Authors: Shashanksharad Kale, Gopishankar Natanasabapathi, Daya Nand Kishore Sharma
Affiliation: All India Institute of Medical Sciences (AIIMS), Department of Radiation Oncology, All India Institute of Medical Sciences
Abstract Preview: Purpose:
The study demonstrates a novel 3D printing method to fabricate an ion chamber insert (ICI) for absolute dosimetry purpose in gamma knife radiosurgery (GKRS).
Methods:
Our institute u...
Authors: Ming Su, Yuenan Nancy Wang
Affiliation: Northeastern University, Hartford Healthcare
Abstract Preview: Purpose: High Z elements such as lead are often used to protect critical structures in clinical radiotherapy. Nanoparticles have different properties than bulk materials. We proposed a polymer matrix ...
Authors: Izabella L. Barreto, Benjamin Taylor Heggie, Stephanie M. Leon
Affiliation: University of Florida College of Medicine, University of Florida
Abstract Preview: Purpose: 3D printing has the potential for producing materials useful for the imaging field. This work aims to identify absorption (attenuation coefficient) and material properties (effective atomic n...
Authors: Lavsen Dahal, Francesco Ria, Ehsan Samei, Justin B. Solomon, Liesbeth Vancoillie, Yakun Zhang
Affiliation: Duke University, Carilion Clinic, Clinical Imaging Physics Group, Department of Radiology, Duke University Health System
Abstract Preview: Purpose: Clinical diagnostic task-based optimization of CT procedures require precise and organ-specific assessments. This study investigates inter-organ noise variability to highlight the limitations...
Authors: Sarah A. Ashmeg, Travis James McCaw, Joseph Shields, Matthew Spector, Christopher Tyerech, Christopher T Wilke
Affiliation: UPMC Hillman Cancer Center, UPMC Hillman Cancer Center and University of Pittsburgh School of Medicine, Department of Radiation Oncology, UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pennsylvania, UPMC
Abstract Preview: Purpose: Patients with oral cavity cancer often undergo surgical extirpation prior to radiation, and surgical implants are utilized to reconstruct the resulting defect. This study dosimetrically evalu...
Authors: Philip Cutter, Mark D'Souza, Arman Sarfehnia
Affiliation: Toronto Metropolitan University, Sunnybrook Health Sciences Centre, Sunnybrook Health Science Center
Abstract Preview: Purpose: Water calorimetry (WC) serves as an important standard for measuring absorbed dose to water, an essential metric in radiation therapy. WC directly and absolutely quantifies energy deposition ...
Authors: Hungcheng Hank Chen, Laura A. Doyle, Helena Frisbie-Firsching, Amy S. Harrison, Jackson D Reeves, Lindsay B Romak, Jon Strasser
Affiliation: Christiana Care
Abstract Preview: Purpose: Brass mesh bolus (BMB) is a high-density woven metal mesh which is an excellent alternative to tissue equivalent bolus in photon beams, offering improved surface conformality. Unlike utilizat...
Authors: Matthew J Ferris, Jason K Molitoris
Affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, University of Maryland
Abstract Preview: Purpose: Anatomy changes often happen in head-and-neck (HN) patients treated with proton radiation therapy. These changes can result in deteriorations of target dose coverage and increased dose to org...
Authors: Luke Connell, Stephen F. Kry, Malcolm R. McEwen, Bryan R. Muir, James Renaud, Emil Schueler, Hayden Scott, Paige A. Taylor
Affiliation: National Research Council, The University of Texas MD Anderson Cancer Center, UT MD Anderson Cancer Center, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center
Abstract Preview: Purpose: To demonstrate the capability of a robust calorimeter to accurately determine the absorbed dose delivered by an electron FLASH beamline.
Methods: Electron FLASH beams of 6 MeV and 9 Me...
Authors: Brett G Erickson, Joseph P. Kowalski, Xinyi Li, Qiuwen Wu, Sua Yoo
Affiliation: Duke University, Mayo Clinic - Department of Radiation Oncology, Duke University Medical Center
Abstract Preview: Purpose: Characterization and commissioning of the BeO-based myOSLchip system was performed (per TG191) to assess its feasibility as a full replacement for the recalled Landauer aluminum oxide OSL in ...
Authors: Kaile Li, Esmail Parsai
Affiliation: Alexander T. Augusta Military Medical Center, Alexander T. Augusta Miliary Medical Center
Abstract Preview: Purpose: To evaluate the sensitivity of the portal dosimetry system with the Arc CHECK system at identical Volumetric Modulated Arc Therapy (VMAT) setup
Methods: An Arc CHECK system from Sun Nuclea...
Authors: Jonathan J. Chen, Alexei V. Chvetsov, Yulun He, Ramesh Rengan, Andrew Stacey, Kent Wallner
Affiliation: University of Washington and Fred Hutchinson Cancer Center, University of Washington
Abstract Preview: Purpose: To show that the RBE of low-energy photon sources used in COMS (Collaborative Ocular Melanoma Study) eye plaques compensates for protracted irradiation and attenuation of low-energy photons i...
Authors: Hector Andrade-Loarca, Ines Butz, Chiara Gianoli, Prof. Gitta Kutyniok, Jianfei Li, Katia Parodi, Prof. Vincenzo Patera, Angelo Schiavi, Prof. Ozan Öktem
Affiliation: Sapienza University of Rome, Department of Mathematics, Royal Institute of Technology, School of Computation, Information and Technology, Technische Universitaet Muenchen, Department of Medical Physics, Ludwig-Maximilians-Universität München (LMU Munich), Department of Mathematics, Ludwig-Maximilians-Universität (LMU) München, Department of Medical Physics, Ludwig-Maximilians-Universität (LMU) München
Abstract Preview: Purpose: To explore and demonstrate the feasibility of accurate and fast prediction of the water equivalent thickness (WET) distribution of tissue traversed by a proton imaging pencil beam, aiming at ...
Authors: Imad M. Ali, Nesreen Alsbou, Sakeeneh Majeed
Affiliation: University of Central Oklahoma, University of Oklahoma Health Sciences Center
Abstract Preview: Purpose: to design and assess a microwave imaging system equipped with multiple antennas for generating high-resolution 3D images of phantom models that simulate abdominal, thoracic, and brain tissues...
Authors: Edward A. Opalko, Matthew B. Podgorsak, Dheerendra Prasad
Affiliation: Roswell Park Comprehensive Cancer Center
Abstract Preview: Purpose: To design a 3D printed insert for Varian’s SRS Head Phantom that allows for multi-planar film dosimetry and to evaluate its ability in end-to-end testing for Gamma Knife treatments.
Method...
Authors: Jared Baggett, Wesley E. Bolch, Lukas M. Carter, Laura Dinwiddie, Benjamin Taylor Heggie, Adam Leon Kesner, Juan Camilo Ocampo Ramos, Graham Joseph Stoddard
Affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, University of Florida, MD Anderson
Abstract Preview: Purpose: The objective of this study is to develop a physical phantom to quantify tube current modulation (TCM) and assess the limitations of a TCM model used in Monte Carlo patient CT organ dose esti...
Authors: Haonian Gong, Yue Gu, Meiqi Liu, Hsiao-Ming Lu, Yuxiang Wang, Yidong Yang
Affiliation: Hefei Ion Medical Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Department of Engineering and Applied Physics, University of Science and Technology of China
Abstract Preview: Purpose: To develop a proton CT system using scintillator-based 2D dose distribution detection for accurate proton imaging.
Methods: The proposed proton CT system consists of a brass collimator wit...
Authors: Chang Chang, Mohammad Kanber, Stephen Kenneth Northway
Affiliation: East Carolina University, California Protons Cancer Therapy Center, California Proton Cancer Therapy Center
Abstract Preview: Purpose:
Proton therapy treatment planning involves the consideration of unique physical quantities such as Linear Energy Transfer (LET) and spot location maps that do not exist in photon treatment...
Authors: Jordan B Lunsford, Sagar Pokhrel, Ashkan Shafiee, Curtis S. Whiddon
Affiliation: Atrium Health Wake Forest Baptist, University of North Carolina, Atrium Health Wake Forest Baptist High Point Medical Center
Abstract Preview: Purpose: To investigate the dosimetric characteristics of a platinum cured silicone rubber material (Platsil) for use as custom bolus in radiotherapy
Methods: Sheets of 2, 4, 6, and 8 mm Platsil we...
Authors: J Isabelle Choi, Meng Wei Ho, Isabel Lin, Hang Qi, Qi Zeng, Ajay Zheng
Affiliation: New York Proton Center, Scarsdale High School
Abstract Preview: Purpose: Proton therapy is a promising treatment modality for breast cancer due to its unique dosimetric advantage. Accurate dose calculation is critical to ensure effective treatment outcomes. The fo...
Authors: Mervat A. Alharbi, Wesley S. Culberson
Affiliation: Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Medical Physics Department, School of medicine and Public Health, University of Wisconsin-Madison
Abstract Preview: Purpose: The charge collection using ionization chambers is challenging at ultra-high dose rates (UHDR) due to the high ion recombination The Exradin A30 prototype parallel-plate ion chamber manufactu...
Authors: Seohyeon An, Yoonsun Chung, Seonghoon Jeong, Seongmoon Jung, Chae-Eon Kim, In Jung Kim, Sung Hun Kim, Se Byeong Lee, Sang-il Pak, Jong In Park
Affiliation: POHANG ACCELERATOR LABORATORY, Hanyang University, Korea Research Institute of Standards and Science (KRISS), Ilsan Paik Hospital, National Cancer Center, National Cancer Center Korea, Korea Research Institute of Standards and Science
Abstract Preview: Purpose: To evaluate the performance of three ion chambers—Advanced Markus (AMC), PinPoint, and Roos—under FLASH proton beam conditions and assess the response of the nozzle monitor chamber for their ...
Authors: Yunzhi Ma, Ling Zhuang
Affiliation: Northwestern Medicine
Abstract Preview: Purpose: Multiple layers of brass mesh bolus (RPD, Inc., Albertville, MN) may be needed to provide better body conformity and sufficient dose build up on patient surface during electron treatment. Thi...
Authors: Yoshihiko Hoshino, Kenji Hotta, Taeko Matsuura, Ai Nakaoka, Hidenobu Tachibana
Affiliation: Hokkaido University, Department of Radiology, Gunma University Hospital, Radiation Safety and Quality Assurance Division, National Cancer Center Hospital East
Abstract Preview: Purpose: Gel dosimeters enable three-dimensional dose measurements, but no reports have evaluated the fundamental performance of VIPER-type gel dosimeters in proton beam measurements. Therefore, we ev...
Authors: Niels Bassler, Jonathan Bortfeldt, Davide Boscaini, Francesco Evangelista, Guyue Hu, Ze Huang, Margarita Kozak, Julie Lascaud, Giulio Lovatti, Eero Lönnqvist, Jasper Nijkamp, Munetaka Nitta, Prasannakumar Palaniappan, Katia Parodi, Marco Pinto, Per R. Poulsen, Marco Riboldi, Babak Sharifi, Brita Singers Sørensen, Peter Thirolf
Affiliation: Department of Medical Physics, Ludwig-Maximilians-Universität München (LMU Munich), Ludwig-Maximilians Universität, Danish Centre for Particle Therapy, Aarhus University Hospital, Department of Medical Physics, Ludwig-Maximilians-Universität (LMU) München, Department of Experimental Clinical Oncology, Aarhus University, Department of Oncology, Aarhus University Hospital
Abstract Preview: Purpose: To perform the first in vivo application of a novel small animal radiation research platform combining on-board image-guidance with multi-field intensity modulated spot scanning delivery [1] ...
Authors: Niels Bassler, Jonathan Bortfeldt, Carlos Granja, Guyue Hu, Margarita Kozak, Julie Lascaud, Kirsten Lauber, Grigory Liubchenko, Jasper Nijkamp, Cristina Oancea, Prasannakumar Palaniappan, Katia Parodi, Marco Pinto, Per R. Poulsen, Marco Riboldi, Brita Singers Sørensen, Matthias Würl
Affiliation: Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Department of Radiation Oncology, LMU University Hospital, LMU Munich, Department of Medical Physics, Ludwig-Maximilians-Universität München (LMU Munich), Danish Centre for Particle Therapy, Aarhus University Hospital, Department of Medical Physics, Ludwig-Maximilians-Universität (LMU) München, Department of Experimental Clinical Oncology, Aarhus University, Department of Oncology, Aarhus University Hospital, Advacam
Abstract Preview: Purpose: To apply in-vivo proton radiography (pRad) to aid image registration and treatment plan refinement for a novel precision image-guided small animal proton irradiation platform.
Methods:...
Authors: Samuel L. Brady, Joseph G. Meier
Affiliation: Cincinnati Childrens Hospital Med Ctr
Abstract Preview: Purpose:
To establish noise reference levels for our pediatric hospital.
Methods:
Water equivalent diameter (Dw) and image noise was automatically measured by using a global noise algorithm i...
Authors: Alexander Alsalihi, Gary Y. Ge, Charles Mike Weaver, Jie Zhang
Affiliation: University of Kentucky
Abstract Preview: Purpose: The upcoming CMS regulation, titled “Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults”, employs two measures, size-adjusted DLP (SAD) and...
Authors: Harald Keller, Iymad Mansour, Jeff D. Winter
Affiliation: Princess Margaret Cancer Centre
Abstract Preview: Purpose: The growing number of adaptive therapy applications is motivating image segmentation and direct dose calculation on CBCT. The purpose of this investigation is to evaluate the recently release...
Authors: Afrouz Ataei, Xinhui Duan, Mi-Ae Park, Liqiang Ren
Affiliation: Department of Radiology, UT Southwestern Medical Center, UT Southwestern Medical Center, Rush University
Abstract Preview: Purpose:
Photon-counting CT (PCCT) has become commercially available recently, offering significant potential to enhance patient care. However, it also introduces unique challenges. One such challe...
Authors: Liang Cui, Xingyu Lu, Hang Shang, LingHong Zhou
Affiliation: Southern Medical University
Abstract Preview: Purpose: This study examines how varying dose rates of radiotherapy impact normal tissues outside the target area and analyzes the protective effects and regulatory mechanisms of ultra-high dose rate ...
Authors: James Chun Lam Chow, Harry E Ruda
Affiliation: University of Toronto, Princess Margaret Cancer Centre
Abstract Preview: Purpose: FLASH radiotherapy (FLASH-RT) with dose rate greater than 40 Gy/s, has demonstrated potential in reducing normal tissue toxicity while maintaining tumor control. However, accurate and reliabl...
Authors: Mandar S. Bhagwat, Casey Y. Lee
Affiliation: Duke University, Massachusetts General Hospital and Harvard Medical School
Abstract Preview: Purpose: TG43-based dose calculation leads to inaccurate field-size dependent dose calculation in superficial HDR brachytherapy, due to full-scatter condition accounted in TG43, but not during treatme...
Authors: Carina Gassner, Guyue Hu, Thomas Kröncke, Christopher Kurz, Guillaume Landry, Katharina Niepel, Katia Parodi, Franka Risch, Florian Schwarz
Affiliation: Department of Radiation Oncology, LMU University Hospital, LMU Munich, Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Department of Medical Physics, Ludwig-Maximilians-Universität (LMU) München, Department of Medical Physics, Ludwig-Maximilians-Universität München (LMU Munich)
Abstract Preview: Purpose: To evaluate the performance of a clinical photon-counting CT (PCCT) scanner in terms of proton relative stopping power (RSP) estimation using PCCT data and to compare the impact of different ...
Authors: Marcos Feijoo, Mamoru Ichiki, Tatsuya Maeda, Tatsuhiro Makino, Tomonori Megumi, Tadashi Nakabayashi, Yukino Nakata, Shuichi Ozawa, Daishi Takayama
Affiliation: Hiroshima High-Precision Radiotherapy Cancer Center, Blue Physics LLC, Imamura General Hospital, Accuray Inc.
Abstract Preview: Purpose: This study aims to accurately measure the leaf open time (LOT) of the multi-leaf collimator (MLC) in tomotherapy using an advanced plastic scintillator detector (PSD) with high time resolutio...
Authors: Njood Alsaihati, Francesco Ria, Ehsan Samei, Justin B. Solomon, Martina Talarico, Jered Wells
Affiliation: Duke University, Clinical Imaging Physics Group, Department of Radiology, Duke University Health System
Abstract Preview: Purpose: Radiation dose and associated risk in X-ray imaging is principally informed by patient size, further used in Computed Tomography (CT) to achieve prescribed image quality levels through tube c...
Authors: Salahuddin Ahmad, Imad M. Ali, Zaid Alkalani, Nesreen Alsbou
Affiliation: University of Oklahoma, University of Central Oklahoma, University of Oklahoma Health Sciences Center
Abstract Preview: Purpose: To design and evaluate a 3D-detector for proton CT-imaging and radiography, utilizing volumetric plastic scintillator detector exposed to high-energy therapeutic beams from proton therapy sys...
Authors: Paul J. Black, Jordan B Lunsford, James D. Ververs, India Wood
Affiliation: Atrium Health Wake Forest Baptist, Wake Forest University School of Medicine, Wake Forest School of Medicine
Abstract Preview: Purpose:
To develop a 3D-printed modular CT simulator phantom that allows the assessment of all AAPM TG-66 recommended monthly quality assurance (QA) tests.
Methods:
A modular CT simulator mo...
Authors: Haiqa Arain, Ping Xia, Zhexuan Zhang
Affiliation: Cleveland Clinic
Abstract Preview: Purpose: To quantify water contents and thickness of wet towel (as a flexible bolus) on curved surface dose for partial breast irradiation.
Methods: Two VMAT partial breast plans (3000 cGy in 5...
Authors: Chih-Chiang Chang, Chingyun Cheng, Ben Durkee, Minglei Kang, Elissa Khoudary, Yangguang Ma, Xuanqin Mou, YuFei Wang, Tengda Zhang, Wang Zhengda
Affiliation: Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, School of Software Engineering, Xi’an Jiaotong University, School of information and communications engineering, Faculty of electronic and information engineering, Xi’an Jiaotong University, Department of Medical Physics, Columbia University, University of Pennsylvania, Department of Human Oncology, University of Wisconsin-Madison
Abstract Preview: Purpose: This study presents a voxel-based analysis method based on deformable image registration to accurately quantify respiratory-induced motion and deformation of both targets and organs at risk (...
Authors: Wesley S. Culberson, Miguel Angel Flores Mancera, Jeff Radtke
Affiliation: Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison
Abstract Preview: Purpose: Beam current transformers (BCTs) are a promising alternative to ion chambers for real-time monitoring of ultra-high dose per-pulse (UHDPP) beams. The signal of the BCT is insensitive to ion r...
Authors: Joke Binst, Hilde TC Bosmans, Niki Fitousi, Bram Miseur, Dimitar Petrov, Kwinten Torfs, Janne Vignero
Affiliation: Qaelum NV, Department of radiology, UZLeuven, Department of imaging and pathology, KULeuven
Abstract Preview: Purpose: Routine quality monitoring in CT abdomen is crucial for ensuring optimal image quality and patient safety, but the simultaneous evaluation of all aspects of importance is challenging. The pur...
Authors: Anahita Bakhtiari Moghaddam, Don F. DeJongh, Ethan DeJongh, Jennifer Hardt, Oliver Jäkel, Lukas Martin, Alexander Pryanichnikov, Joao Seco, Christina Stengl, Niklas Wahl
Affiliation: Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Division of Biomedical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), ProtonVDA LLC, Department of Physics and Astronomy, Heidelberg University, Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT)
Abstract Preview: Purpose:
To evaluate the feasibility and performance of single-plane position tracking for proton and helium pencil beam radiography using a prototype imaging system, with the goal of providing a c...
Authors: Thomas I. Banks, Tsuicheng D. Chiu, Viktor M. Iakovenko, Christopher Kabat, Chang-Shiun Lin, Mu-Han Lin, Arnold Pompos
Affiliation: Department of Radiation Oncology, UT Southwestern Medical Center, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Lab & Department of Radiation Oncology, UT Southwestern Medical Center, Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX
Abstract Preview: Purpose: The superior soft-tissue contrast provided by MR imaging offers favorable conditions for the effective application of stereotactic body radiation therapy (SBRT). Accurate small field dosimetr...
Authors: Izabella L. Barreto, Benjamin Taylor Heggie, Stephanie M. Leon
Affiliation: University of Florida College of Medicine, University of Florida
Abstract Preview: Purpose: Filament deposition modeling (FDM) 3D printers may utilize proprietary calibration methods inadequate for medical imaging. Proper techniques are necessary to achieve imaging uniformity standa...
Authors: Guang-Pei Chen, Renae Conlin, Juan A. Garcia-Alvarez, Kirk Morris, Haidy G. Nasief, Eenas A. Omari, Eric S. Paulson
Affiliation: Department of Radiation Oncology, Medical College of Wisconsin
Abstract Preview: Purpose: Cumulative dose limits make replacing and calibrating Metal Oxide Semiconductor Field Effect dosimeters (MOSFET-d) used for in-vivo dosimetry a common clinical task. Calibration protocols for...
Authors: Nuraddeen Nasiru Garba, Kalpana M Kanal, Abdullahi Mohammed, Rabiu Nasiru, Muhammad SHAFIU Shehu, Daniel Vergara, Joseph Everett Wishart
Affiliation: AHMADU BELLO UNIVERSITY, ZARIA, University of Washington
Abstract Preview: Purpose: To establish local Diagnostic Reference Levels (DRLs) for head and neck computed tomography (CT) exams in Abuja, Nigeria, and to investigate the performance of brain metastasis (BM) and brain...
Authors: Thomas Furno, Arjen Winkel, Ramtin Zakikhani
Affiliation: Genesis Care USA, QLRAD, SMH
Abstract Preview: Purpose: To quantify the dosimetric impact of the newly introduced “Inframammary Fold (IMF) Breast WedgeTM ” device by QLRAD inc. in the region of the inframammary fold during breast radiotherapy.
...
Authors: Ozgur Ates, Chin-Cheng Chen, Chia-Ho Hua, Matthew J. Krasin, Thomas E. Merchant
Affiliation: St. Jude Children's Research Hospital
Abstract Preview: Purpose: To validate the use of synthetic CTs generated from CBCT images for online monitoring, ensuring accurate and reliable daily plan quality assessments in adaptive proton therapy (APT).
Metho...
Authors: Naruomi Akino, Kirsten Lee Boedeker, Ilmar Hein, Akira Nishikori, Daniel W Shin
Affiliation: Canon Medical Systems Corporation, Canon Medical Research USA
Abstract Preview: Purpose: To validate a simulation tool using physics-based image quality metrics in both phantom and patient data, and to assess the low contrast detectability (LCD) of Super Resolution-Deep Learning ...
Authors: Hadley Anna DeBrosse, Edward J. Stafford, Kevin A. Wunderle
Affiliation: Ohio State University, The Ohio State University
Abstract Preview: Purpose: To investigate automatic dose response curves from fluoroscopes across multiple manufacturers for an abdominal imaging protocol.
Methods: ADRC response for multiple fluoroscopes were evalu...
Authors: Duncan Henry Bohannon, Pretesh Patel, Sibo Tian, Yinan Wang, Xiaofeng Yang, Ahmal Jawad Zafar, Jun Zhou
Affiliation: Emory University, Department of Radiation Oncology and Winship Cancer Institute, Department of Radiation Oncology and Winship Cancer Institute, Emory University
Abstract Preview: Purpose:
4D robust optimization, incorporating additional images (e.g., maximum inhale/exhale phases), is commonly used to account for target motion in proton treatment planning. However, the incre...