Hello, everyone. I'm very happy to be there. Let's start. This is defeating VPN always on. My name is Maxime Clemens. As you can hear, I'm French. Hopefully the speech-to-text will be able to translate what I can say. Sorry if that's not the case. Yeah, okay. I got my first indistinguishable. Okay. Let's go. I work in Luxembourg. It's a very small country. I work in the PwC company. Do we have anyone from PwC in the room? Yeah. Great. Okay. Okay, let's start. So I will try to show you how our liaison can be a bit off sometimes. So the reason of this talk is that I uncontrolled this kind of control during some penetration tests on. I managed to find one bypass, then two bypasses, then three. So I decided to dig further and to try to better understand how it works when it does not really work. We will start with the high-level concepts, with the components of always on, and then we will see the practical analysis. So what it is made of. We will almost directly identify some naive attacks. I would say naive because we don't need to understand exactly how it is implemented. Just based on the documentation, we will find some attack that might work or not. Those attacks on the results will raise some questions. And maybe we will need to look behind the scenes to better understand all these results. We will inspect some of the filters to try to find new attacks that will allow us to break free from the always on.  So who is this talk for? Definitely red teams or offensive teams. I will try to show some of the attacks that I found that will allow you to defeat always on to bypass this control. For the blue team, of course, I will try to show what are the main issues that we have in the most popular VPN agents. Or definitely we will try to improve the situation here. Most importantly, we can find a lot of ways to actually bypass VPN always on. I will be focusing on all the techniques that we can use without privileges, without complex tools, without specific attacks. So I'm really looking forward to showing some attacks that anyone can replay so that you can use it in your offensive assignments, for instance, on the victim side as well. I want to run some attacks that might work without privileges. So the main concept I guess that I don't need to explain what the VPN is, but I'm specifically referring to VPN in the corporate context. So if the company, the organization tries to protect their remote end users, then of course they will try to implement a tunnel so that you can get all the protection from the corporate controls. If you know VPN, then you might already know the differences between split tunneling and full tunneling, but today we are going to focus on always on, which is also called lockdown mode, which is again like full tunneling mode, but then with the user is not even able to disable the control. So it will be forced to connect to the VPN gateway. Today I selected three editors that we are going to attack and we are going to review how they are implementing such controls, but basically they are almost all the same. If you look at the documentation of other providers, you will see that they are probably going to be vulnerable to the same things. So this is the typical symptoms of having enforced always on, on Windows machine, for instance. You will see the quite typical general failure, like when you are doing some ping comment, it will not say that the ping is not coming back and that there is no response. Now it will be this weird message, general failure. So this is kind of a typical symptom that we can have on. Obviously, if the tunnel is not established, like I took AVNT for instance, then in that case we have a restricted network access. We will get some error messages from the browser. And again, since it is enforced, the end user is not able of, cannot disable this control. So we will get some other error messages. In the scenarios that we have, obviously if we are admin, if we can steal all the data by plugging in USB key, if we can decrypt the drive, all those we are not, I would say they are not relevant for this scenario. I'm really speaking about a scenario in which the endpoint is very well hardened, so the end user doesn't have any admin access. We cannot just plug a USB key, and so on, and so on. So the web proxy in the corporate environment is doing TLS interception, so everything is there to actually prevent any kind of data leak or any kind of C2 bidirectional channel. But another thing very important, we know there have been many talks about exfiltration with sound, electromagnetic noise, pixel, QR code and so on. They are great, but we are really interested in simple things with high throughput. So we want to be able to exfiltrate big files, for instance. So we need to find much effective attacks. The scenarios that we are going to consider, obviously the first one, the hacker in the middle, the hacker does not have access to the target device, so the target device can be a laptop, typically. And the other scenario that we can consider is if the attacker has access to the device or if it is a malicious insider, then obviously it will be able to do both commands on the laptops as well as controlling the network. So enough theory, let's have a look at some of the components that are needed for always on to work. The first one is trusted network detection. Of course, the local VPN agent must understand, must conclude if it has to connect to the gateway or not. So for this, the algorithms that are being implemented in the VPN agents are called trusted network detection. When outside of the trusted network, the VPN agent needs to know if the gateway is directly accessible or not, because if you are behind a captive portal, for instance, you will not be able to reach the VPN gateway and you will be first allowed some specific network access until you can authenticate on the captive portal, pay what you want or just enter your credentials until you are authenticated and then you can eventually reach out the VPN gateway. If we look at the implementation of trusted network detection in the three VPN agents that I selected, it's more or less the same. Let's take for example Cisco to determine if we are on the trusted network, then it can use the internal DNS suffix or the internal DNS server IP. Just to mention a very important point here, Cisco is the only one provider that is actually proposing an option that is secure enough. So if you want to determine that you are on the LAN, on the trusted network, then you can still use the fingerprint of TLS certificate. So this in my opinion is the only way you can do that properly, but it's so impractical that to be honest, I've never seen that implemented correctly in the wild. For the other ones, you can see that it's also something that are pushed by JCP offers or IP settings, these kind of things. I'm already showing the pass on location of these settings on logs because we will actually find all the values that we need to attack these agents. Another observation is the files that we have there on the logs, they are all user readable. So you do not even need admin rights to get these files to read them and to understand what is expected so that the VPN agent will conclude that it's on the trusted network. Obviously, most of these checks can be tracked. Finally, I referred to split turning earlier. This is also where you will find all the exceptions for the IPs, domains that you can connect to directly. If you look at these files, you might already find everything you need to perform your attack if you want to break free from this situation. Let's move on to the captive portal detection. So it's a kind of security trade-off for connectivity. I just explained there what are the main algorithms that are being used to determine if the laptop, if the system that you are using is directly connected to the Internet or not. For Microsoft, Google, and Apple, it's quite similar in the way that they are performing some HTTP requests and depending on the response, of course, it will determine that you are directly connected or not. When not, if this check fails, then it is assumed that you are behind a captive portal and this is where you will get the prompt that you need to authenticate with your web browser before you can get access to the Internet. The VPN agents that I'm going to, I would say, attack today are using a combination of these tech checks, but for Cisco, it's a bit different. It will use some HTTPS connection before, but all these tests can be tricked. So we had a look at trusted network detection. We had a look at captive portal detection. Obviously, you know that we can already find some attacks that we can try. But just a quick reminder, what you are trying to achieve there is to do some data expiltration, but with important files, very big stuff, or to establish a commoner control with a bidirectional channel. So this is what we try to achieve there. And again, with the constraints, we are not admin or we do not even have access to the laptop itself. We want simple attacks. We don't want to use binaries that we would have to compile and to put on the laptop and so on. And again, the endpoint is hardened. So as you understood, the VPN agent still needs DNS to work because this will be the only way for it to get the IP address of the gateway, the VPN gateway. So, thankfully, we can think that maybe we can use DNS ourselves in order to establish some tunnel. And indeed, it works. So indeed, I mentioned some of the tools right here, but again, we do not need any external tools to do these kind of things. We can simply use PowerShell, for instance, that is capable of doing DNS on LLMNR. The conclusion for this quick on-nive attack is that it will work for Cisco on Palo Alto. The UDP LLMNR will work with Palo Alto only and with Eventi, nothing works. So it's not possible to try to establish a tunnel or to send some data over DNS with Eventi. We already found some discrepancies here that I will try to explain later. Another example of attack that is highly effective is if you are able to do some Ethernet management like with Slim Machine or these kind of things, but they only make sense if you are inside the corporate environment and you have access to network plugs. So let's not discuss about this there. The third option that we have, based on the design issues of VPN Always On, is that we can try some other protocols that could be there and that could be useful and that could work. Honestly, I wanted this talk to be about some crazy exfiltration protocols and ideas that I have, but it was so easy to bypass the actual controls that we can already forget about those, especially since I do not want to compile or to add some new binaries to the victim machines. Okay, I mentioned DNS, but we do not really need to comply with the DNS protocol. We can simply try to use UDP 53 as an outbound connection to try to send some data grams, you know. It will be much more effective than a DNS tunnel because then we will have the full bandwidth that we can try to send. So I'm just putting there a very naive PowerShell script because we can use the UDP client PowerShell function that will allow us to send some data grams over the port that we like. On again, some kind of discrepancy there. So this is a not DNS UDP 53. It will work with Cisco on Palo Alto, but again, not with Eventi. So you might think that, okay, Eventi managed to implement a much better always-on feature. Wait for the end of this talk. For some reasons, you might think that, okay, DNS worked, but we also need DHCP to be working even if we haven't always enabled. Well, it did not work at all for any of these three, and we will try to figure out later. Another thing that I found interesting is a kind of lockdown grace period that can be observed for Cisco on Eventi. So as long as we get the DHCP response with an IP in it, then for Cisco on Eventi, it will take them between four to 10 seconds in my experience before the connection is, I would say, locked again. Unfortunately, this is long enough to get this kind of screenshot that I know you like seeing on your screen. You are completely able to get the hashes of the user with Responder or any other tool. So this is well enough either to get this kind of hash or to extract some small files already. So you have nothing to do just with this grace period. You can already get some nice results. But again, another discrepancy with Palo Alto Global Protect, there is no such grace period observed. So again, something that we will try to answer later. So I mentioned captive portal detection. It's kind of obvious what we will try to do there now. If you remember some of the algorithms that I explained about, okay, how can we determine if we are behind captive portal or not? Well, then it's trivial to spoof, this kind of things. And I'm just suggesting some IP tables will allow you to make the VPN agent to think that you are behind a captive portal and it will unlock some connectivity so that you can use that on authenticate. So for event T on Palo Alto, it's just with the 80, HTTP, so TCP 80 port for Cisco. It just requires to redirect the 443 as well just because of the algorithm that they use. But now that we can pretend we are a captive portal, the VPN agent will unlock some connectivity and we can then try to steal credentials. We can try to establish bidirectional channel to exfiltrate data on to send some commands. So we can try that. On the right, I wrote a very, very naive captive portal web server which will pretend that we have to authenticate to connect. So based on, thanks to the IP tables rules, we will redirect all the connection to that. Depending on the type of VPN agent, we will have, I would say, different outcomes. So for Cisco, by default, it's five minutes of unlocked access. We must use the embedded browser. But the embedded browser has all HTTP features that you might need to establish a tunnel or to exfiltrate some data. For Pulsecure or the new name of Pulsecure is event T. Then it's not even restricted to the captive portal IP so you can have access to the full LAN as long as event T believes that you are behind a captive portal. But we are still forced to use the embedded browser. For Palo Alto, there is no restrictions on the binary that is authorized to connect on the network. So as long as you pretend you have a captive portal on the network, you can then use any binary, any program to connect on the network. And I'm just giving an example where we can simply use some HTTP form to upload some files on. It was very naive. You can use any other more convenient web server that you want to do some file sharing, to do your C2, whatever. It can work this way. Now I think it's time to move on to the most interesting attack, I believe, because it's definitely the most powerful one. It will completely unlock the network access. So as I mentioned, the trusted network detection for the vulnerable ones, again, I have to insist, Cisco made a night job because they are the only ones to propose something that is secure enough. But for the other one, it's either IP values or DNS values that are pushed in GHCP offers.  Again, ping is trivial to spoof. So if we combine all this information, indeed, not only all these values can be spoofed, there is no authentication on these values, but they are also returned in clear in the logs or in the configuration, and they can also leak in the traffic. So you will be able to see all these values in the traffic.  So we will try to pretend that our rogue network is the actual LAN, and you will see that it will be happy with it. So I'll just give you an example with Cisco that has not been configured with the trusted network, or the secure version. So it's not a TLS certificate there, but you can see that, okay, it will consider that we are not trusted network, while that's not the case, obviously. And then that the network access is available. Yes, this is what we want to do, even though the Divcon bank does not exist at all, but Cisco will be happy with what we give in our DHCP offers. So let's try to explore that. I will give the examples for the three. You will see that it's more or less the same. On the left we have, on the right, sorry, top right we have an extract of the eventy connection settings. So it is located at this pass. It is user readable, and you will find the connection policy there that is Boolean statement that will combine all the criterias, all the checks that are available. So if we want to avoid the VPN agent to force the connection, we just have to simply understand the Boolean logic here and try to inverse it. And we can do it one by one. So I will be using DNS mask as a DHCP server, as well as the DNS server. I will simply say that, okay, let's look at every values that is expected there, and I will propose everything so that eventy will believe that it's on the social network. So I will use host record. I will just write what is expected there. DHCP launch, I will write something that matches with what is expected there. On DHCP option six for the DNS server IP, I will just give it what it wants to read. If I do that, eventy will consider that the device is connected to the internal network and completely unlock the network access. So unfortunately for eventy, they only implement weak or spoofable trusted network detection check. DNS server, DNS A records on interface IP launch. And you can select and you can create a very big statement. Since it will only be composed of these spoofable checks, you will always be able to pretend you are the trusted network. Let's move on to the TND of Cisco. Again, if it is not configured with this secure trusted network, it will only use the trusted DNS domain on sometimes the IP address of the internal DNS domain. These values can be found in the profile, in an XML file at this location. And if you do that, it will be enough for Cisco to consider that, okay, this is indeed the trusted network. And since I like to work in a very convenient and easy way, I can also tell you that if you run this command, that works, but you can also avoid any conflicts with your already running DNS mask. And you can use that on the default hotspot features on any user friendly Linux distribution. If you put all these values there in the command line, you put them in the DNS mask shared configuration, it will peacefully run along the already running DNS mask, and you will not even need to run any commands actually to spoof the trusted network. And let's finish with Palo Alto because it's also vulnerable. This time, it will not be in the configuration because good for them. They decided to encrypt part of the configuration. Nice, unfortunately. The same values are leaking in clear text in the logs. So you will find everything you need as well. There you will see the IP on the name of the host. On little trick, it's not a DNS A record that is expected, it's a DNS PTR record. So it will require you to do some effort on to write the IP address in the inverse order. But once you do that, you are completely breaking free from the always on feature, and you have access to that. So just to show you this how quickly it can be in a short demo, on the left of the screen, you will see the target machine with Cisco VPN agent. And on the right, you will see my own Linux distribution with this DNS mask that is running. Okay, so I will first try with giving the nope.local, which is not the expected value. So we will see that when we do that, I'm trying some pings so that we can see the results almost in real time. You will see that we might get some ping response because of the grace period that I explained earlier because Cisco is amenable to that. Now since it is not the DHCP value, since it is not the internal DNS domain, we will see that Cisco is not happy about that. And we will definitely try to connect to the VPN gateway, which obviously does not exist for this one, but then I will try with what is expected on what I could see in the configuration file. I'm restarting my DHCP server with the DNS values that I want to push on after a few graphical glitches. Then we should be able to see that Cisco is happy with that. So we get the ping replies, meaning that the network is now completely unlocked, and I just want to see the graphical interface. Thanks. So it's now happy. Consider that we are on a trusted network. On that, we have completely unlocked the network access, and now we can do whatever we want. So again, we did not need to understand how it is completely implemented. I did not need to reverse anything to understand all that. I just had to read the documentation on to do some experiments with some assumptions. But we raised some questions. We have some discrepancies between the VPN agents. We have some things that did not work while we expected such DHCP or other protocols to work. It was not the case. So we will now need admin privileges just to try to understand how it works and try to get new attacks that might be working without privileges, okay? So let's have a look at behind the scene. Behind the scene is the Windows filtering platform. I'm not going to explain it at length there because there are other talks that will deep dive in this. You just have to understand that it is an API that is provided by Microsoft so that you can interact with the filtering engine of Windows. So the main idea is you have a provider that you can define. So it will be Cisco, Eventi, Palo Alto, for instance. They will open a session to the Windows engine, to the Windows kernel, basically. And then they will define some layers on sublayers which are network definitions.  And the filter will simply be something that you will define as, okay, you block this protocol from this IP to this port and you can define everything you want. The Windows firewall is actually using this API. So everything that is network filtering on Windows, on modern Windows platform, is using WFP. I'm showing there some API functions that we will be using later. So because it's using WFP, the Windows filtering platform, we already have some nice tools on Event1 that are already built in Windows. It's part of the NetSH command. You can use NetSH WFP on show filters and it will show you all the filters that are currently enabled on the system. You can see there that since I just run this command again, I have to be admin to execute this command. I will get, as an output, a nice XML file that is quite clear to understand. And I can see there the filter that is being committed by Event1 to block all the outgoing connections. So this is kind of an artifact of the always-on configuration there. And you will see that, okay, this is the name of the filter. This is connectV4, so it will block all the outbound connections on IPv4. And then the main action there is block with no condition. So this is kind of the most important rule of the VPN always-on feature. It will just block everything. So we can inspect all these rules with just a simple command. On the other tools that I want to talk about are WFP Explorer from Pavel Yosifovich on Jams4Show who made a lot of WFP functions available in his nice anti-object manager. Thanks to these two tools, we will be able to actually impact and change the rules or specifically delete some rules. So let's have a look at the WFP Explorer. This is just an attack. It's not an exploit. It's just to prove that it's just by deleting the filters that have been committed to the kernel, to the Windows filtering platform framework, we will be able to get our connectivity back. So I will obviously choose to delete this outgoing V4 rule. Okay, same situation. The tunnel is not established, so I'm in lockdown mode. I cannot connect to anything. I will just select the rule. You can see on the right that as soon as I delete the rule, then the connectivity is back for being to work. But again, that was just to demonstrate or to illustrate these filters. So now that we know what we have to look at, I used and I obviously tried to inspect all the filters so that I could maybe find some nice hard-coded values, some backdoors on some things that could be interesting. And I've done that with Palo Alto, even T. But for Cisco, it did not work. I could not see the filters that were implemented by Cisco for some reason. And it was kind of a big problem for me because I really wanted to see all these filters. So none of the filters implemented by Cisco would show up in the net-to-state WFP output. But by enabling the audit policy, you could have a look at all the things that are being made, all the changes that are being made on WFP. So we can definitely select some event logs that will show the fact that some filters are being committed. But on Cisco, they will commit filters very frequently. So it was very hard to follow. I really wanted to look at all the filters that were being implemented and being pushed to the platform live. So this is where I wrote some Frida scripts to hook all the calls to the API. It was quite long because I wanted to decode everything. Unfortunately, this was not necessary at all, but anyways, I'm using some codes to do that. I will show you this example. So I'm injecting in the VPN agent binary. What I want to do is simply to hook the filter add function based on that, then I will parse all the scripts, follow all the pointers, and so on, so that I can reconstruct the values that are being there pushed in the filters. So by the way, Cisco chose a very nice lead grid there, you can see. But again, I'm happy now because I can look at my filters directly in live, but it will not show up if I'm trying to ask the API after that. I finally get this weird answer that access is denied. So maybe this is why I could not see all the filters on Indeed. One subtlety of the WFP framework is that you can define some security descriptor that will block or reduce the access to the filters themselves, to the providers on everything that you can add to the filtering engine. This security descriptor is a nightmare to parse because it's with a lot of variables, some pointers, so it's really hard to do that. But I got the hint from James Forshohe himself to actually just dump the first values appointed by the security descriptor pointer, and then we will try to parse them automatically with his anti-object manager and try to format that as a security descriptor. And then we finally have this answer that if you want to look at all the filters that are being committed by Cisco, then you will see that system does not even have a read access to these filters. It only has write on delete access. If you want to read these filters, you will need to be local service because only local service has open on read. So we got our answer there, but it's not over. We still need to craft a token that will show that we can be local service. So again, kudos to James Forshohe who actually gave me the trick on Twitter when we discussed about that. And we can see there that we just need to define the token with the local service value there. So you can see that if I'm opening the engine without this token, then I get no results right here. Get filter. If for all Cisco filter, then I got no answer. But if I'm actually using the engine that I use, for which I open a session with the proper token, then I finally get all the filters. So that was kind of good news. Even if I spent several weeks writing something to dump in the function, I just had to do that. But anyways, I got my answers. The other ways to do that is since we are able to hook the functions, we can also try to change these values. So another alternative to do that is to either hook the function call on set the SID on the DACL to null so that everyone, every admin will get direct access to the filters or eventually you can use your admin access to first become owner of the object and then you will be able to change the DACL. So those are just some Pog code that I'm using as well as they are not so complex. But again, you need to be admin to do that. So now that we've managed to get the list of filters, we can now answer our questions if we take them one by one. DHCP was not usable at all because all the permit filters specify this true support as well. This is not possible on Windows if you do not have privileges. So this is why it could not work. The fact that we cannot use TCP DNS on TCP LMNR, well, that's similar. The permit filters are only defined for UDP protocols. The fact that we could not use even DNS tunnel with Eventi, it's because Eventi only permits a system process to be able to use the EDP 53 because with Windows filtering platform you can even define a user, a system, account groups and you can define who can access the network based on these values. And finally for the grace period that is not observable for Global Protect, it's because Global Protect is using persistent filters and not dynamic filters. So the filters are already there at all time and only when it's happy with the connection it will decide to remove that. So unfortunately I could not explain all the attacks that I managed to find, but if you see this table again I insist it's only unprivileged techniques. So I really want to be able to do this kind of break free exercise of VPN always on. But you can see that none of the VPN agent is perfect because they are always vulnerable to at least one of the attack that I explained there. I also found some hard coded values but you do not even need to do that because they are most of the time vulnerable to the trusted network detection which is in my opinion the most important one. The most flexible one. When it comes to recommendation, I try to prepare this talk with all the ideas that I have for detecting all the attacks that I could imagine or that I demonstrated but it's not practical at all. You have to do some correlation. ETW will not give you all the information that you are looking for so you will have to do a lot of things. So let's not waste our time on detection opportunities there and let's directly move on to the prevention part. The security agency in France wrote a very nice report which is full of guidelines and they are a bit extreme but I think that I agree with them. If you want to circumvent the captive portal problem then do not connect on always connect your laptop through a smartphone access point for instance. So you would use 3, 4, 5G just to avoid being connected to any Wi-Fi network that you do not trust. The other way to do that I think they are right you can use your smartphone that will connect to the captive portal and then your laptop will connect through the smartphone. I think that works quite well on Android devices I'm not sure for iOS. When it comes to the trusted network detection well they concluded well before me that most of the mechanisms are not secure except the one from Cisco that is relying on a certificate hash. And the other idea they have I think it's promising but not so convenient is to deploy an internal VPN gateway as well. In that case there will never be any notion of trusted network it will either be connected to the internal gateway or the external gateway. So it's a bit extreme but it works. On from the recommendation from this research I would say that from a configuration point of view for the blue team there you will need to check the access rights. You might want to change them because I use simple users have access to settings on logs and you might also consider looking at your TND on CPD settings. For the implementation issues well now that you get to know the various weaknesses of the VPN agents depending on your own provider you might consider changing a bit how you are configuring them and eventually you can consider deploying your own WFP filter but then you will need to know the API provided by Microsoft it is well documented but it's not so convenient so good luck with that. Key takeaways again as I said always can be a bit off sometimes definitely VPN agents are not securing the always on feature in the same way. None of them is perfect so you have to keep that in mind. Naive attacks work you do not need privileges you do not always need to have access to the laptop that you are attacking on all the information that you need for instance to do the Trusted Networks Poofing are found in files that are accessible to the low privileged user even sometimes on the packets themselves if you are able to do some man in the middle or just to look at what's happening on the wire. TND Spoofing again from my point of view is the most convenient on generic technique on for the rest most of the answers can be found in the documentation itself as well as in open source tools that are well made and that will give you all the answers that you need provided that you are able to look at the trap that I fault into with the Cisco settings. And finally IT admins have to consider configuration mistakes because even if we have weaknesses in the VPN agents themselves we also form in many occurrences the fact that the IT admins change the settings through the end user would also be able to change the profiles on the settings themselves so it's not demonstrated there but it is also something to consider. Thank you very much for your attention .


mean duration per occurrence interval observer agreement right so this one's for a duration type behavior continuous behavior one that you're using time to track right so we got two people are gonna track a particular behavior let's say how long kiddo X kiddo B get Bob let's say how long Bob stays out of seat all right so person one is going to measure oh Bob was out of seat for 35 seconds and person two goes oh no he was out of seat for 30 so we're gonna take in that interval right remember this is done by interval so we're gonna do so we're gonna take that first duration for the lowest duration divided by the highest duration for each interval right we're gonna get a number a ratio right a percentage we're gonna do that for each and every interval that you have within your your time period and then you're gonna average those ratios those percentages so we have the you know so anyway anyway it could be all the way from 0% agreement to 100% agreement in each interval and you have a continuous scale on there and basically unlimited right I mean you average all those out it's a pretty conservative number or a pretty conservative method and it's it's highly preferred it's very useful if you actually have duration type data if you can count it down with it with a stopwatch so use it if you can


So, okay, let's start with this second talk, which is devoted to organ motion management. And as I told you before, I will also use some concepts we have already seen in my first presentation here. When we speak of organ motion in radiation oncology, it's quite clear to all, I think that we speak especially of respiratory motion. But we have to be aware that we have different sources of motion in radiation therapy. Spiritual motion is of course the most important. It's a pseudo-regular motion. It's not completely regular, as all we know. It's predictable in a very short interval if needed. And I'm going to show you later why we think that it's necessary to predict the respiratory motion in some applications. But we also have skeletal muscular motion, which is an irregular, completely regular motion that can be controlled, asking the patient to cooperate and using a positioning device that you have seen in the previous presentation. We also have cardiac motion, which is generally not explicitly accounted for in radiation therapy, okay? We have gastrointestinal motion, which is unpredictable, totally unpredictable, but can be partly limited. And we have motion of the genital urinary system, in particular bladder filling, which is important in prostate treatment, for example. And especially if we use hyperfractionation techniques that take a very long time. For example, I have a direct personal experience with hyperfractionation in prostate that was given in fractions of 40 to 45, even 60 minutes sometimes. And in that time, of course, we have a problem of bladder filling that results in a generally a rotation of the prostate of several degrees. It can reach up to seven, eight, or even nine, or 10 degrees. It can be partly limited with the cooperation and the equation with the patient that has, once again, you have heard in the previous presentation. But for my part now, I have this choice. I will devote my time today with you on just respiratory motion, okay? And in particular, I will do it by analyzing the principal lines that we see in this important document of the double APM, which is management of respiratory motion and radiation oncology, which is not particularly new now. It was published in the year 2006, but still is a very important report which is called the report of the TG-764 for respiratory motion and radiation therapy. So we start by having a look at what anatomical sites we are dealing with when we talk of respiratory motion. Of course, we expect respiratory motion in lung. And for shallow breathing, which means superficial breathing, not forced, okay? We have descriptions in the literature of motion that can reach up to five centimeters for the lung. For the esophagus as well, we have important displacements. We have displacements of the liver up to four centimeters with normal respiration. We have the movement of the pancreas, which is also very important. Pancreas is thought to be an organ that is quite fixed, very deep in the anatomy, but still it's very subject to motion due to respiration. Three to 3.5 centimeters is a normal range of motion in normal respiration for the pancreas, which is really a problem because it's quite close to very critical structures. So if we have an approach of high doses in radiotherapy for the pancreas, which is required because pancreas does not really respond well to low doses. It's really a problem of toxicity for the nearby tissues. The breast moves with respiration. Even the prostate moves with respiration, even if this is generally not accounted for in any way. But I think, for example, or some techniques which fortunately are not common that treated the prostate in the prone position. If you put the patient in the prone position, you have a more severe problem of displacement due to respiration than in the supine position. So you have to be aware of that, of course. And for kidney as well, you can reach several millimeters. This is a table taken from double APM test group 76 that shows you the displacement report from the literature for lung lesions. And it is divided in three columns, which are superior, inferior, motion, interior, posterior, and lateral motion. As we expect, the most important motion of lung lesions is in the superior, inferior direction like this, because it is due to the motion that the diaphragm, okay, which in respiration makes the lesion go down, and in respiration makes the lesion go up. This is the most important. And as you can see, the various studies that are reported here give a displacement of nine to three, nine millimeters, sorry, to three centimeters. This up to five centimeters, three and a half centimeters, and so on. In the anterior, posterior direction, it's less important, but still it's a big range of motion, can reach up to two to 2.5 centimeters, and it is very observed for lesions that are in the upper part of the lung, okay? If you think of a person which is breathing, normally you have an anterior, posterior displacement like this, in this part, but when you go down, you are close to the diaphragm, the motion that you expect is in the superior, inferior direction like this. And this is important if you describe the motion with an external monitor, for example, which always goes practically up and down in the anterior, posterior direction, okay? Please be aware, do not think that any external monitor is describing exactly the direction of motion of what is really inside. This is a similar table for abdominal regions, the pancreas, liver, and kidney, and you can see here that motion of the pancreas is reported up to 3.5 centimeters, which is an important range of motion, of course. The sources of information that we can use to measure or to account for motion in imaging are the one reported here. We have radiography, of course, a double exposure or a cinema modality. We have fluoroscopy with or without fiducial markers that can give us some information on the pattern of motion of a lesion, if it's quite visible. We have ultrasound, but the most important tool that we have is once again CT, and in particular for DCT if available, that is able to describe in a complete, an entire cycle of respiration, giving you the information of different volumes pertaining to the different instants within the respiratory cycle. We will see a movie in a while describing this. We also have MR, and for DMR, but these are very less common techniques, very difficult to be used, and we have seen before, we have PET and 4D PET, which is already quite common in various centers now. Of course, patient training is very important if we have to deal with motion. This, for example, is a graph which is taken from a study coming from 2006, which shows you the variability of the respiratory patterns in free breathing with no patient instructions and cooperation compared to an analogous cohort of patients for which instructions and audio visual feedback was used. And it's quite clear how the variability is much more restricted if you use things like this. Other strategies can be the administration of oxygen, for example, to allow patients that breathe with difficulty to be more cooperative and to maintain a predictable pattern of respiration. The double APM-TG76 report that we have seen gives you several levels of motion management, starting from motion encompassing techniques which are the most easy to do, going up to respiratory gating in increasing complexity in this way, and then with breath hold techniques, forced shallow breathing techniques, and the probably most refined from the technological point of view, which is tracking or respiration synchronized techniques. I will try to show you some considerations on at least three of these levels which are motion encompassing, gating, and tracking in increasing the level of complexity. For motion encompassing, motion encompassing means that we estimate the position of a lesion, a target, like this one, this red dot one, for example, in say, expiration. Then we estimate the position of the same lesion in inspiration, for example, on the two extreme ends of respiratory cycle, and then we build what is called an ITV, an internal target volume defined in this document here. Which is built putting together the clinical target volume with the internal margin, and can be represented, for example, with this dotted line here. And on this volume, you build those distribution that encompasses the whole trajectory of the lesion, which is taken during the motion due to respiration. Of course, the main limitation of this study, it is quite easy to do, even if you do not have a real 4D CT, okay, with the cooperation of the patients, a normal respiration and a CT taken in full inspiration and full expiration during normal breathing, you can actually estimate the range of motion like this. The main limitation of this is that, of course, it takes a lot of volume. You have to irradiate a lot of a healthy tissue to be sure that your dose distribution, which is static, covers something that is actually moving within it, okay? So you're not sparing that much organs of risk and the surround destruction by using this technique. But it's easy, it's readily available in practical all centers, and allows you to miss the target in small fractions of cases. This is an example of motion encompassing. This is taken from a real treatment that was performed some years ago and here you see the situation of the lesion in this sagittal plane, which I suggest you to see rather than the other ones, okay? This is the position of the lesion in full expiration. This is the dose distribution that is built around the lesion to cover it, and this is the situation in full inspiration, okay? So in the inspiration, you see that the lesion moved here, in expiration moves here, the dose distribution is fixed, and the lesion moves within the dose distribution, okay? This is the concept of motion encompassing technique. Well, motion encompassing techniques, of course, still requires margins for uncertainty in position, okay? Do not confuse this one with the concept of passing from CTV to PTV for setup errors. Setup errors are to be accounted for separately for this motion, okay? And this is the concept of gating. Well, the main limitation of motion encompassing was that we had the whole trajectory and we had to move the lesion within a large dose distribution, okay? So why not using, for example, a fixed position like this and switching the beam off when the lesion is moving like this, okay? This is the concept of respiratory gating in treatment delivery. We deliver the treatment just in the phase that we have taken in our city. We have planned the treatment in this phase, and then we have a system at the accelerator which is able to shut the beam off when the position is not the position that we use for treatment planning, okay? This is a respiratory gating. Of course, the main advantage of this is that we can spare volume in this case compared to the other one. The limitation is that we get very long treatment times. It depends, of course, on the fraction of the respiratory cycle that we want to use to do this. If we want to use 25%, for example, the respiratory cycle, we have treatment times that require four times the beam on time compared to the motion encompassing technique. If we use, because we want to be more precise, just one in 10 phases, we, of course, have 10% of beam on time, which is useful, so we have times which can be 10 times longer for treatment delivery, which, of course, is a problem from the clinical point of view. But still, this is the concept of respiratory gating. Sorry. Respiratory gating is made, performed by means of systems like this one. You need an external marker, which can be a block like this one, this thing from an external camera, okay? And it's important to understand what you are looking at is something that is not really the tumor. You are looking to an object that normally goes up and down in the anterior posterior direction like this, while the tumor very often moves like this in the superior inferior, so you have to be aware of this and especially have to be aware of problems like the one reported here. Here you have on the left a case where the motion of the external marker that you use on the chest or abdomen of the patient is described by the green line. The motion of the tumor is described by the blue line, okay? In the left panel, they are very superimposed to each other, so if you use the marker motion to give the beam on time, you are quite sure that you are irradiating the tumor when the tumor is within the window, good for treatment, which is enclosed by these two lines here. But if the correlation between the external motion and the motion of the tumor is bad or is not constant in time, you can get a situation like this one where you get the beam on time corresponding to the marker motion within the window, but this situation does not correspond to the tumor motion within the window, so you are irradiating the tumor or you are missing the tumor because it's not really in the window that it was planned for the treatment. So this is another important limitation of gating together with the limitation due to long treatment time. Well, and this is the concept of tracking. Tracking is not very user-friendly and as we use today, we have just a very few systems that can really do a tracking, a respiratory tracking for radiation therapy, but the concept is to spare the volume together with time by redirecting in real time the beam while the tumor moves like this. You build a dose distribution around the target and then you redirect, you move the beams to move the dose distribution while the target moves. This is done, for example, by this machine here which is based on an industrial robot on top of which is mounted a linear accelerator and by using the whole degrees of freedom of the robot, the system is able to follow in real time the motion of the tumor. This is one of the very few systems available today for tumor tracking, but there are studies for using multi-lift collimator, for example, for tracking which probably will become available in shortly, in probably a few months or few years. What is the problem of tracking? The problem of respiratory tracking is, probably you have already seen in my previous slide, that if you build a dose distribution around your target here, and if you have an organ at risk here which might be the spinal cord, for example, you make a dose distribution by planning in one single phase and then you switch on the system and the actual dose distribution is not what you planned but involves the organs at risk that are around the lesion. So the solution to this is that you need a real 4D planning. It's not like in motion encompassing or ingating where you just need a simple CT for simulation. Here you need a real 4D CT because you need a description of all the respiratory phases and you have to build a dose distribution which takes into account all the situations in the various respiratory phases that you have. And for example, there has been the evidence in the literature in the past of a real deformation of the dose distribution due to this effect here. So it's really a thing to be made with much attention. Okay, problem in motion control include also imaging, of course. We have to be sure that we are using good imaging, proper imaging to describe the situation that we are going to find at treatment. In particular, we need a temporal coherence between imaging for treatment planning and treatment delivery treatment administration. Imaging shall always describe the treatment condition. This is very important. And this is especially important. We have already seen in the previous talk something if we use quantitative imaging to describe the tumor or to describe the type that we want to irradiate. And in particular, if you use PET CT to describe a biological target volume, a BTV. This is what you get in CT if you do not control respiration. You see here that we have motion artifacts. I'm sure all of you are aware of this problem here. And this is the correct coronal slice corresponding to it. And this is the image of a sphere taken at CT in static condition and on top of a table that simulates the normal respiration. And of course, what you get is an object that does not have the volume and does not have the shape of the real object that you had to scan. And this is another important part. You can solve this problem in particular if you have a tracking system with 4D CT. 4D CT is a modality in which you have a CT scanner and an external reference like the blocks we have seen for gating before the accelerator that allows you to make in correspondence each single slice with the instant within the respiratory cycle in which that slice was taken. And this allows you to sort the slices to build N 3D volumes corresponding to the single respiratory cycle. This is what you need absolutely if you use tracking. But once again, if you just use gating or a motion encompassing technique, even a normal CT simulator or CT is enough to get good information. 4D CT can use a prospective or a retrospective acquisition. Very briefly, the prospective acquisition allows you to acquire the volume just in the respiratory cycle that is of interest to you. And this results in dose sparing, of course, but you have limited information on the respiratory cycle. Or you can use retrospective sorting in which you have a redundant acquisition of the volume continuously and sorting which is made just after the acquisition was taken. You have, of course, higher dose here but full information on the respiratory cycle and what you need if you use 4D planning for tracking, for example. Okay, this is just a concept I had already told you. Before. Yes, please. That is a strategy that is good, in my opinion. If you want to use MIP, MIP allows you to get a description of the whole range of motion, right? We do that in some cases. In some other cases, we use a real 4D CT and then we estimate the envelope of positions when we build the CTV. One important consideration to do is that you do not normally need a high number of phases to get a good result. For example, if you compare what happens with 11 phases, which is a standard, which is a standard, a gold standard, I would say, for the CT to six phases, you have an average dosimetric error, which is just 0.3%. If you compare 11 to two phases, you get 1.5%. If you compare 11 phases to an average phase, which is made averaging the two phases taken here, for example, you have 2% error. You make a big error just if you compare the 11 phases with just one instant in the respiratory cycle. So the message is do not aim for a high number of phases if you use 4D CT. Just be aware that resolving the respiratory cycle within different times, just two times is enough to get a good situation for the dosimetric point of view. For magnetic resonance, I would not spend much time on 4D MR because it's really not a modality which is already used for treatment planning today. Still, you can do breath hold here. You have some cinema mode or very short acquisitions like echoplano imaging that allows you to do very fast imaging and get the different instance of the respiratory cycle. Real 4D techniques are not so common and they can use external surrogate signals, for example, or internal surrogate signal like the position of the diaphragm and so on. But once again, it's really still in the research phase rather than a real clinical application. So if you allow me, I will skip this part on MR just to go to PET CT, which is much more important in the definition of the biological target volume to irradiate. This is really very much used today. That is a real quantitative imaging modality as we all know. We do not have just FDG, which is the common modality. I would say it's 99% of the use of PET CT today, but we also have applications in radiation therapy with different traces like fluoromisonidazole here, which is a marker of hypoxia together with copper ATSM and so on. All these modalities have in common a problem, which is the very low signal to noise ratio and the fact that motion can be really a problem for their use. I have already shown you this slide in the previous talk once again. It's a comparison between the SUV, maximum SUV that you get in this lesion here. If you do not take motion into account, here we have an SUV, which is below two, which is quite low, okay? Could be even mis-taken by for a benign lesion if you do not see the real situation here. But if you control motion, you have SUV values which are much higher. Once again, this is a very extreme case. Fortunately, not all the lung lesions behave like this, but it can be an example of what is really happening in reality and how motion control techniques can help you getting the real situation. Motion is of course a problem of quantification here because it has a huge impact on quantification. And the methods that we have today for control of motion impact are scanners like this, which are equipped with a 4D pad system. This is a variant system which is called RPM, which is the same system that in our center we use in one of the linear accelerators. So we have a couple of systems, one in PET-CT, the other one at the accelerator, and allows us to get for the information like this. This is another very extreme case which in my opinion is quite interesting. On top, we see a lesion which is this one, okay, taken with no motion control, which is in full acquisition during the whole breathing cycle. And here we see on the left the maximum inspiration and on the right the maximum exploration situations. You can see that here we do not see the lesion anymore because it's displaced inferiorly in inspiration by the motion of the diaphragm and the motion is still there in expiration. But you can also see two things that are very important. First, the boundary of the lesion is much more defined here than here. And the lesion is even bigger here than here. But on the other hand, we have a problem here and here which is the low signal to noise ratio. I'm sure you can see that the image quality, if you look at this region here, for example, in the mediasional region here, is much less defined than here. This is because with gating, we are losing a lot of information. If we use, for example, five phases and we get just maximum exploration like this, we are discarding 80% of our counts, okay. So the signal to noise ratio that we get is much worse here than here. And you must be aware of this. So one problem is how many phases do we use in 4D path to get a good information? Let's go back to this one. If we want to recover the full quantification for information, we must use nine to 10 phases or 11 like here, okay. But if we do like this, we must be aware that we have a problem of signal to noise ratio which might be very, very low. So maybe the optimum number of phases is around here. I will tell you what is the choice that we have made in our center. We, in our center, we have made this choice. We, if we need the 4D city, we just need, use five phases up to now. Why five? Because if we start, this is time. This is percentage of respiratory cycle from zero to 100, okay. Generally the systems that allows you to do a 4D path use 100% to describe full inspiration, okay.  So this point is the same point here, okay. You start from the beginning from here. The maximum expiration point is exactly in the middle of this graph. Well, if you use an uneven number of phases which might be four or six, you have a division of your graph that splits maximum inspiration into. If you use an odd number of phases like three or five or seven, you get a situation in which your maximum expiration is correctly described by wise one single phase like this. So the choice was between three, five, and seven, okay. Between three, five, and seven. If you look at this graph, if we use three, the signal that we get is quite low once again. If you use five, this is a very extreme case once again, but in the vast majority of cases, if we use five, we get an underestimation of the SUV which is no lower than 10% compared to the maximum, okay. So the choice was if we use four D-pad CT, we just use five phases. Of course there can be more refined strategies to use for the information and to recover the whole signal to noise ratio. For example, we could use one of the techniques of the formable registration that we have seen in the first talk. With the formable registration, we could do something like this. We have a four D CT data set here. So this is for example, maximum inspiration and this is maximum expiration say. We register each single phase to the three dimensional phase with no motion control and we get n maps of the formable registration. Then we take the whole path without motion control and we apply the inverse transformation to get the single phases in path. This is called the virtual four D-pad strategy and allows you to recover both the real shape and the SNR, the signal to noise ratio and the activity of the region. But once again these strategies are not like in the formable registration commonly implemented in commercial systems. It's still in the research stage. So you just have to be aware that it is probably coming in the next years but not yet available. For all techniques of organ imaging with organ motion, we have to rely on tools for quality control. One of the tools of quality control that we can use is the one that you see here. This is a motion phantom which has two important characteristics. First, it can describe both the motion of the surrogate signal which is the block here, the external signal and the motion of the real tumor inside the lung like this. And second, it can be driven with a real, for example, log file taken from a system that describes the respiratory motion of the patient and in this way it's able to describe a real motion and not just a mathematical model like a sinusoidal or something like that. These two characteristics are very important because they allow you to describe exactly what you get in the real patient. And of course, tools like these are not the only tool that you have for quality control of techniques that manage motion. You can also make an analysis of log files of the system, make consistency checks, for example, see if the volume is preserved in inspiration, in expiration to have a real description what is happening in your system and of course you cannot make anything without the expert judgment of a physician that says you if you are taking the wrong or the right direction. I would like to finish this part with an example of a decision tree or whether you have to use, it can be for the PET CT in our case because this is an example of a decision tree we use in our center, but you can as well apply it to for DCT without PET. To make the decision if we need for the technique or not, we first of all see if the anatomical region is affected by respiratory motion and the patient can tolerate the procedure. For the first part, the region affected by the respiratory motion we normally estimate five millimeters of displacement as a minimum. If the patient can tolerate the procedure and needs an explicit technique for the respiratory motion like this one, we estimate the lesion with caution. If the patient cannot tolerate the procedure of course we discard the idea. If the motion is greater than five millimeter, we make the decision to use for DCT or for the PET CT with five phases for the reason I have already told you. If the motion is smaller than five millimeter, we go to a standard planning imaging. And once we have the for the PET CT, we see if we have a close proximity between the target and the organ set risk. If there is a close proximity, we choose the phase which is the one that allows us to spare the organ set risk. If we have no proximity to the organ set risk, we use generally maximum expiration because it is the phase in which the patient spends more time during the breathing cycle and which is more reproducible compared to the other. And then the phase which is chosen is used to build the PTV and then the PTV with the setup error sensor. So in conclusion, tumor motion or organ motion must always be considered and accounted for, but it's not always necessary to do an explicit management of respiratory motion. Sometimes it's really too complicated, too long for the patient, too long for your clinical activity to be performed. Explicit methods for motion management might prolong treatment time and introduce significant uncertainties. For example, we have seen the uncertainty that we introduce if we do not take into account properly the full 4D information in tracking. We need a temporal coherence which is always necessary between imaging for planning and treatment administration. And we also need to put in place a quality assurance program that allows us to validate our technique and see if we are making any important mistake. And finally, it's always necessary to make a balance between accuracy and clinical applicability of the study which can be a very refined technique that allows you to do very nice things but maybe it's too long for your clinical work. So in my opinion, it's always necessary to do a proper balance between these two aspects. Okay, that's all and thank you very much for your attention once again. Thank you.


And... Patriot Prime! And how many minutes on Comic-Con? Comic-Con is in about 50 minutes. Yeah, so Comic-Con is the day. And we're going to do a bunch of toy finding and stuff like that. I hope so. Yeah, we hope so. And I already got my Spider-Man costume on and stuff. We're ready, so... Oh!  Toby McGuire the Spider-Man? Yeah, I am. Yeah, check this out. He's in his Toby McGuire Spider-Man costume. But he's ready to go. He said he wants to get Spider-Man's autograph while he's there.  And he says, hey Patriot and Dylan. See, this is what's cool about doing lives. Yeah. People can actually talk to us. Isn't it awesome? Patriot and Dylan. And they disappear real quick. That's seven people watching right now. So yes, Comic-Con, Roan-Earth's big lick Comic-Con here in Roanoke, Virginia. It's five miles down the road. So it starts at 11. We're going to go and hopefully have a really good time. I agree for you. He says, that's so cool. You. And he says, yo, that's yo, not you. Oh. Yo! Yeah, show them your Spider-Man mask how cool that is. Yeah, look at my Spider-Man mask. Yeah. This is probably the coolest Spider-Man costume I've ever seen. If I was like 80 pounds lighter, I would dress as one too. And I'd shave and I'd go as J. Jonah Jamison in Spider-Man costume. That'd be cool. So what are you, what are you excited about that? I'm excited for the toy hunting and stuff. What kind of toys are you after? Pops. Funko Pops? Anything else? He says, nice costume. Thanks. He says, hello guys. Enjoy your time at the con. Spider-Boy and Pop Pop. Got your swag bag ready, right? Yeah. Want to show them your swag bag? Craig Oxford says, hello Dylan and Patriot Prime. And he says, hello from Colorado Springs.  Thanks. We got to get this boy some more channel content. He hasn't filmed a video in ages. He got switch obsessed. What were you playing Minecraft and? Watching YouTube. Watching YouTube. He watches it. He won't put out content. He keeps saying, dad, I need to make a new video. And we're like, okay, let's do something. Not right now. Oh, any autographs you're trying to get? Go grab my Blu-ray over there. What I want to get autographed. Okay. I'm getting lectured. There's certain things he wants to do at the end of this video. Do you see it's over there at the end? It's the Blu-ray disc. Yeah. This is the one autograph I'm really after. Thank you, sir. Michael Bean from the original Terminator movie is going to be here today. And I want him to sign my Blu-ray copy of the Terminator. That's a, he was Kyle Reese. Y'all remember from the Terminator one, the greatest Terminator movie right there. Cannot wait to meet him. How about you, man? What are you? Any autographs you're wanting to get? Spider-Man. He wants Spider-Man's autograph. I want my autograph. We might see all kinds of Spider-Man there. Oh, that disappeared too fast. That's what I like about doing the lives mobile. Your comments pop up. And if I don't read it fast enough, it feeds away. How do you even do put in a comment? I want to know so that's what type in the comments stuff. People tell me to type in the comments. Well, like right here. There's going to be so many people cosplaying. It is amazing cosplaying is dressing up. I hope you guys have fun getting the things you want and enjoy the father-son day. There's going to be a father-son weekend. Yeah. There you go. Maybe let him review simple figures. Actually, he has his own YouTube channel and he reviews figures. His predator review. He reviewed that Lenard Toys giant predator. That's your biggest one. About 2,000-some views, wasn't it? Yeah. He just does random stuff. He likes his Funko Pop reviews. He's not doing Pokemon cards, but didn't really do anything with that. Can he do funny quips? This is the funniest kid you've ever seen. This guy is hilarious with some of the weird stuff he does. He says if he might ask him for an autograph, he's going to do a Spider-Man pose. So... Yeah. Yeah. So, let's see. What else are you excited about with Comic-Con? This is actually going to be his third convention. He went to Con of the Mountain, a simple con in Virginia. I won a medal. You won a medal. He won second prize in a costume contest. Second? Yeah, you're in second prize. Second place. We'll go for first today. Oh, what's your costume tomorrow? We're going two days. Uh, Shazam. Shazam. And what are you going to do when you walk around Comic-Con as Shazam? Your fun charge. Your fun charge. Your fun charge. You were just asked any video game thoughts. Huh? Any thoughts on video games. What's your favorite Switch game? Right now it's Bowser's Fury. Yeah, Bowser's Fury. He just got that. And so he was jealous he didn't get to go to TF-Con, but I told him with the crowd I was with the TF-Con, he would probably be in his room most of the time because, you know... Drink and wine? Drink and wine. That's right. We were drinking wine. This is my... Gosh, how many conventions have I been to? My very first convention was in 2013. Shardicon. Transformer convention. Shardicon. Con of the Mountain. TF-Con. TF-Con again. Lego convention. This one. That's my sixth one. No, we haven't gone there yet. Okay, we haven't gone there yet. I've been to five. Yeah. Dylan, he says, are you going to eat hot chips too? Yes. Can you smell the BO yet? See, Dylan's going to be lucky. He's going to have a mask on. BO's people that stink. That disappeared too quick. So, let's see. What else? LeVar Burton's supposed to be there from Star Trek and Reading Rainbow Fame. There's going to be a Power Ranger there. Lots of comic book artists.  It's like trying to hold on to a 50-pound octopus. So, what time is it now? Comic... It actually starts at 11 o'clock. If you had a weekend pass, you could go at 10. But they kind of got you. It's either the weekend pass was 25 or it's $16 a day. He gets in free. Weekend pass was 25. But if you ordered online, it was 25 plus an $8 convenience fee. And they're like, well, it's cheaper just to go every day and pay 16. Which Spider-Man is supposed to be at the con? Who knows? They're probably all kinds of different Spider-Man's. A multiverse of Spider-Man's. Can you do Transformers vintage figures? Have you not watched my channel? That's how I started was with Transformers vintage figures. I got a plethora still of Transformers vintage figures to put up. And that's what I'm hopefully will find at the con. I want to get some more vintage ones. I love doing restorations. I actually ran into a guy at work the other day.  Most of them were broke, but they'd be fun to restore. Let's see. Spider-Man Metaverse. It'll be like the Spider-Man multiverse at Comic-Con. Thanks for running your hand through there. Brian says, hey, elites, which hotel were you staying at? Because I swear I saw you last night. Brian Tester. Hey, buddy. What do you think about the Transformers movies? Which is the best one? The one with the unicorn eating the plant? Bumblebee movie? Yeah, the Bumblebee movie. That was a good one. Somebody said the Spider-Man costume he had was the Andrew Garfield Spider-Man costume. I'll show them your shoes. See, his costume has these little sock-type feet, but his mom got him some really cool shoes to wear with the costume. Great boys, show them real quick. Okay, so it wasn't you. It looked like you from the back. Show them those cool shoes. So you've got these cool Spider-Man shoes to wear with his costume. I told him that was in case he stepped in something funky. Got 14 people watching, I'm sorry. Of course it is early on a Saturday. What is your opinion about Rise of the Beasts? I have no hopes for that whatsoever. I just have a feeling it's going to be overblown, a lot of studio interference, and it's going to be screwed up. They're going to take what worked with Bumblebee and flush it down the toilet. That's my personal opinion. I could be surprised, I'm still going to go see it, but I have zero expectations. What time is it for you guys? For me it's 10-01, 10-18. That's what time it is for us two, we're East Coast. So we're going to probably leave here in about 20 minutes. Get ready, are you excited? Yeah. Got our swag bags and stuff to go. We'll pass out some Patriot Prime stuff. Beast Machines. I think I only had like three Beast Machine figures. That's going to be a cool look at those. I'm about to leave, at least as he's getting ready to go. I know that he says remember that Comic-Con people are some of the most nice real world people. Real weird people, you'll ever meet. That's the same with TF-Con. I missed that so much. About an hour down the road I was already having withdrawals from TF-Con. Will you ever like to movie studio series figures? I have a few of them, mainly from Bumblebee. Will do, Brian. Just look for me on Facebook. It's too bad they don't allow the messages on YouTube anymore. I'm hoping to find him, Craig. There's a target right across the street from us. Of course I think those are Walmart exclusives. I don't know, we'll see. Excuse me, I'm choked up. I have tried to. Just look up Patriot Prime reviews on Facebook. Message me that way. Yeah, Leech. Last time I first met you, remember you hid from us. So if I see you, talk to me this time. Okay, Walmart only. Will you do cyberverse transformer figures? I've done one, but those are two kitty from my channel. He may do cyberverse transformers, but here's something sad. Dylan is not that big of a transformers fan as I am. What's your favorite toy lines? What do you like to collect? Funko Pop. Yeah, he's a Funko Pop guy. What do you think of Cad Bane in the book of Boba Fett? He was awesome. They should have put him in the show earlier to be a main antagonist instead of saving him for the end, which I thought was the worst part of that series. The end was the best.  I felt if they did like the Tuscan flashbacks as the beginning of the show, instead of flashbacks and kind of led up to everything, it worked a little better.  Oh, breakfast time. Yeah, got a few left. May, watch for spoilers. Maybe everybody hasn't watched it yet. I have no idea what a Bakugan is. He likes his movie characters and comic book pops. What's the last pop you got? Slimer. One Slimer. Something else.  He's yelling at me. AJJ Prime. But yeah, we both got swag bags. I brought my TF Con bag. Dylan's got his Grogu bag. We couldn't find the Spider-Man one, so he's going to be rocking Grogu. Hope we can find some good stuff. Yeah. Hell no, I'm not going to do any Jurassic Park Mattel figures. You know what's funny? I think Universal has stepped in on that because Barbie is a Mattel property, He-Man is a Mattel property, and those reviewers are being left alone. It's just the Jurassic Park stuff. So I think Universal Studios has stepped in somehow. Yes, it is. You don't know what I'm talking about. No, I was reading one in the comments. That's right. I forget how good you can read now. Who'd you comment to? Don't watch it. He just all of a sudden started reading like that. He said it's Spider-Boy. Is that Webman? Yeah, that's what he said. Okay. See your Webman? Not good with people and being broke. Yeah, being broke is a big thing of this.  So then TF Con, then Christmas, then anniversary, then birthdays, then Valentine's Day. There's a hole in my leg. There's a hole in your leg. That's just a little tiny one. Don't be picking at it. That's your spider pocket. Legacy stuff. Would you quit messing with her up? Legacy stuff isn't out in the States. Yeah, it's not. Somebody says, what's up, Patriot Prime reviews and Dylan's toy box? Dylan apparently can't stand sitting in my lap. He's like holding on to a jellyfish. He's just constantly moving and slimy. What's the occasion for the stream as we're going to Big Lit Comic Con here in about 30 minutes? Quit yelling at me, Gabriel. Oh, guys, by the way, that was not a towel in there. That was a huge blanket. If you watch my video. Well, what do you think? It's about time for us to get ready. He said, LOL. He said, LOL, laugh out loud. Quit giving Dylan monsters to drink. He didn't have a monster. He had a hot chocolate this morning. JJ Prime says he loves your Spider-Man suit. Thank you. What's your son thinking about Spider-Man and No Way Home? What do you think about the last Spider-Man movie? Good. Very good. Very, very good. What's funny is we watched every Spider-Man movie leading up to homecoming. And I was very proud because after we watched them all, Dylan says, Dad, can I watch the old Spider-Man's again? The one with Green Goblin and Doc Ock? Doc Ock's his favorite. All right. Well, you ready to go? Mm-hmm. All right.  I don't know if we'll do live streams from the event because it depends on the internet. So, but we will be doing a lot of filming and there will be videos posted on both of our channels. Want to tell them what your channel's name is so they can find you? Dylan's Toy Box. Dylan's Toy Box. He's even got his own swag. So you guys take care and we will talk to you later. Once again, don't forget to like, don't forget to subscribe. This is Patriot Prime and... Dylan's Toy Box. Signing out. Who are? Now, how do you stop one of these?


When you notice that you're procrastinating, you're putting it off, you're delaying action on an important thing, project or goal. What I want you to repeat to yourself is, it's safe for me to move, it's safe for me to start, it's safe for me to move, it's safe for me to start. Procrastination has nothing to do with laziness or willpower. Procrastination is about safety. We disarm our nervous system and we will move effortlessly into action.