The delivery accuracy of radiation therapy for pulmonary and abdominal tumors suffers from tumor motion due to respiration. Respiratory gating should be applied to avoid the use of a large target volume margin that results in a substantial dose to the surrounding normal tissue. Precise respiratory gating requires the exact spatial position of the tumor to be determined in real time during treatment. Usually, fiducial markers are implanted inside or next to the tumor to provide both accurate patient setup and real-time tumor tracking. However, current tumor tracking systems require either substantial x-ray exposure to the patient or large fiducial markers that limit the value of their application for pulmonary tumors. We propose a real-time tumor tracking system using implanted positron emission markers (PeTrack). Each marker will be labeled with low activity positron emitting isotopes, such as 124I, 74As, or 84Rb. These isotopes have half-lives comparable to the duration of radiation therapy (from a few days to a few weeks). The size of the proposed PeTrack marker will be 0.5-0.8 mm, which is approximately one-half the size of markers currently employed in other techniques. By detecting annihilation gammas using position-sensitive detectors, multiple positron emission markers can be tracked in real time. A multimarker localization algorithm was developed using an Expectation-Maximization clustering technique. A Monte Carlo simulation model was developed for the PeTrack system. Patient dose, detector sensitivity, and scatter fraction were evaluated. Depending on the isotope, the lifetime dose from a 3.7 MBq PeTrack marker was determined to be 0.7-5.0 Gy at 10 mm from the marker. At the center of the field of view (FOV), the sensitivity of the PeTrack system was 240-320 counts/s per 1 MBq marker activity within a 30 cm thick patient. The sensitivity was reduced by 45% when the marker was near the edge of the FOV. The scatter fraction ranged from 12% (124I, 74As) to 16% (84Rb). In addition, four markers (labeled with 124I) inside a 30 cm diameter water phantom were simulated to evaluate the feasibility of the multimarker localization algorithm. Localization was considered successful if a marker was localized to within 2 mm from its true location. The success rate of marker localization was found to depend on the number of annihilation events used and the error in the initial estimate of the marker position. By detecting 250 positron annihilation events from 4 markers (average of 62 events per marker), the marker success rates for initial errors of +/-5, +/-10, and +/-15 mm were 99.9%, 99.6%, and 92.4%, respectively. Moreover, the average localization error was 0.55 (+/-0.27) mm, which was independent of initial error. The computing time for localizing four markers was less than 20 ms (Pentium 4, 2.8 GHz processor, 512 MB memory). In conclusion, preliminary results demonstrate that the PeTrack technique can potentially provide real-time tumor tracking with low doses associated with the marker's activity. Furthermore,...

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A series of experiments were carried out to simulate air cavities in a polystyrene phantom. Dose was measured at air/polystyrene interface and as a function of depth. Results of experiments were compared to calculations done using three treatment planning systems. These systems employ Batho, modified Batho, and the equivalent tissue-air-ratio methods for inhomogeneity corrections. The measured interface dose decreased by 55% for a 5 cm air gap, 5ϫ5 cm 2 field size, and 6 MV photons. This has been attributed to a lack of electronic equilibrium and dispersion of secondary particles transported through the air gap. These results are at variance with predictions of calculations using three treatment planning systems, for which only a 10% decrease was calculated. This is because the calculation algorithms employed do not incorporate electron transport. Further experiments were conducted to study the contribution of scatter from sides of the walls of the cavities. Dose measurements as a function of depth were also performed to investigate the effect of primary fluence attenuation. The Batho algorithm did not show any sensitivity to the position of air gap sidewalls. This points to the need for proper inclusion of disequilibrium effects and shape of inhomogeneity.

The objective of this project is to develop and construct an innovative imaging system for nuclear medicine and molecular imaging that uses photon diffraction and is capable of generating 1-2 mm spatial resolution images in two or three dimensions. The proposed imaging system would be capable of detecting radiopharmaceuticals that emit 100-200 keV gamma rays which are typically used in diagnostic nuclear medicine and in molecular imaging. The system is expected to be optimized for the 140.6 keV gamma ray from a Tc-99m source, which is frequently used in nuclear medicine. This new system will focus the incoming gamma rays in a manner analogous to a magnifying glass focusing sunlight into a small focal point on a detector's sensitive area. Focusing gamma rays through photon diffraction has already been demonstrated with the construction of a diffraction lens telescope for astrophysics and a scaled-down lens for medical imaging, both developed at Argonne National Laboratory (ANL). In addition, spatial resolutions of 3 mm have been achieved with a prototype medical lens. The proposed imaging system would be comprised of an array of photon diffraction lenses tuned to diffract a specific gamma ray energy (within 100-200 keV) emitted by a common source. The properties of photon diffraction make it possible to diffract only one specific gamma ray energy at a time, which significantly reduces scattering background. The system should be sufficiently sensitive to the detection of small concentrations of radioactivity that can reveal potential tumor sites at their initial stages of development. Moreover, the system's sensitivity would eliminate the need for re-injecting a patient with more radiopharmaceutical if this patient underwent a prior nuclear imaging scan.Detection of a tumor site at its inception could allow for an earlier initiation of treatment and wider treatment options, which can potentially improve the chances for cure.