bluuebunny/crossref_metadata_2025_split huggingface dataset:
TH‐CD‐207B‐11: Multi‐Vendor Phantom Study of CT Lung Density Metrics: Is a Reproducibility of Less Than 1 HU Achievable?
Authors: Chen‐Mayer H , Judy P , Fain S , Hoppel B , Lynch D , Fuld M 
Published: July 2016

Purpose:To standardize the calibration procedures of CT lung density measurements using low‐density reference foams in a phantom, and to demonstrate a reproducibility of less than 1 HU for lung equivalent foam densities measured across CT vendor platforms and protocols.Methods:A phantom study was conducted on CT scanner models from 4 vendors at 100, 120, and 135/140 kVp and 1.5, 3, and 6 mGy dose settings, using a lung density phantom containing air, water, and 3 reference foams (indirectly calibrated) with discrete densities simulating a 5‐cm slice of the human chest. Customized segmentation software was used to analyze the images and generate a mean HU and variance for each of the density for the 22 vendor/protocols. A 3‐step calibration process was devised to remove a scanner‐dependent parameter using linear regression of the HU value vs the relative electron density. The results were mapped to a single energy (80 keV) for final comparison.Results:The heterogeneity across vendor platforms for each density assessed by a random effects model was reduced by 50% after re‐calibration, while the standard deviation of the mean HU values also improved by about the same amount. The 95% CI of the final HU value was within +/−1 HU for all 3 reference foam densities. For the backing lung foam in the phantom (served as an “unknown”), this CI is +/− 1.6 HU. The kVp and dose settings did not appear to have significant contributions to the variability.Conclusion:With the proposed calibration procedures, the inter‐scanner reproducibility of better than 1 HU is demonstrated in the current phantom study for the reference foam densities, but not yet achieved for a test density. The sources of error are being investigated in the next round of scanning with a certified Standard Reference Material for direct calibration.Fain: research funding from GE Healthcare to develop pulmonary MRI techniques. Hoppel: employee of Toshiba Medical Research Institute USA/financial interest with GE Healthcare. M. Fuld: employee of Siemens Healthcare for medical device equipment and software. This project is supported partially by RSNA QIBA Concept Award (Fain), NIH/NIBIB, HHSN268201300071C (Y).
TH‐D‐204‐01: The Pursuit of Radiation Oncology Performance Excellence
Authors: Sternick E. 
Published: July 2016

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance U.S. business competitiveness and economic growth. Administered by the National Institute of Standards and Technology NIST, the Act created the Baldrige National Quality Program, now renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self‐assessment approach is used for radiotherapy program evaluation and development in order to generate a fact based knowledge driven system for improving quality of care, increasing patient satisfaction, building employee engagement, and boosting organizational innovation. The methodology also provides a valuable framework for benchmarking an individual radiation oncology practice against guidelines defined by accreditation and professional organizations and regulatory agencies.

Learning Objectives:
To gain knowledge of the Baldrige Performance Excellence Program as it relates to Radiation Oncology.
To appreciate the value of a multidisciplinary self‐assessment approach in the pursuit of Radiation Oncology quality care, patient satisfaction, and workforce commitment.
To acquire a set of useful measurement tools with which an individual Radiation Oncology practice can benchmark its performance against guidelines defined by accreditation and professional organizations and regulatory agencies.
TH‐EF‐BRC‐04: Quality Management Program
Authors: Yorke E. 
Published: July 2016

This Hands‐on Workshop will be focused on providing participants with experience with the principal tools of TG 100 and hence start to build both competence and confidence in the use of risk‐based quality management techniques. The three principal tools forming the basis of TG 100's risk analysis: Process mapping, Failure‐Modes and Effects Analysis and fault‐tree analysis will be introduced with a 5 minute refresher presentation and each presentation will be followed by a 30 minute small group exercise. An exercise on developing QM from the risk analysis follows. During the exercise periods, participants will apply the principles in 2 different clinical scenarios. At the conclusion of each exercise there will be ample time for participants to discuss with each other and the faculty their experience and any challenges encountered.

Learning Objectives:
To review the principles of Process Mapping, Failure Modes and Effects Analysis and Fault Tree Analysis.
To gain familiarity with these three techniques in a small group setting.
To share and discuss experiences with the three techniques with faculty and participants.Director, TreatSafely, LLC. Director, Center for the Assessment of Radiological Sciences. Occasional Consultant to the IAEA and Varian.
TH‐EF‐204‐00: AAPM‐AMPR (Russia)‐SEFM (Spain) Joint Course On Challenges and Advantages of Small Field Radiation Treatment Techniques
Authors: Cygler Joanna 
Published: July 2016

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad BorrasStereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic‐controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG‐51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image‐guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT.

Learning Objectives:
To learn the physics of small fields in contrast to dosimetry of conventional fields
To learn about detectors suitable for small fields
To learn about the role of Monte Carlo simulations in determination of small field output factors
To provide an overview of the IAEA small field dosimetry recommendations
To provide an overview of the content of the ICRU report on Prescribing, Reporting and Recording of Small Field Radiation Therapy.
To learn about special technical considerations in delivering IMRT and SBRT treatments
To appreciate specific challenges of IMRT implementationJ. Seuntjens, Natural Sciences and Engineering Research Council; Canadian Institutes of Health Research
TH‐EF‐204‐02: Small Field Radiation Therapy: Physics and Recent Recommendations From IAEA and ICRU
Authors: Seuntjens J. 
Published: July 2016

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad BorrasStereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic‐controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG‐51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image‐guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT.

Learning Objectives:
To learn the physics of small fields in contrast to dosimetry of conventional fields
To learn about detectors suitable for small fields
To learn about the role of Monte Carlo simulations in determination of small field output factors
To provide an overview of the IAEA small field dosimetry recommendations
To provide an overview of the content of the ICRU report on Prescribing, Reporting and Recording of Small Field Radiation Therapy.
To learn about special technical considerations in delivering IMRT and SBRT treatments
To appreciate specific challenges of IMRT implementationJ. Seuntjens, Natural Sciences and Engineering Research Council; Canadian Institutes of Health Research
TH‐EF‐204‐03: Determination of Small Field Output Factors, Advantages and Limitations of Monte Carlo Simulation
Authors: Vaque J. Puxeu 
Published: July 2016

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad BorrasStereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic‐controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG‐51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image‐guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT.

Learning Objectives:
To learn the physics of small fields in contrast to dosimetry of conventional fields
To learn about detectors suitable for small fields
To learn about the role of Monte Carlo simulations in determination of small field output factors
To provide an overview of the IAEA small field dosimetry recommendations
To provide an overview of the content of the ICRU report on Prescribing, Reporting and Recording of Small Field Radiation Therapy.
To learn about special technical considerations in delivering IMRT and SBRT treatments
To appreciate specific challenges of IMRT implementationJ. Seuntjens, Natural Sciences and Engineering Research Council; Canadian Institutes of Health Research
TH‐EF‐204‐05: Application of Small‐Field Treatment: The Promises and Pitfalls of SBRT
Authors: Ford E. 
Published: July 2016

Joanna E. Cygler, Jan Seuntjens, J. Daniel Bourland, M. Saiful Huq, Josep Puxeu Vaque, Daniel Zucca Aparicio, Tatiana Krylova, Yuri Kirpichev, Eric Ford, Caridad BorrasStereotactic Radiation Therapy (SRT) utilizes small static and dynamic (IMRT) fields, to successfully treat malignant and benign diseases using techniques such as Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). SRT is characterized by sharp dose gradients for individual fields and their resultant dose distributions. For appropriate targets, small field radiotherapy offers improved treatment quality by allowing better sparing of organs at risk while delivering the prescribed target dose. Specialized small field treatment delivery systems, such as robotic‐controlled linear accelerators, gamma radiosurgery units, and dynamic arc linear accelerators may utilize rigid fixation, image guidance, and tumor tracking, to insure precise dose delivery to static or moving targets. However, in addition to great advantages, small field delivery techniques present special technical challenges for dose calibration due to unique geometries and small field sizes not covered by existing reference dosimetry protocols such as AAPM TG‐51 or IAEA TRS 398. In recent years extensive research has been performed to understand small field dosimetry and measurement instrumentation. AAPM, IAEA and ICRU task groups are expected to provide soon recommendations on the dosimetry of small radiation fields. In this symposium we will: 1] discuss the physics, instrumentation, methodologies and challenges for small field radiation dose measurements; 2] review IAEA and ICRU recommendations on prescribing, recording and reporting of small field radiation therapy; 3] discuss selected clinical applications and technical aspects for specialized image‐guided, small field, linear accelerator based treatment techniques such as IMRT and SBRT.

Learning Objectives:
To learn the physics of small fields in contrast to dosimetry of conventional fields
To learn about detectors suitable for small fields
To learn about the role of Monte Carlo simulations in determination of small field output factors
To provide an overview of the IAEA small field dosimetry recommendations
To provide an overview of the content of the ICRU report on Prescribing, Reporting and Recording of Small Field Radiation Therapy.
To learn about special technical considerations in delivering IMRT and SBRT treatments
To appreciate specific challenges of IMRT implementationJ. Seuntjens, Natural Sciences and Engineering Research Council; Canadian Institutes of Health Research
TH‐EF‐BRB‐07: Novel Hardware and Software Platform for Intermediate Energy 4π Radiotherapy
Authors: Woods K , Harrison M , Boucher S , McNevin J , Kutsaev S , Faillace L , Sheng K 
Published: July 2016

Purpose:To develop a robust and efficient platform for the optimization and robotic delivery of highly noncoplanar intensity modulated radiotherapy, which enables significant reduction of normal tissue toxicity and escalation of tumor dose.Methods:An innovative high‐output compact 3 MV linac was designed for mounting onto a commercial robotic system in order to access the entire 4π beam solution space without moving the patient couch. The use of intermediate energy X‐rays for radiotherapy was evaluated in comparison to clinical plans delivered using 6 MV X‐rays and a state‐of‐the‐art delivery system. Monte Carlo simulations of a 3 MV percent depth dose curve were performed for intermediate energy dose calculation. The beam model was used to create a convolution/superposition‐based dose calculation engine for 3MV X‐rays. The 4π greedy column generation algorithm was used for optimized beam selection and fluence map optimization.Results:A detailed design of the first 3 MV linac capable of producing a competitively high dose rate of >800 cGy/min at 100 cm was completed and verified through extensive simulation. The complete linac head including a multileaf collimator can access most of the 4π solution space including the posterior orientations without changing the couch height. When compared to 6 MV clinical plans, the proposed 3 MV 4π plans demonstrated significantly better dose compactness and normal tissue sparing in brain, prostate, and partial breast treatment plans.Conclusion:We demonstrate the design of a highly versatile radiotherapy machine to natively deliver non‐coplanar 4π radiotherapy without the need to move the patient during treatment. This novel platform is efficient and capable of providing dosimetry that is 30–50% more compact than existing therapy platforms. The new system is projected to be cost effective due to improved treatment time and automation.NIH R43CA183390, NIH R01CA188300
TH‐EF‐BRB‐10: Dosimetric Validation of a Trajectory Based Cranial SRS Treatment Technique On a Varian TrueBeam Linac
Authors: Wilson B , Gete E 
Published: July 2016

Purpose:This work investigates the dosimetric accuracy of a trajectory based delivery technique in which an optimized radiation beam is delivered along a Couch‐Gantry trajectory that is formed by simultaneous rotation of the linac gantry and the treatment couch.Methods:Nine trajectory based cranial SRS treatment plans were created using in‐house optimization software. The plans were calculated for delivery on the TrueBeam STx linac with 6MV photon beam. Dose optimization was performed along a user‐defined trajectory using MLC modulation, dose rate modulation and jaw tracking. The pre‐defined trajectory chosen for this study is formed by a couch rotation through its full range of 180 degrees while the gantry makes four partial arc sweeps which are 170 degrees each. For final dose calculation, the trajectory based plans were exported to the Varian Eclipse Treatment Planning System. The plans were calculated on a homogeneous cube phantom measuring 18.2×18.2×18.2 cm3 with the analytical anisotropic algorithm (AAA) using a 1mm3 calculation voxel. The plans were delivered on the TrueBeam linac via the developer's mode. Point dose measurements were performed on 9 patients with the IBA CC01 mini‐chamber with a sensitive volume of 0.01 cc. Gafchromic film measurements along the sagittal and coronal planes were performed on three of the 9 treatment plans. Point dose values were compared with ion chamber measurements. Gamma analysis comparing film measurement and AAA calculations was performed using FilmQA Pro.Results:The AAA calculations and measurements were in good agreement. The point dose difference between AAA and ion chamber measurements were within 2.2%. Gamma analysis test pass rates (2%, 2mm passing criteria) for the Gafchromic film measurements were >95%.Conclusion:We have successfully tested TrueBeam's ability to deliver accurate trajectory based treatments involving simultaneous gantry and couch rotation with MLC and dose rate modulation along the trajectory.
TH‐EF‐BRA‐08: A Novel Technique for Estimating Volumetric Cine MRI (VC‐MRI) From Multi‐Slice Sparsely Sampled Cine Images Using Motion Modeling and Free Form Deformation
Authors: Harris W , Yin F , Wang C , Chang Z , Cai J , Zhang Y , Ren L 
Published: July 2016

Purpose:To develop a technique to estimate on‐board VC‐MRI using multi‐slice sparsely‐sampled cine images, patient prior 4D‐MRI, motion‐modeling and free‐form deformation for real‐time 3D target verification of lung radiotherapy.Methods:A previous method has been developed to generate on‐board VC‐MRI by deforming prior MRI images based on a motion model(MM) extracted from prior 4D‐MRI and a single‐slice on‐board 2D‐cine image. In this study, free‐form deformation(FD) was introduced to correct for errors in the MM when large anatomical changes exist. Multiple‐slice sparsely‐sampled on‐board 2D‐cine images located within the target are used to improve both the estimation accuracy and temporal resolution of VC‐MRI. The on‐board 2D‐cine MRIs are acquired at 20–30frames/s by sampling only 10% of the k‐space on Cartesian grid, with 85% of that taken at the central k‐space. The method was evaluated using XCAT(computerized patient model) simulation of lung cancer patients with various anatomical and respirational changes from prior 4D‐MRI to onboard volume. The accuracy was evaluated using Volume‐Percent‐Difference(VPD) and Center‐of‐Mass‐Shift(COMS) of the estimated tumor volume. Effects of region‐of‐interest(ROI) selection, 2D‐cine slice orientation, slice number and slice location on the estimation accuracy were evaluated.Results:VCMRI estimated using 10 sparsely‐sampled sagittal 2D‐cine MRIs achieved VPD/COMS of 9.07±3.54%/0.45±0.53mm among all scenarios based on estimation with ROI_MM‐ROI_FD. The FD optimization improved estimation significantly for scenarios with anatomical changes. Using ROI‐FD achieved better estimation than global‐FD. Changing the multi‐slice orientation to axial, coronal, and axial/sagittal orthogonal reduced the accuracy of VCMRI to VPD/COMS of 19.47±15.74%/1.57±2.54mm, 20.70±9.97%/2.34±0.92mm, and 16.02±13.79%/0.60±0.82mm, respectively. Reducing the number of cines to 8 enhanced temporal resolution of VC‐MRI by 25% while maintaining the estimation accuracy. Estimation using slices sampled uniformly through the tumor achieved better accuracy than slices sampled non‐uniformly.Conclusions:Preliminary studies showed that it is feasible to generate VC‐MRI from multi‐slice sparsely‐sampled 2D‐cine images for real‐time 3D‐target verification.This work was supported by the National Institutes of Health under Grant No. R01‐CA184173 and a research grant from Varian Medical Systems.