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At least 1,153 records · Page 64

SU-D-BRE-04: Evaluating the Dose Accuracy of a 2D Ion Chamber Array in High Dose Rate Pencil Beam Scanning Proton Beam

Purpose: To evaluate the absolute dose accuracy of the PTW Octavius 729 XDR 2D ion chamber array at a high dose rate pencil beam scanning proton therapy facility. Methods: A set of 18 plans were created in our treatment planning system, each of which comprising a unique combination of field sizes (FS), length of spread out of Bragg peaks (SOBP) and depths. The parameters used were: FS of 5×5cm{sup 2}, 10×10cm{sup 2} and 15×15cm{sup 2}; flat SOBP of 5cm and 10cm; and isocenter depths of 10cm, 15cm and 20cm, which coincides with the center of the SOBP. The 2D array detector was positioned at the machine isocenter and the appropriate amount of solid water was used to match the planned depths of 10, 15 and 20 cm water equivalent depth. Subsequently, we measured the absolute dose at isocenter using a CC04 ion chamber in a 1D water tank. Both 2D array and CC04 were previously cross calibrated. We also collected the MU rates used by our proton machine from the log files. Results: The relative differences between the CC04 and the 2D array can be summarized into two groups, one with 5 cm SOBP and another with 10 cm SOBP. Plotting these datasets against FS shows that the 2D array response for high dose rate fields (FS of 5×5cm{sup 2} and 5cm SOBP) can be up to 2% lower. Similarly, plotting them against isocenter depths reveals the detector's response can be up to 2% lower for higher energy beams (about 200MeV nominal). The MU rate found in the machine log files for 5cm SOBP's were as high as twice the MU rate for the 10cm SOBP. Conclusion: The 2D array dose response showed a dose rate effect in scanning pencil beam delivery, which needs to be corrected to achieve a better dose accuracy.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-J-86: Lobar Lung Function Quantification by PET Galligas and CT Ventilation Imaging in Lung Cancer Patients

Purpose: The purpose of this study was to quantify the lobar lung function using the novel PET Galligas ([68Ga]-carbon nanoparticle) ventilation imaging and the investigational CT ventilation imaging in lung cancer patients pre-treatment. Methods: We present results on our first three lung cancer patients (2 male, mean age 78 years) as part of an ongoing ethics approved study. For each patient a PET Galligas ventilation (PET-V) image and a pair of breath hold CT images (end-exhale and end-inhale tidal volumes) were acquired using a Siemens Biograph PET CT. CT-ventilation (CT-V) images were created from the pair of CT images using deformable image registration (DIR) algorithms and the Hounsfield Unit (HU) ventilation metric. A comparison of ventilation quantification from each modality was done on the lobar level and the voxel level. A Bland-Altman plot was used to assess the difference in mean percentage contribution of each lobe to the total lung function between the two modalities. For each patient, a voxel-wise Spearmans correlation was calculated for the whole lungs between the two modalities. Results: The Bland-Altman plot demonstrated strong agreement between PET-V and CT-V for assessment of lobar function (r=0.99, p<0.001; range mean difference: −5.5 to 3.0). The correlation between PET-V and CT-V at the voxel level was moderate(r=0.60, p<0.001). Conclusion: This preliminary study on the three patients data sets demonstrated strong agreement between PET and CT ventilation imaging for the assessment of pre-treatment lung function at the lobar level. Agreement was only moderate at the level of voxel correlations. These results indicate that CT ventilation imaging has potential for assessing pre-treatment lobar lung function in lung cancer patients.

60 APPLIED LIFE SCIENCES↗

SU-E-J-196: New Visualization Methods for Longitudinal MRI Registrations and Segmentations

Purpose: To develop visualization techniques to facilitate easy assessment of (a) registration and (b) tracking volumetric changes in structures during radiation therapy from MRI. Method: The frequently used method for visualizing registrations between scans is a multi-color overlay technique or deformation vector fields. However, the overlay technique is unintuitive and does not help to appreciate the quality of registration particularly when the registration mismatches are not very large. Similarly, the deformation fields give an indication of extent of deformation but do not help to assess the differences in registration. We present a mirroring and edge-augmented mirroring technique that places the fixed and moving image next to each other and allows the user to quickly assess the small differences in registration. Next, we present a volumetric intersection based 3D model to visualize the changes in diseased lymph node volumes in head and neck cancer. 3D model-based visualization provides more information about the location-specific changes in volume rather than the simplistic one dimensional information obtained from 2D plot of nodal volume changes. Result: We show results comparing our approach with the standard colorbased overlay method for comparing registrations of intra-patient registrations using T2-MRI. Upon comparing the mirroring technique with the color-overlay, one can more easily appreciate the differences in registration. Adding edge-based mirroring seems to further assist in evaluating the registration. Our approach for viewing registrations seems to be more intuitive and easy to use in order to help assess the quality of registration compared to color-based overlays. Similarly, the change volumetric model together with a 2D plot reveals more information including the locations undergoing changes and responding to treatment. Conclusions: Better approaches are necessary for assessing the quality of registrations and changes in diseased structures over time. Our approach presents some novel visualization solutions for registration and segmentation.

60 APPLIED LIFE SCIENCES↗

SU-E-J-270: Study of PET Response to HDR Brachytherapy of Rectal Cancer

Purpose: Dose-response studies in radiation therapy are typically using single response values for tumors across ensembles of tumors. Using the high dose rate (HDR) treatment plan dose grid and pre- and post-therapy FDG-PET images, we look for correlations between voxelized dose and FDG uptake response in individual tumors. Methods: Fifteen patients were treated for localized rectal cancer using 192Ir HDR brachytherapy in conjunction with surgery. FDG-PET images were acquired before HDR therapy and 6–8 weeks after treatment (prior to surgery). Treatment planning was done on a commercial workstation and the dose grid was calculated. The two PETs and the treatment dose grid were registered to each other using non-rigid registration. The difference in PET SUV values before and after HDR was plotted versus absorbed radiation dose for each voxel. The voxels were then separated into bins for every 400 cGy of absorbed dose and the bin average values plotted similarly. Results: Individual voxel doses did not correlate with PET response; however, when group into tumor subregions corresponding to dose bins, eighty percent of the patients showed a significant positive correlation (R2 > 0) between PET uptake difference in the targeted region and the absorbed dose. Conclusion: By considering larger ensembles of voxels, such as organ average absorbed dose or the dose bins considered here, valuable information may be obtained. The dose-response correlations as measured by FDG-PET difference potentially underlines the importance of FDG-PET as a measure of response, as well as the value of voxelized information.

60 APPLIED LIFE SCIENCES↗

SU-E-T-466: Dosimetric Assessment of the Salivary Glands in Head and Neck Tumour Patients Treated with Radiation Therapy

Purpose: To estimate the correlation between different dosimetric indices and the clinical outcome, which was recorded at different time points after the treatment, regarding the structure of salivary glands in head and neck cancer radiotherapy. Methods: 218 salivary glands from patients with head and neck tumours treated at IPOCFG from 2007 to 2013 were included in this study. The follow up of those patients consisted on weekly medical visits during the treatment that take about seven weeks. After that the patients had consults every three months. Treatment complications were graded using the RTOG/EORTC guidelines. The response of the salivary glands (both parotids, oral cavity and both submandibular glands) was analyzed for six time periods: 7th week, 3rd, 7th, 12th, 18th and 24th months after the start of the radiotherapy. The total dose distributions, converted to a fractionation scheme of 2Gy fractional doses, were used to calculate the DVHs and dose-response plots of salivary glands. Results: The small differences obtained between the mean DVHs showed that patients should be grouped into: with complications (G1+G2) and without complications (G0). The mean dose/2Gy was 22.2±13.2 Gy (G0) and 33.2±8.0 Gy (G1+G2) for the 7th week, 31.9±9.6 Gy (G0) and 34.6±6.8 Gy (G1+G2) for the 12th month and, 32.9±9.3 Gy (G0) and 37.2±8.5 Gy (G1+G2) for the 24th month. The dose-response plots for the 7th week and 24th month were similar to the dose-response curves published in the literature. Conclusion: In some cases, there were not major differences between the mean DVHs of the groups with and without complications in the salivary glands, when comparing them at different time periods. More radiobiological analysis should thus be made to estimate the clinical impact of those differences.

60 APPLIED LIFE SCIENCES↗

SU-E-T-467: Definition of the Proper Tolerances for Beam-Position Accuracy and Beam Width for Quality Assurance in Active Proton Pencil Beam Scanning

Purpose: To estimate the correlation between different dosimetric indices and the clinical outcome, which was recorded at different time points after the treatment, regarding the structure of salivary glands in head and neck cancer radiotherapy. Methods: 218 salivary glands from patients with head and neck tumours treated at IPOCFG from 2007 to 2013 were included in this study. The follow up of those patients consisted on weekly medical visits during the treatment that take about seven weeks. After that the patients had consults every three months. Treatment complications were graded using the RTOG/EORTC guidelines. The response of the salivary glands (both parotids, oral cavity and both submandibular glands) was analyzed for six time periods: 7th week, 3rd, 7th, 12th, 18th and 24th months after the start of the radiotherapy. The total dose distributions, converted to a fractionation scheme of 2Gy fractional doses, were used to calculate the DVHs and dose-response plots of salivary glands. Results: The small differences obtained between the mean DVHs showed that patients should be grouped into: with complications (G1+G2) and without complications (G0). The mean dose/2Gy was 22.2±13.2 Gy (G0) and 33.2±8.0 Gy (G1+G2) for the 7th week, 31.9±9.6 Gy (G0) and 34.6±6.8 Gy (G1+G2) for the 12th month and, 32.9±9.3 Gy (G0) and 37.2±8.5 Gy (G1+G2) for the 24th month. The dose-response plots for the 7th week and 24th month were similar to the dose-response curves published in the literature. Conclusion: In some cases, there were not major differences between the mean DVHs of the groups with and without complications in the salivary glands, when comparing them at different time periods. More radiobiological analysis should thus be made to estimate the clinical impact of those differences.

60 APPLIED LIFE SCIENCES↗

SU-E-T-546: Use of Implant Volume for Quality Assurance of Low Dose Rate Brachytherapy Treatment Plans

Purpose: To analyze the application of volume implant (V100) data as a method for a global check of low dose rate (LDR) brachytherapy plans. Methods: Treatment plans for 335 consecutive patients undergoing permanent seed implants for prostate cancer and for 113 patients treated with plaque therapy for ocular melanoma were analyzed. Plaques used were 54 COMS (10 to 20 mm, notched and regular) and 59 Eye Physics EP917s with variable loading. Plots of treatment time x implanted activity per unit dose versus v100 ^.667 were made. V100 values were obtained using dose volume histograms calculated by the treatment planning systems (Variseed 8.02 and Plaque Simulator 5.4). Four different physicists were involved in planning the prostate seed cases; two physicists for the eye plaques. Results: Since the time and dose for the prostate cases did not vary, a plot of implanted activity vs V100 ^.667 was made. A linear fit with no intercept had an r{sup 2} = 0.978; more than 94% of the actual activities fell within 5% of the activities calculated from the linear fit. The greatest deviations were in cases where the implant volumes were large (> 100 cc). Both COMS and EP917 plaque linear fits were good (r{sup 2} = .967 and .957); the largest deviations were seen for large volumes. Conclusions: The method outlined here is effective for checking planning consistency and quality assurance of two types of LDR brachytherapy treatment plans (temporary and permanent). A spreadsheet for the calculations enables a quick check of the plan in situations were time is short (e.g. OR-based prostate planning)

07 ISOTOPE AND RADIATION SOURCES↗

Verification of a novel method for tube voltage constancy measurement of orthovoltage x-ray irradiators

Purpose: For orthovoltage x-ray irradiators, the tube voltage is one of the most fundamental system parameters as this directly relates to the dosimetry in radiation biology studies; however, to the best of our knowledge, there is no commercial portable quality assurance (QA) tool to directly test the constancy of the tube voltage greater than 160 kV. The purpose of this study is to establish the Beam Quality Index (BQI), a quantity strongly correlated to the tube voltage, as an alternative parameter for the verification of the tube voltage as part of the QA program of orthovoltage x-ray irradiators. Methods: A multipurpose QA meter and its associated data acquisition software were used to customize the measurement parameters to measure the BQI and collect its time-plot. BQI measurements were performed at 320 kV with four filtration levels on three orthovoltage x-ray irradiators of the same model, one of which had been recently energy-calibrated at the factory. Results: For each of the four filtration levels, the measured BQI values were in good agreement (<5%) between the three irradiators. BQI showed filtration-specificity, possibly due to the difference in beam quality. Conclusions: The BQI has been verified as a feasible alternative for monitoring the constancy of the tube voltage for orthovoltage irradiators. The time-plot of BQI offers information on the behavior of beam energy at different phases of the irradiation time line. In addition, this would provide power supply performance characteristics from initial ramp-up to plateau, and finally, the sharp drop-off at the end of the exposure.

60 APPLIED LIFE SCIENCES↗

SU-E-I-34: Evaluating Use of AEC to Lower Dose for Lung Cancer Screening CT Protocols

Purpose: The National Lung Screening Trial mandated manual low dose CT technique factors, where up to a doubling of radiation output could be used over a regular to large patient size range. Recent guidance from the AAPM and ACR for lung cancer CT screening recommends radiation output adjustment for patient size either through AEC or a manual technique chart. This study evaluated the use of AEC for output control and dose reduction. Methods: The study was performed on a multidetector helical CT scanner (Aquillion ONE, Toshiba Medical) equipped with iterative reconstruction (ADIR-3D), AEC was adjusted with a standard deviation (SD) image quality noise index. The protocol SD parameter was incrementally increased to reduce patient population dose while image quality was evaluated by radiologist readers scoring the clinical utility of images on a Likert scale. Results: Plots of effective dose vs. body size (water cylinder diameter reported by the scanner) demonstrate monotonic increase in patient dose with increasing patient size. At the initial SD setting of 19 the average CTDIvol for a standard size patient was ∼ 2.0 mGy (1.2 mSv effective dose). This was reduced to ∼1.0 mGy (0.5 mSv) at an SD of 25 with no noticeable reduction in clinical utility of images as demonstrated by Likert scoring. Plots of effective patient diameter and BMI vs body size indicate that these metrics could also be used for manual technique charts. Conclusion: AEC offered consistent and reliable control of radiation output in this study. Dose for a standard size patient was reduced to one-third of the 3 mGy CTDIvol limit required for ACR accreditation of lung cancer CT screening. Gary Arbique: Research Grant, Toshiba America Medical Systems; Cecelia Brewington: Research Grant, Toshiba America Medical Systems; Di Zhang: Employee, Toshiba America Medical Systems.

60 APPLIED LIFE SCIENCES↗

SU-E-I-84: Accuracy Comparison of Multi-Modality Image-Based Volumes of Rodent Solid Tumors Using In-Air Micro-CT Image Volume

Purpose: Tumor volume is considered as a better predictor for therapy response monitoring and tumor staging over Response Evaluation Criteria In Solid Tumors (RECIST) or World Health Organization (WHO) criteria. In this study, the accuracy of subcutaneous rodent tumor volumes using preclinical magnetic resonance imaging (MRI), micro-computed tomography (micro-CT) and ultrasound (US) equipment and with an external caliper was compared using in-air micro-CT image volume of excised tumors determined as reference tumor volume in our prior study. Methods: MR, US and micro-CT images of subcutaneous SCC4 head and neck tumor xenografts were acquired 4, 6, 9, 11 and 13 days after tumor cell inoculation. Before MR and US scans, caliper measurements were made. After tumors were excised, in-air micro-CT imaging and ex vivo caliper measurements were performed. Tumor volumes were calculated using formula V = (π/6)*a*b*c where a, b and c are the maximum diameters in three perpendicular dimensions determined by the three image modalities and caliper, and compared with reference tumor volume by linear regression analysis as well as Bland-Altman plots. A one-way Analysis of Variance (ANOVA) test was also performed to compare volumes among caliper measurements. Results: The correlation coefficients (R2) of the regression lines for tumor volumes measured by the three imaging modalities and caliper were 0.9939, 0.9669, 0.9806, 0.9274, 0.9619 and 0.9819 for MRI, US and micro-CT, caliperbeforeMRI, caliperbeforeUS and ex vivo caliper respectively. In Bland-Altman plots, the average of tumor volume difference from reference tumor volume (bias) was significant for caliper and micro- CT, but not for MRI and US. Comparison of caliper measurements showed a significant difference (p < 0.05). Conclusion: Using the in-air micro-CT image volume, tumor volume measured by MRI was the most accurate among the three imaging modalities. In vivo caliper volume measurements showed unreliability while ex vivo caliper measurements reduced errors.

60 APPLIED LIFE SCIENCES↗

SU-E-J-244: Development and Validation of a Knowledge Based Planning Model for External Beam Radiation Therapy of Locally Advanced Non-Small Cell Lung Cancer

Purpose: The study aims to develop and validate a knowledge based planning (KBP) model for external beam radiation therapy of locally advanced non-small cell lung cancer (LA-NSCLC). Methods: RapidPlan™ technology was used to develop a lung KBP model. Plans from 65 patients with LA-NSCLC were used to train the model. 25 patients were treated with VMAT, and the other patients were treated with IMRT. Organs-at-risk (OARs) included right lung, left lung, heart, esophagus, and spinal cord. DVH and geometric distribution DVH were extracted from the treated plans. The model was trained using principal component analysis and step-wise multiple regression. Box plot and regression plot tools were used to identify geometric outliers and dosimetry outliers and help fine-tune the model. The validation was performed by (a) comparing predicted DVH boundaries to actual DVHs of 63 patients and (b) using an independent set of treatment planning data. Results: 63 out of 65 plans were included in the final KBP model with PTV volume ranging from 102.5cc to 1450.2cc. Total treatment dose prescription varied from 50Gy to 70Gy based on institutional guidelines. One patient was excluded due to geometric outlier where 2.18cc of spinal cord was included in PTV. The other patient was excluded due to dosimetric outlier where the dose sparing to spinal cord was heavily enforced in the clinical plan. Target volume, OAR volume, OAR overlap volume percentage to target, and OAR out-of-field volume were included in the trained model. Lungs and heart had two principal component scores of GEDVH, whereas spinal cord and esophagus had three in the final model. Predicted DVH band (mean ±1 standard deviation) represented 66.2±3.6% of all DVHs. Conclusion: A KBP model was developed and validated for radiotherapy of LA-NSCLC in a commercial treatment planning system. The clinical implementation may improve the consistency of IMRT/VMAT planning.

60 APPLIED LIFE SCIENCES↗

SU-E-T-136: Assessment of Seasonal Linear Accelerator Output Variations and Associated Impacts

Purpose: Application of process control theory in quality assurance programs promises to allow earlier identification of problems and potentially better quality in delivery than traditional paradigms based primarily on tolerances and action levels. The purpose of this project was to characterize underlying seasonal variations in linear accelerator output that can be used to improve performance or trigger preemptive maintenance. Methods: Review of runtime plots of daily (6 MV) output data acquired using in house ion chamber based devices over three years and for fifteen linear accelerators of varying make and model were evaluated. Shifts in output due to known interventions with the machines were subtracted from the data to model an uncorrected scenario for each linear accelerator. Observable linear trends were also removed from the data prior to evaluation of periodic variations. Results: Runtime plots of output revealed sinusoidal, seasonal variations that were consistent across all units, irrespective of manufacturer, model or age of machine. The average amplitude of the variation was on the order of 1%. Peak and minimum variations were found to correspond to early April and September, respectively. Approximately 48% of output adjustments made over the period examined were potentially avoidable if baseline levels had corresponded to the mean output, rather than to points near a peak or valley. Linear trends were observed for three of the fifteen units, with annual increases in output ranging from 2–3%. Conclusion: Characterization of cyclical seasonal trends allows for better separation of potentially innate accelerator behaviour from other behaviours (e.g. linear trends) that may be better described as true out of control states (i.e. non-stochastic deviations from otherwise expected behavior) and could indicate service requirements. Results also pointed to an optimal setpoint for accelerators such that output of machines is maintained within set tolerances and interventions are required less frequently.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-144: Bayesian Inference of Local Relapse Data Using a Poisson-Based Tumour Control Probability Model

Purpose: The purpose of this project is to develop a robust method of parameter estimation for a Poisson-based TCP model using Bayesian inference. Methods: Bayesian inference was performed using the PyMC3 probabilistic programming framework written in Python. A Poisson-based TCP regression model that accounts for clonogen proliferation was fit to observed rates of local relapse as a function of equivalent dose in 2 Gy fractions for a population of 623 stage-I non-small-cell lung cancer patients. The Slice Markov Chain Monte Carlo sampling algorithm was used to sample the posterior distributions, and was initiated using the maximum of the posterior distributions found by optimization. The calculation of TCP with each sample step required integration over the free parameter α, which was performed using an adaptive 24-point Gauss-Legendre quadrature. Convergence was verified via inspection of the trace plot and posterior distribution for each of the fit parameters, as well as with comparisons of the most probable parameter values with their respective maximum likelihood estimates. Results: Posterior distributions for α, the standard deviation of α (σ), the average tumour cell-doubling time (Td), and the repopulation delay time (Tk), were generated assuming α/β = 10 Gy, and a fixed clonogen density of 10{sup 7} cm−{sup 3}. Posterior predictive plots generated from samples from these posterior distributions are in excellent agreement with the observed rates of local relapse used in the Bayesian inference. The most probable values of the model parameters also agree well with maximum likelihood estimates. Conclusion: A robust method of performing Bayesian inference of TCP data using a complex TCP model has been established.

60 APPLIED LIFE SCIENCES↗

WE-G-204-06: Grid-Line Artifact Minimization for High Resolution Detectors Using Iterative Residual Scatter Correction

Purpose: Anti-scatter grid-line artifacts are more prominent for high-resolution x-ray detectors since the fraction of a pixel blocked by the grid septa is large. Direct logarithmic subtraction of the artifact pattern is limited by residual scattered radiation and we investigate an iterative method for scatter correction. Methods: A stationary Smit-Rοntgen anti-scatter grid was used with a high resolution Dexela 1207 CMOS X-ray detector (75 µm pixel size) to image an artery block (Nuclear Associates, Model 76-705) placed within a uniform head equivalent phantom as the scattering source. The image of the phantom was divided by a flat-field image obtained without scatter but with the grid to eliminate grid-line artifacts. Constant scatter values were subtracted from the phantom image before dividing by the averaged flat-field-with-grid image. The standard deviation of pixel values for a fixed region of the resultant images with different subtracted scatter values provided a measure of the remaining grid-line artifacts. Results: A plot of the standard deviation of image pixel values versus the subtracted scatter value shows that the image structure noise reaches a minimum before going up again as the scatter value is increased. This minimum corresponds to a minimization of the grid-line artifacts as demonstrated in line profile plots obtained through each of the images perpendicular to the grid lines. Artifact-free images of the artery block were obtained with the optimal scatter value obtained by this iterative approach. Conclusion: Residual scatter subtraction can provide improved grid-line artifact elimination when using the flat-field with grid “subtraction” technique. The standard deviation of image pixel values can be used to determine the optimal scatter value to subtract to obtain a minimization of grid line artifacts with high resolution x-ray imaging detectors. This study was supported by NIH Grant R01EB002873 and an equipment grant from Toshiba Medical Systems Corp.

60 APPLIED LIFE SCIENCES↗

Permanent-magnet energy spectrometer for electron beams from radiotherapy accelerators

Purpose: The purpose of this work was to adapt a lightweight, permanent magnet electron energy spectrometer for the measurement of energy spectra of therapeutic electron beams. Methods: An irradiation geometry and measurement technique were developed for an approximately 0.54-T, permanent dipole magnet spectrometer to produce suitable latent images on computed radiography (CR) phosphor strips. Dual-pinhole electron collimators created a 0.318-cm diameter, approximately parallel beam incident on the spectrometer and an appropriate dose rate at the image plane (CR strip location). X-ray background in the latent image, reduced by a 7.62-cm thick lead block between the pinhole collimators, was removed using a fitting technique. Theoretical energy-dependent detector response functions (DRFs) were used in an iterative technique to transform CR strip net mean dose profiles into energy spectra on central axis at the entrance to the spectrometer. These spectra were transformed to spectra at 95-cm source to collimator distance (SCD) by correcting for the energy dependence of electron scatter. The spectrometer was calibrated by comparing peak mean positions in the net mean dose profiles, initially to peak mean energies determined from the practical range of central-axis percent depth-dose (%DD) curves, and then to peak mean energies that accounted for how the collimation modified the energy spectra (recalibration). The utility of the spectrometer was demonstrated by measuring the energy spectra for the seven electron beams (7–20 MeV) of an Elekta Infinity radiotherapy accelerator. Results: Plots of DRF illustrated their dependence on energy and position in the imaging plane. Approximately 15 iterations solved for the energy spectra at the spectrometer entrance from the measured net mean dose profiles. Transforming those spectra into ones at 95-cm SCD increased the low energy tail of the spectra, while correspondingly decreasing the peaks and shifting them to slightly lower energies. Energy calibration plots of peak mean energy versus peak mean position of the net mean dose profiles for each of the seven electron beams followed the shape predicted by the Lorentz force law for a uniform z-component of the magnetic field, validating its being modeled as uniform (0.542 ± 0.027 T). Measured Elekta energy spectra and their peak mean energies correlated with the 0.5-cm (7–13 MeV) and the 1.0-cm (13–20 MeV) R{sub 90} spacings of the %DD curves. The full-width-half-maximum of the energy spectra decreased with decreasing peak mean energy with the exception of the 9-MeV beam, which was anomalously wide. Similarly, R{sub 80–20} decreased linearly with peak mean energy with the exception of the 9 MeV beam. Both were attributed to suboptimal tuning of the high power phase shifter for the recycled radiofrequency power reentering the traveling wave accelerator. Conclusions: The apparatus and analysis techniques of the authors demonstrated that an inexpensive, lightweight, permanent magnet electron energy spectrometer can be used for measuring the electron energy distributions of therapeutic electron beams (6–20 MeV). The primary goal of future work is to develop a real-time spectrometer by incorporating a real-time imager, which has potential applications such as beam matching, ongoing beam tune maintenance, and measuring spectra for input into Monte Carlo beam calculations.

60 APPLIED LIFE SCIENCES↗

SU-F-R-12: Prediction of TrueBeam Hardware Issues Using Trajectory Log Analysis

Purpose: To predict potential failures of hardware within the Varian TrueBeam linear accelerator in order to proactively replace parts and decrease machine downtime. Methods: Machine downtime is a problem for all radiation oncology departments and vendors. Most often it is the result of unexpected equipment failure, and increased due to lack of in-house clinical engineering support. Preventative maintenance attempts to assuage downtime, but often is ineffective at preemptively preventing many failure modes such as MLC motor failures, the need to tighten a gantry chain, or the replacement of a jaw motor, among other things. To attempt to alleviate downtime, software was developed in house that determines the maximum value of each axis enumerated in the Truebeam trajectory log files. After patient treatments, this data is stored in a SQL database. Microsoft Power BI is used to plot the average maximum error of each day of each machine as a function of time. The results are then correlated with actual faults that occurred at the machine with the help of Varian service engineers. Results: Over the course of six months, 76,312 trajectory logs have been written into the database and plotted in Power BI. Throughout the course of analysis MLC motors have been replaced on three machines due to the early warning of the trajectory log analysis. The service engineers have also been alerted to possible gantry issues on one occasion due to the aforementioned analysis. Conclusion: Analyzing the trajectory log data is a viable and effective early warning system for potential failures of the TrueBeam linear accelerator. With further analysis and tightening of the tolerance values used to determine a possible imminent failure, it should be possible to pinpoint future issues more thoroughly and for more axes of motion.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-F-T-293: Experimental Comparisons of Ionization Chambers with Different Volumes for CyberKnife Delivery Quality Assurance

Purpose: To evaluate the practicality use of ionization chambers with different volumes for delivery quality assurance of CyberKnife plans, Methods: Dosimetric measurements with a spherical solid water phantom and three ionization chambers with volumes of 0.13, 0.04, and 0.01 cm3 (IBA CC13, CC04, and CC01, respectively) were performed for various CyberKnife clinical treatment plans including both isocentric and nonisocentric delivery. For each chamber, the ion recombination correction factors Ks were calculated using the Jaffe plot method and twovoltage method at a 10-cm depth for a 60-mm collimator field in a water phantom. The polarity correction factors Kpol were determined for 5–60-mm collimator fields in same experimental setup. The measured doses were compared to the doses for the detectors calculated using a treatment planning system. Results: The differences in the Ks between the Jaffe plot method and two-voltage method were −0.12, −0.02, and 0.89% for CC13, CC04, and CC01, respectively. The changes in Kpol for the different field sizes were 0.2, 0.3, and 0.8% for CC13, CC04, and CC01, respectively. The measured doses for CC04 and CC01 were within 3% of the calculated doses for the clinical treatment plans with isocentric delivery with collimator fields greater than 12.5 mm. Those for CC13 had differences of over 3% for the plans with isocentric delivery with collimator fields less than 15 mm. The differences for the isocentric plans were similar to those for the single beam plans. The measured doses for each chamber were within 3% of the calculated doses for the non-isocentric plans except for that with a PTV volume less than 1.0 cm{sup 3}. Conclusion: Although there are some limitations, the ionization chamber with a smaller volume is a better detector for verification of the CyberKnife plans owing to the high spatial resolution.

60 APPLIED LIFE SCIENCES↗

TU-FG-201-07: Development of SRS Conical Collimator Collision Prediction Software for Radiation Treatment Safety

Purpose: Stereotactic radiosurgery (SRS) treatments using conical collimators can potentially result in gantry collision with treatment table due to limited collision-clear spaces. An in-house software was developed to help the SRS treatment planner mitigate potential SRS conical collimator (Varian Medical System, Palo Alto, CA) collisions with the treatment table. This software was designed to remove treatment re-planning secondary to unexpected collisions. Methods: A BrainLAB SRS ICT Frameless Extension used for SRS treatments in our clinic was mathematically modelled using surface points registered to the 3D co-ordinate space of the couch extension. The surface points are transformed based on the treatment isocenter point and potential collisions are determined in 3D space for couch and gantry angle combinations. The distance between the SRS conical collimators and LINAC isocenter is known. The collision detection model was programmed in MATLAB (Mathwork, Natick, MA) to display graphical plots of the calculations, and the plotted data is used to avoid the gantry and couch angle combinations that would likely result in a collision. We have utilized the cone collision tool for 23 SRS cone treatment plans (8 retrospective and 15 prospective for 10 patients). Results: Twenty one plans strongly agreed with the software tool prediction for collision. However, in two plans, a collision was observed with a 0.5 cm margin when the software predicted no collision. Therefore, additional margins were added to the clearance criteria in the program to achieve a lower risk of actual collisions. Conclusion: Our in-house developed collision check software successfully avoided SRS cone re-planning by 91.3% due to a reduction in cone collisions with the treatment table. Future developments to our software will include a CT image data set based collision prediction model as well as a beam angle optimization tool to avoid normal critical tissues as well as previously treated lesions.

60 APPLIED LIFE SCIENCES↗