The major change this year was to move away from our long association with a vendor of volume rendering hardware and select instead a commercial vendor of high performance video graphics accelerators. These units offer comparable performance to the old boards, but are both substantially less expensive and have a greater potential for growth in performance. The commercial vendor also provides software for utilizing the boards for Monte Carlo calculations, which further supports our research objectives. We have transitioned from 3-dimensional image fusion to exploring 4-dimensional radiotherapy imaging. Our research has established a fundamental relationship between the temporal motion of the 3-dimensional external torso volume and those of internal organs, especially the lungs. This can serve as the basis for the validation of dose gating or dose tracking methodologies that rely on external fiducials. The Electron-Gamma Shower (EGS-4)-based Monte Carlo Dose Calculation Engine (DCE) has been fully implemented in both a LINUX and Windows environment. In the Windows environment, the DCE has been integrated into a full featured treatment planning system. Work is now centered on the development of phase-space source models. Currently, this system is used to investigate small field stereotactic radiosurgery. Due to the reduced field size, edge effects become important and the size of detectors used to access the radiation output affect the measurement results. Monte Carlo simulation of these output measurements greatly assisted in the selection of the detector system that is most suitable for these measurements. The Monte Carlo algorithm provided good agreement with experimental measurements down to applicators as small as 5mm. In a related project, we have adapted both algebraic and Monte Carlo DCEs to predict organ doses received from diagnostic CT scans. The characterization of the x-ray beam from a GE CT Scanner used for clinical scanning at Children's National Medical Center is complete. We have also completed absolute dosimetry measurements linking the standard diagnostic measurement of Computer Tomography Dose Index (CTDI) to actual absorbed dose.
