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All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Dosimetric properties of an amorphous silicon EPID for verification of modulated electron radiotherapy

Purpose: To investigate the dosimetric properties of an electronic portal imaging device (EPID) for electron beam detection and to evaluate its potential for quality assurance (QA) of modulated electron radiotherapy (MERT). Methods: A commercially available EPID was used to detect electron beams shaped by a photon multileaf collimator (MLC) at a source-surface distance of 70 cm. The fundamental dosimetric properties such as reproducibility, dose linearity, field size response, energy response, and saturation were investigated for electron beams. A new method to acquire the flood-field for the EPID calibration was tested. For validation purpose, profiles of open fields and various MLC fields (square and irregular) were measured with a diode in water and compared to the EPID measurements. Finally, in order to use the EPID for QA of MERT delivery, a method was developed to reconstruct EPID two-dimensional (2D) dose distributions in a water-equivalent depth of 1.5 cm. Comparisons were performed with film measurement for static and dynamic monoenergy fields as well as for multienergy fields composed by several segments of different electron energies. Results: The advantageous EPID dosimetric properties already known for photons as reproducibility, linearity with dose, and dose rate were found to be identical for electron detection. The flood-field calibration method was proven to be effective and the EPID was capable to accurately reproduce the dose measured in water at 1.0 cm depth for 6 MeV, 1.3 cm for 9 MeV, and 1.5 cm for 12, 15, and 18 MeV. The deviations between the output factors measured with EPID and in water at these depths were within {+-}1.2% for all the energies with a mean deviation of 0.1%. The average gamma pass rate (criteria: 1.5%, 1.5 mm) for profile comparison between EPID and measurements in water was better than 99% for all the energies considered in this study. When comparing the reconstructed EPID 2D dose distributions at 1.5 cm depth to film measurements, the gamma pass rate (criteria: 2%, 2 mm) was better than 97% for all the tested cases. Conclusions: This study demonstrates the high potential of the EPID for electron dosimetry, and in particular, confirms the possibility to use it as an efficient verification tool for MERT delivery.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-T-54: Benefits of Biological Cost Functions

Purpose: To verify the benefits of the biological cost functions. Methods: TG166 patients were used for the test case scenarios. Patients were planned using Monaco V5.0 (CMS/Elekta, St.Louis, MO) Monaco has 3 biological and 8 physical CFs. In this study the plans were optimized using 3 different scenarios. 1- Biological CFs only 2-Physical CFs only 3- Combination of Physical and Biological CFsMonaco has 3 biological CFs. Target EUD used for the targets, derived from the poisson cell kill model, has an α value that controls the cold spots inside the target. α values used in the optimization were 0.5 and 0.8. if cold spots needs to be penalized α value increased. Serial CF: it's called serial to mimic the behaviour of the serial organs, if a high k value like 12 or 14 is used it controls the maximum dose. Serial CF has a k parameter that is used to shape the whole dvh curve. K value ranges between 1–20. k:1 is used to control the mean dose, lower k value controls the mean dose, higher k value controls the higher dose, using 2 serial CFs with different k values controls the whole DVH. Paralel CF controls the percentage of the volume that tolerates higher doses than the reference dose to mimic the behaviour of the paralel organs. Results: It was possible to achive clinically accepted plans in all 3 scenarios. The benefit of the biological cost functions were to control the mean dose for target and OAR, to shape the DVH curve using one EUD value and one k value simplifies the optimization process. Using the biological CFs alone, it was hard to control the dose at a point. Conclusion: Biological CFs in Monaco doesn't require the ntcp/tcp values from the labs and useful to shape the whole dvh curve. I work as an applications support specialist for Elekta and I am a Ph.D. Student in Istanbul University for radiation therapy physics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-71: Commissioning and Acceptance Testing of a Commercial Monte Carlo Electron Dose Calculation Model (eMC) for TrueBeam

Purpose: To provide commissioning and acceptance test data of the Varian Eclipse electron Monte Carlo model (eMC v.11) for TrueBeam linac. We also investigated the uncertainties in beam model parameters and dose calculation results for different geometric configurations. Methods: For beam commissioning, PTW CC13 thimble chamber and IBA Blue Phantom2 were used to collect PDD and dose profiles in air. Cone factors were measured with a parallel plate chamber (PTW N23342) in solid water. GafChromic EBT3 films were used for dose calculation verifications to compare with parallel plate chamber results in the following test geometries: oblique incident, extended distance, small cutouts, elongated cutouts, irregular surface, and heterogeneous layers. Results: Four electron energies (6e, 9e, 12e, and 15e) and five cones (6×6, 10×10, 15×15, 20×20, and 25×25) with standard cutouts were calculated for different grid sizes (1, 1.5,2, and 2.5 mm) and compared with chamber measurements. The results showed calculations performed with a coarse grid size underestimated the absolute dose. The underestimation decreased as energy increased. For 6e, the underestimation (max 3.3 %) was greater than the statistical uncertainty level (3%) and was systematically observed for all cone sizes. By using a 1mm grid size, all the calculation results agreed with measurements within 5% for all test configurations. The calculations took 21s and 46s for 6e and 15e (2.5mm grid size) respectively distributed on 4 calculation servants. Conclusion: In general, commissioning the eMC dose calculation model on TrueBeam is straightforward and thedose calculation is in good agreement with measurements for all test cases. Monte Carlo dose calculation provides more accurate results which improves treatment planning quality. However, the normal acceptable grid size (2.5mm) would cause systematic underestimation in absolute dose calculation for lower energies, such as 6e. Users need to be cautious in this situation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-194: From Dicom-RT to Radiobiological Dose Metrics in 5 Minutes

Purpose: To develop a flexible and standalone framework for batch calculation of radiobiological dose metrics from Dicom-RT. Methods: Software has been developed which allows (1) The calculation of DVH data from DICOM dose and structure files (DVHgenerator), (2) Calculation of a wide range of radiobiological metrics from this data (CompPlanGui). Both these tools are run via graphical user interface (GUI), making them fast and simple. Part 1 is a new tool which has not previously been published, whilst part 2 is a GUI overlay for the previously published software ‘Comp-Plan’ (Holloway et. al., Medical Dosimetry, 2012), previously reliant on command line interface. The time taken for an experienced user to evaluate a test case of 6 plans with and without CompPlanGUI was quantified. Results: The DVH-generator has been found to be faster, more robust and require far less physical memory then using alternative software solutions for the same purpose. The Comp Plan GUI significantly reduces the amount of time required to set up a base directory, eliminates code crashes arising from typographical errors, and renders the code far more accessible to non-expert users. It took an experienced user of the code around 3 minutes to set up a base directory of 6 plans compared around 8 minutes without, indicating that using CompPlanGUI reduced setup time by over 50%. Conclusion: A standalone GUI based framework has developed which allows for the batch calculation of radiobiological dose metrics directly from Dicom-RT files. As with the original code, this work will be made freely available on request, as well as via matlab file exchange.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-555: A Protontherapy Inverse Treatment Planning System Prototype with Linear Energy Transfer (LET) Optimization

Purpose: Develop and benchmark an inverse treatment planning system (TPS) for proton radiotherapy integrating fast analytical dose and LET calculations in patient geometries and a dual objective function with both dose and LET components, enabling us to apply optimization techniques to improve the predicted outcome of treatments based on radiobiological models. Methods: The software package was developed in MATLAB and implements a fluence-dose calculation technique based on a pencil beam model for dose calculations and a 3D LET model based on the extension of the LET in the radial direction as a function of the predicted radiological pathway. Both models were benchmarked against commissioning data from our institution, dose calculations performed with a commercial treatment planning system and Monte Carlo simulations. The optimization is based on the adaptive simulated annealing approach . Results: The dose and LET calculations were tested in a water phantom and several real patient treatments. The pass rate for the gamma index analysis (3%/3mm) test was above 90% for all test cases analyzed, and the calculation time was of the order of seconds. The inverse planning module produced plans with a significantly higher mean LET in the target compared to traditional plans, without any loss of target coverage. The clinical relevance of this improvement is under consideration . Conclusion: The developed treatment planning system is a valuable clinical and research tool that enables us to incorporate LET effects into proton radiotherapy planning in a streamlined fashion.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

TU-C-BRE-04: 3D Gel Dosimetry Using ViewRay On-Board MR Scanner: A Feasibility Study

Purpose: MR based 3D gel has been proposed for radiation therapy dosimetry. However, access to MR scanner has been one of the limiting factors for its wide acceptance. Recent commercialization of an on-board MR-IGRT device (ViewRay) may render the availability issue less of a concern. This work reports our attempts to simulate MR based dose measurement accuracy on ViewRay using three different gels. Methods: A spherical BANG gel dosimeter was purchased from MGS Research. Cylindrical MAGIC gel and Fricke gel were fabricated in-house according to published recipes. After irradiation, BANG and MAGIC were imaged using a dual-echo spin echo sequence for T2 measurement on a Philips 1.5T MR scanner, while Fricke gel was imaged using multiple spin echo sequences. Difference between MR measured and TPS calculated dose was defined as noise. The noise power spectrum was calculated and then simulated for the 0.35 T magnetic field associated with ViewRay. The estimated noise was then added to TG-119 test cases to simulate measured dose distributions. Simulated measurements were evaluated against TPS calculated doses using gamma analysis. Results: Given same gel, sequence and coil setup, with a FOV of 180×90×90 mm3, resolution of 3×3×3 mm3, and scanning time of 30 minutes, the simulated measured dose distribution using BANG would have a gamma passing rate greater than 90% (3%/3mm and absolute). With a FOV 180×90×90 mm3, resolution of 4×4×5 mm3, and scanning time of 45 minutes, the simulated measuremened dose distribution would have a gamma passing rate greater than 97%. MAGIC exhibited similar performance while Fricke gel was inferior due to much higher noise. Conclusions: The simulation results demonstrated that it may be feasible to use MAGIC and BANG gels for 3D dose verification using ViewRay low-field on-board MRI scanner.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-C-BRD-01: Analytical Computation of Prompt Gamma Ray Emission and Detection for Proton Range Verification

Purpose: A prompt gamma (PG) slit camera prototype demonstrated that on-line range monitoring within 1–2 mm could be performed by comparing expected and measured PG detection profiles. Monte Carlo (MC) can simulate the expected PG profile but this would result in prohibitive computation time for a complete pencil beam treatment plan. We implemented a much faster method that is based on analytical processing of pre-computed MC data. Methods: The formation of the PG detection signal can be separated into: 1) production of PGs and 2) detection by the camera detectors after PG transport in geometry. For proton energies from 40 to 230 MeV, PG productions in depth were pre-computed by MC (PENH) for 12C, 14N, 16O, 31P and 40Ca. The PG production was then modeled analytically by adding the PG production for each element according to local proton energy and tissue composition.PG transport in the patient/camera geometries and the detector response were modeled by convolving the PG production profile with a transfer function. The latter is interpolated from a database of transfer functions fitted to pre-computed MC data (PENELOPE). The database was generated for a photon source in a cylindrical phantom with various radiuses and a camera placed at various positions.As a benchmark, the analytical model was compared to PENH for a water phantom, a phantom with different slabs (adipose, muscle, lung) and a thoracic CT. Results: Good agreement (within 5%) was observed between the analytical model and PENH for the PG production. Similar accuracy for detecting range shifts was also observed. Speed of around 250 ms per profile was achieved (single CPU) using a non-optimized MatLab implementation. Conclusion: We devised a fast analytical model for generating PG detection profiles. In the test cases considered in this study, similar accuracy than MC was achieved for detecting range shifts. This research is supported by IBA.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-E-BRE-01: A 3D Solver of Linear Boltzmann Transport Equation Based On a New Angular Discretization Method with Positivity for Photon Dose Calculation Benchmarked with Geant4

Purpose: The Linear Boltzmann Transport Equation (LBTE) solved through statistical Monte Carlo (MC) method provides the accurate dose calculation in radiotherapy. This work is to investigate the alternative way for accurately solving LBTE using deterministic numerical method due to its possible advantage in computational speed from MC. Methods: Instead of using traditional spherical harmonics to approximate angular scattering kernel, our deterministic numerical method directly computes angular scattering weights, based on a new angular discretization method that utilizes linear finite element method on the local triangulation of unit angular sphere. As a Result, our angular discretization method has the unique advantage in positivity, i.e., to maintain all scattering weights nonnegative all the time, which is physically correct. Moreover, our method is local in angular space, and therefore handles the anisotropic scattering well, such as the forward-peaking scattering. To be compatible with image-guided radiotherapy, the spatial variables are discretized on the structured grid with the standard diamond scheme. After discretization, the improved sourceiteration method is utilized for solving the linear system without saving the linear system to memory. The accuracy of our 3D solver is validated using analytic solutions and benchmarked with Geant4, a popular MC solver. Results: The differences between Geant4 solutions and our solutions were less than 1.5% for various testing cases that mimic the practical cases. More details are available in the supporting document. Conclusion: We have developed a 3D LBTE solver based on a new angular discretization method that guarantees the positivity of scattering weights for physical correctness, and it has been benchmarked with Geant4 for photon dose calculation.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2014

Asymmetric dose–volume optimization with smoothness control for rotating-shield brachytherapy

Purpose: It is important to reduce fluence map complexity in rotating-shield brachytherapy (RSBT) inverse planning to improve delivery efficiency while maintaining plan quality. This study proposes an efficient and effective RSBT dose optimization method which enables to produce smooth fluence maps. Methods: Five cervical cancer patients each with a high-risk clinical-target-volume (HR-CTV) larger than 40 cm{sup 3} were considered as the test cases. The RSBT source was a partially shielded electronic brachytherapy source (Xoft Axxent™). The anchor RSBT plans generated by the asymmetric dose–volume optimization with smoothness control (ADOS) method were compared against those produced by the dose–surface optimization (DSO) method and inverse-planning with simulated annealing (IPSA). Either L{sub 1}-norm or L{sub 2}-norm was used to measure the smoothness of a fluence map in the proposed ADOS method as one weighted term of the objective function. Uniform dwell-time scaling was applied to all plans such that HR-CTV D{sub 90} was maximized without violating the D{sub 2cc} tolerances of the rectum, bladder, and sigmoid colon. The quality of the anchor plans was measured with HR-CTV D{sub 90} of the anchor plans. Single-shielded RSBT [(S-RSBT), RSBT with single, fix sized delivery window] and dynamic-sheilded RSBT [(D-RSBT), RSBT with dynamically varying sized delivery window] delivery plans generated based on the anchor plans were also measured, with delivery time constraints of 10, 20, and 30 min/fraction (fx). Results: The average HR-CTV D{sub 90} values of the anchor plans achieved by the ADOS, DSO, and IPSA methods were 111.5, 94.2, and 107.4 Gy, respectively, where the weighting parameter β used in ADOS with L{sub 2}-norm was set to be 100. By using S-RSBT sequencing and 20 min/fx delivery time, the corresponding D{sub 90} values were 88.8, 81.9, and 83.4 Gy; while using D-RSBT sequencing with 20 min/fx delivery time, the corresponding D{sub 90} values were 91.4, 88.3, and 78.9 Gy, respectively. The average optimization times for ADOS, DSO, and IPSA were, respectively, 77, 4, and 1800 s. By using L{sub 1}-norm instead of L{sub 2}-norm in the ADOS method, the optimization time was increased by 20 s, while the D{sub 90} was reduced by 6.8 Gy on average. ADOS-L1 was found to be more sensitive to the weighting parameter than ADOS-L2. If β was increased to 10 000, the D{sub 90} drop with ADOS-L1 was 38 Gy, while the drop with ADOS-L2 is 13 Gy. Conclusions: The ADOS method had a reasonable optimization time cost, while achieving comparable RSBT dose plans as the IPSA method, which is of much higher time complexity. Compared to the DSO and IPSA methods, ADOS is able to generate anchor plans which are more suitable for RSBT delivery while preserving the high quality of the original plans. Compared to ADOS-L1, ADOS-L2 is able to achieve better quality of anchor plans more efficiently.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-04: 3D Dose Based Patient Compensator QA Procedure for Proton Radiotherapy

Purpose: In proton double-scattering radiotherapy, compensators are the essential patient specific devices to contour the distal dose distribution to the tumor target. Traditional compensator QA is limited to checking the drilled surface profiles against the plan. In our work, a compensator QA process was established that assess the entire compensator including its internal structure for patient 3D dose verification. Methods: The fabricated patient compensators were CT scanned. Through mathematical image processing and geometric transformations, the CT images of the proton compensator were combined with the patient simulation CT images into a new series of CT images, in which the imaged compensator is placed at the planned location along the corresponding beam line. The new CT images were input into the Eclipse treatment planning system. The original plan was calculated to the combined CT image series without the plan compensator. The newly computed patient 3D dose from the combined patientcompensator images was verified against the original plan dose. Test plans include the compensators with defects intentionally created inside the fabricated compensators. Results: The calculated 3D dose with the combined compensator and patient CT images reflects the impact of the fabricated compensator to the patient. For the test cases in which no defects were created, the dose distributions were in agreement between our method and the corresponding original plans. For the compensator with the defects, the purposely changed material and a purposely created internal defect were successfully detected while not possible with just the traditional compensator profiles detection methods. Conclusion: We present here a 3D dose verification process to qualify the fabricated proton double-scattering compensator. Such compensator detection process assesses the patient 3D impact of the fabricated compensator surface profile as well as the compensator internal material and structure changes. This research receives funding support from CURA Medical Technologies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-250: Determining VMAT Machine Limitations of An Elekta Linear Accelerator with Agility MLC for Accurate Modeling in RayStation and Robust Delivery

Purpose: To implement VMAT in RayStation with the Elekta Synergy linac with the new Agility MLC, and to utilize the same vendor softwares to determine the optimum Elekta VMAT machine parameters in RayStation for accurate modeling and robust delivery. Methods: iCOMCat is utilized to create various beam patterns with user defined dose rate, gantry, MLC and jaw speed for each control point. The accuracy and stability of the output and beam profile are qualified for each isolated functional component of VMAT delivery using ion chamber and Profiler2 with isocentric mounting fixture. Service graphing on linac console is used to verify the mechanical motion accuracy. The determined optimum Elekta VMAT machine parameters were configured in RayStation v4.5.1. To evaluate the system overall performance, TG-119 test cases and nine retrospective VMAT patients were planned on RayStation, and validated using both ArcCHECK (with plug and ion chamber) and MapCHECK2. Results: Machine output and profile varies <0.3% when only variable is dose rate (35MU/min-600MU/min). <0.9% output and <0.3% profile variation are observed with additional gantry motion (0.53deg/s–5.8deg/s both directions). The output and profile variation are still <1% with additional slow leaf motion (<1.5cm/s both direction). However, the profile becomes less symmetric, and >1.5% output and 7% profile deviation is seen with >2.5cm/s leaf motion. All clinical cases achieved comparable plan quality as treated IMRT plans. The gamma passing rate is 99.5±0.5% on ArcCheck (<3% iso center dose deviation) and 99.1±0.8% on MapCheck2 using 3%/3mm gamma (10% lower threshold). Mechanical motion accuracy in all VMAT deliveries is <1°/1mm. Conclusion: Accurate RayStation modeling and robust VMAT delivery is achievable on Elekta Agility for <2.5cm/s leaf motion and full range of dose rate and gantry speed determined by the same vendor softwares. Our TG-119 and patient results have provided us with the confidence to use VMAT clinically.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-467: Implementation of Monte Carlo Dose Calculation for a Multileaf Collimator Equipped Robotic Radiotherapy System

Purpose: To improve the treatment efficiency and capabilities for full-body treatment, a robotic radiosurgery system has equipped with a multileaf collimator (MLC) to extend its accuracy and precision to radiation therapy. To model the MLC and include it in the Monte Carlo patient dose calculation is the goal of this work. Methods: The radiation source and the MLC were carefully modeled to consider the effects of the source size, collimator scattering, leaf transmission and leaf end shape. A source model was built based on the output factors, percentage depth dose curves and lateral dose profiles measured in a water phantom. MLC leaf shape, leaf end design and leaf tilt for minimizing the interleaf leakage and their effects on beam fluence and energy spectrum were all considered in the calculation. Transmission/leakage was added to the fluence based on the transmission factors of the leaf and the leaf end. The transmitted photon energy was tuned to consider the beam hardening effects. The calculated results with the Monte Carlo implementation was compared with measurements in homogeneous water phantom and inhomogeneous phantoms with slab lung or bone material for 4 square fields and 9 irregularly shaped fields. Results: The calculated output factors are compared with the measured ones and the difference is within 1% for different field sizes. The calculated dose distributions in the phantoms show good agreement with measurements using diode detector and films. The dose difference is within 2% inside the field and the distance to agreement is within 2mm in the penumbra region. The gamma passing rate is more than 95% with 2%/2mm criteria for all the test cases. Conclusion: Implementation of Monte Carlo dose calculation for a MLC equipped robotic radiosurgery system is completed successfully. The accuracy of Monte Carlo dose calculation with MLC is clinically acceptable. This work was supported by Accuray Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-499: Initial Developments of An OpenCL-Based Cross-Platform Monte Carlo Dose Engine for Carbon Ion Therapy

Purpose Dose calculation is of critical importance for carbon ion therapy. Monte Carlo (MC) simulation is considered to be the most accurate method for calculation of absorbed dose and of all the more fundamental physical quantities related to biological effects. The long computation time, however, limits its routine clinical applications. We have recently started developing a fast MC package, gCMC for carbon therapy on a parallel processing platform, e.g. GPU, aiming at achieving sufficient efficiency to enable MC in clinically important tasks. This abstract reports our progress. Methods gCMC was developed in OpenCL environment. Our initial developments focused on water material. gCMC supported carbon ion transport in the energy range of 1–450 MeV/u. A Class II condensed history algorithm was implemented for charged particle transport simulations with stopping power computed via Bethe-Bloch equation. Energy straggling and multiple scattering were modeled. Total cross section of nuclear interaction was extracted from Geant4. At present, nuclear interaction events were sampled but transports of secondary particles were not included. Results We tested cases with a homogeneous water phantom and a pencil carbon ion beam with energy of 200–400 MeV/u. When only electro-magnetic channel was included, dose/fluence difference between gCMC and Geant4 results averaged within 10% isodose line was <0.5% of the maximum dose/fluence. After enabling nuclear interactions without transporting secondary particles, dose and fluence agreed with the corresponding results computed by Geant4 with <1% difference. Due to the support for multiple platforms of OpenCL, gCMC was executable on NVidia and AMD GPUs, and Intel CPUs. It took ∼50 sec to transport 107 200MeV/u source carbon ions on an NVidia Titan GPU card. Conclusion Preliminary studies have demonstrated the accuracy and efficiency of gCMC. With further developments in near future, gCMC will potentially achieve clinically acceptable fast and accurate MC simulations for carbon ion therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-678: Response Calibration Using Electron Depth-Dose Data for MRI-Based 3D Polymer Gel Dosimetry

Purpose: To evaluate a calibration method using the depth-dose data of an electron beam for MRI-based polymer gel dosimetry. Methods: MAGAT was manufactured in-house to fill two 400mL-cylindrical phantoms and nine 22mL-glass vials. Phantom-A was irradiated along the cylinder axis with a 9MeV electron beam of 6 cm x 6 cm field size (FS). Phantom-B was irradiated with a 6MV photon beam of 3 cm x 3 cm FS by a 360-degree arc technique. Eight vials were irradiated in a water-bath to various doses with a 20 cm x 20 cm FS 6MV photon beam. All irradiated phantoms and one un-irradiated vial were scanned with a 3T MRI scanner to obtain the spin-spin relaxation rate (R2) distributions. By comparing the measured R2-to-depth data with the known depth-dose data for Phantom-A, R2-to-dose calibration data were obtained (e-beam method). Another calibration data were obtained from the 9 vials data (9-vial method). We tested two regression equations, i.e., third-order polynomial and tangent functions, and two dose normalization methods, i.e., one-point and two-point methods. Then, these two calibration methods were used to obtain the 3D dose distribution of Phantom-B and evaluated by comparing the measured data with the dose distribution from a treatment planning system. The comparison was made with gamma passing rate (2%/2mm criteria). Results: We did not observe a clear advantage of the e-beam method over the 9-vial method for the 3D dose comparison with the test case. Nevertheless, we found that the e-beam method required a smaller dose scaling for the dose comparison. Furthermore, the tangent function showed better data fitting than the polynomial function with smaller uncertainty of the estimated coefficients. Conclusions: Considering the overall superior performance, we recommend the e-beam method with the tangent function as the regression equation and one-point dose normalization for the MRI-based polymer gel dosimetry.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
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

TU-AB-303-10: KVCBCT, MVCBCT and MVCT On-Board Imaging Suitability for An Urgent Radiotherapy Treatment Workflow

Purpose: A comparison of image quality and dose calculation accuracy to study the suitability of available on-board imaging systems for a new treatment workflow in emergency radiotherapy situations. Methods: Water and anthropomorphic phantom images were acquired on four different Linac on-board imaging systems, including kVCBCT (Varian TrueBeam and Elekta VersaHD), MVCBCT (Siemens Artiste) and MVCT (Accuray Tomotherapy). Simple treatments of single or opposed beams were planned on the respective kVCT images and copied to all CT images. Image suitability for dose planning was based on the overall mean dose differences and 3D gamma index with 3%/3mm criteria for a prescription of 100 monitor units (MU) and differences in calculated MUs per plan for dose prescriptions to mid-plane. Results: TrueBeam kVCBCT and Tomotherapy MVCT images produced most accurate dose calculation for all tested cases (γ-index >95%). MVCBCT and VersaHD kVCBCT images resulted in minimum γ-passing rates of 94% and 87%, respectively. MUs calculated from treatment plans prescribed to mid-plane were within differences of 5% relative to kVCT-based plans in all cases. However, VersaHD images showed considerable local image artifacts in the pelvis water and anthropomorphic neck phantom that complicated accurate Hounsfield unit (HU) to electron density conversion, thus causing local dose differences of more than 10% relative to kVCT-based dose distributions. Conclusion: TrueBeam kVCBCT, MVCBCT and MVCT systems provide image quality that allows for accurate simple treatment plan calculation. Prescription points should be placed away from areas found to cause local dose discrepancies, such as air cavities. Improved image filter settings and HU-to-electron density calibration adjustments may be required for the VersaHD system to obtain an overall accurate dose distribution. To evaluate a system’s overall suitability, its clinical features also require consideration, such as imaging field of view, acquisition time and the ability to instantly export images for treatment planning.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-F-201-00: Practical Guidelines for Commissioning Advanced Brachytherapy Dose Calculation Algorithms

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-F-201-01: Identify Key Clinical Applications Needing Advanced Dose Calculation in Brachytherapy

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗