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Phage-based delivery of CRISPR-associated transposases for targeted bacterial editing

Phage λ, a well-characterized temperate phage, has been recently leveraged for bacterial genome editing by selectively delivering base editors into targeted bacterial species. We extend this concept by engineering phage λ to deliver CRISPR-guided transposases, accomplishing large insertions and targeted gene disruptions. To achieve this, we engineered phage λ using homologous recombination paired with Cas13a-based counterselection for precise phage modifications. Initially, we established the utility of Cas13a in phage λ by conducting minimal recoding edits, deletions, and insertions. Subsequently, we scaled up the engineering to embed the comprehensive DNA-editing CRISPR-Cas transposase (DART) system within the phage genome, creating λ-DART phages. These modified λ-DART phages were then employed to infectEscherichia coli, generating CRISPR RNA-guided transposition events in the host genome. Applying our engineered λ-DART phages to monocultures and a mixed bacterial community comprising three genera led to efficient, precise, and specific gene knockouts and insertions in the targetedE. colicells, achieving editing efficiencies surpassing 50% of the population. This research enhances phage-mediated genome editing by enabling efficient in situ gene integrations in bacteria, offering an avenue for further application in microbial community contexts. This scalable method enables flexible microbial genome editing in situ to manipulate the function and composition of diverse ecosystems.

Science & Technology - Other Topics↗

The Standing Pool of Genomic Structural Variation in a Natural Population of Mimulus guttatus

Major unresolved questions in evolutionary genetics include determining the contributions of different mutational sources to the total pool of genetic variation in a species, and understanding how these different forms of genetic variation interact with natural selection. Recent work has shown that structural variants (SVs) (insertions, deletions, inversions, and transpositions) are a major source of genetic variation, often outnumbering single nucleotide variants in terms of total bases affected. Despite the near ubiquity of SVs, major questions about their interaction with natural selection remain. For example, how does the allele frequency spectrum of SVs differ when compared with single nucleotide variants? How often do SVs affect genes, and what are the consequences? To begin to address these questions, we have systematically identified and characterized a large set of submicroscopic insertion and deletion (indel)variants (between1and200 kb in length) among ten inbred lines from a single natural population of the plant species Mimulus guttatus. After extensive computational filtering, we focused on a set of 4,142 high-confidence indels that showed an experimental validation rate of 73%. All but one of these indels were less than 200 kb. Although the largest were generally at lower frequencies in the population, a surprising number of large indels are at intermediate frequencies. Although indels overlapping with genes were much rarer than expected by chance, approximately 600 genes were affected by an indel. Nucleotide-binding site leucine-rich repeat (NBS–LRR) defense response genes were the most enriched among the gene families affected. Most indels associated with genes were rare and appeared to be under purifying selection, though we do find four high-frequency derived insertion alleles that show signatures of recent positive selection.

59 BASIC BIOLOGICAL SCIENCES↗

Computationally efficient zero-noise extrapolation for quantum-gate-error mitigation

Zero noise extrapolation (ZNE) is a widely used technique for gate error mitigation on near term quantum computers because it can be implemented in software and does not require knowledge of the quantum computer noise parameters. Traditional ZNE requires a significant resource overhead in terms of quantum operations. A recent proposal using a targeted (or random) instead of fixed identity insertion method (riim versus fiim) requires significantly fewer quantum gates for the same formal precision. We start by showing that riim can allow for ZNE to be deployed on deeper circuits than fiim but requires many more measurements to maintain the same statistical uncertainty. We develop two extensions to fiim and riim. The List Identity Insertion Method (liim) allows to mitigate the error from certain cnot gates, typically those with the largest error. Set Identity Insertion Method (siim) naturally interpolates between the measurement-efficient fiim and the gate-efficient riim allowing to trade off fewer cnot gates for more measurements. Finally, we investigate a way to boost the number of measurements, namely to run ZNE in parallel, utilizing as many quantum devices as are available. We explore the performance of riim in a parallel setting where there is a non-trivial spread in noise across sets of qubits within or across quantum computers.

97 MATHEMATICS AND COMPUTING↗

The Structure and Catalytic Mechanism of Sorghum bicolor Caffeoyl-CoA O-Methyltransferase

Caffeoyl-coenzyme A 3-O-methyltransferase (CCoAOMT) is an S-adenosyl methionine (SAM)-dependent O-methyltransferase responsible for methylation of the meta-hydroxyl group of caffeoyl-coenzyme A (CoA) on the pathway to monolignols, with their ring methoxylation status characteristic of guaiacyl or syringyl units in lignin. In order to better understand the unique class of type 2 O-methyltransferases from monocots, we have characterized CCoAOMT from sorghum (Sorghum bicolor; SbCCoAOMT), including the SAM binary complex crystal structure and steady-state enzyme kinetics. Key amino acid residues were validated with site-directed mutagenesis. Isothermal titration calorimetry data indicated a sequential binding mechanism for SbCCoAOMT, wherein SAM binds prior to caffeoyl-CoA, and the enzyme showed allosteric behavior with respect to it. 5-Hydroxyferuloyl-CoA was not a substrate for SbCCoAOMT. We propose a catalytic mechanism in which lysine-180 acts as a catalytic base and deprotonates the reactive hydroxyl group of caffeoyl-CoA. This deprotonation is facilitated by the coordination of the reactive hydroxyl group by Ca 2+ in the active site, lowering the pK a of the 3'-OH group. Collectively, these data give a new perspective on the catalytic mechanism of CCoAOMTs and provide a basis for the functional diversity exhibited by type 2 plant OMTs that contain a unique insertion loop (residues 208–231) conferring affinity for phenylpropanoid-CoA thioesters. The structural model of SbCCoAOMT can serve as the basis for protein engineering approaches to enhance the nutritional, agronomic, and industrially relevant properties of sorghum.

Walker, Alexander M.↗

Towards Resiliency Evaluation of Vector Programs

The systems resilience research community has developed methods to manually insert additional source-program level assertions to trap errors, and also devised tools to conduct fault injection studies for scalar program codes. In this work, we contribute the first vector oriented LLVM-level fault injector VULFI to help study the effects of faults in vector architectures that are of growing importance, especially for vectorizing loops. Using VULFI, we conduct a resiliency study of nine real-world vector benchmarks using Intel’s AVX and SSE extensions as the target vector instruction sets, and offer the first reported understanding of how faults affect vector instruction sets. We take this work further toward automating the insertion of resilience assertions during compilation. This is based on our observation that during intermediate (e.g., LLVM-level) code generation to handle full and partial vectorization, modern compilers exploit (and explicate in their code-documentation) critical invariants. These invariants are turned into error-checking code. We confirm the efficacy of these automatically inserted low-overhead error detectors for vectorized for-loops.

fault injection↗

A lock-free priority queue design based on multi-dimensional linked lists

The throughput of concurrent priority queues is pivotal to multiprocessor applications such as discrete event simulation, best-first search and task scheduling. Existing lock-free priority queues are mostly based on skiplists, which probabilistically create shortcuts in an ordered list for fast insertion of elements. The use of skiplists eliminates the need of global rebalancing in balanced search trees and ensures logarithmic sequential search time on average, but the worst-case performance is linear with respect to the input size. In this paper, we propose a quiescently consistent lock-free priority queue based on a multi-dimensional list that guarantees worst-case search time of O(logN) for key universe of size N. The novel multi-dimensional list (MDList) is composed of nodes that contain multiple links to child nodes arranged by their dimensionality. The insertion operation works by first injectively mapping the scalar key to a high-dimensional vector, then uniquely locating the target position by using the vector as coordinates. Nodes in MDList are ordered by their coordinate prefixes and the ordering property of the data structure is readily maintained during insertion without rebalancing nor randomization. Furthermore, in our experimental evaluation using a micro-benchmark, our priority queue achieves an average of 50% speedup over the state of the art approaches under high concurrency.

97 MATHEMATICS AND COMPUTING↗

Proton radiography in three dimensions: A proof of principle of a new technique

Purpose: Monte Carlo simulations were used to investigate a range of phantom configurations to establish enabling three-dimensional proton radiographic techniques.Methods: A large parameter space of stacked phantom geometries composed of tissue inhomogeneity materials such as lung, bone, and cartilage inserted within water background were simulated using a purposefully modified version of TOPAS, an application running on top of the GEANT4 Monte Carlo code. The phantoms were grouped in two classes, one with the inhomogeneity inserted only half-way in the lateral direction and another with complete inhomogeneity insertion. The former class was used to calculate the track count and the energy fluence of the protons as they exit the phantoms either having traversed the inhomogeneity or not. The latter class was used to calculate one yield value accounting for loss of protons due to physical processes only and another yield value accounting for deliberately discarded protons due to large scattering angles. A graphical fingerprinting method was developed to determine the inhomogeneity thickness and location within the phantom based on track count and energy fluence information. Two additional yield values extended this method to the general case which also determines the inhomogeneity material and the phantom thickness.Results: The graphical fingerprinting method was manually validated for two, and automatically tested for all, tissue materials using an exhaustive set of inhomogeneity geometries for 16 cm thick phantoms. Unique recognition of test phantom configurations was achieved in the large majority of cases. The method in the general case was further tested using an exhaustive set of inhomogeneity and phantom tissues and geometries where the phantom thicknesses ranged between 8 and 24 cm. Unique recognition of the test phantom configurations was achieved only for part of the phantom parameter space. The correlations between the remaining false positive recognitions were analyzed.Conclusions: The concept of 3D proton radiography for tissue inhomogeneities of simple geometries was established with the current work. In contrast to conventional 2D proton radiography, the main objective of the demonstrated 3D technique is not proton range. Rather, it is to measure the depth and thickness of an inhomogeneity located in an imaged geometry. Further work is needed to extend and apply the method to more complex geometries.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A comprehensive investigation of the accuracy and reproducibility of a multitarget single isocenter VMAT radiosurgery technique

Purpose: Recent trends in stereotactic radiosurgery use multifocal volumetric modulated arc therapy (VMAT) plans to simultaneously treat several distinct targets. Conventional verification often involves low resolution measurements in a single plane, a cylinder, or intersecting planes of diodes or ion chambers. This work presents an investigation into the consistency and reproducibility of this new treatment technique using a comprehensive commissioned high-resolution 3D dosimetry system (PRESAGE{sup ®}/Optical-CT).Methods: A complex VMAT plan consisting of a single isocenter but five separate targets was created in Eclipse for a head phantom containing a cylindrical PRESAGE{sup ®} dosimetry insert of 11 cm diameter and height. The plan contained five VMAT arcs delivering target doses from 12 to 20 Gy. The treatment was delivered to four dosimeters positioned in the head phantom and repeated four times, yielding four separate 3D dosimetry verifications. Each delivery was completely independent and was given after image guided radiation therapy (IGRT) positioning using Brainlab ExacTrac and cone beam computed tomography. A final delivery was given to a modified insert containing a pin-point ion chamber enabling calibration of PRESAGE{sup ®} 3D data to dose. Dosimetric data were read out in an optical-CT scanner. Consistency and reproducibility of the treatment technique (including IGRT setup) was investigated by comparing the dose distributions in the four inserts, and with the predicted treatment planning system distribution.Results: Dose distributions from the four dosimeters were registered and analyzed to determine the mean and standard deviation at all points throughout the dosimeters. A dose standard deviation of <3% was found from dosimeter to dosimeter. Global 3D gamma maps show that the predicted and measured dose matched well [3D gamma passing rate was 98.0% (3%, 2 mm)].Conclusions: The deliveries of the irradiation were found to be consistent and matched the treatment plan, demonstrating high accuracy and reproducibility of both the treatment machine and the IGRT procedure. The complexity of the treatment (multiple arcs) and dosimetry (multiple strong gradients) pose a substantial challenge for comprehensive verification. 3D dosimetry can be uniquely effective in this scenario.

61 RADIATION PROTECTION AND DOSIMETRY↗

Evaluation of dual energy quantitative CT for determining the spatial distributions of red marrow and bone for dosimetry in internal emitter radiation therapy

Purpose: To evaluate a three-equation three-unknown dual-energy quantitative CT (DEQCT) technique for determining region specific variations in bone spongiosa composition for improved red marrow dose estimation in radionuclide therapy. Methods: The DEQCT method was applied to 80/140 kVp images of patient-simulating lumbar sectional body phantoms of three sizes (small, medium, and large). External calibration rods of bone, red marrow, and fat-simulating materials were placed beneath the body phantoms. Similar internal calibration inserts were placed at vertebral locations within the body phantoms. Six test inserts of known volume fractions of bone, fat, and red marrow were also scanned. External-to-internal calibration correction factors were derived. The effects of body phantom size, radiation dose, spongiosa region segmentation granularity [single (∼17 × 17 mm) region of interest (ROI), 2 × 2, and 3 × 3 segmentation of that single ROI], and calibration method on the accuracy of the calculated volume fractions of red marrow (cellularity) and trabecular bone were evaluated. Results: For standard low dose DEQCT x-ray technique factors and the internal calibration method, the RMS errors of the estimated volume fractions of red marrow of the test inserts were 1.2–1.3 times greater in the medium body than in the small body phantom and 1.3–1.5 times greater in the large body than in the small body phantom. RMS errors of the calculated volume fractions of red marrow within 2 × 2 segmented subregions of the ROIs were 1.6–1.9 times greater than for no segmentation, and RMS errors for 3 × 3 segmented subregions were 2.3–2.7 times greater than those for no segmentation. Increasing the dose by a factor of 2 reduced the RMS errors of all constituent volume fractions by an average factor of 1.40 ± 0.29 for all segmentation schemes and body phantom sizes; increasing the dose by a factor of 4 reduced those RMS errors by an average factor of 1.71 ± 0.25. Results for external calibrations exhibited much larger RMS errors than size matched internal calibration. Use of an average body size external-to-internal calibration correction factor reduced the errors to closer to those for internal calibration. RMS errors of less than 30% or about 0.01 for the bone and 0.1 for the red marrow volume fractions would likely be satisfactory for human studies. Such accuracies were achieved for 3 × 3 segmentation of 5 mm slice images for: (a) internal calibration with 4 times dose for all size body phantoms, (b) internal calibration with 2 times dose for the small and medium size body phantoms, and (c) corrected external calibration with 4 times dose and all size body phantoms. Conclusions: Phantom studies are promising and demonstrate the potential to use dual energy quantitative CT to estimate the spatial distributions of red marrow and bone within the vertebral spongiosa.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-J-194: Dynamic Tumor Tracking End-To-End Testing Using a 4D Thorax Phantom and EBT3 Films

Purpose: To quantify the Vero linac dosimetric accuracy of the tumor dynamic tracking treatment using EBT3 film embedded in a 4D thorax phantom. Methods: A dynamic thorax phantom with tissue equivalent materials and a film insert were used in this study. The thorax phantom was scanned in 4DCT mode with a viscoil embedded in its film insert composed of lung equivalent material. Dynamic tracking planning was performed using the 50% phase CT set with 5 conformal beams at gantry angles of 330, 15, 60, 105 and 150 degrees. Each field is a 3cm by 3cm square centered at viscoil since there was no solid mass target. Total 3 different 1–2cos4 motion profiles were used with varied motion magnitude and cycle frequency. Before treatment plan irradiation, a 4D motion model of the target was established using a series of acquired fluoroscopic images and infrared markers motion positions. During irradiation, fluoroscopic image monitoring viscoil motion was performed to verify model validity. The irradiated films were scanned and the dose maps were compared to the planned Monte Carlo dose distributions. Gamma analyses using 3%–3mm, 2%–3mm, 3%–2mm, 2%–2mm criteria were performed and presented. Results: For each motion pattern, a 4D motion model was built successfully and the target tracking performance was verified with fluoroscopic monitoring of the viscoil motion and its model predicted locations. The film gamma analysis showed the average pass rates among the 3 motion profiles are 98.14%, 96.2%, 91.3% and 85.61% for 3%–3mm, 2%–3mm, 3%–2mm, 2%–2mm criteria. Conclusion: Target dynamic tracking was performed using patient-like breathing patterns in a 4D thorax phantom with EBT3 film insert and a viscoil. There was excellent agreement between acquired and planned dose distributions for all three target motion patterns. This study performed end-to-end testing and verified the treatment accuracy of tumor dynamic tracking.

60 APPLIED LIFE SCIENCES↗

WE-G-18A-01: JUNIOR INVESTIGATOR WINNER - Low-Dose C-Arm Cone-Beam CT with Model-Based Image Reconstruction for High-Quality Guidance of Neurosurgical Intervention

Purpose: To address the challenges of image quality, radiation dose, and reconstruction speed in intraoperative cone-beam CT (CBCT) for neurosurgery by combining model-based image reconstruction (MBIR) with accelerated algorithmic and computational methods. Methods: Preclinical studies involved a mobile C-arm for CBCT imaging of two anthropomorphic head phantoms that included simulated imaging targets (ventricles, soft-tissue structures/bleeds) and neurosurgical procedures (deep brain stimulation (DBS) electrode insertion) for assessment of image quality. The penalized likelihood (PL) framework was used for MBIR, incorporating a statistical model with image regularization via an edgepreserving penalty. To accelerate PL reconstruction, the ordered-subset, separable quadratic surrogates (OS-SQS) algorithm was modified to incorporate Nesterov's method and implemented on a multi-GPU system. A fair comparison of image quality between PL and conventional filtered backprojection (FBP) was performed by selecting reconstruction parameters that provided matched low-contrast spatial resolution. Results: CBCT images of the head phantoms demonstrated that PL reconstruction improved image quality (∼28% higher CNR) even at half the radiation dose (3.3 mGy) compared to FBP. A combination of Nesterov's method and fast projectors yielded a PL reconstruction run-time of 251 sec (cf., 5729 sec for OS-SQS, 13 sec for FBP). Insertion of a DBS electrode resulted in severe metal artifact streaks in FBP reconstructions, whereas PL was intrinsically robust against metal artifact. The combination of noise and artifact was reduced from 32.2 HU in FBP to 9.5 HU in PL, thereby providing better assessment of device placement and potential complications. Conclusion: The methods can be applied to intraoperative CBCT for guidance and verification of neurosurgical procedures (DBS electrode insertion, biopsy, tumor resection) and detection of complications (intracranial hemorrhage). Significant improvement in image quality, dose reduction, and reconstruction time of ∼4 min will enable practical deployment of low-dose C-arm CBCT within the operating room. AAPM Research Seed Funding (2013-2014); NIH Fellowship F32EB017571; Siemens Healthcare (XP Division)

60 APPLIED LIFE SCIENCES↗

TH-C-12A-01: Develop a Patient-Specific QA Program for Radiation Therapy with On-Board MRI

Purpose: This work describes development of the first patient-specific quality assurance (QA) program for magnetic resonance imaging guided radiation therapy (MR-IGRT). Methods: The program consisted of following components: 1) multipoint ionization chamber (IC) measurement using a 15 cm3 cubic phantom, 2) 2D stacked radiographic film dosimetry using a 30×30×20 cm3 phantom with multiple inserted ICs, 3) 3D ArcCHECK measurement with a centrally inserted IC, 4) machine delivery file verification, 5) 3D Monte-Carlo dose re-calculation with machine delivery file and phantom CT, 6) 2-head mode delivery validation in case of a malfunctioning head, and 7) independent beam-on time calculation for non-IMRT fields. Both ADCL calibrated ICs and ArcCHECK were MRI compatible. Experimental data were analyzed for the first 10 patients treated at our institution. Results: The customized phantoms allowed measuring multiple points with ICs in one delivery. Absolute IC measurements were all within 3% in all phantom geometry/shape/material combinations. Despite known uncertainty associated with film dosimetry, passing rates greater than 90% were achieved in both absolute and composite modes using TG-129 criteria. Due to the simultaneous irradiation by three radiation sources, ArcCHECK was used as a 3D relative dosimeter with angular and energy dependences uncorrected. 95–100% passing rates were obtained and the centrally inserted IC measurement assured that the overall dose normalization was within 3%. Machine delivery file verification and MC recalculated dose to the phantom results showed 98–100% passing rates, providing opportunity of moving from gamma passing rates to patient DVHbased QA metrics. Same results were obtained for the 2-head delivery mode. Manual beam-on time calculation for non-IMRT fields showed better than 5% agreement. Conclusion: We have successfully developed the first MRIGRT patient specific QA program by adopting experimental and computational dosimetry methods that were developed in the past decade for other radiation therapy modalities.

60 APPLIED LIFE SCIENCES↗

Application of a radiophotoluminescent glass dosimeter to nonreference condition dosimetry in the postal dose audit system

Purpose: The purpose of this study was to obtain a set of correction factors of the radiophotoluminescent glass dosimeter (RGD) output for field size changes and wedge insertions. Methods: Several linear accelerators were used for irradiation of the RGDs. The field sizes were changed from 5 × 5 cm to 25 × 25 cm for 4, 6, 10, and 15 MV x-ray beams. The wedge angles were 15°, 30°, 45°, and 60°. In addition to physical wedge irradiation, nonphysical (dynamic/virtual) wedge irradiations were performed. Results: The obtained data were fitted with a single line for each energy, and correction factors were determined. Compared with ionization chamber outputs, the RGD outputs gradually increased with increasing field size, because of the higher RGD response to scattered low-energy photons. The output increase was about 1% per 10 cm increase in field size, with a slight difference dependent on the beam energy. For both physical and nonphysical wedged beam irradiation, there were no systematic trends in the RGD outputs, such as monotonic increase or decrease depending on the wedge angle change if the authors consider the uncertainty, which is approximately 0.6% for each set of measured points. Therefore, no correction factor was needed for all inserted wedges. Based on this work, postal dose audits using RGDs for the nonreference condition were initiated in 2010. The postal dose audit results between 2010 and 2012 were analyzed. The mean difference between the measured and stated doses was within 0.5% for all fields with field sizes between 5 × 5 cm and 25 × 25 cm and with wedge angles from 15° to 60°. The standard deviations (SDs) of the difference distribution were within the estimated uncertainty (1SD) except for the 25 × 25 cm field size data, which were not reliable because of poor statistics (n = 16). Conclusions: A set of RGD output correction factors was determined for field size changes and wedge insertions. The results obtained from recent postal dose audits were analyzed, and the mean differences between the measured and stated doses were within 0.5% for every field size and wedge angle. The SDs of the distribution were within the estimated uncertainty, except for one condition that was not reliable because of poor statistics.

07 ISOTOPE AND RADIATION SOURCES↗

Clinical evaluation of the iterative metal artifact reduction algorithm for CT simulation in radiotherapy

Purpose: To clinically evaluate an iterative metal artifact reduction (IMAR) algorithm prototype in the radiation oncology clinic setting by testing for accuracy in CT number retrieval, relative dosimetric changes in regions affected by artifacts, and improvements in anatomical and shape conspicuity of corrected images. Methods: A phantom with known material inserts was scanned in the presence/absence of metal with different configurations of placement and sizes. The relative change in CT numbers from the reference data (CT with no metal) was analyzed. The CT studies were also used for dosimetric tests where dose distributions from both photon and proton beams were calculated. Dose differences and gamma analysis were calculated to quantify the relative changes between doses calculated on the different CT studies. Data from eight patients (all different treatment sites) were also used to quantify the differences between dose distributions before and after correction with IMAR, with no reference standard. A ranking experiment was also conducted to analyze the relative confidence of physicians delineating anatomy in the near vicinity of the metal implants. Results: IMAR corrected images proved to accurately retrieve CT numbers in the phantom study, independent of metal insert configuration, size of the metal, and acquisition energy. For plastic water, the mean difference between corrected images and reference images was −1.3 HU across all scenarios (N = 37) with a 90% confidence interval of [−2.4, −0.2] HU. While deviations were relatively higher in images with more metal content, IMAR was able to effectively correct the CT numbers independent of the quantity of metal. Residual errors in the CT numbers as well as some induced by the correction algorithm were found in the IMAR corrected images. However, the dose distributions calculated on IMAR corrected images were closer to the reference data in phantom studies. Relative spatial difference in the dose distributions in the regions affected by the metal artifacts was also observed in patient data. However, in absence of a reference ground truth (CT set without metal inserts), these differences should not be interpreted as improvement/deterioration of the accuracy of calculated dose. With limited data presented, it was observed that proton dosimetry was affected more than photons as expected. Physicians were significantly more confident contouring anatomy in the regions affected by artifacts. While site specific preferences were detected, all indicated that they would consistently use IMAR corrected images. Conclusions: IMAR correction algorithm could be readily implemented in an existing clinical workflow upon commercial release. While residual errors still exist in IMAR corrected images, these images present with better overall conspicuity of the patient/phantom geometry and offer more accurate CT numbers for improved local dosimetry. The variety of different scenarios included herein attest to the utility of the evaluated IMAR for a wide range of radiotherapy clinical scenarios.

60 APPLIED LIFE SCIENCES↗

SU-C-204-04: Patient Specific Proton Stopping Powers Estimation by Combining Proton Radiography and Prior-Knowledge X-Ray CT Information

Purpose: The material relative stopping power (RSP) uncertainty is the highest contributor to the range uncertainty in proton therapy. The purpose of this work is to develop a robust and systematic method that yields accurate, patient specific, RSP by combining 1) pre-treatment x-ray CT and 2) daily proton radiograph of the patient. Methods: The method is formulated as a linear least-square optimization problem (min||Ax-B||2). The parameter A represents the pathlength crossed by the proton in each material. The RSPs for the materials (water equivalent thickness (WET)/physical thickness) are denoted by x. B is the proton radiograph expressed as WET crossed. The problem is minimized using a convex-conic optimization algorithm with xi<xi+1 constraint. The Gammex RMI-465 phantom, with 13 material inserts, is used to investigate the optimal RSPs. The proton radiograph (B) is produced using Geant4 simulation. The matrix A is computed by calculating proton trajectories through the CT with the cubic-spline approach. Geant4 RSPs are used as reference and the clinical HU-RSP calibration curve is used as comparison. The convergence is investigated as a function of the number of angles and protons used. The radiographs angle which yield the most accurate RSPs are investigated. Results: Optimization with 9 angles and 104 protons/angle yields precise RSP (<0.75%) for all materials, except plastic lung (1.5%). Average deviation relative to Geant4 RSP is 0.5% and 3.5% using HU-RSP. Using more than two angles or more than 4×103 proton does not further increase the RSP estimate accuracy. The insert distance to the beam initial plane is related to the RSP error for this insert material. Specific filters are applied on the proton angle and energy loss to remove nuclear interaction artefacts. Conclusion: The proposed formulation of the problem with prior knowledge x-ray CT demonstrates serious potential to increase the accuracy of present RSP estimates.

60 APPLIED LIFE SCIENCES↗

SU-E-J-27: Shifting Multiple EPID Imager Layers to Improve Image Quality and Resolution in MV CBCT

Purpose: Vertical stacking of four conventional EPID layers can improve DQE for MV-CBCT applications. We hypothesize that shifting each layer laterally by half a pixel relative to the layer above, will improve the contrast-to-noise ratio (CNR) and image resolution. Methods: For CNR assessment, a 20 cm diameter digital phantom with 8 inserts is created. The attenuation coefficient of the phantom is similar to lung at the average energy of a 6 MV photon beam. The inserts have attenuations 1, 2…8 times of lung. One of the inserts is close to soft tissue, resembling the case of a tumor in lung. For resolution assessment, a digital phantom featuring a bar pattern is created. The phantom has an attenuation coefficient similar to soft tissue and the bars have an attenuation coefficient of calcium sulfate. A 2 MeV photon beam is attenuated through these phantoms and hits each of the four stacked detector layers. Each successive layer is shifted by half a pixel in the x only, y only, and x and y (combined) directions, respectively. Blurring and statistical noise are added to the projections. Projections from one, two, three and four layers are used for reconstruction. CNR and image resolution are evaluated and compared. Results: When projections from multiple layers are combined for reconstruction, CNR increases with the number of layers involved. CNR in reconstructions from two, three and four layers are 1.4, 1.7 and 1.99 times that from one layer. The resolution from the shifted four layer detector is also improved from a single layer. In a comparison between one layer versus four layers in this preliminary study, the resolution from four shifted layers is at least 20% better. Conclusion: Layer-shifting in a stacked EPID imager design enhances resolution as well as CNR for half scan MV-CBCT. The project described was supported, in part, by a grant from Varian Medical Systems, Inc., and Award No. R01CA188446-01 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

60 APPLIED LIFE SCIENCES↗

SU-E-J-123: Assessing Segmentation Accuracy of Internal Volumes and Sub-Volumes in 4D PET/CT of Lung Tumors Using a Novel 3D Printed Phantom

Purpose: To assess the accuracy of internal target volume (ITV) segmentation of lung tumors for treatment planning of simultaneous integrated boost (SIB) radiotherapy as seen in 4D PET/CT images, using a novel 3D-printed phantom. Methods: The insert mimics high PET tracer uptake in the core and 50% uptake in the periphery, by using a porous design at the periphery. A lung phantom with the insert was placed on a programmable moving platform. Seven breathing waveforms of ideal and patient-specific respiratory motion patterns were fed to the platform, and 4D PET/CT scans were acquired of each of them. CT images were binned into 10 phases, and PET images were binned into 5 phases following the clinical protocol. Two scenarios were investigated for segmentation: a gate 30–70 window, and no gating. The radiation oncologist contoured the outer ITV of the porous insert with on CT images, while the internal void volume with 100% uptake was contoured on PET images for being indistinguishable from the outer volume in CT images. Segmented ITVs were compared to the expected volumes based on known target size and motion. Results: 3 ideal breathing patterns, 2 regular-breathing patient waveforms, and 2 irregular-breathing patient waveforms were used for this study. 18F-FDG was used as the PET tracer. The segmented ITVs from CT closely matched the expected motion for both no gating and gate 30–70 window, with disagreement of contoured ITV with respect to the expected volume not exceeding 13%. PET contours were seen to overestimate volumes in all the cases, up to more than 40%. Conclusion: 4DPET images of a novel 3D printed phantom designed to mimic different uptake values were obtained. 4DPET contours overestimated ITV volumes in all cases, while 4DCT contours matched expected ITV volume values. Investigation of the cause and effects of the discrepancies is undergoing.

60 APPLIED LIFE SCIENCES↗

SU-E-J-147: Monte Carlo Study of the Precision and Accuracy of Proton CT Reconstructed Relative Stopping Power Maps

Purpose: The quantification of the intrinsic performances of proton computed tomography (pCT) as a modality for treatment planning in proton therapy. The performance of an ideal pCT scanner is studied as a function of various parameters. Methods: Using GATE/Geant4, we simulated an ideal pCT scanner and scans of several cylindrical phantoms with various tissue equivalent inserts of different sizes. Insert materials were selected in order to be of clinical relevance. Tomographic images were reconstructed using a filtered backprojection algorithm taking into account the scattering of protons into the phantom. To quantify the performance of the ideal pCT scanner, we study the precision and the accuracy with respect to the theoretical relative stopping power ratios (RSP) values for different beam energies, imaging doses, insert sizes and detector positions. The planning range uncertainty resulting from the reconstructed RSP is also assessed by comparison with the range of the protons in the analytically simulated phantoms. Results: The results indicate that pCT can intrinsically achieve RSP resolution below 1%, for most examined tissues at beam energies below 300 MeV and for imaging doses around 1 mGy. RSP maps accuracy of less than 0.5 % is observed for most tissue types within the studied dose range (0.2–1.5 mGy). Finally, the uncertainty in the proton range due to the accuracy of the reconstructed RSP map is well below 1%. Conclusion: This work explores the intrinsic performance of pCT as an imaging modality for proton treatment planning. The obtained results show that under ideal conditions, 3D RSP maps can be reconstructed with an accuracy better than 1%. Hence, pCT is a promising candidate for reducing the range uncertainties introduced by the use of X-ray CT alongside with a semiempirical calibration to RSP.Supported by the DFG Cluster of Excellence Munich-Centre for Advanced Photonics (MAP)

60 APPLIED LIFE SCIENCES↗