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Structural isomers of the S 2 state in photosystem II: do they exist at room temperature and are they important for function?

In nature, an oxo‐bridged Mn 4 CaO 5 cluster embedded in photosystem II (PSII), a membrane‐bound multi‐subunit pigment protein complex, catalyzes the water oxidation reaction that is driven by light‐induced charge separations in the reaction center of PSII. The Mn 4 CaO 5 cluster accumulates four oxidizing equivalents to enable the four‐electron four‐proton catalysis of two water molecules to one dioxygen molecule and cycles through five intermediate S‐states, S 0 – S 4 in the Kok cycle. One important question related to the catalytic mechanism of the oxygen‐evolving complex (OEC) that remains is, whether structural isomers are present in some of the intermediate S‐states and if such equilibria are essential for the mechanism of the O‐O bond formation. Here we compare results from electron paramagnetic resonance (EPR) and X‐ray absorption spectroscopy (XAS) obtained at cryogenic temperatures for the S 2 state of PSII with structural data collected of the S 1 , S 2 and S 3 states by serial crystallography at neutral pH (∼6.5) using an X‐ray free electron laser at room temperature. While the cryogenic data show the presence of at least two structural forms of the S 2 state, the room temperature crystallography data can be well‐described by just one S 2 structure. We discuss the deviating results and outline experimental strategies for clarifying this mechanistically important question.

Chatterjee, Ruchira↗

Probing the in situ volumes of Arabidopsis leaf plastids using three‐dimensional confocal and scanning electron microscopy

SUMMARY Leaf plastids harbor a plethora of biochemical reactions including photosynthesis, one of the most important metabolic pathways on Earth. Scientists are eager to unveil the physiological processes within the organelle but also their interconnection with the rest of the plant cell. An increasingly important feature of this venture is to use experimental data in the design of metabolic models. A remaining obstacle has been the limited in situ volume information of plastids and other cell organelles. To fill this gap for chloroplasts, we established three microscopy protocols delivering in situ volumes based on: (i) chlorophyll fluorescence emerging from the thylakoid membrane, (ii) a CFP marker embedded in the envelope, and (iii) calculations from serial block‐face scanning electron microscopy (SBFSEM). The obtained data were corroborated by comparing wild‐type data with two mutant lines affected in the plastid division machinery known to produce small and large mesophyll chloroplasts, respectively. Furthermore, we also determined the volume of the much smaller guard cell plastids. Interestingly, their volume is not governed by the same components of the division machinery which defines mesophyll plastid size. Based on our three approaches, the average volume of a mature Col‐0 wild‐type mesophyll chloroplasts is 93 μm 3 . Wild‐type guard cell plastids are approximately 18 μm 3 . Lastly, our comparative analysis shows that the chlorophyll fluorescence analysis can accurately determine chloroplast volumes, providing an important tool to research groups without access to transgenic marker lines expressing genetically encoded fluorescence proteins or costly SBFSEM equipment.

Knoblauch, Jan↗

Role of the blocking capacitor in control of ion energy distributions in pulsed capacitively coupled plasmas sustained in Ar/CF{sub 4}/O{sub 2}

In plasma etching for microelectronics fabrication, the quality of the process is in large part determined by the ability to control the ion energy distribution (IED) onto the wafer. To achieve this control, dual frequency capacitively coupled plasmas (DF-CCPs) have been developed with the goal of separately controlling the magnitude of the fluxes of ions and radicals with the high frequency (HF) and the shape of the IED with the low frequency (LF). In steady state operation, plasma properties are determined by a real time balance between electron sources and losses. As such, for a given geometry, pressure, and frequency of operation, the latitude for controlling the IED may be limited. Pulsed power is one technique being investigated to provide additional degrees of freedom to control the IED. In one configuration of a DF-CCP, the HF power is applied to the upper electrode and LF power is applied to the lower electrode which is serially connected to a blocking capacitor (BC) which generates a self dc-bias. In the steady state, the value of the dc-bias is, in fact, constant. During pulsed operation, however, there may be time modulation of the dc-bias which provides an additional means to control the IED. In this paper, IEDs to the wafer in pulsed DF-CCPs sustained in Ar/CF{sub 4}/O{sub 2} are discussed with results from a two-dimensional plasma hydrodynamics model. The IED can be manipulated depending on whether the LF or HF power is pulsed. The dynamic range of the control can be tuned by the dc-bias generated on the substrate, whose time variation depends on the size of the BC during pulsed operation. It was found that high energy ions can be preferentially produced when pulsing the HF power and low energy ions are preferentially produced when pulsing the LF power. A smaller BC value which allows the bias to follow the change in charged particle fluxes produces a larger dynamic range with which to control IEDs.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

Multiresonant layered plasmonic films

Multi-resonant nanoplasmonic films have numerous applications in areas such as nonlinear optics, sensing, and tamper indication. While techniques such as focused ion beam milling and electron beam lithography can produce high-quality multi-resonant films, these techniques are expensive, serial processes that are difficult to scale at the manufacturing level. Here, we present the fabrication of multi-resonant nanoplasmonic films using a layered stacking technique. Periodically-spaced gold nanocup substrates were fabricated using self-assembled polystyrene nanospheres followed by oxygen plasma etching and metal deposition via magnetron sputter coating. By adjusting etch parameters and initial nanosphere size, it was possible to achieve an optical response ranging from the visible to the near-infrared. Singly resonant, flexible films were first made by performing peel-off using an adhesive-coated polyolefin film. Through stacking layers of the nanofilm, we demonstrate fabrication of multi-resonant films at a fraction of the cost and effort as compared to top-down lithographic techniques.

nano↗

Photonic ring resonator notch filters for astronomical OH line suppression

Photonic ring resonator arrays used as notch filters are a promising novel solution to improve the signal-to-noise ratio of ground-based astronomical observations by suppressing OH emission lines in the near-infrared (NIR) wavelength range (0.9-2.5 μm). We aim to fabricate a series of ring resonators connected by a waveguide, each with its resonance wavelength and full-width-half-maximum (FWHM) matched with one of the OH emission lines. The fundamental structure of ring resonator-based notch filters is a ring resonator evanescently coupled to a waveguide. Due to the optical loss of the ring resonator, the transmission of light through the waveguide will be suppressed at the resonance wavelength of the ring resonator. The degree of suppression can be controlled by varying the coupling strength between the waveguide and the ring resonator, while the resonance wavelength can be controlled by the geometry and size of the ring. However, since a single ring resonator has multiple modes each with a different wavelength separated by its free spectral range (FSR), the additional suppression at other wavelengths may undermine the signal. Therefore, the ideal FSR off the ring resonators needs to be larger than the measurement window. For this application, we aim the FSR to be 1 larger than 30 nm . Our initial measurement results revealed two major challenges for this application. First, the FSR of the ring resonators is limited by the bending loss of ring resonators. In a standard 220 nm silicon-on-insulator material platform, the FSR of ring resonators cannot exceed 30 nm; Second, due to the wafer thickness variation and fabrication inaccuracy, the achievable accuracy in the resonance wavelength of a fabricated single ring resonator is only ~1.5 nm. In this work, we report our novel solutions to the above two challenges. For the first one, we have developed a novel structure based on the Vernier effect to greatly raise the FSR of ring resonators. Serially coupled Vernier ring structures is a typical approach to increase the FSR without encountering bending loss, but it requires restrictive matching of the coupling and optical loss of the rings and any imperfect matching can result in even noisier signals. On the contrary, our structure, as shown in shown in Fig. 1, does not require the restrictive matching. The signals of two output ports in our structure marked in Fig. 1 will be added together to form the final output signal, and Fig. 2 shows the finite-difference time-domain (FDTD) simulation results of the final output signal. As can be seen, the FSR of the entire structure is well-beyond 60 nm with little noise at other wavelengths. For the second one, we have developed an easy-to-implement method to permanently tune the resonance wavelengths of ring resonators within 0.1 nm accuracy. The tuning mechanism is based on the property of hydrogen silsesquioxane (HSQ) resist. As a negative tone electron beam resist, HSQ upon exposure will cross-link and eventually form SiO2. The refractive 2 index of HSQ resist and formed SiO2 are slightly different , enabling the tuning. By having a thin layer of HSQ resist on top of ring resonator structures followed by SiO2 cladding, the resonance wavelengths of ring resonators can be post-tuned Advances in Optical Astronomical Instrumentation 2019, edited by Simon Ellis, Céline d'Orgeville, Downloaded From: https://www.spiedigitallibrary.org/conference-proceedings-of-spie on 23 Sep 2020 Terms of Use: https://www.spiedigitallibrary.org/terms-of-use through electron beam exposure. We have found that, within 5 nm tuning range, the resonance wavelength shift and dosage applied obeys a linear relationship. So a simple calibration beforehand can result in resonance wavelength tuning within 0.1 nm accuracy. The transmission spectra of a 3-ring device before and after tuning is shown in Fig. 3.

Astronomical optics↗

Verification of Gamma Knife extend system based fractionated treatment planning using EBT2 film

Purpose: This paper presents EBT2 film verification of fractionated treatment planning with the Gamma Knife (GK) extend system, a relocatable frame system for multiple-fraction or serial multiple-session radiosurgery.Methods: A human head shaped phantom simulated the verification process for fractionated Gamma Knife treatment. Phantom preparation for Extend Frame based treatment planning involved creating a dental impression, fitting the phantom to the frame system, and acquiring a stereotactic computed tomography (CT) scan. A CT scan (Siemens, Emotion 6) of the phantom was obtained with following parameters: Tube voltage—110 kV, tube current—280 mA, pixel size—0.5 × 0.5 and 1 mm slice thickness. A treatment plan with two 8 mm collimator shots and three sectors blocking in each shot was made. Dose prescription of 4 Gy at 100% was delivered for the first fraction out of the two fractions planned. Gafchromic EBT2 film (ISP Wayne, NJ) was used as 2D verification dosimeter in this process. Films were cut and placed inside the film insert of the phantom for treatment dose delivery. Meanwhile a set of films from the same batch were exposed from 0 to 12 Gy doses for calibration purposes. An EPSON (Expression 10000 XL) scanner was used for scanning the exposed films in transparency mode. Scanned films were analyzed with inhouse written MATLAB codes.Results: Gamma index analysis of film measurement in comparison with TPS calculated dose resulted in high pass rates >90% for tolerance criteria of 1%/1 mm. The isodose overlay and linear dose profiles of film measured and computed dose distribution on sagittal and coronal plane were in close agreement.Conclusions: Through this study, the authors propose treatment verification QA method for Extend frame based fractionated Gamma Knife radiosurgery using EBT2 film.

61 RADIATION PROTECTION AND DOSIMETRY↗

Longitudinal, intermodality registration of quantitative breast PET and MRI data acquired before and during neoadjuvant chemotherapy: Preliminary results

Purpose: The authors propose a method whereby serially acquired DCE-MRI, DW-MRI, and FDG-PET breast data sets can be spatially and temporally coregistered to enable the comparison of changes in parameter maps at the voxel level. Methods: First, the authors aligned the PET and MR images at each time point rigidly and nonrigidly. To register the MR images longitudinally, the authors extended a nonrigid registration algorithm by including a tumor volume-preserving constraint in the cost function. After the PET images were aligned to the MR images at each time point, the authors then used the transformation obtained from the longitudinal registration of the MRI volumes to register the PET images longitudinally. The authors tested this approach on ten breast cancer patients by calculating a modified Dice similarity of tumor size between the PET and MR images as well as the bending energy and changes in the tumor volume after the application of the registration algorithm. Results: The median of the modified Dice in the registered PET and DCE-MRI data was 0.92. For the longitudinal registration, the median tumor volume change was −0.03% for the constrained algorithm, compared to −32.16% for the unconstrained registration algorithms (p = 8 × 10{sup −6}). The medians of the bending energy were 0.0092 and 0.0001 for the unconstrained and constrained algorithms, respectively (p = 2.84 × 10{sup −7}). Conclusions: The results indicate that the proposed method can accurately spatially align DCE-MRI, DW-MRI, and FDG-PET breast images acquired at different time points during therapy while preventing the tumor from being substantially distorted or compressed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Semiautomatic segmentation of aortic valve from sequenced ultrasound image using a novel shape-constraint GCV model

Purpose: Effective and accurate segmentation of the aortic valve (AV) from sequenced ultrasound (US) images remains a technical challenge because of intrinsic factors of ultrasound images that impact the quality and the continuous changes of shape and position of segmented objects. In this paper, a novel shape-constraint gradient Chan-Vese (GCV) model is proposed for segmenting the AV from time serial echocardiography. Methods: The GCV model is derived by incorporating the energy of the gradient vector flow into a CV model framework, where the gradient vector energy term is introduced by calculating the deviation angle between the inward normal force of the evolution contour and the gradient vector force. The flow force enlarges the capture range and enhances the blurred boundaries of objects. This is achieved by adding a circle-like contour (constructed using the AV structure region as a constraint shape) as an energy item to the GCV model through the shape comparison function. This shape-constrained energy can enhance the image constraint force by effectively connecting separate gaps of the object edge as well as driving the evolution contour to quickly approach the ideal object. Because of the slight movement of the AV in adjacent frames, the initial constraint shape is defined by users, with the other constraint shapes being derived from the segmentation results of adjacent sequence frames after morphological filtering. The AV is segmented from the US images by minimizing the proposed energy function. Results: To evaluate the performance of the proposed method, five assessment parameters were used to compare it with manual delineations performed by radiologists (gold standards). Three hundred and fifteen images acquired from nine groups were analyzed in the experiment. The area-metric overlap error rate was 6.89% ± 2.88%, the relative area difference rate 3.94% ± 2.63%, the average symmetric contour distance 1.08 ± 0.43 mm, the root mean square symmetric contour distance 1.37 ± 0.52 mm, and the maximum symmetric contour distance was 3.57 ± 1.72 mm. Conclusions: Compared with the CV model, as a result of the combination of the gradient vector and neighborhood shape information, this semiautomatic segmentation method significantly improves the accuracy and robustness of AV segmentation, making it feasible for improved segmentation of aortic valves from US images that have fuzzy boundaries.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Quality control procedures for dynamic treatment delivery techniques involving couch motion

In this study, the authors introduce and demonstrate quality control procedures for evaluating the geometric and dosimetric fidelity of dynamic treatment delivery techniques involving treatment couch motion synchronous with gantry and multileaf collimator (MLC). Tests were designed to evaluate positional accuracy, velocity constancy and accuracy for dynamic couch motion under a realistic weight load. A test evaluating the geometric accuracy of the system in delivering treatments over complex dynamic trajectories was also devised. Custom XML scripts that control the Varian TrueBeam™ STx (Serial #3) axes in Developer Mode were written to implement the delivery sequences for the tests. Delivered dose patterns were captured with radiographic film or the electronic portal imaging device. The couch translational accuracy in dynamic treatment mode was 0.01 cm. Rotational accuracy was within 0.3°, with 0.04 cm displacement of the rotational axis. Dose intensity profiles capturing the velocity constancy and accuracy for translations and rotation exhibited standard deviation and maximum deviations below 3%. For complex delivery involving MLC and couch motions, the overall translational accuracy for reproducing programmed patterns was within 0.06 cm. The authors conclude that in Developer Mode, TrueBeam™ is capable of delivering dynamic treatment delivery techniques involving couch motion with good geometric and dosimetric fidelity.

60 APPLIED LIFE SCIENCES↗

SU-E-I-78: Improving Prostatic Delineation Using Dual-Energy CT

Purpose: Visual prostatic definition is difficult using conventional CT. This is because the prostate is surrounded closely with tissue of similar electron density. Definition is further hindered when the region contains high-Z material (such as fiducial markers). Dual-energy CT (DECT) is a technique where images are rendered using two tube voltages during a single scan session. This study evaluates DECT as a means of improving prostatic volume delineation for radiation oncology. Methods: The patients were scanned using a Definition AS20 (Siemens Healthcare, Malvern, PA). This device uses a single-tube configuration, where two scans of differing energies are performed in serial. The scans are acquired with tube voltage of 80kVp and 140kVp. Following acquisition, these scan data were used to generate effective monoenergetic scans ranging from 40keV to 190keV. In the current study, the data were presented to observers using a novel program, which allows real-time adjustment of window, level, and effective keV; all while scrolling through volumetric slices. Three patients were scanned, each with a different high-contrast material in or around the prostate: I-125 seeds, gold fiducial markers, and prostatic calcifications. These images are compared to a weighted average of the 80kVp and 140kVP scans, which yield a scan similar to that of a 120 kVp scan, which is a common tube voltage in radiation oncology. Results: Prostatic definition improved in each case. Differentiation of soft tissue from surrounding adipose improved with lower keV, while higher keV provided a reduction of high-z artifacts. Furthermore, the dynamic adjustment of the keV allowed observers to better recognize regions of differing tissue composition within this relatively homogeneous area. Conclusion: By simultaneously providing the observer with the benefits of high-energy images and low-energy images, and allowing adjustment in real-time, improved imaging in highly homogeneous regions such as the male pelvis is achievable.

60 APPLIED LIFE SCIENCES↗

SU-E-J-122: Detecting Treatment-Induced Metabolic Abnormalities in Craniopharyngioma Patients Undergoing Surgery and Proton Therapy

Purpose: To identify treatment-induced defects in the brain of children with craniopharyngioma receiving surgery and proton therapy using fluorodeoxyglucose positron emission tomography (FDG PET). Methods: Forty seven patients were enrolled on a clinical trial for craniopharyngioma with serial imaging and functional evaluations. Proton therapy was delivered using the double-scattered beams with a prescribed dose of 54 Cobalt Gray Equivalent. FDG tracer uptake in each of 63 anatomical regions was computed after warping PET images to a 3D reference template in Talairach coordinates. Regional uptake was deemed significantly low or high if exceeding two standard deviations of normal population from the mean. For establishing the normal ranges, 132 children aged 1–20 years with noncentral nervous system related diseases and normal-appearing cerebral PET scans were analyzed. Age- and gender-dependent regional uptake models were developed by linear regression and confidence intervals were calculated. Results: Most common PET abnormality before proton therapy was significantly low uptake in the frontal lobe, the occipital lobe (particularly in cuneus), the medial and ventral temporal lobe, cingulate gyrus, caudate nuclei, and thalamus. They were related to injury from surgical corridors, tumor mass effect, insertion of a ventricular catheter, and the placement of an Ommaya reservoir. Surprisingly a significantly high uptake was observed in temporal gyri and the parietal lobe. In 13 patients who already completed 18-month PET scans, metabolic abnormalities improved in 11 patients from baseline. One patient had persistent abnormalities. Only one revealed new uptake abnormalities in thalamus, brainstem, cerebellum, and insula. Conclusion: Postoperative FDG PET of craniopharyngioma patients revealed metabolic abnormalities in specific regions of the brain. Proton therapy did not appear to exacerbate these surgery- and tumor-induced defects. In patients with persistent and new abnormalities, continued investigation on clinical symptoms and cognitive outcomes is ongoing to establish the association and predictive values of metabolic imaging.

60 APPLIED LIFE SCIENCES↗

SU-E-J-148: Evaluating Tumor Response with a Commercially Available Deformable Registration System

Purpose: The purpose of this study is to present a method for evaluating the response to treatment using a commercially available deformable image registration software package (Velocity Medical Systems) and repeat PET/CT imaging. This technique can be used to identify volumes that are risk for tumor recurrence. Methods: Response to treatment was evaluated using PET/CT images acquired prior-to and post-treatment for radiation therapy patients treated with concurrent chemotherapy. Velocity (Version 3.0.1) was used to deform the initial PET/CT to the post treatment PET/CT. The post-treatment PET images were then subtracted from the pre-treatment PET images. The resulting re-sampled image is a three-dimensional SUV difference map that shows pixels with increasing SUV values. SUV values increases greater than 2.5 in the post treatment images were identified for additional follow-up. Results: A total of 5 Lung patients were analyzed as part of this study. One lung patient in the cohort had an SUV increase of +3.28 that was identified using the SUV difference map. This volume of increased uptake was located outside the treatment field and adjacent to the 35 Gy isodose line. The remaining four patients all had SUV decreases inside the planning target volume, and no unexpected areas of increase outside the irradiated volumes. All five patients were analyzed using standard tools inside the Velocity application. Conclusion: The response to treatment can easily be measured using serial PET/CT images and a commercially available deformable image registration. This provides both the radiation oncologists and medical oncologists with a quantitative assessment of their treatment to use in patient follow-up.

60 APPLIED LIFE SCIENCES↗

SU-E-T-345: Validation of a Patient-Specific Monte Carlo Targeted Radionuclide Therapy Dosimetry Platform

Purpose: There is a compelling need for personalized dosimetry in targeted radionuclide therapy given that conventional dose calculation methods fail to accurately predict dose response relationships. To address this need, we have developed a Geant4-based Monte Carlo patient-specific 3D dosimetry platform for TRT. This platform calculates patient-specific dose distributions based on serial CT/PET or CT/SPECT images acquired after injection of the TRT agent. In this work, S-values and specific absorbed fractions (SAFs) were calculated using this platform and benchmarked against reference values. Methods: S-values for 1, 10, 100, and 1000g spherical tumors with uniform activity distributions of I-124, I-125, I-131, F-18, and Ra-223 were calculated and compared to OLINDA/EXM reference values. SAFs for monoenergetic photons of 0.01, 0.1, and 1 MeV and S factors for monoenergetic electrons of 0.935 MeV were calculated for the liver, kidneys, lungs, pancreas, spleen, and adrenals in the Zubal Phantom and compared with previously published values. Sufficient particles were simulated to keep the voxel statistical uncertainty below 5%. Results: The calculated spherical S-values agreed within a few percent of reference data from OLINDA/EXM for each radionuclide and sphere size. The comparison of photon SAFs and electron S-values with previously published values showed good agreement with the previously published values. The S-values and SAFs of the source organs agreed within 1%. Conclusion: Our platform has been benchmarked against reference values for a variety of radionuclides and over a wide range of energies and tumor sizes. Therefore, this platform could be used to provide accurate patientspecific dosimetry for use in radiopharmaceutical clinical trials.

60 APPLIED LIFE SCIENCES↗

SU-E-QI-20: A Review of Advanced PET and CT Image Features for the Evaluation of Tumor Response

Purpose: To review the literature in using quantitative PET and CT image features for the evaluation of tumor response. Methods: We reviewed and summarized more than fifty papers that use advanced, quantitative PET/CT image features for the evaluation of tumor response. We also discussed future works on extracting disease-specific features, combining multiple and complementary features in response modeling, delineating tumor in multimodality images, and exploring biological explanations of these advanced features. Results: Advanced PET image features considering spatial information, such as tumor volume, tumor shape, total glycolytic volume, histogram distance, and texture features (characterizing spatial distribution of FDG uptake) have been found more informative than the traditional SUVmax for the prediction of tumor response. Advanced CT features, including volumetric, attenuation, morphologic, structure, and texture descriptors, have also been found advantage over the traditional RECIST and WHO criteria in certain tumor types. Conclusions: Advanced, quantitative FDG PET/CT image features have been shown promising for the evaluation of tumor response. With the emerging multi-modality imaging performed at multiple time points for each patient, it becomes more important to analyze the serial images quantitatively, select and combine both complementary and contradictory information from various sources, for accurate and personalized evaluation of tumor response to therapy.

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-02: Application of ARCHERRT-- A GPU-Based Monte Carlo Dose Engine for Radiation Therapy -- to Tomotherapy and Patient-Independent IMRT

Purpose: As a module of ARCHER -- Accelerated Radiation-transport Computations in Heterogeneous EnviRonments, ARCHER{sub RT} is designed for RadioTherapy (RT) dose calculation. This paper describes the application of ARCHERRT on patient-dependent TomoTherapy and patient-independent IMRT. It also conducts a 'fair' comparison of different GPUs and multicore CPU. Methods: The source input used for patient-dependent TomoTherapy is phase space file (PSF) generated from optimized plan. For patient-independent IMRT, the open filed PSF is used for different cases. The intensity modulation is simulated by fluence map. The GEANT4 code is used as benchmark. DVH and gamma index test are employed to evaluate the accuracy of ARCHER{sub RT} code. Some previous studies reported misleading speedups by comparing GPU code with serial CPU code. To perform a fairer comparison, we write multi-thread code with OpenMP to fully exploit computing potential of CPU. The hardware involved in this study are a 6-core Intel E5-2620 CPU and 6 NVIDIA M2090 GPUs, a K20 GPU and a K40 GPU. Results: Dosimetric results from ARCHER{sub RT} and GEANT4 show good agreement. The 2%/2mm gamma test pass rates for different clinical cases are 97.2% to 99.7%. A single M2090 GPU needs 50~79 seconds for the simulation to achieve a statistical error of 1% in the PTV. The K40 card is about 1.7∼1.8 times faster than M2090 card. Using 6 M2090 card, the simulation can be finished in about 10 seconds. For comparison, Intel E5-2620 needs 507∼879 seconds for the same simulation. Conclusion: We successfully applied ARCHER{sub RT} to Tomotherapy and patient-independent IMRT, and conducted a fair comparison between GPU and CPU performance. The ARCHER{sub RT} code is both accurate and efficient and may be used towards clinical applications.

60 APPLIED LIFE SCIENCES↗

TU-F-BRF-03: Effect of Radiation Therapy Planning Scan Registration On the Dose in Lung Cancer Patient CT Scans

Purpose: To characterize the effect of deformable registration of serial computed tomography (CT) scans on the radiation dose calculated from a treatment planning scan. Methods: Eighteen patients who received curative doses (≥60Gy, 2Gy/fraction) of photon radiation therapy for lung cancer treatment were retrospectively identified. For each patient, a diagnostic-quality pre-therapy (4–75 days) CT scan and a treatment planning scan with an associated dose map calculated in Pinnacle were collected. To establish baseline correspondence between scan pairs, a researcher manually identified anatomically corresponding landmark point pairs between the two scans. Pre-therapy scans were co-registered with planning scans (and associated dose maps) using the Plastimatch demons and Fraunhofer MEVIS deformable registration algorithms. Landmark points in each pretherapy scan were automatically mapped to the planning scan using the displacement vector field output from both registration algorithms. The absolute difference in planned dose (|ΔD|) between manually and automatically mapped landmark points was calculated. Using regression modeling, |ΔD| was modeled as a function of the distance between manually and automatically matched points (registration error, E), the dose standard deviation (SD-dose) in the eight-pixel neighborhood, and the registration algorithm used. Results: 52–92 landmark point pairs (median: 82) were identified in each patient's scans. Average |ΔD| across patients was 3.66Gy (range: 1.2–7.2Gy). |ΔD| was significantly reduced by 0.53Gy using Plastimatch demons compared with Fraunhofer MEVIS. |ΔD| increased significantly as a function of E (0.39Gy/mm) and SD-dose (2.23Gy/Gy). Conclusion: An average error of <4Gy in radiation dose was introduced when points were mapped between CT scan pairs using deformable registration. Dose differences following registration were significantly increased when the Fraunhofer MEVIS registration algorithm was used, spatial registration errors were larger, and dose gradient was higher (i.e., higher SD-dose). To our knowledge, this is the first study to directly compute dose errors following deformable registration of lung CT scans.

60 APPLIED LIFE SCIENCES↗

WE-E-BRE-02: BEST IN PHYSICS (THERAPY) - Stereotactic Radiotherapy for Renal Sympathetic Ablation for the Treatment of Refractory Hypertension

Purpose: To determine the safety and efficacy of stereotactic radiotherapy as a novel treatment for patients with refractory hypertension in a swine model. Uncontrolled hypertension is a significant contributor to morbidity and mortality, substantially increasing the risk of ischemic stroke, ischemic heart disease, and kidney failure. Methods: High-resolution computed tomography (CT) images of anesthetized pigs were acquired and treatment plans for each renal artery and nerve were developed using our clinically implemented treatment planning system. Stereotactic radiotherapy, 40Gy in single fraction was delivered bilaterally to the renal nerves using a state-of-the-art medical linear accelerator under image guidance utilizing dynamic conformal arcs. Dose to nearby critical organs was evaluated by dosevolume histogram analysis and correlated to toxicity data obtained through follow up pathology analysis. The animals were observed for six months with serial measurements of blood pressure, urine analysis, serum laboratories, and overall clinical and behavioral status. Results: All animals survived to the follow-up point without evidence of renal dysfunction (stable serum creatinine), skin changes, or behavioral changes that might suggest animal discomfort. Plasma norepinephrine levels (ng/ml) were followed monthly for 6 months. The average reduction observed was 63%, with the median reduction at 73.5%. Microscopic evaluation 4–6 weeks after treatment showed evidence of damage to the nerves around treated renal arteries. Considerable attenuation in pan neurofilament expression by immunohistochemistry was observed with some vacuolar changes indicative of injury. There was no histological or immunohistochemical evidence of damage to nearby spinal cord or spinal nerve root structures. Conclusion: Our preclinical studies have shown stereotactic radiotherapy to the renal sympathetic plexus to be safe and effective in reducing blood pressure, thus this approach holds great promise as a novel treatment modality for patients with refractory hypertension. This study was funded by the Stanford University Cardiovascular Institute. B. Loo and P. Maxim have received funding from RaySearch Laboratories.

60 APPLIED LIFE SCIENCES↗

Sci—Thur AM: YIS - 03: irtGPUMCD: a new GPU-calculated dosimetry code for {sup 177}Lu-octreotate radionuclide therapy of neuroendocrine tumors

In peptide receptor radionuclide therapy (PRRT), huge inter-patient variability in absorbed radiation doses per administered activity mandates the utilization of individualized dosimetry to evaluate therapeutic efficacy and toxicity. We created a reliable GPU-calculated dosimetry code (irtGPUMCD) and assessed {sup 177}Lu-octreotate renal dosimetry in eight patients (4 cycles of approximately 7.4 GBq). irtGPUMCD was derived from a brachytherapy dosimetry code (bGPUMCD), which was adapted to {sup 177}Lu PRRT dosimetry. Serial quantitative single-photon emission computed tomography (SPECT) images were obtained from three SPECT/CT acquisitions performed at 4, 24 and 72 hours after {sup 177}Lu-octreotate administration, and registered with non-rigid deformation of CT volumes, to obtain {sup 177}Lu-octreotate 4D quantitative biodistribution. Local energy deposition from the β disintegrations was assumed. Using Monte Carlo gamma photon transportation, irtGPUMCD computed dose rate at each time point. Average kidney absorbed dose was obtained from 1-cm{sup 3} VOI dose rate samples on each cortex, subjected to a biexponential curve fit. Integration of the latter time-dose rate curve yielded the renal absorbed dose. The mean renal dose per administered activity was 0.48 ± 0.13 Gy/GBq (range: 0.30–0.71 Gy/GBq). Comparison to another PRRT dosimetry code (VRAK: Voxelized Registration and Kinetics) showed fair accordance with irtGPUMCD (11.4 ± 6.8 %, range: 3.3–26.2%). These results suggest the possibility to use the irtGPUMCD code in order to personalize administered activity in PRRT. This could allow improving clinical outcomes by maximizing per-cycle tumor doses, without exceeding the tolerable renal dose.

60 APPLIED LIFE SCIENCES↗