Search NASA⌕ Search

SEARCH · Search NASA

Results for “ABDOMEN”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7
All sourcesNASA NTRSDOE OSTI
DOE OSTI2020

Combined computed tomography and position-resolved X-ray diffraction of an intact Roman-era Egyptian portrait mummy

Hawara Portrait Mummy 4, a Roman-era Egyptian portrait mummy, was studied with computed tomography (CT) and with CT-guided synchrotron X-ray diffraction mapping. These are the first X-ray diffraction results obtained non-invasively from objects within a mummy. The CT data showed human remains of a 5-year-old child, consistent with the female (but not the age) depicted on the portrait. Physical trauma was not evident in the skeleton. Diffraction at two different mummy-to-detector separations allowed volumetric mapping of features including wires and inclusions within the wrappings and the skull and femora. Additionally, the largest uncertainty in origin determination was approximately 1.5 mm along the X-ray beam direction, and diffraction- and CT-determined positions matched. Diffraction showed that the wires were a modern dual-phase steel and showed that the 7 × 5 × 3 mm inclusion ventral of the abdomen was calcite. Tracing the 00.2 and 00.4 carbonated apatite (bone's crystalline phase) reflections back to their origins produced cross-sectional maps of the skull and of femora; these maps agreed with transverse CT slices within approximately 1 mm. Coupling CT and position-resolved X-ray diffraction, therefore, offers considerable promise for non-invasive studies of mummies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

PpIX‐enabled fluorescence‐based detection and photodynamic priming of platinum‐resistant ovarian cancer cells under fluid shear stress

Over 75% percent of ovarian cancer patients are diagnosed with advanced-stage disease characterized by unresectable intraperitoneal dissemination and the presence of ascites, or excessive fluid build-up within the abdomen. Conventional treatments include cytoreductive surgery followed by multi-line platinum and taxane chemotherapy regimens. Despite an initial response to treatment, over 75% of patients with advanced-stage ovarian cancer will relapse and succumb to platinum-resistant disease. Recent evidence suggests that fluid shear stress (FSS), which results from the movement of fluid such as ascites, induces epithelial-to-mesenchymal transition and confers resistance to carboplatin in ovarian cancer cells. This study demonstrates, for the first time, that FSS-induced platinum resistance correlates with increased cellular protoporphyrin IX (PpIX), the penultimate downstream product of heme biosynthesis, the production of which can be enhanced using the clinically approved pro-drug aminolevulinic acid (ALA). These data suggest that, with further investigation, PpIX could serve as a fluorescence-based biomarker of FSS-induced platinum resistance. Additionally, this study investigates the efficacy of PpIX-enabled photodynamic therapy (PDT) and the secretion of extracellular vesicles under static and FSS conditions in Caov-3 and NIH:OVCAR-3 cells, two representative cell lines for high-grade serous ovarian carcinoma (HGSOC), the most lethal form of the disease. FSS induces resistance to ALA-PpIX-mediated PDT, along with a significant increase in the number of EVs. Finally, the ability of PpIX-mediated photodynamic priming (PDP) to enhance carboplatin efficacy under FSS conditions is quantified. These preliminary findings in monolayer cultures necessitate additional studies to determine the feasibility of PpIX as a fluorescence-based indicator, and mediator of PDP, to target chemoresistance in the context of FSS.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2015

Dual energy CT: How well can pseudo-monochromatic imaging reduce metal artifacts?

Purpose: Dual Energy CT (DECT) provides so-called monoenergetic images based on a linear combination of the original polychromatic images. At certain patient-specific energy levels, corresponding to certain patient- and slice-dependent linear combination weights, e.g., E = 160 keV corresponds to α = 1.57, a significant reduction of metal artifacts may be observed. The authors aimed at analyzing the method for its artifact reduction capabilities to identify its limitations. The results are compared with raw data-based processing. Methods: Clinical DECT uses a simplified version of monochromatic imaging by linearly combining the low and the high kV images and by assigning an energy to that linear combination. Those pseudo-monochromatic images can be used by radiologists to obtain images with reduced metal artifacts. The authors analyzed the underlying physics and carried out a series expansion of the polychromatic attenuation equations. The resulting nonlinear terms are responsible for the artifacts, but they are not linearly related between the low and the high kV scan: A linear combination of both images cannot eliminate the nonlinearities, it can only reduce their impact. Scattered radiation yields additional noncanceling nonlinearities. This method is compared to raw data-based artifact correction methods. To quantify the artifact reduction potential of pseudo-monochromatic images, they simulated the FORBILD abdomen phantom with metal implants, and they assessed patient data sets of a clinical dual source CT system (100, 140 kV Sn) containing artifacts induced by a highly concentrated contrast agent bolus and by metal. In each case, they manually selected an optimal α and compared it to a raw data-based material decomposition in case of simulation, to raw data-based material decomposition of inconsistent rays in case of the patient data set containing contrast agent, and to the frequency split normalized metal artifact reduction in case of the metal implant. For each case, the contrast-to-noise ratio (CNR) was assessed. Results: In the simulation, the pseudo-monochromatic images yielded acceptable artifact reduction results. However, the CNR in the artifact-reduced images was more than 60% lower than in the original polychromatic images. In contrast, the raw data-based material decomposition did not significantly reduce the CNR in the virtual monochromatic images. Regarding the patient data with beam hardening artifacts and with metal artifacts from small implants the pseudo-monochromatic method was able to reduce the artifacts, again with the downside of a significant CNR reduction. More intense metal artifacts, e.g., as those caused by an artificial hip joint, could not be suppressed. Conclusions: Pseudo-monochromatic imaging is able to reduce beam hardening, scatter, and metal artifacts in some cases but it cannot remove them. In all cases, the CNR is significantly reduced, thereby rendering the method questionable, unless special post processing algorithms are implemented to restore the high CNR from the original images (e.g., by using a frequency split technique). Raw data-based dual energy decomposition methods should be preferred, in particular, because the CNR penalty is almost negligible.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-C-303-04: Evaluation of On- and Off-Line Bioluminescence Tomography System for Focal Irradiation Guidance

Purpose: We have developed offline and on-board bioluminescence tomography(BLT) systems for the small animal radiation research platform(SARRP) for radiation guidance of soft tissue targets. We investigated the effectiveness of offline BLT guidance. Methods: CBCT is equipped on both the offline BLT system and SARRP that are 10 ft. apart. To evaluate the setup error during animal transport between the two systems, we implanted a luminescence source in the abdomen of anesthetized mice. Five mice were studied. After CBCT was acquired on both systems, source centers and correlation coefficients were calculated. CBCT was also used to generate object mesh for BLT reconstruction. To assess target localization, we compared the localization of the luminescence source based on (1)on-board SARRP BLT and CBCT, (2)offline BLT and CBCT, and (3)offline BLT and SARRP CBCT. The 3rd comparison examines if an offline BLT system can be used to guide radiation when there is minimal target contrast in CBCT. Results: Our CBCT results show the offset of the light source center can be maintained within 0.2 mm during animal transport. The center of mass(CoM) of the light source reconstructed by the offline BLT has an offset of 1.0 ± 0.4 mm from the ‘true’ CoM as derived from the SARRP CBCT. The results compare well with the offset of 1.0 ± 0.2 mm using on-line BLT. Conclusion: With CBCT information provided by the SARRP and effective animal immobilization during transport, these findings support the use of offline BLT in close vicinity for accurate soft tissue target localization for irradiation. However, the disadvantage of the off-line system is reduced efficiency as care is required to maintain stable animal transport. We envisage a dual use system where the on-board arrangement allows convenient access to CBCT and avoids disturbance of animal setup. The off-line capability would support standalone longitudinal imaging studies. The work is supported by NIH R01CA158100 and Xstrahl Ltd. Drs. John Wong and Iulian Iordachita receive royalty payment from a licensing agreement between Xstrahl Ltd and Johns Hopkins University. John Wong also has a consultant agreement with Xstrahl Ltd.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-161: Characterization and Validation of CT Simulator Hounsfield Units to Relative Stopping Power Values for Proton Treatment Planning

Purpose: To develop a calibration curve that includes and minimizes the variations of Hounsfield Unit (HU) from a CT scanner to Relative Stopping Power (RSP) of tissues along the proton beam path. The variations are due to scanner and proton energy, technique, phantom size and placement, and tissue arrangement. Methods: A CIRS 062 M phantom with 10 plugs of known relative electron density (RED) was scanned through a 16 slice GE Discovery CT Simulator scanner. Three setup combinations of plug distributions and techniques clinically implemented for five treatment regions were scanned with energies of 100, 120, and 140 kV. Volumetric HU values were measured for each plug and scan. The RSP values derived through the Bethe-Bloch formula are currently being verified with parallel-plate ionization chamber measurements in water using 80, 150, and 225 MeV proton beam. Typical treatment plans for treatment regions of brain, head-&-neck, chest, abdomen, and pelvis are being planned and dose delivered will be compared with film and Optically Stimulated Luminescence (OSL) measurements. Results: Percentage variations were determined for each variable. For tissues close to water, variations were <1% from any given parameter. Tissues far from water equivalence (lung and bone) showed the greatest sensitivity to change (7.4% maximum) with scanner energy and up to 5.3% with positioning of the phantom. No major variations were observed for proton energies within the treatment range. Conclusion: When deriving a calibration curve, attention should be placed to low and high HU values. A thorough verification process of calculated vs. water-phantom measured RSP values at different proton energies, followed by dose validation of planned vs. measured doses in phantom with film and OSL detectors are currently being undertaken.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-F-CAMPUS-J-01: Acoustic Range Verification of Proton Beams: Simulation of Heterogeneity and Clinical Proton Pulses

Purpose: Through simulation, to assess acoustic-based range verification of proton beams (protoacoustics) under clinical conditions. Methods: Pressure waves generated by the energy deposition of a 150 MeV, 8 mm FWHM pulsed pencil proton beam were numerically simulated through two Methods: 1) For a homogeneous water medium, an analytical wave-equation solution was used to calculate the time-dependent pressure measured at detector points surrounding the proton Bragg peak. 2) For heterogeneity studies, a CT tissue image was used to calculate the proton dose deposition and define the acoustic properties of the voxels through which numerical pressure wave propagation was simulated with the k-Wave matlab toolbox. The simulations were used to assess the dependence of the acoustic amplitude and range-verification accuracy on proton pulse rise time and tissue heterogeneity. Results: As the proton pulse rise time is increased from 1 to 40 µs, the amplitude of the expected acoustic emission decreases (a 60% drop distal to the Bragg peak), the central frequency of the expected signal decreases (from 45 to 6 kHz), and the accuracy of the range-verification decreases (from <1 mm to 16 mm at 5 cm distal to the Bragg peak). For a 300 nA pulse, the expected pressure range is on the order of 0.1 Pa, which is observable with commercial detectors. For the heterogeneous medium, our test case shows that pressure waves emitted by an anterior pencil beam directed into the abdomen and detected posteriorly can determine the Bragg peak range to an accuracy of <2mm for a 1 µs proton pulse. Conclusion: For proton pulses with fast rise-times, protoacoustics is a promising potential method for monitoring penetration depth through heterogeneous tissue. The loss of range-verification accuracy with increasing rise-times, however, suggests the need for comparisons to modeling to improve accuracy for slower cyclotron proton sources.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

Radiotherapy for stage I seminoma of the testis: Organ equivalent dose to partially in-field structures and second cancer risk estimates on the basis of a mechanistic, bell-shaped, and plateau model

Purpose: The aim of the current study was to (a) calculate the organ equivalent dose (OED) and (b) estimate the associated second cancer risk to partially in-field critical structures from adjuvant radiotherapy for stage I seminoma of the testis on the basis of three different nonlinear risk models. Methods: Three-dimensional plans were created for twelve patients who underwent a treatment planning computed tomography of the abdomen. The plans for irradiation of seminoma consisted of para-aortic anteroposterior and posteroanterior fields giving 20 Gy to the target site with 6 MV photons. The OED of stomach, colon, liver, pancreas, and kidneys, that were partially included in the treatment volume, was calculated using differential dose–volume histograms. The mechanistic, bell-shaped, and plateau models were employed for these calculations provided that organ-specific parameters were available for the subsequent assessment of the excess absolute risk (EAR) for second cancer development. The estimated organ-specific lifetime risks were compared with the respective nominal intrinsic probabilities for cancer induction. Results: The mean OED, which was calculated from the patients’ treatment plans, varied from 0.54 to 6.61 Gy by the partially in-field organ of interest and the model used for dosimetric calculations. The difference between the OED of liver derived from the mechanistic model with those from the bell-shaped and plateau models was less than 1.8%. An even smaller deviation of 1.0% was observed for colon. For the rest organs of interest, the differences between the OED values obtained by the examined models varied from 8.6% to 50.0%. The EAR for stomach, colon, liver, pancreas, and kidney cancer induction at an age of 70 yr because of treatment of a typical 39-yr-old individual was up to 4.24, 11.39, 0.91, 3.04, and 0.14 per 10 000 persons-yr, respectively. Patient’s irradiation was found to elevate the lifetime intrinsic risks by 8.3%–63.0% depending upon the organ of interest and the model employed for risk analysis. Conclusions: Radiotherapy for stage I seminoma of the testis may result in an excess risk for the appearance of secondary malignancies in partially in-field organs. The organ- and model-dependent second cancer risk assessments of this study may be of value for patient counseling and follow-up.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Investigation of practical initial attenuation image estimates in TOF-MLAA reconstruction for PET/MR

Purpose: Time-of-flight joint attenuation and activity positron emission tomography reconstruction requires additional calibration (scale factors) or constraints during or post-reconstruction to produce a quantitative μ-map. In this work, the impact of various initializations of the joint reconstruction was investigated, and the initial average mu-value (IAM) method was introduced such that the forward-projection of the initial μ-map is already very close to that of the reference μ-map, thus reducing/minimizing the offset (scale factor) during the early iterations of the joint reconstruction. Consequently, the accuracy and efficiency of unconstrained joint reconstruction such as time-of-flight maximum likelihood estimation of attenuation and activity (TOF-MLAA) can be improved by the proposed IAM method. Methods: 2D simulations of brain and chest were used to evaluate TOF-MLAA with various initial estimates which include the object filled with water uniformly (conventional initial estimate), bone uniformly, the average μ-value uniformly (IAM magnitude initialization method), and the perfect spatial μ-distribution but with a wrong magnitude (initialization in terms of distribution). 3D GATE simulation was also performed for the chest phantom under a typical clinical scanning condition, and the simulated data were reconstructed with a fully corrected list-mode TOF-MLAA algorithm with various initial estimates. The accuracy of the average μ-values within the brain, chest, and abdomen regions obtained from the MR derived μ-maps was also evaluated using computed tomography μ-maps as the gold-standard. Results: The estimated μ-map with the initialization in terms of magnitude (i.e., average μ-value) was observed to reach the reference more quickly and naturally as compared to all other cases. Both 2D and 3D GATE simulations produced similar results, and it was observed that the proposed IAM approach can produce quantitative μ-map/emission when the corrections for physical effects such as scatter and randoms were included. The average μ-value obtained from MR derived μ-map was accurate within 5% with corrections for bone, fat, and uniform lungs. Conclusions: The proposed IAM-TOF-MLAA can produce quantitative μ-map without any calibration provided that there are sufficient counts in the measured data. For low count data, noise reduction and additional regularization/rescaling techniques need to be applied and investigated. The average μ-value within the object is prior information which can be extracted from MR and patient database, and it is feasible to obtain accurate average μ-value using MR derived μ-map with corrections as demonstrated in this work.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

Upper limits of the photon fluence rate on CT detectors: Case study on a commercial scanner

Purpose: The highest photon fluence rate that a computed tomography (CT) detector must be able to measure is an important parameter. The authors calculate the maximum transmitted fluence rate in a commercial CT scanner as a function of patient size for standard head, chest, and abdomen protocols. Methods: The authors scanned an anthropomorphic phantom (Kyoto Kagaku PBU-60) with the reference CT protocols provided by AAPM on a GE LightSpeed VCT scanner and noted the tube current applied with the tube current modulation (TCM) system. By rescaling this tube current using published measurements on the tube current modulation of a GE scanner [N. Keat, “CT scanner automatic exposure control systems,” MHRA Evaluation Report 05016, ImPACT, London, UK, 2005], the authors could estimate the tube current that these protocols would have resulted in for other patient sizes. An ECG gated chest protocol was also simulated. Using measured dose rate profiles along the bowtie filters, the authors simulated imaging of anonymized patient images with a range of sizes on a GE VCT scanner and calculated the maximum transmitted fluence rate. In addition, the 99th and the 95th percentiles of the transmitted fluence rate distribution behind the patient are calculated and the effect of omitting projection lines passing just below the skin line is investigated. Results: The highest transmitted fluence rates on the detector for the AAPM reference protocols with centered patients are found for head images and for intermediate-sized chest images, both with a maximum of 3.4 ⋅ 10{sup 8} mm{sup −2} s{sup −1}, at 949 mm distance from the source. Miscentering the head by 50 mm downward increases the maximum transmitted fluence rate to 5.7 ⋅ 10{sup 8} mm{sup −2} s{sup −1}. The ECG gated chest protocol gives fluence rates up to 2.3 ⋅ 10{sup 8} − 3.6 ⋅ 10{sup 8} mm{sup −2} s{sup −1} depending on miscentering. Conclusions: The fluence rate on a CT detector reaches 3 ⋅ 10{sup 8} − 6 ⋅ 10{sup 8} mm{sup −2} s{sup −1} in standard imaging protocols, with the highest rates occurring for ECG gated chest and miscentered head scans. These results will be useful to developers of CT detectors, in particular photon counting detectors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-114: A Novel Anatomically Predictive Extension Model of Computational Human Phantoms for Dose Reconstruction in Retrospective Epidemiological Studies of Second Cancer Risks in Radiotherapy Patients

Purpose: Recent advances in cancer treatments have greatly increased the likelihood of post-treatment patient survival. Secondary malignancies, however, have become a growing concern. Epidemiological studies determining secondary effects in radiotherapy patients require assessment of organ-specific dose both inside and outside the treatment field. An essential input for Monte Carlo modeling of particle transport is radiological images showing full patient anatomy. However, in retrospective studies it is typical to only have partial anatomy from CT scans used during treatment planning. In this study, we developed a multi-step method to extend such limited patient anatomy to full body anatomy for estimating dose to normal tissues located outside the CT scan coverage. Methods: The first step identified a phantom from a library of body size-dependent computational human phantoms by matching the height and weight of patients. Second, a Python algorithm matched the patient CT coverage location in relation to the whole body phantom. Third, an algorithm cut the whole body phantom and scaled them to match the size of the patient. Then, merged the two anatomies into one whole body. We entitled this new approach, Anatomically Predictive Extension (APE). Results: The APE method was examined by comparing the original chest-abdomen-pelvis CT images of the five patients with the APE phantoms developed from only the chest part of the CAP images and whole body phantoms. We achieved average percent differences of tissue volumes of 25.7%, 34.2%, 16.5%, 26.8%, and 31.6% with an average of 27% across all patients. Conclusion: Our APE method extends the limited CT patient anatomy to whole body anatomy by using image processing and computational human phantoms. Our ongoing work includes evaluating the accuracy of these APE phantoms by comparing normal tissue doses in the APE phantoms and doses calculated for the original full CAP images under generic radiotherapy simulations. This research was supported by the NIH Intramural Research Program.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-435: Helical Tomotherapy for Craniospinal Irradiation: What We Have Learned from a Multi-Institutional Study

Purpose: To report cranio-spinal irradiation (CSI) planning experience, compare dosimetric quality and delivery efficiency with Tomotherapy from different institutions, and to investigate effect of planning parameters on plan quality and treatment time. Methods: Clinical helical tomotherapy IMRT plans for thirty-nine CSI cases from three academic institutions were retrospectively evaluated. The planning parameters: field width (FW), pitch, modulation factor (MF), and achieved dosimetric endpoints were cross-compared. A fraction-dose-delivery-timing index (FDTI), defined as treatment time per fraction dose per PTV length, was utilized to evaluate plan delivery efficiency. A lower FDTI indicates higher delivery efficiency. We studied the correlation between planning quality, treatment time and planning parameters by grouping the plans under specific planning parameters. Additionally, we created new plans using 5cm jaw for a subset of plans that used 2.5cm jaw to exam if treatment efficiency can be improved without sacrificing plan quality. Results: There were significant dosimetric differences for organ at risks (OARs) among different institutions (A,B,C). Using the lowest average MF (1.9±0.4) and 5cm field width, C had the highest lung, heart, kidney, liver mean doses and maximum doses for lens. Using the same field width of 5cm, but higher MF (2.6±0.6), B had lower doses to the OARs in the thorax and abdomen area. Most of A’s plans were planned with 2.5cm jaw, the plans yielded better PTV coverage, higher OAR doses and slightly shorter FDTI compared to institution B. The replanned 5cm jaw plans achieved comparable PTV coverage and OARs sparing, while saving up to 44.7% treatment time. Conclusion: Plan quality and delivery efficiency could vary significantly in CSI planning on Tomotheapy due to choice of different planning parameters. CSI plans using a 5cm jaw, with proper selection of pitch and MF, can achieve comparable/ better plan quality with shorter delivery time compared to 2.5cm jaw plans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-494: A Multi-Institutional Study of Independent Dose Verification Using Golden Beam Data

Purpose: In general, beam data of individual linac is measured for independent dose verification software program and the verification is performed as a secondary check. In this study, independent dose verification using golden beam data was compared to that using individual linac’s beam data. Methods: Six institutions were participated and three different beam data were prepared. The one was individual measured data (Original Beam Data, OBD) .The others were generated by all measurements from same linac model (Model-GBD) and all linac models (All-GBD). The three different beam data were registered to the independent verification software program for each institute. Subsequently, patient’s plans in eight sites (brain, head and neck, lung, esophagus, breast, abdomen, pelvis and bone) were analyzed using the verification program to compare doses calculated using the three different beam data. Results: 1116 plans were collected from six institutes. Compared to using the OBD, the results shows the variation using the Model-GBD based calculation and the All-GBD was 0.0 ± 0.3% and 0.0 ± 0.6%, respectively. The maximum variations were 1.2% and 2.3%, respectively. The plans with the variation over 1% shows the reference points were located away from the central axis with/without physical wedge. Conclusion: The confidence limit (2SD) using the Model-GBD and the All-GBD was within 0.6% and 1.2%, respectively. Thus, the use of golden beam data may be feasible for independent verification. In addition to it, the verification using golden beam data provide quality assurance of planning from the view of audit. This research is partially supported by Japan Agency for Medical Research and Development(AMED)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-206-08: How Should Focal Spot Be Chosen for Optimized CT Imaging with Dose Modulation?

Purpose: To choose the preferred focal spot for achieving optimized CT image quality with balanced tube heating considerations. Methods: An anthropomorphic pelvic phantom was scanned using a GE Discovery CT750 HD at 120 and 140kVp, 0.8s rotation time, and pitch of 0.984. “Smart mA” was enabled to simulate a routine abdomen–pelvis CT scan. Permissible mA values at 120 and 140 kVp were obtained from the Serial Load Rating table (for mimicking a busy CT clinical operation) in the scanner Technical Reference Manual. At each kVp station and two Noise Index levels, the mA Upper Limit was set above/below the permissible mA values. Scanned mA values and focal spot (FS) used were obtained from the DICOM header of each image, and the FS-mA relationship was analyzed. For visual confirmation beyond recorded FS information, a CatPhan with a fat-ring attached for mimicking patient size/shape was scanned at 120kVp. A group of radiologists/physicists compared a pair of CatPhan images qualitatively. Lastly, a number of patient cases were evaluated to confirm the FS-mA relationship. Results: When preset Upper Limit values were above the permissible mA values, the Large FS (labeled 1.2) was used in scans, even if the maximum scanned mA values were much lower than the permissible values at both 120 and 140 kVp. Otherwise the Small FS (labeled 0.7) was used. Visual evaluation of the high contrast module of CatPhan and additional analysis of patient cases further confirmed that the preset Upper Limit determines which focal spot is to be used, not the actual maximum mA value to be scanned. Conclusion: Specific FS can be selected by setting up appropriate mA Upper Limit in a protocol. CT protocols could be optimized by selecting appropriate FS for improving patient image quality, especially benefiting the small size and pediatric patients.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-206-11: The Effect of Table Height On CTDIvol and SSDE in CT Scanning: A Phantom Study

Purpose: Localizer projection radiographs acquired prior to CT scans are used to estimate patient size, affecting the function of Automatic Tube Current Modulation (ATCM) and calculation of the Size Specific Dose Estimate (SSDE). Due to geometric effects, the projected patient size varies with scanner table height and with the orientation of the localizer (AP versus PA). Consequently, variations in scanner table height may affect both CTDIvol and the calculated size-corrected dose index (SSDE). This study sought to characterize these effects. Methods: An anthropomorphic phantom was imaged using an AP localizer, followed by a diagnostic scan using ATCM and our institution’s routine abdomen protocol. This was repeated at various scanner table heights, recording the scanner-reported CTDIvol for each diagnostic scan. The width of the phantom was measured from the localizer and diagnostic images using in-house software. The measured phantom width and scanner-reported CTDIvol were used to calculate SSDE. This was repeated using PA localizers followed by diagnostic scans. Results: 1) The localizer-based phantom width varied by up to 54% of the nominal phantom width between minimum and maximum table heights. 2) Changing the table height caused a variation in scanner-reported CTDIvol of a factor greater than 4.6 when using a PA localizer and almost 2 when using an AP localizer. 3) SSDE, calculated from measured phantom size and scanner-reported CTDIvol, varied by a factor of more than 2.8 when using a PA localizer and almost 1.5 when using an AP localizer. Conclusion: Our study demonstrates that off-center patient positioning affects the efficacy of ATCM, more severely when localizers are acquired in the PA rather than AP projection. Further, patient positioning errors can cause a large variation in the calculated SSDE. This hinders interpretation of SSDE for individual patients and aggregate SSDE data when evaluating CT protocols and clinical practices.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-JeP1-14: Respiratory Motion Tracking Using Kinect V2

Purpose: Investigate capability and accuracy of Kinect v2 camera for tracking respiratory motion to use as a tool during 4DCT or in combination with motion management during radiotherapy treatments. Methods: Utilizing the depth sensor on the Kinect as well as code written in C#, the respiratory motion of a patient was tracked by recording the depth (distance) values obtained at several points on the patient. Respiratory traces were also obtained using Varian’s RPM system, which traces the movement of a propriety marker placed on the patient’s abdomen, as well as an Anzai belt, which utilizes a pressure sensor to track respiratory motion. With the Kinect mounted 60 cm above the patient and pointing straight down, 11 breathing cycles were recorded with each system simultaneously. Relative displacement values during this time period were saved to file. While RPM and the Kinect give displacement values in distance units, the Anzai system has arbitrary units. As such, displacement for all three are displayed relative to the maximum value for the time interval from that system. Additional analysis was performed between RPM and Kinect for absolute displacement values. Results: Analysis of the data from all three systems indicates the relative motion obtained from the Kinect is both accurate and in sync with the data from RPM and Anzai. The absolute displacement data from RPM and Kinect show similar displacement values throughout the acquisition except for the depth obtained from the Kinect during maximum exhalation (largest distance from Kinect). Conclusion: By simply utilizing the depth data of specific points on a patient obtained from the Kinect, respiratory motion can be tracked and visualized with accuracy comparable to that of the Varian RPM and Anzai belt.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-IeP3-13: Real-Time Patient and Staff Dose Monitoring in Fluoroscopy Guided Interventions

Purpose: Interventional radiology procedures involve the use of X-rays, which can pose a large radiation burden on both patients and staff. Although some reports on radiation dose are available, most studies focus on limited types of procedures and only report patient dose. In our cathlabs a dedicated real-time patient and staff monitoring system was installed in November 2015. The aim of this study was to investigate the patient and staff dose exposure for different types of interventions. Methods: Radiologists involved in fluoroscopy guided interventional radiology procedures wore personal dose meters (PDM, DoseAware, Philips) on their lead-apron that measured the personal dose equivalent Hp(10), a measure for the effective dose (E). Furthermore, reference PDMs were installed in the C-arms of the fluoroscopy system (Allura XPer, Philips). Patient dose-area-product (DAP) and PDM doses were retrieved from the monitoring system (DoseWise, Philips) for each procedure. A total of 399 procedures performed between November 2015 and February 2016 were analyzed with respect to the type of intervention. Interventions were grouped by anatomy and radiologist position. Results: The mean DAP for the different types of interventions ranged from 2.86±2.96 Gycm{sup 2} (percutaneous gastrostomy) to 147±178 Gycm{sup 2} (aortic repair procedures). The radiologist dose (E) ranged from 5.39±7.38 µSv (cerebral interventions) to 84.7±106 µSv (abdominal interventions) and strongly correlated with DAP (R{sup 2}=0.83). The E normalized to DAP showed that the relative radiologist dose was higher for interventions in larger body parts (e.g. abdomen) compared to smaller body parts (e.g. head). Conclusion: Using a real-time dose monitoring system we were able to assess the staff and patient dose revealing that the relative staff dose strongly depended on the type of procedure and patient anatomy. This could be explained by the position of the radiologist with respect to the patient and X-ray tube. To facilitate this study L Vergoossen received a scholarship from Philips Medical Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-AB-BRA-01: Abdominal Synthetic CT Generation in Support of Liver SBRT Dose Calculation

Purpose: To demonstrate and validate a technique for generating MRI-derived synthetic CT volumes (MRCTs) in support of adaptive liver SBRT. Methods: Under IRB approval, ten hepatocellular carcinoma patients were scanned using a single MR sequence (T1 Dixon-VIBE), yielding inherently-registered water, fat, and T1-weighted images. Air-containing voxels were identified by intensity thresholding. The envelope of the anterior vertebral bodies was segmented from the fat image by fitting a shape model to vertebral body candidate voxels, then using level sets to expand the contour outward. Fuzzy-C-Means (FCM) was then used to classify each non-air voxel in the image as fat, water, bone, or marrow. Bone and marrow only were classified within the vertebral body envelope. The MRCT was created by integrating the product of the FCM class probability with the assigned class density for each voxel. The resulting MRCTs were deformably aligned with planning CTs and 2-ARC SBRT VMAT plans were optimized on the MRCT density maps. Fluence was copied onto the CT density grids and dose recalculated. Results: The MRCTs faithfully reproduced most of the features visible in the corresponding CT image volumes, with exceptions of ribs and posterior spinous processes. The liver, vertebral bodies, kidneys, spleen and cord all had median HU differences of less than 75 between MRCT and CT images. PTV D99% values had an average 0.2% difference (standard deviation: 0.46%) between calculations on MRCT and CT density grids. The maximum difference in dose to 0.1cc of the PTV was 0.25% (std:0.49%). OAR dose differences were similarly small (mean:0.03Gy, std:0.26Gy). The largest normal tissue complication percentage (NTCP) difference was 1.48% (mean:0.06%, std:0.54%). Conclusions: MRCTs from a single abdominal imaging sequence are promising for use in SBRT dose calculation. Future work will focus on extending models to better define bones in the upper abdomen. Supported by NIHR01EB016079 and NIH1L30CA199594-01.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-FG-209-12: Treatment Site and View Recognition in X-Ray Images with Hierarchical Multiclass Recognition Models

Purpose: To investigate an approach of automatically recognizing anatomical sites and imaging views (the orientation of the image acquisition) in 2D X-ray images. Methods: A hierarchical (binary tree) multiclass recognition model was developed to recognize the treatment sites and views in x-ray images. From top to bottom of the tree, the treatment sites are grouped hierarchically from more general to more specific. Each node in the hierarchical model was designed to assign images to one of two categories of anatomical sites. The binary image classification function of each node in the hierarchical model is implemented by using a PCA transformation and a support vector machine (SVM) model. The optimal PCA transformation matrices and SVM models are obtained by learning from a set of sample images. Alternatives of the hierarchical model were developed to support three scenarios of site recognition that may happen in radiotherapy clinics, including two or one X-ray images with or without view information. The performance of the approach was tested with images of 120 patients from six treatment sites – brain, head-neck, breast, lung, abdomen and pelvis – with 20 patients per site and two views (AP and RT) per patient. Results: Given two images in known orthogonal views (AP and RT), the hierarchical model achieved a 99% average F1 score to recognize the six sites. Site specific view recognition models have 100 percent accuracy. The computation time to process a new patient case (preprocessing, site and view recognition) is 0.02 seconds. Conclusion: The proposed hierarchical model of site and view recognition is effective and computationally efficient. It could be useful to automatically and independently confirm the treatment sites and views in daily setup x-ray 2D images. It could also be applied to guide subsequent image processing tasks, e.g. site and view dependent contrast enhancement and image registration. The senior author received research grants from ViewRay Inc. and Varian Medical System.

60 APPLIED LIFE SCIENCES↗