We are using a commercial vendor of video processor boards (NVidia) which are both substantially less expensive than the previous generation of custom volume rendering boards as well as haveing a greater potential for growth in performance. The commercial vendor also provides software (CUDA) for utilizing the boards for Monte Carlo calculations, which further supports our research objectives.We have transitioned from 3-dimensional image fusion to exploring 4-dimensional radiotherapy imaging. Our research has established a fundamental relationship between the temporal motion of the 3-dimensional external torso volume and those of internal organs, especially the lungs. Our research has developed a volumetric methodology for image tracking using external torso volume change for which a patent has been applied for.The Electron-Gamma Shower (EGS-4)-based Monte Carlo Dose Calculation Engine (DCE) has been fully implemented in both a LINUX and Windows environment. In the Windows environment, the DCE has been integrated into a full featured treatment planning system. Work is now centered on the development of phase-space source models. Currently, this system is used to investigate small field stereotactic radiosurgery. Due to the reduced field size, edge effects become important and the size of detectors used to access the radiation output affect the measurement results. Monte Carlo simulation of these output measurements greatly assisted in the selection of the detector system that is most suitable for these measurements. The Monte Carlo algorithm provided good agreement with experimental measurements down to applicators as small as 5mm. In a related project, we have adapted both algebraic and Monte Carlo DCEs to predict organ doses received from diagnostic CT scans. The characterization of the x-ray beam from a GE CT Scanner used for clinical scanning at Children's National Medical Center is complete. We have also completed absolute dosimetry measurements linking the standard diagnostic measurement of Computer Tomography Dose Index (CTDI) to actual absorbed dose.Our first manuscript on the CT Dosimetry System (CTDS) has been published and has received an award for Best Imaging Paper of 2011 from the Journal of Applied Clinical Medical Physics. Further research will be a direct comparison of traditional CT dosimetry methodology versus the new CTDS to highlight the advantages of individualized dosimetry and demonstrate organ-specific dose descriptions. Our next goal is to undertake the commissioning of a helical fan-beam CT scanner using a small point-dosimeter, as opposed to the traditional measurement of CTDI employed in diagnostic radiology. The acquisition of a new, state-of-the-art 3-dimensional scanning water phantom will greatly facilitate the necessary measurements. It is hoped that this system will provide the framework for a more complete dose assessment of patient populations for epidemiological dose-response studies. Additionally, we have begun to model the dosimetric behavior of low energy x-ray fields which have energy spectra different from standardized calibration conditions using the Monte Carlo dosimetry system described above. This mapping of dose-response is essential for the proper calibration of x-ray fields from cabinet x-ray units which are widely utilized for radiobiological experiments.