results confirmed the CyberMAT design parameters including output factors and 3D dose distributions. Its beam penumbra is 5mm to 10mm for field sizes 1cm to 10cm, respectively and its isocenter accuracy is <0.5mm. Compared to the 6 MV photons of Tomotherapy and conventional linacs, Cobalt beams produce lower-energy secondary electrons that exhibit better dose properties in low-density lung tissues. Cobalt beams are ideal for peripheral lung tumors with half-arc arrangements to spare the opposite lung and other critical structures. Superior dose distributions have been obtained for brain, head and neck, breast, spine and lung tumors with half/full arc arrangements. Conclusion: Because of the unique dosimetric properties of Cobalt sources and its accurate stereotaxy/dose delivery CyberMAT is ideally suited for image guided MAT and SBRT. Full-arc arrangements are superior for brain and H&N treatments while half-arc arrangements produce best dose distributions for thoracic tumors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-BRA-14: Dose in a Rigidly Moving Phantom with Jaw and MLC Compensation

Purpose: To validate dose calculation for a rigidly moving object with jaw motion and MLC shifts to compensate for the motion in a TomoTherapy™ treatment delivery. Methods: An off-line version of the TomoTherapy dose calculator was extended to perform dose calculations for rigidly moving objects. A variety of motion traces were added to treatment delivery plans, along with corresponding jaw compensation and MLC shift compensation profiles. Jaw compensation profiles were calculated by shifting the jaws such that the center of the treatment beam moved by an amount equal to the motion in the longitudinal direction. Similarly, MLC compensation profiles were calculated by shifting the MLC leaves by an amount that most closely matched the motion in the transverse direction. The same jaw and MLC compensation profiles were used during simulated treatment deliveries on a TomoTherapy system, and film measurements were obtained in a rigidly moving phantom. Results: The off-line TomoTherapy dose calculator accurately predicted dose profiles for a rigidly moving phantom along with jaw motion and MLC shifts to compensate for the motion. Calculations matched film measurements to within 2%/1 mm. Jaw and MLC compensation substantially reduced the discrepancy between the delivered dose distribution and the calculated dose with no motion. For axial motion, the compensated dose matched the no-motion dose within 2%/1mm. For transverse motion, the dose matched within 2%/3mm (approximately half the width of an MLC leaf). Conclusion: The off-line TomoTherapy dose calculator accurately computes dose delivered to a rigidly moving object, and accurately models the impact of moving the jaws and shifting the MLC leaf patterns to compensate for the motion. Jaw tracking and MLC leaf shifting can effectively compensate for the dosimetric impact of motion during a TomoTherapy treatment delivery.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-TeP2-12: IROCHouston and MDAPL SRS Anthropomorphic Phantom Results

Purpose: To report the results of SRS phantom irradiations Methods: Anthropomorphic SRS head phantoms were sent to institutions participating in NCI sponsored SRS clinical trials and institutions interested in verifying SRS treatment delivery. The phantom shell was purchased from Phantom Laboratory and altered to house dosimetry and imaging inserts. The imaging insert has 1.9 cm diameter spherical target. The dosimetry insert holds two TLD capsules and radiochromic film in the coronal and sagittal planes through the center of the target. Institutions were asked to image, plan and treat the phantom as they would an SRS patient. GammaKnife, CyberKnife and c-arm accelerator institutions were asked to cover the target with 15 Gy, 20 Gy and 25 Gy, respectively. Following these guidelines and typical planning protocols for these three types of machines gives roughly 30 Gy to the center of the target for all units. Submission of the DICOM digital data set was required for analysis. Criteria of 5% for TLD results and 85% of pixels passing 5%/3mm gamma analysis were applied beginning in 2013. Results: The phantom was analyzed 269 times between the beginning of 2013 to present. The pass rate is 81%. Nineteen of the irradiation results failed only the TLD criteria, 19 failed only the film criteria and 12 failed both. Irradiations included 32 CyberKnife 23 GammaKnife, 3 TomoTherapy and 211 c-arm units. Planning systems included Eclipse, Ergo, GammaPlan, Hi-Art, iPlan, Monaco, MultiPlan, Pinnacle, RayStation, XiO and XKnife. Irradiations that were not accompanied with DICOM data were not included in this analysis. Conclusion: The phantom is a valuable end-to-end test used to independently verify the accuracy of SRS treatment delivery. This investigation was supported by IROC grant CA180803 awarded by the NCI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-E-TOUR-T-00: Exhibit Hall Guided Tours-Microdosimeters for Therapy (Tuesday)

Tour Leader: Indra Das, NYU Langone Medical Center, New York, NY Tour Guides: Hsui Ai, Indiana University School of Medicine, Indianapolis, IN Aaron Andersen, Indiana University School of Medicine, Indianapolis, IN Olga Volotoskova, NYU Langone Medical Center, New York, NY Participating Vendors: IBA PTW – New York RTI Electronics, Inc. Standard Imaging, Inc. Sun Nuclear Corporation Small fields are increasing used in specialized radiation treatments such as Gammaknife, Cyberknife, Tomotherapy, IMRT, VMAT, SRS and SBRT. Due to small field size electron transport creates lateral electronic disequilibrium and thus dosimetry could be very difficult. Microdetectors are used for small field dosimetry which will be discussed in preface of this tour as below: Understanding small field e.g. meaning and definition of small field IAEA definition and approach Characteristics of microdetectors in terms of perturbation, recombination, correction Suitability of microdetectors in small field dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-DE-BRA-09: Fast Megavoltage CT Imaging with Rapid Scan Time and Low Imaging Dose in Helical Tomotherapy

Purpose: Megavoltage computed tomography (MVCT) imaging has been widely used for daily patient setup with helical tomotherapy (HT). One drawback of MVCT is its very long imaging time, owing to slow couch speed. The purpose of this study was to develop an MVCT imaging method allowing faster couch speeds, and to assess its accuracy for image guidance for HT. Methods: Three cadavers (mimicking closest physiological and physical system of patients) were scanned four times with couch speeds of 1, 2, 3, and 4 mm/s. The resulting MVCT images were reconstructed using an iterative reconstruction (IR) algorithm. The MVCT images were registered with kilovoltage CT images, and the registration errors were compared with the errors with conventional filtered back projection (FBP) algorithm. Moreover, the fast MVCT imaging was tested in three cases of total marrow irradiation as a clinical trial. Results: Three-dimensional registration errors of the MVCT images reconstructed with the IR algorithm were significantly smaller (p < 0.05) than the errors of images reconstructed with the FBP algorithm at fast couch speeds (3, 4 mm/s). The scan time and imaging dose at a speed of 4 mm/s were reduced to 30% of those from a conventional coarse mode scan. For the patient imaging, a limited number of conventional MVCT (1.2 mm/s) and fast MVCT (3 mm/s) reveals acceptable reduced imaging time and dose able to use for anatomical registration. Conclusion: Fast MVCT with IR algorithm maybe clinically feasible alternative for rapid 3D patient localization. This technique may also be useful for calculating daily dose distributions or organ motion analyses in HT treatment over a wide area.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-C-TOUR-T-00: Exhibit Hall Guided Tours-Microdosimeters for Therapy (Wednesday) WE-C-TOUR-T-01

Tour Leader: Indra Das, NYU Langone Medical Center, New York, NY Tour Guides: Hsui Ai, Indiana University School of Medicine, Indianapolis, IN Paulina Galvis, NYU Langone Medical Center, New York, NY Olga Volotoskova, NYU Langone Medical Center, New York, NY Participating Vendors: IBA PTW – New York RTI Electronics, Inc. Standard Imaging, Inc. Sun Nuclear Corporation Small fields are increasing used in specialized radiation treatments such as Gammaknife, Cyberknife, Tomotherapy, IMRT, VMAT, SRS and SBRT. Due to small field size electron transport creates lateral electronic disequilibrium and thus dosimetry could be very difficult. Microdetectors are used for small field dosimetry which will be discussed in preface of this tour as below: Understanding small field e.g. meaning and definition of small field IAEA definition and approach Characteristics of microdetectors in terms of perturbation, recombination, correction Suitability of microdetectors in small field dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-C-TOUR-T-01: Microdosimeters for Therapy

Tour Leader: Indra Das, NYU Langone Medical Center, New York, NY Tour Guides: Hsui Ai, Indiana University School of Medicine, Indianapolis, IN Paulina Galvis, NYU Langone Medical Center, New York, NY Olga Volotoskova, NYU Langone Medical Center, New York, NY Participating Vendors: IBA PTW – New York RTI Electronics, Inc. Standard Imaging, Inc. Sun Nuclear Corporation Small fields are increasing used in specialized radiation treatments such as Gammaknife, Cyberknife, Tomotherapy, IMRT, VMAT, SRS and SBRT. Due to small field size electron transport creates lateral electronic disequilibrium and thus dosimetry could be very difficult. Microdetectors are used for small field dosimetry which will be discussed in preface of this tour as below: Understanding small field e.g. meaning and definition of small field IAEA definition and approach Characteristics of microdetectors in terms of perturbation, recombination, correction Suitability of microdetectors in small field dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-AB-207A-07: A Planning CT-Guided Scatter Artifact Correction Method for CBCT Images

Purpose: Cone beam computed tomography (CBCT) imaging is on increasing demand for high-performance image-guided radiotherapy such as online tumor delineation and dose calculation. However, the current CBCT imaging has severe scatter artifacts and its current clinical application is therefore limited to patient setup based mainly on the bony structures. This study’s purpose is to develop a CBCT artifact correction method. Methods: The proposed scatter correction method utilizes the planning CT to improve CBCT image quality. First, an image registration is used to match the planning CT with the CBCT to reduce the geometry difference between the two images. Then, the planning CT-based prior information is entered into the Bayesian deconvolution framework to iteratively perform a scatter artifact correction for the CBCT mages. This technique was evaluated using Catphan phantoms with multiple inserts. Contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR), and the image spatial nonuniformity (ISN) in selected volume of interests (VOIs) were calculated to assess the proposed correction method. Results: Post scatter correction, the CNR increased by a factor of 1.96, 3.22, 3.20, 3.46, 3.44, 1.97 and 1.65, and the SNR increased by a factor 1.05, 2.09, 1.71, 3.95, 2.52, 1.54 and 1.84 for the Air, PMP, LDPE, Polystryrene, Acrylic, Delrin and Teflon inserts, respectively. The ISN decreased from 21.1% to 4.7% in the corrected images. All values of CNR, SNR and ISN in the corrected CBCT image were much closer to those in the planning CT images. The results demonstrated that the proposed method reduces the relevant artifacts and recovers CT numbers. Conclusion: We have developed a novel CBCT artifact correction method based on CT image, and demonstrated that the proposed CT-guided correction method could significantly reduce scatter artifacts and improve the image quality. This method has great potential to correct CBCT images allowing its use in adaptive radiotherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Computed Tomography Number Changes Observed During Computed Tomography–Guided Radiation Therapy for Head and Neck Cancer

Purpose: To investigate CT number (CTN) changes in gross tumor volume (GTV) and organ at risk (OAR) according to daily diagnostic-quality CT acquired during CT-guided intensity modulated radiation therapy for head and neck cancer (HNC) patients. Methods and Materials: Computed tomography scans acquired using a CT-on-rails during daily CT-guided intensity modulated radiation therapy for 15 patients with stage II to IVa squamous cell carcinoma of the head and neck were analyzed. The GTV, parotid glands, spinal cord, and nonspecified tissue were generated on each selected daily CT. The changes in CTN distributions and the mean and mode values were collected. Pearson analysis was used to assess the correlation between the CTN change, organ volume reduction, and delivered radiation dose. Results: Volume and CTN changes for GTV and parotid glands can be observed during radiation therapy delivery for HNC. The mean (±SD) CTNs in GTV and ipsi- and contralateral parotid glands were reduced by 6 ± 10, 8 ± 7, and 11 ± 10 Hounsfield units, respectively, for all patients studied. The mean CTN changes in both spinal cord and nonspecified tissue were almost invisible (<2 Hounsfield units). For 2 patients studied, the absolute mean CTN changes in GTV and parotid glands were strongly correlated with the dose delivered (P<.001 and P<.05, respectively). For the correlation between CTN reductions and delivered isodose bins for parotid glands, the Pearson coefficient varied from −0.98 (P<.001) in regions with low-dose bins to 0.96 (P<.001) in high-dose bins and were patient specific. Conclusions: The CTN can be reduced in tumor and parotid glands during the course of radiation therapy for HNC. There was a fair correlation between CTN reduction and radiation doses for a subset of patients, whereas the correlation between CTN reductions and volume reductions in GTV and parotid glands were weak. More studies are needed to understand the mechanism for the radiation-induced CTN changes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

SU-C-BRA-03: An Automated and Quick Contour Errordetection for Auto Segmentation in Online Adaptive Radiotherapy

Purpose: To develop a tool that can quickly and automatically assess contour quality generated from auto segmentation during online adaptive replanning. Methods: Due to the strict time requirement of online replanning and lack of ‘ground truth’ contours in daily images, our method starts with assessing image registration accuracy focusing on the surface of the organ in question. Several metrics tightly related to registration accuracy including Jacobian maps, contours shell deformation, and voxel-based root mean square (RMS) analysis were computed. To identify correct contours, additional metrics and an adaptive decision tree are introduced. To approve in principle, tests were performed with CT sets, planned and daily CTs acquired using a CT-on-rails during routine CT-guided RT delivery for 20 prostate cancer patients. The contours generated on daily CTs using an auto-segmentation tool (ADMIRE, Elekta, MIM) based on deformable image registration of the planning CT and daily CT were tested. Results: The deformed contours of 20 patients with total of 60 structures were manually checked as baselines. The incorrect rate of total contours is 49%. To evaluate the quality of local deformation, the Jacobian determinant (1.047±0.045) on contours has been analyzed. In an analysis of rectum contour shell deformed, the higher rate (0.41) of error contours detection was obtained compared to 0.32 with manual check. All automated detections took less than 5 seconds. Conclusion: The proposed method can effectively detect contour errors in micro and macro scope by evaluating multiple deformable registration metrics in a parallel computing process. Future work will focus on improving practicability and optimizing calculation algorithms and metric selection.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-D-202-03: Statistical Segmentation On Quantitative CT for Assessing Spatial Tumor Response During Radiation Therapy Delivery

Purpose: Develop a method to segment regions of interest (ROIs) in tumor with statistically similar Hounsfield unit (HU) values and/or HU changes during chemoradiation therapy (CRT) delivery, to assess spatial tumor treatment response based on daily CTs during CRT delivery. Methods: Generate a three region map of ROIs with differential HUs, by sampling neighboring voxels around a selected voxel and comparing to the mean of the entire ROI using a t-test. The cumulative distribution function, P, is calculated from the t-test. The P value is assigned to be the value at the selected voxel, and this is repeated over all voxels in the initial ROI. Three regions are defined as: (1-P) < 0.00001 (mid region), and 0.00001 < (1-P) (mean greater than baseline and mean lower than baseline). The test is then expanded to compare daily CT sets acquired during routine CT-guided RT delivery using a CT-on-rails. The first fraction CT is used as the baseline for comparison. We tested 15 pancreatic head tumor cases undergoing CRT, to identify the ROIs and changes corresponding to normal, fibrotic, and tumor tissue. The obtained ROIs were compared with MRI-ADC maps acquired pre- and post-CRT. Results: The ROIs in 13 out of 15 patients’ first fraction CTs and pre-CRT MRIs matched the general region and slices covered, as well as in 6 out of the 9 patients with post-CRT MRIs. The high HU region designated by the t-test was seen to correlate with the tumor region in MR, and these ROIs are positioned within the same region over the course of treatment. In patients with poorly delineated tumors in MR, the t-test was inconclusive. Conclusion: The proposed statistical segmentation technique shows the potential to identify regions in tumor with differential HUs and HU changes during CRT delivery for patients with pancreas head cancer.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-R-54: CT-Texture Based Early Tumor Treatment Response Assessment During Radiation Therapy Delivery: Small Cell Versus Non-Small Cell Lung Cancers

Purpose: Tumor treatment response may potentially be assessed during radiation therapy (RT) by analyzing changes in CT-textures. We investigated the different early RT-responses between small cell (SCLC) and non-small cell lung cancer (NSCLC) as assessed by CT-texture. Methods: Daily diagnostic-quality CT acquired during routine CT-guided RT using a CT-on-Rails for 13-NSCLC and 5-SCLC patients were analyzed. These patient had ages ranging from 45–78 and 38–63 years, respectively, for NSCLC and SCLC groups, and tumor-stages ranging from T2-T4, and were treated with either RT or chemotherapy and RT with 45–66Gy/ 20–34 fractions. Gross-tumor volume (GTV) contour was generated on each daily CT by populating GTV contour from simulation to daily CTs with manual editing if necessary. CT-texture parameters, such as Hounsfield Unit (HU) histogram, mean HU, skewness, kurtosis, entropy, and short-run high-gray level emphasis (SRHGLE), were calculated in GTV from each daily CT-set using an in house software tool. Difference in changes of these texture parameters during RT between NSCLC and SCLC was analyzed and compared with GTV volume changes. Results: Radiation-induced changes in CT-texture were different between SCLC and NSCLC. Average changes from first to the last fractions for NSCLC and SCLC in GTV were 28±10(12–44) and 30±15(11–47) HU (mean HU reduction), 12.7% and 18.3% (entropy), 50% and 55% (SRHGLE), 19% and 22% (kurtosis), and 5.2% and 22% (skewness), respectively. Good correlation in kurtosis changes and GTV was seen (R{sup 2}=0.8923) for SCLC, but not for NSCLC (R{sup 2}=0.4748). SCLC had better correlations between GTV volume reduction and entropy (SCLC R{sup 2}=0.847; NSCLC R{sup 2}=0.6485), skewness (SCLC R{sup 2}=0.935; NSCLC R{sup 2}=0.7666), or SRHGLE (SCLC R{sup 2}=0.9619; NSCLC R{sup 2}=0.787). Conclusion: NSCLC and SCLC exhibited different early RT-responses as assessed by CT-texture changes during RT-delivery. The observed larger changes in various CT-texture parameters for SCLC indicate that SCLC may respond to RT more rapid than NSCLC.

60 APPLIED LIFE SCIENCES↗