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Maria Grazia Pia, INFN Genova Technology transfer from HEP computing to the medical field F. Foppiano 3, S. Guatelli 2, J. Moscicki 1, M.G. Pia 2, M. Piergentili.

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Presentation on theme: "Maria Grazia Pia, INFN Genova Technology transfer from HEP computing to the medical field F. Foppiano 3, S. Guatelli 2, J. Moscicki 1, M.G. Pia 2, M. Piergentili."— Presentation transcript:

1 Maria Grazia Pia, INFN Genova Technology transfer from HEP computing to the medical field F. Foppiano 3, S. Guatelli 2, J. Moscicki 1, M.G. Pia 2, M. Piergentili 2 CERN 1 INFN Genova 2 National Institute for Cancer Research, IST Genova 3 Topical Seminar on Innovative Radiation Detectors Siena, May S. Agostinelli, S. Garelli (IST Genova) L. Archambault, L. Beaulieu, J.-F. Carrier, V.-H. Tremblay (Univ. Laval) M.C. Lopes, L. Peralta, P. Rodrigues, A. Trindade (LIP Lisbon) G. Ghiso (S. Paolo Hospital, Savona) Including contributions from:

2 Maria Grazia Pia, INFN Genova A real life case A dosimetric system for brachytherapy derived from HEP computing (but all the developments and applications presented in this talk are general) Technology transfer Activity initiated at IST Genova, Natl. Inst. for Cancer Research (F. Foppiano et al.) –hosted at San Martino Hospital in Genova (the largest hospital in Europe) Collaboration with San Paolo Hospital, Savona (G. Ghiso et al.) –a small hospital in a small town

3 Maria Grazia Pia, INFN Genova The goal of radiotherapy Delivering the required therapeutic dose to the tumor area with high precision, while preserving the surrounding healthy tissue Dosimetry system precision accurate model of the real configuration (from CT) speed adequate for clinical use user-friendly interface for hospital usage Calculate the dose released to the patient by the radiotherapy system Accurate dosimetry is at the basis of radiotherapy treatment planning

4 Maria Grazia Pia, INFN Genova The reality Treatment planning is performed by means of commercial software The software calculates the dose distribution delivered to the patient in a given source configuration Open issues Precision Cost approximated analytical methods, Commercial systems are based on approximated analytical methods, because of speed constraints geometry modeling Approximation in geometry modeling material modeling Approximation in material modeling specific to one technique one type of source Each treatment planning software is specific to one technique and one type of source expensive Treatment planning software is expensive

5 Maria Grazia Pia, INFN Genova Commercial factors Commercial treatment planning systems are governed by commercial rules (as any other commercial product...) i.e., they are produced and marketed by a company only if the investment for development is profitable No commercial treatment planning systems are available for non- conventional radiotherapy techniques hadrontherapy such as hadrontherapy or for niche applications superficial brachytherapy such as superficial brachytherapy Treatment planning systems for hadrontherapy are quite primitive not commercially convenient so far

6 Maria Grazia Pia, INFN Genova Monte Carlo methods in radiotherapy Monte Carlo methods have been explored for years as a tool for precise dosimetry, in alternative to analytical methods de facto, Monte Carlo simulation is not used in clinical practice (only side studies) speed The limiting factor is the speed Other limitations: reliable? for software specialists only, not user-friendly for general practice requires ad hoc modeling

7 Maria Grazia Pia, INFN Genova CT-simulation with a Rando phantom Experimental data with TLD LiF dosimeter CT images used to define the geometry: a thorax slice from a Rando anthropomorphic phantom Comparison with commercial treatment planning systems M. C. Lopes IPOFG-CROC Coimbra Oncological Regional Center L. Peralta, P. Rodrigues, A. Trindade LIP - Lisbon Central-Axis depth dose Profile curves at 9.8 cm depth PLATO overestimates the dose at ~ 5% level

8 Maria Grazia Pia, INFN Genova M. C. Lopes 1, L. Peralta 2, P. Rodrigues 2, A. Trindade 2 1 IPOFG-CROC Coimbra Oncological Regional Center - 2 LIP - Lisbon Head and neck with two opposed beams for a 5x5 and 10x10 field size A more complex set-up An off-axis depth dose taken at one of the slices near the isocenter PLATO fails on the air cavities and bone structures and cannot predict accurately the dose to tissue that is surrounded by air Deviations are up to 25-30% Beam plane Skull bone Tumor Air Bone In some tumours sites (ex: larynx T2/T3-stage) a 5% underdosage will decrease local tumour control probability from ~75% to ~50%

9 Maria Grazia Pia, INFN Genova The challenge

10 Maria Grazia Pia, INFN Genova Develop a general purpose precise dosimetric system with the capability of realistic geometry and material modeling interface to CT images with a user-friendly interface at low cost adequate speed for clinical usage performing at

11 Maria Grazia Pia, INFN Genova Precision Accurate model of the real experimental set-up Easy configuration for hospital usage Easy configuration for hospital usage Speed 3-D dose distribution Calculation of 3-D dose distribution in tissue isodose Determination of isodose curves Monte Carlo Based on Monte Carlo methods physics Accurate description of physics interactions validation Experimental validation of physics involved geometrytissue Realistic description of geometry and tissue Possibility to interface to CT images Simple user interface + Graphic visualisation dose distributionsisodoses Elaboration of dose distributions and isodoses Parallelisation distributed computing resources Access to distributed computing resources Other requirements Transparent extension Open to extension and new functionality Publicly accessible RequirementsRequirements

12 Maria Grazia Pia, INFN Genova PrecisionPrecision Monte Carlo methods Based on Monte Carlo methods Extension of electromagnetic interactions down to low energies (< 1 keV) Microscopic validation of the physics models Comparison experimental data Comparison with experimental data specific to the brachytherapic practice physics Accurate description of physics interactions validation Experimental validation of physics involved

13 Maria Grazia Pia, INFN Genova Code and documentation publicly distributed from web 1st production release: end 1998 –2 new releases/year since then Developed and maintained by an international collaboration of physicists and computer scientists Run, Event and Track management PDG-compliant Particle management Geometry and Materials Tracking Detector response User Interface Visualisation Persistency Physics Processes

14 Maria Grazia Pia, INFN Genova Barkas effect (charge dependence) models for negative hadrons e, down to 250 eV EGS4, ITS to 1 keV Geant3 to 10 keV Hadron and ion models based on Ziegler and ICRU data and parameterisations Based on EPDL97, EEDL and EADL evaluated data libraries Bragg peak shell effects antiprotons protons ions Fe lines GaAs lines Atomic relaxation Fluorescence Auger effect Based on Penelope analytical models

15 Maria Grazia Pia, INFN Genova Validation Microscopic validation: verification of Geant4 physics Dosimetric validation: in the experimental context

16 Maria Grazia Pia, INFN Genova proton straggling ions e -, Sandia database Al NIST Geant4-LowE Geant4-Standard Stopping power Microscopic validation many more validation results available! 2 N-L =13.1 – =20 - p=0.87 NIST Geant4-LowE Geant4-Standard Photon attenuation coefficient Al 2 N-S =23.2 – =15 - p=0.08

17 Maria Grazia Pia, INFN Genova Dosimetric validation Distance along Z (mm) Simulation Nucletron Data F. Foppiano et al., IST Genova Comparison to manufacturer data, protocol data, original experimental data experimental mesurements G. Ghiso, S. Guatelli S. Paolo Hospital Savona Ir-192I-125

18 Maria Grazia Pia, INFN Genova General purpose system Object Oriented technology Software system designed in terms of Abstract Interfaces Abstract Factory design pattern Source spectrum and geometry transparently interchangeable For any brachytherapy technique For any source type

19 Maria Grazia Pia, INFN Genova Flexibility of modeling CT DICOM interface Geant4 parameterised volumes through Geant4 parameterised volumes parameterisation function: material Abstract Factory Configuration of any brachytherapy technique any source type any source type Abstract Factory through an Abstract Factory geometry, primary spectrum to define geometry, primary spectrum Phantom various materials water, soft tissue, bone, muscle etc. General purpose software system for brachytherapy No commercial general software exists!

20 Maria Grazia Pia, INFN Genova Realistic model of the experimental set-up Realistic model of the experimental set-up IrI Spectrum ( 192 Ir, 125 I) Geometry Phantom with realistic material model Possibility to interface the system to CT images Radioactive source Patient

21 Maria Grazia Pia, INFN Genova Modeling the source geometry Precise geometry and material model of any type of source Iodium core Air Titanium capsule tip Titanium tube Iodium core: Inner radius :0 Outer radius: 0.30mm Half length:1.75mm Air: Outer radius:0.35mm half length:1.84mm Titanium tube: Outer radius:0.40mm Half length:1.84mm Titanium capsule tip: Box Side :0.80mm I-125 source for interstitial brachytherapy Ir-192 source + applicator for superficial brachytherapy

22 Maria Grazia Pia, INFN Genova Effects of source anisotropy Longitudinal axis of the source Difficult to make direct measurements Transverse axis of the source Comparison with experimental data Plato-BPS treatment planning algorithm makes some crude approximation ( dependence, no radial dependence) Distance along X (mm) SimulationPlatoData Distance along Z (mm) Effects of source anisotropy SimulationPlato Rely on simulation for better accuracy than conventional treatment planning software

23 Maria Grazia Pia, INFN Genova Modeling the patient source Modeling a phantom of any material (water, tissue, bone, muscle etc.) thanks to the flexibility of Geant4 materials package Modeling geometry and materials from CT data Acquisition of CT image 3D patient anatomy file DICOM is the universal standard for sharing resources between heterogeneous and multi-vendor equipment 3-D view Geant4-DICOM interface developed by L. Archambault, L. Beaulieu, V.-H. Tremblay (Univ. Laval and l'Hôtel-Dieu, Québec)

24 Maria Grazia Pia, INFN Genova User-friendly interface to facilitate the usage in hospitals User-friendly interface to facilitate the usage in hospitals Graphic visualisation of dose distributions Elaboration of isodose curves Application configuration Job submission Dosimetric analysis Web interface

25 Maria Grazia Pia, INFN Genova DosimetryDosimetry AIDA + Anaphe Python Analysis of the energy deposit in the phantom resulting from the simulation Dose distribution Isodose curves for analysis for interactivity + any AIDA-compliant analysis system Simulation of energy deposit through Geant4 Low Energy Electromagnetic package to obtain accurate dose distribution Production threshold: 100 m 2-D histogram with energy deposit in the plane containing the source Abstract Interfaces for Data Analysis

26 Maria Grazia Pia, INFN Genova MicroSelectron-HDR source Dosimetry Endocavitary brachytherapy Dosimetry Superficial brachytherapy Leipzig applicator Dosimetry Interstitial brachytherapy Bebig Isoseed I-125 source

27 Maria Grazia Pia, INFN Genova Application configuration Fully configurable from the web Type of source Phantom configuration # events Run modes: demo parallel on a cluster (under test) on the GRID (under development)

28 Maria Grazia Pia, INFN Genova Speed adequate for clinic use Transparent configuration in sequential or parallel mode Transparent access to the GRID through an intermediate software layer Parallelisation Access to distributed computing resources

29 Maria Grazia Pia, INFN Genova Performance Endocavitary brachytherapy 1M events 61 minutes Interstitial brachytherapy 1M events 67 minutes Superficial brachytherapy 1M events 65 minutes on an average PIII machine, as an average hospital may own Monte Carlo simulation is not practically conceivable for clinical application, even if more precise

30 Maria Grazia Pia, INFN Genova DIANE DIstributed ANalysis Environment prototype for an intermediate layer between applications and the GRID Hide complex details of underlying technology Developed by J. Moscicki, CERN R&D in progress for Large Scale Master-Worker Computing DIANE ParallelisationAccess to the GRID Transparent access to a distributed computing environment

31 Maria Grazia Pia, INFN Genova Performance: parallel mode on a local cluster 1M events 4 minutes 34 5M events 4 minutes 36 1M events 4 minutes 25 on up to 50 workers, LSF at CERN, PIII machine, MHz Performance adequate for clinical application, but… it is not realistic to expect any hospital to own and maintain a PC farm Endocavitary brachytherapy Interstitial brachytherapy Superficial brachytherapy preliminary: further optimisation in progress

32 Maria Grazia Pia, INFN Genova Running on the GRID Via DIANE Same application code as running on a sequential machine or on a dedicated cluster –completely transparent to the user A hospital is not required to own and maintain extensive computing resources to exploit the scientific advantages of Monte Carlo simulation for radiotherapy Any hospital even small ones, or in less wealthy countries, that cannot afford expensive commercial software systems – may have access to advanced software technologies and tools for radiotherapy

33 Maria Grazia Pia, INFN Genova Traceback from a run on CrossGrid testbed Current #Grid setup (computing elements): 5000 events, 2 workers, 10 tasks (500 events each) - aocegrid.uab.es:2119/jobmanager-pbs-workq - bee001.ific.uv.es:2119/jobmanager-pbs-qgrid - cgnode00.di.uoa.gr:2119/jobmanager-pbs-workq - cms.fuw.edu.pl:2119/jobmanager-pbs-workq - grid01.physics.auth.gr:2119/jobmanager-pbs-workq - xg001.inp.demokritos.gr:2119/jobmanager-pbs-workq - xgrid.icm.edu.pl:2119/jobmanager-pbs-workq - zeus24.cyf-kr.edu.pl:2119/jobmanager-pbs-infinite - zeus24.cyf-kr.edu.pl:2119/jobmanager-pbs-long - zeus24.cyf-kr.edu.pl:2119/jobmanager-pbs-medium - zeus24.cyf-kr.edu.pl:2119/jobmanager-pbs-short - ce01.lip.pt:2119/jobmanager-pbs-qgrid Spain Poland Greece Portugal Resource broker running in Portugal matchmaking CrossGrid computing elements

34 Maria Grazia Pia, INFN Genova Extension and evolution General dosimetry system for radiotherapy extensible to other techniques plug-ins for external beams plug-ins for external beams ( (factories for beam, geometry, physics...) Configuration of any brachytherapy technique any source type any source type Plug-ins in progress System extensible to any source configuration without changing the existing code treatment head treatment head hadrontherapy hadrontherapy......

35 Maria Grazia Pia, INFN Genova A medical accelerator for IMRT Build a simulation tool which determines the dose distributions given in a phantom by the head of a linear accelerator used for IMRT. Many algorithms were developed to estimate dose distributions, but even the most sophisticated ones resort to some approximations. These approximations might affect the outcome of dose calculation, especially in a complex treatment planning as IMRT. step and shoot IMRT generates tightly conforming dose distributions. This microscopic control allows IMRT to produce dose distribution patterns that are much closer to the desired patterns than possible previously

36 Maria Grazia Pia, INFN Genova The user can choose the energy and standard deviation of the primary particles energy distribution (Gaussian) The primary particles (e - ) leave from a point source with random direction (0˚< θ < 0.3˚) and a gaussian distribution The head components modeled include: target, primary and secondary collimators, vacuum window, flattening filter, ion chamber, mirror, vacuum and air Each pair of jaws can be rotated through an axis that is perpendicular to the beam axis The actual analysis produces some histograms from which the user can calculate the Percent Depth Dose (PDD) and the flatness at the following depths in the phantom: 15 mm, 50 mm, 100 mm and 200 mm. Work in progress...

37 Maria Grazia Pia, INFN Genova Design

38 Maria Grazia Pia, INFN Genova (very) Preliminary results Flatness Percent Depth Dose

39 Maria Grazia Pia, INFN Genova Real hadron-therapy beam line GEANT4 simulation CATANA hadrontherapy talk by P. Cirrone on Monday

40 Maria Grazia Pia, INFN Genova Dosimetry in interplanetary missions Aurora Programme Dose in astronaut resulting from Galactic Cosmic Rays vehicle concept

41 Maria Grazia Pia, INFN Genova Conclusions key issues Physics & software technology from HEP have a potential to address key issues in medical physics social impact The social impact of technology transfer from HEP computing may be significant What is the support of HEP to technology transfer? Geant4 + AIDA/Anaphe/PI + WWW + DIANE + GRID = precise, versatile, fast, user-friendly, low-cost dosimetry

42 Maria Grazia Pia, INFN Genova Thanks! G. Cosmo (CERN, Geant4) L. Moneta, A. Pfeiffer (Anaphe/PI, CERN) J. Knobloch (CERN/IT) S. Agostinelli, S. Garelli (IST Genova) G. Ghiso, R. Martinelli (S. Paolo Hospital, Savona) G.A.P. Cirrone, G. Cuttone (INFN LNS, CATANA project) M.C. Lopes, L. Peralta, P. Rodrigues, A. Trindade (LIP Lisbon) L. Archambault, J.F. Carrier, L. Beaulieu, V.H. Tremblay (Univ. Laval) This project has fostered a collaborative aggregation of contributions from many groups all over the world the authors medical physicist F. Foppiano (IST) – medical physicist students S. Guatelli, M. Piergentili (Univ. and INFN Genova) – students computer scientist J. Moscicki (CERN) – computer scientist particle physicist M.G. Pia (INFN Genova) – particle physicist


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