SU-F-J-38: Dose Rates and Preliminary Evaluation of Contouring Similarity Metrics Using 4D Cone Beam CT

Purpose: 4D imaging modalities require detailed characterization for clinical optimization. The On-Board Imager mounted on the linear accelerator was used to investigate dose rates in a tissue mimicking phantom using 4D-CBCT and assess variability of contouring similarity metrics between 4D-CT and 4D-CBCT retrospective reconstructions. Methods: A 125 kVp thoracic protocol was used. A phantom placed on a motion platform simulated a patient's breathing cycle. An ion chamber was affixed inside the phantom's tissue mimicking cavities (i.e. bone, lung, and soft tissue). A sinusoidal motion waveform was executed with a five second period and superior-inferior motion. Dose rates were measured at six ion chamber positions. A preliminary workflow for contouring similarity between 4D-CT and 4D-CBCT was established using a single lung SBRT patient's historical data. Average intensity projection (Ave-IP) and maximum intensity projection (MIP) reconstructions generated offline were compared between the 4D modalities. Similarity metrics included Dice similarity coefficient (DSC), Hausdorff distance, and center of mass (COM) deviation. Two isolated lesions were evaluated in the patient's scans: one located in the right lower lobe (ITVRLL) and one located in the left lower lobe (ITVLLL). Results: Dose rates ranged from 2.30 (lung) to 5.18 (bone) E-3 cGy/mAs. For fixed acquisition parameters, cumulative dose is inversely proportional to gantry speed. For ITVRLL, DSC were 0.70 and 0.68, Hausdorff distances were 6.11 and 5.69 mm, and COM deviations were 1.24 and 4.77 mm, for Ave-IP and MIP respectively. For ITVLLL, DSC were 0.64 and 0.75, Hausdorff distances were 10.74 and 8.00 mm, and COM deviations were 7.55 and 4.3 mm, for Ave-IP and MIP respectively. Conclusion: While the dosimetric output of 4D-CBCT is low, characterization is necessary to assure clinical optimization. A basic workflow for comparison of simulation and treatment 4D image-based contours was established. This work was partially supported by a Research Scholar Grant (RSG-15-137-01-CCE) from the American Cancer Society.