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Title: Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton

Abstract

Many have speculated about the future of computational technology in clinical radiation oncology. It has been advocated that the next generation of computational infrastructure will improve on the current generation by incorporating richer aspects of automation, more heavily and seamlessly featuring distributed and parallel computation, and providing more flexibility toward aggregate data analysis. In this report we describe how a recently created — but currently existing — analysis framework (DICOMautomaton) incorporates these aspects. DICOMautomaton supports a variety of use cases but is especially suited for dosimetric outcomes correlation analysis, investigation and comparison of radiotherapy treatment efficacy, and dose-volume computation. We describe: how it overcomes computational bottlenecks by distributing workload across a network of machines; how modern, asynchronous computational techniques are used to reduce blocking and avoid unnecessary computation; and how issues of out-of-date data are addressed using reactive programming techniques and data dependency chains. We describe internal architecture of the software and give a detailed demonstration of how DICOMautomaton could be used to search for correlations between dosimetric and outcomes data.

Authors:
 [1];  [2];  [2];  [3];  [4];  [5]
  1. University of British Columbia, Vancouver, B.C. (Canada)
  2. (Canada)
  3. BC Cancer Agency, Vancouver, B.C. (Canada)
  4. University of California San Diego, La Jolla, Ca (United States)
  5. BC Cancer Agency, Surrey, B.C. (Canada)
Publication Date:
OSTI Identifier:
22407695
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 41; Journal Issue: 8; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; AUTOMATION; CALCULATION METHODS; CORRELATIONS; DATA ANALYSIS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Clark, Haley, BC Cancer Agency, Surrey, B.C., BC Cancer Agency, Vancouver, B.C., Wu, Jonn, Moiseenko, Vitali, and Thomas, Steven. Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton. United States: N. p., 2014. Web. doi:10.1118/1.4894935.
Clark, Haley, BC Cancer Agency, Surrey, B.C., BC Cancer Agency, Vancouver, B.C., Wu, Jonn, Moiseenko, Vitali, & Thomas, Steven. Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton. United States. doi:10.1118/1.4894935.
Clark, Haley, BC Cancer Agency, Surrey, B.C., BC Cancer Agency, Vancouver, B.C., Wu, Jonn, Moiseenko, Vitali, and Thomas, Steven. Fri . "Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton". United States. doi:10.1118/1.4894935.
@article{osti_22407695,
title = {Poster — Thur Eve — 74: Distributed, asynchronous, reactive dosimetric and outcomes analysis using DICOMautomaton},
author = {Clark, Haley and BC Cancer Agency, Surrey, B.C. and BC Cancer Agency, Vancouver, B.C. and Wu, Jonn and Moiseenko, Vitali and Thomas, Steven},
abstractNote = {Many have speculated about the future of computational technology in clinical radiation oncology. It has been advocated that the next generation of computational infrastructure will improve on the current generation by incorporating richer aspects of automation, more heavily and seamlessly featuring distributed and parallel computation, and providing more flexibility toward aggregate data analysis. In this report we describe how a recently created — but currently existing — analysis framework (DICOMautomaton) incorporates these aspects. DICOMautomaton supports a variety of use cases but is especially suited for dosimetric outcomes correlation analysis, investigation and comparison of radiotherapy treatment efficacy, and dose-volume computation. We describe: how it overcomes computational bottlenecks by distributing workload across a network of machines; how modern, asynchronous computational techniques are used to reduce blocking and avoid unnecessary computation; and how issues of out-of-date data are addressed using reactive programming techniques and data dependency chains. We describe internal architecture of the software and give a detailed demonstration of how DICOMautomaton could be used to search for correlations between dosimetric and outcomes data.},
doi = {10.1118/1.4894935},
journal = {Medical Physics},
number = 8,
volume = 41,
place = {United States},
year = {Fri Aug 15 00:00:00 EDT 2014},
month = {Fri Aug 15 00:00:00 EDT 2014}
}
  • Volumetric modulated arc therapy (VMAT) allows fast delivery of stereotactic radiotherapy. However, the discrepancies between the calculated and delivered dose distributions due to respiratory motion and dynamic multileaf collimators (MLCs) interplay are not avoidable. The purpose of this study is to investigate RapidArc lung SBRT treatment delivered by the flattening filter-free (FFF) beam and flattened beam with Varian TrueBeam machine. CIRS Dynamic Thorax Phantom with in-house made lung tumor insertion was CT scanned both in free breathing and 4DCT. 4DCT was used to determine the internal target volume. The free breathing CT scan was used for treatment planning. A 5more » mm margin was given to ITV to generate a planning target volume. Varian Eclipse treatment planning was used to generate RapidArc plans based on the 6 MV flattened beam and 6MV FFF beam. The prescription dose was 48 Gy in 4 fractions. At least 95% of PTV was covered by the prescribed dose. The RapidArc plans with 6 MV flattened beam and 6MV FFF beam were delivered with Varian TrueBeam machine. The dosimetric measurements were performed with Gafchromic XR-RV3 film, which was placed in the lung tumor insertion. The interplay between the dynamic MLC-based delivery of VMAT and the respiratory motion of the tumor degraded target coverage and created undesired hot or cold dose spots inside the lung tumor. Lung SBRT RapidArc treatments delivered by the FFF beam of TrueBeam linear accelerator is superior to the flattened beam. Further investigation will be performed by Monte Carlo simulation.« less
  • This study investigated dosimetric impact due to the bone backscatter in orthovoltage radiotherapy. Monte Carlo simulations were used to calculate depth doses and photon fluence spectra using the EGSnrc-based code. Inhomogeneous bone phantom containing a thin water layer (1–3 mm) on top of a bone (1 cm) to mimic the treatment sites of forehead, chest wall and kneecap was irradiated by the 220 kVp photon beam produced by the Gulmay D3225 x-ray machine. Percentage depth doses and photon energy spectra were determined using Monte Carlo simulations. Results of percentage depth doses showed that the maximum bone dose was about 210–230%more » larger than the surface dose in the phantoms with different water thicknesses. Surface dose was found to be increased from 2.3 to 3.5%, when the distance between the phantom surface and bone was increased from 1 to 3 mm. This increase of surface dose on top of a bone was due to the increase of photon fluence intensity, resulting from the bone backscatter in the energy range of 30 – 120 keV, when the water thickness was increased. This was also supported by the increase of the intensity of the photon energy spectral curves at the phantom and bone surface as the water thickness was increased. It is concluded that if the bone inhomogeneity during the dose prescription in the sites of forehead, chest wall and kneecap with soft tissue thickness = 1–3 mm is not considered, there would be an uncertainty in the dose delivery.« less
  • In this study we investigate the deliverability of dosimetric plans generated by the irregular surface compensator (ISCOMP) algorithm for 6 MV photon beams in Eclipse (Varian Medical System, CA). In contrast to physical tissue compensation, the electronic ISCOMP uses MLCs to dynamically modulate the fluence of a photon beam in order to deliver a uniform dose at a user defined plane in tissue. This method can be used to shield critical organs that are located within the treatment portal or improve dose uniformity by tissue compensation in inhomogeneous regions. Three site specific plans and a set of test fields weremore » evaluated using the γ-metric of 3%/ 3 mm on Varian EPID, MapCHECK, and Gafchromic EBT3 film with a clinical tolerance of >95% passing rates. Point dose measurements with an NRCC calibrated ionization chamber were also performed to verify the absolute dose delivered. In all cases the MapCHECK measured plans met the gamma criteria. The mean passing rate for the six EBT3 film field measurements was 96.2%, with only two fields at 93.4 and 94.0% passing rates. The EPID plans passed for fields encompassing the central ∼10 × 10 cm{sup 2} region of the detector; however for larger fields and greater off-axis distances discrepancies were observed and attributed to the profile corrections and modeling of backscatter in the portal dose calculation. The magnitude of the average percentage difference for 21 ion chamber point dose measurements and 17 different fields was 1.4 ± 0.9%, and the maximum percentage difference was −3.3%. These measurements qualify the algorithm for routine clinical use subject to the same pre-treatment patient specific QA as IMRT.« less
  • Stereotactic Body Radiation Therapy (SBRT) is a treatment option for early stage non-small cell lung cancer (NSCLC). SBRT uses tightly conformed megavoltage (MV) x-ray beams to ablate the tumour. However, small MV x-ray fields may produce lateral electron disequilibrium (LED) within lung tissue, which can reduce the dose to tumour. The goal of this work is to estimate the prevalence of LED in NSCLC patients treated with SBRT, and determine dose effects for patients prone or averse to LED. Thirty NSCLC patients were randomly selected for analysis. 4-dimensional CT lung images were segmented into the right and left upper andmore » lower lobes (RUL, RLL, LUL, LLL), and the right middle lobe. Dose calculations were performed using volume-modulated arc therapy in the Pinnacle{sup 3} TPS. Most tumours were located in the upper lobes (RUL 53%, LUL 27%) where density was significantly lower (RUL −808±46 HU vs. RLL −743±71 HU; LUL −808 ±56 HU vs. LLL −746±70 HU; p<0.001). In general, the prevalence of LED increased with higher beam energy. Using 6MV photons, patients with a RUL tumour experienced moderate (81 %), and mild (19%) levels of LED. At 18MV, LED became more prominent with severe (50%) and moderate (50%) LED exhibited. Dosimetrically, for patients prone to LED, poorer target coverage (i.e. increased R100 by 20%) and improved lung sparing (i.e. reduced V20 by −46%) was observed. The common location of lung cancers in the upper lobes, coupled with lower lung density, results in the potential occurrence of LED, which may underdose the tumour.« less
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