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Cross-facility science with the Superfacility Project at LBNL

As data sets from DOE user science facilities grow in both size and complexity there is an urgent need for new capabilities to transfer, analyze and manage the data underlying scientific discoveries. LBNL's Superfacility project brings together experimental and observational research instruments with computational and network facilities at the National Energy Research Scientific Computing Center (NERSC) and the Energy Sciences Network (ESnet) with the goal of enabling user science. Here, we report on recent innovations in the Superfacility project, including advanced data management, API-based automation, real-Time interactive user interfaces, and supported infrastructure for 'edge' services.

Enders, B↗

Advanced simulation capability for environmental management - current status and future applications

The U.S. Department of Energy (US DOE) Office of Environmental Management (EM), Office of Soil and Groundwater (EM-12), is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach that is currently aimed at understanding and predicting contaminant fate and transport in natural and engineered systems. ASCEM is a modular and open source high-performance computing tool. It will be used to facilitate integrated approaches to modeling and site characterization, and provide robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, with current emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Tool-sets and High-Performance Computing (HPC) multi-process simulator. The Platform capabilities provide the user interface and tools for end-to-end model development, starting with definition of the conceptual model, management of data for model input, model calibration and uncertainty analysis, and processing of model output, including visualization. The HPC capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The integration of the Platform and HPC capabilities were tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities in 2012. The current maturity of the ASCEM computational and analysis capabilities has afforded the opportunity for collaborative efforts to develop decision analysis tools to support and optimize radioactive waste disposal. Recent advances in computerized decision analysis frameworks provide the perfect opportunity to bring this capability into ASCEM. This will allow radioactive waste disposal to be evaluated based on decision needs, such as disposal, closure, and maintenance. Decision models will be used in ASCEM to identify information/data needs, and model refinements that might be necessary to effectively reduce uncertainty in waste disposal decisions. Decision analysis models start with tools for framing the problem, and continue with modeling both the science side of the problem (for example, inventories, source terms, fate and transport, receptors, risk, etc.), and the cost side of the problem, which could include costs of implementation of any action that is chosen (e.g., for disposal or closure), and the values associated with those actions. The cost side of the decision problem covers economic, environmental and societal costs, which correspond to the three pillars of sustainability (economic, social, and environmental). These tools will facilitate stakeholder driven decision analysis to support optimal sustainable solutions in ASCEM. In this paper the current state of ASCEM is first described, followed by a description of the approach that will be taken to augment ASCEM for simulating fate and transport with tools that facilitate a top-down or systems level view of finding optimal, sustainable solutions to difficult environmental (including radioactive waste) problems. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Brachytherapy structural shielding calculations using Monte Carlo generated, monoenergetic data

Purpose: To provide a method for calculating the transmission of any broad photon beam with a known energy spectrum in the range of 20–1090 keV, through concrete and lead, based on the superposition of corresponding monoenergetic data obtained from Monte Carlo simulation. Methods: MCNP5 was used to calculate broad photon beam transmission data through varying thickness of lead and concrete, for monoenergetic point sources of energy in the range pertinent to brachytherapy (20–1090 keV, in 10 keV intervals). The three parameter empirical model introduced byArcher et al. [“Diagnostic x-ray shielding design based on an empirical model of photon attenuation,” Health Phys. 44, 507–517 (1983)] was used to describe the transmission curve for each of the 216 energy-material combinations. These three parameters, and hence the transmission curve, for any polyenergetic spectrum can then be obtained by superposition along the lines of Kharrati et al. [“Monte Carlo simulation of x-ray buildup factors of lead and its applications in shielding of diagnostic x-ray facilities,” Med. Phys. 34, 1398–1404 (2007)]. A simple program, incorporating a graphical user interface, was developed to facilitate the superposition of monoenergetic data, the graphical and tabular display of broad photon beam transmission curves, and the calculation of material thickness required for a given transmission from these curves. Results: Polyenergetic broad photon beam transmission curves of this work, calculated from the superposition of monoenergetic data, are compared to corresponding results in the literature. A good agreement is observed with results in the literature obtained from Monte Carlo simulations for the photon spectra emitted from bare point sources of various radionuclides. Differences are observed with corresponding results in the literature for x-ray spectra at various tube potentials, mainly due to the different broad beam conditions or x-ray spectra assumed. Conclusions: The data of this work allow for the accurate calculation of structural shielding thickness, taking into account the spectral variation with shield thickness, and broad beam conditions, in a realistic geometry. The simplicity of calculations also obviates the need for the use of crude transmission data estimates such as the half and tenth value layer indices. Although this study was primarily designed for brachytherapy, results might also be useful for radiology and nuclear medicine facility design, provided broad beam conditions apply.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-D-9A-03: STAMP: Simulator for Texture Analysis in MRI/PET

Purpose: To develop a convenient simulation platform to facilitate PET/MR image analysis with the prospect of gaining a better understanding of the influence of acquisition parameters on PET/MRI textural features. The simulation platform is demonstrated by showing textural variations of a representative case study using different image acquisition parameters. Methods: The simulation platform is composed of MRI simulators JEMRIS and SIMRI to achieve simulations of customized MRI sequences on sample tumor models. The PET simulator GATE is used to get 2D and 3D Monte Carlo acquisitions of voxelized PET sources using a phantom geometry and a customized scanner architecture. The platform incorporates a series of graphical user interfaces written in Matlab. Two GUIs are used to facilitate communication with the simulation executables installed on a computer cluster. A third GUI is used to collect and display the clinical and simulated images, as well as fused PET/MRI images, and perform computation of textural features.To illustrate the capabilities of this platform, one FDG-PET and T1-weighted (T1w) digitized tumor models were generated from clinical images of a soft-tissue sarcoma patient. Numerically simulated MR images were produced using 3 different echo times (TE) and 5 different repetition times (TR). PET 2D images were simulated using an OSEM algorithm with 1 to 32 iterations and a post-reconstruction Gaussian filter of 0, 2, 4 or 6 mm width. Results: STAMP was successfully used to produce numerically simulated FDG-PET and MRI images, and to calculate their corresponding textures. Three typical textures (GLCM-Contrast, GLSZM-ZSV and NGTDM-Coarseness) were found to vary by a range of 45% on average compared to reference scanning conditions in the case of FDG-PET, and by a range of 40% in the case of T1w MRI. Conclusion: We have successfully developed a Matlab-based simulation platform to facilitate PET/MRI texture image analysis for outcome prediction.

60 APPLIED LIFE SCIENCES↗

SU-F-18C-01: Minimum Detectability Analysis for Comprehensive Sized Based Optimization of Image Quality and Radiation Dose Across CT Protocols

Purpose: This work involved a comprehensive modeling of task-based performance of CT across a wide range of protocols. The approach was used for optimization and consistency of dose and image quality within a large multi-vendor clinical facility. Methods: 150 adult protocols from the Duke University Medical Center were grouped into sub-protocols with similar acquisition characteristics. A size based image quality phantom (Duke Mercury Phantom) was imaged using these sub-protocols for a range of clinically relevant doses on two CT manufacturer platforms (Siemens, GE). The images were analyzed to extract task-based image quality metrics such as the Task Transfer Function (TTF), Noise Power Spectrum, and Az based on designer nodule task functions. The data were analyzed in terms of the detectability of a lesion size/contrast as a function of dose, patient size, and protocol. A graphical user interface (GUI) was developed to predict image quality and dose to achieve a minimum level of detectability. Results: Image quality trends with variations in dose, patient size, and lesion contrast/size were evaluated and calculated data behaved as predicted. The GUI proved effective to predict the Az values representing radiologist confidence for a targeted lesion, patient size, and dose. As an example, an abdomen pelvis exam for the GE scanner, with a task size/contrast of 5-mm/50-HU, and an Az of 0.9 requires a dose of 4.0, 8.9, and 16.9 mGy for patient diameters of 25, 30, and 35 cm, respectively. For a constant patient diameter of 30 cm, the minimum detected lesion size at those dose levels would be 8.4, 5, and 3.9 mm, respectively. Conclusion: The designed CT protocol optimization platform can be used to evaluate minimum detectability across dose levels and patient diameters. The method can be used to improve individual protocols as well as to improve protocol consistency across CT scanners.

60 APPLIED LIFE SCIENCES↗

TH-A-19A-01: An Open Source Software for Proton Treatment Planning in Heterogeneous Medium

Purpose: Due to its success in Radiation Oncology during the last decade, interest in proton therapy is on the rise. Unfortunately, despite the global enthusiasm in the field, there is presently no free, multiplatform and customizable Treatment Planning System (TPS) providing proton dose distributions in heterogenous medium. This restricts substantially the progress of clinical research for groups without access to a commercial Proton TPS. The latest implementation of our pencil beam dose calculation algorithm for proton beams within the 3D Slicer open-source environment fulfills all the conditions described above. Methods: The core dose calculation algorithm is based on the Hong algorithm (1), which was upgraded with the Kanematsu theory describing the evolution of the lateral scattering of proton beamlets in heterogeneous medium. This algorithm deals with both mono-energetic beams and Spread Out Bragg Peak (SOBP). In order to be user-friendly, we provide a graphical user interface implemented with the Qt libraries, and visualization with the 3D Slicer medical image analysis software. Two different pencil beam algorithms were developed, and the clinical proton beam line at our facility was modeled. Results: The dose distributions provided by our algorithms were compared to dose distributions coming from both commercialized XiO TPS and literature (dose measurements, GEANT4 and MCNPx) and turned out to be in a good agreement, with maximum dose discrepancies of 5% in homogeneous phantoms and 10% in heterogeneous phantoms. The algorithm of SOBP creation from an optimized weigthing of mono-energetic beams results in flat SOBP. Conclusion: We hope that our efforts in implementing this new, open-source proton TPS will help the research groups to have a free access to a useful, reliable proton dose calculation software.(1) L. Hong et al., A pencil beam algorithm for proton dose calculations, Phys. Med. Biol. 41 (1996) 1305–1330. This project is paid for by NCI/MGH Federal share as a research grant.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Sci—Thur PM: Planning and Delivery — 02: Treatment planning workflow for very high-energy electron beam radiotherapy

Purpose: To develop treatment planning workflow for rapid radiotherapy delivered with very-high energy electron (VHEE) scanning beam. Methods: VHEE radiotherapy treatment planning was performed by linking Monte Carlo (MC) dose calculations with inverse optimization in a research version of RayStation. In order to study a number of treatment parameters, a Matlab graphical user interface (GUI) for calculation of VHEE beamlet dose was developed. Through the GUI, EGSnrc MC simulations were run for a number of beam energies, number of beams, beamlet spot and grid sizes, and machine bore sizes. VHEE plans for a pediatric patient with a 4.3 cm{sup 3} brain target optimized with spot-scanning algorithm in RayStation were compared to the clinically delivered 6 MV VMAT plan. Results and Discussion: VHEE beam energy had the largest effect on the quality of dose distributions. For the same target dose, the mean doses to critical organs decreased by 10–15% when planned with 100 MeV compared to 60 MeV. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams. While beamlet spacing and bore size had a small effect on VHEE dose distributions, 0.1-3mm beamlet sizes resulted in identical dose distributions. Critical organ doses were by up to 70% lower in the best VHEE plan compared to the clinical 6 MV VMAT plan. Conclusions: We have developed a GUI for MC beamlet generation for treatment planning of VHEE radiotherapy. We have demonstrated that pediatric VHEE plans resulted in significant critical organ dose sparing compared to the clinical VMAT plan.

60 APPLIED LIFE SCIENCES↗

Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual quality assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable ranges. Results: The observer study indicated that, for each image quality attribute, the averaged observer ranking strongly correlated with the algorithmic ranking (linear correlation coefficient R > 0.92), with highest correlation (R = 1) for lung gray level and the lowest (R = 0.92) for mediastinum noise. There was a strong concordance between the observers in terms of their rankings (i.e., Kendall’s tau agreement > 0.84). The observers also generally indicated similar tolerance and preference levels in terms of acceptable ranges, as 85% of the values were close to the overall tolerance or preference levels and the differences were smaller than 0.15. Conclusions: The observer study indicates that the previously proposed technique provides a robust reflection of the perceptual image quality in clinical images. The results established the range of algorithmic outputs for each metric that can be used to quantitatively assess and qualify the appearance quality of clinical chest radiographs.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Computer aided detection of surgical retained foreign object for prevention

Purpose: Surgical retained foreign objects (RFOs) have significant morbidity and mortality. They are associated with approximately $1.5 × 10{sup 9} annually in preventable medical costs. The detection accuracy of radiographs for RFOs is a mediocre 59%. The authors address the RFO problem with two complementary technologies: a three-dimensional (3D) gossypiboma micro tag, the μTag that improves the visibility of RFOs on radiographs, and a computer aided detection (CAD) system that detects the μTag. It is desirable for the CAD system to operate in a high specificity mode in the operating room (OR) and function as a first reader for the surgeon. This allows for fast point of care results and seamless workflow integration. The CAD system can also operate in a high sensitivity mode as a second reader for the radiologist to ensure the highest possible detection accuracy. Methods: The 3D geometry of the μTag produces a similar two dimensional (2D) depiction on radiographs regardless of its orientation in the human body and ensures accurate detection by a radiologist and the CAD. The authors created a data set of 1800 cadaver images with the 3D μTag and other common man-made surgical objects positioned randomly. A total of 1061 cadaver images contained a single μTag and the remaining 739 were without μTag. A radiologist marked the location of the μTag using an in-house developed graphical user interface. The data set was partitioned into three independent subsets: a training set, a validation set, and a test set, consisting of 540, 560, and 700 images, respectively. A CAD system with modules that included preprocessing μTag enhancement, labeling, segmentation, feature analysis, classification, and detection was developed. The CAD system was developed using the training and the validation sets. Results: On the training set, the CAD achieved 81.5% sensitivity with 0.014 false positives (FPs) per image in a high specificity mode for the surgeons in the OR and 96.1% sensitivity with 0.81 FPs per image in a high sensitivity mode for the radiologists. On the independent test set, the CAD achieved 79.5% sensitivity with 0.003 FPs per image in a high specificity mode for the surgeons and 90.2% sensitivity with 0.23 FPs per image in a high sensitivity mode for the radiologists. Conclusions: To the best of the authors’ knowledge, this is the first time a 3D μTag is used to produce a recognizable, substantially similar 2D projection on radiographs regardless of orientation in space. It is the first time a CAD system is used to search for man-made objects over anatomic background. The CAD system for the μTags achieved reasonable performance in both the high specificity and the high sensitivity modes.

60 APPLIED LIFE SCIENCES↗

Treatment planning for radiotherapy with very high-energy electron beams and comparison of VHEE and VMAT plans

Purpose: The aim of this work was to develop a treatment planning workflow for rapid radiotherapy delivered with very high-energy electron (VHEE) scanning pencil beams of 60–120 MeV and to study VHEE plans as a function of VHEE treatment parameters. Additionally, VHEE plans were compared to clinical state-of-the-art volumetric modulated arc therapy (VMAT) photon plans for three cases. Methods: VHEE radiotherapy treatment planning was performed by linking EGSnrc Monte Carlo (MC) dose calculations with inverse treatment planning in a research version of RayStation. In order to study the effect of VHEE treatment parameters on VHEE dose distributions, a MATLAB graphical user interface (GUI) for calculation of VHEE MC pencil beam doses was developed. Through the GUI, pediatric case MC simulations were run for a number of beam energies (60, 80, 100, and 120 MeV), number of beams (13, 17, and 36), pencil beam spot (0.1, 1.0, and 3.0 mm) and grid (2.0, 2.5, and 3.5 mm) sizes, and source-to-axis distance, SAD (40 and 50 cm). VHEE plans for the pediatric case calculated with the different treatment parameters were optimized and compared. Furthermore, 100 MeV VHEE plans for the pediatric case, a lung, and a prostate case were calculated and compared to the clinically delivered VMAT plans. All plans were normalized such that the 100% isodose line covered 95% of the target volume. Results: VHEE beam energy had the largest effect on the quality of dose distributions of the pediatric case. For the same target dose, the mean doses to organs at risk (OARs) decreased by 5%–16% when planned with 100 MeV compared to 60 MeV, but there was no further improvement in the 120 MeV plan. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams, but to a more modest degree (<8%). While pencil beam spacing and SAD had a small effect on VHEE dose distributions, 0.1–3 mm pencil beam sizes resulted in identical dose distributions. For the 100 MeV VHEE pediatric plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI{sub 100} = 1.09 and CI{sub 50} = 4.07) were better than VMAT conformity indices (CI{sub 100} = 1.30 and CI{sub 50} = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI{sub 100} and CI{sub 50} conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI{sub 100} and CI{sub 50} conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans.

60 APPLIED LIFE SCIENCES↗

GMctdospp: Description and validation of a CT dose calculation system

Purpose: To develop a Monte Carlo (MC)-based computed tomography (CT) dose estimation method with a graphical user interface with options to define almost arbitrary simulation scenarios, to make calculations sufficiently fast for comfortable handling, and to make the software free of charge for general availability to the scientific community. Methods: A framework called GMctdospp was developed to calculate phantom and patient doses with the MC method based on the EGSnrc system. A CT scanner was modeled for testing and was adapted to half-value layer, beam-shaping filter, z-profile, and tube-current modulation (TCM). To validate the implemented variance reduction techniques, depth-dose and cross-profile calculations of a static beam were compared against DOSXYZnrc/EGSnrc. Measurements for beam energies of 80 and 120 kVp at several positions of a CT dose-index (CTDI) standard phantom were compared against calculations of the created CT model. Finally, the efficiency of the adapted code was benchmarked against EGSnrc defaults. Results: The CT scanner could be modeled accurately. The developed TCM scheme was confirmed by the dose measurement. A comparison of calculations to DOSXYZnrc showed no systematic differences. Measurements in a CTDI phantom could be reproduced within 2% average, with a maximal difference of about 6%. Efficiency improvements of about six orders of magnitude were observed for larger organ structures of a chest-examination protocol in a voxelized phantom. In these cases, simulations took 25 s to achieve a statistical uncertainty of ∼0.5%. Conclusions: A fast dose-calculation system for phantoms and patients in a CT examination was developed, successfully validated, and benchmarked. Influences of scan protocols, protection method, and other issues can be easily examined with the developed framework.

60 APPLIED LIFE SCIENCES↗

SU-E-J-253: The Radiomics Toolbox in the Computational Environment for Radiological Research (CERR)

Purpose: To present an open source and free platform to facilitate radiomics research — The “Radiomics toolbox” in CERR. Method: There is scarcity of open source tools that support end-to-end modeling of image features to predict patient outcomes. The “Radiomics toolbox” strives to fill the need for such a software platform. The platform supports (1) import of various kinds of image modalities like CT, PET, MR, SPECT, US. (2) Contouring tools to delineate structures of interest. (3) Extraction and storage of image based features like 1st order statistics, gray-scale co-occurrence and zonesize matrix based texture features and shape features and (4) Statistical Analysis. Statistical analysis of the extracted features is supported with basic functionality that includes univariate correlations, Kaplan-Meir curves and advanced functionality that includes feature reduction and multivariate modeling. The graphical user interface and the data management are performed with Matlab for the ease of development and readability of code and features for wide audience. Open-source software developed with other programming languages is integrated to enhance various components of this toolbox. For example: Java-based DCM4CHE for import of DICOM, R for statistical analysis. Results: The Radiomics toolbox will be distributed as an open source, GNU copyrighted software. The toolbox was prototyped for modeling Oropharyngeal PET dataset at MSKCC. The analysis will be presented in a separate paper. Conclusion: The Radiomics Toolbox provides an extensible platform for extracting and modeling image features. To emphasize new uses of CERR for radiomics and image-based research, we have changed the name from the “Computational Environment for Radiotherapy Research” to the “Computational Environment for Radiological Research”.

60 APPLIED LIFE SCIENCES↗

SU-E-T-188: Commission of World 1st Commercial Compact PBS Proton System

Purpose: ProteusONE is the 1st commercial compact PBS proton system with an upstream scanning gantry and C230 cyclotron. We commissioned XiO and Raystation TPS simultaneously. This is a summary of beam data collection, modeling, and verification and comparison without range shiter for this unique system with both TPS. Methods: Both Raystation and XiO requires the same measurements data: (i) integral depth dose(IDDs) of single central spot measured in water tank; (ii) absolute dose calibration measured at 2cm depth of water with mono-energetic 10×10 cm2 field with spot spacing 4mm, 1MU per spot; and (iii) beam spot characteristics in air at 0cm and ± 20cm away from ISO. To verify the beam model for both TPS, same 15 cube plans were created to simulate different treatment sites, target volumes and positions. PDDs of each plan were measured using a Multi-layer Ionization Chamber(MLIC), absolute point dose verification were measured using PPC05 in water tank and patient-specific QA were measured using MatriXX PT, a 2D ion chamber array. Results: All the point dose measurements at midSOBP were within 2% for both XiO and Raystation. However, up to 5% deviations were observed in XiO’s plans at shallow depth while within 2% in Raystation plans. 100% of the ranges measured were within 1 mm with maximum deviation of 0.5 mm. 20 patient specific plan were generated and measured in 3 planes (distal, proximal and midSOBP) in Raystation. The average of gamma index is 98.7%±3% with minimum 94% Conclusions: Both TPS were successfully commissioned and can be safely deployed for clinical use for ProteusONE. Based on our clinical experience in PBS planning, user interface, function and workflow, we preferably use Raystation as our main clinical TPS. Gamma Index >95% at 3%/3 mm criteria is our institution action level for patient specific plan QAs.

60 APPLIED LIFE SCIENCES↗

SU-E-T-258: Development of a New Patient Set-Up Monitoring System Using Force Sensing Resistor (FSR) Sensor for the Radiation Therapy

Purpose: The purpose of this work is to develop a new patient set-up monitoring system using force sensing resistor (FSR) sensors that can confirm pressure of contact surface and evaluate its feasibility. Methods: In this study, we focused on develop the patient set-up monitoring system to compensate for the limitation of existing optical based monitoring system, so the developed system can inform motion in the radiation therapy. The set-up monitoring system was designed consisting of sensor units (FSR sensor), signal conditioning devices (USB cable/interface electronics), a control PC, and a developed analysis software. The sensor unit was made by attaching FSR sensor and dispersing pressure sponge to prevent error which is caused by concentrating specific point. Measured signal from the FSR sensor was sampled to arduino mega 2560 microcontroller, transferred to control PC by using serial communication. The measured data went through normalization process. The normalized data was displayed through the developed graphic user interface (GUI) software. The software was designed to display a single sensor unit intensity (maximum 16 sensors) and display 2D pressure distribution (using 16 sensors) according to the purpose. Results: Changes of pressure value according to motion was confirmed by the developed set-up monitoring system. Very small movement such as little physical change in appearance can be confirmed using a single unit and using 2D pressure distribution. Also, the set-up monitoring system can observe in real time. Conclusion: In this study, we developed the new set-up monitoring system using FSR sensor. Especially, we expect that the new set-up monitoring system is suitable for motion monitoring of blind area that is hard to confirm existing optical system and compensate existing optical based monitoring system. As a further study, an integrated system will be constructed through correlation of existing optical monitoring system. This work was supported by the Industrial R&D program of MOTIE/KEIT. [10048997, Development of the core technology for integrated therapy devices based on real-time MRI guided tumor tracking] and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning.

60 APPLIED LIFE SCIENCES↗

SU-E-T-262: Development of An In-House Forward Planning System for Conformal Arc Therapy

Purpose: Conformal radiotherapy with forward planning has many practical advantages (e.g., more uniform target dose) and has been used routinely for stereotactic body radiation therapy (SBRT) and other conventional treatment. This study investigates a forward-planning approach for conformal arc therapy and a dedicated treatment planning system (TPS) for a newly designed cobalt 60 machine with a ring type gantry and a multileaf collimator (MLC). Methods: Conformal arcs were modeled with continuous delivery of treatment fields conformal to the target cross-section. Treatment plans were further optimized by weighting or offsetting beams based on the target-critical structure relationship. CT and structure data of seven previous SBRT patients treated at our center were used for plan evaluation. An in-house forward planning tool was developed to aid the forward planning process. A graphical user interface (GUI) was designed with interactive and automatic adjustment between beam gantry angle and the beam weight. Dose distributions were calculated using our in-house Monte Carlo based TPS. Dose contributions from individual beam angles were summed together with different weight factors, which were continuously optimized until the pre-set dose conformity goal was met. Results: We were able to achieve target coverage and critical structure sparing to meet the required clinical criteria in all studied cases. It should be mentioned that those cases were selected having critical structures not proximal to the target. However, this was usually the case in the majority of SBRT cases especially those involving lung targets. The developed GUI tool was very useful in the forward treatment planning process. Conclusion: Conformal arcs can be used successfully on the new Cobalt 60 modality for the treatment of a sizeable fraction of cancer patients, which can be efficiently planned with our simple forward planning approach.

60 APPLIED LIFE SCIENCES↗

MO-FG-303-06: Evaluation of the Performance of Very High-Energy Electron (VHEE) Beams in Radiotherapy: Five Clinical Cases

Purpose: To evaluate the performance of 100–120 MeV very-high energy electron (VHEE) scanning pencil beams to radiotherapy by means of Monte Carlo (MC) simulations. Methods: We selected five clinical cases with target sizes of 1.2 cm{sup 3} to 990.4 cm{sup 3}. We calculated VHEE treatment plans using the MC EGSnrc code implemented in a MATLAB-based graphical user interface developed by our group. We generated phase space data for beam energies: 100 and 120 MeV and pencil beam spot sizes of 1, 3, and 5 mm at FWHM. The number of equidistant beams considered in this work was 16 or 32. Dose was calculated and then imported into a research version of RayStation where treatment plan optimization was performed. We compared the VHEE plans with the clinically delivered volumetric modulated arc therapy (VMAT) plan to evaluate VHEE plans performance. Results: VHEE plans provided the same PTV coverage and dose homogeneity than VMAT plans for all the cases. In average, the mean dose to organs at risk (OARs) was 24% lower for the VHEE plans. The structures that benefited the most from using VHEE were: large bowel for the esophagus case, chest wall for the liver case, brainstem for the acoustic case, carina for the lung case, and genitalia for the anal case, with 23.7–34.6% lower dose. VHEE dose distributions were more conformal than VMAT solution as confirmed by conformity indices CI100 and CI50. Integral dose to the body was in average 19.6% (9.2%–36.5%) lower for the VHEE plans. Conclusion: We have shown that VHEE plans resulted in similar or superior dose distributions compared to clinical VMAT plans for five different cases and a wide range of target volumes, including a case with a small target (1.2 cm{sup 3}), which represents a challenge for VMAT planning and might require the use of more complex non-coplanar VMAT plans. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Laboratories AB. E Hynning: Employee, RaySearch Laboratories AB. B Qu: None. B Loo Jr.: Research support, RaySearch, Varian. P Maxim: Research support, RaySearch, Varian.

60 APPLIED LIFE SCIENCES↗

Validation of a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial HDR brachytherapy

Purpose: In current clinical practice, there is no integrated 3D ultrasound (3DUS) guidance system clinically available for breast brachytherapy. In this study, the authors present a novel robot-assisted 3DUS system for real-time planning and guidance of breast interstitial high dose rate (HDR) brachytherapy treatment. Methods: For this work, a new computer controlled robotic 3DUS system was built to perform a hybrid motion scan, which is a combination of a 6 cm linear translation with a 30° rotation at both ends. The new 3DUS scanner was designed to fit on a modified Kuske assembly, keeping the current template grid configuration but modifying the frame to allow the mounting of the 3DUS system at several positions. A finer grid was also tested. A user interface was developed to perform image reconstruction, semiautomatic segmentation of the surgical bed as well as catheter reconstruction and tracking. A 3D string phantom was used to validate the geometric accuracy of the reconstruction. The volumetric accuracy of the system was validated with phantoms using magnetic resonance imaging (MRI) and computed tomography (CT) images. In order to accurately determine whether 3DUS can effectively replace CT for treatment planning, the authors have compared the 3DUS catheter reconstruction to the one obtained from CT images. In addition, in agarose-based phantoms, an end-to-end procedure was performed by executing six independent complete procedures with both 14 and 16 catheters, and for both standard and finer Kuske grids. Finally, in phantoms, five end-to-end procedures were performed with the final CT planning for the validation of 3DUS preplanning. Results: The 3DUS acquisition time is approximately 10 s. A paired Student t-test showed that there was no statistical significant difference between known and measured values of string separations in each direction. Both MRI and CT volume measurements were not statistically different from 3DUS volume (Student t-test: p > 0.05) and they were significantly correlated to 3DUS measurement (Pearson test: MRI p < 0.05 and CT p < 0.001). The mean angular separation distance between catheter trajectories segmented from 3DUS and CT images was 0.42° ± 0.24°, while the maximum and mean trajectory separations were 0.51 ± 0.19 and 0.37 ± 0.17 mm, respectively. Overall, the new finer grid has performed significantly better in terms of dosimetric indices. The planning target volume dosimetric indices were not found statistically different between 3DUS and CT planning (Student t-test, p > 0.05). Both the skin and the pectoral muscle dosimetric indices were within ABS guidelines. Conclusions: A novel robot-assisted 3DUS system was designed and validated. To their knowledge, this is the first system capable of performing real-time guidance and planning of breast multicatheter HDR brachytherapy treatments. Future investigation will test the feasibility of using the system in the clinic and for permanent breast brachytherapy.

60 APPLIED LIFE SCIENCES↗