Systematic investigation of automated plan generation for breast cancer including beam angle and isocenter selection

Il tumore al seno è il più comune tra le donne nel mondo. La radioterapia è comunemente usata dopo la chirurgia per distruggere eventuali cellule maligne rimaste nel volume del seno. Nei trattamenti di radioterapia bisogna cercare di irradiare il volume da curare limitando contemporaneamente la tossicità nei tessuti sani. In clinica i parametri che definiscono il piano di trattamento radioterapeutico sono selezionati manualmente utilizzando un software di simulazione per trattamenti. Questo processo, detto di trial and error, in cui i differenti parametri vengono modificati e il trattamento viene simulato nuovamente e valutato, può richiedere molte iterazioni rendendolo dispendioso in termini di tempo. Lo studio presentato in questa tesi si concentra sulla generazione automatica di piani di trattamento per irradiare l'intero volume del seno utilizzando due fasci approssimativamente opposti e tangenti al paziente. In particolare ci siamo concentrati sulla selezione delle direzioni dei fasci e la posizione dell'isocentro. A questo scopo, è stato investigata l'efficacia di un approccio combinatorio, nel quale sono stati generati un elevato numero di possibili piani di trattamento utilizzando differenti combinazioni delle direzioni dei due fasci. L'intensità del profilo dei fasci viene ottimizzata automaticamente da un algoritmo, chiamato iCycle, sviluppato nel ospedale Erasmus MC di Rotterdam. Inizialmente tra tutti i possibili piani di trattamento generati solo un sottogruppo viene selezionato, avente buone caratteristiche per quel che riguarda l'irraggiamento del volume del seno malato. Dopo di che i piani che mostrano caratteristiche ottimali per la salvaguardia degli organi a rischio (cuore, polmoni e seno controlaterale) vengono considerati. Questi piani di trattamento sono matematicamente equivalenti quindi per selezionare tra questi il piano migliore è stata utilizzata una somma pesata dove i pesi sono stati regolati per ottenere in media piani che abbiano caratteristiche simili ai piani di trattamento approvati in clinica. Questo metodo in confronto al processo manuale oltre a ridurre considerevol-mente il tempo di generazione di un piano di trattamento garantisce anche i piani selezionati abbiano caratteristiche ottimali nel preservare gli organi a rischio. Inizialmente è stato utilizzato l'isocentro scelto in clinica dal tecnico. Nella parte finale dello studio l'importanza dell'isocentro è stata valutata; ne è risultato che almeno per un sottogruppo di pazienti la posizione dell'isocentro può dare un importante contributo alla qualità del piano di trattamento e quindi potrebbe essere un ulteriore parametro da ottimizzare. 

Beam Angle Optimization for Automated Coplanar IMRT Lung Plans

Purpose: To investigate the effect of incorporating a beam spreading parameter in a beam angle optimization algorithm and to evaluate its efficacy for creating coplanar IMRT lung plans in conjunction with machine learning generated dose objectives.

Methods: Fifteen anonymized patient cases were each re-planned with ten values over the range of the beam spreading parameter, k, and analyzed with a Wilcoxon signed-rank test to determine whether any particular value resulted in significant improvement over the initially treated plan created by a trained dosimetrist. Dose constraints were generated by a machine learning algorithm and kept constant for each case across all k values. Parameters investigated for potential improvement included mean lung dose, V20 lung, V40 heart, 80% conformity index, and 90% conformity index.

Results: With a confidence level of 5%, treatment plans created with this method resulted in significantly better conformity indices. Dose coverage to the PTV was improved by an average of 12% over the initial plans. At the same time, these treatment plans showed no significant difference in mean lung dose, V20 lung, or V40 heart when compared to the initial plans; however, it should be noted that these results could be influenced by the small sample size of patient cases.

Conclusions: The beam angle optimization algorithm, with the inclusion of the beam spreading parameter k, increases the dose conformity of the automatically generated treatment plans over that of the initial plans without adversely affecting the dose to organs at risk. This parameter can be varied according to physician preference in order to control the tradeoff between dose conformity and OAR sparing without compromising the integrity of the plan.

Development and Testing of An Automatic Lung IMRT Planning Algorithm

Knowledge-based radiation treatment is an emerging concept in radiotherapy. It

mainly refers to the technique that can guide or automate treatment planning in

clinic by learning from prior knowledge. Dierent models are developed to realize

it, one of which is proposed by Yuan et al. at Duke for lung IMRT planning. This

model can automatically determine both beam conguration and optimization ob-

jectives with non-coplanar beams based on patient-specic anatomical information.

Although plans automatically generated by this model demonstrate equivalent or

better dosimetric quality compared to clinical approved plans, its validity and gener-

ality are limited due to the empirical assignment to a coecient called angle spread

constraint dened in the beam eciency index used for beam ranking. To eliminate

these limitations, a systematic study on this coecient is needed to acquire evidences

for its optimal value.

To achieve this purpose, eleven lung cancer patients with complex tumor shape

with non-coplanar beams adopted in clinical approved plans were retrospectively

studied in the frame of the automatic lung IMRT treatment algorithm. The primary

and boost plans used in three patients were treated as dierent cases due to the

dierent target size and shape. A total of 14 lung cases, thus, were re-planned using

the knowledge-based automatic lung IMRT planning algorithm by varying angle

spread constraint from 0 to 1 with increment of 0.2. A modied beam angle eciency

index used for navigate the beam selection was adopted. Great eorts were made to assure the quality of plans associated to every angle spread constraint as good

as possible. Important dosimetric parameters for PTV and OARs, quantitatively

re

ecting the plan quality, were extracted from the DVHs and analyzed as a function

of angle spread constraint for each case. Comparisons of these parameters between

clinical plans and model-based plans were evaluated by two-sampled Students t-tests,

and regression analysis on a composite index built on the percentage errors between

dosimetric parameters in the model-based plans and those in the clinical plans as a

function of angle spread constraint was performed.

Results show that model-based plans generally have equivalent or better quality

than clinical approved plans, qualitatively and quantitatively. All dosimetric param-

eters except those for lungs in the automatically generated plans are statistically

better or comparable to those in the clinical plans. On average, more than 15% re-

duction on conformity index and homogeneity index for PTV and V40, V60 for heart

while an 8% and 3% increase on V5, V20 for lungs, respectively, are observed. The

intra-plan comparison among model-based plans demonstrates that plan quality does

not change much with angle spread constraint larger than 0.4. Further examination

on the variation curve of the composite index as a function of angle spread constraint

shows that 0.6 is the optimal value that can result in statistically the best achievable

plans.

DEVELOPMENT OF A BEAM-SPECIFIC PLANNING TARGET VOLUME AND A ROBUST PLAN ANALYSIS TOOL FOR PROTON THERAPY

Proton therapy is growing increasingly popular due to its superior dose characteristics compared to conventional photon therapy. Protons travel a finite range in the patient body and stop, thereby delivering no dose beyond their range. However, because the range of a proton beam is heavily dependent on the tissue density along its beam path, uncertainties in patient setup position and inherent range calculation can degrade thedose distribution significantly. Despite these challenges that are unique to proton therapy, current management of the uncertainties during treatment planning of proton therapy has been similar to that of conventional photon therapy. The goal of this dissertation research was to develop a treatment planning method and a planevaluation method that address proton-specific issues regarding setup and range uncertainties. Treatment plan designing method adapted to proton therapy: Currently, for proton therapy using a scanning beam delivery system, setup uncertainties are largely accounted for by geometrically expanding a clinical target volume (CTV) to a planning target volume (PTV). However, a PTV alone cannot adequately account for range uncertainties coupled to misaligned patient anatomy in the beam path since it does not account for the change in tissue density. In order to remedy this problem, we proposed a beam-specific PTV (bsPTV) that accounts for the change in tissue density along the beam path due to the uncertainties. Our proposed method was successfully implemented, and its superiority over the conventional PTV was shown through a controlled experiment.. Furthermore, we have shown that the bsPTV concept can be incorporated into beam angle optimization for better target coverage and normal tissue sparing for a selected lung cancer patient. Treatment plan evaluation method adapted to proton therapy: The dose-volume histogram of the clinical target volume (CTV) or any other volumes of interest at the time of planning does not represent the most probable dosimetric outcome of a given plan as it does not include the uncertainties mentioned earlier. Currently, the PTV is used as a surrogate of the CTV’s worst case scenario for target dose estimation. However, because proton dose distributions are subject to change under these uncertainties, the validity of the PTV analysis method is questionable. In order to remedy this problem, we proposed the use of statistical parameters to quantify uncertainties on both the dose-volume histogram and dose distribution directly. The robust plan analysis tool was successfully implemented to compute both the expectation value and its standard deviation of dosimetric parameters of a treatment plan under the uncertainties. For 15 lung cancer patients, the proposed method was used to quantify the dosimetric difference between the nominal situation and its expected value under the uncertainties.

Laser cooling of a metastable argon atomic beam

A production of low velocity and monoenergetic atomic beams would increase the resolution in spectroscopic studies and many other experiments in atomic physics. Laser Cooling uses the radiation pressure to decelerate and cool atoms. The effusing from a glow discharge metastable argon atomic beam is affected by a counterpropagating laser light tuned to the cycling transition in argon. The Zeeman shift caused by a spatially varying magnetic field compensates for the changing Doppler shift that takes the atoms out of resonance as they decelerated. Deceleration and velocity bunching of atoms to a final velocity that depends on the detuning of the laser relative to a frequency of the transition have been observed. Time-of-Flight (TOF) spectroscopy is used to examine the velocity distribution of the cooled atomic beam. These TOF studies of the laser cooled atomic beam demonstrate the utility of laser deceleration for atomic-beam "velocity selection".

Profilometry of semiconductor components by two-colour holography with Bi12TiO20 crystals

We studied the shape measurement of semiconductor components by holography with photorefractive Bi12TiO20 crystal as holographic medium and two diode lasers emitting in the red region as light sources. By properly tuning and aligning the lasers a synthetic wavelength was generated and the resulting holographic image of the studied object appears modulated by cos2-contour fringes which correspond to the intersection of the object surface with planes of constant elevation. The position of such planes as a function of the illuminating beam angle and the tuning of the lasers was studied, as well as the fringe visibility. The fringe evaluation was performed by the four stepping technique for phase mapping and through the branch-cut method for phase unwrapping. A damage in an integrated circuit was analysed as well as the relief of a coin was measured, and a precision up to 10 μm was estimated. © 2009 SPIE.

Reconhecimento semiautomático de dentes para a identificação humana forense

Pós-graduação em Ciência da Computação - IBILCE

HTS and HTSn: New shape descriptors based on Hough transform statistics

With the widespread proliferation of computers, many human activities entail the use of automatic image analysis. The basic features used for image analysis include color, texture, and shape. In this paper, we propose a new shape description method, called Hough Transform Statistics (HTS), which uses statistics from the Hough space to characterize the shape of objects or regions in digital images. A modified version of this method, called Hough Transform Statistics neighborhood (HTSn), is also presented. Experiments carried out on three popular public image databases showed that the HTS and HTSn descriptors are robust, since they presented precision-recall results much better than several other well-known shape description methods. When compared to Beam Angle Statistics (BAS) method, a shape description method that inspired their development, both the HTS and the HTSn methods presented inferior results regarding the precision-recall criterion, but superior results in the processing time and multiscale separability criteria. The linear complexity of the HTS and the HTSn algorithms, in contrast to BAS, make them more appropriate for shape analysis in high-resolution image retrieval tasks when very large databases are used, which are very common nowadays. (C) 2014 Elsevier Inc. All rights reserved.

Symmetry Issues in Directly Irradiated Targets

In direct drive Inertial Confinement Fusion (ICF), the typical laser beam to laser beam angle is around 30o. This fact makes the study of the irradiation symmetry agenuine 3D problem. In this paper we use the three dimensional version of the MULTI hydrocode to assess the symmetry of such ICF implosions. More specifically, we study a shock-ignition proposal for the Laser-M´egajoule facility (LMJ) in which two of the equatorial beam cones are used to implode and pre compress a spherical capsule (the “reference” capsule of HiPER project) made of 0.59 mg of pure Deuterium-Tritium mixture. The symmetry of this scheme is analysed and optimized to get a design inside the operating limits of LMJ. The studied configuration has been found essentially axial-symmetric, so that the use of 2D hydrocodes would be appropriate for this specific situation.

Symmetry issues in Directly Irradiated Targets

In direct drive Inertial Confinement Fusion (ICF), the typical laser beam to laser beam angle is around 30o. This fact makes the study of the irradiation symmetry agenuine 3D problem. In this paper we use the three dimensional version of the MULTI hydrocode to assess the symmetry of such ICF implosions. More specifically, we study a shock-ignition proposal for the Laser-M´egajoule facility (LMJ) in which two of the equatorial beam cones are used to implode and pre compress a spherical capsule (the “reference” capsule of HiPER project) made of 0.59 mg of pure Deuterium-Tritium mixture. The symmetry of this scheme is analysed and optimized to get a design inside the operating limits of LMJ. The studied configuration has been found essentially axial-symmetric, so that the use of 2D hydrocodes would be appropriate for this specific situation

Micromesistius poutassou (blue whiting) abundance and biomass data in Bay of Biscay estimated from acoustic surveys (2000-2012)

Acoustic and pelagic trawl data were collected during various pelagic surveys carried out by IFREMER in May between 2000 and 2012 (except 2001), on the eastern continental shelf of the Bay of Biscay (Pelgas series). The acoustic data were collected with a Simrad EK60 echosounder operating at 38 kHz (beam angle at -3 dB: 7°, pulse length set to 1.024 ms). The echosounder transducer was mounted on the vessel keel, at 6 m below the sea surface. The sampling design were parallel transects spaced 12 nm apart which were orientated perpendicular to the coast line from 20 m to about 200 m bottom depth. The nominal sailing speed was 10 knots and 3 knots on average during fishing operations. The scrutinising (species identification) of acoustic data was done by first characterising acoustic schools by type and then linking these types with the species composition of specific trawl hauls. The data set contains nautical area backscattering values, biomass and abundance estimates for blue whiting for one nautical mile long transect lines. Further information on the survey design, scrutinising and biomass estimation can be found in Doray et al. 2012.

Variations in seafloor depth estimates under different swath-width characteristics of submarine structures in the California Borderlands

Senior thesis written for Oceanography 445

Calypso’s array attenuation

Introduction: The Calypso 4D Localization System gives the possibility to track the tumour during treatment, with no additional ionising radiation delivered. To monitor the patient continuously an array is positioned above the patient during the treatment. We intend to study, for various gantry angles, the attenuation effect of the array for 6- and 10 MV and flattening filter free (FFF) 6- and FFF 10 MV photon beams. Materials and methods: Measurements were performed using an ion chamber placed in a slab phantom positioned at the linac isocenter for 6 MV, 10 MV, FFF 6 MV and FFF 10 MV photon beams. Measurements were performed with and without array above the phantom for 0°, 10°, 20°, 40° and 50° beam angle for a True Beam STx linac, for 5×5 and 10×10 and 15×15 cm2 field size beams to evaluate the attenuation of the array. A VMAT treatment plan was measured using an ArcCheck with and without the array in the beam path. Results and discussion: Attenuation measured values were up to 3%. Attenuation values were between 1 and 2% with the exception of the 30°–50° gantry angles which were up to 3.3%. The ratio values calculated in the ArcCheck for relative dose and absolute dose 10 were both 1·00. Conclusion: Attenuation of the treatment beam by the Calypso array is within acceptable limits.

Combined T2 -preparation and two-dimensional pencil-beam inner volume selection.

PURPOSE: To improve coronary magnetic resonance angiography (MRA) by combining a two-dimensional (2D) spatially selective radiofrequency (RF) pulse with a T2 -preparation module ("2D-T2 -Prep"). METHODS: An adiabatic T2 -Prep was modified so that the first and last pulses were of differing spatial selectivity. The first RF pulse was replaced by a 2D pulse, such that a pencil-beam volume is excited. The last RF pulse remains nonselective, thus restoring the T2 -prepared pencil-beam, while tipping the (formerly longitudinal) magnetization outside of the pencil-beam into the transverse plane, where it is then spoiled. Thus, only a cylinder of T2 -prepared tissue remains for imaging. Numerical simulations were followed by phantom validation and in vivo coronary MRA, where the technique was quantitatively evaluated. Reduced field-of-view (rFoV) images were similarly studied. RESULTS: In vivo, full field-of-view 2D-T2 -Prep significantly improved vessel sharpness as compared to conventional T2 -Prep, without adversely affecting signal-to-noise (SNR) or contrast-to-noise ratios (CNR). It also reduced respiratory motion artifacts. In rFoV images, the SNR, CNR, and vessel sharpness decreased, although scan time reduction was 60%. CONCLUSION: When compared with conventional T2 -Prep, the 2D-T2 -Prep improves vessel sharpness and decreases respiratory ghosting while preserving both SNR and CNR. It may also acquire rFoV images for accelerated data acquisition.

A matheuristic for the selection of beam directions and dose distribution in radiotherapy planning

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)