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All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

Atomic layer deposition of ultrathin blocking layer for low-temperature solid oxide fuel cell on nanoporous substrate

An ultrathin yttria-stabilized zirconia (YSZ) blocking layer deposited by atomic layer deposition (ALD) was utilized for improving the performance and reliability of low-temperature solid oxide fuel cells (SOFCs) supported by an anodic aluminum oxide substrate. Physical vapor-deposited YSZ and gadolinia-doped ceria (GDC) electrolyte layers were deposited by a sputtering method. The ultrathin ALD YSZ blocking layer was inserted between the YSZ and GDC sputtered layers. To investigate the effects of an inserted ultrathin ALD blocking layer, SOFCs with and without an ultrathin ALD blocking layer were electrochemically characterized. The open circuit voltage (1.14 V) of the ALD blocking-layered SOFC was visibly higher than that (1.05 V) of the other cell. Furthermore, the ALD blocking layer augmented the power density and improved the reproducibility.

36 MATERIALS SCIENCE↗
DOE OSTI2013

Needle segmentation using 3D Hough transform in 3D TRUS guided prostate transperineal therapy

Purpose: Prostate adenocarcinoma is the most common noncutaneous malignancy in American men with over 200 000 new cases diagnosed each year. Prostate interventional therapy, such as cryotherapy and brachytherapy, is an effective treatment for prostate cancer. Its success relies on the correct needle implant position. This paper proposes a robust and efficient needle segmentation method, which acts as an aid to localize the needle in three-dimensional (3D) transrectal ultrasound (TRUS) guided prostate therapy. Methods: The procedure of locating the needle in a 3D TRUS image is a three-step process. First, the original 3D ultrasound image containing a needle is cropped; the cropped image is then converted to a binary format based on its histogram. Second, a 3D Hough transform based needle segmentation method is applied to the 3D binary image in order to locate the needle axis. The position of the needle endpoint is finally determined by an optimal threshold based analysis of the intensity probability distribution. The overall efficiency is improved through implementing a coarse-fine searching strategy. The proposed method was validated in tissue-mimicking agar phantoms, chicken breast phantoms, and 3D TRUS patient images from prostate brachytherapy and cryotherapy procedures by comparison to the manual segmentation. The robustness of the proposed approach was tested by means of varying parameters such as needle insertion angle, needle insertion length, binarization threshold level, and cropping size. Results: The validation results indicate that the proposed Hough transform based method is accurate and robust, with an achieved endpoint localization accuracy of 0.5 mm for agar phantom images, 0.7 mm for chicken breast phantom images, and 1 mm for in vivo patient cryotherapy and brachytherapy images. The mean execution time of needle segmentation algorithm was 2 s for a 3D TRUS image with size of 264 Multiplication-Sign 376 Multiplication-Sign 630 voxels. Conclusions: The proposed needle segmentation algorithm is accurate, robust, and suitable for 3D TRUS guided prostate transperineal therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

Evaluation of plastic materials for range shifting, range compensation, and solid-phantom dosimetry in carbon-ion radiotherapy

Purpose: Beam range control is the essence of radiotherapy with heavy charged particles. In conventional broad-beam delivery, fine range adjustment is achieved by insertion of range shifting and compensating materials. In dosimetry, solid phantoms are often used for convenience. These materials should ideally be equivalent to water. In this study, the authors evaluated dosimetric water equivalence of four common plastics, high-density polyethylene (HDPE), polymethyl methacrylate (PMMA), polyethylene terephthalate (PET), and polyoxymethylene (POM). Methods: Using the Bethe formula for energy loss, the Gottschalk formula for multiple scattering, and the Sihver formula for nuclear interactions, the authors calculated the effective densities of the plastics for these interactions. The authors experimentally measured variation of the Bragg peak of carbon-ion beams by insertion of HDPE, PMMA, and POM, which were compared with analytical model calculations. Results: The theoretical calculation resulted in slightly reduced multiple scattering and severely increased nuclear interactions for HDPE, compared to water and the other plastics. The increase in attenuation of carbon ions for 20-cm range shift was experimentally measured to be 8.9% for HDPE, 2.5% for PMMA, and 0.0% for POM while PET was theoretically estimated to be in between PMMA and POM. The agreement between the measurements and the calculations was about 1% or better. Conclusions: For carbon-ion beams, POM was dosimetrically indistinguishable from water and the best of the plastics examined in this study. The poorest was HDPE, which would reduce the Bragg peak by 0.45% per cm range shift, although with marginal superiority for reduced multiple scattering. Between the two clear plastics, PET would be superior to PMMA in dosimetric water equivalence.

36 MATERIALS SCIENCE↗
DOE OSTI2013

A method of measuring gold nanoparticle concentrations by x-ray fluorescence for biomedical applications

Purpose: This paper reports a technique that enables the quantitative determination of the concentration of gold nanoparticles (GNPs) through the accurate detection of their fluorescence radiation in the diagnostic x-ray spectrum. Methods: Experimentally, x-ray fluorescence spectra of 1.9 and 15 nm GNP solutions are measured using an x-ray spectrometer, individually and within chicken breast tissue samples. An optimal combination of excitation and emission filters is determined to segregate the fluorescence spectra at 66.99 and 68.80 keV from the background scattering. A roadmap method is developed that subtracts the scattered radiation (acquired before the insertion of GNP solutions) from the signal radiation acquired after the GNP solutions are inserted. Results: The methods effectively minimize the background scattering in the spectrum measurements, showing linear relationships between GNP solutions from 0.1% to 10% weight concentration and from 0.1% to 1.0% weight concentration inside a chicken breast tissue sample. Conclusions: The investigation demonstrated the potential of imaging gold nanoparticles quantitatively in vivo for in-tissue studies, but future studies will be needed to investigate the ability to apply this method to clinical applications.

36 MATERIALS SCIENCE↗
DOE OSTI2013

The impacts of dental filling materials on RapidArc treatment planning and dose delivery: Challenges and solution

Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined initially and weekly during the course of radiotherapy.Results: For a RapidArc treatment technique, the backscatter dose from the DFM insert was measured to be 9.25 ± 2.17 in the IMRT-verification-phantom. The measured backscatter upstream dose from DFM for a single-field was 22% higher than without the DFM, whereas the downstream dose was lower by 14%. The values of homogeneity index for the plans with and without the application of mask were 0.09 and 0.14, respectively. The calculated mean treatment planning volume (PTV) dose differed from the delivered dose by 13% and was reduced to 2% when using the mask and virtual filter together. A grade 3 mucosa reaction was observed in the control group after 22–24 fractions (44–48 Gy). In contrast, no grade 3 mucositis was observed in the patients wearing the PDM after 25–26 fractions (50–52 Gy).Conclusions: The backscatter from the DFM for a single, parallel-opposed fields, and RapidArc treatment technique was found significant. The application of mask in replacing streaking artifacts can be useful in improving dose homogeneity in the PTV. The use of a virtual filter around the teeth during the planning phase reduces the target underdosage issue in the phantom. Furthermore, a reduction in mucositis is observed in the head and neck patients with the use of PDM.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

A BrachyPhantom for verification of dose calculation of HDR brachytherapy planning system

Purpose: To develop a calibration phantom for {sup 192}Ir high dose rate (HDR) brachytherapy units that renders possible the direct measurement of absorbed dose to water and verification of treatment planning system.Methods: A phantom, herein designated BrachyPhantom, consists of a Solid Water™ 8-cm high cylinder with a diameter of 14 cm cavity in its axis that allows the positioning of an A1SL ionization chamber with its reference measuring point at the midheight of the cylinder's axis. Inside the BrachyPhantom, at a 3-cm radial distance from the chamber's reference measuring point, there is a circular channel connected to a cylindrical-guide cavity that allows the insertion of a 6-French flexible plastic catheter from the BrachyPhantom surface. The PENELOPE Monte Carlo code was used to calculate a factor, P{sub sw}{sup lw}, to correct the reading of the ionization chamber to a full scatter condition in liquid water. The verification of dose calculation of a HDR brachytherapy treatment planning system was performed by inserting a catheter with a dummy source in the phantom channel and scanning it with a CT. The CT scan was then transferred to the HDR computer program in which a multiple treatment plan was programmed to deliver a total dose of 150 cGy to the ionization chamber. The instrument reading was then converted to absorbed dose to water using the N{sub gas} formalism and the P{sub sw}{sup lw} factor. Likewise, the absorbed dose to water was calculated using the source strength, S{sub k}, values provided by 15 institutions visited in this work.Results: A value of 1.020 (0.09%, k= 2) was found for P{sub sw}{sup lw}. The expanded uncertainty in the absorbed dose assessed with the BrachyPhantom was found to be 2.12% (k= 1). To an associated S{sub k} of 27.8 cGy m{sup 2} h{sup −1}, the total irradiation time to deliver 150 cGy to the ionization chamber point of reference was 161.0 s. The deviation between the absorbed doses to water assessed with the BrachyPhantom and those calculated by the treatment plans and using the S{sub k} values did not exceed ±3% and ±1.6%, respectively.Conclusions: The BrachyPhantom may be conveniently used for quality assurance and/or verification of HDR planning system with a priori threshold level to spot problems of 2% and ±3%, respectively, and in the long run save time for the medical physicist.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

An efficient polyenergetic SART (pSART) reconstruction algorithm for quantitative myocardial CT perfusion

Purpose: In quantitative myocardial CT perfusion imaging, beam hardening effect due to dense bone and high concentration iodinated contrast agent can result in visible artifacts and inaccurate CT numbers. In this paper, an efficient polyenergetic Simultaneous Algebraic Reconstruction Technique (pSART) was presented to eliminate the beam hardening artifacts and to improve the CT quantitative imaging ability. Methods: Our algorithm made threea priori assumptions: (1) the human body is composed of several base materials (e.g., fat, breast, soft tissue, bone, and iodine); (2) images can be coarsely segmented to two types of regions, i.e., nonbone regions and noniodine regions; and (3) each voxel can be decomposed into a mixture of two most suitable base materials according to its attenuation value and its corresponding region type information. Based on the above assumptions, energy-independent accumulated effective lengths of all base materials can be fast computed in the forward ray-tracing process and be used repeatedly to obtain accurate polyenergetic projections, with which a SART-based equation can correctly update each voxel in the backward projecting process to iteratively reconstruct artifact-free images. This approach effectively reduces the influence of polyenergetic x-ray sources and it further enables monoenergetic images to be reconstructed at any arbitrarily preselected target energies. A series of simulation tests were performed on a size-variable cylindrical phantom and a realistic anthropomorphic thorax phantom. In addition, a phantom experiment was also performed on a clinical CT scanner to further quantitatively validate the proposed algorithm. Results: The simulations with the cylindrical phantom and the anthropomorphic thorax phantom showed that the proposed algorithm completely eliminated beam hardening artifacts and enabled quantitative imaging across different materials, phantom sizes, and spectra, as the absolute relative errors were reduced from [−7.5%, 12.1%] for SART to [−0.1%, 0.1%] for pSART. When using low kVp spectra and high reference energies, pSART also showed improved reconstruction efficiency in terms of convergence speed compared to the conventional SART algorithm. The phantom experiment on a clinical CT scanner indicated that the quantitative advantage of pSART is realizable in experimental CT acquisition, as the absolute relative errors across material inserts were less than 0.4%. Conclusions: By incorporatinga priori information (material attenuation coefficients, x-ray source spectrum, and region type information) into the reconstruction process, the proposed pSART algorithm could effectively eliminate beam hardening artifacts, reconstruct the accurate attenuation coefficients for precise quantitative imaging, and accelerate the reconstruction process.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-D-BRF-06: A Brachytherapy Simulator with Realistic Haptic Force Feedback and Real-Time Ultrasounds Image Simulation for Training and Teaching

Purpose: Surgical procedures require dexterity, expertise and repetition to reach optimal patient outcomes. However, efficient training opportunities are usually limited. This work presents a simulator system with realistic haptic force-feedback and full, real-time ultrasounds image simulation. Methods: The simulator is composed of a custom-made Linear-DELTA force-feedback robotic platform. The needle tip is mounted on a force gauge at the end effector of the robot, which responds to needle insertion by providing reaction forces. 3D geometry of the tissue is using a tetrahedral finite element mesh (FEM) mimicking tissue properties. As the needle is inserted/retracted, tissue deformation is computed using a mass-tensor nonlinear visco-elastic FEM. The real-time deformation is fed to the L-DELTA to take into account the force imparted to the needle, providing feedback to the end-user when crossing tissue boundaries or needle bending. Real-time 2D US image is also generated synchronously showing anatomy, needle insertion and tissue deformation. The simulator is running on an Intel I7 6- core CPU at 3.26 MHz. 3D tissue rendering and ultrasound display are performed on a Windows 7 computer; the FEM computation and L-DELTA control are executed on a similar PC using the Neutrino real-time OS. Both machines communicate through an Ethernet link. Results: The system runs at 500 Hz for a 8333-tetrahedron tissue mesh and a 100-node angular spring needle model. This frame rate ensures a relatively smooth displacement of the needle when pushed or retracted (±20 N in all directions at speeds of up to 2 m/s). Unlike commercially-available haptic platforms, the oblong workspace of the L-DELTA robot complies with that required for brachytherapy needle displacements of 0.1m by 0.1m by 0.25m. Conclusion: We have demonstrated a real-life, realistic brachytherapy simulator developed for prostate implants (LDR/HDR). The platform could be adapted to other sites or training for other types of needle-based procedures.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-I-04: A Mammography Phantom to Measure Mean Glandular Dose and Image Quality

Purpose: To evaluate mean glandular dose (MGD) and image quality in a selection of mammography systems using a novel phantom based on thermoluminescent dosemeters and the ACR wax insert. Methods: The phantom consists of two acrylic, 19 cm diameter, 4.5 cm thick, semicircular modules, used in sequence. The image quality module contains the ACR insert and is used to obtain a quality control image under automatic exposure conditions. The dosimetric module carries 15 TLD-100 chips, some under Al foils, to determine air kerma and half-value-layer. TL readings take place at our laboratory under controlled conditions. Calibration was performed using an ionization chamber and a Senographe 2000D unit for a variety of beam qualities, from 24 to 40 kV, Mo and Rh anodes and filters. Phantom MGD values agree, on the average, within 3% with ionization chamber data, and their precision is better than 10% (k=1). Results: MGD and image quality have been evaluated in a selection of mammography units currently used in Mexican health services. The sample includes analogic (screen/film), flexible digital (CR), and full-field digital image receptors. The highest MDG are associated to the CR technology. The most common image quality failure is due to artifacts (dust, intensifying screen scratches, and processor marks for film/screen, laser reader defects for CR). Conclusion: The developed phantom permits the MGD measurement without the need of a calibrated ionization chamber at the mammography site and can be used by a technician without the presence of a medical physicist. The results indicate the urgent need to establish quality control programs for mammography.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-I-41: Non-Cartesian MR Image Reconstruction with Integrated Gradient Non-Linearity Correction

Purpose: Nonlinearities in the spatial encoding gradients of MRI systems cause geometric distortion in images. Typically, this is retrospectively corrected via image-domain interpolation (a.k.a., “gradwarp”) albeit with a loss of spatial resolution. For non-Cartesian MRI, the latter problem is exaggerated by noise and undersampling artifact. In this study, we describe a novel correction strategy that accounts for gradient nonlinearities during — rather than after — non-Cartesian MRI reconstruction, and demonstrate that this approach mitigates the resolution loss that can occur with standard methods. Methods: To test the proposed method, the American College of Radiology (ACR) quality control phantom was scanned on at 1.5 T (General Electric, v16.0, “zoom” gradient) using a 1.6x undersampled 3D non- Cartesian Shells trajectory (GRE, FOV=24 cm3, 120 shells, 16552 shots, 512 readout, matrix=2403). Image reconstruction was first performed via standard k-space density-compensated gridding and retrospectively corrected via cubic spline interpolation. Image reconstruction was then separately performed using a k-space and image-domain densitycompensated type-3 non-uniform fast Fourier transform (NUFFT), which provides a direct mapping between non-Cartesian k-space samples and warped image space voxel locations. Thus, no separate distortion correction procedure is needed for the proposed approach. The gradient distortion field was determined using vendor provided calibration data. Results: Phantom scan results show that both processing approaches successfully correct geometric distortion. However, visual inspection of the ACR phantom spatial resolution inserts shows that the proposed strategy preserves the resolution of the nominal (uncorrected) reconstruction while “gradwarp” imparts marked spatial blurring (especially for the 1.0 and 1.1 mm inserts) and thus resolution loss. Conclusion: We've presented a novel reconstruction strategy for non-Cartesian MRI that corrects for gradient nonlinearities during — rather than after — reconstruction, and thus better preserves image resolution than traditional interpolation-based methods. This approach is expected to be especially advantageous when imaging with non-standard magnet geometries. NIH RR018898; NIH EB10065.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-I-75: Evaluation of An Orthopedic Metal Artifact Reduction (O-MAR) Algorithm On Patients with Spinal Prostheses Near Spinal Tumors

Purpose: To evaluate the impact of a commercial orthopedic metal artifact reduction (O-MAR) algorithm on CT image quality and dose calculation for patients with spinal prostheses near spinal tumors. Methods: A CT electron density phantom was scanned twice: with tissue-simulating inserts only, and with a titanium insert replacing solid water. A patient plan was mapped to the phantom images in two ways: with the titanium inside or outside of the spinal tumor. Pinnacle and Eclipse were used to evaluate the dosimetric effects of O-MAR on 12-bit and 16-bit CT data, respectively. CT images from five patients with spinal prostheses were reconstructed with and without O-MAR. Two observers assessed the image quality improvement from O-MAR. Both pencil beam and Monte Carlo dose calculation in iPlan were used for the patient study. The percentage differences between non-OMAR and O-MAR datasets were calculated for PTV-min, PTV-max, PTV-mean, PTV-V100, PTV-D90, OAR-V10Gy, OAR-max, and OAR-D0.1cc. Results: O-MAR improved image quality but did not significantly affect the dose distributions and DVHs for both 12-bit and 16- bit CT phantom data. All five patient cases demonstrated some degree of image quality improvement from O-MAR, ranging from small to large metal artifact reduction. For pencil beam, the largest discrepancy was observed for OARV-10Gy at 5.4%, while the other seven parameters were ≤0.6%. For Monte Carlo, the differences between non-O-MAR and O-MAR datasets were ≤3.0%. Conclusion: Both phantom and patient studies indicated that O-MAR can substantially reduce metal artifacts on CT images, allowing better visualization of the anatomical structures and metal objects. The dosimetric impact of O-MAR was insignificant regardless of the metal location, image bit-depth, and dose calculation algorithm. O-MAR corrected images are recommended for radiation treatment planning on patients with spinal prostheses because of the improved image quality and no need to modify current dose constraints. This work was supported by a research grant from Philips Healthcare. Paul Klahr is an employee of Philips Healthcare.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-156: Preclinical Inverstigation of Dynamic Tumor Tracking Using Vero SBRT Linear Accelerator: Motion Phantom Dosimetry Study

Purpose: Following the ‘end-to-end testing’ paradigm of Dynamic Target Tracking option in our Image-Guided dedicated SBRT VeroTM linac, we verify the capability of the system to deliver planned dose to moving targets in the heterogeneous thorax phantom (CIRSTM). The system includes gimbaled C-band linac head, robotic 6 degree of freedom couch and a tumor tracking method based on predictive modeling of target position using fluoroscopically tracked implanted markers and optically tracked infrared reflecting external markers. Methods: 4DCT scan of the motion phantom with the VisicoilTM implanted marker in the close vicinity of the target was acquired, the ‘exhale’=most prevalent phase was used for planning (iPlan by BrainLabTM). Typical 3D conformal SBRT treatment plans aimed to deliver 6-8Gy/fx to two types of targets: a)solid water-equivalent target 3cm in diameter; b)single VisicoilTM marker inserted within lung equivalent material. The planning GTV/CTV-to-PTV margins were 2mm, the block margins were 3 mm. The dose calculated by MonteCarlo algorithm with 1% variance using option Dose-to-water was compared to the ion chamber (CC01 by IBA Dosimetry) measurements in case (a) and GafchromicTM EBT3 film measurements in case (b). During delivery, the target 6 motion patterns available as a standard on CIRSTM motion phantom were investigated: in case (a), the target was moving along the designated sine or cosine4 3D trajectory; in case (b), the inserted marker was moving sinusoidally in 1D. Results: The ion chamber measurements have shown the agreement with the planned dose within 1% under all the studied motion conditions. The film measurements show 98.1% agreement with the planar calculated dose (gamma criteria: 3%/3mm). Conclusion: We successfully verified the capability of the SBRT VeroTM linac to perform real-time tumor tracking and accurate dose delivery to the target, based on predictive modeling of the correlation between implanted marker motion and external surrogate of breathing motion.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-235: Varian Portal Dosimetry Accuracy at Detecting Simulated Delivery Errors

Purpose: To use receiver operating characteristic (ROC) analysis to quantify the Varian Portal Dosimetry (VPD) application's ability to detect delivery errors in IMRT fields. Methods: EPID and VPD were calibrated/commissioned using vendor-recommended procedures. Five clinical plans comprising 56 modulated fields were analyzed using VPD. Treatment sites were: pelvis, prostate, brain, orbit, and base of tongue. Delivery was on a Varian Trilogy linear accelerator at 6MV using a Millenium120 multi-leaf collimator. Image pairs (VPD-predicted and measured) were exported in dicom format. Each detection test imported an image pair into Matlab, optionally inserted a simulated error (rectangular region with intensity raised or lowered) into the measured image, performed 3%/3mm gamma analysis, and saved the gamma distribution. For a given error, 56 negative tests (without error) were performed, one per 56 image pairs. Also, 560 positive tests (with error) with randomly selected image pairs and randomly selected in-field error location. Images were classified as errored (or error-free) if percent pixels with γ<κ was < (or ≥) τ. (Conventionally, κ=1 and τ=90%.) A ROC curve was generated from the 616 tests by varying τ. For a range of κ and τ, true/false positive/negative rates were calculated. This procedure was repeated for inserted errors of different sizes. VPD was considered to reliably detect an error if images were correctly classified as errored or error-free at least 95% of the time, for some κ+τ combination. Results: 20mm{sup 2} errors with intensity altered by ≥20% could be reliably detected, as could 10mm{sup 2} errors with intensity was altered by ≥50%. Errors with smaller size or intensity change could not be reliably detected. Conclusion: Varian Portal Dosimetry using 3%/3mm gamma analysis is capable of reliably detecting only those fluence errors that exceed the stated sizes. Images containing smaller errors can pass mathematical analysis, though may be detected by visual inspection. This work was not funded by Varian Oncology Systems. Some authors have other work partly funded by Varian Oncology Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-23: A Novel Two-Step Optimization Scheme for Tandem and Ovoid (T and O) HDR Brachytherapy Treatment for Locally Advanced Cervical Cancer

Purpose: To present a novel method allowing fast, true volumetric optimization of T and O HDR treatments and to quantify its benefits. Materials and Methods: 27 CT planning datasets and treatment plans from six consecutive cervical cancer patients treated with 4–5 intracavitary T and O insertions were used. Initial treatment plans were created with a goal of covering high risk (HR)-CTV with D90 > 90% and minimizing D2cc to rectum, bladder and sigmoid with manual optimization, approved and delivered. For the second step, each case was re-planned adding a new structure, created from the 100% prescription isodose line of the manually optimized plan to the existent physician delineated HR-CTV, rectum, bladder and sigmoid. New, more rigorous DVH constraints for the critical OARs were used for the optimization. D90 for the HR-CTV and D2cc for OARs were evaluated in both plans. Results: Two-step optimized plans had consistently smaller D2cc's for all three OARs while preserving good D90s for HR-CTV. On plans with “excellent” CTV coverage, average D90 of 96% (range 91–102), sigmoid D2cc was reduced on average by 37% (range 16–73), bladder by 28% (range 20–47) and rectum by 27% (range 15–45). Similar reductions were obtained on plans with “good” coverage, with an average D90 of 93% (range 90–99). For plans with inferior coverage, average D90 of 81%, an increase in coverage to 87% was achieved concurrently with D2cc reductions of 31%, 18% and 11% for sigmoid, bladder and rectum. Conclusions: A two-step DVH-based optimization can be added with minimal planning time increase, but with the potential of dramatic and systematic reductions of D2cc for OARs and in some cases with concurrent increases in target dose coverage. These single-fraction modifications would be magnified over the course of 4–5 intracavitary insertions and may have real clinical implications in terms of decreasing both acute and late toxicity.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-89: Comprehensive Quality Assurance Phantom for the Small Animal Radiation Research Platform

Purpose: Use of Small Animal Radiation Research Platform (SARRP) systems for conducting state-of-the-art image guided radiotherapy (IGRT) research on small animals has become more common over the past years. The purpose of this work is to develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the SARRP. Methods: A QA phantom was developed for carrying out daily, monthly and annual QA tasks including imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of nine (60×60×5 mm3) KV-energy tissue equivalent solid water slabs that can be employed for annual dosimetry QA with film. Three of the top slabs are replaceable with ones incorporating Mosfets or OSLDs arranged in a quincunx pattern, or a slab drilled to accommodate an ion chamber insert. These top slabs are designed to facilitate routine daily and monthly QA tasks such as output constancy, isocenter congruency test, treatment planning system (TPS) QA, etc. One slab is designed with inserts for image QA. A prototype of the phantom was applied to test the performance of the imaging, planning and treatment delivery systems. Results: Output constancy test results showed daily variations within 3%. For isocenter congruency test, the phantom could be used to detect 0.3 mm deviations of the CBCT isocenter from the radiation isocenter. Using the Mosfet in phantom as target, the difference between TPS calculations and measurements was within 5%. Image-quality parameters could also be assessed in terms of geometric accuracy, CT number accuracy, linearity, noise and image uniformity, etc. Conclusion: The developed phantom can be employed as a simple tool for comprehensive performance evaluation of the SARRP. The study provides a reference for development of a comprehensive quality assurance program for the SARRP, with proposed tolerances and frequency of required tests.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-133: Dosimetric Impact of Scan Orientation Relative to Target Motion During Spot Scanning Proton Therapy

Purpose: This study seeks to evaluate the dosimetric effects of intra-fraction motion during spot scanning proton beam therapy as a function of beam-scan orientation and target motion amplitude. Method: Multiple 4DCT scans were collected of a dynamic anthropomorphic phantom mimicking respiration amplitudes of 0 (static), 0.5, 1.0, and 1.5 cm. A spot-scanning treatment plan was developed on the maximum intensity projection image set, using an inverse-planning approach. Dynamic phantom motion was continuous throughout treatment plan delivery.The target nodule was designed to accommodate film and thermoluminescent dosimeters (TLD). Film and TLDs were uniquely labeled by location within the target. The phantom was localized on the treatment table using the clinically available orthogonal kV on-board imaging device. Film inserts provided data for dose uniformity; TLDs provided a 3% precision estimate of absolute dose. An inhouse script was developed to modify the delivery order of the beam spots, to orient the scanning direction parallel or perpendicular to target motion.TLD detector characterization and analysis was performed by the Imaging and Radiation Oncology Core group (IROC)-Houston. Film inserts, exhibiting a spatial resolution of 1mm, were analyzed to determine dose homogeneity within the radiation target. Results: Parallel scanning and target motions exhibited reduced target dose heterogeneity, relative to perpendicular scanning orientation. The average percent deviation in absolute dose for the motion deliveries relative to the static delivery was 4.9±1.1% for parallel scanning, and 11.7±3.5% (p<<0.05) for perpendicularly oriented scanning. Individual delivery dose deviations were not necessarily correlated to amplitude of motion for either scan orientation. Conclusions: Results demonstrate a quantifiable difference in dose heterogeneity as a function of scan orientation, more so than target amplitude. Comparison to the analyzed planar dose of a single field hint that multiple-field delivery alters intra-fraction beam-target motion synchronization and may mitigate heterogeneity, though further study is warranted.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-178: Experimental Study of Acceptable Movement Conditions for SBRT Lung Treatments

Purpose: To experimentally study the acceptable movement conditions for SBRT lung treatments we quantified with film dosimetry the change in dose distributions due to periodic movements of 5 different amplitudes and 4 respiratory gating duty cycles on a SBRT treatment plan. Methods: We planned a SBRT treatment plan for the QUASAR™ (Modus Medical) phantom equipped with the respiratory motion device. We placed a 3 mm water-equivalent sphere simulating a tumour inside the lung-equivalent insert. This sphere is divided in two hemispheres that allow placing films in between. We used radiochromic EBT2™ (Ashland) films. We oriented the lung insert in such a way that sagittal dose distributions could be measured. We applied a sinusoidal movement with 3 s period for 5 different amplitudes of 0(static), 5, 7, 10, 15 and 20 mm without gating. For the 20 mm amplitude we studied the gating technique with 4 duty cycles of 20, 40, 60 and 80% of the respiratory cycle. Each situation was irradiated in a Clinac 2100 linac (Varian) equipped with the RPM™ system. FilmQA Pro™ (Ashland) software together with an Expression 10000XL scanner (EPSON) were used to analyze and compare the measured dose distributions with those planned by the Eclipse™ TPS v. 8.9 (Varian) by means of gamma analysis with 6 criteria: 5%/3mm, 5%/2mm, 5%/1mm, 3%/3mm, 3%/2mm and 2%/2mm (threshold of 10%). Results: Movements with amplitude of less than 7mm do not significantly modified the dosimetry. Gating duty cycles of less than 40% yielded also acceptable results for a 2 cm amplitude movement. Conclusion: To safely perform daily accurate SBRT treatments, movements have to be restricted to 7 mm amplitude (±3.5 mm). Otherwise, a gating strategy should be considered.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-279: Realization of Three-Dimensional Conformal Dose Planning in Prostate Brachytherapy

Purpose: Successful clinical treatment in prostate brachytherapy is largely dependent on the effectiveness of pre-surgery dose planning. Conventional dose planning method could hardly arrive at a satisfy result. In this abstract, a three-dimensional conformal localized dose planning method is put forward to ensure the accuracy and effectiveness of pre-implantation dose planning. Methods: Using Monte Carlo method, the pre-calculated 3-D dose map for single source is obtained. As for multiple seeds dose distribution, the maps are combined linearly to acquire the 3-D distribution. The 3-D dose distribution is exhibited in the form of isodose surface together with reconstructed 3-D organs group real-timely. Then it is possible to observe the dose exposure to target volume and normal tissues intuitively, thus achieving maximum dose irradiation to treatment target and minimum healthy tissues damage. In addition, the exfoliation display of different isodose surfaces can be realized applying multi-values contour extraction algorithm based on voxels. The needles could be displayed in the system by tracking the position of the implanted seeds in real time to conduct block research in optimizing insertion trajectory. Results: This study extends dose planning from two-dimensional to three-dimensional, realizing the three-dimensional conformal irradiation, which could eliminate the limitations of 2-D images and two-dimensional dose planning. A software platform is developed using VC++ and Visualization Toolkit (VTK) to perform dose planning. The 3-D model reconstruction time is within three seconds (on a Intel Core i5 PC). Block research could be conducted to avoid inaccurate insertion into sensitive organs or internal obstructions. Experiments on eight prostate cancer cases prove that this study could make the dose planning results more reasonable. Conclusion: The three-dimensional conformal dose planning method could improve the rationality of dose planning by safely reducing the large target margin and avoiding dose dead zones for prostate cancer treatment. 1) National Natural Science Foundation of People's Republic of China (No. 51175373); 2) New Century Educational Talents Plan of Chinese Education Ministry (NCET-10-0625); 3) Scientific and Technological Major Project, Tianjin (No. 12ZCDZSY10600)

60 APPLIED LIFE SCIENCES↗