Despite recent technological advances, on-treatment imaging for radiotherapy procedures is still a significant challenge for tens of thousands of patients. On-board MRI or kV x-ray systems are either prohibitively expensive, provide incomplete information, or are incompatible with implanted metal devices. According to the American College of Radiology, megavoltage (MV) volumetric imaging has a clear advantage in terms of metal artifact reduction, direct dose calculation and real-time adaptive radiotherapy, but is challenged by low contrast and high imaging doses. We have demonstrated that this limitation can be overcome by a novel multi-layer imager to provide high-contrast, low-dose on-treatment MV imaging. This new technology will remove metal artifacts while retaining soft-tissue contrast and enable real-time adaptive radiotherapy. We have invented and validated a Monte Carlo-based tool that enables accurate image simulation in a fraction of the time required for conventional Monte Carlo simulation ? enabling efficient imager optimization to be performed. Our preliminary data with a novel low-cost scintillator and efficient layering combinations has already demonstrated low- dose/high-quality MV-CBCT, rivaling conventional kV-CBCT, with added benefits of artifact reduction and Hounsfield unit accuracy.
The Specific Aims of the current proposal will leverage our combined experience and previous results to produce an optimized imager suitable for widespread clinical use. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

Public Health Relevance

Despite recent technological advances, on-treatment imaging for radiotherapy procedures is still a significant challenge for tens of thousands of patients. According to the American College of Radiology, megavoltage (MV) volumetric imaging has a clear advantage in terms of metal artifact reduction, direct dose calculation and real-time adaptive radiotherapy, but is challenged by low contrast and high imaging doses. We have demonstrated that this limitation can be overcome by a novel multi-layer imager to provide high-contrast, low- dose on-treatment MV imaging which will remove metal artifacts while retaining soft-tissue contrast and enable real-time adaptive radiotherapy. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
2R01CA188446-06A1
Application #
10051610
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Baker, Houston
Project Start
2014-09-01
Project End
2025-06-30
Budget Start
2020-07-01
Budget End
2021-06-30
Support Year
6
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Dana-Farber Cancer Institute
Department
Type
DUNS #
076580745
City
Boston
State
MA
Country
United States
Zip Code
02215
Myronakis, Marios; Hu, Yue-Houng; Fueglistaller, Rony et al. (2018) Multi-layer imager design for mega-voltage spectral imaging. Phys Med Biol 63:105002
Hu, Yue-Houng; Rottmann, Joerg; Fueglistaller, Rony et al. (2018) Leveraging multi-layer imager detector design to improve low-dose performance for megavoltage cone-beam computed tomography. Phys Med Biol 63:035022
Shi, Mengying; Myronakis, Marios; Hu, Yue-Houng et al. (2018) A Monte Carlo study of the impact of phosphor optical properties on EPID imaging performance. Phys Med Biol 63:165013
Hu, Yue-Houng; Fueglistaller, Rony; Myronakis, Marios et al. (2018) Physics considerations in MV-CBCT multi-layer imager design. Phys Med Biol 63:125016
Myronakis, Marios; Fueglistaller, Rony; Rottmann, Joerg et al. (2017) Spectral imaging using clinical megavoltage beams and a novel multi-layer imager. Phys Med Biol 62:9127-9139
Chen, Haijian; Rottmann, Joerg; Yip, Stephen Sf et al. (2017) Super-resolution imaging in a multiple layer EPID. Biomed Phys Eng Express 3:025004
Hu, Yue-Houng; Myronakis, Marios; Rottmann, Joerg et al. (2017) A novel method for quantification of beam's-eye-view tumor tracking performance. Med Phys 44:5650-5659
Myronakis, Marios; Star-Lack, Josh; Baturin, Paul et al. (2017) A novel multilayer MV imager computational model for component optimization. Med Phys 44:4213-4222
Rottmann, Joerg; Morf, Daniel; Fueglistaller, Rony et al. (2016) A novel EPID design for enhanced contrast and detective quantum efficiency. Phys Med Biol 61:6297-306
Star-Lack, Josh; Shedlock, Daniel; Swahn, Dennis et al. (2015) A piecewise-focused high DQE detector for MV imaging. Med Phys 42:5084-99

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