Earl Nixon

Dosimetric characterization and application of an imaging beam line with a carbon electron target for megavoltage cone beam computed tomography.

Imaging dose from megavoltage cone beam computed tomography (MVCBCT) can be significantly reduced without loss of image quality by using an imaging beam line (IBL), with no flattening filter and a carbon, rather than tungsten, electron target. The IBL produces a greater keV-range x-ray fluence than the treatment beam line (TBL), which results in a more optimal detector response. The IBL imaging dose is not necessarily negligible, however. In this work an IBL was dosimetrically modeled with the Philips Pinnacle3 treatment planning system (TPS), verified experimentally, and applied to clinical cases. The IBL acquisition dose for a 200 degrees gantry rotation was verified in a customized acrylic cylindrical phantom at multiple imaging field sizes with 196 ion chamber measurements. Agreement between the measured and calculated IBL dose was quantified with the 3D gamma index. Representative IBL and TBL imaging dose distributions were calculated for head and neck and prostate patients and included in treatment plans using the imaging dose incorporation (IDI) method. Surface dose was measured for the TBL and IBL for four head and neck cancer patients with MOSFETs. The IBL model, when compared to the percentage depth dose and profile measurements, had 97% passing gamma indices for dosimetric and distance acceptance criteria of 3%, 3 mm, and 100% passed for 5.2%, 5.2 mm. For the ion chamber measurements of phantom image acquisition dose, the IBL model had 93% passing gamma indices for acceptance criteria of 3%, 3 mm, and 100% passed for 4%, 4 mm. Differences between the IBL- and TBL-based IMRT treatment plans created with the IDI method were dosimetrically insignificant for both the prostate and head and neck cases. For IBL and TBL beams with monitor unit values that would result in the delivery of the same dose to the depth of maximum dose under standard calibration conditions, the IBL imaging surface dose was higher than the TBL imaging surface dose by an average of 18%, with a standard deviation of 8% (p = 2 x 10(-6)). The IBL can be modeled with acceptable accuracy using a standard TPS, and accounting for IBL dose in treatment plans with the IDI method is straightforward. The resulting composite dose distributions, assuming similar imaging doses, are negligibly different from those of the TBL. The increased IBL surface dose relative to the TBL is likely clinically insignificant.

Development and implementation of an EPID-based method for localizing isocenter

The aim of this study was to develop a phantom and analysis software that could be used to quickly and accurately determine the location of radiation isocenter to an accuracy of less than 1 mm using the EPID (Electronic Portal Imaging Device). The proposed solution uses a collimator setting of 10×10cm2 to acquire EPID images of a new phantom constructed from LEGO blocks. Images from a number of gantry and collimator angles are analyzed by automated analysis software to determine the position of the jaws and center of the phantom in each image. The distance between a chosen jaw and the phantom center is then compared to the same distance measured after a 180° collimator rotation to determine if the phantom is centered in the dimension being investigated. Repeated tests show that the system is reproducibly independent of the imaging session, and calculated offsets of the phantom from radiation isocenter are a function of phantom setup only. Accuracy of the algorithms calculated offsets were verified by imaging the LEGO phantom before and after applying the calculated offset. These measurements show that the offsets are predicted with an accuracy of approximately 0.3 mm, which is on the order of the detectors pitch. Comparison with a star‐shot analysis yielded agreement of isocenter location within 0.5 mm. Additionally, the phantom and software are completely independent of linac vendor, and this study presents results from two linac manufacturers. A Varian Optical Guidance Platform (OGP) calibration array was also integrated into the phantom to allow calibration of the OGP while the phantom is positioned at radiation isocenter to reduce setup uncertainty in the calibration. This solution offers a quick, objective method to perform isocenter localization as well as laser alignment and OGP calibration on a monthly basis. PACS number: 87.55.Qr

Assessment of three dead detector correction methods for cone-beam computed tomography

PURPOSE Dead detectors due to manufacturing defects or radiation damage in the electronic portal imaging devices (EPIDs) used for cone-beam computed tomography (CBCT) can lead to image degradation and ring artifacts. In this work three dead detector correction methods were assessed using megavoltage CBCT (MVCBCT) as a test system, with the goals of assessing the relative effectiveness of the three methods and establishing the conditions for which they fail. METHODS MVCBCT projections acquired with four linacs at 8 and 60 MU (monitor units) were degraded with varying percentages (2%-95%) of randomly distributed dead single detectors (RDSs), randomly distributed dead detector clusters (RDCs) of 2 mm diameter, and nonrandomly distributed dead detector disks (NRDDs) of varying diameter (4-16 mm). Correction algorithms were bidirectional linear interpolation (BLI), quad-directional linear interpolation (QLI), and a Laplacian solution (LS) method. Correction method failure was defined to occur if ring artifacts were present in the reconstructed phantom images from any linac or if the modulation transfer function (MTF) for any linac dropped below baseline with a p value, calculated with the two sample t test, of less than 0.01. RESULTS All correction methods failed at the same or lower RDC/RDS percentages and NRDD diameters for the 60 MU as for the 8 MU cases. The LS method tended to outperform or match the BLI and QLI methods. If ring artifacts anywhere in the images were considered unacceptable, the LS method failed for 60 MU at >33% RDS, >2% RDC, and >4 mm NRDD. If ring artifacts within 4 mm longitudinally of the phantom section interfaces were considered acceptable, the LS method failed for 60 MU at >90% RDS, >80% RDC, and >4 mm NRDD. LS failed due to MTF drop for 60 MU at >50% RDS, >25% RDC, and >4 mm NRDD. CONCLUSIONS The LS method is superior to the BLI and QLI methods, and correction algorithm effectiveness decreases as imaging dose increases. All correction methods failed first due to ring artifacts and second due to MTF drop. If ring artifacts in axial slices within a 4 mm longitudinal distance from phantom section interfaces are acceptable, statistically significant loss in spatial resolution does not occur until over 25% of the EPID is covered in randomly distributed dead detectors, or NRDDs of 4 mm diameter are present.

Methods of in-vivo mouse lung micro-CT

Micro-CT will have a profound influence on the accumulation of anatomical and physiological phenotypic changes in natural and transgenetic mouse models. Longitudinal studies will be greatly facilitated, allowing for a more complete and accurate description of events if in-vivo studies are accomplished. The purpose of the ongoing project is to establish a feasible and reproducible setup for in-vivo mouse lung micro-computed tomography (μCT). We seek to use in-vivo respiratory-gated μCT to follow mouse models of lung disease with subsequent recovery of the mouse. Methodologies for optimizing scanning parameters and gating for the in-vivo mouse lung are presented. A Scireq flexiVent ventilated the gas-anesthetized mice at 60 breaths/minute, 30 cm H20 PEEP, 30 ml/kg tidal volume and provided a respiratory signal to gate a Skyscan 1076 μCT. Physiologic monitoring allowed the control of vital functions and quality of anesthesia, e.g. via ECG monitoring. In contrary to longer exposure times with ex-vivo scans, scan times for in-vivo were reduced using 35μm pixel size, 158ms exposure time and 18μm pixel size, 316ms exposure time to reduce motion artifacts. Gating via spontaneous breathing was also tested. Optimal contrast resolution was achieved at 50kVp, 200μA, applying an aluminum filter (0.5mm). There were minimal non-cardiac related motion artifacts. Both 35μm and 1μm voxel size images were suitable for evaluation of the airway lumen and parenchymal density. Total scan times were 30 and 65 minutes respectively. The mice recovered following scanning protocols. In-vivo lung scanning with recovery of the mouse delivered reasonable image quality for longitudinal studies, e.g. mouse asthma models. After examining 10 mice, we conclude μCT is a feasible tool evaluating mouse models of lung pathology in longitudinal studies with increasing anatomic detail available for evaluation as one moves from in-vivo to ex-vivo studies. Further developments include automated bronchial tree segmentation and airway wall thickness measurement tools. Improvements in Hounsfield unit calibration have to be performed when the interest of the study lies in determining and quantifying parenchymal changes and rely on estimating partial volume contributions of underlying structures to voxel densities.

TH-D-BRC-02: Dosimetric Characterization of An Imaging Beam Line with a Carbon Electron Target for Megavoltage Cone Beam Computed Tomography

Purpose: Megavoltage cone beam CTimage quality can be significantly improved with an imaging beam line (IBL) with no flattener and a carbon electron target. The IBL imaging dose is non‐negligible, however, and the high keV‐range x‐ray fluence makes beam modeling nontrivial. An IBL was modeled with the Philips Pinnacle3 treatment planning system, verified experimentally, and applied to clinical cases. Method and Materials: The IBL was modeled and the image acquisition dose was verified in a customized acrylic cylindrical phantom with 196 ion chambermeasurements. Agreement between the measured and modeled IBL dose was quantified with the 3D γ‐index. Representative IBL and TBL imaging dose distributions were calculated for head and neck and prostate patients and included in treatment plans using the imaging dose incorporation (IDI) method. Surface dose was measured for the TBL and IBL for four head and neck cancer patients with metal oxide field effect transistors. Results: The depth dose and profile curves had 97% passing γ‐indices for dosimetric and distance acceptance criteria of 3%, 3 mm, and 100% passed for 5.2%, 5.2 mm. For the ion chambermeasurements of phantom image acquisition dose, the IBL model had 93% passing γ‐ indices for acceptance criteria of 3%, 3 mm, and 100% passed for 4%, 4 mm. Differences between the IBL‐ and TBL‐based IMRT treatment plans created with the IDI method were dosimetrically insignificant. IBL surface dose was greater than TBL by 18% (p = 2x10minus;6). Conclusion: The IBL can be modeled with acceptable accuracy using a standard TPS, and accounting for IBL dose in treatment plans with the IDI‐method is straightforward. The resulting composite dose distributions, assuming similar imaging doses, are negligibly different from those of the TBL. The increased IBL surface dose relative to the TBL is likely clinically insignificant. Conflict of Interest: Partially funded by Siemens.

SU‐FF‐T‐210: Evaluation of CT Extended Field of View Imaging Impact On Radiation Therapy Treatment Planning

Purpose:CTimaging of patients for radiotherapytreatment planning frequently includes anatomy that extends beyond the 50cm nominal field‐of‐view (nFOV): 28.35% of the 575 CT scans we acquired from July–December 2006. The purpose of this study was to evaluate 1) the degradation of Hounsfield units (HU) in the extended field of view (eFOV), and 2) the dosimetric impact of ignoring or correcting this degradation within the treatment planning system (TPS). Method and Materials:CTimages were acquired at maximum FOV (82cm) on a diamond‐shaped 30×30×13cm solid‐water phantom, challenging the reconstruction algorithms ability to model the truncated projection data adequately. A unique dataset was acquired for 19 phantom locations (1cm intervals outside of the nFOV) and each imported into a TPS. Each phantom was contoured using a threshold of −200HU. A single treatment beam with isocenter placed at the center of the phantom was planned to deliver 100cGy to isocenter for each CT data set; dose map comparisons with and without homogenous correction for density (HU>−700 =1gm/cc) were performed relative to the control phantom within the nFOV. Results: Significant variation of HU was observed as a function of phantom displacement outside the nFOV (range +513 to −873HU); most dramatically ∼5cm beyond the nFOV border. If uncorrected, these changes in HU produced significant dose errors. Plans were compared to control plans and dose difference maps were generated; uncorrected images 3cm outside the nFOV demonstrated >5% difference, where overriding HU values above −700HU maintained <5% error for phantom positions ∼10cm beyond nFOV. Conclusion: HU values differ significantly for anatomy 2cm outside the nFOV, can be visualized and should be corrected for dose calculations. These results show <5% dose error can be accomplished for anatomy extending ∼10cm beyond the nFOV (which accounts for 98% of eFOV patients here).

In vivo tomographic imaging based on bioluminescence

The most important task for bioluminescence imaging is to identify the emission source from the captured bioluminescent signal on the surface of a small tested animal. Quantitative information on the source location, geometry and intensity serves for in-vivo monitoring of infectious diseases, tumor growth, metastases in the small animal. In this paper, we present a point-spread function-based method for reconstructing the internal bioluminescent source from the surface light output flux signal. The method is evaluated for sensing the internal emission sources in nylon phantoms and within a live mouse. The surface bioluminescent signal is taken with a highly sensitive CCD camera. The results show the feasibility and efficiency of the proposed point-spread function-based method.

SU-G-TeP2-04: Comprehensive Machine Isocenter Evaluation with Separation of Gantry, Collimator, and Table Variables

PURPOSE To develop and demonstrate application of a method that characterizes deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter as a function of gantry, collimator, and table variables. METHODS A set of Winston-Lutz ball-bearing images was used to determine the gantry radiation isocenter as the midrange of deviation values resulting from gantry and collimator rotation. Also determined were displacement of table axis from gantry isocenter and recommended table axis adjustment. The method, previously reported, has been extended to include the effect of collimator walkout by obtaining measurements with 0 and 180 degree collimator rotation for each gantry angle. Twelve images were used to characterize the volumetric isocenter for the full range of available gantry, collimator, and table rotations. RESULTS Three Varian True Beam, two Elekta Infinity and four Versa HD linacs at five institutions were tested using identical methodology. Varian linacs exhibited substantially less deviation due to head sag than Elekta linacs (0.4 mm vs. 1.2 mm on average). One linac from each manufacturer had additional isocenter deviation of 0.3 to 0.4 mm due to jaw instability with gantry and collimator rotation. For all linacs, the achievable isocenter tolerance was dependent on adjustment of collimator position offset, transverse position steering, and alignment of the table axis with gantry isocenter, facilitated by these test results. The pattern and magnitude of table axis wobble vs. table angle was reproducible and unique to each machine. CONCLUSION This new method provides a comprehensive set of isocenter deviation values including all variables. It effectively facilitates minimization of deviation between beam center and target (ball-bearing) position. This method was used to quantify the effect of jaw instability on isocenter deviation and to identify the offending jaw. The test is suitable for incorporation into a routine machine QA program. Software development was performed by Radiological Imaging Technology, Inc.

SU-E-T-54: A New Method for Optimizing Radiation Isocenter for Linac-Based SRS

Purpose: To develop a new method to minimize deviation of linac x-ray beams from the centroid of the volumetric radiation isocenter for all combinations of gantry and table angle. Methods: A set of ball-bearing (Winston-Lutz) images was used to determine the gantry radiation isocenter as the midrange of deviation values. Deviations in the cross-plane direction were minimized by calibration of MLC leaf position offset, and by adjusting beam position steering for each energy. Special attention was also paid to matching the absolute position of isocenter across all energies by adjusting position steering in the gun-target axis. Displacement of table axis from the gantry isocenter, and recommended table axis adjustment for contemporary Elekta linacs, was also determined. Eight images were used to characterize the volumetric isocenter for the full range of gantry and table rotations available. Tabulation of deviation for each beam was used to test compliance with isocenter tolerance. Results: Four contemporary Elekta linacs were evaluated and the radius in the gun-target axis of the radiation isocenter was 0.5 to 0.7 mm. After beam steering adjustment, the radius in the cross-plane direction was typically 0.2 to 0.4 mm. Position matching between energies can be reduced to 0.28 mm. Maximum total deviation was 0.68 to 1.07 mm, depending primarily on the effect of systematic table axis wobble with rotation. Conclusion: This new method effectively facilitates minimization of deviation between beam center and target position. The test, which requires a few minutes to perform, can be easily incorporated into a routine machine QA program. A tighter radiation isocenter for contemporary Elekta linacs would require reducing the effect of gantry arm flex and/or table axis wobble that are the two main components of deviation from the designated isocenter point.

SU‐E‐J‐36: Development of a Low Cost, Easily‐Made, Interchangeable, Prostate Brachytherapy Phantom for Multi‐Imaging Guidance Using Ultrasound, CT and MRI

PURPOSE To develop an easily-made, interchangeable prostate brachytherapy phantom for implant training and/or dummy-run treatment planning that is feasible for ultrasound (US), CT and MRI guidance. Commercially available phantoms are expensive and not reusable for repeated implant practice. METHODS The phantom consists of two parts: a multiple use lower transrectal-ultrasound part and an interchangeable upper part. Material composition was iteratively updated based upon each scan of US, CT, and MRI. Image quality on US, CT and MRI was evaluated in terms of the contrasts seen in prostate, urethra, seminal vesicles, and periprostatic tissues. Two dummy-run needle implants were tested with transrectal-ultrasound guidance. RESULTS An interchangeable phantom was developed using soft polyvinyl chloride (PVC) in the lower transrectal-ultrasound part, the seminal vesicles, and the urethra. The upper interchangeable part consisted of the prostate, urethra, and seminal vesicles, all of which were surrounded by gelatin (2 packets/cup of water). The seminal vesicle (soft PVC) and the prostate (gelatin) were embedded into gelatin. The prostate was made by mixing gelatin (4 packets gelatin and 1.5 tablespoons psyllium/cup of water) into a 50 mL egg shaped mold and then adding the urethra. The first prostate used soft PVC and plasticizer and resulted in poor contrast when using US. After testing with dummy-run needle implants, the concentration of the upper phantom background (gelatin) was doubled to make it more resistant to wear. The developed phantom produced image quality comparable to those of commercial phantoms but at a cost of only