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Individualized 3D Reconstruction of Normal Tissue Dose for Patients With Long-term Follow-up: A Step Toward Understanding Dose Risk for Late Toxicity

Purpose: Understanding the relationship between normal tissue dose and delayed radiation toxicity is an important component of developing more effective radiation therapy. Late outcome data are generally available only for patients who have undergone 2-dimensional (2D) treatment plans. The purpose of this study was to evaluate the accuracy of 3D normal tissue dosimetry derived from reconstructed 2D treatment plans in Hodgkin's lymphoma (HL) patients. Methods and Materials: Three-dimensional lung, heart, and breast volumes were reconstructed from 2D planning radiographs for HL patients who received mediastinal radiation therapy. For each organ, a reference 3D organ was modified with patient-specific structural information, using deformable image processing software. Radiation therapy plans were reconstructed by applying treatment parameters obtained from patient records to the reconstructed 3D volumes. For each reconstructed organ mean dose (D{sub mean}) and volumes covered by at least 5 Gy (V{sub 5}) and 20Gy (V{sub 20}) were calculated. This process was performed for 15 patients who had both 2D and 3D planning data available to compare the reconstructed normal tissue doses with those derived from the primary CT planning data and also for 10 historically treated patients with only 2D imaging available. Results: For patients with 3D planning data, the normal tissue doses could be reconstructed accurately using 2D planning data. Median differences in D{sub mean} between reconstructed and actual plans were 0.18 Gy (lungs), -0.15 Gy (heart), and 0.30 Gy (breasts). Median difference in V{sub 5} and V{sub 20} were less than 2% for each organ. Reconstructed 3D dosimetry was substantially higher in historical mantle-field treatments than contemporary involved-field mediastinal treatments: average D{sub mean} values were 15.2 Gy vs 10.6 Gy (lungs), 27.0 Gy vs 14.3 Gy (heart), and 8.0 Gy vs 3.2 Gy (breasts). Conclusions: Three-dimensional reconstruction of absorbed dose to organs at risk can be estimated accurately many years after exposure by using limited 2D data. Compared to contemporary involved-field treatments, normal tissue doses were significantly higher in historical mantle-field treatments. These methods build capacity to quantify the relationship between 3D normal tissue dose and observed late effects.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

TU-PIS-Exhibit Hall-5: Use of the Enterprise-wide Dose Tracking Software Radimetrics In an Academic Medical System

The current clinical standard of organ respiratory imaging, 4D-CT, is fundamentally limited by poor soft-tissue contrast and imaging dose. These limitations are potential barriers to beneficial “4D” radiotherapy methods which optimize the target and OAR dose-volume considering breathing motion but rely on a robust motion characterization. Conversely, MRI imparts no known radiation risk and has excellent soft-tissue contrast. MRI-based motion management is therefore highly desirable and holds great promise to improve radiotherapy of moving cancers, particularly in the abdomen. Over the past decade, MRI techniques have improved significantly, making MR-based motion management clinically feasible. For example, cine MRI has high temporal resolution up to 10 f/s and has been used to track and/or characterize tumor motion, study correlation between external and internal motions. New MR technologies, such as 4D-MRI and MRI hybrid treatment machines (i.e. MR-linac or MR-Co60), have been recently developed. These technologies can lead to more accurate target volume determination and more precise radiation dose delivery via direct tumor gating or tracking. Despite all these promises, great challenges exist and the achievable clinical benefit of MRI-based tumor motion management has yet to be fully explored, much less realized. In this proposal, we will review novel MR-based motion management methods and technologies, the state-of-the-art concerning MRI development and clinical application and the barriers to more widespread adoption. Learning Objectives: Discuss the need of MR-based motion management for improving patient care in radiotherapy. Understand MR techniques for motion imaging and tumor motion characterization. Understand the current state of the art and future steps for clinical integration. Henry Ford Health System holds research agreements with Philips Healthcare. Research sponsored in part by a Henry Ford Health System Internal Mentored Grant.

60 APPLIED LIFE SCIENCES↗

SU-E-J-113: The Influence of Optimizing Pediatric CT Simulator Protocols On the Treatment Dose Calculation in Radiotherapy

Purpose: To investigate the possibility of applying optimized scanning protocols for pediatric CT simulation by quantifying the dosimetric inaccuracy introduced by using a fixed HU to density conversion. Methods: The images of a CIRS electron density reference phantom (Model 062) were acquired by a Siemens CT simulator (Sensation Open) using the following settings of tube voltage and beam current: 120 kV/190mA (the reference protocol used to calibrate CT for our treatment planning system (TPS)); Fixed 190mA combined with all available kV: 80, 100, and 140; fixed 120 kV and various current from 37 to 444 mA (scanner extremes) with interval of 30 mA. To avoid the HU uncertainty of point sampling in the various inserts of known electron densities, the mean CT numbers of the central cylindrical volume were calculated using DICOMan software. The doses per 100 MU to the reference point (SAD=100cm, Depth=10cm, Field=10X10cm, 6MV photon beam) in a virtual cubic phantom (30X30X30cm) were calculated using Eclipse TPS (calculation model: AcurosXB-11031) by assigning the CT numbers to HU of typical materials acquired by various protocols. Results: For the inserts of densities less than muscle, CT number fluctuations of all protocols were within the tolerance of 10 HU as accepted by AAPM-TG66. For more condensed materials, fixed kV yielded stable HU with any mA combination where largest disparities were found in 1750mg/cc insert: HU{sub reference}=1801(106.6cGy), HU{sub minimum}=1799 (106.6cGy, error{sub dose}=0.00%), HU{sub maximum}=1815 (106.8cGy, error{sub dose}=0.19%). Yet greater disagreements were observed with increasing density when kV was modified: HU{sub minimum}=1646 (104.5cGy, error{sub dose}=- 1.97%), HU{sub maximum}=2487 (116.4cGy, error{sub dose}=9.19%) in 1750mg/cc insert. Conclusion: Without affecting treatment dose calculation, personalized mA optimization of CT simulator can be conducted by fixing kV for a better cost-effectiveness of imaging dose and quality especially for children. Unless recalibrated, kV should be constant for all anatomical sites if diagnostic CT scanner is used as a simulator. This work was partially supported by Capital Medical Development Scientific Research Fund of China.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-F-E-19: A Novel Method for TrueBeam Jaw Calibration

Purpose: A simple jaw calibration method is proposed for Varian TrueBeam using an EPID-Encoder combination that gives accurate fields sizes and a homogeneous junction dose. This benefits clinical applications such as mono-isocentric half-beam block breast cancer or head and neck cancer treatment with junction/field matching. Methods: We use EPID imager with pixel size 0.392 mm × 0.392 mm to determine the radiation jaw position as measured from radio-opaque markers aligned with the crosshair. We acquire two images with different symmetric field sizes and record each individual jaw encoder values. A linear relationship between each jaw’s position and its encoder value is established, from which we predict the encoder values that produce the jaw positions required by TrueBeam’s calibration procedure. During TrueBeam’s jaw calibration procedure, we move the jaw with the pendant to set the jaw into position using the predicted encoder value. The overall accuracy is under 0.1 mm. Results: Our in-house software analyses images and provides sub-pixel accuracy to determine field centre and radiation edges (50% dose of the profile). We verified the TrueBeam encoder provides a reliable linear relationship for each individual jaw position (R{sup 2}>0.9999) from which the encoder values necessary to set jaw calibration points (1 cm and 19 cm) are predicted. Junction matching dose inhomogeneities were improved from >±20% to <±6% using this new calibration protocol. However, one technical challenge exists for junction matching, if the collimator walkout is large. Conclusion: Our new TrueBeam jaw calibration method can systematically calibrate the jaws to crosshair within sub-pixel accuracy and provides both good junction doses and field sizes. This method does not compensate for a larger collimator walkout, but can be used as the underlying foundation for addressing the walkout issue.

60 APPLIED LIFE SCIENCES↗

SU-E-T-117: Dose to Organs Outside of CT Scan Range- Monte Carlo and Hybrid Phantom Approach

Purpose: Epidemiological study of second cancer risk for cancer survivors often requires the dose to normal tissues located outside the anatomy covered by radiological imaging, which is usually limited to tumor and organs at risk. We have investigated the feasibility of using whole body computational human phantoms for estimating out-of-field organ doses for patients treated by Intensity Modulated Radiation Therapy (IMRT). Methods: Identical 7-field IMRT prostate plans were performed using X-ray Voxel Monte Carlo (XVMC), a radiotherapy-specific Monte Carlo transport code, on the computed tomography (CT) images of the torso of an adult male patient (175 cm height, 66 kg weight) and an adult male hybrid computational phantom with the equivalent body size. Dose to the liver, right lung, and left lung were calculated and compared. Results: Considerable differences are seen between the doses calculated by XVMC for the patient CT and the hybrid phantom. One major contributing factor is the treatment method, deep inspiration breath hold (DIBH), used for this patient. This leads to significant differences in the organ position relative to the treatment isocenter. The transverse distances from the treatment isocenter to the inferior border of the liver, left lung, and right lung are 19.5cm, 29.5cm, and 30.0cm, respectively for the patient CT, compared with 24.3cm, 36.6cm, and 39.1cm, respectively, for the hybrid phantom. When corrected for the distance, the mean doses calculated using the hybrid phantom are within 28% of those calculated using the patient CT. Conclusion: This study showed that mean dose to the organs located in the missing CT coverage can be reconstructed by using whole body computational human phantoms within reasonable dosimetric uncertainty, however appropriate corrections may be necessary if the patient is treated with a technique that will significantly deform the size or location of the organs relative to the hybrid phantom.

60 APPLIED LIFE SCIENCES↗

SU-G-JeP2-14: MRI-Based HDR Prostate Brachytherapy: A Phantom Study for Interstitial Catheter Reconstruction with 0.35T MRI Images

Purpose: To evaluate the accuracy of interstitial catheter reconstruction with 0.35T MRI images for MRI-based HDR prostate brachytherapy. Methods: Recently, a real-time MRI-guided radiotherapy system combining a 0.35T MRI system and three cobalt 60 heads (MRIdian System, ViewRay, Cleveland, OH, USA) was installed in our department. A TrueFISP sequence for MRI acquisition at lower field on Viewray was chosen due to its fast speed and high signal-to-noise efficiency. Interstitial FlexiGuide needles were implanted into a tissue equivalent ultrasound prostate phantom (CIRS, Norfolk, Virginia, USA). After an initial 15s pilot MRI to confirm the location of the phantom, planning MRI was acquired with a 172s TrueFISP sequence. The pulse sequence parameters included: flip angle = 60 degree, echo time (TE) =1.45 ms, repetition time (TR) = 3.37 ms, slice thickness = 1.5 mm, field of view (FOV) =500 × 450mm. For a reference image, a CT scan was followed. The CT and MR scans were then fused with the MIM Maestro (MIM software Inc., Cleveland, OH, USA) and sent to the Oncentra Brachy planning system (Elekta, Veenendaal, Netherlands). Automatic catheter reconstruction using CT and MR image intensities followed by manual reconstruction was used to digitize catheters. The accuracy of catheter reconstruction was evaluated from the catheter tip location. Results: The average difference between the catheter tip locations reconstructed from the CT and MR in the transverse, anteroposterior, and craniocaudal directions was −0.1 ± 0.1 mm (left), 0.2 ± 0.2 mm (anterior), and −2.3 ± 0.5 mm (cranio). The average distance in 3D was 2.3 mm ± 0.5 mm. Conclusion: This feasibility study proved that interstitial catheters can be reconstructed with 0.35T MRI images. For more accurate catheter reconstruction which can affect final dose distribution, a systematic shift should be applied to the MR based catheter reconstruction in HDR prostate brachytherapy.

60 APPLIED LIFE SCIENCES↗

EBT GAFCHROMIC{sup TM} film dosimetry in compensator-based intensity modulated radiation therapy

The electron benefit transfer (EBT) GAFCHROMIC films possess a number of features making them appropriate for high-quality dosimetry in intensity-modulated radiation therapy (IMRT). Compensators to deliver IMRT are known to change the beam-energy spectrum as well as to produce scattered photons and to contaminate electrons; therefore, the accuracy and validity of EBT-film dosimetry in compensator-based IMRT should be investigated. Percentage-depth doses and lateral-beam profiles were measured using EBT films in perpendicular orientation with respect to 6 and 18 MV photon beam energies for: (1) different thicknesses of cerrobend slab (open, 1.0, 2.0, 4.0, and 6.0 cm), field sizes (5×5, 10×10, and 20×20 cm{sup 2}), and measurement depths (D{sub max}, 5.0 and 10.0 cm); and (2) step-wedged compensator in a solid phantom. To verify results, same measurements were implemented using a 0.125 cm{sup 3} ionization chamber in a water phantom and also in Monte Carlo simulations using the Monte Carlo N-particle radiation transport computer code. The mean energy of photons was increased due to beam hardening in comparison with open fields at both 6 and 18 MV energies. For a 20×20 cm{sup 2} field size of a 6 MV photon beam and a 6.0 cm thick block, the surface dose decreased by about 12% and percentage-depth doses increased up to 3% at 30.0 cm depth, due to the beam-hardening effect induced by the block. In contrast, at 18 MV, the surface dose increased by about 8% and depth dose reduced by 3% at 30.0 cm depth. The penumbral widths (80% to 20%) increase with block thickness, field size, and beam energy. The EBT film results were in good agreement with the ionization chamber dose profiles and Monte Carlo N-particle radiation transport computer code simulation behind the step-wedged compensator. Also, there was a good agreement between the EBT-film and the treatment-planning results on the anthropomorphic phantom. The EBT films can be accurately used as a 2D dosimeter for dose verification and quality assurance of compensator-based C-IMRT.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-F-SPS-03: Direct Measurement of Organ Doses Resulting From Head and Cervical Spine Trauma CT Protocols

Purpose: This retrospective study analyzes the exposure history of emergency department (ED) patients undergoing head and cervical spine trauma computed tomography (CT) studies. This study investigated dose levels received by trauma patients and addressed any potential concerns regarding radiation dose issues. Methods: Under proper IRB approval, a cohort of 300 trauma cases of head and cervical spine trauma CT scans received in the ED was studied. The radiological image viewing software of the hospital was used to view patient images and image data. The following parameters were extracted: the imaging history of patients, the reported dose metrics from the scanner including the volumetric CT Dose Index (CTDIvol) and Dose Length Product (DLP). A postmortem subject was scanned using the same scan techniques utilized in a standard clinical head and cervical spine trauma CT protocol with 120 kVp and 280 mAs. The CTDIvol was recorded for the subject and the organ doses were measured using optically stimulated luminescent (OSL) dosimeters. Typical organ doses to the brain, thyroid, lens, salivary glands, and skin, based on the cadaver studies, were then calculated and reported for the cohort. Results: The CTDIvol reported by the CT scanner was 25.5 mGy for the postmortem subject. The average CTDIvol from the patient cohort was 34.1 mGy. From these metrics, typical average organ doses in mGy were found to be: Brain (44.57), Thyroid (33.40), Lens (82.45), Salivary Glands (61.29), Skin (47.50). The imaging history of the cohort showed that on average trauma patients received 26.1 scans over a lifetime. Conclusion: The average number of scans received on average by trauma ED patients shows that radiation doses in trauma patients may be a concern. Available dose tracking software would be helpful to track doses in trauma ED patients, highlighting the importance of minimizing unnecessary scans and keeping doses ALARA.

60 APPLIED LIFE SCIENCES↗

beam loss scenarios for MuCool Test Area

The MuCool Test Area (MTA) is an intense primary beam facility derived directly from the Fermilab Linac to test heat deposition and other technical concerns associated with the liquid hydrogen targets, gas-filled RF cavities, and other apparatus being developed to cool intense, large-emittance muon beams. In this study the results of Monte Carlo modeling of several beam loss scenarios are presented. The MTA facility was designed to test targets and other muon cooling apparatus using the intense Fermilab Linac beam. The requested intensity of the proton beam for the MTA is essentially full Linac capability, or 1.6 x 10{sup 13} protons per pulse and an energy of 400 MeV. Two modes of operation will be supported in the MuCOOL beamline: one mode for emittance measurements (and beamline studies) and a second mode for MTA experiments. Maximum beam intensity for these two modes is: 9.6 x 10{sup 15} protons/hr - 600 beam pulses/hour of full Linac beam pulse intensity (1.6 x 10{sup 13} protons/pulse) to the emittance beam absorber and 9.6 x 10{sup 14} protons/hour - 60 beam pulses/hour of full Linac beam pulse intensity to experiments in the MTA experimental hall. This extremely high intensity implies careful investigation into and application of proper shielding materials and configuration in order to satisfy the following two requirements: (i) to reduce the instantaneous dose rate outside of the experimental enclosure to prescribed levels appropriate for the area considered; (ii) to ensure the civil construction of the hall is capable of additional shielding and, further, that the weight of the shielding is commensurate with the loading specifications of the enclosure, notably the ceiling. A number of scenarios for beam loss at different locations were studied in order to determine the maximum beam intensity which is in compliance with the existing shielding. The modeling was performed with the MARS15 code.

43 PARTICLE ACCELERATORS↗

Review of Hybrid (Deterministic/Monte Carlo) Radiation Transport Methods, Codes, and Applications at Oak Ridge National Laboratory

This paper provides a review of the hybrid (Monte Carlo/deterministic) radiation transport methods and codes used at the Oak Ridge National Laboratory and examples of their application for increasing the efficiency of real-world, fixed-source Monte Carlo analyses. The two principal hybrid methods are (1) Consistent Adjoint Driven Importance Sampling (CADIS) for optimization of a localized detector (tally) region (e.g., flux, dose, or reaction rate at a particular location) and (2) Forward Weighted CADIS (FW-CADIS) for optimizing distributions (e.g., mesh tallies over all or part of the problem space) or multiple localized detector regions (e.g., simultaneous optimization of two or more localized tally regions). The two methods have been implemented and automated in both the MAVRIC sequence of SCALE 6 and ADVANTG, a code that works with the MCNP code. As implemented, the methods utilize the results of approximate, fast-running 3-D discrete ordinates transport calculations (with the Denovo code) to generate consistent space- and energy-dependent source and transport (weight windows) biasing parameters. These methods and codes have been applied to many relevant and challenging problems, including calculations of PWR ex-core thermal detector response, dose rates throughout an entire PWR facility, site boundary dose from arrays of commercial spent fuel storage casks, radiation fields for criticality accident alarm system placement, and detector response for special nuclear material detection scenarios and nuclear well-logging tools. Substantial computational speed-ups, generally O(102-4), have been realized for all applications to date. This paper provides a brief review of the methods, their implementation, results of their application, and current development activities, as well as a considerable list of references for readers seeking more information about the methods and/or their applications.

97 MATHEMATICS AND COMPUTING↗

Variations in the Contouring of Organs at Risk: Test Case From a Patient With Oropharyngeal Cancer

Purpose: Anatomy contouring is critical in radiation therapy. Inaccuracy and variation in defining critical volumes will affect everything downstream: treatment planning, dose-volume histogram analysis, and contour-based visual guidance used in image-guided radiation therapy. This study quantified: (1) variation in the contouring of organs at risk (OAR) in a clinical test case and (2) corresponding effects on dosimetric metrics of highly conformal plans. Methods and Materials: A common CT data set with predefined targets from a patient with oropharyngeal cancer was provided to a population of clinics, which were asked to (1) contour OARs and (2) design an intensity-modulated radiation therapy plan. Thirty-two acceptable plans were submitted as DICOM RT data sets, each generated by a different clinical team. Using those data sets, we quantified: (1) the OAR contouring variation and (2) the impact this variation has on dosimetric metrics. New technologies were employed, including a software tool to quantify three-dimensional structure comparisons. Results: There was significant interclinician variation in OAR contouring. The degree of variation is organ-dependent. We found substantial dose differences resulting strictly from contouring variation (differences ranging from -289% to 56% for mean OAR dose; -22% to 35% for maximum dose). However, there appears to be a threshold in the OAR comparison metric beyond which the dose differences stabilize. Conclusions: The effects of interclinician variation in contouring organs-at-risk in the head and neck can be large and are organ-specific. Physicians need to be aware of the effect that variation in OAR contouring can play on the final treatment plan and not restrict their focus only to the target volumes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Practical Method of Adaptive Radiotherapy for Prostate Cancer Using Real-Time Electromagnetic Tracking

Purpose: We have created an automated process using real-time tracking data to evaluate the adequacy of planning target volume (PTV) margins in prostate cancer, allowing a process of adaptive radiotherapy with minimal physician workload. We present an analysis of PTV adequacy and a proposed adaptive process. Methods and Materials: Tracking data were analyzed for 15 patients who underwent step-and-shoot multi-leaf collimation (SMLC) intensity-modulated radiation therapy (IMRT) with uniform 5-mm PTV margins for prostate cancer using the Calypso Registered-Sign Localization System. Additional plans were generated with 0- and 3-mm margins. A custom software application using the planned dose distribution and structure location from computed tomography (CT) simulation was developed to evaluate the dosimetric impact to the target due to motion. The dose delivered to the prostate was calculated for the initial three, five, and 10 fractions, and for the entire treatment. Treatment was accepted as adequate if the minimum delivered prostate dose (D{sub min}) was at least 98% of the planned D{sub min}. Results: For 0-, 3-, and 5-mm PTV margins, adequate treatment was obtained in 3 of 15, 12 of 15, and 15 of 15 patients, and the delivered D{sub min} ranged from 78% to 99%, 96% to 100%, and 99% to 100% of the planned D{sub min}. Changes in D{sub min} did not correlate with magnitude of prostate motion. Treatment adequacy during the first 10 fractions predicted sufficient dose delivery for the entire treatment for all patients and margins. Conclusions: Our adaptive process successfully used real-time tracking data to predict the need for PTV modifications, without the added burden of physician contouring and image analysis. Our methods are applicable to other uses of real-time tracking, including hypofractionated treatment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-G-BRA-16: Target Dose Comparison for Dynamic MLC Tracking and Mid- Ventilation Planning in Lung Radiotherapy Subject to Intrafractional Baseline Drifts

Purpose: Lung tumor motion during radiotherapy can be accounted for by expanded treatment margins, for example using a mid-ventilation planning approach, or by localizing the tumor in real-time and adapting the treatment beam with multileaf collimator (MLC) tracking. This study evaluates the effect of intrafractional changes in the average tumor position (baseline drifts) on these two treatment techniques. Methods: Lung stereotactic treatment plans (9-beam IMRT, 54Gy/3 fractions, mean treatment time: 9.63min) were generated for three patients: either for delivery with MLC tracking (isotropic GTV-to-PTV margin: 2.6mm) or planned with a mid-ventilation approach and delivered without online motion compensation (GTV-to-PTV margin: 4.4-6.3mm). Delivery to a breathing patient was simulated using DynaTrack, our in-house tracking and delivery software. Baseline drifts in cranial and posterior direction were simulated at a rate of 0.5, 1.0 or 1.5mm/min. For dose reconstruction, the corresponding 4DCT phase was selected for each time point of the delivery. Baseline drifts were accounted for by rigidly shifting the CT to ensure correct relative beam-to-target positioning. Afterwards, the doses delivered to each 4DCT phase were accumulated deformably on the mid-ventilation phase using research RayStation v4.6 and dose coverage of the GTV was evaluated. Results: When using the mid-ventilation planning approach, dose coverage of the tumor deteriorated substantially in the presence of baseline drifts. The reduction in D98% coverage of the GTV in a single fraction ranged from 0.4-1.2, 0.6-3.3 and 4.5-6.2Gy, respectively, for the different drift rates. With MLC tracking the GTV D98% coverage remained unchanged (+/− 0.1Gy) regardless of drift. Conclusion: Intrafractional baseline drifts reduce the tumor dose in treatments based on mid-ventilation planning. In rare, large target baseline drifts tumor dose coverage may drop below the prescription, potentially affecting clinical outcome in hypofractionated treatment protocols. Dynamic MLC tracking preserves tumor dose coverage even in the presence of extreme baseline drifts. We acknowledge financial and technical support of the MLC tracking research from Elekta AB. Research at ICR is supported by CRUK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR. MFF is supported by CRUK under Programme C33589/A19908.

60 APPLIED LIFE SCIENCES↗

A benchmarking study of Geant4 for Auger electrons emitted by medical radioisotopes

Auger emitting radioisotopes are of great interest in targeted radiotherapy because, once internalised in the tumour cells, they can deliver dose locally to the radiation sensitive targets, while not affecting surrounding cells. Geant4 is a Monte Carlo code widely used to characterise the physics mechanism at the basis of targeted radiotherapy. Here, we benchmarked the modelling of the emission of Auger electrons in Geant4 deriving from the decay of 123 I, 124 I, 125 I radionuclides against existing theoretical approaches. We also compared Geant4 against reference data in the case of 131 Cs, which is of interest for brachytherapy. In the case of 125 I and 131 Cs, the simulation results are compared to experimental measurements as well. Good agreement was found between Geant4 and the reference data. As far as we know, this is the first study aimed to benchmark against experimental measurements the emission of Auger electrons in Geant4 for radiotherapy applications.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Reducing statistical uncertainties in simulated organ doses of phantoms immersed in water

In this study, methods are addressed to reduce the computational time to compute organ-dose rate coefficients using Monte Carlo techniques. Several variance reduction techniques are compared including the reciprocity method, importance sampling, weight windows and the use of the ADVANTG software package. For low-energy photons, the runtime was reduced by a factor of 10 5 when using the reciprocity method for kerma computation for immersion of a phantom in contaminated water. This is particularly significant since impractically long simulation times are required to achieve reasonable statistical uncertainties in organ dose for low-energy photons in this source medium and geometry. Although the MCNP Monte Carlo code is used in this paper, the reciprocity technique can be used equally well with other Monte Carlo codes.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-237: Monte Carlo Dosimetric Characterization of the Mobetron Mobile Linac

Purpose: The aim of this work is to characterize dosimetrically a clinical intraoperative electron beam accelerator, Mobetron (IntraOp Medical, Inc.) in clinical use in our Hospital. Once this first step is completed our purpose is to evaluate shielding requirements for such a device by preparing adequate phase space files. Methods: It is known that electron beam simulation parameters required for state-of-the-art Monte Carlo codes to obtain a good match with measured data, like the mean energy or the FWHM, may not be code-independent due to the different set of process simulated and formalisms involved. Then, to cross-check our results against any issue in the simulation we have compared experimental data (PDD and profiles for electrons in the range 4 to 12 MeV) with simulations performed independently using both Penelope2011 and Geant4 codes. To do so, the geometry and materials of the head of the accelerator have been fully characterized following information provided by the manufacturer. Results: Both simulations agree with experimental data within experimental uncertainties (±1 mm displacement), although small variations (less than 10%) in the mean energy and FWHM are required to match measured values depending on the code used. Conclusion: Independent Monte Carlo simulations were used to obtain an excellent match to measured electron dose distributions. This opens the road to use such data for evaluating shielding requirements which is the main objective of this project.

07 ISOTOPE AND RADIATION SOURCES↗

Scoping estimates of the LDEF satellite induced radioactivity

The Long Duration Exposure Facility (LDEF) satellite was recovered after almost six years in space. It was well-instrumented with ionizing radiation dosimeters, including thermoluminescent dosimeters, plastic nuclear track detectors, and a variety of metal foil samples for measuring nuclear activation products. The extensive LDEF radiation measurements provide the type of radiation environments and effects data needed to evaluate and help resolve uncertainties in present radiation models and calculational methods. A calculational program was established to aid in LDEF data interpretation and to utilize LDEF data for assessing the accuracy of current models. A summary of the calculational approach is presented. The purpose of the reported calculations is to obtain a general indication of: (1) the importance of different space radiation sources (trapped, galactic, and albedo protons, and albedo neutrons); (2) the importance of secondary particles; and (3) the spatial dependence of the radiation environments and effects expected within the spacecraft. The calculational method uses the High Energy Transport Code (HETC) to estimate the importance of different sources and secondary particles in terms of fluence, absorbed dose in tissue and silicon, and induced radioactivity as a function of depth in aluminum.

Armstrong, Tony W.↗

SU-E-T-348: Verification MU Calculation for Conformal Radiotherapy with Multileaf Collimator Using Report AAPM TG 114

Purpose: The purpose of this work was to develop and validate an open source independent MU dose calculation software for 3D conformal radiotherapy with multileaf high and low resolution according to the report of AAPM TG 11 Methods: Treatment plans were done using Iplan v4.5 BrainLAB TPS. A 6MV photon beam produced by Primus and Novalis linear accelerators equipped with an Optifocus MLC and HDMLC, respectively. TPS dose calculation algorithms were pencil beam and Monte Carlo. 1082 treatments plans were selected for the study. The algorithm was written in free and open source CodeBlocks C++ platform. Treatment plans were imported by the software using RTP format. Equivalent size field is obtained from the positions of the leaves; the effective depth of calculation can be introduced by TPS's dosimetry report or automatically calculated starting from SSD. The inverse square law is calculated by the 3D coordinates of the isocenter and normalization point of the treatment plan. The dosimetric parameters TPR, Sc, Sp and WF are linearly interpolated. Results: 1082 plans of both machines were analyzed. The average uncertainty between the TPS and the independent calculation was −0.43% ± 2.42% [−7.90%, 7.50%]. Specifically for the Primus the variation obtained was −0.85% ± 2.53% and for the Novalis 0.00% ± 2.23%. Data show that 94.8% of the cases the uncertainty was less than or equal to 5%, while 98.9% is less than or equal to 6%. Conclusion: The developed software is appropriate for use in calculation of UM. This software can be obtained upon request.

07 ISOTOPE AND RADIATION SOURCES↗