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Surface guided radiation therapy (SGRT) is a non-radiation, non-invasive technology that provides continuous postural monitoring of patients during radiotherapy. Using advanced 3D optical surface localization and tracking technology, SGRT quickly captures the surface contour information of patients through optical means to generate high-precision 3D surface contours, enabling real-time monitoring of patients during radiotherapy to ensure its accuracy. This image-guided technology has been widely applied in radiotherapy for tumors in different parts of the body, such as breast, intracranial, head and neck, and limbs. SGRT can reduce initial setup errors and provide real-time monitoring during treatment, or be combined with respiratory gating and deep inspiration breath-hold techniques. SGRT can also reduce radiation dose by reducing the use of CBCT, improve patient comfort with the use of immobilization devices, and enhance clinical speed, efficiency, and safety. This review aims to provide an overview of the commonly used technology and clinical applications of SGRT, and discuss its current limitations and future prospects.

This study compared the reproducibility of chestwall and heart position using surface‐guided versus RPM (real‐time position management)‐guided deep inspiration breath hold (DIBH) radiotherapy for left sided breast cancer. Forty DIBH patients under either surface‐guided radiotherapy (SGRT) or RPM guidance were studied. For patients treated with tangential fields, reproducibility was measured as the displacements in central lung distance (CLD) and heart shadow to field edge distance (HFD) between pretreatment MV (megavoltage) images and planning DRRs (digitally reconstructed radiographs). For patients treated with volumetric modulated arc therapy (VMAT), sternum to isocenter (ISO) distance (StID), spine to rib edge distance (SpRD), and heart shadow to central axis (CAX) distance (HCD) between pretreatment kV images and planning DRRs were measured. These displacements were compared between SGRT and RPM‐guided DIBH. In tangential patients, the mean absolute displacements of SGRT versus RPM guidance were 0.19 versus 0.23 cm in CLD, and 0.33 versus 0.62 cm in HFD. With respect to planning DRR, heart appeared closer to the field edge by 0.04 cm with surface imaging versus 0.62 cm with RPM. In VMAT patients, the displacements of surface imaging versus RPM guidance were 0.21 versus 0.15 cm in StID, 0.24 versus 0.19 cm in SpRD, and 0.72 versus 0.41 cm in HCD. Heart appeared 0.41 cm further away from CAX with surface imaging, whereas 0.10 cm closer to field CAX with RPM. None of the differences between surface imaging and RPM guidance was statistically significant. In conclusion, the displacements of chestwall were small and were comparable with SGRT‐ or RPM‐guided DIBH. The position deviations of heart were larger than those of chestwall with SGRT or RPM. Although none of the differences between SGRT and RPM guidance were statistically significant, there was a trend that the position deviations of heart were smaller and more favorable with SGRT than with RPM guidance in tangential patients. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to evaluate the overall accuracy of the surface-guided radiotherapy (SGRT) workflow through a comprehensive commissioning and quality assurance procedures and assess the potential benefits of deep-inspiration breath-hold (DIBH) radiotherapy as a cardiac and lung dose reduction approach for left-sided breast cancer irradiation. Materials and methods: Accuracy and reproducibility of the optical surface scanner used for DIBH treatment were evaluated using different phantoms. patient positioning accuracy and reproducibility of DIBH treatment were evaluated. Twenty patients were studied for treatment plan quality in target dose coverage and healthy organ sparing for the two different treatment techniques. Results: reproducibility tests for the surface scanner showed good stability within 1 mm in all directions. The maximum position variation between applied shifts on the couch and the scanner measured offsets is 1 mm in all directions. The clinical study of 200 fractions showed good agreement between the surface scanner and portal imaging with the isocenter position deviation of less than 3 mm in each lateral, longitudinal, and vertical direction. The standard deviation of the DIBH level showed a value of < 2 mm during all evaluated DIBHS. Compared to the free breathing (FB) technique, DIBH showed significant reduction of 48% for heart mean dose, 43% for heart V25, and 20% for ipsilateral lung V20. Conclusion: surface-guided radiotherapy can be regarded as an accurate tool for patient positioning and monitoring in breast radiotherapy. DIBH treatment are considered to be effective techniques in heart and ipsilateral lung dose reductions for left breast radiotherapy. [ABSTRACT FROM AUTHOR]

Purpose: To validate surface imaging (SI)‐reported offsets using a six degree‐of‐freedom couch and an anthropomorphic phantom for commissioning and routine quality assurance of an SI system used for stereotactic radiosurgery (SRS). Methods: An anthropomorphic phantom with a radiopaque ball bearing (BB) placed either anterior, midline, or posterior, was tracked with SI with a typical SRS region of interest. Couch motion in all six degrees of freedom was programmed and delivered on a linac. SI system logs were synchronized with linac trajectory logs. Ten random couch positions were selected at couch 0°, 45°, 90°, 270°, 315° with megavolt (MV) images taken to account for couch walkout. The SI residual error (ε), the difference between SI reported offset and MV or trajectory log position, was calculated. Residual errors were measured with and without one SI pod blocked. Results: The median [range] of magnitude of translational ε was 0.13 [0.07, 0.21], 0.16 [0.11, 0.26], 0.61 [0.50, 0.68], 0.49 [0.42, 0.55], 0.55 [0.38, 0.72] mm for couch rotations of 0°, 45°, 90°, 270°, 315°, respectively, for the midline BB and no pod blocked. The range of all translational ε from all couch angles (with and without pod block) at different BB positions is [0.05, 0.96] mm. The absolute range of difference when changing BB position when no pod is blocked in median translational ε is [0.01, 0.40] mm with the maximum at BB posterior. The absolute range of difference when not changing BB positions with and without pod block in median translational ε is [0.01, 0.37] mm with the maximum at BB posterior and couch 315°. Conclusion: SI system and linac trajectory log analysis can be used to assess SI system performance with automated couch motion to validate SI accuracy. [ABSTRACT FROM AUTHOR]

Advances in flexible integrated circuit technology and piezoelectric materials allow high-quality stretchable piezoelectric transducers to be built in a form that is easy to integrate with the body's soft, curved, and time-dynamic surfaces. The resulting capabilities create new opportunities for studying disease states, monitoring health/wellness, building human–machine interfaces, and performing other operations. However, more widespread application scenarios are placing new demands on the high flexibility and small size of the array. This paper provides a 8 × 8 two-dimensional flexible ultrasonic array (2D-FUA) based on laser micromachining; a novel single-layer "island bridge" structure was used to design flexible array and piezoelectric array elements to improve the imaging capability on complex surfaces. The mechanical and acoustoelectric properties of the array are characterized, and a novel laser scanning and positioning method is introduced to solve the problem of array element displacement after deformation of the 2D-FUA. Finally, a multi-modal localization imaging experiment was carried out on the multi-target steel pin on the plane and curved surface based on the Verasonics system. The results show that the laser scanning method has the ability to assist the rapid imaging of flexible arrays on surfaces with complex shapes, and that 2D-FUA has wide application potential in medical-assisted localization imaging. [ABSTRACT FROM AUTHOR]

Introduction: Two end‐to‐end tests evaluate the accuracy of a surface‐guided radiation therapy (SGRT) system (CRAD Catalyst HD) for position verification in comparison to a stereoscopic x‐ray imaging system (Brainlab Exactrac) for single‐isocenter, multiple metastases stereotactic radiosurgery (SRS) using 3D polymer gel inserts. Materials and methods: A 3D‐printed phantom (Prime phantom, RTsafe PC, Athens, Greece) with two separate cylindrical polymer gel inserts were immobilized in open‐face masks and treated with a single isocentric, multitarget SRS plan. Planning was done in Brainlab (Elements) to treat five metastatic lesions in one fraction, and initial setup was done using cone beam computed tomography. Positional verification was done using orthogonal X‐ray imaging (Brainlab Exactrac) and/or a surface imaging system (CRAD Catalyst HD, Uppsala, Sweden), and shift discrepancies were recorded for each couch angle. Forty‐two hours after irradiation, the gel phantom was scanned in a 1.5 Tesla MRI, and images were fused with the patient computed tomography data/structure set for further analysis of spatial dose distribution. Results: Discrepancies between the CRAD Catalyst HD system and Brainlab Exactrac were <1 mm in the translational direction and <0.5° in the angular direction at noncoplanar couch angles. Dose parameters (DMean%,D95%) and 3D gamma index passing rates were evaluated for both setup modalities for each planned target volume (PTV) at a variety of thresholds: 3%/2 mm (Exactrac≥93.1% and CRAD ≥87.2%), 5%/2 mm (Exactrac≥95.6% and CRAD ≥94.6%), and 5%/1 mm (Exactrac≥81.8% and CRAD ≥83.7%). Conclusion: Dose metrics for a setup with surface imaging was found to be consistent with setup using x‐ray imaging, demonstrating high accuracy and reproducibility for treatment delivery. Results indicate the feasibility of using surface imaging for position verification at noncoplanar couch angles for single‐isocenter, multiple‐target SRS using end‐to‐end quality assurance (QA) testing with 3D polymer gel dosimetry. [ABSTRACT FROM AUTHOR]

In this paper, we offer a laboratory facility for in situ visualization of the combustion of ultrafine metal powders, which combines laser initiation and simultaneous high-speed recording of images of the flame of a burning material and a surface covered by a flame. Visualization of the surface through the flame is realized using a laser monitor—an optical projection system with brightness amplification. The proposed imaging system makes it possible to get more detailed information about the combustion process, in particular, to study the change in the surface through the flame in the area of laser initiation, and the propagation of heating and combustion waves over the sample, as well as to study the change in the surface reflectance during combustion. To study the area of laser initiation, it is proposed to simultaneously record images of a laser monitor with two cameras. The symmetry of the combustion wave front propagation and the combustion products' formation during laser initiation of the nanoAl + Fe3O4 thermite mixture was demonstrated. The nature of propagation in the form of a ring is a consequence of the symmetry of the properties of the system under study, at the micro and macro levels. [ABSTRACT FROM AUTHOR]

Abstract Purpose To develop a novel approach to accurately verify patient set up in proton radiotherapy, especially for the verification of the nozzle – body surface air gap and source-to-skin distance (SSD), the consistency and accuracy of which is extremely important in proton treatment. Methods Patient body surfaces can be captured and monitored with the optical surface imaging system during radiation treatment for improved intrafraction accuracy. An in-house software package was developed to reconstruct the patient body surface in the treatment position from the optical surface imaging reference capture and to calculate the corresponding nozzle – body surface air gap and SSD. To validate this method, a mannequin was scanned on a CT simulator and proton plans were generated for a Mevion S250 Proton machine with 20 gantry/couch angle combinations, as well as two different snout sizes, in the Varian Eclipse Treatment Planning Systems (TPS). The surface generated in the TPS from the CT scan was imported into the optical imaging system as an RT Structure for the purpose of validating and establishing a benchmark for ground truth comparison. The optical imaging surface reference capture was acquired at the treatment setup position after orthogonal kV imaging to confirm the positioning. The air gaps and SSDs calculated with the developed method from the surface captured at the treatment setup position (VRT surface) and the CT based surface imported from the TPS were compared to those calculated in TPS. The same approach was also applied to 14 clinical treatment fields for 10 patients to further validate the methodology. Results The air gaps and SSDs calculated from our program agreed well with the corresponding values derived from the TPS. For the phantom results, using the CT surface, the absolute differences in the air gap were 0.45 mm ± 0.33 mm for the small snout, and 0.51 mm ± 0.49 mm for the large snout, and the absolute differences in SSD were 0.68 mm ± 0.42 mm regardless of snout size. Using the VRT surface, the absolute differences in air gap were 1.17 mm ± 1.17 mm and 2.1 mm ± 3.09 mm for the small and large snouts, respectively, and the absolute differences in SSD were 0.81 mm ± 0.45 mm. Similarly, for patient data, using the CT surface, the absolute differences in air gap were 0.42 mm ± 0.49 mm, and the absolute differences in SSD were 1.92 mm ± 1.4 mm. Using the VRT surface, the absolute differences in the air gap were 2.35 mm ± 2.3 mm, and the absolute differences in SSD were 2.7 mm ± 2.17 mm. Conclusion These results showed the feasibility and robustness of using an optical surface imaging approach to conveniently determine the air gap and SSD in proton treatment, providing an accurate and efficient way to confirm the target depth at treatment.

In scanning field emission microscopy (SFEM), a tip (the source) is approached to few (or a few tens of) nanometres distance from a surface (the collector) and biased to field-emit electrons. In a previous study (Zanin et al. 2016 Proc. R. Soc. A 472, 20160475. (doi:10.1098/rspa.2016.0475)), the field-emitted current was found to change by approximately 1% at a monatomic surface step (approx. 200 pm thick). Here we prepare surface domains of adjacent different materials that, in some instances, have a topographic contrast smaller than 15 pm. Nevertheless, we observe a contrast in the field-emitted current as high as 10%. This non-topographic collector material dependence is a yet unexplored degree of freedom calling for a new understanding of the quantum mechanical tunnelling barrier at the source site that takes into account the properties of the material at the collector site.

PurposeThis study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV–kV, MV–MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI).Methods and MaterialsThe QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV–kV, MV–MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation.ResultsThe 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV–kV was negligible, the maximal discrepancies between CBCT and MV–MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were

Purpose: Electron radiation therapy dose distributions are affected by irregular body surface contours. This study investigates the feasibility of three‐dimensional (3D) cameras to substitute for the treatment planning computerized tomography (CT) scan by capturing the body surfaces to be treated for accurate electron beam dosimetry. Methods: Dosimetry was compared for six electron beam treatments to the nose, toe, eye, and scalp using full CT scan, CT scan with Hounsfield Unit (HU) overridden to water (mimic 3D camera cases), and flat‐phantom techniques. Radiation dose was prescribed to a depth on the central axis per physician's order, and the monitor units (MUs) were calculated. The 3D camera spatial accuracy was evaluated by comparing the 3D surface of a head phantom captured by a 3D camera and that generated with the CT scan in the treatment planning system. A clinical case is presented, and MUs were calculated using the 3D camera body contour with HU overridden to water. Results: Across six cases the average change in MUs between the full CT and the 3Dwater (CT scan with HU overridden to water) calculations was 1.3% with a standard deviation of 1.0%. The corresponding hotspots had a mean difference of 0.4% and a standard deviation of 1.9%. The 3D camera captured surface of a head phantom was found to have a 0.59 mm standard deviation from the surface derived from the CT scan. In‐vivo dose measurements (213 ± 8 cGy) agreed with the 3D‐camera planned dose of 209 ± 6 cGy, compared to 192 ± 6 cGy for the flat‐phantom calculation (same MUs). Conclusions: Electron beam dosimetry is affected by irregular body surfaces. 3D cameras can capture irregular body contours which allow accurate dosimetry of electron beam treatment as an alternative to costly CT scans with no extra exposure to radiation. Tools and workflow for clinical implementation are provided. [ABSTRACT FROM AUTHOR]

Purpose: This study was to propose and validate an efficient and streamlined quality assurance (QA) method with a single phantom setup to check performances of patient positioning guidance systems including six-degree-of-freedom (6DoF) couch, X-ray modalities (kV–kV, MV–MV and CBCT), optical surface imaging system (AlignRT), lasers and optical distance indicator (ODI). Methods and Materials: The QA method was based on a pseudo-patient treatment plan using the AlignRT cube phantom. The cube was first randomly set up on the couch, and the initial position offsets were acquired by AlignRT and CBCT. The cube was restored to its reference position by 6DoF couch shift, during which the couch motion accuracy and tracking performances of AlignRT and CBCT were derived. After that, the residual offsets were acquired by kV–kV, MV–MV and AlignRT to derive the isocenter discrepancies. Finally, the laser alignment and ODI values were visually inspected. The QA procedure had been internally approved as a standard weekly QA test, and the results over 50 weeks were longitudinally analyzed for clinical validation. Results: The 6DoF couch motion errors as well as the tracking errors of AlignRT were sub-millimeter and sub-degree, and no deviation over 1 mm or 1 deg was identified. The ROI mode of isocenter (ISO) in AlignRT exhibited more consistent results than the centroid (CEN). While the isocenter discrepancy between CBCT and kV–kV was negligible, the maximal discrepancies between CBCT and MV–MV were 0.4 mm in LNG and 0.3 deg in PITCH. The isocenter discrepancies between CBCT and AlignRT were <0.5 mm in translation and <0.3 deg in rotation. For AlignRT, the isocenter discrepancies between the DICOM and SGRT references were about 0.6 mm in VRT, 0.5 mm in LNG and 0.2 deg in PITCH. As the therapists became familiar with the workflow, the average time to complete the whole procedure was around 23 min. Conclusions: The streamlined QA exhibits desirable practicality as an efficient multipurpose performance check on positioning guidance systems. The stability, tracking performance and isocenter congruence of the positioning guidance systems have been fully validated for all clinical image guidance RT application, even SRS/SBRT, which requires the strictest tolerance. [ABSTRACT FROM AUTHOR]

Advances in flexible integrated circuit technology and piezoelectric materials allow high-quality stretchable piezoelectric transducers to be built in a form that is easy to integrate with the body’s soft, curved, and time-dynamic surfaces. The resulting capabilities create new opportunities for studying disease states, monitoring health/wellness, building human–machine interfaces, and performing other operations. However, more widespread application scenarios are placing new demands on the high flexibility and small size of the array. This paper provides a 8 × 8 two-dimensional flexible ultrasonic array (2D-FUA) based on laser micromachining; a novel single-layer “island bridge” structure was used to design flexible array and piezoelectric array elements to improve the imaging capability on complex surfaces. The mechanical and acoustoelectric properties of the array are characterized, and a novel laser scanning and positioning method is introduced to solve the problem of array element displacement after deformation of the 2D-FUA. Finally, a multi-modal localization imaging experiment was carried out on the multi-target steel pin on the plane and curved surface based on the Verasonics system. The results show that the laser scanning method has the ability to assist the rapid imaging of flexible arrays on surfaces with complex shapes, and that 2D-FUA has wide application potential in medical-assisted localization imaging.

Introduction: We investigated the correlation between optical surface imaging using a three‐dimensional (3D) scanner and magnetic resonance imaging (MRI) for suggesting feasibility in the clinical process of tracking volume changes in head and neck patients during radiation treatment. Methods: Ten patients were divided into two groups depending on the location of their tumor (i.e., right or left side). With weekly imaging data, the change in volume based on MRI was evaluated during the treatment course. Four volumes of interest (VOIs) were calculated on the 3D surface image of the facial and cervical areas using an optical 3D scanner, and the correlation between volumetric parameters were analyzed. Results: The target volume changed significantly overall for both groups. The changes parotid volume reduced by up to 3.8% and 28.0% for groups A (right side) and B (left side), respectively. In Group A, VOI 1 on the facial area and VOI 3 on the cervical area decreased gradually during the treatment course by up to 3.3% and 10.7%, respectively. In Group B, only VOI 4 decreased gradually during the treatment course and reduced by up to 9.2%. In group A, the change in target volume correlated strongly with right‐side parotid, VOI 1, and VOI 3, respectively. The parotid also showed strong correlations with VOIs (P < 0.01). The weight loss was strongly correlated with either PTV or parotid without statistical significance (P > 0.05). In group B (left side), the change in target volume correlated strongly with each volumetric parameter, including weight loss. For individual patient, PTV showed more correlation with VOIs on the cervical area than VOIs on the facial area. Conclusions: An optical 3D scanner can be applied to track changes in volume without radiation exposure during treatment and the optical surface image correlated with MRI. [ABSTRACT FROM AUTHOR]

In this paper, we offer a laboratory facility for in situ visualization of the combustion of ultrafine metal powders, which combines laser initiation and simultaneous high-speed recording of images of the flame of a burning material and a surface covered by a flame. Visualization of the surface through the flame is realized using a laser monitor—an optical projection system with brightness amplification. The proposed imaging system makes it possible to get more detailed information about the combustion process, in particular, to study the change in the surface through the flame in the area of laser initiation, and the propagation of heating and combustion waves over the sample, as well as to study the change in the surface reflectance during combustion. To study the area of laser initiation, it is proposed to simultaneously record images of a laser monitor with two cameras. The symmetry of the combustion wave front propagation and the combustion products’ formation during laser initiation of the nanoAl + Fe3O4 thermite mixture was demonstrated. The nature of propagation in the form of a ring is a consequence of the symmetry of the properties of the system under study, at the micro and macro levels.

Among all transition metal oxides, titanium dioxide (TiO2) is one of the most intensively investigated materials due to its large range of applications, both in the amorphous and crystalline forms. We have produced amorphous TiO2 thin films by means of room temperature ion-plasma assisted e-beam deposition, and we have heat-treated the samples to study the onset of crystallization. Herein, we have detailed the earliest stage and the evolution of crystallization, as a function of both the annealing temperature, in the range 250–1000 °C, and the TiO2 thickness, varying between 5 and 200 nm. We have explored the structural and morphological properties of the as grown and heat-treated samples with Atomic Force Microscopy, Scanning Electron Microscopy, X-ray Diffractometry, and Raman spectroscopy. We have observed an increasing crystallization onset temperature as the film thickness is reduced, as well as remarkable differences in the crystallization evolution, depending on the film thickness. Moreover, we have shown a strong cross-talking among the complementary techniques used displaying that also surface imaging can provide distinctive information on material crystallization. Finally, we have also explored the phonon lifetime as a function of the TiO2 thickness and annealing temperature, both ultimately affecting the degree of crystallinity.

Purpose: To develop a novel approach to accurately verify patient set up in proton radiotherapy, especially for the verification of the nozzle - body surface air gap and source-to-skin distance (SSD), the consistency and accuracy of which is extremely important in proton treatment.Methods: Patient body surfaces can be captured and monitored with the optical surface imaging system during radiation treatment for improved intrafraction accuracy. An in-house software package was developed to reconstruct the patient body surface in the treatment position from the optical surface imaging reference capture and to calculate the corresponding nozzle - body surface air gap and SSD. To validate this method, a mannequin was scanned on a CT simulator and proton plans were generated for a Mevion S250 Proton machine with 20 gantry/couch angle combinations, as well as two different snout sizes, in the Varian Eclipse Treatment Planning Systems (TPS). The surface generated in the TPS from the CT scan was imported into the optical imaging system as an RT Structure for the purpose of validating and establishing a benchmark for ground truth comparison. The optical imaging surface reference capture was acquired at the treatment setup position after orthogonal kV imaging to confirm the positioning. The air gaps and SSDs calculated with the developed method from the surface captured at the treatment setup position (VRT surface) and the CT based surface imported from the TPS were compared to those calculated in TPS. The same approach was also applied to 14 clinical treatment fields for 10 patients to further validate the methodology.Results: The air gaps and SSDs calculated from our program agreed well with the corresponding values derived from the TPS. For the phantom results, using the CT surface, the absolute differences in the air gap were 0.45 mm ± 0.33 mm for the small snout, and 0.51 mm ± 0.49 mm for the large snout, and the absolute differences in SSD were 0.68 mm ± 0.42 mm regardless of snout size. Using the VRT surface, the absolute differences in air gap were 1.17 mm ± 1.17 mm and 2.1 mm ± 3.09 mm for the small and large snouts, respectively, and the absolute differences in SSD were 0.81 mm ± 0.45 mm. Similarly, for patient data, using the CT surface, the absolute differences in air gap were 0.42 mm ± 0.49 mm, and the absolute differences in SSD were 1.92 mm ± 1.4 mm. Using the VRT surface, the absolute differences in the air gap were 2.35 mm ± 2.3 mm, and the absolute differences in SSD were 2.7 mm ± 2.17 mm.Conclusion: These results showed the feasibility and robustness of using an optical surface imaging approach to conveniently determine the air gap and SSD in proton treatment, providing an accurate and efficient way to confirm the target depth at treatment. [ABSTRACT FROM AUTHOR]

Surface imaging (SI) has been rapidly integrated into radiotherapy clinics across the country without specific guidelines and recommendations on its commissioning and use aside from vendor‐provided information. A survey was created under the auspices of AAPM TG‐302 to assess the current status of SI to identify if there is need for formal guidance. The survey was designed to determine the institutional setting of responders, availability and length of its use, commissioning procedures, and clinical applications. This survey was created in REDCap, and approved as IRB exempt to collect anonymized data. Questions were reviewed by multiple physicists to ensure concept validity and piloted by a small group of independent physicists to ensure process validity. All full members of AAPM self‐identified as "therapy" or "other" were sent the survey link by email. The survey was active from February to March 2018. Of 3677 members successfully contacted, 439 completed responses; the summary of these responses provides insight on current surface imaging clinical practices, though they should not be assumed to be representative of radiation oncology as a whole. Results showed that 53.3% of respondents have SI in their clinics, mostly in treatment rooms, rarely in simulation rooms. Half of those without SI plan on purchasing it within 3 years. Over 10% have SI but do not use it clinically, 36.8% classify themselves as "expert" users, and 85.5% agreed/strongly agreed that SI guidelines are needed. Initial positioning with SI is most common for breast/chestwall and SRS/SBRT treatments, least common for pediatrics. Use of SI for intra‐fraction monitoring follows a similar distribution. Gating with SI is most prevalent for breast/chestwall (66.0%) but also used in SBRT (33.0%), and non‐SBRT lung/abdomen (<30%) treatments. SI is a rapidly growing technology in the field with widespread use for several anatomic sites. Guidelines and recommendations on commissioning and clinical use are warranted. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of surface image guidance (SG) for pre‐imaging setup of stereotactic body radiotherapy (SBRT) patients, and to investigate the impact of SG reference surface selection on this process. Methods and materials: 284 SBRT fractions (SG‐SBRT = 113, non‐SG‐SBRT = 171) were retrospectively evaluated. Differences between initial (pre‐imaging) and treatment couch positions were extracted from the record‐and‐verify system and compared for the two groups. Rotational setup discrepancies were also computed. The utility of orthogonal kVs in reducing CBCT shifts in the SG‐SBRT/non‐SG‐SBRT groups was also calculated. Additionally, the number of CBCTs acquired for setup was recorded and the average for each cohort was compared. These data served to evaluate the effectiveness of surface imaging in pre‐imaging patient positioning and its potential impact on the necessity of including orthogonal kVs for setup. Since reference surface selection can affect SG setup, daily surface reproducibility was estimated by comparing camera‐acquired surface references (VRT surface) at each fraction to the external surface of the planning CT (DICOM surface) and to the VRT surface from the previous fraction. Results: The reduction in all initial‐to‐treatment translation/rotation differences when using SG‐SBRT was statistically significant (Rank‐Sum test, α = 0.05). Orthogonal kV imaging kept CBCT shifts below reimaging thresholds in 19%/51% of fractions for SG‐SBRT/non‐SG‐SBRT cohorts. Differences in average number of CBCTs acquired were not statistically significant. The reference surface study found no statistically significant differences between the use of DICOM or VRT surfaces. Conclusions: SG‐SBRT improved pre‐imaging treatment setup compared to in‐room laser localization alone. It decreased the necessity of orthogonal kV imaging prior to CBCT but did not affect the average number of CBCTs acquired for setup. The selection of reference surface did not have a significant impact on initial patient positioning. [ABSTRACT FROM AUTHOR]

Purpose: Patients undergoing external beam accelerated partial breast irradiation (APBI) receive permanent tattoos to aid with daily setup alignment and verification. With the advent of three‐dimensional (3D) body surface imaging and two‐dimensional (2D) x‐ray imaging‐based matching to surgical clips, tattoos may not be necessary to ensure setup accuracy. We compared the accuracy of conventional tattoo‐based setups to a patient setup without tattoos. Materials/methods: Twenty consecutive patients receiving APBI at our institution from July 10, 2017 to February 13, 2018 were identified. All patients received tattoos per standard of care. Ten patients underwent setup using tattoos for initial positioning followed by surface imaging and 2D matching of surgical clips. The other ten patients underwent positioning using surface imaging followed by 2D matching without reference to tattoos. Overall setup time and orthogonal x‐ray‐based shifts after surface imaging per fraction were recorded. Shift data were used to calculate systematic and random error. Results: Among ten patients in the "no tattoo" group, the average setup time per fraction was 6.83 min vs 8.03 min in the tattoo cohort (P < 0.01). Mean 3D vector shifts for patients in the "no tattoo" group were 4.6 vs 5.9 mm in the "tattoo" cohort (P = NS). Mean systematic errors in the "no tattoo" group were: 1.2 mm (1.5 mm SD) superior/inferior, 0.5 mm (1.6 mm SD) right/left, and 2.3 mm (1.9 mm SD) anterior/posterior directions. Mean systematic errors in the "tattoo" group were: 0.8 mm (2.2 mm SD) superior/inferior, 0.3 mm (2.5 mm SD) right/left, and 1.4 mm (4.4 mm SD) anterior/posterior directions. The random errors in the "no tattoo" group ranged from 0.6 to 0.7 mm vs 1.2 to 1.7 mm in the "tattoo" group. Conclusions: Using both surface imaging and 2D matching to surgical clips provides excellent accuracy in APBI patient alignment and setup verification with reduced setup time relative to the tattoo cohort. Skin‐based tattoos may no longer be warranted for patients receiving external beam APBI. [ABSTRACT FROM AUTHOR]

Reflection ion microscopy (RIM) is a technique that uses a low angle of incidence and scattered ions to form an image of the specimen surface. This paper reports on the development of the instrumentation and the analysis of the capabilities and limitations of the scanning RIM in a helium ion microscope (HIM). The reflected ions were detected by their “conversion” to secondary electrons on a platinum surface. An angle of incidence in the range 5–10° was used in the experimental setup. It was shown that the RIM image contrast was determined mostly by surface morphology but not by the atomic composition. A simple geometrical analysis of the reflection process was performed together with a Monte Carlo simulation of the angular dependence of the reflected ion yield. An interpretation of the RIM image formation and a quantification of the height of the surface steps were performed. The minimum detectable step height was found to be approximately 5 nm. RIM imaging of an insulator surface without the need for charge compensation was successfully demonstrated.

Purpose: Surface imaging (SI) offers a nonionizing, near real time alternative to radiographic imaging for intrafraction radiosurgery localization. In this work, we systematically compared a commercial SI system vs a commercial room mounted x‐ray localization system in phantom. Methods: An anthropomorphic head phantom with fiducial markers was imaged with linear accelerator on‐board x‐ray imaging, SI, and room mounted x‐ray imaging (RM) at ±45° and ±90° couch angles for three different head tilts and six different isocenters (72 total positions). The shifts generated by the three systems were compared as functions of couch angle, head tilt, and isocenter position with the on‐board imaging shifts used as ground truth. Two sample Kolmogorov–Smirnov tests were used to evaluate equivalence of the groups. Results: The magnitude of the displacement vectors for RM minus on‐board imaging and SI minus on‐board imaging over all 72 phantom positions were 0.7 ± 0.3 mm for both cases. The RM and SI showed no significant difference based on couch angle or isocenter position. Both systems showed decreasing accuracy with increasing couch angle, but both systems agreed with ground truth to <=1.1 mm at all couch angles. The exaggerated chin‐up head orientation showed significantly different shifts for SI and RM based on increased variance in the SI measurements, although both had submillimeter accuracy on average. The standard deviation of the real time SI displacement vector was <0.06 mm over all measurements, during which the on‐board imaging panels partially blocked the lateral camera pods for half the time. Conclusions: RM and SI showed similar accuracy over measurements at 72 different phantom positions. SI showed minimal performance loss with camera pods blocked. SI is a feasible option for intra‐fraction radiosurgery localization based on these phantom measurements. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: We calculated setup margins for whole breast radiotherapy during voluntary deep‐inspiration breath‐hold (vDIBH) using real‐time surface imaging (SI). Methods and Materials: Patients (n = 58) with a 27‐to‐31 split between right‐ and left‐sided cancers were analyzed. Treatment beams were gated using AlignRT by registering the whole breast region‐of‐interest to the surface generated from the simulation CT scan. AlignRT recorded (three‐dimensional) 3D displacements and the beam‐on‐state every 0.3 s. Means and standard deviations of the displacements during vDIBH for each fraction were used to calculate setup margins. Intra‐DIBH stability and the intrafraction reproducibility were estimated from the medians of the 5th to 95th percentile range of the translations in each breath‐hold and fraction, respectively. Results: A total of 7269 breath‐holds were detected over 1305 fractions in which a median dose of 200 cGy was delivered. Each fraction was monitored for 5.95 ± 2.44 min. Calculated setup margins were 4.8 mm (A/P), 4.9 mm (S/I), and 6.4 mm (L/R). The intra‐DIBH stability and the intrafraction reproducibility were ≤0.7 mm and ≤2.2 mm, respectively. The isotropic margin according to SI (9.2 mm) was comparable to other institutions’ calculations that relied on x‐ray imaging and/or spirometry for patients with left‐sided cancer (9.8–11.0 mm). Likewise, intra‐DIBH variability and intrafraction reproducibility of breast surface measured with SI agreed with spirometry‐based positioning to within 1.2 and 0.36 mm, respectively. Conclusions: We demonstrated that intra‐DIBH variability, intrafraction reproducibility, and setup margins are similar to those reported by peer studies who utilized spirometry‐based positioning. [ABSTRACT FROM AUTHOR]

During the past years, atomic force microscopy (AFM) has matured to an indispensable tool to characterize nanomaterials in colloid and interface science. For imaging, a sharp probe mounted near to the end of a cantilever scans over the sample surface providing a high resolution three-dimensional topographic image. In addition, the AFM tip can be used as a force sensor to detect local properties like adhesion, stiffness, charge etc. After the invention of the colloidal probe technique it has also become a major method to measure surface forces. In this review, we highlight the advances in the application of AFM in the field of mineral flotation, such as mineral morphology imaging, water at mineral surface, reagent adsorption, inter-particle force, and bubble-particle interaction. In the coming years, the complementary characterization of chemical composition such as using infrared spectroscopy and Raman spectroscopy for AFM topography imaging and the synchronous measurement of the force and distance involving deformable bubble as a force sensor will further assist the fundamental understanding of flotation mechanism. [ABSTRACT FROM AUTHOR]

Purpose Historically, the process of positioning a patient prior to imaging verification used a set of permanent patient marks, or tattoos, placed subcutaneously. After aligning to these tattoos, plan specific shifts are applied and the position is verified with imaging, such as cone-beam computed tomography ( CBCT). Due to a variety of factors, these marks may deviate from the desired position or it may be hard to align the patient to these marks. Surface-based imaging systems are an alternative method of verifying initial positioning with the entire skin surface instead of tattoos. The aim of this study was to retrospectively compare the CBCT-based 3D corrections of patients initially positioned with tattoos against those positioned with the C- RAD Catalyst HD surface imager system. Methods A total of 6000 individual fractions (600-900 per site per method) were randomly selected and the post- CBCT 3D corrections were calculated and recorded. For both positioning methods, four common treatment site combinations were evaluated: pelvis/lower extremities, abdomen, chest/upper extremities, and breast. Statistical differences were evaluated using a paired sample Wilcoxon signed-rank test with significance level of <0.01. Results The average magnitudes of the 3D shift vectors for tattoos were 0.9 ± 0.4 cm, 1.0 ± 0.5 cm, 0.9 ± 0.6 cm and 1.4 ± 0.7 cm for the pelvis/lower extremities, abdomen, chest/upper extremities and breast, respectively. For the Catalyst HD, the average magnitude of the 3D shifts for the pelvis/lower extremities, abdomen, chest/upper extremities and breast were 0.6 ± 0.3 cm, 0.5 ± 0.3 cm, 0.5 ± 0.3 cm and 0.6 ± 0.2 cm, respectively. Statistically significant differences ( P < 0.01) in the 3D shift vectors were found for all four sites. Conclusion This study shows that the overall 3D shift corrections for patients initially aligned with the C- RAD Catalyst HD were significantly smaller than those aligned with subcutaneous tattoos. Surface imaging systems can be considered a viable option for initial patient setup and may be preferable to permanent marks for specific clinics and patients. [ABSTRACT FROM AUTHOR]

Three-dimensional (3-D) surface imaging has gained clinical acceptance, especially in the field of cranio-maxillo-facial and plastic, reconstructive, and aesthetic surgery. Six scanners based on different scanning principles (Minolta Vivid 910®, Polhemus FastSCAN™, GFM PRIMOS®, GFM TopoCAM®, Steinbichler Comet® Vario Zoom 250, 3dMD DSP 400®) were used to measure five sheep skulls of different sizes. In three areas with varying anatomical complexity (areas, 1 = high; 2 = moderate; 3 = low), 56 distances between 20 landmarks are defined on each skull. Manual measurement (MM), coordinate machine measurements (CMM) and computer tomography (CT) measurements were used to define a reference method for further precision and accuracy evaluation of different 3-D scanning systems. MM showed high correlation to CMM and CT measurements (both r = 0.987; p < 0.001) and served as the reference method. TopoCAM®, Comet® and Vivid 910® showed highest measurement precision over all areas of complexity; Vivid 910®, the Comet® and the DSP 400® demonstrated highest accuracy over all areas with Vivid 910® being most accurate in areas 1 and 3, and the DSP 400® most accurate in area 2. In accordance to the measured distance length, most 3-D devices present higher measurement precision and accuracy for large distances and lower degrees of precision and accuracy for short distances. In general, higher degrees of complexity are associated with lower 3-D assessment accuracy, suggesting that for optimal results, different types of scanners should be applied to specific clinical applications and medical problems according to their special construction designs and characteristics. [ABSTRACT FROM AUTHOR]

Abstract: This study develops an objective breast symmetry evaluation using 3-D surface imaging (Konica-Minolta V910® scanner) by superimposing the mirrored left breast over the right and objectively determining the mean 3-D contour difference between the 2 breast surfaces. 3 observers analyzed the evaluation protocol precision using 2 dummy models (n = 60), 10 test subjects (n = 300), clinically tested it on 30 patients (n = 900) and compared it to established 2-D measurements on 23 breast reconstructive patients using the BCCT.core software (n = 690). Mean 3-D evaluation precision, expressed as the coefficient of variation (VC), was 3.54 ± 0.18 for all human subjects without significant intra- and inter-observer differences (p > 0.05). The 3-D breast symmetry evaluation is observer independent, significantly more precise (p < 0.001) than the BCCT.core software (VC = 6.92 ± 0.88) and may play a part in an objective surgical outcome analysis after incorporation into clinical practice. [Copyright &y& Elsevier]

Abstract: Aim: To investigate the clinical application of a technique for patient set-up verification in breast cancer radiotherapy based on a 3D surface image registration system. Background: Accurate and reproducible patient set-up is a prerequisite to correctly deliver fractionated radiotherapy. Various approaches are available to verify and correct patient setup for 3D image acquisition in a radiation treatment room. Materials and methods: The study analyzed the setup reproducibility of 15 patients affected by breast cancer and candidates for conformal radiotherapy by using the AlignRT system (VisionRT, London, UK). At the initial setup, electronic portal imaging device (EPID) images were compared with Digitally Reconstructed Radiographs (DRRs) and a reference three-dimensional (3D) surface image was obtained by AlignRT. Surface images were acquired prior to every subsequent setup procedure. The systematic and random errors along longitudinal and vertical directions were measured and compared for the two systems. Results: The procedure for surface registration, image acquisition and comparison with the reference image took less than 1min on average. The T test for systematic error showed no significant difference between the 2 verification systems along the longitudinal (p =0.69) and vertical (p =0.67) axes. The T-test for random error showed a significant difference between the 2 systems along the vertical axis (p =0.05). Conclusion: AlignRT is fast, simple, non-invasive and seems to be reliable in detecting patient setup errors. Our results suggest that it could be used to assess the setup reproducibility for breast cancer patients. [Copyright &y& Elsevier]

Abstract: Surface-assisted laser desorption/ionization (SALDI) is a matrix-free mass spectrometry (MS) approach that utilizes the unique properties of a nanostructured surface to promote desorption and ionization. However, there are still questions on what constitutes a suitable SALDI substrate for mass spectrometric application. A range of SALDI substrates prepared by anodization with an oxidizing electrolyte was investigated. The laser desorption/ionization (LDI) performance was examined on a reflectron time-of-flight (ToF) mass spectrometer. The physicochemical properties of the substrates were characterized by a number of surface analysis techniques including scanning electron microscopy (SEM), atomic force microscopy (AFM), secondary ion mass spectrometry (SIMS), X-ray photoelectron spectroscopy (XPS) and water contact angle measurement. Examination of surface cleaning technologies and methods for surface chemical modification were carried out. Correlation between the substrate physicochemical properties and the LDI performance was determined. It was found that only the substrate, which had a thick nanostructured layer, was effective for LDI-MS. SALDI substrate was found to have a high surface potential. However, this unique property offered no advantage for the application of LDI-MS. Surface chemistry is also an important factor in affecting the LDI performance. Plasma etching can effectively remove the surface contamination but it also increases the thickness of the oxide layer. Fluorine and hydroxyl termination is advantageous. Fluorine passivation increases the surface hydrophobicity, which confines the analyte solution droplet to a smaller area and also withdraws the electronic density from the surface, and acidifies the surface Si–OH moieties, which is believed a major proton source. The effect of laser etching was investigated by SIMS and XPS imaging and provided new insight of the SALDI ionization mechanism. [Copyright &y& Elsevier]

Microscopic methods usable for sample surface imaging and subsequent qualitative and quantitative evaluation of platelet adhesion to the surface of the biomaterial studied were compared. It was shown, making use of the samples of medical steel (AISI 316L), that such tools as surface imaging with scanning electron microscopy (SEM), glutaraldehyde induced fluorescence technique (GIFT) and metallurgical microscopy (MM) are equivalent in evaluating surface platelet adhesion. The importance of biological variability of blood samples for a proper result assessment and the necessity of using internal standards were also considered. [ABSTRACT FROM AUTHOR]

The purpose of this study was to demonstrate a novel method of extracting relevant information from undispersed bulk powder surfaces to be used in particle size analysis. A new surface imaging approach for undispersed powders combined with multivariate modeling was used. Digital surface images of various granule batches were captured using an inventive optical setup in controlled illumination conditions. A descriptor, the gray scale difference matrix (GSDM), which describes the particle size of granular material was generated and extracted from the powder surface image information. Partial least squares (PLS) modeling was used to create a model between the GSDM and the particle size distribution of granules measured with sieving. The use of lateral illumination and the combining of information from 2 surface images strengthened the shading effects on the powder surfaces. The shading effects exposed the topography or the visual texture of the powder surfaces. This textural information was efficiently extracted using the GSDM descriptor. The goodness-of-fit (R2) for the created PLS model was 0.91 and the predicted variation (Q2) was 0.87, indicating a good model. The model covered granule sizes in the size range of approximately 20 to 2500 μm. The extracted descriptor was effectively used in particle size measurement. This study confirms that digital images taken from undispersed bulk powder surfaces contain substantial information needed for particle size distribution analysis. The use of the GSDM enabled the utilization of bulk powder surface information and provided a fast method for particle size measurement. [ABSTRACT FROM AUTHOR]

The partial oxidation of n-butane at high alkane to oxygen ratio was studied in the presence of a Pt–Rh gauze and in an empty tubular reactor under identical conditions.Temperature-programmed reaction (TPR) experiments with the metal gauze showed dramatic changes in the product distribution in the range 25–500 °C. Total oxidation of butane at low temperature is followed by selective conversion to olefins and oxygenates around 400 °C; a further increase in the oven temperature enhances selectively olefins formation.In situ infrared and visible imaging of the reacting gauze revealed remarkable ignition/extinction phenomena of the surface reactions. Fast ignition on the metal catalyst was observed around 200 °C; upon further raising the oven temperature, suppression of these reactions occurred at a temperature level corresponding to the transition to high selectivity conditions. These results indicate a shift from heterogeneous to homogeneous reaction mechanism, the latter being responsible for high selectivity to partial oxidation products (84% olefins+oxygenates). With the empty reactor, conversion and selectivity were similar to those obtained in the presence of the catalyst.The study shows that the gauze plays no significant role in butane partial oxidation, as reactions take place in the void upstream of the catalyst, presumably via an alkylperoxy intermediate. [Copyright &y& Elsevier]