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Sample records for develop treatment plans

  1. Development of Consensus Treatment Plans for Juvenile Localized Scleroderma

    Science.gov (United States)

    Li, Suzanne C.; Torok, Kathryn S.; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T.; Rabinovich, C. Egla; Laxer, Ronald M.; Higgins, Gloria C.; Ferguson, Polly J.; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M.; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A.; Ilowite, Norman T.; Fuhlbrigge, Robert C

    2013-01-01

    Objective To develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile localized scleroderma (jLS). Background jLS is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies have been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment of have made it difficult to compare approaches and identify optimal therapy. Methods A core group of pediatric rheumatologists, dermatologists and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for jLS using consensus methods/nominal group techniques. Recommendations were validated in two face-to-face conferences with a larger group of practitioners with expertise in jLS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the U.S and Canada. Results Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (67% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with jLS. Conclusions Using consensus methodology, we have developed standardized treatment plans and assessment methods for jLS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of jLS. PMID:22505322

  2. Hyperthermia treatment planning

    International Nuclear Information System (INIS)

    Lagendijk, J.J.W.

    2000-01-01

    The development of hyperthermia, the treatment of tumours with elevated temperatures in the range of 40-44 deg. C with treatment times over 30 min, greatly benefits from the development of hyperthermia treatment planning. This review briefly describes the state of the art in hyperthermia technology, followed by an overview of the developments in hyperthermia treatment planning. It particularly highlights the significant problems encountered with heating realistic tissue volumes and shows how treatment planning can help in designing better heating technology. Hyperthermia treatment planning will ultimately provide information about the actual temperature distributions obtained and thus the tumour control probabilities to be expected. This will improve our understanding of the present clinical results of thermoradiotherapy and thermochemotherapy, and will greatly help both in optimizing clinical heating technology and in designing optimal clinical trials. (author)

  3. Development of independent MU/treatment time verification algorithm for non-IMRT treatment planning: A clinical experience

    Science.gov (United States)

    Tatli, Hamza; Yucel, Derya; Yilmaz, Sercan; Fayda, Merdan

    2018-02-01

    The aim of this study is to develop an algorithm for independent MU/treatment time (TT) verification for non-IMRT treatment plans, as a part of QA program to ensure treatment delivery accuracy. Two radiotherapy delivery units and their treatment planning systems (TPS) were commissioned in Liv Hospital Radiation Medicine Center, Tbilisi, Georgia. Beam data were collected according to vendors' collection guidelines, and AAPM reports recommendations, and processed by Microsoft Excel during in-house algorithm development. The algorithm is designed and optimized for calculating SSD and SAD treatment plans, based on AAPM TG114 dose calculation recommendations, coded and embedded in MS Excel spreadsheet, as a preliminary verification algorithm (VA). Treatment verification plans were created by TPSs based on IAEA TRS 430 recommendations, also calculated by VA, and point measurements were collected by solid water phantom, and compared. Study showed that, in-house VA can be used for non-IMRT plans MU/TT verifications.

  4. Monte Carlo treatment planning with modulated electron radiotherapy: framework development and application

    Science.gov (United States)

    Alexander, Andrew William

    Within the field of medical physics, Monte Carlo radiation transport simulations are considered to be the most accurate method for the determination of dose distributions in patients. The McGill Monte Carlo treatment planning system (MMCTP), provides a flexible software environment to integrate Monte Carlo simulations with current and new treatment modalities. A developing treatment modality called energy and intensity modulated electron radiotherapy (MERT) is a promising modality, which has the fundamental capabilities to enhance the dosimetry of superficial targets. An objective of this work is to advance the research and development of MERT with the end goal of clinical use. To this end, we present the MMCTP system with an integrated toolkit for MERT planning and delivery of MERT fields. Delivery is achieved using an automated "few leaf electron collimator" (FLEC) and a controller. Aside from the MERT planning toolkit, the MMCTP system required numerous add-ons to perform the complex task of large-scale autonomous Monte Carlo simulations. The first was a DICOM import filter, followed by the implementation of DOSXYZnrc as a dose calculation engine and by logic methods for submitting and updating the status of Monte Carlo simulations. Within this work we validated the MMCTP system with a head and neck Monte Carlo recalculation study performed by a medical dosimetrist. The impact of MMCTP lies in the fact that it allows for systematic and platform independent large-scale Monte Carlo dose calculations for different treatment sites and treatment modalities. In addition to the MERT planning tools, various optimization algorithms were created external to MMCTP. The algorithms produced MERT treatment plans based on dose volume constraints that employ Monte Carlo pre-generated patient-specific kernels. The Monte Carlo kernels are generated from patient-specific Monte Carlo dose distributions within MMCTP. The structure of the MERT planning toolkit software and

  5. Computerized radiation treatment planning

    International Nuclear Information System (INIS)

    Laarse, R. van der.

    1981-01-01

    Following a general introduction, a chain consisting of three computer programs which has been developed for treatment planning of external beam radiotherapy without manual intervention is described. New score functions used for determination of optimal incidence directions are presented and the calculation of the position of the isocentre for each optimum combination of incidence directions is explained. A description of how a set of applicators, covering fields with dimensions of 4 to 20 cm, for the 6 to 20 MeV electron beams of a MEL SL75-20 linear accelerator was developed, is given. A computer program for three dimensional electron beam treatment planning is presented. A microprocessor based treatment planning system for the Selectron remote controlled afterloading system for intracavitary radiotherapy is described. The main differences in treatment planning procedures for external beam therapy with neutrons instead of photons is discussed. A microprocessor based densitometer for plotting isodensity lines in film dosimetry is described. A computer program for dose planning of brachytherapy is presented. Finally a general discussion about the different aspects of computerized treatment planning as presented in this thesis is given. (Auth.)

  6. Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

    Science.gov (United States)

    Court, Laurence E.; Kisling, Kelly; McCarroll, Rachel; Zhang, Lifei; Yang, Jinzhong; Simonds, Hannah; du Toit, Monique; Trauernicht, Chris; Burger, Hester; Parkes, Jeannette; Mejia, Mike; Bojador, Maureen; Balter, Peter; Branco, Daniela; Steinmann, Angela; Baltz, Garrett; Gay, Skylar; Anderson, Brian; Cardenas, Carlos; Jhingran, Anuja; Shaitelman, Simona; Bogler, Oliver; Schmeller, Kathleen; Followill, David; Howell, Rebecca; Nelson, Christopher; Peterson, Christine; Beadle, Beth

    2018-01-01

    The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated arc therapy (VMAT) plans for patients with head/neck cancer and 4-field box plans for patients with cervical cancer. It is a combination of specially developed in-house software that uses an application programming interface to communicate with a commercial radiotherapy treatment planning system. It also interfaces with a commercial secondary dose verification software. The necessary inputs to the system are a Treatment Plan Order, approved by the radiation oncologist, and a simulation computed tomography (CT) image, approved by the radiographer. The RPA then generates a complete radiotherapy treatment plan. For the cervical cancer treatment plans, no additional user intervention is necessary until the plan is complete. For head/neck treatment plans, after the normal tissue and some of the target structures are automatically delineated on the CT image, the radiation oncologist must review the contours, making edits if necessary. They also delineate the gross tumor volume. The RPA then completes the treatment planning process, creating a VMAT plan. Finally, the completed plan must be reviewed by qualified clinical staff. PMID:29708544

  7. Teaching Treatment Planning.

    Science.gov (United States)

    Seligman, Linda

    1993-01-01

    Describes approach to teaching treatment planning that author has used successfully in both seminars and graduate courses. Clarifies nature and importance of systematic treatment planning, then describes context in which treatment planning seems more effectively taught, and concludes with step-by-step plan for teaching treatment planning.…

  8. WE-F-BRB-00: New Developments in Knowledge-Based Treatment Planning and Automation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

  9. WE-F-BRB-00: New Developments in Knowledge-Based Treatment Planning and Automation

    International Nuclear Information System (INIS)

    2015-01-01

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

  10. Development of an autonomous treatment planning strategy for radiation therapy with effective use of population-based prior data.

    Science.gov (United States)

    Wang, Huan; Dong, Peng; Liu, Hongcheng; Xing, Lei

    2017-02-01

    Current treatment planning remains a costly and labor intensive procedure and requires multiple trial-and-error adjustments of system parameters such as the weighting factors and prescriptions. The purpose of this work is to develop an autonomous treatment planning strategy with effective use of prior knowledge and in a clinically realistic treatment planning platform to facilitate radiation therapy workflow. Our technique consists of three major components: (i) a clinical treatment planning system (TPS); (ii) a formulation of decision-function constructed using an assemble of prior treatment plans; (iii) a plan evaluator or decision-function and an outer-loop optimization independent of the clinical TPS to assess the TPS-generated plan and to drive the search toward a solution optimizing the decision-function. Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines for querying and interacting with the TPS. These subroutines are called back in the outer-loop optimization program to navigate the plan selection process through the solution space iteratively. The utility of the approach is demonstrated by using clinical prostate and head-and-neck cases. An autonomous treatment planning technique with effective use of an assemble of prior treatment plans is developed to automatically maneuver the clinical treatment planning process in the platform of a commercial TPS. The process mimics the decision-making process of a human planner and provides a clinically sensible treatment plan automatically, thus reducing/eliminating the tedious manual trial-and-errors of treatment planning. It is found that the prostate and head-and-neck treatment plans generated using the approach compare favorably with that used for the patients' actual treatments. Clinical inverse treatment planning process can be automated effectively with the guidance of an assemble of prior treatment plans. The approach has the potential to

  11. Development of a Whole Body Atlas for Radiation Therapy Planning and Treatment Optimization

    International Nuclear Information System (INIS)

    Qatarneh, Sharif

    2006-01-01

    The main objective of radiation therapy is to obtain the highest possible probability of tumor cure while minimizing adverse reactions in healthy tissues. A crucial step in the treatment process is to determine the location and extent of the primary tumor and its loco regional lymphatic spread in relation to adjacent radiosensitive anatomical structures and organs at risk. These volumes must also be accurately delineated with respect to external anatomic reference points, preferably on surrounding bony structures. At the same time, it is essential to have the best possible physical and radiobiological knowledge about the radiation responsiveness of the target tissues and organs at risk in order to achieve a more accurate optimization of the treatment outcome. A computerized whole body Atlas has therefore been developed to serve as a dynamic database, with systematically integrated knowledge, comprising all necessary physical and radiobiological information about common target volumes and normal tissues. The Atlas also contains a database of segmented organs and a lymph node topography, which was based on the Visible Human dataset, to form standard reference geometry of organ systems. The reference knowledge base and the standard organ dataset can be utilized for Atlas-based image processing and analysis in radiation therapy planning and for biological optimization of the treatment outcome. Atlas-based segmentation procedures were utilized to transform the reference organ dataset of the Atlas into the geometry of individual patients. The anatomic organs and target volumes of the database can be converted by elastic transformation into those of the individual patient for final treatment planning. Furthermore, a database of reference treatment plans was started by implementing state-of-the-art biologically based radiation therapy planning techniques such as conformal, intensity modulated, and radio biologically optimized treatment planning. The computerized Atlas can

  12. Inverse planning and class solutions for brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Trnkova, P.

    2010-01-01

    Brachytherapy or interventional radiooncology is a method of radiation therapy. It is a method, where a small encapsulated radioactive source is placed near to / in the tumour and therefore delivers high doses directly to the target volume. Organs at risk (OARs) are spared due to the inverse square dose fall-off. In the past years there was a slight stagnation in the development of techniques for brachytherapy treatment. While external beam radiotherapy became more and more sophisticated, in brachytherapy traditional methods have been still used. Recently, 3D imaging was considered also as the modality for brachytherapy and more precise brachytherapy could expand. Nowadays, an image guided brachytherapy is state-of-art in many centres. Integration of imaging methods lead to the dose distribution individually tailored for each patient. Treatment plan optimization is mostly performed manually as an adaptation of a standard loading pattern. Recently, inverse planning approaches have been introduced into brachytherapy. The aim of this doctoral thesis was to analyze inverse planning and to develop concepts how to integrate inverse planning into cervical cancer brachytherapy. First part of the thesis analyzes the Hybrid Inverse treatment Planning and Optimization (HIPO) algorithm and proposes a workflow how to safely work with this algorithm. The problem of inverse planning generally is that only the dose and volume parameters are taken into account and spatial dose distribution is neglected. This fact can lead to unwanted high dose regions in a normal tissue. A unique implementation of HIPO into the treatment planning system using additional features enabled to create treatment plans similar to the plans resulting from manual optimization and to shape the high dose regions inside the CTV. In the second part the HIPO algorithm is compared to the Inverse Planning Simulated Annealing (IPSA) algorithm. IPSA is implemented into the commercial treatment planning system. It

  13. SU-G-TeP1-05: Development and Clinical Introduction of Automated Radiotherapy Treatment Planning for Prostate Cancer

    International Nuclear Information System (INIS)

    Winkel, D; Bol, GH; Asselen, B van; Hes, J; Scholten, V; Kerkmeijer, LGW; Raaymakers, BW

    2016-01-01

    Purpose: To develop an automated radiotherapy treatment planning and optimization workflow for prostate cancer in order to generate clinical treatment plans. Methods: A fully automated radiotherapy treatment planning and optimization workflow was developed based on the treatment planning system Monaco (Elekta AB, Stockholm, Sweden). To evaluate our method, a retrospective planning study (n=100) was performed on patients treated for prostate cancer with 5 field intensity modulated radiotherapy, receiving a dose of 35×2Gy to the prostate and vesicles and a simultaneous integrated boost of 35×0.2Gy to the prostate only. A comparison was made between the dosimetric values of the automatically and manually generated plans. Operator time to generate a plan and plan efficiency was measured. Results: A comparison of the dosimetric values show that automatically generated plans yield more beneficial dosimetric values. In automatic plans reductions of 43% in the V72Gy of the rectum and 13% in the V72Gy of the bladder are observed when compared to the manually generated plans. Smaller variance in dosimetric values is seen, i.e. the intra- and interplanner variability is decreased. For 97% of the automatically generated plans and 86% of the clinical plans all criteria for target coverage and organs at risk constraints are met. The amount of plan segments and monitor units is reduced by 13% and 9% respectively. Automated planning requires less than one minute of operator time compared to over an hour for manual planning. Conclusion: The automatically generated plans are highly suitable for clinical use. The plans have less variance and a large gain in time efficiency has been achieved. Currently, a pilot study is performed, comparing the preference of the clinician and clinical physicist for the automatic versus manual plan. Future work will include expanding our automated treatment planning method to other tumor sites and develop other automated radiotherapy workflows.

  14. Some recent developments in treatment planning software and methodology for BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wheeler, F.J.; Wessol, D.E.; Wemple, C.A.; Babcock, R.; Capala, J.

    1996-01-01

    Over the past several years/the Idaho National Engineering Laboratory (INEL) has led the development of a unique, internationally-recognized set of software modules (BNCT rtpe) for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT). The computational capability represented by this software is essential to the proper administration of all forms of radiotherapy for cancer. Such software addresses the need to perform pretreatment computation and optimization of the radiation dose distribution in the target volume. This permits the achievement of the optimal therapeutic ratio (tumor dose relative to critical normal tissue dose) for each individual patient via a systematic procedure for specifying the appropriate irradiation parameters to be employed for a given treatment. These parameters include angle of therapy beam incidence, beam aperture and shape,and beam intensity as a function of position across the beam front. The INEL software is used for treatment planning in the current series of human glioma trials at Brookhaven National Laboratory (BNL) and has also been licensed for research and developmental purposes to several other BNCT research centers in the US and in Europe

  15. Some recent developments in treatment planning software and methodology for BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wheeler, F.J.; Wessol, D.E.

    1996-01-01

    Over the past several years the Idaho National Engineering Laboratory (INEL) has led the development of a unique, internationally-recognized set of software modules (BNCT-rtpe) for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT). The computational capability represented by this software is essential to the proper administration of all forms of radiotherapy for cancer. Such software addresses the need to perform pretreatment computation and optimization of the radiation dose distribution in the target volume. This permits the achievement of the optimal therapeutic ratio (tumor dose relative to critical normal tissue dose) for each individual patient via a systematic procedure for specifying the appropriate irradiation parameters to be employed for a given treatment. These parameters include angle of therapy beam incidence, beam aperture and shape, and beam intensity as a function of position across the beam front. The INEL software is used for treatment planning in the current series of human glioma trials at Brookhaven National Laboratory (BNL) and has also been licensed for research and developmental purposes to several other BNCT research centers in the US and in Europe

  16. When does treatment plan optimization require inverse planning?

    International Nuclear Information System (INIS)

    Sherouse, George W.

    1995-01-01

    Increasing maturity of image-based computer-aided design of three-dimensional conformal radiotherapy has recently sparked a great deal of work in the area of treatment plan optimization. Optimization of a conformal photon beam treatment plan is that exercise through which a set of intensity-modulated static beams or arcs is specified such that, when the plan is executed, 1) a region of homogeneous dose is produced in the patient with a shape which geometrically conforms (within a specified tolerance) to the three-dimensional shape of a designated target volume and 2) acceptably low incidental dose is delivered to non-target tissues. Interest in conformal radiotherapy arise from a fundamental assumption that there is significant value to be gained from aggressive customization of the treatment for each individual patient In our efforts to design optimal treatments, however, it is important to remember that, given the biological and economic realities of clinical radiotherapy, mathematical optimization of dose distribution metrics with respect to some minimal constraint set is not a necessary or even sufficient condition for design of a clinically optimal treatment. There is wide variation in the complexity of the clinical situations encountered in practice and there are a number of non-physical criteria to be considered in planning. There is also a complementary variety of computational and engineering means for achieving optimization. To date, the scientific dialogue regarding these techniques has concentrated on development of solutions to worst-case scenarios, largely in the absence of consideration of appropriate matching of solution complexity to problem complexity. It is the aim of this presentation to propose a provisional stratification of treatment planning problems, stratified by relative complexity, and to identify a corresponding stratification of necessary treatment planning techniques. It is asserted that the subset of clinical radiotherapy cases for

  17. Investigation of development and management of treatment planning systems for BNCT at foreign facilities

    International Nuclear Information System (INIS)

    2001-03-01

    A new computational dosimetry system for BNCT: JCDS is developed by JAERI in order to carry out BNCT with epithermal neutron beam at present. The development and management situation of computational dosimetry system, which are developed and are used in BNCT facilities in foreign countries, were investigated in order to accurately grasp functions necessary for preparation of the treatment planning and its future subjects. In present state, 'SERA', which are developed by Idaho National Engineering and Environmental Laboratory (INEEL), is used in many BNCT facilities. Followings are necessary for development and management of the treatment planning system. (1) Reliability confirmation of system performance by verification as comparison examination of calculated value with actual experimental measured value. (2) Confirmation systems such as periodic maintenance for retention of the system quality. (3) The improvement system, which always considered relative merits and demerits with other computational dosimetry system. (4) The development of integrated system with patient setting. (author)

  18. SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

    International Nuclear Information System (INIS)

    Kabat, C; Cline, K; Li, Y; Ha, C; Stathakis, S

    2016-01-01

    Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process while also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.

  19. SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Kabat, C; Cline, K; Li, Y; Ha, C; Stathakis, S [University of Texas HSC SA, San Antonio, TX (United States)

    2016-06-15

    Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process while also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.

  20. MINERVA - a multi-modal radiation treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Wemple, C.A. E-mail: cew@enel.gov; Wessol, D.E.; Nigg, D.W.; Cogliati, J.J.; Milvich, M.L.; Frederickson, C.; Perkins, M.; Harkin, G.J

    2004-11-01

    Researchers at the Idaho National Engineering and Environmental Laboratory and Montana State University have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system. This system can be used for planning and analyzing several radiotherapy modalities, either singly or combined, using common modality independent image and geometry construction and dose reporting and guiding. It employs an integrated, lightweight plugin architecture to accommodate multi-modal treatment planning using standard interface components. The MINERVA design also facilitates the future integration of improved planning technologies. The code is being developed with the Java Virtual Machine for interoperability. A full computation path has been established for molecular targeted radiotherapy treatment planning, with the associated transport plugin developed by researchers at the Lawrence Livermore National Laboratory. Development of the neutron transport plugin module is proceeding rapidly, with completion expected later this year. Future development efforts will include development of deformable registration methods, improved segmentation methods for patient model definition, and three-dimensional visualization of the patient images, geometry, and dose data. Transport and source plugins will be created for additional treatment modalities, including brachytherapy, external beam proton radiotherapy, and the EGSnrc/BEAMnrc codes for external beam photon and electron radiotherapy.

  1. Clinical physics for charged particle treatment planning

    International Nuclear Information System (INIS)

    Chen, G.T.Y.; Pitluck, S.; Lyman, J.T.

    1981-01-01

    The installation of a computerized tomography (CT) scanner which can be used with the patient in an upright position is described. This technique will enhance precise location of tumor position relative to critical structures for accurate charged particle dose delivery during fixed horizontal beam radiotherapy. Pixel-by-pixel treatment planning programs have been developed to calculate the dose distribution from multi-port charged particle beams. The plan includes CT scans, data interpretation, and dose calculations. The treatment planning computer is discussed. Treatment planning for irradiation of ocular melanomas is described

  2. Monte Carlo Treatment Planning for Advanced Radiotherapy

    DEFF Research Database (Denmark)

    Cronholm, Rickard

    This Ph.d. project describes the development of a workflow for Monte Carlo Treatment Planning for clinical radiotherapy plans. The workflow may be utilized to perform an independent dose verification of treatment plans. Modern radiotherapy treatment delivery is often conducted by dynamically...... modulating the intensity of the field during the irradiation. The workflow described has the potential to fully model the dynamic delivery, including gantry rotation during irradiation, of modern radiotherapy. Three corner stones of Monte Carlo Treatment Planning are identified: Building, commissioning...... and validation of a Monte Carlo model of a medical linear accelerator (i), converting a CT scan of a patient to a Monte Carlo compliant phantom (ii) and translating the treatment plan parameters (including beam energy, angles of incidence, collimator settings etc) to a Monte Carlo input file (iii). A protocol...

  3. Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma.

    Science.gov (United States)

    Li, Suzanne C; Torok, Kathryn S; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T; Rabinovich, C Egla; Laxer, Ronald M; Higgins, Gloria C; Ferguson, Polly J; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A; Ilowite, Norman T; Fuhlbrigge, Robert C

    2012-08-01

    Juvenile localized scleroderma (LS) is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies has been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment has made it difficult to compare approaches and identify optimal therapy. Our objective was to develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile LS. A core group of pediatric rheumatologists, dermatologists, and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for juvenile LS using consensus methods/nominal group techniques. Recommendations were validated in 2 face-to-face conferences with a larger group of practitioners with expertise in juvenile LS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the US and Canada. Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (66% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with juvenile LS. Using consensus methodology, we have developed standardized treatment plans and assessment methods for juvenile LS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of juvenile LS. Copyright © 2012 by the American College of Rheumatology.

  4. Automatic planning of head and neck treatment plans

    DEFF Research Database (Denmark)

    Hazell, Irene; Bzdusek, Karl; Kumar, Prashant

    2016-01-01

    radiation dose planning (dosimetrist) and potentially improve the overall plan quality. This study evaluates the performance of the Auto-Planning module that has recently become clinically available in the Pinnacle3 radiation therapy treatment planning system. Twenty-six clinically delivered head and neck...... as the previously delivered clinical plans. For all patients, the Auto-Planning tool produced clinically acceptable head and neck treatment plans without any manual intervention, except for the initial target and OAR delineations. The main benefit of the method is the likely improvement in the overall treatment......Treatment planning is time-consuming and the outcome depends on the person performing the optimization. A system that automates treatment planning could potentially reduce the manual time required for optimization and could also pro-vide a method to reduce the variation between persons performing...

  5. Science-based strategic planning for hazardous fuel treatment.

    Science.gov (United States)

    D.L. Peterson; M.C. Johnson

    2007-01-01

    A scientific foundation coupled with technical support is needed to develop long-term strategic plans for fuel and vegetation treatments on public lands. These plans are developed at several spatial scales and are typically a component of fire management plans and other types of resource management plans. Such plans need to be compatible with national, regional, and...

  6. Development of reference problems for neutron capture therapy treatment planning systems

    International Nuclear Information System (INIS)

    Albritton, J.R.; Kiger, W.S. III

    2006-01-01

    Currently, 5 different treatment planning systems (TPSs) are or have been used in clinical trials of Neutron Capture Therapy (NCT): MacNCTPlan, NCTPlan, BNCT Rtpe, SERA, and JCDS. This paper describes work performed to comprehensively test and compare 4 of these NCT treatment planning systems in order to facilitate the pooling of patient data from the different clinical sites for analysis of the clinical results as well as to provide an important quality assurance tool for existing and future TPSs. Two different phantoms were used to evaluate the planning systems: the modified Snyder head phantom and a large water-filled box, similar to that used in the International Dosimetry Exchange for NCT. The comparison of the resulting dose profile, isodose contours, and dose volume histograms to reference calculations performed with the Monte Carlo radiation transport code MCNP5 yielded many interesting differences. Each of the planning systems deviated from the reference calculations, with the newer systems (i.e., SERA and NCTPlan) most often yielding better agreement than their predecessors (i.e., BNCT Rtpe and MacNCTPlan). The combination of simple phantoms and sources with more complicated and realistic planning conditions has produced a well-rounded and useful suite of test problems for NCT treatment planning system analysis. (author)

  7. Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards.

    Science.gov (United States)

    Mayo, Charles S; Yao, John; Eisbruch, Avraham; Balter, James M; Litzenberg, Dale W; Matuszak, Martha M; Kessler, Marc L; Weyburn, Grant; Anderson, Carlos J; Owen, Dawn; Jackson, William C; Haken, Randall Ten

    2017-01-01

    To develop statistical dose-volume histogram (DVH)-based metrics and a visualization method to quantify the comparison of treatment plans with historical experience and among different institutions. The descriptive statistical summary (ie, median, first and third quartiles, and 95% confidence intervals) of volume-normalized DVH curve sets of past experiences was visualized through the creation of statistical DVH plots. Detailed distribution parameters were calculated and stored in JavaScript Object Notation files to facilitate management, including transfer and potential multi-institutional comparisons. In the treatment plan evaluation, structure DVH curves were scored against computed statistical DVHs and weighted experience scores (WESs). Individual, clinically used, DVH-based metrics were integrated into a generalized evaluation metric (GEM) as a priority-weighted sum of normalized incomplete gamma functions. Historical treatment plans for 351 patients with head and neck cancer, 104 with prostate cancer who were treated with conventional fractionation, and 94 with liver cancer who were treated with stereotactic body radiation therapy were analyzed to demonstrate the usage of statistical DVH, WES, and GEM in a plan evaluation. A shareable dashboard plugin was created to display statistical DVHs and integrate GEM and WES scores into a clinical plan evaluation within the treatment planning system. Benchmarking with normal tissue complication probability scores was carried out to compare the behavior of GEM and WES scores. DVH curves from historical treatment plans were characterized and presented, with difficult-to-spare structures (ie, frequently compromised organs at risk) identified. Quantitative evaluations by GEM and/or WES compared favorably with the normal tissue complication probability Lyman-Kutcher-Burman model, transforming a set of discrete threshold-priority limits into a continuous model reflecting physician objectives and historical experience

  8. Improvements in patient treatment planning systems

    International Nuclear Information System (INIS)

    Wheeler, F.J.; Wessol, D.E.; Nigg, D.W.; Atkinson, C.A.; Babcock, R.; Evans, J.

    1995-01-01

    The Boron Neutron Capture Therapy, Radiation treatment planning environment (BNCT-Rtpe) software system is used to develop treatment planning information. In typical use BNCT-Rtpe consists of three main components: (1) Semi-automated geometric modeling of objects (brain, target, eyes, sinus) derived from MRI, CT, and other medical imaging modalities, (2) Dose computations for these geometric models with rtt-MC, the INEL Monte Carlo radiation transport computer code, and (3) Dose contouring overlaid on medical images as well as generation of other dose displays. We continue to develop a planning system based on three-dimensional image-based reconstructions using Bspline surfaces. Even though this software is in an experimental state, it has been applied for large animal research and for an isolated case of treatment for a human glioma. Radiation transport is based on Monte Carlo, however there will be implementations of faster methods (e.g. diffusion theory) in the future. The important thing for treatment planning is the output which must convey, to the radiologist, the deposition of dose to healthy and target tissue. Many edits are available such that one can obtain contours registered to medical image, dose/volume histograms and most information required for treatment planning and response assessment. Recent work has been to make the process more automatic and easier to use. The interface, now implemented for contouring and reconstruction, utilizes the Xwindowing system and the MOTIF graphical users interface for effective interaction with the planner. Much work still remains before the tool can be applied in a routine clinical setting

  9. Role of disposal in developing Federal Facility Compliance Act mixed waste treatment plans

    International Nuclear Information System (INIS)

    Case, J.T.; Rhoderick, J.

    1994-01-01

    The Federal Facilities Compliance Act (FFCA) was enacted on October 6, 1992. This act amends the Solid Waste Disposal Act, which was previously amended by the Resource Conservation and Recovery Act (RCRA). The FFCA set in place a process for managing the Department of Energy's (DOE) mixed low-level radioactive wastes (MLLW), wastes that contain both hazardous and low-level radioactive constituents, with full participation of the affected states. The FFCA provides the framework for the development of treatment capacity for DOE's mixed waste. Disposal of the treatment residues is not addressed by the FFCA. DOE has initiated efforts in concert with the states in the development of a disposal strategy for the treated mixed wastes. This paper outlines DOE efforts in development of a mixed waste disposal strategy which is integrated with the FFCA Site Treatment Planning process

  10. Federal Facilities Compliance Act, Draft Site Treatment Plan: Compliance Plan Volume. Part 2, Volume 2

    International Nuclear Information System (INIS)

    1994-01-01

    This document presents the details of the implementation of the Site Treatment Plan developed by Ames Laboratory in compliance with the Federal Facilities Compliance Act. Topics discussed in this document include: implementation of the plan; milestones; annual updates to the plan; inclusion of new waste streams; modifications of the plan; funding considerations; low-level mixed waste treatment plan and schedules; and TRU mixed waste streams

  11. Estimation of second primary cancers risk based on the treatment planning system

    International Nuclear Information System (INIS)

    Jin Chufeng; Sun Guangyao; Liu Hui; Zheng Huaqing; Cheng Mengyun; Li Gui; Wu Yican; FDS Team

    2011-01-01

    Estimates of second primary cancers risk after radiotherapy has become increasingly important for comparative treatment planning. A new method based on the treatment planning system to estimate the risk of second primary cancers was introduced in this paper. Using the Advanced/Accurate Radiotherapy Treatment System(ARTS), a treatment planning system developed by the FDS team,the risk of second primary cancer was estimated over two treatment plans for a patient with pancreatic cancer. Based on the second primary cancer risk, the two plans were compared. It was found that,kidney and gall-bladder had higher risk to develop second primary cancer. A better plan was chosen by the analysis of second primary cancer risk. The results showed that this risk estimation method we developed could be used to evaluate treatment plans. (authors)

  12. Patient-specific dosimetric endpoints based treatment plan quality control in radiotherapy

    International Nuclear Information System (INIS)

    Song, Ting; Zhou, Linghong; Staub, David; Chen, Mingli; Lu, Weiguo; Tian, Zhen; Jia, Xun; Li, Yongbao; Jiang, Steve B; Gu, Xuejun

    2015-01-01

    In intensity modulated radiotherapy (IMRT), the optimal plan for each patient is specific due to unique patient anatomy. To achieve such a plan, patient-specific dosimetric goals reflecting each patient’s unique anatomy should be defined and adopted in the treatment planning procedure for plan quality control. This study is to develop such a personalized treatment plan quality control tool by predicting patient-specific dosimetric endpoints (DEs). The incorporation of patient specific DEs is realized by a multi-OAR geometry-dosimetry model, capable of predicting optimal DEs based on the individual patient’s geometry. The overall quality of a treatment plan is then judged with a numerical treatment plan quality indicator and characterized as optimal or suboptimal. Taking advantage of clinically available prostate volumetric modulated arc therapy (VMAT) treatment plans, we built and evaluated our proposed plan quality control tool. Using our developed tool, six of twenty evaluated plans were identified as sub-optimal plans. After plan re-optimization, these suboptimal plans achieved better OAR dose sparing without sacrificing the PTV coverage, and the dosimetric endpoints of the re-optimized plans agreed well with the model predicted values, which validate the predictability of the proposed tool. In conclusion, the developed tool is able to accurately predict optimally achievable DEs of multiple OARs, identify suboptimal plans, and guide plan optimization. It is a useful tool for achieving patient-specific treatment plan quality control. (paper)

  13. Knowledge-based radiation therapy (KBRT) treatment planning versus planning by experts: validation of a KBRT algorithm for prostate cancer treatment planning

    International Nuclear Information System (INIS)

    Nwankwo, Obioma; Mekdash, Hana; Sihono, Dwi Seno Kuncoro; Wenz, Frederik; Glatting, Gerhard

    2015-01-01

    A knowledge-based radiation therapy (KBRT) treatment planning algorithm was recently developed. The purpose of this work is to investigate how plans that are generated with the objective KBRT approach compare to those that rely on the judgment of the experienced planner. Thirty volumetric modulated arc therapy plans were randomly selected from a database of prostate plans that were generated by experienced planners (expert plans). The anatomical data (CT scan and delineation of organs) of these patients and the KBRT algorithm were given to a novice with no prior treatment planning experience. The inexperienced planner used the knowledge-based algorithm to predict the dose that the OARs receive based on their proximity to the treated volume. The population-based OAR constraints were changed to the predicted doses. A KBRT plan was subsequently generated. The KBRT and expert plans were compared for the achieved target coverage and OAR sparing. The target coverages were compared using the Uniformity Index (UI), while 5 dose-volume points (D 10 , D 30, D 50 , D 70 and D 90 ) were used to compare the OARs (bladder and rectum) doses. Wilcoxon matched-pairs signed rank test was used to check for significant differences (p < 0.05) between both datasets. The KBRT and expert plans achieved mean UI values of 1.10 ± 0.03 and 1.10 ± 0.04, respectively. The Wilcoxon test showed no statistically significant difference between both results. The D 90 , D 70, D 50 , D 30 and D 10 values of the two planning strategies, and the Wilcoxon test results suggests that the KBRT plans achieved a statistically significant lower bladder dose (at D 30 ), while the expert plans achieved a statistically significant lower rectal dose (at D 10 and D 30 ). The results of this study show that the KBRT treatment planning approach is a promising method to objectively incorporate patient anatomical variations in radiotherapy treatment planning

  14. Consensus Treatment Plans for New-Onset Systemic Juvenile Idiopathic Arthritis

    Science.gov (United States)

    DeWitt, Esi Morgan; Kimura, Yukiko; Beukelman, Timothy; Nigrovic, Peter A.; Onel, Karen; Prahalad, Sampath; Schneider, Rayfel; Stoll, Matthew L.; Angeles-Han, Sheila; Milojevic, Diana; Schikler, Kenneth N.; Vehe, Richard K.; Weiss, Jennifer E.; Weiss, Pamela; Ilowite, Norman T.; Wallace, Carol A.

    2012-01-01

    Objective There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (sJIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of sJIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies. Methods Case-based surveys were administered to CARRA members to identify prevailing treatments for new-onset sJIA. A 2-day consensus conference in April 2010 employed modified nominal group technique to formulate preliminary treatment plans and determine important data elements for collection. Follow-up surveys were employed to refine the plans and assess clinical acceptability. Results The initial case-based survey identified significant variability among current treatment approaches for new onset sJIA, underscoring the utility of standardized plans to evaluate comparative effectiveness. We developed four consensus treatment plans for the first 9 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The four treatment regimens included glucocorticoids only, or therapy with methotrexate, anakinra or tocilizumab, with or without glucocorticoids. This approach was approved by >78% of CARRA membership. Conclusion Four standardized treatment plans were developed for new-onset sJIA. Coupled with data collection at defined intervals, use of these treatment plans will create the opportunity to evaluate comparative effectiveness in an observational setting to optimize initial management of sJIA. PMID:22290637

  15. The evolution of brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Rivard, Mark J.; Venselaar, Jack L. M.; Beaulieu, Luc

    2009-01-01

    Brachytherapy is a mature treatment modality that has benefited from technological advances. Treatment planning has advanced from simple lookup tables to complex, computer-based dose-calculation algorithms. The current approach is based on the AAPM TG-43 formalism with recent advances in acquiring single-source dose distributions. However, this formalism has clinically relevant limitations for calculating patient dose. Dose-calculation algorithms are being developed based on Monte Carlo methods, collapsed cone, and solving the linear Boltzmann transport equation. In addition to improved dose-calculation tools, planning systems and brachytherapy treatment planning will account for material heterogeneities, scatter conditions, radiobiology, and image guidance. The AAPM, ESTRO, and other professional societies are working to coordinate clinical integration of these advancements. This Vision 20/20 article provides insight into these endeavors.

  16. Improving treatment planning accuracy through multimodality imaging

    International Nuclear Information System (INIS)

    Sailer, Scott L.; Rosenman, Julian G.; Soltys, Mitchel; Cullip, Tim J.; Chen, Jun

    1996-01-01

    Purpose: In clinical practice, physicians are constantly comparing multiple images taken at various times during the patient's treatment course. One goal of such a comparison is to accurately define the gross tumor volume (GTV). The introduction of three-dimensional treatment planning has greatly enhanced the ability to define the GTV, but there are times when the GTV is not visible on the treatment-planning computed tomography (CT) scan. We have modified our treatment-planning software to allow for interactive display of multiple, registered images that enhance the physician's ability to accurately determine the GTV. Methods and Materials: Images are registered using interactive tools developed at the University of North Carolina at Chapel Hill (UNC). Automated methods are also available. Images registered with the treatment-planning CT scan are digitized from film. After a physician has approved the registration, the registered images are made available to the treatment-planning software. Structures and volumes of interest are contoured on all images. In the beam's eye view, wire loop representations of these structures can be visualized from all image types simultaneously. Each registered image can be seamlessly viewed during the treatment-planning process, and all contours from all image types can be seen on any registered image. A beam may, therefore, be designed based on any contour. Results: Nineteen patients have been planned and treated using multimodality imaging from November 1993 through August 1994. All registered images were digitized from film, and many were from outside institutions. Brain has been the most common site (12), but the techniques of registration and image display have also been used for the thorax (4), abdomen (2), and extremity (1). The registered image has been an magnetic resonance (MR) scan in 15 cases and a diagnostic CT scan in 5 cases. In one case, sequential MRs, one before treatment and another after 30 Gy, were used to plan

  17. Assessing DOE's success in implementing the FFC Act: A federal and state partnership to develop treatment plans

    International Nuclear Information System (INIS)

    Letourneau, M.J.; Bubar, P.M.

    1995-01-01

    Implementation of the Federal Facility Compliance Act (FFCAct) required total cooperation among the Department of Energy (DOE), the involved States and interested stakeholders. Although the effort was time consuming, tedious and (at times) trying, the results obtained [Site Treatment Plans (STP)] were an unprecedented success. Through long-range planning, attention to details and organization of effort, a coordinated, cohesive, focused team was developed that included the DOE Headquarters, the Environmental Protection Agency (EPA), 40 DOE sites, 20 states and multiple interested stakeholders. The efforts of the FFCAct team resulted in the preparation of 37 STPs which outline the methods, locations and schedules for the treatment and disposal of DOE's mixed wastes. The Plans provided a strong foundation upon which consent orders were prepared and approved. The FFCAct approach also resulted in the development of working relationships that will prove not only useful but vital to the planning and implementation necessary to the successful clean-up and disposal DOE's mixed wastes

  18. Feature-based plan adaptation for fast treatment planning in scanned ion beam therapy

    International Nuclear Information System (INIS)

    Chen Wenjing; Gemmel, Alexander; Rietzel, Eike

    2013-01-01

    We propose a plan adaptation method for fast treatment plan generation in scanned ion beam therapy. Analysis of optimized treatment plans with carbon ions indicates that the particle number modulation of consecutive rasterspots in depth shows little variation throughout target volumes with convex shape. Thus, we extract a depth-modulation curve (DMC) from existing reference plans and adapt it for creation of new plans in similar treatment situations. The proposed method is tested with seven CT serials of prostate patients and three digital phantom datasets generated with the MATLAB code. Plans are generated with a treatment planning software developed by GSI using single-field uniform dose optimization for all the CT datasets to serve as reference plans and ‘gold standard’. The adapted plans are generated based on the DMC derived from the reference plans of the same patient (intra-patient), different patient (inter-patient) and phantoms (phantom-patient). They are compared with the reference plans and a re-positioning strategy. Generally, in 1 min on a standard PC, either a physical plan or a biological plan can be generated with the adaptive method provided that the new target contour is available. In all the cases, the V95 values of the adapted plans can achieve 97% for either physical or biological plans. V107 is always 0 indicating no overdosage, and target dose homogeneity is above 0.98 in all cases. The dose received by the organs at risk is comparable to the optimized plans. The plan adaptation method has the potential for on-line adaptation to deal with inter-fractional motion, as well as fast off-line treatment planning, with either the prescribed physical dose or the RBE-weighted dose. (paper)

  19. A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

    Science.gov (United States)

    Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

    2018-01-01

    The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

  20. A One-Step Cone-Beam CT-Enabled Planning-to-Treatment Model for Palliative Radiotherapy-From Development to Implementation

    International Nuclear Information System (INIS)

    Wong, Rebecca K.S.; Letourneau, Daniel; Varma, Anita; Bissonnette, Jean Pierre; Fitzpatrick, David; Grabarz, Daniel; Elder, Christine; Martin, Melanie; Bezjak, Andrea; Panzarella, Tony; Gospodarowicz, Mary; Jaffray, David A.

    2012-01-01

    Purpose: To develop a cone-beam computed tomography (CT)–enabled one-step simulation-to-treatment process for the treatment of bone metastases. Methods and Materials: A three-phase prospective study was conducted. Patients requiring palliative radiotherapy to the spine, mediastinum, or abdomen/pelvis suitable for treatment with simple beam geometry (≤2 beams) were accrued. Phase A established the accuracy of cone-beam CT images for the purpose of gross tumor target volume (GTV) definition. Phase B evaluated the feasibility of implementing the cone-beam CT–enabled planning process at the treatment unit. Phase C evaluated the online cone-beam CT–enabled process for the planning and treatment of patients requiring radiotherapy for bone metastases. Results: Eighty-four patients participated in this study. Phase A (n = 9) established the adequacy of cone-beam CT images for target definition. Phase B (n = 45) established the quality of treatment plans to be adequate for clinical implementation for bone metastases. When the process was applied clinically in bone metastases (Phase C), the degree of overlap between planning computed tomography (PCT) and cone-beam CT for GTV and between PCT and cone-beam CT for treatment field was 82% ± 11% and 97% ± 4%, respectively. The oncologist’s decision to accept the plan under a time-pressured environment remained of high quality, with the cone-beam CT–generated treatment plan delivering at least 90% of the prescribed dose to 100% ± 0% of the cone-beam CT planning target volume (PTV). With the assumption that the PCT PTV is the gold-standard target, the cone-beam CT–generated treatment plan delivered at least 90% and at least 95% of dose to 98% ± 2% and 97% ± 5% of the PCT PTV, respectively. The mean time for the online planning and treatment process was 32.7 ± 4.0 minutes. Patient satisfaction was high, with a trend for superior satisfaction with the cone-beam CT–enabled process. Conclusions: The cone-beam CT

  1. A One-Step Cone-Beam CT-Enabled Planning-to-Treatment Model for Palliative Radiotherapy-From Development to Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Rebecca K.S., E-mail: rebecca.wong@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Letourneau, Daniel; Varma, Anita [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Bissonnette, Jean Pierre; Fitzpatrick, David; Grabarz, Daniel; Elder, Christine [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Martin, Melanie; Bezjak, Andrea [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Panzarella, Tony [Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario (Canada); Gospodarowicz, Mary [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario (Canada)

    2012-11-01

    Purpose: To develop a cone-beam computed tomography (CT)-enabled one-step simulation-to-treatment process for the treatment of bone metastases. Methods and Materials: A three-phase prospective study was conducted. Patients requiring palliative radiotherapy to the spine, mediastinum, or abdomen/pelvis suitable for treatment with simple beam geometry ({<=}2 beams) were accrued. Phase A established the accuracy of cone-beam CT images for the purpose of gross tumor target volume (GTV) definition. Phase B evaluated the feasibility of implementing the cone-beam CT-enabled planning process at the treatment unit. Phase C evaluated the online cone-beam CT-enabled process for the planning and treatment of patients requiring radiotherapy for bone metastases. Results: Eighty-four patients participated in this study. Phase A (n = 9) established the adequacy of cone-beam CT images for target definition. Phase B (n = 45) established the quality of treatment plans to be adequate for clinical implementation for bone metastases. When the process was applied clinically in bone metastases (Phase C), the degree of overlap between planning computed tomography (PCT) and cone-beam CT for GTV and between PCT and cone-beam CT for treatment field was 82% {+-} 11% and 97% {+-} 4%, respectively. The oncologist's decision to accept the plan under a time-pressured environment remained of high quality, with the cone-beam CT-generated treatment plan delivering at least 90% of the prescribed dose to 100% {+-} 0% of the cone-beam CT planning target volume (PTV). With the assumption that the PCT PTV is the gold-standard target, the cone-beam CT-generated treatment plan delivered at least 90% and at least 95% of dose to 98% {+-} 2% and 97% {+-} 5% of the PCT PTV, respectively. The mean time for the online planning and treatment process was 32.7 {+-} 4.0 minutes. Patient satisfaction was high, with a trend for superior satisfaction with the cone-beam CT-enabled process. Conclusions: The cone

  2. Improving treatment plan evaluation with automation

    Science.gov (United States)

    Covington, Elizabeth L.; Chen, Xiaoping; Younge, Kelly C.; Lee, Choonik; Matuszak, Martha M.; Kessler, Marc L.; Keranen, Wayne; Acosta, Eduardo; Dougherty, Ashley M.; Filpansick, Stephanie E.

    2016-01-01

    The goal of this work is to evaluate the effectiveness of Plan‐Checker Tool (PCT) which was created to improve first‐time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the physics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33 checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was successfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. PACS number(s): 87.55.‐x, 87.55.N‐, 87.55.Qr, 87.55.tm, 89.20.Bb PMID:27929478

  3. 3D treatment planning systems.

    Science.gov (United States)

    Saw, Cheng B; Li, Sicong

    2018-01-01

    Three-dimensional (3D) treatment planning systems have evolved and become crucial components of modern radiation therapy. The systems are computer-aided designing or planning softwares that speed up the treatment planning processes to arrive at the best dose plans for the patients undergoing radiation therapy. Furthermore, the systems provide new technology to solve problems that would not have been considered without the use of computers such as conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). The 3D treatment planning systems vary amongst the vendors and also the dose delivery systems they are designed to support. As such these systems have different planning tools to generate the treatment plans and convert the treatment plans into executable instructions that can be implemented by the dose delivery systems. The rapid advancements in computer technology and accelerators have facilitated constant upgrades and the introduction of different and unique dose delivery systems than the traditional C-arm type medical linear accelerators. The focus of this special issue is to gather relevant 3D treatment planning systems for the radiation oncology community to keep abreast of technology advancement by assess the planning tools available as well as those unique "tricks or tips" used to support the different dose delivery systems. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  4. SU-D-BRD-03: Improving Plan Quality with Automation of Treatment Plan Checks

    International Nuclear Information System (INIS)

    Covington, E; Younge, K; Chen, X; Lee, C; Matuszak, M; Kessler, M; Acosta, E; Orow, A; Filpansick, S; Moran, J; Keranen, W

    2015-01-01

    Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One example is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827

  5. SU-D-BRD-03: Improving Plan Quality with Automation of Treatment Plan Checks

    Energy Technology Data Exchange (ETDEWEB)

    Covington, E; Younge, K; Chen, X; Lee, C; Matuszak, M; Kessler, M; Acosta, E; Orow, A; Filpansick, S; Moran, J [University of Michigan Hospital and Health System, Ann Arbor, MI (United States); Keranen, W [Varian Medical Systems, Palo Alto, CA (United States)

    2015-06-15

    Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One example is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827.

  6. SBNCT plan: A 3-dimensional treatment planning system for boron neutron capture therapy

    International Nuclear Information System (INIS)

    Reinstein, L.E.; Ramsay, E.B.; Gajewski, J.; Ramamoorthy, S.; Meek, A.G.

    1993-01-01

    The need for accurate and comprehensive 3-dimensional treatment planning for boron neutron capture therapy (BNCT) has been debated for the past several years. Although many argue against the need for elaborate and expensive treatment planning programs which mimic conventional radiotherapy planning systems, it is clear that in order to realize significant gains over conventional fractionated radiation therapy, patients must be treated to the edge of normal tissue tolerance. Just how close to this edge is dictated by the uncertainties in dosimetry. Hence the focus of BNCT planning is the determination of dose distribution throughout normal tissue volumes. Although precise geometric manipulation of the epithermal neutron beam is not achievable, the following variables play an important role in BNCT optimization: patient orientation, dose fractionation, number of fields, megawatt-minutes per fraction, use of surface bolus, and use of collimation. Other variables which are not as easily adjustable and would not, therefore, be part of treatment planning optimization, include external patient contour, internal patient heterogeneities, boron compound distributions, and RBE's. The boron neutron capture therapy planning system developed at SUNY Stony Brook (SBNCT-Plan) was designed as an interactive graphic tool to assist the radiation oncologist in generating the optimum plan for a neutron capture treatment

  7. Implementation of BNCT treatment planning procedures

    International Nuclear Information System (INIS)

    Capala, J.; Ma, R.; Diaz, A.Z.; Chanana, A.D.; Coderre, J.A.

    2001-01-01

    Estimation of radiation doses delivered during boron neutron capture therapy (BNCT) requires combining data on spatial distribution of both the thermal neutron fluence and the 10 B concentration, as well as the relative biological effectiveness of various radiation dose components in the tumor and normal tissues. Using the treatment planning system created at Idaho National Engineering and Environmental Laboratory and the procedures we had developed for clinical trials, we were able to optimize the treatment position, safely deliver the prescribed BNCT doses, and carry out retrospective analyses and reviews. In this paper we describe the BNCT treatment planning process and its implementation in the ongoing dose escalation trials at Brookhaven National Laboratory. (author)

  8. Development and status of the AL Mixed Waste Treatment Plan or I love that mobile unit of mine

    International Nuclear Information System (INIS)

    Bounini, L.; Williams, M.; Zygmunt, S.

    1995-01-01

    Nine Department of Energy (DOE) sites reporting to the Albuquerque Office (AL) have mixed waste that is chemically hazardous and radioactive. The hazardous waste regulations require the chemical portion of mixed waste to be to be treated to certain standards. The total volume of low-level mixed waste at the nine sites is equivalent to 7,000 drums, with individual site volumes ranging from 1 gallon of waste at the Pinellas Plant to 4,500 drums at Los Alamos National Laboratory. Nearly all the sites have a diversity of wastes requiring a diversity of treatment processes. Treatment capacity does not exist for much of this waste, and it would be expensive for each site to build the diversity of treatment processes needed to treat its own wastes. DOE-AL assembled a team that developed the AL Mixed Waste Treatment Plan that uses the resources of the nine sites to treat the waste at the sites. Work on the plan started in October 1993, and the plan was finalized in March 1994. The plan uses commercial treatment, treatability studies, and mobile treatment units. The plan specifies treatment technologies that will be built as mobile treatment units to be moved from site to site. Mobile units include bench-top units for very small volumes and treatability studies, drum-size units that treat one drum per day, and skid-size units that handle multiple drum volumes. After the tools needed to treat the wastes were determined, the sites were assigned to provide part of the treatment capacity using their own resources and expertise. The sites are making progress on treatability studies, commercial treatment, and mobile treatment design and fabrication. To date, this is the only plan for treating waste that brings the resources of several DOE sites together to treat mixed waste. It is the only program actively planning to use mobile treatment coordinated between DOE sites

  9. 3-D conformal radiation therapy - Part I: Treatment planning

    International Nuclear Information System (INIS)

    Burman, Chandra M.; Mageras, Gikas S.

    1997-01-01

    Objective: In this presentation we will look into the basic components of 3-dimensional conformal treatment planning, and will discuss planning for some selected sites. We will also review some current and future trends in 3-D treatment planning. External beam radiation therapy is one of the arms of cancer treatment. In the recent years 3-D conformal therapy had significant impact on the practice of external beam radiation therapy. Conformal radiation therapy shapes the high-dose volume so as to conform to the target volume while minimizing the dose to the surrounding normal tissues. The advances that have been achieved in conformal therapy are in part due to the development of 3-D treatment planning, which in turn has capitalized on 3-D imaging for tumor and normal tissue localization, as well as on available computational power for the calculation of 3-D dose distributions, visualization of anatomical and dose volumes, and numerical evaluation of treatment plans. In this course we will give an overview of how 3-D conformal treatments are designed and transferred to the patient. Topics will include: 1) description of the major components of a 3-D treatment planning system, 2) techniques for designing treatments, 3) evaluation of treatment plans using dose distribution displays, dose-volume histograms and normal tissue complication probabilities, 4) implementation of treatments using shaped blocks and multileaf collimators, 5) verification of treatment delivery using portal films and electronic portal imaging devices. We will also discuss some current and future trends in 3-D treatment planning, such as field shaping with multileaf collimation, computerized treatment plan optimization, including the use of nonuniform beam profiles (intensity modulation), and incorporating treatment uncertainties due to patient positioning errors and organ motion into treatment planning process

  10. Treatment planning for a small animal using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Chow, James C. L.; Leung, Michael K. K.

    2007-01-01

    The development of a small animal model for radiotherapy research requires a complete setup of customized imaging equipment, irradiators, and planning software that matches the sizes of the subjects. The purpose of this study is to develop and demonstrate the use of a flexible in-house research environment for treatment planning on small animals. The software package, called DOSCTP, provides a user-friendly platform for DICOM computed tomography-based Monte Carlo dose calculation using the EGSnrcMP-based DOSXYZnrc code. Validation of the treatment planning was performed by comparing the dose distributions for simple photon beam geometries calculated through the Pinnacle3 treatment planning system and measurements. A treatment plan for a mouse based on a CT image set by a 360-deg photon arc is demonstrated. It is shown that it is possible to create 3D conformal treatment plans for small animals with consideration of inhomogeneities using small photon beam field sizes in the diameter range of 0.5-5 cm, with conformal dose covering the target volume while sparing the surrounding critical tissue. It is also found that Monte Carlo simulation is suitable to carry out treatment planning dose calculation for small animal anatomy with voxel size about one order of magnitude smaller than that of the human

  11. Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

    2013-01-01

    Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

  12. Assessing DOE`s success in implementing the FFC Act: A federal and state partnership to develop treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Letourneau, M.J.; Bubar, P.M. [Dept. of Energy, Germantown, MD (United States)

    1995-12-31

    Implementation of the Federal Facility Compliance Act (FFCAct) required total cooperation among the Department of Energy (DOE), the involved States and interested stakeholders. Although the effort was time consuming, tedious and (at times) trying, the results obtained [Site Treatment Plans (STP)] were an unprecedented success. Through long-range planning, attention to details and organization of effort, a coordinated, cohesive, focused team was developed that included the DOE Headquarters, the Environmental Protection Agency (EPA), 40 DOE sites, 20 states and multiple interested stakeholders. The efforts of the FFCAct team resulted in the preparation of 37 STPs which outline the methods, locations and schedules for the treatment and disposal of DOE`s mixed wastes. The Plans provided a strong foundation upon which consent orders were prepared and approved. The FFCAct approach also resulted in the development of working relationships that will prove not only useful but vital to the planning and implementation necessary to the successful clean-up and disposal DOE`s mixed wastes.

  13. Proposed Site Treatment Plan (PSTP). STP reference document

    International Nuclear Information System (INIS)

    1995-01-01

    The Department of Energy (DOE) is required by Section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (FFCAct), to prepare a plan describing the development of treatment capacities and technologies for treating mixed waste (hazardous/radioactive waste). DOE decided to prepare its site treatment plan in a three phased approach. The first phase, called the Conceptual Site Treatment Plan (CSTP), was issued in October 1993. At the Savannah River Site (SRS) the CSTP described mixed waste streams generated at SRS and listed treatment scenarios for each waste stream utilizing an onsite, offsite DOE, and offsite or onsite commercial or vendor treatment option. The CSTP is followed by the Draft Site Treatment Plan (DSTP), due to be issued in August 1994. The DSTP, the current activity., will narrow the options discussed in the CSTP to a preferred treatment option, if possible, and will include waste streams proposed to be shipped to SRS from other DOE facilities as well as waste streams SRS may send offsite for treatment. The SRS DSTP process has been designed to address treatment options for each of the site's mixed waste streams. The SRS Proposed Site Treatment Plan (PSTP) is due to be issued in February 1995. The compliance order would be derived from the PSTP

  14. Development of an adjoint sensitivity field-based treatment-planning technique for the use of newly designed directional LDR sources in brachytherapy.

    Science.gov (United States)

    Chaswal, V; Thomadsen, B R; Henderson, D L

    2012-02-21

    The development and application of an automated 3D greedy heuristic (GH) optimization algorithm utilizing the adjoint sensitivity fields for treatment planning to assess the advantage of directional interstitial prostate brachytherapy is presented. Directional and isotropic dose kernels generated using Monte Carlo simulations based on Best Industries model 2301 I-125 source are utilized for treatment planning. The newly developed GH algorithm is employed for optimization of the treatment plans for seven interstitial prostate brachytherapy cases using mixed sources (directional brachytherapy) and using only isotropic sources (conventional brachytherapy). All treatment plans resulted in V100 > 98% and D90 > 45 Gy for the target prostate region. For the urethra region, the D10(Ur), D90(Ur) and V150(Ur) and for the rectum region the V100cc, D2cc, D90(Re) and V90(Re) all are reduced significantly when mixed sources brachytherapy is used employing directional sources. The simulations demonstrated that the use of directional sources in the low dose-rate (LDR) brachytherapy of the prostate clearly benefits in sparing the urethra and the rectum sensitive structures from overdose. The time taken for a conventional treatment plan is less than three seconds, while the time taken for a mixed source treatment plan is less than nine seconds, as tested on an Intel Core2 Duo 2.2 GHz processor with 1GB RAM. The new 3D GH algorithm is successful in generating a feasible LDR brachytherapy treatment planning solution with an extra degree of freedom, i.e. directionality in very little time.

  15. Development of an adjoint sensitivity field-based treatment-planning technique for the use of newly designed directional LDR sources in brachytherapy

    Science.gov (United States)

    Chaswal, V.; Thomadsen, B. R.; Henderson, D. L.

    2012-02-01

    The development and application of an automated 3D greedy heuristic (GH) optimization algorithm utilizing the adjoint sensitivity fields for treatment planning to assess the advantage of directional interstitial prostate brachytherapy is presented. Directional and isotropic dose kernels generated using Monte Carlo simulations based on Best Industries model 2301 I-125 source are utilized for treatment planning. The newly developed GH algorithm is employed for optimization of the treatment plans for seven interstitial prostate brachytherapy cases using mixed sources (directional brachytherapy) and using only isotropic sources (conventional brachytherapy). All treatment plans resulted in V100 > 98% and D90 > 45 Gy for the target prostate region. For the urethra region, the D10Ur, D90Ur and V150Ur and for the rectum region the V100cc, D2cc, D90Re and V90Re all are reduced significantly when mixed sources brachytherapy is used employing directional sources. The simulations demonstrated that the use of directional sources in the low dose-rate (LDR) brachytherapy of the prostate clearly benefits in sparing the urethra and the rectum sensitive structures from overdose. The time taken for a conventional treatment plan is less than three seconds, while the time taken for a mixed source treatment plan is less than nine seconds, as tested on an Intel Core2 Duo 2.2 GHz processor with 1GB RAM. The new 3D GH algorithm is successful in generating a feasible LDR brachytherapy treatment planning solution with an extra degree of freedom, i.e. directionality in very little time.

  16. Progress of radiotherapy by three-dimensional treatment planning

    International Nuclear Information System (INIS)

    Imada, Hajime; Nomoto, Satoshi; Takahashi, Hiroyuki; Nakata, Hajime

    1998-01-01

    The recent progress of three-dimensional radiation treatment planning was reviewed. And clinical cases such as lung cancer and breast cancer are introduced. In the University of Occupational and Development Health, the treatment system FOCUS which is made up of CT simulator and linac was used mainly. Three-dimensional treatment planning was carried for about 90% of 330 patients who underwent radiotherapy for one year. The target becomes to be accurate and dose distribution with all CT slices in radiation field can be confirmed by using three-dimensional radiation treatment planning apparatus. High dose irradiation localized to tumor part is possible. Relations between total dose and volume of normal tissue and/or tumor can be estimated numerically and easily by DVH. A prediction of indication and affection became possible by this procedure. In conclusion, generalization of three-dimensional radiation treatment planning will bring progress of more effective radiotherapy with less adverse reaction. (K.H.). 21 refs

  17. Radiation therapy treatment planning: CT, MR imaging and three-dimensional planning

    International Nuclear Information System (INIS)

    Lichter, A.S.

    1987-01-01

    The accuracy and sophistication of radiation therapy treatment planning have increased rapidly in the last decade. Currently, CT-based treatment planning is standard throughout the country. Care must be taken when CT is used for treatment planning because of clear differences between diagnostic scans and scans intended for therapeutic management. The use of CT in radiation therapy planning is discussed and illustrated. MR imaging adds another dimension to treatment planning. The ability to use MR imaging directly in treatment planning involves an additional complex set of capabilities from a treatment planning system. The ability to unwarp the geometrically distorted MR image is a first step. Three-dimensional dose calculations are important to display the dose on sagittal and acoronal sections. The ability to integrate the MR and CT images into a unified radiographic image is critical. CT and MR images are two-dimensional representations of a three-dimensional problem. Through sophisticated computer graphics techniques, radiation therapists are now able to integrate a three-dimensional image of the patient into the treatment planning process. This allows the use of noncoplanar treatment plans and a detailed analysis of tumor and normal tissue anatomy; it is the first step toward a fully conformational treatment planning system. These concepts are illustrated and future research goals outlined

  18. Assessment of PlanIQ Feasibility DVH for head and neck treatment planning.

    Science.gov (United States)

    Fried, David V; Chera, Bhishamjit S; Das, Shiva K

    2017-09-01

    Designing a radiation plan that optimally delivers both target coverage and normal tissue sparing is challenging. There are limited tools to determine what is dosimetrically achievable and frequently the experience of the planner/physician is relied upon to make these determinations. PlanIQ software provides a tool that uses target and organ at risk (OAR) geometry to indicate the difficulty of achieving different points for organ dose-volume histograms (DVH). We hypothesized that PlanIQ Feasibility DVH may aid planners in reducing dose to OARs. Clinically delivered head and neck treatments (clinical plan) were re-planned (re-plan) putting high emphasis on maximally sparing the contralateral parotid gland, contralateral submandibular gland, and larynx while maintaining routine clinical dosimetric objectives. The planner was blinded to the results of the clinically delivered plan as well as the Feasibility DVHs from PlanIQ. The re-plan treatments were designed using 3-arc VMAT in Raystation (RaySearch Laboratories, Sweden). The planner was then given the results from the PlanIQ Feasibility DVH analysis and developed an additional plan incorporating this information using 4-arc VMAT (IQ plan). The DVHs across the three treatment plans were compared with what was deemed "impossible" by PlanIQ's Feasibility DVH (Impossible DVH). The impossible DVH (red) is defined as the DVH generated using the minimal dose that any voxel outside the targets must receive given 100% target coverage. The re-plans performed blinded to PlanIQ Feasibilty DVH achieved superior sparing of aforementioned OARs compared to the clinically delivered plans and resulted in discrepancies from the impossible DVHs by an average of 200-700 cGy. Using the PlanIQ Feasibility DVH led to additionalOAR sparing compared to both the re-plans and clinical plans and reduced the discrepancies from the impossible DVHs to an average of approximately 100 cGy. The dose reduction from clinical to re-plan and re-plan to

  19. Reducing the sensitivity of IMPT treatment plans to setup errors and range uncertainties via probabilistic treatment planning

    International Nuclear Information System (INIS)

    Unkelbach, Jan; Bortfeld, Thomas; Martin, Benjamin C.; Soukup, Martin

    2009-01-01

    Treatment plans optimized for intensity modulated proton therapy (IMPT) may be very sensitive to setup errors and range uncertainties. If these errors are not accounted for during treatment planning, the dose distribution realized in the patient may by strongly degraded compared to the planned dose distribution. The authors implemented the probabilistic approach to incorporate uncertainties directly into the optimization of an intensity modulated treatment plan. Following this approach, the dose distribution depends on a set of random variables which parameterize the uncertainty, as does the objective function used to optimize the treatment plan. The authors optimize the expected value of the objective function. They investigate IMPT treatment planning regarding range uncertainties and setup errors. They demonstrate that incorporating these uncertainties into the optimization yields qualitatively different treatment plans compared to conventional plans which do not account for uncertainty. The sensitivity of an IMPT plan depends on the dose contributions of individual beam directions. Roughly speaking, steep dose gradients in beam direction make treatment plans sensitive to range errors. Steep lateral dose gradients make plans sensitive to setup errors. More robust treatment plans are obtained by redistributing dose among different beam directions. This can be achieved by the probabilistic approach. In contrast, the safety margin approach as widely applied in photon therapy fails in IMPT and is neither suitable for handling range variations nor setup errors.

  20. Treatment planning optimization for linear accelerator radiosurgery

    International Nuclear Information System (INIS)

    Meeks, Sanford L.; Buatti, John M.; Bova, Francis J.; Friedman, William A.; Mendenhall, William M.

    1998-01-01

    Purpose: Linear accelerator radiosurgery uses multiple arcs delivered through circular collimators to produce a nominally spherical dose distribution. Production of dose distributions that conform to irregular lesions or conformally avoid critical neural structures requires a detailed understanding of the available treatment planning parameters. Methods and Materials: Treatment planning parameters that may be manipulated within a single isocenter to provide conformal avoidance and dose conformation to ellipsoidal lesions include differential arc weighting and gantry start/stop angles. More irregular lesions require the use of multiple isocenters. Iterative manipulation of treatment planning variables can be difficult and computationally expensive, especially if the effects of these manipulations are not well defined. Effects of treatment parameter manipulation are explained and illustrated. This is followed by description of the University of Florida Stereotactic Radiosurgery Treatment Planning Algorithm. This algorithm organizes the manipulations into a practical approach for radiosurgery treatment planning. Results: Iterative treatment planning parameters may be efficiently manipulated to achieve optimal treatment plans by following the University of Florida Treatment Planning Algorithm. The ability to produce conformal stereotactic treatment plans using the algorithm is demonstrated for a variety of clinical presentations. Conclusion: The standard dose distribution produced in linear accelerator radiosurgery is spherical, but manipulation of available treatment planning parameters may result in optimal dose conformation. The University of Florida Treatment Planning Algorithm organizes available treatment parameters to efficiently produce conformal radiosurgery treatment plans

  1. PyCMSXiO: an external interface to script treatment plans for the Elekta® CMS XiO treatment planning system

    Science.gov (United States)

    Xing, Aitang; Arumugam, Sankar; Holloway, Lois; Goozee, Gary

    2014-03-01

    Scripting in radiotherapy treatment planning systems not only simplifies routine planning tasks but can also be used for clinical research. Treatment planning scripting can only be utilized in a system that has a built-in scripting interface. Among the commercially available treatment planning systems, Pinnacle (Philips) and Raystation (Raysearch Lab.) have inherent scripting functionality. CMS XiO (Elekta) is a widely used treatment planning system in radiotherapy centres around the world, but it does not have an interface that allows the user to script radiotherapy plans. In this study an external scripting interface, PyCMSXiO, was developed for XiO using the Python programming language. The interface was implemented as a python package/library using a modern object-oriented programming methodology. The package was organized as a hierarchy of different classes (objects). Each class (object) corresponds to a plan object such as the beam of a clinical radiotherapy plan. The interface of classes was implemented as object functions. Scripting in XiO using PyCMSXiO is comparable with Pinnacle scripting. This scripting package has been used in several research projects including commissioning of a beam model, independent three-dimensional dose verification for IMRT plans and a setup-uncertainty study. Ease of use and high-level functions provided in the package achieve a useful research tool. It was released as an open-source tool that may benefit the medical physics community.

  2. PyCMSXiO: an external interface to script treatment plans for the Elekta® CMS XiO treatment planning system

    International Nuclear Information System (INIS)

    Xing, Aitang; Arumugam, Sankar; Holloway, Lois; Goozee, Gary

    2014-01-01

    Scripting in radiotherapy treatment planning systems not only simplifies routine planning tasks but can also be used for clinical research. Treatment planning scripting can only be utilized in a system that has a built-in scripting interface. Among the commercially available treatment planning systems, Pinnacle (Philips) and Raystation (Raysearch Lab.) have inherent scripting functionality. CMS XiO (Elekta) is a widely used treatment planning system in radiotherapy centres around the world, but it does not have an interface that allows the user to script radiotherapy plans. In this study an external scripting interface, PyCMSXiO, was developed for XiO using the Python programming language. The interface was implemented as a python package/library using a modern object-oriented programming methodology. The package was organized as a hierarchy of different classes (objects). Each class (object) corresponds to a plan object such as the beam of a clinical radiotherapy plan. The interface of classes was implemented as object functions. Scripting in XiO using PyCMSXiO is comparable with Pinnacle scripting. This scripting package has been used in several research projects including commissioning of a beam model, independent three-dimensional dose verification for IMRT plans and a setup-uncertainty study. Ease of use and high-level functions provided in the package achieve a useful research tool. It was released as an open-source tool that may benefit the medical physics community.

  3. Development of novel conformity indices for quantitative comparison of radiation treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Min; Park, So Yeon; Wu, Hong Gyun; Ye, Sung Joon; Kim, Jin Ho; Kim, Jung In [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2013-11-15

    The conformity index (CI) is an indicator to assess the degree of congruence between a shape of reference isodose volume (VRI) and a shape of the target volume (TV). Two concepts are included in the CI, which are the target coverage and the degree of normal tissue sparing in the proximity of the target. Even though this could be verified by a manual review of dose distributions calculated on patient CT images slice by slice, detailed comparisons among several treatment plans would be inconvenient. The conformity could be also verified by reviewing dose-volume histograms (DVHs) of each structure calculated by treatment planning system (TPS). The prerequisite for this is the contouring of not only organs at risk (OARs) but also every structure in a patient body, which is not practical in the clinic. Therefore, a value possible to quantify the conformity was needed, and various studies on CI have been performed. Various CIs have been developed since 1993. Most of them are based on the calculation of the volumes except for the CI suggested by Wu et al. and Cheung et al. which were based on the distance. The aim of this study was to develop new CIs based on the calculations of angles and distances. The CI angle based on the analysis of the angle differences as well as the CIabs{sub d}istance and the CIdistance based on the analysis of the distances between the TV and the VRI were developed and evaluated in this study. The CI distance with Sornatomedins better performances than the CIangle and the CIabs{sub d}istance as well as the conventional CIs in various situations.

  4. Applications of NTCP calculations to treatment planning

    International Nuclear Information System (INIS)

    Kutcher, G.J.

    1995-01-01

    A fundamental step in the treatment decision process is the evaluation of a treatment plan. Most often treatment plans are judged by tradition using guidelines like target homogeneity and maximum dose to non-target tissues. While such judgments implicitly assume a relationship between dose distribution parameters and patient response, the judgment process is essentially supported by clinical outcomes from previous treatments. With the development of conformal therapy, new and unusual dose distributions and escalated doses are possible, while the clinical consequences are unknown. this situation has instigated attempts to place plan evaluation on a more systematic platform. One such endeavor has centered around attempts to calculate normal tissue complication probability (NTCP) and its sibling, tumor control probability (TCP). This lecture will be composed of two parts. The first will begin with a review of two categories of NTCP models: (1) an 'empirical' approach, based upon a power-law relationship between partial organ tolerance and irradiated volume, and histogram reduction to account for inhomogeneous irradiation: (2) a 'statistical' approach in which local responses are combined according to the underlying tissue architecture. Since both rely upon clinical data - often of limited and questionable validity - we will review some examples from the clinical and biological literature. The second part of the lecture will review clinical applications of biological-index based models: ranking competing treatment plans; design of dose escalation protocols; optimization of treatment plans with intensity modulation. We will also demonstrate how biological indices can be used to derive dose-volume histograms which account for treatment uncertainty

  5. Three-dimensional radiation treatment planning

    International Nuclear Information System (INIS)

    Mohan, R.

    1989-01-01

    A major aim of radiation therapy is to deliver sufficient dose to the tumour volume to kill the cancer cells while sparing the nearby health organs to prevent complications. With the introduction of devices such as CT and MR scanners, radiation therapy treatment planners have access to full three-dimensional anatomical information to define, simulate, and evaluate treatments. There are a limited number of prototype software systems that allow 3D treatment planning currently in use. In addition, there are more advanced tools under development or still in the planning stages. They require sophisticated graphics and computation equipment, complex physical and mathematical algorithms, and new radiation treatment machines that deliver dose very precisely under computer control. Components of these systems include programs for the identification and delineation of the anatomy and tumour, the definition of radiation beams, the calculation of dose distribution patterns, the display of dose on 2D images and as three dimensional surfaces, and the generation of computer images to verify proper patient positioning in treatment. Some of these functions can be performed more quickly and accurately if artificial intelligence or expert systems techniques are employed. 28 refs., figs

  6. SU-D-BRD-01: Cloud-Based Radiation Treatment Planning: Performance Evaluation of Dose Calculation and Plan Optimization

    International Nuclear Information System (INIS)

    Na, Y; Kapp, D; Kim, Y; Xing, L; Suh, T

    2014-01-01

    Purpose: To report the first experience on the development of a cloud-based treatment planning system and investigate the performance improvement of dose calculation and treatment plan optimization of the cloud computing platform. Methods: A cloud computing-based radiation treatment planning system (cc-TPS) was developed for clinical treatment planning. Three de-identified clinical head and neck, lung, and prostate cases were used to evaluate the cloud computing platform. The de-identified clinical data were encrypted with 256-bit Advanced Encryption Standard (AES) algorithm. VMAT and IMRT plans were generated for the three de-identified clinical cases to determine the quality of the treatment plans and computational efficiency. All plans generated from the cc-TPS were compared to those obtained with the PC-based TPS (pc-TPS). The performance evaluation of the cc-TPS was quantified as the speedup factors for Monte Carlo (MC) dose calculations and large-scale plan optimizations, as well as the performance ratios (PRs) of the amount of performance improvement compared to the pc-TPS. Results: Speedup factors were improved up to 14.0-fold dependent on the clinical cases and plan types. The computation times for VMAT and IMRT plans with the cc-TPS were reduced by 91.1% and 89.4%, respectively, on average of the clinical cases compared to those with pc-TPS. The PRs were mostly better for VMAT plans (1.0 ≤ PRs ≤ 10.6 for the head and neck case, 1.2 ≤ PRs ≤ 13.3 for lung case, and 1.0 ≤ PRs ≤ 10.3 for prostate cancer cases) than for IMRT plans. The isodose curves of plans on both cc-TPS and pc-TPS were identical for each of the clinical cases. Conclusion: A cloud-based treatment planning has been setup and our results demonstrate the computation efficiency of treatment planning with the cc-TPS can be dramatically improved while maintaining the same plan quality to that obtained with the pc-TPS. This work was supported in part by the National Cancer Institute (1

  7. SU-D-BRD-01: Cloud-Based Radiation Treatment Planning: Performance Evaluation of Dose Calculation and Plan Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Na, Y; Kapp, D; Kim, Y; Xing, L [Stanford University School of Medicine, Stanford, CA (United States); Suh, T [Catholic UniversityMedical College, Seoul, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: To report the first experience on the development of a cloud-based treatment planning system and investigate the performance improvement of dose calculation and treatment plan optimization of the cloud computing platform. Methods: A cloud computing-based radiation treatment planning system (cc-TPS) was developed for clinical treatment planning. Three de-identified clinical head and neck, lung, and prostate cases were used to evaluate the cloud computing platform. The de-identified clinical data were encrypted with 256-bit Advanced Encryption Standard (AES) algorithm. VMAT and IMRT plans were generated for the three de-identified clinical cases to determine the quality of the treatment plans and computational efficiency. All plans generated from the cc-TPS were compared to those obtained with the PC-based TPS (pc-TPS). The performance evaluation of the cc-TPS was quantified as the speedup factors for Monte Carlo (MC) dose calculations and large-scale plan optimizations, as well as the performance ratios (PRs) of the amount of performance improvement compared to the pc-TPS. Results: Speedup factors were improved up to 14.0-fold dependent on the clinical cases and plan types. The computation times for VMAT and IMRT plans with the cc-TPS were reduced by 91.1% and 89.4%, respectively, on average of the clinical cases compared to those with pc-TPS. The PRs were mostly better for VMAT plans (1.0 ≤ PRs ≤ 10.6 for the head and neck case, 1.2 ≤ PRs ≤ 13.3 for lung case, and 1.0 ≤ PRs ≤ 10.3 for prostate cancer cases) than for IMRT plans. The isodose curves of plans on both cc-TPS and pc-TPS were identical for each of the clinical cases. Conclusion: A cloud-based treatment planning has been setup and our results demonstrate the computation efficiency of treatment planning with the cc-TPS can be dramatically improved while maintaining the same plan quality to that obtained with the pc-TPS. This work was supported in part by the National Cancer Institute (1

  8. Treatment planning systems for high precision radiotherapy

    International Nuclear Information System (INIS)

    Deshpande, D.D.

    2008-01-01

    Computerized Treatment Planning System (TPS) play an important role in radiotherapy with the intent to maximize tumor control and minimize normal tissue complications. Treatment planning during earlier days was generally carried out through the manual summations of standard isodose charts on to patient body contours that were generated by direct tracing or lead wire representation, and relied heavily on the careful choices of beam weights and wedging. Since then there had been tremendous advances in field of Radiation Oncology in last few decades. The linear accelerators had evolved from MLC's to IGRT, the techniques like 3DCRT, IMRT has become almost routine affair. The simulation has seen transition from simple 2D film/fluoroscopy localization to CT Simulator with added development in PET, PET- CT and MR imaging. The Networking and advances in computer technology has made it possible to direct transfer of Images, contours to the treatment planning systems

  9. Collision detection and avoidance during treatment planning

    International Nuclear Information System (INIS)

    Humm, John L.; Pizzuto, Domenico; Fleischman, Eric; Mohan, Radhe

    1995-01-01

    Purpose: To develop computer software that assists the planner avoid potential gantry collisions with the patient or patient support assembly during the treatment planning process. Methods and Materials: The approach uses a simulation of the therapy room with a scale model of the treatment machine. Because the dimensions of the machine and patient are known, one can calculate a priori whether any desired therapy field is possible or will result in a collision. To assist the planner, we have developed a graphical interface enabling the accurate visualization of each treatment field configuration with a 'room's eye view' treatment planning window. This enables the planner to be aware of, and alleviate any potential collision hazards. To circumvent blind spots in the graphic representation, an analytical software module precomputes whether each update of the gantry or turntable position is safe. Results: If a collision is detected, the module alerts the planner and suggests collision evasive actions such as either an extended distance treatment or the gantry angle of closest approach. Conclusions: The model enables the planner to experiment with unconventional noncoplanar treatment fields, and immediately test their feasibility

  10. Real-time interactive treatment planning

    International Nuclear Information System (INIS)

    Otto, Karl

    2014-01-01

    The goal of this work is to develop an interactive treatment planning platform that permits real-time manipulation of dose distributions including DVHs and other dose metrics. The hypothesis underlying the approach proposed here is that the process of evaluating potential dose distribution options and deciding on the best clinical trade-offs may be separated from the derivation of the actual delivery parameters used for the patient’s treatment. For this purpose a novel algorithm for deriving an Achievable Dose Estimate (ADE) was developed. The ADE algorithm is computationally efficient so as to update dose distributions in effectively real-time while accurately incorporating the limits of what can be achieved in practice. The resulting system is a software environment for interactive real-time manipulation of dose that permits the clinician to rapidly develop a fully customized 3D dose distribution. Graphical navigation of dose distributions is achieved by a sophisticated method of identifying contributing fluence elements, modifying those elements and re-computing the entire dose distribution. 3D dose distributions are calculated in ∼2–20 ms. Including graphics processing overhead, clinicians may visually interact with the dose distribution (e.g. ‘drag’ a DVH) and display updates of the dose distribution at a rate of more than 20 times per second. Preliminary testing on various sites shows that interactive planning may be completed in ∼1–5 min, depending on the complexity of the case (number of targets and OARs). Final DVHs are derived through a separate plan optimization step using a conventional VMAT planning system and were shown to be achievable within 2% and 4% in high and low dose regions respectively. With real-time interactive planning trade-offs between Target(s) and OARs may be evaluated efficiently providing a better understanding of the dosimetric options available to each patient in static or adaptive RT. (paper)

  11. Draft Site Treatment Plan (DSTP), Volumes I and II

    International Nuclear Information System (INIS)

    D'Amelio, J.

    1994-01-01

    Site Treatment Plans (STP) are required for facilities at which the DOE generates or stores mixed waste. This Draft Site Treatment Plan (DSTP) the second step in a three-phase process, identifies the currently preferred options for treating mixed waste at the Savannah River Site (SRS) or for developing treatment technologies where technologies do not exist or need modification. The DSTP reflects site-specific preferred options, developed with the state's input and based on existing available information. To the extent possible, the DSTP identifies specific treatment facilities for treating the mixed waste and proposes schedules. Where the selection of specific treatment facilities is not possible, schedules for alternative activities such as waste characterization and technology assessment are provided. All schedule and cost information presented is preliminary and is subject to change. The DSTP is comprised of two volumes: this Compliance Plan Volume and the Background Volume. This Compliance Plan Volume proposes overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) of RCRA and procedures for converting the target dates into milestones to be enforced under the Order. The more detailed discussion of the options contained in the Background Volume is provided for informational purposes only

  12. MINERVA: A multi-modality plug-in-based radiation therapy treatment planning system

    International Nuclear Information System (INIS)

    Wemple, C. A.; Wessol, D. E.; Nigg, D. W.; Cogliati, J. J.; Milvich, M.; Fredrickson, C. M.; Perkins, M.; Harkin, G. J.; Hartmann-Siantar, C. L.; Lehmann, J.; Flickinger, T.; Pletcher, D.; Yuan, A.; DeNardo, G. L.

    2005-01-01

    Researchers at the INEEL, MSU, LLNL and UCD have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system, which can be used for planning and analysing several radiotherapy modalities, either singly or combined, using common treatment planning tools. It employs an integrated, lightweight plug-in architecture to accommodate multi-modal treatment planning using standard interface components. The design also facilitates the future integration of improved planning technologies. The code is being developed with the Java programming language for inter-operability. The MINERVA design includes the image processing, model definition and data analysis modules with a central module to coordinate communication and data transfer. Dose calculation is performed by source and transport plug-in modules, which communicate either directly through the database or through MINERVA's openly published, extensible markup language (XML)-based application programmer's interface (API). All internal data are managed by a database management system and can be exported to other applications or new installations through the API data formats. A full computation path has been established for molecular-targeted radiotherapy treatment planning, with additional treatment modalities presently under development. (authors)

  13. Clinical treatment planning optimization by Powell's method for gamma unit treatment system

    International Nuclear Information System (INIS)

    Yan Yulong; Shu Huazhong; Bao Xudong; Luo Limin; Bai Yi

    1997-01-01

    Purpose: This article presents a new optimization method for stereotactic radiosurgery treatment planning for gamma unit treatment system. Methods and Materials: The gamma unit has been utilized in stereotactic radiosurgery for about 30 years, but the usual procedure for a physician-physicist team to design a treatment plan is a trial-and-error approach. Isodose curves are viewed on two-dimensional computed tomography (CT) or magnetic resonance (MR) image planes, which is not only time consuming but also seldom achieves the optimal treatment plan, especially when the isocenter weights are regarded. We developed a treatment-planning system on a computer workstation in which Powell's optimization method is realized. The optimization process starts with the initial parameters (the number of iso centers as well as corresponding 3D iso centers' coordinates, collimator sizes, and weight factors) roughly determined by the physician-physicist team. The objective function can be changed to consider protection of sensitive tissues. Results: We use the plan parameters given by a well-trained physician-physicist team, or ones that the author give roughly as the initial parameters for the optimization procedure. Dosimetric results of optimization show a better high dose-volume conformation to the target volume compared to the doctor's plan. Conclusion: This method converges quickly and is not sensitive to the initial parameters. It achieves an excellent conformation of the estimated isodose curves with the contours of the target volume. If the initial parameters are varied, there will be a little difference in parameters' configuration, but the dosimetric results proved almost to be the same

  14. Treatment planning for radiotherapy with very high-energy electron beams and comparison of VHEE and VMAT plans

    International Nuclear Information System (INIS)

    Bazalova-Carter, Magdalena; Qu, Bradley; Palma, Bianey; Jensen, Christopher; Maxim, Peter G.; Loo, Billy W.; Hårdemark, Björn; Hynning, Elin

    2015-01-01

    Purpose: The aim of this work was to develop a treatment planning workflow for rapid radiotherapy delivered with very high-energy electron (VHEE) scanning pencil beams of 60–120 MeV and to study VHEE plans as a function of VHEE treatment parameters. Additionally, VHEE plans were compared to clinical state-of-the-art volumetric modulated arc therapy (VMAT) photon plans for three cases. Methods: VHEE radiotherapy treatment planning was performed by linking EGSnrc Monte Carlo (MC) dose calculations with inverse treatment planning in a research version of RayStation. In order to study the effect of VHEE treatment parameters on VHEE dose distributions, a MATLAB graphical user interface (GUI) for calculation of VHEE MC pencil beam doses was developed. Through the GUI, pediatric case MC simulations were run for a number of beam energies (60, 80, 100, and 120 MeV), number of beams (13, 17, and 36), pencil beam spot (0.1, 1.0, and 3.0 mm) and grid (2.0, 2.5, and 3.5 mm) sizes, and source-to-axis distance, SAD (40 and 50 cm). VHEE plans for the pediatric case calculated with the different treatment parameters were optimized and compared. Furthermore, 100 MeV VHEE plans for the pediatric case, a lung, and a prostate case were calculated and compared to the clinically delivered VMAT plans. All plans were normalized such that the 100% isodose line covered 95% of the target volume. Results: VHEE beam energy had the largest effect on the quality of dose distributions of the pediatric case. For the same target dose, the mean doses to organs at risk (OARs) decreased by 5%–16% when planned with 100 MeV compared to 60 MeV, but there was no further improvement in the 120 MeV plan. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams, but to a more modest degree (<8%). While pencil beam spacing and SAD had a small effect on VHEE dose distributions, 0.1–3 mm pencil beam sizes resulted in identical dose distributions. For the 100 MeV VHEE pediatric

  15. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs

    International Nuclear Information System (INIS)

    Li, Nan; Zarepisheh, Masoud; Uribe-Sanchez, Andres; Moore, Kevin; Tian, Zhen; Zhen, Xin; Graves, Yan Jiang; Gautier, Quentin; Mell, Loren; Jia, Xun; Jiang, Steve; Zhou, Linghong

    2013-01-01

    Adaptive radiation therapy (ART) can reduce normal tissue toxicity and/or improve tumor control through treatment adaptations based on the current patient anatomy. Developing an efficient and effective re-planning algorithm is an important step toward the clinical realization of ART. For the re-planning process, manual trial-and-error approach to fine-tune planning parameters is time-consuming and is usually considered unpractical, especially for online ART. It is desirable to automate this step to yield a plan of acceptable quality with minimal interventions. In ART, prior information in the original plan is available, such as dose–volume histogram (DVH), which can be employed to facilitate the automatic re-planning process. The goal of this work is to develop an automatic re-planning algorithm to generate a plan with similar, or possibly better, DVH curves compared with the clinically delivered original plan. Specifically, our algorithm iterates the following two loops. An inner loop is the traditional fluence map optimization, in which we optimize a quadratic objective function penalizing the deviation of the dose received by each voxel from its prescribed or threshold dose with a set of fixed voxel weighting factors. In outer loop, the voxel weighting factors in the objective function are adjusted according to the deviation of the current DVH curves from those in the original plan. The process is repeated until the DVH curves are acceptable or maximum iteration step is reached. The whole algorithm is implemented on GPU for high efficiency. The feasibility of our algorithm has been demonstrated with three head-and-neck cancer IMRT cases, each having an initial planning CT scan and another treatment CT scan acquired in the middle of treatment course. Compared with the DVH curves in the original plan, the DVH curves in the resulting plan using our algorithm with 30 iterations are better for almost all structures. The re-optimization process takes about 30

  16. MMCTP: a radiotherapy research environment for Monte Carlo and patient-specific treatment planning

    International Nuclear Information System (INIS)

    Alexander, A; DeBlois, F; Stroian, G; Al-Yahya, K; Heath, E; Seuntjens, J

    2007-01-01

    Radiotherapy research lacks a flexible computational research environment for Monte Carlo (MC) and patient-specific treatment planning. The purpose of this study was to develop a flexible software package on low-cost hardware with the aim of integrating new patient-specific treatment planning with MC dose calculations suitable for large-scale prospective and retrospective treatment planning studies. We designed the software package 'McGill Monte Carlo treatment planning' (MMCTP) for the research development of MC and patient-specific treatment planning. The MMCTP design consists of a graphical user interface (GUI), which runs on a simple workstation connected through standard secure-shell protocol to a cluster for lengthy MC calculations. Treatment planning information (e.g., images, structures, beam geometry properties and dose distributions) is converted into a convenient MMCTP local file storage format designated, the McGill RT format. MMCTP features include (a) DICOM R T, RTOG and CADPlan CART format imports; (b) 2D and 3D visualization views for images, structure contours, and dose distributions; (c) contouring tools; (d) DVH analysis, and dose matrix comparison tools; (e) external beam editing; (f) MC transport calculation from beam source to patient geometry for photon and electron beams. The MC input files, which are prepared from the beam geometry properties and patient information (e.g., images and structure contours), are uploaded and run on a cluster using shell commands controlled from the MMCTP GUI. The visualization, dose matrix operation and DVH tools offer extensive options for plan analysis and comparison between MC plans and plans imported from commercial treatment planning systems. The MMCTP GUI provides a flexible research platform for the development of patient-specific MC treatment planning for photon and electron external beam radiation therapy. The impact of this tool lies in the fact that it allows for systematic, platform

  17. Development of a neuro-fuzzy technique for automated parameter optimization of inverse treatment planning

    International Nuclear Information System (INIS)

    Stieler, Florian; Yan, Hui; Lohr, Frank; Wenz, Frederik; Yin, Fang-Fang

    2009-01-01

    Parameter optimization in the process of inverse treatment planning for intensity modulated radiation therapy (IMRT) is mainly conducted by human planners in order to create a plan with the desired dose distribution. To automate this tedious process, an artificial intelligence (AI) guided system was developed and examined. The AI system can automatically accomplish the optimization process based on prior knowledge operated by several fuzzy inference systems (FIS). Prior knowledge, which was collected from human planners during their routine trial-and-error process of inverse planning, has first to be 'translated' to a set of 'if-then rules' for driving the FISs. To minimize subjective error which could be costly during this knowledge acquisition process, it is necessary to find a quantitative method to automatically accomplish this task. A well-developed machine learning technique, based on an adaptive neuro fuzzy inference system (ANFIS), was introduced in this study. Based on this approach, prior knowledge of a fuzzy inference system can be quickly collected from observation data (clinically used constraints). The learning capability and the accuracy of such a system were analyzed by generating multiple FIS from data collected from an AI system with known settings and rules. Multiple analyses showed good agreements of FIS and ANFIS according to rules (error of the output values of ANFIS based on the training data from FIS of 7.77 ± 0.02%) and membership functions (3.9%), thus suggesting that the 'behavior' of an FIS can be propagated to another, based on this process. The initial experimental results on a clinical case showed that ANFIS is an effective way to build FIS from practical data, and analysis of ANFIS and FIS with clinical cases showed good planning results provided by ANFIS. OAR volumes encompassed by characteristic percentages of isodoses were reduced by a mean of between 0 and 28%. The study demonstrated a feasible way

  18. Development of a neuro-fuzzy technique for automated parameter optimization of inverse treatment planning

    Directory of Open Access Journals (Sweden)

    Wenz Frederik

    2009-09-01

    Full Text Available Abstract Background Parameter optimization in the process of inverse treatment planning for intensity modulated radiation therapy (IMRT is mainly conducted by human planners in order to create a plan with the desired dose distribution. To automate this tedious process, an artificial intelligence (AI guided system was developed and examined. Methods The AI system can automatically accomplish the optimization process based on prior knowledge operated by several fuzzy inference systems (FIS. Prior knowledge, which was collected from human planners during their routine trial-and-error process of inverse planning, has first to be "translated" to a set of "if-then rules" for driving the FISs. To minimize subjective error which could be costly during this knowledge acquisition process, it is necessary to find a quantitative method to automatically accomplish this task. A well-developed machine learning technique, based on an adaptive neuro fuzzy inference system (ANFIS, was introduced in this study. Based on this approach, prior knowledge of a fuzzy inference system can be quickly collected from observation data (clinically used constraints. The learning capability and the accuracy of such a system were analyzed by generating multiple FIS from data collected from an AI system with known settings and rules. Results Multiple analyses showed good agreements of FIS and ANFIS according to rules (error of the output values of ANFIS based on the training data from FIS of 7.77 ± 0.02% and membership functions (3.9%, thus suggesting that the "behavior" of an FIS can be propagated to another, based on this process. The initial experimental results on a clinical case showed that ANFIS is an effective way to build FIS from practical data, and analysis of ANFIS and FIS with clinical cases showed good planning results provided by ANFIS. OAR volumes encompassed by characteristic percentages of isodoses were reduced by a mean of between 0 and 28%. Conclusion The

  19. Prescribing and evaluating target dose in dose-painting treatment plans

    DEFF Research Database (Denmark)

    Håkansson, Katrin; Specht, Lena; Aznar, Marianne C

    2014-01-01

    BACKGROUND: Assessment of target dose conformity in multi-dose-level treatment plans is challenging due to inevitable over/underdosage at the border zone between dose levels. Here, we evaluate different target dose prescription planning aims and approaches to evaluate the relative merit of such p......-painting and multi-dose-level plans. The tool can be useful for quality assurance of multi-center trials, and for visualizing the development of treatment planning in routine clinical practice....... of such plans. A quality volume histogram (QVH) tool for history-based evaluation is proposed. MATERIAL AND METHODS: Twenty head and neck cancer dose-painting plans with five prescription levels were evaluated, as well as clinically delivered simultaneous integrated boost (SIB) plans from 2010 and 2012. The QVH...

  20. Online Adaptive Hyperthermia Treatment Planning During Locoregional Heating to Suppress Treatment-Limiting Hot Spots.

    Science.gov (United States)

    Kok, H Petra; Korshuize-van Straten, Linda; Bakker, Akke; de Kroon-Oldenhof, Rianne; Geijsen, Elisabeth D; Stalpers, Lukas J A; Crezee, Johannes

    2017-11-15

    Adequate tumor temperatures during hyperthermia are essential for good clinical response, but excessive heating of normal tissue should be avoided. This makes locoregional heating using phased array systems technically challenging. Online application of hyperthermia treatment planning could help to improve the heating quality. The aim of this study was to evaluate the clinical benefit of online treatment planning during treatment of pelvic tumors heated with the AMC-8 locoregional hyperthermia system. For online adaptive hyperthermia treatment planning, a graphical user interface was developed. Electric fields were calculated in a preprocessing step using our in-house-developed finite-difference-based treatment planning system. This allows instant calculation of the temperature distribution for user-selected phase-amplitude settings during treatment and projection onto the patient's computed tomographic scan for online visualization. Online treatment planning was used for 14 treatment sessions in 8 patients to reduce the patients' reports of hot spots while maintaining the same level of tumor heating. The predicted decrease in hot spot temperature should be at least 0.5°C, and the tumor temperature should decrease less than 0.2°C. These predictions were compared with clinical data: patient feedback about the hot spot and temperature measurements in the tumor region. In total, 17 hot spot reports occurred during the 14 sessions, and the alternative settings predicted the hot spot temperature to decrease by at least 0.5°C, which was confirmed by the disappearance of all 17 hot spot reports. At the same time, the average tumor temperature was predicted to change on average -0.01°C (range, -0.19°C to 0.34°C). The measured tumor temperature change was on average only -0.02°C (range, -0.26°C to 0.31°C). In only 2 cases the temperature decrease was slightly larger than 0.2°C, but at most it was 0.26°C. Online application of hyperthermia treatment planning is

  1. "SABER": A new software tool for radiotherapy treatment plan evaluation.

    Science.gov (United States)

    Zhao, Bo; Joiner, Michael C; Orton, Colin G; Burmeister, Jay

    2010-11-01

    Both spatial and biological information are necessary in order to perform true optimization of a treatment plan and for predicting clinical outcome. The goal of this work is to develop an enhanced treatment plan evaluation tool which incorporates biological parameters and retains spatial dose information. A software system is developed which provides biological plan evaluation with a novel combination of features. It incorporates hyper-radiosensitivity using the induced-repair model and applies the new concept of dose convolution filter (DCF) to simulate dose wash-out effects due to cell migration, bystander effect, and/or tissue motion during treatment. Further, the concept of spatial DVH (sDVH) is introduced to evaluate and potentially optimize the spatial dose distribution in the target volume. Finally, generalized equivalent uniform dose is derived from both the physical dose distribution (gEUD) and the distribution of equivalent dose in 2 Gy fractions (gEUD2) and the software provides three separate models for calculation of tumor control probability (TCP), normal tissue complication probability (NTCP), and probability of uncomplicated tumor control (P+). TCP, NTCP, and P+ are provided as a function of prescribed dose and multivariable TCP, NTCP, and P+ plots are provided to illustrate the dependence on individual parameters used to calculate these quantities. Ten plans from two clinical treatment sites are selected to test the three calculation models provided by this software. By retaining both spatial and biological information about the dose distribution, the software is able to distinguish features of radiotherapy treatment plans not discernible using commercial systems. Plans that have similar DVHs may have different spatial and biological characteristics and the application of novel tools such as sDVH and DCF within the software may substantially change the apparent plan quality or predicted plan metrics such as TCP and NTCP. For the cases examined

  2. Automated radiotherapy treatment plan integrity verification

    Energy Technology Data Exchange (ETDEWEB)

    Yang Deshan; Moore, Kevin L. [Department of Radiation Oncology, School of Medicine, Washington University in Saint Louis, St. Louis, Missouri 63110 (United States)

    2012-03-15

    Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

  3. Automated radiotherapy treatment plan integrity verification

    International Nuclear Information System (INIS)

    Yang Deshan; Moore, Kevin L.

    2012-01-01

    Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

  4. Inverse treatment planning based on MRI for HDR prostate brachytherapy

    International Nuclear Information System (INIS)

    Citrin, Deborah; Ning, Holly; Guion, Peter; Li Guang; Susil, Robert C.; Miller, Robert W.; Lessard, Etienne; Pouliot, Jean; Xie Huchen; Capala, Jacek; Coleman, C. Norman; Camphausen, Kevin; Menard, Cynthia

    2005-01-01

    Purpose: To develop and optimize a technique for inverse treatment planning based solely on magnetic resonance imaging (MRI) during high-dose-rate brachytherapy for prostate cancer. Methods and materials: Phantom studies were performed to verify the spatial integrity of treatment planning based on MRI. Data were evaluated from 10 patients with clinically localized prostate cancer who had undergone two high-dose-rate prostate brachytherapy boosts under MRI guidance before and after pelvic radiotherapy. Treatment planning MRI scans were systematically evaluated to derive a class solution for inverse planning constraints that would reproducibly result in acceptable target and normal tissue dosimetry. Results: We verified the spatial integrity of MRI for treatment planning. MRI anatomic evaluation revealed no significant displacement of the prostate in the left lateral decubitus position, a mean distance of 14.47 mm from the prostatic apex to the penile bulb, and clear demarcation of the neurovascular bundles on postcontrast imaging. Derivation of a class solution for inverse planning constraints resulted in a mean target volume receiving 100% of the prescribed dose of 95.69%, while maintaining a rectal volume receiving 75% of the prescribed dose of <5% (mean 1.36%) and urethral volume receiving 125% of the prescribed dose of <2% (mean 0.54%). Conclusion: Systematic evaluation of image spatial integrity, delineation uncertainty, and inverse planning constraints in our procedure reduced uncertainty in planning and treatment

  5. TU-H-209-00: Planning and Delivering HDR APBI Treatments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Learnings Objectives: Although brachytherapy is the oldest form of radiation therapy, the rapid advancement of the methods of dose calculation, treatment planning and treatment delivery pushes us to keep updating our knowledge and experience to new procedures all the time. Our purpose is to present the newest applicators used in Accelerated Partial Breast Irradiation (APBI) and the techniques of using them for a maximum effective treatment. Our objective will be to get the user familiar with the Savi, Contura and ML Mammosite from the detailed description and measurements to cavity eval and choice or size, to acceptance tests and use of each. At the end of the session the attendants will be able to assist at the scanning of the patient for the first treatment, decide on the proper localization and immobilization devices, import the scans in the treatment planning system, perform the structure segmentation, reconstruct the catheters and develop a treatment plan using inverse planning (IPSA) or volume optimization. The attendant should be able to evaluate the quality of a treatment plan according to the ABS protocols and B39 after this session. Our goal is that all the attendants to gain knowledge of all the quality assurance procedures required to be performed prior to a treatment, at the beginning of a treatment day, weekly, monthly and annualy on the remote afterloader, the treatment planning system and the secondary check system. We will provide tips for a consistent treatment delivery of the 10 fractions in a BID (twice daily) regimen.

  6. SERA -- An advanced treatment planning system for neutron therapy and BNCT

    International Nuclear Information System (INIS)

    Nigg, D.W.; Wemple, C.A.; Wessol, D.E.; Wheeler, F.J.; Albright, C.; Cohen, M.; Frandsen, M.; Harkin, G.; Rossmeier, M.

    1999-01-01

    Detailed treatment planning calculations on a patient-specific basis are required for boron neutron capture therapy (BNCT). Two integrated treatment planning systems developed specifically for BNCT have been in clinical use in the United States over the past few years. The MacNCTPLAN BNCT treatment planning system is used in the clinical BNCT trials that are underway at the Massachusetts Institute of Technology. A second system, BNCT rtpe (BNCT radiation therapy planning environment), developed independently by the Idaho national Engineering and Environmental Laboratory (INEEL) in collaboration with Montana State University (MSU), is used for treatment planning in the current series of BNCT clinical trials for glioblastoma at Brookhaven National Laboratory (BNL). This latter system is also licensed for use at several other BNCT research facilities worldwide. Although the currently available BNCT planning systems have served their purpose well, they suffer from somewhat long computation times (2 to 3 CPU-hours or more per field) relative to standard photon therapy planning software. This is largely due to the need for explicit three-dimensional solutions to the relevant transport equations. The simplifying approximations that work well for photon transport computations are not generally applicable to neutron transport computations. Greater computational speeds for BNCT treatment planning must therefore generally be achieved through the application of improved numerical techniques rather than by simplification of the governing equations. Recent efforts at INEEL and MSU have been directed toward this goal. This has resulted in a new paradigm for this type of calculation and the subsequent creation of the new simulation environment for radiotherapy applications (SERA) treatment planning system for BNCT. SERA is currently in initial clinical testing in connection with the trials at BNL, and it is expected to replace the present BNCT rtpe system upon general release

  7. WE-B-304-03: Biological Treatment Planning

    International Nuclear Information System (INIS)

    Orton, C.

    2015-01-01

    The ultimate goal of radiotherapy treatment planning is to find a treatment that will yield a high tumor control probability (TCP) with an acceptable normal tissue complication probability (NTCP). Yet most treatment planning today is not based upon optimization of TCPs and NTCPs, but rather upon meeting physical dose and volume constraints defined by the planner. It has been suggested that treatment planning evaluation and optimization would be more effective if they were biologically and not dose/volume based, and this is the claim debated in this month’s Point/Counterpoint. After a brief overview of biologically and DVH based treatment planning by the Moderator Colin Orton, Joseph Deasy (for biological planning) and Charles Mayo (against biological planning) will begin the debate. Some of the arguments in support of biological planning include: this will result in more effective dose distributions for many patients DVH-based measures of plan quality are known to have little predictive value there is little evidence that either D95 or D98 of the PTV is a good predictor of tumor control sufficient validated outcome prediction models are now becoming available and should be used to drive planning and optimization Some of the arguments against biological planning include: several decades of experience with DVH-based planning should not be discarded we do not know enough about the reliability and errors associated with biological models the radiotherapy community in general has little direct experience with side by side comparisons of DVH vs biological metrics and outcomes it is unlikely that a clinician would accept extremely cold regions in a CTV or hot regions in a PTV, despite having acceptable TCP values Learning Objectives: To understand dose/volume based treatment planning and its potential limitations To understand biological metrics such as EUD, TCP, and NTCP To understand biologically based treatment planning and its potential limitations

  8. Automated treatment planning engine for prostate seed implant brachytherapy

    International Nuclear Information System (INIS)

    Yu Yan; Zhang, J.B.Y.; Brasacchio, Ralph A.; Okunieff, Paul G.; Rubens, Deborah J.; Strang, John G.; Soni, Arvind; Messing, Edward M.

    1999-01-01

    Purpose: To develop a computer-intelligent planning engine for automated treatment planning and optimization of ultrasound- and template-guided prostate seed implants. Methods and Materials: The genetic algorithm was modified to reflect the 2D nature of the implantation template. A multi-objective decision scheme was used to rank competing solutions, taking into account dose uniformity and conformity to the planning target volume (PTV), dose-sparing of the urethra and the rectum, and the sensitivity of the resulting dosimetry to seed misplacement. Optimized treatment plans were evaluated using selected dosimetric quantifiers, dose-volume histogram (DVH), and sensitivity analysis based on simulated seed placement errors. These dosimetric planning components were integrated into the Prostate Implant Planning Engine for Radiotherapy (PIPER). Results: PIPER has been used to produce a variety of plans for prostate seed implants. In general, maximization of the minimum peripheral dose (mPD) for given implanted total source strength tended to produce peripherally weighted seed patterns. Minimization of the urethral dose further reduced the loading in the central region of the PTV. Isodose conformity to the PTV was achieved when the set of objectives did not reflect seed positioning uncertainties; the corresponding optimal plan generally required fewer seeds and higher source strength per seed compared to the manual planning experience. When seed placement uncertainties were introduced into the set of treatment planning objectives, the optimal plan tended to reach a compromise between the preplanned outcome and the likelihood of retaining the preferred outcome after implantation. The reduction in the volatility of such seed configurations optimized under uncertainty was verified by sensitivity studies. Conclusion: An automated treatment planning engine incorporating real-time sensitivity analysis was found to be a useful tool in dosimetric planning for prostate

  9. MO-B-BRB-00: Optimizing the Treatment Planning Process

    International Nuclear Information System (INIS)

    2015-01-01

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  10. MO-B-BRB-00: Optimizing the Treatment Planning Process

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  11. SU-F-J-94: Development of a Plug-in Based Image Analysis Tool for Integration Into Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Owen, D; Anderson, C; Mayo, C; El Naqa, I; Ten Haken, R; Cao, Y; Balter, J; Matuszak, M [University of Michigan, Ann Arbor, MI (United States)

    2016-06-15

    Purpose: To extend the functionality of a commercial treatment planning system (TPS) to support (i) direct use of quantitative image-based metrics within treatment plan optimization and (ii) evaluation of dose-functional volume relationships to assist in functional image adaptive radiotherapy. Methods: A script was written that interfaces with a commercial TPS via an Application Programming Interface (API). The script executes a program that performs dose-functional volume analyses. Written in C#, the script reads the dose grid and correlates it with image data on a voxel-by-voxel basis through API extensions that can access registration transforms. A user interface was designed through WinForms to input parameters and display results. To test the performance of this program, image- and dose-based metrics computed from perfusion SPECT images aligned to the treatment planning CT were generated, validated, and compared. Results: The integration of image analysis information was successfully implemented as a plug-in to a commercial TPS. Perfusion SPECT images were used to validate the calculation and display of image-based metrics as well as dose-intensity metrics and histograms for defined structures on the treatment planning CT. Various biological dose correction models, custom image-based metrics, dose-intensity computations, and dose-intensity histograms were applied to analyze the image-dose profile. Conclusion: It is possible to add image analysis features to commercial TPSs through custom scripting applications. A tool was developed to enable the evaluation of image-intensity-based metrics in the context of functional targeting and avoidance. In addition to providing dose-intensity metrics and histograms that can be easily extracted from a plan database and correlated with outcomes, the system can also be extended to a plug-in optimization system, which can directly use the computed metrics for optimization of post-treatment tumor or normal tissue response

  12. WE-G-16A-01: Evolution of Radiation Treatment Planning

    International Nuclear Information System (INIS)

    Rothenberg, L; Mohan, R; Van Dyk, J; Fraass, B; Bortfeld, T

    2014-01-01

    Welcome and Introduction - Lawrence N. Rothenberg This symposium is one a continuing series of presentations at AAPM Annual Meetings on the historical aspects of medical physics, radiology, and radiation oncology that have been organized by the AAPM History Committee. Information on previous presentations including “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen's Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website. The Austin 2014 History Symposium will be on “Evolution of Radiation Treatment Planning.” Overview - Radhe Mohan Treatment planning is one of the most critical components in the chain of radiation therapy of cancers. Treatment plans of today contain a wide variety of sophisticated information conveying the potential clinical effectiveness of the designed treatment to practitioners. Examples of such information include dose distributions superimposed on three- or even four-dimensional anatomic images; dose volume histograms, dose, dose-volume and dose-response indices for anatomic structures of interest; etc. These data are used for evaluating treatment plans and for making treatment decisions. The current state-of-the-art has evolved from the 1940s era when the dose to the tumor and normal tissues was estimated approximately by manual means. However, the symposium will cover the history of the field from the late-1950's, when computers were first introduced for treatment planning, to the present state involving the use of high performance computing and advanced multi-dimensional anatomic, functional and biological imaging, focusing only on external beam treatment planning. The symposium will start with a general overview of the treatment planning process including imaging

  13. WE-G-16A-01: Evolution of Radiation Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Rothenberg, L [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Mohan, R [UT MD Anderson Cancer Center, Houston, TX (United States); Van Dyk, J [Western University, London, ON (United Kingdom); Fraass, B [Cedars-Sinai Medical Center, Los Angeles, CA (United States); Bortfeld, T [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-15

    Welcome and Introduction - Lawrence N. Rothenberg This symposium is one a continuing series of presentations at AAPM Annual Meetings on the historical aspects of medical physics, radiology, and radiation oncology that have been organized by the AAPM History Committee. Information on previous presentations including “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen's Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website. The Austin 2014 History Symposium will be on “Evolution of Radiation Treatment Planning.” Overview - Radhe Mohan Treatment planning is one of the most critical components in the chain of radiation therapy of cancers. Treatment plans of today contain a wide variety of sophisticated information conveying the potential clinical effectiveness of the designed treatment to practitioners. Examples of such information include dose distributions superimposed on three- or even four-dimensional anatomic images; dose volume histograms, dose, dose-volume and dose-response indices for anatomic structures of interest; etc. These data are used for evaluating treatment plans and for making treatment decisions. The current state-of-the-art has evolved from the 1940s era when the dose to the tumor and normal tissues was estimated approximately by manual means. However, the symposium will cover the history of the field from the late-1950's, when computers were first introduced for treatment planning, to the present state involving the use of high performance computing and advanced multi-dimensional anatomic, functional and biological imaging, focusing only on external beam treatment planning. The symposium will start with a general overview of the treatment planning process including imaging

  14. Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

    Science.gov (United States)

    Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

    2016-03-08

    A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of

  15. An Approach for Practical Multiobjective IMRT Treatment Planning

    International Nuclear Information System (INIS)

    Craft, David; Halabi, Tarek; Shih, Helen A.; Bortfeld, Thomas

    2007-01-01

    Purpose: To introduce and demonstrate a practical multiobjective treatment planning procedure for intensity-modulated radiation therapy (IMRT) planning. Methods and Materials: The creation of a database of Pareto optimal treatment plans proceeds in two steps. The first step solves an optimization problem that finds a single treatment plan which is close to a set of clinical aspirations. This plan provides an example of what is feasible, and is then used to determine mutually satisfiable hard constraints for the subsequent generation of the plan database. All optimizations are done using linear programming. Results: The two-step procedure is applied to a brain, a prostate, and a lung case. The plan databases created allow for the selection of a final treatment plan based on the observed tradeoffs between the various organs involved. Conclusions: The proposed method reduces the human iteration time common in IMRT treatment planning. Additionally, the database of plans, when properly viewed, allows the decision maker to make an informed final plan selection

  16. A simple planning technique of craniospinal irradiation in the eclipse treatment planning system

    Directory of Open Access Journals (Sweden)

    Hemalatha Athiyaman

    2014-01-01

    Full Text Available A new planning method for Craniospinal Irradiation by Eclipse treatment planning system using Field alignment, Field-in-Field technique was developed. Advantage of this planning method was also studied retrospectively for previously treated five patients of medulloblastoma with variable spine length. Plan consists of half beam blocked parallel opposed cranium, and a single posterior cervicospine field was created by sharing the same isocenter, which obviates divergence matching. Further, a single symmetrical field was created to treat remaining Lumbosacral spine. Matching between a inferior diverging edge of cervicospine field and superior diverging edge of a Lumbosacral field was done using the field alignment option. ′Field alignment′ is specific option in the Eclipse Treatment Planning System, which automatically matches the field edge divergence as per field alignment rule. Multiple segments were applied in both the spine field to manage with hot and cold spots created by varying depth of spinal cord. Plan becomes fully computerized using this field alignment option and multiple segments. Plan evaluation and calculated mean modified Homogeneity Index (1.04 and 0.1 ensured that dose to target volume is homogeneous and critical organ doses were within tolerance. Dose variation at the spinal field junction was verified using ionization chamber array (I′MatriXX for matched, overlapped and gap junction spine fields; the delivered dose distribution confirmed the ideal clinical match, over exposure and under exposure at the junction, respectively. This method is simple to plan, executable in Record and Verify mode and can be adopted for various length of spinal cord with only two isocenter in shorter treatment time.

  17. Hazardous Waste Development, Demonstration, and Disposal (HAZWDDD) Program Plan

    International Nuclear Information System (INIS)

    McGinnis, C.P.; Eisenhower, B.M.; Reeves, M.E.; DePaoli, S.M.; Stinton, L.H.; Harrington, E.H.

    1989-02-01

    The objective of the Hazardous Waste Development, Demonstration and Disposal (HAZWDDD) Program Plan is to ensure that the needs for treatment and disposal of all its hazardous and mixed wastes have been identified and planned for. A multifaceted approach to developing and implementing this plan is given, including complete plans for each of the five installations, and an overall integrated plan is also described in this report. The HAZWDDD Plan accomplishes the following: (1) provides background and organizational information; (2) summarizes the 402 hazardous and mixed waste streams from the five installations by grouping them into 13 general waste categories; (3) presents current treatment, storage, and disposal capabilities within Energy Systems; (4) develops a management strategy by outlining critical issues, presents flow sheets describing management schemes for problem waste streams, and builds on the needs identified; (5) outlines specific activities needed to implement the strategy developed; and (6) presents schedule and budget requirements for the next decade. The HAZWDDD Program addresses current and future technical problems and regulatory issues and uncertainties. Because of the nature and magnitude of the problems in hazardous and mixed waste management, substantial funding will be required. 10 refs., 39 figs., 16 tabs

  18. Federal Facility Compliance Act, Proposed Site Treatment Plan: Background Volume. Executive Summary

    International Nuclear Information System (INIS)

    1995-01-01

    This Federal Facility Compliance Act Site Treatment Plan discusses the options of radioactive waste management for Ames Laboratory. This is the background volume which discusses: site history and mission; framework for developing site treatment plans; proposed plan organization and related activities; characterization of mixed waste and waste minimization; low level mixed waste streams and the proposed treatment approach; future generation of TRU and mixed wastes; the adequacy of mixed waste storage facilities; and a summary of the overall DOE activity in the area of disposal of mixed waste treatment residuals

  19. Computational Dosimetry and Treatment Planning Considerations for Neutron Capture Therapy

    International Nuclear Information System (INIS)

    Nigg, David Waler

    2003-01-01

    Specialized treatment planning software systems are generally required for neutron capture therapy (NCT) research and clinical applications. The standard simplifying approximations that work well for treatment planning computations in the case of many other modalities are usually not appropriate for application to neutron transport. One generally must obtain an explicit three-dimensional numerical solution of the governing transport equation, with energy-dependent neutron scattering completely taken into account. Treatment planning systems that have been successfully introduced for NCT applications over the past 15 years rely on the Monte Carlo stochastic simulation method for the necessary computations, primarily because of the geometric complexity of human anatomy. However, historically, there has also been interest in the application of deterministic methods, and there have been some practical developments in this area. Most recently, interest has turned toward the creation of treatment planning software that is not limited to any specific therapy modality, with NCT as only one of several applications. A key issue with NCT treatment planning has to do with boron quantification, and whether improved information concerning the spatial biodistribution of boron can be effectively used to improve the treatment planning process. Validation and benchmarking of computations for NCT are also of current developmental interest. Various institutions have their own procedures, but standard validation models are not yet in wide use

  20. Evaluation of a commercial automatic treatment planning system for prostate cancers.

    Science.gov (United States)

    Nawa, Kanabu; Haga, Akihiro; Nomoto, Akihiro; Sarmiento, Raniel A; Shiraishi, Kenshiro; Yamashita, Hideomi; Nakagawa, Keiichi

    2017-01-01

    Recent developments in Radiation Oncology treatment planning have led to the development of software packages that facilitate automated intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) planning. Such solutions include site-specific modules, plan library methods, and algorithm-based methods. In this study, the plan quality for prostate cancer generated by the Auto-Planning module of the Pinnacle 3 radiation therapy treatment planning system (v9.10, Fitchburg, WI) is retrospectively evaluated. The Auto-Planning module of Pinnacle 3 uses a progressive optimization algorithm. Twenty-three prostate cancer cases, which had previously been planned and treated without lymph node irradiation, were replanned using the Auto-Planning module. Dose distributions were statistically compared with those of manual planning by the paired t-test at 5% significance level. Auto-Planning was performed without any manual intervention. Planning target volume (PTV) dose and dose to rectum were comparable between Auto-Planning and manual planning. The former, however, significantly reduced the dose to the bladder and femurs. Regression analysis was performed to examine the correlation between volume overlap between bladder and PTV divided by the total bladder volume and resultant V70. The findings showed that manual planning typically exhibits a logistic way for dose constraint, whereas Auto-Planning shows a more linear tendency. By calculating the Akaike information criterion (AIC) to validate the statistical model, a reduction of interoperator variation in Auto-Planning was shown. We showed that, for prostate cancer, the Auto-Planning module provided plans that are better than or comparable with those of manual planning. By comparing our results with those previously reported for head and neck cancer treatment, we recommend the homogeneous plan quality generated by the Auto-Planning module, which exhibits less dependence on anatomic complexity

  1. Community development planning

    International Nuclear Information System (INIS)

    Gray, S.I.

    1983-01-01

    The focus of this paper will be methods of local community involvement in the community development planning efforts which will be required at the recommended sites. Community development planning will include capital improvement plans, housing plans, zoning changes, business development plans and other community service and fiscal plans required to meet the projected needs of new residents as a result of the repository construction and operation. This paper will present, (1) the need for community planning, (2) methods of responding to community planning needs, (3) current community planning issues to be addressed. 2 references, 1 figure

  2. Normalisation: ROI optimal treatment planning - SNDH pattern

    International Nuclear Information System (INIS)

    Shilvat, D.V.; Bhandari, Virendra; Tamane, Chandrashekhar; Pangam, Suresh

    2001-01-01

    Dose precision maximally to the target / ROI (Region of Interest), taking care of tolerance dose of normal tissue is the aim of ideal treatment planning. This goal is achieved with advanced modalities such as, micro MLC, simulator and 3-dimensional treatment planning system. But SNDH PATTERN uses minimum available resources as, ALCYON II Telecobalt unit, CT Scan, MULTIDATA 2-dimensional treatment planning system to their maximum utility and reaches to the required precision, same as that with advance modalities. Among the number of parameters used, 'NORMALISATION TO THE ROI' will achieve the aim of the treatment planning effectively. This is dealing with an example of canal of esophagus modified treatment planning based on SNDH pattern. Results are attractive and self explanatory. By implementing SNDH pattern, the QUALITY INDEX of treatment plan will reach to greater than 90%, with substantial reduction in dose to the vital organs. Aim is to utilize the minimum available resources efficiently to achieve highest possible precision for delivering homogenous dose to ROI while taking care of tolerance dose to vital organs

  3. In situ gas treatment technology demonstration test plan

    International Nuclear Information System (INIS)

    Thornton, E.C.; Miller, R.D.

    1996-01-01

    This document defines the objectives and requirements associated with undertaking a field demonstration of an in situ gas treatment appoach to remediation chromate-contaminated soil. The major tasks presented in this plan include the design and development of the surface gas treatment system, performance of permitting activities, and completion of site preparation and field testing activities

  4. Interactively exploring optimized treatment plans

    International Nuclear Information System (INIS)

    Rosen, Isaac; Liu, H. Helen; Childress, Nathan; Liao Zhongxing

    2005-01-01

    Purpose: A new paradigm for treatment planning is proposed that embodies the concept of interactively exploring the space of optimized plans. In this approach, treatment planning ignores the details of individual plans and instead presents the physician with clinical summaries of sets of solutions to well-defined clinical goals in which every solution has been optimized in advance by computer algorithms. Methods and materials: Before interactive planning, sets of optimized plans are created for a variety of treatment delivery options and critical structure dose-volume constraints. Then, the dose-volume parameters of the optimized plans are fit to linear functions. These linear functions are used to show in real time how the target dose-volume histogram (DVH) changes as the DVHs of the critical structures are changed interactively. A bitmap of the space of optimized plans is used to restrict the feasible solutions. The physician selects the critical structure dose-volume constraints that give the desired dose to the planning target volume (PTV) and then those constraints are used to create the corresponding optimized plan. Results: The method is demonstrated using prototype software, Treatment Plan Explorer (TPEx), and a clinical example of a patient with a tumor in the right lung. For this example, the delivery options included 4 open beams, 12 open beams, 4 wedged beams, and 12 wedged beams. Beam directions and relative weights were optimized for a range of critical structure dose-volume constraints for the lungs and esophagus. Cord dose was restricted to 45 Gy. Using the interactive interface, the physician explored how the tumor dose changed as critical structure dose-volume constraints were tightened or relaxed and selected the best compromise for each delivery option. The corresponding treatment plans were calculated and compared with the linear parameterization presented to the physician in TPEx. The linear fits were best for the maximum PTV dose and worst

  5. Volumetric Modulated Arc Therapy (VMAT) Treatment Planning for Superficial Tumors

    International Nuclear Information System (INIS)

    Zacarias, Albert S.; Brown, Mellonie F.; Mills, Michael D.

    2010-01-01

    The physician's planning objective is often a uniform dose distribution throughout the planning target volume (PTV), including superficial PTVs on or near the surface of a patient's body. Varian's Eclipse treatment planning system uses a progressive resolution optimizer (PRO), version 8.2.23, for RapidArc dynamic multileaf collimator volumetric modulated arc therapy planning. Because the PRO is a fast optimizer, optimization convergence errors (OCEs) produce dose nonuniformity in the superficial area of the PTV. We present a postsurgical cranial case demonstrating the recursive method our clinic uses to produce RapidArc treatment plans. The initial RapidArc treatment plan generated using one 360 o arc resulted in substantial dose nonuniformity in the superficial section of the PTV. We demonstrate the use of multiple arcs to produce improved dose uniformity in this region. We also compare the results of this superficial dose compensation method to the results of a recursive method of dose correction that we developed in-house to correct optimization convergence errors in static intensity-modulated radiation therapy treatment plans. The results show that up to 4 arcs may be necessary to provide uniform dose to the surface of the PTV with the current version of the PRO.

  6. Computerized three-dimensional treatment planning system utilizing interactive colour graphics

    Energy Technology Data Exchange (ETDEWEB)

    McShan, D L; Silverman, A; Lanza, D M; Reinstein, L E; Glicksman, A S [Rhode Island Hospital (US). Dept. of Radiation Oncology

    1979-06-01

    A new computerized radiation treatment planning system has been developed to aid in three-dimensional treatment planning. Using interactive colour graphics in conjunction with a PDP 11/45 computer, the system can take multiple transverse contours and construct a perspective display of the treatment region showing organ surfaces as well as cross-sectional contours. With interactively selected orientations, the display allows easy perception of the relative positioning of the treatment volume and the neighbouring anatomy. For external beam treatment planning, interactive computer simulation is used to select diaphragm sizes which best conform to the target area while avoiding sensitive structures. Dose calculations for the selected beams are carried out on multiple transverse planes. The calculational planes and surfaces are displayed in perspective with radiation dosage displayed in an interactively manipulated colour display. Altogether the system provides an easy assessment of the volume to be irradiated, interactive selection of optimal arrangements of treatment fields and a means of visualizing and evaluating the resulting dose distributions.

  7. Treatment Planning for Ion Beam Therapy

    Science.gov (United States)

    Jäkel, Oliver

    The special aspects of treatment planning for ion beams are outlined in this chapter, starting with positioning and immobilization of the patient, describing imaging and segmentation, definition of treatment parameters, dose calculation and optimization, and, finally, plan assessment, verification, and quality assurance.

  8. Plug pattern optimization for gamma knife radiosurgery treatment planning

    International Nuclear Information System (INIS)

    Zhang Pengpeng; Wu, Jackie; Dean, David; Xing Lei; Xue Jinyue; Maciunas, Robert; Sibata, Claudio

    2003-01-01

    Purpose: To develop a novel dose optimization algorithm for improving the sparing of critical structures during gamma knife radiosurgery by shaping the plug pattern of each individual shot. Method and Materials: We first use a geometric information (medial axis) aided guided evolutionary simulated annealing (GESA) optimization algorithm to determine the number of shots and isocenter location, size, and weight of each shot. Then we create a plug quality score system that checks the dose contribution to the volume of interest by each plug in the treatment plan. A positive score implies that the corresponding source could be open to improve tumor coverage, whereas a negative score means the source could be blocked for the purpose of sparing normal and critical structures. The plug pattern is then optimized via the GESA algorithm that is integrated with this score system. Weight and position of each shot are also tuned in this procedure. Results: An acoustic tumor case is used to evaluate our algorithm. Compared to the treatment plan generated without plug patterns, adding an optimized plug pattern into the treatment planning process boosts tumor coverage index from 95.1% to 97.2%, reduces RTOG conformity index from 1.279 to 1.167, lowers Paddick's index from 1.34 to 1.20, and trims the critical structure receiving more than 30% maximum dose from 16 mm 3 to 6 mm 3 . Conclusions: Automated GESA-based plug pattern optimization of gamma knife radiosurgery frees the treatment planning team from the manual forward planning procedure and provides an optimal treatment plan

  9. Completion of treatment planning

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    The outline of the lecture included the following topics: entering prescription; plan printout; print and transfer DDR; segment BEV; export to R and V; physician approval; and second check. Considerable attention, analysis and discussion. The summary is as follows: Treatment planning completion is a very responsible process which requires maximum attention; Should be independently checked by the planner, physicist, radiation oncologist and a therapist; Should not be done in a last minute rush; Proper communication between team members; Properly set procedure should prevent propagation of an error by one individual to the treatment: the error should be caught by somebody else. (P.A.)

  10. Quantification of the influence of the choice of the algorithm and planning system on the calculation of a treatment plan

    International Nuclear Information System (INIS)

    Moral, F. del; Ramos, A.; Salgado, M.; Andrade, B; Munoz, V.

    2010-01-01

    In this work an analysis of the influence of the choice of the algorithm or planning system, on the calculus of the same treatment plan is introduced. For this purpose specific software has been developed for comparing plans of a series of IMRT cases of prostate and head and neck cancer calculated using the convolution, superposition and fast superposition algorithms implemented in the XiO 4.40 planning system (CMS). It has also been used for the comparison of the same treatment plan for lung pathology calculated in XiO with the mentioned algorithms, and calculated in the Plan 4.1 planning system (Brainlab) using its pencil beam algorithm. Differences in dose among the treatment plans have been quantified using a set of metrics. The recommendation for the dosimetrist of a careful choice of the algorithm has been numerically confirmed. (Author).

  11. Basic considerations in simulated treatment planning for the Stanford Medical Pion Generator (SMPG)

    International Nuclear Information System (INIS)

    Pistenma, D.A.; Li, G.C.; Bagshaw, M.A.

    1977-01-01

    Recent interest in charged heavy particle irradiation is based upon expected improved local tumor control rates because of the greater precision in dose localization and the increased biological effectiveness of the high linear energy transfer ionization of particle beams in their stopping regions (Bragg peaks). A novel 60 beam cylindrical geometry pion spectrometer designed for a hospital-based pion therapy facility has been constructed at Stanford. In conjunction with the development and testing of the SMPG a program of simulated treatment planning is being conducted. This paper presents basic considerations in treatment planning for pions and other charged heavy particles. It also presents the status of simulated treatment planning calculations for the SMPG including a discussion of the principle of irradiation of hypothetical tumor volumes illustrated by examples of simplified treatment plans incorporating tissue density inhomogeneity corrections. Also presented are considerations for realistic simulated treatment planning calculations using computerized tomographic scan cross sections of actual patients and a conceptual plan for an integrated treatment planning and patient treatment system for the SMPG

  12. MO-C-BRF-01: Pediatric Treatment Planning I: Overview of Planning Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Olch, A [Childrens Hospital of LA, Los Angeles, CA (United States); Hua, C [St. Jude Childrens Research Hospital, Memphis, TN (United States)

    2014-06-15

    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child's brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. This fact has important implications for the choice of delivery techniques, especially when considering IMRT. For bilateral retinoblastoma for example, an irradiated child has a 50% chance of developing a second cancer by age 50. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa, neuroblastoma, requiring focal

  13. Automatic liver contouring for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Li, Dengwang; Kapp, Daniel S; Xing, Lei; Liu, Li

    2015-01-01

    To develop automatic and efficient liver contouring software for planning 3D-CT and four-dimensional computed tomography (4D-CT) for application in clinical radiation therapy treatment planning systems.The algorithm comprises three steps for overcoming the challenge of similar intensities between the liver region and its surrounding tissues. First, the total variation model with the L1 norm (TV-L1), which has the characteristic of multi-scale decomposition and an edge-preserving property, is used for removing the surrounding muscles and tissues. Second, an improved level set model that contains both global and local energy functions is utilized to extract liver contour information sequentially. In the global energy function, the local correlation coefficient (LCC) is constructed based on the gray level co-occurrence matrix both of the initial liver region and the background region. The LCC can calculate the correlation of a pixel with the foreground and background regions, respectively. The LCC is combined with intensity distribution models to classify pixels during the evolutionary process of the level set based method. The obtained liver contour is used as the candidate liver region for the following step. In the third step, voxel-based texture characterization is employed for refining the liver region and obtaining the final liver contours.The proposed method was validated based on the planning CT images of a group of 25 patients undergoing radiation therapy treatment planning. These included ten lung cancer patients with normal appearing livers and ten patients with hepatocellular carcinoma or liver metastases. The method was also tested on abdominal 4D-CT images of a group of five patients with hepatocellular carcinoma or liver metastases. The false positive volume percentage, the false negative volume percentage, and the dice similarity coefficient between liver contours obtained by a developed algorithm and a current standard delineated by the expert group

  14. Imaging modalities in radiation treatment planning of brain tumors

    International Nuclear Information System (INIS)

    Georgiev, D.

    2009-01-01

    The radiation therapy is a standard treatment after surgery for most of malignant and some of benignant brain tumors. The restriction in acquiring local tumor control is an inability in realization of high dose without causing radiation necrosis in irradiated area and sparing normal tissues. The development of imaging modalities during the last years is responsible for better treatment results and lower early and late toxicity. Essential is the role of image methods not only in the diagnosis and also in the precise anatomical (during last years also functional) localisation, spreading of the tumor, treatment planning process and the effects of the treatment. Target delineation is one of the great geometrical uncertainties in the treatment planning process. Early studies on the use of CT in treatment planning documented that tumor coverage without CT was clearly inadequate in 20% of the patients and marginal in another 27 %. The image fusion of CT, MBI and PET and also the use of contrast materia helps to get over those restrictions. The use of contrast material enhances the signal in 10 % of the patients with glioblastoma multiform and in a higher percentage of the patients with low-grade gliomas

  15. Developing a Treatment Planning Software Based on TG-43U1 Formalism for Cs-137 LDR Brachytherapy.

    Science.gov (United States)

    Sina, Sedigheh; Faghihi, Reza; Soleimani Meigooni, Ali; Siavashpour, Zahra; Mosleh-Shirazi, Mohammad Amin

    2013-08-01

    The old Treatment Planning Systems (TPSs) used for intracavitary brachytherapy with Cs-137 Selectron source utilize traditional dose calculation methods, considering each source as a point source. Using such methods introduces significant errors in dose estimation. As of 1995, TG-43 is used as the main dose calculation formalism in treatment TPSs. The purpose of this study is to design and establish a treatment planning software for Cs-137 Solectron brachytherapy source, based on TG-43U1 formalism by applying the effects of the applicator and dummy spacers. Two softwares used for treatment planning of Cs-137 sources in Iran (STPS and PLATO), are based on old formalisms. The purpose of this work is to establish and develop a TPS for Selectron source based on TG-43 formalism. In this planning system, the dosimetry parameters of each pellet in different places inside applicators were obtained by MCNP4c code. Then the dose distribution around every combination of active and inactive pellets was obtained by summing the doses. The accuracy of this algorithm was checked by comparing its results for special combination of active and inactive pellets with MC simulations. Finally, the uncertainty of old dose calculation formalism was investigated by comparing the results of STPS and PLATO softwares with those obtained by the new algorithm. For a typical arrangement of 10 active pellets in the applicator, the percentage difference between doses obtained by the new algorithm at 1cm distance from the tip of the applicator and those obtained by old formalisms is about 30%, while the difference between the results of MCNP and the new algorithm is less than 5%. According to the results, the old dosimetry formalisms, overestimate the dose especially towards the applicator's tip. While the TG-43U1 based software perform the calculations more accurately.

  16. Automated high-dose rate brachytherapy treatment planning for a single-channel vaginal cylinder applicator

    Science.gov (United States)

    Zhou, Yuhong; Klages, Peter; Tan, Jun; Chi, Yujie; Stojadinovic, Strahinja; Yang, Ming; Hrycushko, Brian; Medin, Paul; Pompos, Arnold; Jiang, Steve; Albuquerque, Kevin; Jia, Xun

    2017-06-01

    High dose rate (HDR) brachytherapy treatment planning is conventionally performed manually and/or with aids of preplanned templates. In general, the standard of care would be elevated by conducting an automated process to improve treatment planning efficiency, eliminate human error, and reduce plan quality variations. Thus, our group is developing AutoBrachy, an automated HDR brachytherapy planning suite of modules used to augment a clinical treatment planning system. This paper describes our proof-of-concept module for vaginal cylinder HDR planning that has been fully developed. After a patient CT scan is acquired, the cylinder applicator is automatically segmented using image-processing techniques. The target CTV is generated based on physician-specified treatment depth and length. Locations of the dose calculation point, apex point and vaginal surface point, as well as the central applicator channel coordinates, and the corresponding dwell positions are determined according to their geometric relationship with the applicator and written to a structure file. Dwell times are computed through iterative quadratic optimization techniques. The planning information is then transferred to the treatment planning system through a DICOM-RT interface. The entire process was tested for nine patients. The AutoBrachy cylindrical applicator module was able to generate treatment plans for these cases with clinical grade quality. Computation times varied between 1 and 3 min on an Intel Xeon CPU E3-1226 v3 processor. All geometric components in the automated treatment plans were generated accurately. The applicator channel tip positions agreed with the manually identified positions with submillimeter deviations and the channel orientations between the plans agreed within less than 1 degree. The automatically generated plans obtained clinically acceptable quality.

  17. Hanford Site Development Plan

    International Nuclear Information System (INIS)

    Rinne, C.A.; Curry, R.H.; Hagan, J.W.; Seiler, S.W.; Sommer, D.J.; Yancey, E.F.

    1990-01-01

    The Hanford Site Development Plan (Site Development Plan) is intended to guide the short- and long-range development and use of the Hanford Site. All acquisition, development, and permanent facility use at the Hanford Site will conform to the approved plan. The Site Development Plan also serves as the base document for all subsequent studies that involve use of facilities at the Site. This revision is an update of a previous plan. The executive summary presents the highlights of the five major topics covered in the Site Development Plan: general site information, existing conditions, planning analysis, Master Plan, and Five-Year Plan. 56 refs., 67 figs., 31 tabs

  18. Hanford Site Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Rinne, C.A.; Curry, R.H.; Hagan, J.W.; Seiler, S.W.; Sommer, D.J. (Westinghouse Hanford Co., Richland, WA (USA)); Yancey, E.F. (Pacific Northwest Lab., Richland, WA (USA))

    1990-01-01

    The Hanford Site Development Plan (Site Development Plan) is intended to guide the short- and long-range development and use of the Hanford Site. All acquisition, development, and permanent facility use at the Hanford Site will conform to the approved plan. The Site Development Plan also serves as the base document for all subsequent studies that involve use of facilities at the Site. This revision is an update of a previous plan. The executive summary presents the highlights of the five major topics covered in the Site Development Plan: general site information, existing conditions, planning analysis, Master Plan, and Five-Year Plan. 56 refs., 67 figs., 31 tabs.

  19. Simulation model for planning metallurgical treatment of large-size billets

    International Nuclear Information System (INIS)

    Timofeev, M.A.; Echeistova, L.A.; Kuznetsov, V.G.; Semakin, S.V.; Krivonogov, A.B.

    1989-01-01

    The computerized simulation system ''Ritm'' for planning metallurgical treatment of billets is developed. Three principles, specifying the organization structure of the treatment cycle are formulated as follows: a cycling principle, a priority principle and a principle of group treatment. The ''Ritm'' software consists of three independent operating systems: preparation of source data, simulation, data output

  20. Knowledge-based treatment planning and its potential role in the transition between treatment planning systems.

    Science.gov (United States)

    Masi, Kathryn; Archer, Paul; Jackson, William; Sun, Yilun; Schipper, Matthew; Hamstra, Daniel; Matuszak, Martha

    2017-11-22

    Commissioning a new treatment planning system (TPS) involves many time-consuming tasks. We investigated the role that knowledge-based planning (KBP) can play in aiding a clinic's transition to a new TPS. Sixty clinically treated prostate/prostate bed intensity-modulated radiation therapy (IMRT) plans were exported from an in-house TPS and were used to create a KBP model in a newly implemented commercial application. To determine the benefit that KBP may have in a TPS transition, the model was tested on 2 groups of patients. Group 1 consisted of the first 10 prostate/prostate bed patients treated in the commercial TPS after the transition from the in-house TPS. Group 2 consisted of 10 patients planned in the commercial TPS after 8 months of clinical use. The KBP-generated plan was compared with the clinically used plan in terms of plan quality (ability to meet planning objectives and overall dose metrics) and planning efficiency (time required to generate clinically acceptable plans). The KBP-generated plans provided a significantly improved target coverage (p = 0.01) compared with the clinically used plans for Group 1, but yielded plans of comparable target coverage to the clinically used plans for Group 2. For the organs at risk, the KBP-generated plans produced lower doses, on average, for every normal-tissue objective except for the maximum dose to 0.1 cc of rectum. The time needed for the KBP-generated plans ranged from 6 to 15 minutes compared to 30 to 150 and 15 to 60 minutes for manual planning in Groups 1 and 2, respectively. KBP is a promising tool to aid in the transition to a new TPS. Our study indicates that high-quality treatment plans could have been generated in the newly implemented TPS more efficiently compared with not using KBP. Even after 8 months of the clinical use, KBP still showed an increase in plan quality and planning efficiency compared with manual planning. Copyright © 2017 American Association of Medical Dosimetrists. Published

  1. Evaluation and scoring of radiotherapy treatment plans using an artificial neural network

    International Nuclear Information System (INIS)

    Willoughby, Twyla R.; Starkschall, George; Janjan, Nora A.; Rosen, Isaac I.

    1996-01-01

    Purpose: The objective of this work was to demonstrate the feasibility of using an artificial neural network to predict the clinical evaluation of radiotherapy treatment plans. Methods and Materials: Approximately 150 treatment plans were developed for 16 patients who received external-beam radiotherapy for soft-tissue sarcomas of the lower extremity. Plans were assigned a figure of merit by a radiation oncologist using a five-point rating scale. Plan scoring was performed by a single physician to ensure consistency in rating. Dose-volume information extracted from a training set of 511 treatment plans on 14 patients was correlated to the physician-generated figure of merit using an artificial neural network. The neural network was tested with a test set of 19 treatment plans on two patients whose plans were not used in the training of the neural net. Results: Physician scoring of treatment plans was consistent to within one point on the rating scale 88% of the time. The neural net reproduced the physician scores in the training set to within one point approximately 90% of the time. It reproduced the physician scores in the test set to within one point approximately 83% of the time. Conclusions: An artificial neural network can be trained to generate a score for a treatment plan that can be correlated to a clinically-based figure of merit. The accuracy of the neural net in scoring plans compares well with the reproducibility of the clinical scoring. The system of radiotherapy treatment plan evaluation using an artificial neural network demonstrates promise as a method for generating a clinically relevant figure of merit

  2. MO-D-BRB-01: Pediatric Treatment Planning I: Overview of Planning Strategies and Challenges

    Energy Technology Data Exchange (ETDEWEB)

    Olch, A. [Childrens Hospital of LA (United States)

    2015-06-15

    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa

  3. Photodynamic therapy in neurosurgery: a proof of concept of treatment planning system

    Science.gov (United States)

    Dupont, C.; Reyns, N.; Mordon, S.; Vermandel, M.

    2017-02-01

    Glioblastoma (GBM) is the most common primary brain tumor. PhotoDynamic Therapy (PDT) appears as an interesting research field to improve GBM treatment. Nevertheless, PDT cannot fit into the current therapeutic modalities according to several reasons: the lack of reliable and reproducible therapy schemes (devices, light delivery system), the lack of consensus on a photosensitizer and the absence of randomized and controlled multicenter clinical trial. The main objective of this study is to bring a common support for PDT planning. Here, we describe a proof of concept of Treatment Planning System (TPS) dedicated to interstitial PDT for GBM treatment. The TPS was developed with the integrated development environment C++ Builder XE8 and the environment ArtiMED, developed in our laboratory. This software enables stereotactic registration of DICOM images, light sources insertion and an accelerated CUDA GPU dosimetry modeling. Although, Monte-Carlo is more robust to describe light diffusion in biological tissue, analytical model accelerated by GPU remains relevant for dose preview or fast reverse planning processes. Finally, this preliminary work proposes a new tool to plan interstitial or intraoperative PDT treatment and might be included in the design of future clinical trials in order to deliver PDT straightforwardly and homogenously in investigator centers.

  4. Evaluation of plan quality assurance models for prostate cancer patients based on fully automatically generated Pareto-optimal treatment plans.

    Science.gov (United States)

    Wang, Yibing; Breedveld, Sebastiaan; Heijmen, Ben; Petit, Steven F

    2016-06-07

    IMRT planning with commercial Treatment Planning Systems (TPSs) is a trial-and-error process. Consequently, the quality of treatment plans may not be consistent among patients, planners and institutions. Recently, different plan quality assurance (QA) models have been proposed, that could flag and guide improvement of suboptimal treatment plans. However, the performance of these models was validated using plans that were created using the conventional trail-and-error treatment planning process. Consequently, it is challenging to assess and compare quantitatively the accuracy of different treatment planning QA models. Therefore, we created a golden standard dataset of consistently planned Pareto-optimal IMRT plans for 115 prostate patients. Next, the dataset was used to assess the performance of a treatment planning QA model that uses the overlap volume histogram (OVH). 115 prostate IMRT plans were fully automatically planned using our in-house developed TPS Erasmus-iCycle. An existing OVH model was trained on the plans of 58 of the patients. Next it was applied to predict DVHs of the rectum, bladder and anus of the remaining 57 patients. The predictions were compared with the achieved values of the golden standard plans for the rectum D mean, V 65, and V 75, and D mean of the anus and the bladder. For the rectum, the prediction errors (predicted-achieved) were only  -0.2  ±  0.9 Gy (mean  ±  1 SD) for D mean,-1.0  ±  1.6% for V 65, and  -0.4  ±  1.1% for V 75. For D mean of the anus and the bladder, the prediction error was 0.1  ±  1.6 Gy and 4.8  ±  4.1 Gy, respectively. Increasing the training cohort to 114 patients only led to minor improvements. A dataset of consistently planned Pareto-optimal prostate IMRT plans was generated. This dataset can be used to train new, and validate and compare existing treatment planning QA models, and has been made publicly available. The OVH model was highly accurate

  5. Automated replication of cone beam CT-guided treatments in the Pinnacle(3) treatment planning system for adaptive radiotherapy.

    Science.gov (United States)

    Hargrave, Catriona; Mason, Nicole; Guidi, Robyn; Miller, Julie-Anne; Becker, Jillian; Moores, Matthew; Mengersen, Kerrie; Poulsen, Michael; Harden, Fiona

    2016-03-01

    Time-consuming manual methods have been required to register cone-beam computed tomography (CBCT) images with plans in the Pinnacle(3) treatment planning system in order to replicate delivered treatments for adaptive radiotherapy. These methods rely on fiducial marker (FM) placement during CBCT acquisition or the image mid-point to localise the image isocentre. A quality assurance study was conducted to validate an automated CBCT-plan registration method utilising the Digital Imaging and Communications in Medicine (DICOM) Structure Set (RS) and Spatial Registration (RE) files created during online image-guided radiotherapy (IGRT). CBCTs of a phantom were acquired with FMs and predetermined setup errors using various online IGRT workflows. The CBCTs, DICOM RS and RE files were imported into Pinnacle(3) plans of the phantom and the resulting automated CBCT-plan registrations were compared to existing manual methods. A clinical protocol for the automated method was subsequently developed and tested retrospectively using CBCTs and plans for six bladder patients. The automated CBCT-plan registration method was successfully applied to thirty-four phantom CBCT images acquired with an online 0 mm action level workflow. Ten CBCTs acquired with other IGRT workflows required manual workarounds. This was addressed during the development and testing of the clinical protocol using twenty-eight patient CBCTs. The automated CBCT-plan registrations were instantaneous, replicating delivered treatments in Pinnacle(3) with errors of ±0.5 mm. These errors were comparable to mid-point-dependant manual registrations but superior to FM-dependant manual registrations. The automated CBCT-plan registration method quickly and reliably replicates delivered treatments in Pinnacle(3) for adaptive radiotherapy.

  6. Monte Carlo based dosimetry and treatment planning for neutron capture therapy of brain tumors

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Brenner, J.F.; Wazer, D.E.; Madoc-Jones, H.; Clement, S.D.; Harling, O.K.; Yanch, J.C.

    1990-01-01

    Monte Carlo based dosimetry and computer-aided treatment planning for neutron capture therapy have been developed to provide the necessary link between physical dosimetric measurements performed on the MITR-II epithermal-neutron beams and the need of the radiation oncologist to synthesize large amounts of dosimetric data into a clinically meaningful treatment plan for each individual patient. Monte Carlo simulation has been employed to characterize the spatial dose distributions within a skull/brain model irradiated by an epithermal-neutron beam designed for neutron capture therapy applications. The geometry and elemental composition employed for the mathematical skull/brain model and the neutron and photon fluence-to-dose conversion formalism are presented. A treatment planning program, NCTPLAN, developed specifically for neutron capture therapy, is described. Examples are presented illustrating both one and two-dimensional dose distributions obtainable within the brain with an experimental epithermal-neutron beam, together with beam quality and treatment plan efficacy criteria which have been formulated for neutron capture therapy. The incorporation of three-dimensional computed tomographic image data into the treatment planning procedure is illustrated

  7. Optimal partial-arcs in VMAT treatment planning

    International Nuclear Information System (INIS)

    Wala, Jeremiah; Salari, Ehsan; Chen Wei; Craft, David

    2012-01-01

    We present a method for improving the delivery efficiency of VMAT by extending the recently published VMAT treatment planning algorithm vmerge to automatically generate optimal partial-arc plans. A high-quality initial plan is created by solving a convex multicriteria optimization problem using 180 equi-spaced beams. This initial plan is used to form a set of dose constraints, and a set of partial-arc plans is created by searching the space of all possible partial-arc plans that satisfy these constraints. For each partial-arc, an iterative fluence map merging and sequencing algorithm (vmerge) is used to improve the delivery efficiency. Merging continues as long as the dose quality is maintained above a user-defined threshold. The final plan is selected as the partial-arc with the lowest treatment time. The complete algorithm is called pmerge. Partial-arc plans are created using pmerge for a lung, liver and prostate case, with final treatment times of 127, 245 and 147 s. Treatment times using full arcs with vmerge are 211, 357 and 178 s. The mean doses to the critical structures for the vmerge and pmerge plans are kept within 5% of those in the initial plan, and the target volume covered by the prescription isodose is maintained above 98% for the pmerge and vmerge plans. Additionally, we find that the angular distribution of fluence in the initial plans is predictive of the start and end angles of the optimal partial-arc. We conclude that VMAT delivery efficiency can be improved by employing partial-arcs without compromising dose quality, and that partial-arcs are most applicable to cases with non-centralized targets. (paper)

  8. SU-F-T-65: AutomaticTreatment Planning for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

    International Nuclear Information System (INIS)

    Zhou, Y; Tan, J; Jiang, S; Albuquerque, K; Jia, X

    2016-01-01

    Purpose: High dose rate (HDR) brachytherapy treatment planning is conventionally performed in a manual fashion. Yet it is highly desirable to perform computerized automated planning to improve treatment planning efficiency, eliminate human errors, and reduce plan quality variation. The goal of this research is to develop an automatic treatment planning tool for HDR brachytherapy with a cylinder applicator for vaginal cancer. Methods: After inserting the cylinder applicator into the patient, a CT scan was acquired and was loaded to an in-house developed treatment planning software. The cylinder applicator was automatically segmented using image-processing techniques. CTV was generated based on user-specified treatment depth and length. Locations of relevant points (apex point, prescription point, and vaginal surface point), central applicator channel coordinates, and dwell positions were determined according to their geometric relations with the applicator. Dwell time was computed through an inverse optimization process. The planning information was written into DICOM-RT plan and structure files to transfer the automatically generated plan to a commercial treatment planning system for plan verification and delivery. Results: We have tested the system retrospectively in nine patients treated with vaginal cylinder applicator. These cases were selected with different treatment prescriptions, lengths, depths, and cylinder diameters to represent a large patient population. Our system was able to generate treatment plans for these cases with clinically acceptable quality. Computation time varied from 3–6 min. Conclusion: We have developed a system to perform automated treatment planning for HDR brachytherapy with a cylinder applicator. Such a novel system has greatly improved treatment planning efficiency and reduced plan quality variation. It also served as a testbed to demonstrate the feasibility of automatic HDR treatment planning for more complicated cases.

  9. SU-F-T-65: AutomaticTreatment Planning for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Y; Tan, J; Jiang, S; Albuquerque, K; Jia, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: High dose rate (HDR) brachytherapy treatment planning is conventionally performed in a manual fashion. Yet it is highly desirable to perform computerized automated planning to improve treatment planning efficiency, eliminate human errors, and reduce plan quality variation. The goal of this research is to develop an automatic treatment planning tool for HDR brachytherapy with a cylinder applicator for vaginal cancer. Methods: After inserting the cylinder applicator into the patient, a CT scan was acquired and was loaded to an in-house developed treatment planning software. The cylinder applicator was automatically segmented using image-processing techniques. CTV was generated based on user-specified treatment depth and length. Locations of relevant points (apex point, prescription point, and vaginal surface point), central applicator channel coordinates, and dwell positions were determined according to their geometric relations with the applicator. Dwell time was computed through an inverse optimization process. The planning information was written into DICOM-RT plan and structure files to transfer the automatically generated plan to a commercial treatment planning system for plan verification and delivery. Results: We have tested the system retrospectively in nine patients treated with vaginal cylinder applicator. These cases were selected with different treatment prescriptions, lengths, depths, and cylinder diameters to represent a large patient population. Our system was able to generate treatment plans for these cases with clinically acceptable quality. Computation time varied from 3–6 min. Conclusion: We have developed a system to perform automated treatment planning for HDR brachytherapy with a cylinder applicator. Such a novel system has greatly improved treatment planning efficiency and reduced plan quality variation. It also served as a testbed to demonstrate the feasibility of automatic HDR treatment planning for more complicated cases.

  10. SU-F-J-105: Towards a Novel Treatment Planning Pipeline Delivering Pareto- Optimal Plans While Enabling Inter- and Intrafraction Plan Adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Kontaxis, C; Bol, G; Lagendijk, J; Raaymakers, B [University Medical Center Utrecht, Utrecht (Netherlands); Breedveld, S; Sharfo, A; Heijmen, B [Erasmus University Medical Center Rotterdam, Rotterdam (Netherlands)

    2016-06-15

    Purpose: To develop a new IMRT treatment planning methodology suitable for the new generation of MR-linear accelerator machines. The pipeline is able to deliver Pareto-optimal plans and can be utilized for conventional treatments as well as for inter- and intrafraction plan adaptation based on real-time MR-data. Methods: A Pareto-optimal plan is generated using the automated multicriterial optimization approach Erasmus-iCycle. The resulting dose distribution is used as input to the second part of the pipeline, an iterative process which generates deliverable segments that target the latest anatomical state and gradually converges to the prescribed dose. This process continues until a certain percentage of the dose has been delivered. Under a conventional treatment, a Segment Weight Optimization (SWO) is then performed to ensure convergence to the prescribed dose. In the case of inter- and intrafraction adaptation, post-processing steps like SWO cannot be employed due to the changing anatomy. This is instead addressed by transferring the missing/excess dose to the input of the subsequent fraction. In this work, the resulting plans were delivered on a Delta4 phantom as a final Quality Assurance test. Results: A conventional static SWO IMRT plan was generated for two prostate cases. The sequencer faithfully reproduced the input dose for all volumes of interest. For the two cases the mean relative dose difference of the PTV between the ideal input and sequenced dose was 0.1% and −0.02% respectively. Both plans were delivered on a Delta4 phantom and passed the clinical Quality Assurance procedures by achieving 100% pass rate at a 3%/3mm gamma analysis. Conclusion: We have developed a new sequencing methodology capable of online plan adaptation. In this work, we extended the pipeline to support Pareto-optimal input and clinically validated that it can accurately achieve these ideal distributions, while its flexible design enables inter- and intrafraction plan

  11. SU-F-J-105: Towards a Novel Treatment Planning Pipeline Delivering Pareto- Optimal Plans While Enabling Inter- and Intrafraction Plan Adaptation

    International Nuclear Information System (INIS)

    Kontaxis, C; Bol, G; Lagendijk, J; Raaymakers, B; Breedveld, S; Sharfo, A; Heijmen, B

    2016-01-01

    Purpose: To develop a new IMRT treatment planning methodology suitable for the new generation of MR-linear accelerator machines. The pipeline is able to deliver Pareto-optimal plans and can be utilized for conventional treatments as well as for inter- and intrafraction plan adaptation based on real-time MR-data. Methods: A Pareto-optimal plan is generated using the automated multicriterial optimization approach Erasmus-iCycle. The resulting dose distribution is used as input to the second part of the pipeline, an iterative process which generates deliverable segments that target the latest anatomical state and gradually converges to the prescribed dose. This process continues until a certain percentage of the dose has been delivered. Under a conventional treatment, a Segment Weight Optimization (SWO) is then performed to ensure convergence to the prescribed dose. In the case of inter- and intrafraction adaptation, post-processing steps like SWO cannot be employed due to the changing anatomy. This is instead addressed by transferring the missing/excess dose to the input of the subsequent fraction. In this work, the resulting plans were delivered on a Delta4 phantom as a final Quality Assurance test. Results: A conventional static SWO IMRT plan was generated for two prostate cases. The sequencer faithfully reproduced the input dose for all volumes of interest. For the two cases the mean relative dose difference of the PTV between the ideal input and sequenced dose was 0.1% and −0.02% respectively. Both plans were delivered on a Delta4 phantom and passed the clinical Quality Assurance procedures by achieving 100% pass rate at a 3%/3mm gamma analysis. Conclusion: We have developed a new sequencing methodology capable of online plan adaptation. In this work, we extended the pipeline to support Pareto-optimal input and clinically validated that it can accurately achieve these ideal distributions, while its flexible design enables inter- and intrafraction plan

  12. SU-E-T-173: Clinical Comparison of Treatment Plans and Fallback Plans for Machine Downtime

    Energy Technology Data Exchange (ETDEWEB)

    Cruz, W [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Cancer Therapy and Research Center, San Antonio, TX (United States); Papanikolaou, P [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Mavroidis, P [University of North Carolina, Chapel Hill, NC (United States); Stathakis, S [Cancer Therapy and Research Center, San Antonio, TX (United States)

    2015-06-15

    Purpose: The purpose of this study was to determine the clinical effectiveness and dosimetric quality of fallback planning in relation to machine downtime. Methods: Plans for a Varian Novalis TX were mimicked, and fallback plans using an Elekta VersaHD machine were generated using a dual arc template. Plans for thirty (n=30) patients of various treatment sites optimized and calculated using RayStation treatment planning system. For each plan, a fall back plan was created and compared to the original plan. A dosimetric evaluation was conducted using the homogeneity index, conformity index, as well as DVH analysis to determine the quality of the fallback plan on a different treatment machine. Fallback plans were optimized for 60 iterations using the imported dose constraints from the original plan DVH to give fallback plans enough opportunity to achieve the dose objectives. Results: The average conformity index and homogeneity index for the NovalisTX plans were 0.76 and 10.3, respectively, while fallback plan values were 0.73 and 11.4. (Homogeneity =1 and conformity=0 for ideal plan) The values to various organs at risk were lower in the fallback plans as compared to the imported plans across most organs at risk. Isodose difference comparisons between plans were also compared and the average dose difference across all plans was 0.12%. Conclusion: The clinical impact of fallback planning is an important aspect to effective treatment of patients. With the complexity of LINACS increasing every year, an option to continue treating during machine downtime remains an essential tool in streamlined treatment execution. Fallback planning allows the clinic to continue to run efficiently should a treatment machine become offline due to maintenance or repair without degrading the quality of the plan all while reducing strain on members of the radiation oncology team.

  13. An interactive beam-weight optimization tool for three-dimensional radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Burba, S.; Gardey, K.; Nadobny, J.; Stalling, D.; Seebass, M.; Beier, J.; Wust, P.; Budach, V.; Felix, R.

    1997-01-01

    Purpose: A computer software tool has been developed to aid the treatment planner in selecting beam weights for three-dimensional radiotherapy treatment planning. An approach to plan optimization has been made that is based on the use of an iterative feasibility search algorithm combined with a quadratic convergence method that seeks a set of beam weights which satisfies all the dose constraints set by the planner. Materials and Methods: A FORTRAN module for dose calculation for radiotherapy (a VOXELPLAN modification) has been integrated into an object-oriented Silicon Graphics TM platform in an IRIS Inventor environment on basis of the OpenGL which up to now has been exclusively used for the calculation of E-field distributions in hyperthermia (HyperPlan TM ). After the successful calculation and representation of the dose distribution in the Silicon Graphics TM platform, an algorithm involving the minimization method according to the principle of quadratic convergence was developed for optimizing beam weights of a number of pre-calculated fields. The verification of the algorithms for dose calculation and dose optimization has been realized by use of a standardized interface to the program VIRTUOS as well as by the collapsed cone algorithm implemented in the commercial treatment planning system Helax TMS TM . Results: The search algorithm allows the planner to incorporate relative importance weightings to target volumes and anatomical structures, specifying, for example, that a dose constraint to the spinal cord is much more crucial to the overall evaluation of a treatment plan than a dose constraint to otherwise uninvolved soft tissue. In most cases the applied minimization method according to the model of Davidon-Fletcher-Powell showed ultimate fast convergence for a general function f(x) with continuous second derivatives and fast convergence for a positive definite quadratic function. In other cases, however, the absence of an acceptable solution may indicate

  14. Advantages of three-dimensional treatment planning in radiation therapy

    International Nuclear Information System (INIS)

    Attalla, E.M.; ELSAyed, A.A.; ElGantiry, M.; ElTahher, Z.

    2003-01-01

    This study was designed to demonstrate the feasibility of three-dimensional (3-D) treatment planning in-patients maxilla, breast, bladder, and lung tumors to explore its potential therapeutic advantage over the traditional dimensional (2-D) approach in these diseases. Conventional two-dimensional (2-D) treatment planning was compared to three-dimensional (3-D) treatment planning. In five selected disease sites, plans calculated with both types of treatment planning were compared. The (3-D) treatment planning system used in this work TMS version 5.1 B from helax AB is based on a monte Carlo-based pencil beam model. The other treatment planning system (2-D 0, introduced in this study was the multi data treatment planning system version 2.35. For the volumes of interest; quality of dose distribution concerning homogeneity in the target volume and the isodose distribution in organs at risk, was discussed. Qualitative and quantitative comparisons between the two planning systems were made using dose volume histograms (DVH's) . For comparisons of dose distributions in real-patient cases, differences ranged from 0.8% to 6.4% for 6 MV, while in case of 18 MV photon, it ranged from 1,8% to 6.5% and was within -+3 standard deviations for the dose between the two planning systems.Dose volume histogram (DVH) shows volume reduction of the radiation-related organs at risk 3-D planning

  15. Clinical evaluation of treatment plans

    Energy Technology Data Exchange (ETDEWEB)

    Emery, E W [Radiotherapy Department, University College Hospital, London (United Kingdom)

    1966-06-15

    Since the start of radiotherapy, the aim of all radiotherapists has been to treat as many patients who suffer with malignant tumours as possible, so as to give an effective curative dose to the whole tumour, at the same time, doing as little damage as possible to normal tissues. Until 1945, damage to the skin was usually the limiting factor. Since the war, with the rapid development of more powerful X-ray machines and sources of irradiation, we have had at our disposal much more penetrating radiation, allowing us to give effective tumour doses, with little or no damage to the skin. However, with higher tumour doses, there is more likelihood of damage to structures in proximity to the tumour - i.e. bone, nerves, muscle, liver, kidney etc. This has focussed the interest of all radiologists on the need for careful planning, and physicists have worked out with great care the differential absorptions of X-rays on differing tissue, i. e. bone, muscle, fat etc., so that very accurate and correct treatment planning can now be undertaken. This entails a great deal of accurate and complicated work and has had to be done by our physicist colleagues, who may take hours or days to work out a complicated treatment plan. The acceptance of the plan as being the most suitable for a patient is governed by these factors: (a) The dose must be given to the whole tumour area; (b) The nearby structures, i. e. nerves, bowel, kidney etc. must not receive a dose which may cause serious damage; (c) All parts of the tumour must have an effective dose; (d) The integral dose must be such that the patient is not unduly upset. All these factors vary from patient to patient, and thus each plan has to be considered in conjunction with each individual patient so that, although patients have similar tumours, what may be an optimal plan for one may not be for another. Also clinicians themselves vary in their opinions on the size of tumour, general condition of the patient, and the amount of damage

  16. Pre-optimization of radiotherapy treatment planning: an artificial neural network classification aided technique

    International Nuclear Information System (INIS)

    Hosseini-Ashrafi, M.E.; Bagherebadian, H.; Yahaqi, E.

    1999-01-01

    A method has been developed which, by using the geometric information from treatment sample cases, selects from a given data set an initial treatment plan as a step for treatment plan optimization. The method uses an artificial neural network (ANN) classification technique to select a best matching plan from the 'optimized' ANN database. Separate back-propagation ANN classifiers were trained using 50, 60 and 77 examples for three groups of treatment case classes (up to 21 examples from each class were used). The performance of the classifiers in selecting the correct treatment class was tested using the leave-one-out method; the networks were optimized with respect their architecture. For the three groups used in this study, successful classification fractions of 0.83, 0.98 and 0.93 were achieved by the optimized ANN classifiers. The automated response of the ANN may be used to arrive at a pre-plan where many treatment parameters may be identified and therefore a significant reduction in the steps required to arrive at the optimum plan may be achieved. Treatment planning 'experience' and also results from lengthy calculations may be used for training the ANN. (author)

  17. Three dimensional intensity modulated brachytherapy (IMBT): Dosimetry algorithm and inverse treatment planning

    International Nuclear Information System (INIS)

    Shi Chengyu; Guo Bingqi; Cheng, Chih-Yao; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko

    2010-01-01

    Purpose: The feasibility of intensity modulated brachytherapy (IMBT) to improve dose conformity for irregularly shaped targets has been previously investigated by researchers by means of using partially shielded sources. However, partial shielding does not fully explore the potential of IMBT. The goal of this study is to introduce the concept of three dimensional (3D) intensity modulated brachytherapy and solve two fundamental issues regarding the application of 3D IMBT treatment planning: The dose calculation algorithm and the inverse treatment planning method. Methods: A 3D IMBT treatment planning system prototype was developed using the MATLAB platform. This system consists of three major components: (1) A comprehensive IMBT source calibration method with dosimetric inputs from Monte Carlo (EGSnrc) simulations; (2) a ''modified TG-43'' (mTG-43) dose calculation formalism for IMBT dosimetry; and (3) a physical constraint based inverse IMBT treatment planning platform utilizing a simulated annealing optimization algorithm. The model S700 Axxent electronic brachytherapy source developed by Xoft, Inc. (Fremont, CA), was simulated in this application. Ten intracavitary accelerated partial breast irradiation (APBI) cases were studied. For each case, an ''isotropic plan'' with only optimized source dwell time and a fully optimized IMBT plan were generated and compared to the original plan in various dosimetric aspects, such as the plan quality, planning, and delivery time. The issue of the mechanical complexity of the IMBT applicator is not addressed in this study. Results: IMBT approaches showed superior plan quality compared to the original plans and the isotropic plans to different extents in all studied cases. An extremely difficult case with a small breast and a small distance to the ribs and skin, the IMBT plan minimized the high dose volume V 200 by 16.1% and 4.8%, respectively, compared to the original and the isotropic plans. The conformity index for the

  18. Three dimensional intensity modulated brachytherapy (IMBT): Dosimetry algorithm and inverse treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Shi Chengyu; Guo Bingqi; Cheng, Chih-Yao; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko [Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States); Department of Radiation Oncology, Oklahoma University Health Science Center, Oklahoma City, Oklahoma 73104 (United States); Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States)

    2010-07-15

    Purpose: The feasibility of intensity modulated brachytherapy (IMBT) to improve dose conformity for irregularly shaped targets has been previously investigated by researchers by means of using partially shielded sources. However, partial shielding does not fully explore the potential of IMBT. The goal of this study is to introduce the concept of three dimensional (3D) intensity modulated brachytherapy and solve two fundamental issues regarding the application of 3D IMBT treatment planning: The dose calculation algorithm and the inverse treatment planning method. Methods: A 3D IMBT treatment planning system prototype was developed using the MATLAB platform. This system consists of three major components: (1) A comprehensive IMBT source calibration method with dosimetric inputs from Monte Carlo (EGSnrc) simulations; (2) a ''modified TG-43'' (mTG-43) dose calculation formalism for IMBT dosimetry; and (3) a physical constraint based inverse IMBT treatment planning platform utilizing a simulated annealing optimization algorithm. The model S700 Axxent electronic brachytherapy source developed by Xoft, Inc. (Fremont, CA), was simulated in this application. Ten intracavitary accelerated partial breast irradiation (APBI) cases were studied. For each case, an ''isotropic plan'' with only optimized source dwell time and a fully optimized IMBT plan were generated and compared to the original plan in various dosimetric aspects, such as the plan quality, planning, and delivery time. The issue of the mechanical complexity of the IMBT applicator is not addressed in this study. Results: IMBT approaches showed superior plan quality compared to the original plans and the isotropic plans to different extents in all studied cases. An extremely difficult case with a small breast and a small distance to the ribs and skin, the IMBT plan minimized the high dose volume V{sub 200} by 16.1% and 4.8%, respectively, compared to the original and the

  19. Three dimensional intensity modulated brachytherapy (IMBT): dosimetry algorithm and inverse treatment planning.

    Science.gov (United States)

    Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko

    2010-07-01

    The feasibility of intensity modulated brachytherapy (IMBT) to improve dose conformity for irregularly shaped targets has been previously investigated by researchers by means of using partially shielded sources. However, partial shielding does not fully explore the potential of IMBT. The goal of this study is to introduce the concept of three dimensional (3D) intensity modulated brachytherapy and solve two fundamental issues regarding the application of 3D IMBT treatment planning: The dose calculation algorithm and the inverse treatment planning method. A 3D IMBT treatment planning system prototype was developed using the MATLAB platform. This system consists of three major components: (1) A comprehensive IMBT source calibration method with dosimetric inputs from Monte Carlo (EGSnrc) simulations; (2) a "modified TG-43" (mTG-43) dose calculation formalism for IMBT dosimetry; and (3) a physical constraint based inverse IMBT treatment planning platform utilizing a simulated annealing optimization algorithm. The model S700 Axxent electronic brachytherapy source developed by Xoft, Inc. (Fremont, CA), was simulated in this application. Ten intracavitary accelerated partial breast irradiation (APBI) cases were studied. For each case, an "isotropic plan" with only optimized source dwell time and a fully optimized IMBT plan were generated and compared to the original plan in various dosimetric aspects, such as the plan quality, planning, and delivery time. The issue of the mechanical complexity of the IMBT applicator is not addressed in this study. IMBT approaches showed superior plan quality compared to the original plans and tht isotropic plans to different extents in all studied cases. An extremely difficult case with a small breast and a small distance to the ribs and skin, the IMBT plan minimized the high dose volume V200 by 16.1% and 4.8%, respectively, compared to the original and the isotropic plans. The conformity index for the target was increased by 0.13 and 0

  20. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning

    International Nuclear Information System (INIS)

    Zarepisheh, Masoud; Li, Nan; Long, Troy; Romeijn, H. Edwin; Tian, Zhen; Jia, Xun; Jiang, Steve B.

    2014-01-01

    Purpose: To develop a novel algorithm that incorporates prior treatment knowledge into intensity modulated radiation therapy optimization to facilitate automatic treatment planning and adaptive radiotherapy (ART) replanning. Methods: The algorithm automatically creates a treatment plan guided by the DVH curves of a reference plan that contains information on the clinician-approved dose-volume trade-offs among different targets/organs and among different portions of a DVH curve for an organ. In ART, the reference plan is the initial plan for the same patient, while for automatic treatment planning the reference plan is selected from a library of clinically approved and delivered plans of previously treated patients with similar medical conditions and geometry. The proposed algorithm employs a voxel-based optimization model and navigates the large voxel-based Pareto surface. The voxel weights are iteratively adjusted to approach a plan that is similar to the reference plan in terms of the DVHs. If the reference plan is feasible but not Pareto optimal, the algorithm generates a Pareto optimal plan with the DVHs better than the reference ones. If the reference plan is too restricting for the new geometry, the algorithm generates a Pareto plan with DVHs close to the reference ones. In both cases, the new plans have similar DVH trade-offs as the reference plans. Results: The algorithm was tested using three patient cases and found to be able to automatically adjust the voxel-weighting factors in order to generate a Pareto plan with similar DVH trade-offs as the reference plan. The algorithm has also been implemented on a GPU for high efficiency. Conclusions: A novel prior-knowledge-based optimization algorithm has been developed that automatically adjust the voxel weights and generate a clinical optimal plan at high efficiency. It is found that the new algorithm can significantly improve the plan quality and planning efficiency in ART replanning and automatic treatment

  1. Waste Treatment Technology Process Development Plan For Hanford Waste Treatment Plant Low Activity Waste Recycle

    International Nuclear Information System (INIS)

    McCabe, Daniel J.; Wilmarth, William R.; Nash, Charles A.

    2013-01-01

    The purpose of this Process Development Plan is to summarize the objectives and plans for the technology development activities for an alternative path for disposition of the recycle stream that will be generated in the Hanford Waste Treatment Plant Low Activity Waste (LAW) vitrification facility (LAW Recycle). This plan covers the first phase of the development activities. The baseline plan for disposition of this stream is to recycle it to the WTP Pretreatment Facility, where it will be concentrated by evaporation and returned to the LAW vitrification facility. Because this stream contains components that are volatile at melter temperatures and are also problematic for the glass waste form, they accumulate in the Recycle stream, exacerbating their impact on the number of LAW glass containers. Approximately 32% of the sodium in Supplemental LAW comes from glass formers used to make the extra glass to dilute the halides to acceptable concentrations in the LAW glass, and reducing the halides in the Recycle is a key component of this work. Additionally, under possible scenarios where the LAW vitrification facility commences operation prior to the WTP Pretreatment facility, this stream does not have a proven disposition path, and resolving this gap becomes vitally important. This task seeks to examine the impact of potential future disposition of this stream in the Hanford tank farms, and to develop a process that will remove radionuclides from this stream and allow its diversion to another disposition path, greatly decreasing the LAW vitrification mission duration and quantity of glass waste. The origin of this LAW Recycle stream will be from the Submerged Bed Scrubber (SBS) and the Wet Electrostatic Precipitator (WESP) from the LAW melter off-gas system. The stream is expected to be a dilute salt solution with near neutral pH, and will likely contain some insoluble solids from melter carryover or precipitates of scrubbed components (e.g. carbonates). The soluble

  2. Waste Treatment Technology Process Development Plan For Hanford Waste Treatment Plant Low Activity Waste Recycle

    Energy Technology Data Exchange (ETDEWEB)

    McCabe, Daniel J.; Wilmarth, William R.; Nash, Charles A.

    2013-08-29

    The purpose of this Process Development Plan is to summarize the objectives and plans for the technology development activities for an alternative path for disposition of the recycle stream that will be generated in the Hanford Waste Treatment Plant Low Activity Waste (LAW) vitrification facility (LAW Recycle). This plan covers the first phase of the development activities. The baseline plan for disposition of this stream is to recycle it to the WTP Pretreatment Facility, where it will be concentrated by evaporation and returned to the LAW vitrification facility. Because this stream contains components that are volatile at melter temperatures and are also problematic for the glass waste form, they accumulate in the Recycle stream, exacerbating their impact on the number of LAW glass containers. Approximately 32% of the sodium in Supplemental LAW comes from glass formers used to make the extra glass to dilute the halides to acceptable concentrations in the LAW glass, and reducing the halides in the Recycle is a key component of this work. Additionally, under possible scenarios where the LAW vitrification facility commences operation prior to the WTP Pretreatment facility, this stream does not have a proven disposition path, and resolving this gap becomes vitally important. This task seeks to examine the impact of potential future disposition of this stream in the Hanford tank farms, and to develop a process that will remove radionuclides from this stream and allow its diversion to another disposition path, greatly decreasing the LAW vitrification mission duration and quantity of glass waste. The origin of this LAW Recycle stream will be from the Submerged Bed Scrubber (SBS) and the Wet Electrostatic Precipitator (WESP) from the LAW melter off-gas system. The stream is expected to be a dilute salt solution with near neutral pH, and will likely contain some insoluble solids from melter carryover or precipitates of scrubbed components (e.g. carbonates). The soluble

  3. Standardization of prostate brachytherapy treatment plans

    International Nuclear Information System (INIS)

    Ove, Roger; Wallner, Kent; Badiozamani, Kas; Korjsseon, Tammy; Sutlief, Steven

    2001-01-01

    Purpose: Whereas custom-designed plans are the norm for prostate brachytherapy, the relationship between linear prostate dimensions and volume calls into question the routine need for customized treatment planning. With the goal of streamlining the treatment-planning process, we have compared the treatment margins (TMs) achieved with one standard plan applied to patients with a wide range of prostate volumes. Methods and Materials: Preimplant transrectal ultrasound (TRUS) images of 50 unselected University of Washington patients with T1-T2 cancer and a prostate volume between 20 cc and 50 cc were studied. Patients were arbitrarily grouped into categories of 20-30 cc, 30-40 cc, and 40-50 cc. A standard 19-needle plan was devised for patients in the 30- to 40-cc range, using an arbitrary minimum margin of 5 mm around the gross tumor volume (GTV), making use of inverse planning technology to achieve 100% coverage of the target volume with accentuation of dose at the periphery and sparing of the central region. The idealized plan was applied to each patient's TRUS study. The distances (TMs) between the prostatic edge (GTV) and treated volume (TV) were determined perpendicular to the prostatic margin. Results: Averaged over the entire patient group, the ratio of thickness to width was 1.4, whereas the ratio of length to width was 1.3. These values were fairly constant over the range of volumes, emphasizing that the prostate retains its general shape as volume increases. The idealized standard plan was overlaid on the ultrasound images of the 17 patients in the 30- to 40-cc group and the V100, the percentage of target volume receiving 100% or more of the prescription dose, was 98% or greater for 15 of the 17 patients. The lateral and posterior TMs fell within a narrow range, most being within 2 mm of the idealized 5-mm TM. To estimate whether a 10-cc volume-interval stratification was reasonable, the standard plan generated from the 30- to 40-cc prostate model was

  4. Application of OMEGA Monte Carlo codes for radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Ayyangar, Komanduri M.; Jiang, Steve B.

    1998-01-01

    The accuracy of conventional dose algorithms for radiosurgery treatment planning is limited, due to the inadequate consideration of the lateral radiation transport and the difficulty of acquiring accurate dosimetric data for very small beams. In the present paper, some initial work on the application of Monte Carlo method in radiation treatment planning in general, and in radiosurgery treatment planning in particular, has been presented. Two OMEGA Monte Carlo codes, BEAM and DOSXYZ, are used. The BEAM code is used to simulate the transport of particles in the linac treatment head and radiosurgery collimator. A phase space file is obtained from the BEAM simulation for each collimator size. The DOSXYZ code is used to calculate the dose distribution in the patient's body reconstructed from CT slices using the phase space file as input. The accuracy of OMEGA Monte Carlo simulation for radiosurgery dose calculation is verified by comparing the calculated and measured basic dosimetric data for several radiosurgery beams and a 4 x 4 cm 2 conventional beam. The dose distributions for three clinical cases are calculated using OMEGA codes as the dose engine for an in-house developed radiosurgery treatment planning system. The verification using basic dosimetric data and the dose calculation for clinical cases demonstrate the feasibility of applying OMEGA Monte Carlo code system to radiosurgery treatment planning. (author)

  5. Research and development plan for the Slagging Pyrolysis Incinerator

    International Nuclear Information System (INIS)

    Hedahl, T.G.; McCormack, M.D.

    1979-01-01

    Objective is to develop an incinerator for processing disposed transuranium waste. This R and D plan describes the R and D efforts required to begin conceptual design of the Slagging Pyrolysis Incinerator (Andco-Torrax). The program includes: incinerator, off-gas treatment, waste handling, instrumentation, immobilization analyses, migration studies, regulations, Belgium R and D test plan, Disney World test plan, and remote operation and maintenance

  6. Treatment planning in radiosurgery: parallel Monte Carlo simulation software

    Energy Technology Data Exchange (ETDEWEB)

    Scielzo, G [Galliera Hospitals, Genova (Italy). Dept. of Hospital Physics; Grillo Ruggieri, F [Galliera Hospitals, Genova (Italy) Dept. for Radiation Therapy; Modesti, M; Felici, R [Electronic Data System, Rome (Italy); Surridge, M [University of South Hampton (United Kingdom). Parallel Apllication Centre

    1995-12-01

    The main objective of this research was to evaluate the possibility of direct Monte Carlo simulation for accurate dosimetry with short computation time. We made us of: graphics workstation, linear accelerator, water, PMMA and anthropomorphic phantoms, for validation purposes; ionometric, film and thermo-luminescent techniques, for dosimetry; treatment planning system for comparison. Benchmarking results suggest that short computing times can be obtained with use of the parallel version of EGS4 that was developed. Parallelism was obtained assigning simulation incident photons to separate processors, and the development of a parallel random number generator was necessary. Validation consisted in: phantom irradiation, comparison of predicted and measured values good agreement in PDD and dose profiles. Experiments on anthropomorphic phantoms (with inhomogeneities) were carried out, and these values are being compared with results obtained with the conventional treatment planning system.

  7. SU-G-TeP4-09: Development of a Plan Data Aggregator for Time Efficient Physics Second-Checks of Machine Parameters for External Beam Treatment Plans

    Energy Technology Data Exchange (ETDEWEB)

    Belley, M; Schmidt, M; Knutson, N [Rhode Island Hospital, Providence RI (United States); University of Rhode Island, Kingston, RI (United States); Price, M [Rhode Island Hospital, Providence RI (United States); University of Rhode Island, Kingston, RI (United States); Alpert Medical School of Brown University, Providence, RI (United States)

    2016-06-15

    Purpose: Physics second-checks for external beam radiation therapy are performed, in-part, to verify that the machine parameters in the Record-and-Verify (R&V) system that will ultimately be sent to the LINAC exactly match the values initially calculated by the Treatment Planning System (TPS). While performing the second-check, a large portion of the physicists’ time is spent navigating and arranging display windows to locate and compare the relevant numerical values (MLC position, collimator rotation, field size, MU, etc.). Here, we describe the development of a software tool that guides the physicist by aggregating and succinctly displaying machine parameter data relevant to the physics second-check process. Methods: A data retrieval software tool was developed using Python to aggregate data and generate a list of machine parameters that are commonly verified during the physics second-check process. This software tool imported values from (i) the TPS RT Plan DICOM file and (ii) the MOSAIQ (R&V) Structured Query Language (SQL) database. The machine parameters aggregated for this study included: MLC positions, X&Y jaw positions, collimator rotation, gantry rotation, MU, dose rate, wedges and accessories, cumulative dose, energy, machine name, couch angle, and more. Results: A GUI interface was developed to generate a side-by-side display of the aggregated machine parameter values for each field, and presented to the physicist for direct visual comparison. This software tool was tested for 3D conformal, static IMRT, sliding window IMRT, and VMAT treatment plans. Conclusion: This software tool facilitated the data collection process needed in order for the physicist to conduct a second-check, thus yielding an optimized second-check workflow that was both more user friendly and time-efficient. Utilizing this software tool, the physicist was able to spend less time searching through the TPS PDF plan document and the R&V system and focus the second-check efforts on

  8. Physical treatment planning by several approaches

    International Nuclear Information System (INIS)

    Burger, G.; Morhart, A.; Wittmann, A.

    1985-01-01

    Neutron isodose planning may be performed by commercial treatment planning systems for photons, providing that certain modifications are applied. All geometry-related corrections such as for nonregular surfaces and oblique incidence remain unchanged. The main modifications concern the tissue-air-ratio, containing essentially the attenuation correction function. We have as a first step applied this modified commercial system to a few regular exposure situations in a homogenious water phantom and compared the generated isodose charts with those derived by direct Monte Carlo calculations of the neutron transport for the corresponding fields. As expected the commercial methods do not incorporate the necessary corrections for the change of scatter conditions in case of oblique incidence or wedged fields. For this reason we developed another approach, based upon the numerical superposition of dose matrices for pencil beams. These matrices were again Monte Carlo calculated. From it build-up functions can be derived by partial radial integration. The isodose charts generated by superposition of pencil beam dose distributions agree much better with directly Monte Carlo calculated ones, than those from the commercial treatment planning system. Based upon these results the method was finally applied to real patients cross sections, as derived from CT or MR-tomography. In the latter case one can even perform a pixelwise attenuation correction, if spin density images are available

  9. Sodium-Bearing Waste Treatment, Applied Technology Plan

    International Nuclear Information System (INIS)

    Lance Lauerhass; Vince C. Maio; S. Kenneth Merrill; Arlin L. Olson; Keith J. Perry

    2003-01-01

    Settlement Agreement between the Department of Energy and the State of Idaho mandates treatment of sodium-bearing waste at the Idaho Nuclear Technology and Engineering Center within the Idaho National Engineering and Environmental Laboratory. One of the requirements of the Settlement Agreement is to complete treatment of sodium-bearing waste by December 31, 2012. Applied technology activities are required to provide the data necessary to complete conceptual design of four identified alternative processes and to select the preferred alternative. To provide a technically defensible path forward for the selection of a treatment process and for the collection of needed data, an applied technology plan is required. This document presents that plan, identifying key elements of the decision process and the steps necessary to obtain the required data in support of both the decision and the conceptual design. The Sodium-Bearing Waste Treatment Applied Technology Plan has been prepared to provide a description/roadmap of the treatment alternative selection process. The plan details the results of risk analyzes and the resulting prioritized uncertainties. It presents a high-level flow diagram governing the technology decision process, as well as detailed roadmaps for each technology. The roadmaps describe the technical steps necessary in obtaining data to quantify and reduce the technical uncertainties associated with each alternative treatment process. This plan also describes the final products that will be delivered to the Department of Energy Idaho Operations Office in support of the office's selection of the final treatment technology

  10. Sodium-Bearing Waste Treatment, Applied Technology Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lance Lauerhass; Vince C. Maio; S. Kenneth Merrill; Arlin L. Olson; Keith J. Perry

    2003-06-01

    Settlement Agreement between the Department of Energy and the State of Idaho mandates treatment of sodium-bearing waste at the Idaho Nuclear Technology and Engineering Center within the Idaho National Engineering and Environmental Laboratory. One of the requirements of the Settlement Agreement is to complete treatment of sodium-bearing waste by December 31, 2012. Applied technology activities are required to provide the data necessary to complete conceptual design of four identified alternative processes and to select the preferred alternative. To provide a technically defensible path forward for the selection of a treatment process and for the collection of needed data, an applied technology plan is required. This document presents that plan, identifying key elements of the decision process and the steps necessary to obtain the required data in support of both the decision and the conceptual design. The Sodium-Bearing Waste Treatment Applied Technology Plan has been prepared to provide a description/roadmap of the treatment alternative selection process. The plan details the results of risk analyzes and the resulting prioritized uncertainties. It presents a high-level flow diagram governing the technology decision process, as well as detailed roadmaps for each technology. The roadmaps describe the technical steps necessary in obtaining data to quantify and reduce the technical uncertainties associated with each alternative treatment process. This plan also describes the final products that will be delivered to the Department of Energy Idaho Operations Office in support of the office's selection of the final treatment technology.

  11. Clinical treatment planning in gynecologic cancer

    International Nuclear Information System (INIS)

    Brady, L.W.; Markoe, A.M.; Micaily, B.; Damsker, J.I.; Karlsson, U.L.; Amendola, B.E.

    1987-01-01

    Treatment planning in gynecologic cancer is a complicated and difficult procedure. It requires an adequate preoperative assessment of the true extent of the patient's disease process and oftentimes this can be achieved not only by conventional studies but must employ surgical exploratory techniques in order to truly define the extent of the disease. However, with contemporary sophisticated treatment planning techniques that are now available in most contemporary departments of radiation oncology, radiation therapy is reemerging as an important and major treatment technique in the management of patients with gynecologic cancer

  12. [Developing a plan of treatment with a cast metal frame removable partial denture

    NARCIS (Netherlands)

    Witter, D.J.; Barel, J.C.; Keltjens, H.M.A.M.; Baat, C. de; Creugers, N.H.J.

    2011-01-01

    When considering prosthetic replacement of absent teeth, a treatment plan is necessary. In evaluating whether replacement of teeth is sensible, the causes and consequences of tooth loss must be considered. This concerns information about problems having to do with the patient, potential

  13. Approved Site Treatment Plan, Volumes 1 and 2. Revision 4

    Energy Technology Data Exchange (ETDEWEB)

    Helmich, E.H.; Molen, G.; Noller, D.

    1996-03-22

    The US Department of Energy, Savannah River Operations Office (DOE-SR), has prepared the Site Treatment Plan (STP) for Savannah River Site (SRS) mixed wastes in accordance with RCRA Section 3021(b), and SCDHEC has approved the STP (except for certain offsite wastes) and issued an order enforcing the STP commitments in Volume 1. DOE-SR and SCDHEC agree that this STP fulfills the requirements contained in the FFCAct, RCRA Section 3021, and therefore, pursuant to Section 105(a) of the FFCAct (RCRA Section 3021(b)(5)), DOE`s requirements are to implement the plan for the development of treatment capacities and technologies pursuant to RCRA Section 3021. Emerging and new technologies not yet considered may be identified to manage waste more safely, effectively, and at lower cost than technologies currently identified in the plan. DOE will continue to evaluate and develop technologies that offer potential advantages in public acceptance, privatization, consolidation, risk abatement, performance, and life-cycle cost. Should technologies that offer such advantages be identified, DOE may request a revision/modification of the STP in accordance with the provisions of Consent Order 95-22-HW. The Compliance Plan Volume (Volume 1) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions (LDR). Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume 2) and is provided for information.

  14. Approved Site Treatment Plan, Volumes 1 and 2. Revision 4

    International Nuclear Information System (INIS)

    Helmich, E.H.; Molen, G.; Noller, D.

    1996-01-01

    The US Department of Energy, Savannah River Operations Office (DOE-SR), has prepared the Site Treatment Plan (STP) for Savannah River Site (SRS) mixed wastes in accordance with RCRA Section 3021(b), and SCDHEC has approved the STP (except for certain offsite wastes) and issued an order enforcing the STP commitments in Volume 1. DOE-SR and SCDHEC agree that this STP fulfills the requirements contained in the FFCAct, RCRA Section 3021, and therefore, pursuant to Section 105(a) of the FFCAct (RCRA Section 3021(b)(5)), DOE's requirements are to implement the plan for the development of treatment capacities and technologies pursuant to RCRA Section 3021. Emerging and new technologies not yet considered may be identified to manage waste more safely, effectively, and at lower cost than technologies currently identified in the plan. DOE will continue to evaluate and develop technologies that offer potential advantages in public acceptance, privatization, consolidation, risk abatement, performance, and life-cycle cost. Should technologies that offer such advantages be identified, DOE may request a revision/modification of the STP in accordance with the provisions of Consent Order 95-22-HW. The Compliance Plan Volume (Volume 1) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions (LDR). Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume 2) and is provided for information

  15. MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

    International Nuclear Information System (INIS)

    Feng, W.

    2015-01-01

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  16. MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

    Energy Technology Data Exchange (ETDEWEB)

    Feng, W. [New York Presbyterian Hospital (United States)

    2015-06-15

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  17. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  18. Fully automated VMAT treatment planning for advanced-stage NSCLC patients

    International Nuclear Information System (INIS)

    Della Gala, Giuseppe; Dirkx, Maarten L.P.; Hoekstra, Nienke; Fransen, Dennie; Pol, Marjan van de; Heijmen, Ben J.M.; Lanconelli, Nico; Petit, Steven F.

    2017-01-01

    To develop a fully automated procedure for multicriterial volumetric modulated arc therapy (VMAT) treatment planning (autoVMAT) for stage III/IV non-small cell lung cancer (NSCLC) patients treated with curative intent. After configuring the developed autoVMAT system for NSCLC, autoVMAT plans were compared with manually generated clinically delivered intensity-modulated radiotherapy (IMRT) plans for 41 patients. AutoVMAT plans were also compared to manually generated VMAT plans in the absence of time pressure. For 16 patients with reduced planning target volume (PTV) dose prescription in the clinical IMRT plan (to avoid violation of organs at risk tolerances), the potential for dose escalation with autoVMAT was explored. Two physicians evaluated 35/41 autoVMAT plans (85%) as clinically acceptable. Compared to the manually generated IMRT plans, autoVMAT plans showed statistically significant improved PTV coverage (V_9_5_% increased by 1.1% ± 1.1%), higher dose conformity (R_5_0 reduced by 12.2% ± 12.7%), and reduced mean lung, heart, and esophagus doses (reductions of 0.9 Gy ± 1.0 Gy, 1.5 Gy ± 1.8 Gy, 3.6 Gy ± 2.8 Gy, respectively, all p [de

  19. Optimization in radiotherapy treatment planning thanks to a fast dose calculation method

    International Nuclear Information System (INIS)

    Yang, Mingchao

    2014-01-01

    This thesis deals with the radiotherapy treatments planning issue which need a fast and reliable treatment planning system (TPS). The TPS is composed of a dose calculation algorithm and an optimization method. The objective is to design a plan to deliver the dose to the tumor while preserving the surrounding healthy and sensitive tissues. The treatment planning aims to determine the best suited radiation parameters for each patient's treatment. In this thesis, the parameters of treatment with IMRT (Intensity modulated radiation therapy) are the beam angle and the beam intensity. The objective function is multi-criteria with linear constraints. The main objective of this thesis is to demonstrate the feasibility of a treatment planning optimization method based on a fast dose-calculation technique developed by (Blanpain, 2009). This technique proposes to compute the dose by segmenting the patient's phantom into homogeneous meshes. The dose computation is divided into two steps. The first step impacts the meshes: projections and weights are set according to physical and geometrical criteria. The second step impacts the voxels: the dose is computed by evaluating the functions previously associated to their mesh. A reformulation of this technique makes possible to solve the optimization problem by the gradient descent algorithm. The main advantage of this method is that the beam angle parameters could be optimized continuously in 3 dimensions. The obtained results in this thesis offer many opportunities in the field of radiotherapy treatment planning optimization. (author) [fr

  20. Vitrification development plan for US Department of Energy mixed wastes

    International Nuclear Information System (INIS)

    Peters, R.; Lucerna, J.; Plodinec, M.J.

    1993-10-01

    This document is a general plan for conducting vitrification development for application to mixed wastes owned by the US Department of Energy. The emphasis is a description and discussion of the data needs to proceed through various stages of development. These stages are (1) screening at a waste site to determine which streams should be vitrified, (2) waste characterization and analysis, (3) waste form development and treatability studies, (4) process engineering development, (5) flowsheet and technical specifications for treatment processes, and (6) integrated pilot-scale demonstration. Appendices provide sample test plans for various stages of the vitrification development process. This plan is directed at thermal treatments which produce waste glass. However, the study is still applicable to the broader realm of thermal treatment since it deals with issues such as off-gas characterization and waste characterization that are not necessarily specific to vitrification. The purpose is to provide those exploring or considering vitrification with information concerning the kinds of data that are needed, the way the data are obtained, and the way the data are used. This will provide guidance to those who need to prioritize data needs to fit schedules and budgets. Knowledge of data needs also permits managers and planners to estimate resource requirements for vitrification development

  1. Hanford 300 Area Development Plan

    International Nuclear Information System (INIS)

    Daly, K.S.; Seiler, S.W.; Hail, J.C.

    1991-09-01

    The purpose of the Hanford 300 Area Development Plan (Development Plan) is to guide the physical development of the 300 Area in accordance with US Department of Energy (DOE) Order 4320.1B (DOE 1991b) by performing the following: (1) Establishing a land use plan, setting land use categories that meet the needs of existing and proposed activities; (2) Coordinating existing, 5-yr, and long-range development plans and guiding growth in accordance with those plans; (3) Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities; (4) Identifying site development issues that need further analysis; Integrating program plans with development plans to ensure a logical progression of development; and, (6) Integrating DOE plans with local agency plans (i.e., city, country, state, and Tri-Cities Science and Technology Park plans)

  2. BDTPS The BNCT Treatment Planning System jointly developed at DIMNP and JRC/IE

    CERN Document Server

    Daquino, G G; Mazzini, M; Moss, R; Muzi, L; International Workshop on "Neutron Capture Therapy: State of the art"

    2003-01-01

    The idea to couple the Treatment Planning System (TPS) to the information on the real boron distribution in the patient is the main added value of the new methodology set-up at DIMNP of University of Pisa, in collaboration with the JRC of Petten (NL). The methodology has been implemented in the new TPS, called BDTPS (Boron Distribution Treatment Planning System), which takes into account the actual boron distribution in the patient brain, while the standard TPS assumes a uniform boron distribution, absolutely far from the reality. Nowadays, Positron Emission Tomography (PET) is able to provide this in vivo information. The new TPS, based on the Monte Carlo technique, has been validated comparing the main BNCT parameters (thermal flux, boron dose, etc.) as measured during the irradiation of a special heterogeneous boron phantom (HEBOM), ad hoc designed, as calculated by the BDTPS and by the standard TPS SERA. An evident SERA overestimation of the thermal neutron flux, as well as the boron dose, has been detect...

  3. FoCa: a modular treatment planning system for proton radiotherapy with research and educational purposes.

    Science.gov (United States)

    Sánchez-Parcerisa, D; Kondrla, M; Shaindlin, A; Carabe, A

    2014-12-07

    FoCa is an in-house modular treatment planning system, developed entirely in MATLAB, which includes forward dose calculation of proton radiotherapy plans in both active and passive modalities as well as a generic optimization suite for inverse treatment planning. The software has a dual education and research purpose. From the educational point of view, it can be an invaluable teaching tool for educating medical physicists, showing the insights of a treatment planning system from a well-known and widely accessible software platform. From the research point of view, its current and potential uses range from the fast calculation of any physical, radiobiological or clinical quantity in a patient CT geometry, to the development of new treatment modalities not yet available in commercial treatment planning systems. The physical models in FoCa were compared with the commissioning data from our institution and show an excellent agreement in depth dose distributions and longitudinal and transversal fluence profiles for both passive scattering and active scanning modalities. 3D dose distributions in phantom and patient geometries were compared with a commercial treatment planning system, yielding a gamma-index pass rate of above 94% (using FoCa's most accurate algorithm) for all cases considered. Finally, the inverse treatment planning suite was used to produce the first prototype of intensity-modulated, passive-scattered proton therapy, using 13 passive scattering proton fields and multi-leaf modulation to produce a concave dose distribution on a cylindrical solid water phantom without any field-specific compensator.

  4. Nevada Test Site Site Treatment Plan. Revision 2

    International Nuclear Information System (INIS)

    1996-03-01

    Treatment Plans (STPS) are required for facilities at which the US Department of Energy (DOE) or stores mixed waste, defined by the Federal Facility Compliance Act (FFCAct) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act and a radioactive material subject to the Atomic Energy Act. On April 6, 1993, DOE published a Federal Register notice (58 FR 17875) describing its proposed process for developing the STPs in three phases including a Conceptual, a Draft, and a Proposed Site Treatment Plan (PSTP). All of the DOE Nevada Operations Office STP iterations have been developed with the state of Nevada's input. The options and schedules reflect a ''bottoms-up'' approach and have been evaluated for impacts on other DOE sites, as well as impacts to the overall DOE program. Changes may have occurred in the preferred option and associated schedules between the PSTP, which was submitted to the state of Nevada and US Environmental Protection Agency April 1995, and the Final STP (hereafter referred to as the STP) as treatment evaluations progressed. The STP includes changes that have occurred since the submittal of the PSTP as a result of state-to-state and DOE-to-state discussions

  5. IMRT, IGRT, SBRT - Advances in the Treatment Planning and Delivery of Radiotherapy

    CERN Document Server

    Meyer, JL

    2011-01-01

    Over the last 4 years, IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy has become a standard reference in the field. During this time, however, significant progress in high-precision technologies for the planning and delivery of radiotherapy in cancer treatment has called for a second edition to include these new developments. Thoroughly updated and extended, this new edition offers a comprehensive guide and overview of these new technologies and the many clinical treatment programs that bring them into practical use. Advances in intensity-modulated radiothera

  6. Commissioning and quality assurance of computerized planning systems for radiation treatment of cancer

    International Nuclear Information System (INIS)

    2004-01-01

    Cancer is a significant health care problem; on average about half of all cancer patients are treated with radiation therapy worldwide. This mode of treatment uses complex technology that involves megavoltage radiation that, if not handled with the greatest of care, could lead to significant patient treatment errors and exposures of staff. Recent years have seen a rapid development in the technology of radiation oncology. One of the prime factors contributing to this rapid development has been the evolution of computer technology and its applications in: (a) patient diagnosis using sophisticated computerized diagnostic imaging equipment; (b) the process of radiation treatment planning using computerized radiation treatment planning systems (TPSs) that are capable of using data from diagnostic imagers; and (c) radiation dose delivery using relatively simple 60 Co machines or complex linear accelerators with computer controlled delivery systems including multileaf collimators (MLCs) for field shaping, possibly in a dynamic mode while the beam is on. The radiation treatment process involves the application of some or all of these technologies to provide the desired dose to the target volume while minimizing exposure to adjacent normal tissues. While dose computational equipment was available as early as 1951, more generalized treatment planning calculations evolved, including under the sponsorship of the IAEA, in the 1960s that made use of time sharing systems to develop atlases of isodose distributions for general use. In the 1970s and 1980s treatment planning computers became more specialized and readily available to individual radiation therapy centres. As computer technology evolved and became more compact so did TPSs, while at the same time dose calculation algorithms and image display capabilities became more sophisticated. While there is a substantial variation in capabilities, today's treatment planning computers have become readily available to virtually all

  7. 3-D CT for cardiovascular treatment planning

    International Nuclear Information System (INIS)

    Wildermuth, S.; Leschka, S.; Duru, F.; Alkadhi, H.

    2005-01-01

    The recently developed 64-slice CT scanner together with the use of 2-D and 3-D reconstructions can aid the cardiovascular surgeon and interventional radiologist in visualizing exact geometric relationships to plan and execute complex procedures via minimally invasive or standard approaches.Cardiac 64-slice CT considerably benefits from the high temporal and spatial resolution allowing the reliable depiction of small coronary segments. Similarly, abdominal vascular 64-slice CT became possible within short examination times and allowing an optimal arterial contrast bolus exploitation. We demonstrate four representative cardiac and abdominal examples using the new 64-slice CT technology which reveal the impact of the new scanner generation for cardiovascular treatment planning. (orig.)

  8. Fuzzy logic guided inverse treatment planning

    International Nuclear Information System (INIS)

    Yan Hui; Yin Fangfang; Guan Huaiqun; Kim, Jae Ho

    2003-01-01

    A fuzzy logic technique was applied to optimize the weighting factors in the objective function of an inverse treatment planning system for intensity-modulated radiation therapy (IMRT). Based on this technique, the optimization of weighting factors is guided by the fuzzy rules while the intensity spectrum is optimized by a fast-monotonic-descent method. The resultant fuzzy logic guided inverse planning system is capable of finding the optimal combination of weighting factors for different anatomical structures involved in treatment planning. This system was tested using one simulated (but clinically relevant) case and one clinical case. The results indicate that the optimal balance between the target dose and the critical organ dose is achieved by a refined combination of weighting factors. With the help of fuzzy inference, the efficiency and effectiveness of inverse planning for IMRT are substantially improved

  9. Three-dimensional teletherapy treatment planning

    International Nuclear Information System (INIS)

    Panthaleon van Eck, R.B. van.

    1986-01-01

    This thesis deals with physical/mathematical backgrounds of computerized teletherapy treatment planning. The subjects discussed in this thesis can be subdivided into three main categories: a) Three-dimensional treatment planning. A method is evaluated which can be used for the purpose of simulation and optimization of dose distributions in three dimensions. b) The use of Computed Tomography. The use of patient information obtained from Computed Tomography for the purpose of dose computations is evaluated. c) Dose computational models for photon- and electron beams. Models are evaluated which provide information regarding the way in which the radiation dose is distributed in the patient (viz. is absorbed and/or dispersed). (Auth.)

  10. Radioembolization of hepatocarcinoma with (90)Y glass microspheres: development of an individualized treatment planning strategy based on dosimetry and radiobiology.

    Science.gov (United States)

    Chiesa, C; Mira, M; Maccauro, M; Spreafico, C; Romito, R; Morosi, C; Camerini, T; Carrara, M; Pellizzari, S; Negri, A; Aliberti, G; Sposito, C; Bhoori, S; Facciorusso, A; Civelli, E; Lanocita, R; Padovano, B; Migliorisi, M; De Nile, M C; Seregni, E; Marchianò, A; Crippa, F; Mazzaferro, V

    2015-10-01

    The aim of this study was to optimize the dosimetric approach and to review the absorbed doses delivered, taking into account radiobiology, in order to identify the optimal methodology for an individualized treatment planning strategy based on (99m)Tc-macroaggregated albumin (MAA) single photon emission computed tomography (SPECT) images. We performed retrospective dosimetry of the standard TheraSphere® treatment on 52 intermediate (n = 17) and advanced (i.e. portal vein thrombosis, n = 35) hepatocarcinoma patients with tumour burden 10 cc). Apparent radiosensitivity values from TCP were around 0.003/Gy, a factor of 3-5 lower than in EBRT, as found by other authors. The dose-rate effect was negligible: a purely linear model can be applied. Toxicity incidence was significantly larger for Child B7 patients (89 vs 14%, p < 0.0001), who were therefore excluded from dose-toxicity analysis. Child A toxic vs non-toxic treatments were significantly separated in terms of dose averaged on whole non-tumoural parenchyma (including non-irradiated regions) with AUC from 0.73 to 0.94. TD50 was ≈ 100 Gy. No methodology was superior to parenchyma mean dose, which therefore can be used for planning, with a limit of TD15 ≈ 75 Gy. A dosimetric treatment planning criterion for Child A patients without complete obstruction of the portal vein was developed.

  11. Savannah River Site Approved Site Treatment Plan, 1998 Annual Update

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B. [Westinghouse Savannah River Company, AIKEN, SC (United States); Berry, M.

    1998-03-01

    The U.S. Department of Energy, Savannah River Operations Office (DOE- SR),has prepared the Site Treatment Plan (STP) for Savannah River Site (SRS) mixed wastes in accordance with RCRA Section 3021(b), and SCDHEC has approved the STP (except for certain offsite wastes) and issued an order enforcing the STP commitments in Volume I. DOE-SR and SCDHEC agree that this STP fulfills the requirements contained in the FFCAct, RCRA Section 3021, and therefore,pursuant to Section 105(a) of the FFCAct (RCRA Section 3021(b)(5)), DOE`s requirements are to implement the plan for the development of treatment capacities and technologies pursuant to RCRA Section 3021.Emerging and new technologies not yet considered may be identified to manage waste more safely, effectively, and at lower cost than technologies currently identified in the plan. DOE will continue to evaluate and develop technologies that offer potential advantages in public acceptance, privatization, consolidation, risk abatement, performance, and life-cycle cost. Should technologies that offer such advantages be identified, DOE may request a revision/modification of the STP in accordance with the provisions of Consent Order 95-22-HW.The Compliance Plan Volume (Volume I) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions (LDR). Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

  12. Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time

    Energy Technology Data Exchange (ETDEWEB)

    Wild, Esther, E-mail: e.wild@dkfz.de; Bangert, Mark [Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg (Germany); Nill, Simeon [Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG (United Kingdom); Oelfke, Uwe [Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG, United Kingdom and Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg (Germany)

    2015-05-15

    Purpose: The authors investigated the potential of optimized noncoplanar irradiation trajectories for volumetric modulated arc therapy (VMAT) treatments of nasopharyngeal patients and studied the trade-off between treatment plan quality and delivery time in radiation therapy. Methods: For three nasopharyngeal patients, the authors generated treatment plans for nine different delivery scenarios using dedicated optimization methods. They compared these scenarios according to dose characteristics, number of beam directions, and estimated delivery times. In particular, the authors generated the following treatment plans: (1) a 4π plan, which is a not sequenced, fluence optimized plan that uses beam directions from approximately 1400 noncoplanar directions and marks a theoretical upper limit of the treatment plan quality, (2) a coplanar 2π plan with 72 coplanar beam directions as pendant to the noncoplanar 4π plan, (3) a coplanar VMAT plan, (4) a coplanar step and shoot (SnS) plan, (5) a beam angle optimized (BAO) coplanar SnS IMRT plan, (6) a noncoplanar BAO SnS plan, (7) a VMAT plan with rotated treatment couch, (8) a noncoplanar VMAT plan with an optimized great circle around the patient, and (9) a noncoplanar BAO VMAT plan with an arbitrary trajectory around the patient. Results: VMAT using optimized noncoplanar irradiation trajectories reduced the mean and maximum doses in organs at risk compared to coplanar VMAT plans by 19% on average while the target coverage remains constant. A coplanar BAO SnS plan was superior to coplanar SnS or VMAT; however, noncoplanar plans like a noncoplanar BAO SnS plan or noncoplanar VMAT yielded a better plan quality than the best coplanar 2π plan. The treatment plan quality of VMAT plans depended on the length of the trajectory. The delivery times of noncoplanar VMAT plans were estimated to be 6.5 min in average; 1.6 min longer than a coplanar plan but on average 2.8 min faster than a noncoplanar SnS plan with comparable

  13. Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time

    International Nuclear Information System (INIS)

    Wild, Esther; Bangert, Mark; Nill, Simeon; Oelfke, Uwe

    2015-01-01

    Purpose: The authors investigated the potential of optimized noncoplanar irradiation trajectories for volumetric modulated arc therapy (VMAT) treatments of nasopharyngeal patients and studied the trade-off between treatment plan quality and delivery time in radiation therapy. Methods: For three nasopharyngeal patients, the authors generated treatment plans for nine different delivery scenarios using dedicated optimization methods. They compared these scenarios according to dose characteristics, number of beam directions, and estimated delivery times. In particular, the authors generated the following treatment plans: (1) a 4π plan, which is a not sequenced, fluence optimized plan that uses beam directions from approximately 1400 noncoplanar directions and marks a theoretical upper limit of the treatment plan quality, (2) a coplanar 2π plan with 72 coplanar beam directions as pendant to the noncoplanar 4π plan, (3) a coplanar VMAT plan, (4) a coplanar step and shoot (SnS) plan, (5) a beam angle optimized (BAO) coplanar SnS IMRT plan, (6) a noncoplanar BAO SnS plan, (7) a VMAT plan with rotated treatment couch, (8) a noncoplanar VMAT plan with an optimized great circle around the patient, and (9) a noncoplanar BAO VMAT plan with an arbitrary trajectory around the patient. Results: VMAT using optimized noncoplanar irradiation trajectories reduced the mean and maximum doses in organs at risk compared to coplanar VMAT plans by 19% on average while the target coverage remains constant. A coplanar BAO SnS plan was superior to coplanar SnS or VMAT; however, noncoplanar plans like a noncoplanar BAO SnS plan or noncoplanar VMAT yielded a better plan quality than the best coplanar 2π plan. The treatment plan quality of VMAT plans depended on the length of the trajectory. The delivery times of noncoplanar VMAT plans were estimated to be 6.5 min in average; 1.6 min longer than a coplanar plan but on average 2.8 min faster than a noncoplanar SnS plan with comparable

  14. Telemedicine in radiotherapy treatment planning: requirements and applications

    International Nuclear Information System (INIS)

    Olsen, D.R.; Bruland, O.S.; Davis, B.J.

    2000-01-01

    Telemedicine facilitates decentralized radiotherapy services by allowing remote treatment planning and quality assurance of treatment delivery. A prerequisite is digital storage of relevant data and an efficient and reliable telecommunication system between satellite units and the main radiotherapy clinic. The requirements of a telemedicine system in radiotherapy is influenced by the level of support needed. In this paper we differentiate between three categories of telemedicine support in radiotherapy. Level 1 features video conferencing and display of radiotherapy images and dose plans. Level 2 involves replication of selected data from the radiotherapy database - facilitating remote treatment planning and evaluation. Level 3 includes real-time, remote operations, e.g. target volume delineation and treatment planning performed by the team at the satellite unit under supervision and guidance from more experienced colleagues at the main clinic. (author)

  15. A research-oriented treatment planning program system

    International Nuclear Information System (INIS)

    Kalet, I.J.; Jacky, J.P.

    1982-01-01

    The function of a treatment planning program is to graphically simulate radiation dose distributions from proposed radiation therapy treatments. While many such programs are available which provide this much-needed service, none addresses the question of how to intercompare calculation and display techniques. This paper describes a program system designed for support of research efforts, particularly development and testing of new calculation algorithms. The system emphasizes a modular flexible structure, enabling programs to be developed somewhat as interchangeable parts. Thus multiple variants of a calculation algorithm can be compared without undue software overhead or additional data management. Unusual features of the system include extensive use of command procedures, logical names and a structured language (PASCAL). These features are described along with other implementation details. Obstacles, limitations and future applications are also discussed. (Auth.)

  16. Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT

    International Nuclear Information System (INIS)

    Herrera, M.S.; González, S.J.; Burlon, A.A.; Minsky, D.M.; Kreiner, A.J.

    2011-01-01

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma.

  17. Hanford 200 Areas Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Rinne, C.A.; Daly, K.S.

    1993-08-01

    The purpose of the Hanford 200 Areas Development Plan (Development Plan) is to guide the physical development of the 200 Areas (which refers to the 200 East Area, 200 West Area, and 200 Area Corridor, located between the 200 East and 200 West Areas) in accordance with US Department of Energy (DOE) Order 4320.lB (DOE 1991a) by performing the following: Establishing a land-use plan and setting land-use categories that meet the needs of existing and proposed activities. Coordinating existing, 5-year, and long-range development plans and guiding growth in accordance with those plans. Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities. Identifying site development issues that need further analysis. Integrating program plans with development plans to ensure a logical progression of development. Coordinate DOE plans with other agencies [(i.e., Washington State Department of Ecology (Ecology) and US Environmental Protection Agency (EPA)]. Being a support document to the Hanford Site Development Plan (DOE-RL 1990a) (parent document) and providing technical site information relative to the 200 Areas.

  18. Hanford 200 Areas Development Plan

    International Nuclear Information System (INIS)

    Rinne, C.A.; Daly, K.S.

    1993-08-01

    The purpose of the Hanford 200 Areas Development Plan (Development Plan) is to guide the physical development of the 200 Areas (which refers to the 200 East Area, 200 West Area, and 200 Area Corridor, located between the 200 East and 200 West Areas) in accordance with US Department of Energy (DOE) Order 4320.lB (DOE 1991a) by performing the following: Establishing a land-use plan and setting land-use categories that meet the needs of existing and proposed activities. Coordinating existing, 5-year, and long-range development plans and guiding growth in accordance with those plans. Establishing development guidelines to encourage cost-effective development and minimize conflicts between adjacent activities. Identifying site development issues that need further analysis. Integrating program plans with development plans to ensure a logical progression of development. Coordinate DOE plans with other agencies [(i.e., Washington State Department of Ecology (Ecology) and US Environmental Protection Agency (EPA)]. Being a support document to the Hanford Site Development Plan (DOE-RL 1990a) (parent document) and providing technical site information relative to the 200 Areas

  19. Considerations for using data envelopment analysis for the assessment of radiotherapy treatment plan quality.

    Science.gov (United States)

    Simpson, John; Raith, Andrea; Rouse, Paul; Ehrgott, Matthias

    2017-10-09

    Purpose The operations research method of data envelopment analysis (DEA) shows promise for assessing radiotherapy treatment plan quality. The purpose of this paper is to consider the technical requirements for using DEA for plan assessment. Design/methodology/approach In total, 41 prostate treatment plans were retrospectively analysed using the DEA method. The authors investigate the impact of DEA weight restrictions with reference to the ability to differentiate plan performance at a level of clinical significance. Patient geometry influences plan quality and the authors compare differing approaches for managing patient geometry within the DEA method. Findings The input-oriented DEA method is the method of choice when performing plan analysis using the key undesirable plan metrics as the DEA inputs. When considering multiple inputs, it is necessary to constrain the DEA input weights in order to identify potential plan improvements at a level of clinical significance. All tested approaches for the consideration of patient geometry yielded consistent results. Research limitations/implications This work is based on prostate plans and individual recommendations would therefore need to be validated for other treatment sites. Notwithstanding, the method that requires both optimised DEA weights according to clinical significance and appropriate accounting for patient geometric factors is universally applicable. Practical implications DEA can potentially be used during treatment plan development to guide the planning process or alternatively used retrospectively for treatment plan quality audit. Social implications DEA is independent of the planning system platform and therefore has the potential to be used for multi-institutional quality audit. Originality/value To the authors' knowledge, this is the first published examination of the optimal approach in the use of DEA for radiotherapy treatment plan assessment.

  20. Hanford Site Development Plan

    International Nuclear Information System (INIS)

    Hathaway, H.B.; Daly, K.S.; Rinne, C.A.; Seiler, S.W.

    1993-05-01

    The Hanford Site Development Plan (HSDP) provides an overview of land use, infrastructure, and facility requirements to support US Department of Energy (DOE) programs at the Hanford Site. The HSDP's primary purpose is to inform senior managers and interested parties of development activities and issues that require a commitment of resources to support the Hanford Site. The HSDP provides an existing and future land use plan for the Hanford Site. The HSDP is updated annually in accordance with DOE Order 4320.1B, Site Development Planning, to reflect the mission and overall site development process. Further details about Hanford Site development are defined in individual area development plans

  1. Radwaste treatment complex. DRAWMACS planned maintenance system

    International Nuclear Information System (INIS)

    Keel, A.J.

    1992-07-01

    This document describes the operation of the Planned Maintenance System for the Radwaste Treatment Complex. The Planned Maintenance System forms part of the Decommissioning and Radwaste Management Computer System (DRAWMACS). Further detailed information about the data structure of the system is contained in Database Design for the DRAWMACS Planned Maintenance System (AEA-D and R-0285, 2nd issue, 25th February 1992). Information for other components of DRAWMACS is contained in Basic User Guide for the Radwaste Treatment Plant Computer System (AEA-D and R-0019, July 1990). (author)

  2. A Preliminary Version of Heavy Ion Treatment Planning System at IMP

    International Nuclear Information System (INIS)

    Liu Xinguo; Dai Zhongying; Ye Fei; Wu Qingfeng; Li Ping; Li Qiang; Jin Xiaodong; Du Xiaogang; WangYangping; Dang Jianwu

    2010-01-01

    Based on the Heavy Ion Research Facility in Lanzhou (HIRFL/HIRFL-CSR), clinical trials of heavy ion radiotherapy are being conducted at the Institute of Modern Physics (IMP), Chinese Academy of Sciences, where two-dimensional(2D) layer-stacking conformal irradiation method in a passive beam delivery system was applied. To make better use of the biophysical advantages of heavy ion beams and ensure success of the clinical trials, a preliminary version of heavy ion treatment planning system (TPS) has been developed at IMP. The TPS was designed in a manner to adapt to the 2D layer-stacking conformal irradiation method. The architecture and function of the TPS software and the implementation of dose calculation algorithm in the TPS were introduced in this paper.The deviation between the doses planned by the TPS and measured through an anthropomorphous phantom was verified to be less than 5%. Finally,the pending issues for developing a sophisticated treatment planning system at IMP were discussed. (authors)

  3. MO-D-BRB-02: Pediatric Treatment Planning II: Applications of Proton Beams for Pediatric Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C. [St. Jude Childrens Research Hospital (United States)

    2015-06-15

    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa

  4. Analysis of Radiation Treatment Planning by Dose Calculation and Optimization Algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Sup; Yoon, In Ha; Lee, Woo Seok; Baek, Geum Mun [Dept. of Radiation Oncology, Asan Medical Center, Seoul (Korea, Republic of)

    2012-09-15

    Analyze the Effectiveness of Radiation Treatment Planning by dose calculation and optimization algorithm, apply consideration of actual treatment planning, and then suggest the best way to treatment planning protocol. The treatment planning system use Eclipse 10.0. (Varian, USA). PBC (Pencil Beam Convolution) and AAA (Anisotropic Analytical Algorithm) Apply to Dose calculation, DVO (Dose Volume Optimizer 10.0.28) used for optimized algorithm of Intensity Modulated Radiation Therapy (IMRT), PRO II (Progressive Resolution Optimizer V 8.9.17) and PRO III (Progressive Resolution Optimizer V 10.0.28) used for optimized algorithm of VAMT. A phantom for experiment virtually created at treatment planning system, 30x30x30 cm sized, homogeneous density (HU: 0) and heterogeneous density that inserted air assumed material (HU: -1,000). Apply to clinical treatment planning on the basis of general treatment planning feature analyzed with Phantom planning. In homogeneous density phantom, PBC and AAA show 65.2% PDD (6 MV, 10 cm) both, In heterogeneous density phantom, also show similar PDD value before meet with low density material, but they show different dose curve in air territory, PDD 10 cm showed 75%, 73% each after penetrate phantom. 3D treatment plan in same MU, AAA treatment planning shows low dose at Lung included area. 2D POP treatment plan with 15 MV of cervical vertebral region include trachea and lung area, Conformity Index (ICRU 62) is 0.95 in PBC calculation and 0.93 in AAA. DVO DVH and Dose calculation DVH are showed equal value in IMRT treatment plan. But AAA calculation shows lack of dose compared with DVO result which is satisfactory condition. Optimizing VMAT treatment plans using PRO II obtained results were satisfactory, but lower density area showed lack of dose in dose calculations. PRO III, but optimizing the dose calculation results were similar with optimized the same conditions once more. In this study, do not judge the rightness of the dose

  5. Analysis of Radiation Treatment Planning by Dose Calculation and Optimization Algorithm

    International Nuclear Information System (INIS)

    Kim, Dae Sup; Yoon, In Ha; Lee, Woo Seok; Baek, Geum Mun

    2012-01-01

    Analyze the Effectiveness of Radiation Treatment Planning by dose calculation and optimization algorithm, apply consideration of actual treatment planning, and then suggest the best way to treatment planning protocol. The treatment planning system use Eclipse 10.0. (Varian, USA). PBC (Pencil Beam Convolution) and AAA (Anisotropic Analytical Algorithm) Apply to Dose calculation, DVO (Dose Volume Optimizer 10.0.28) used for optimized algorithm of Intensity Modulated Radiation Therapy (IMRT), PRO II (Progressive Resolution Optimizer V 8.9.17) and PRO III (Progressive Resolution Optimizer V 10.0.28) used for optimized algorithm of VAMT. A phantom for experiment virtually created at treatment planning system, 30x30x30 cm sized, homogeneous density (HU: 0) and heterogeneous density that inserted air assumed material (HU: -1,000). Apply to clinical treatment planning on the basis of general treatment planning feature analyzed with Phantom planning. In homogeneous density phantom, PBC and AAA show 65.2% PDD (6 MV, 10 cm) both, In heterogeneous density phantom, also show similar PDD value before meet with low density material, but they show different dose curve in air territory, PDD 10 cm showed 75%, 73% each after penetrate phantom. 3D treatment plan in same MU, AAA treatment planning shows low dose at Lung included area. 2D POP treatment plan with 15 MV of cervical vertebral region include trachea and lung area, Conformity Index (ICRU 62) is 0.95 in PBC calculation and 0.93 in AAA. DVO DVH and Dose calculation DVH are showed equal value in IMRT treatment plan. But AAA calculation shows lack of dose compared with DVO result which is satisfactory condition. Optimizing VMAT treatment plans using PRO II obtained results were satisfactory, but lower density area showed lack of dose in dose calculations. PRO III, but optimizing the dose calculation results were similar with optimized the same conditions once more. In this study, do not judge the rightness of the dose

  6. Solid waste management complex site development plan

    International Nuclear Information System (INIS)

    Greager, T.M.

    1994-01-01

    The main purpose of this Solid Waste Management Complex Site Development Plan is to optimize the location of future solid waste treatment and storage facilities and the infrastructure required to support them. An overall site plan is recommended. Further, a series of layouts are included that depict site conditions as facilities are constructed at the SWMC site. In this respect the report serves not only as the siting basis for future projects, but provides siting guidance for Project W-112, as well. The plan is intended to function as a template for expected growth of the site over the next 30 years so that future facilities and infrastructure will be properly integrated

  7. Solid waste management complex site development plan

    Energy Technology Data Exchange (ETDEWEB)

    Greager, T.M.

    1994-09-30

    The main purpose of this Solid Waste Management Complex Site Development Plan is to optimize the location of future solid waste treatment and storage facilities and the infrastructure required to support them. An overall site plan is recommended. Further, a series of layouts are included that depict site conditions as facilities are constructed at the SWMC site. In this respect the report serves not only as the siting basis for future projects, but provides siting guidance for Project W-112, as well. The plan is intended to function as a template for expected growth of the site over the next 30 years so that future facilities and infrastructure will be properly integrated.

  8. Savannah River Site Approved Site Treatment Plan, 1998 Annual Update (U)

    International Nuclear Information System (INIS)

    Lawrence, B.; Berry, M.

    1998-03-01

    The U.S. Department of Energy, Savannah River Operations Office (DOE- SR),has prepared the Site Treatment Plan (STP) for Savannah River Site (SRS) mixed wastes in accordance with RCRA Section 3021(b), and SCDHEC has approved the STP (except for certain offsite wastes) and issued an order enforcing the STP commitments in Volume I. DOE-SR and SCDHEC agree that this STP fulfills the requirements contained in the FFCAct, RCRA Section 3021, and therefore,pursuant to Section 105(a) of the FFCAct (RCRA Section 3021(b)(5)), DOE's requirements are to implement the plan for the development of treatment capacities and technologies pursuant to RCRA Section 3021.Emerging and new technologies not yet considered may be identified to manage waste more safely, effectively, and at lower cost than technologies currently identified in the plan. DOE will continue to evaluate and develop technologies that offer potential advantages in public acceptance, privatization, consolidation, risk abatement, performance, and life-cycle cost. Should technologies that offer such advantages be identified, DOE may request a revision/modification of the STP in accordance with the provisions of Consent Order 95-22-HW.The Compliance Plan Volume (Volume I) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions (LDR). Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information

  9. Geometric moments and artificial neural network in per optimization of radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Yahaqi, E.; Movafeghi, A.; Hosseini- Ashrafi, M.E.

    2004-01-01

    Given the number of possible combinations of different setting in radiotherapy such as the number of fields etc., arriving at an optimum treatment plan with a completely conventional solution would require an unacceptable number of interaction. Using a priori information whether of a qualitative or quantitative nature has the potential of greatly reducing amount of calculation required in any optimization procedure. Having extracted the outline of the body counter line the treatment area, the sensitive organ and any in- homogeneity present in the given cross section quantitative information in the form of moments is calculated for each treatment case. An artificial neural network classifier is then developed using group of sample treatment case and applied to arrive at initial treatment plan for any new case. The approach has been shown to have strong potential for greatly reducing the number of choices in selecting the optimum answer in treatment planning

  10. Microbeam radiation therapy. Physical and biological aspects of a new cancer therapy and development of a treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Bartzsch, Stefan

    2014-11-05

    Microbeam Radiation Therapy (MRT) is a novel treatment strategy against cancer. Highly brilliant synchrotron radiation is collimated to parallel, a few micrometre wide, planar beams and used to irradiate malignant tissues with high doses. The applied peak doses are considerably higher than in conventional radiotherapy, but valley doses between the beams remain underneath the established tissue tolerance. Previous research has shown that these beam geometries spare normal tissue, while being effective in tumour ablation. In this work physical and biological aspects of the therapy were investigated. A therapy planning system was developed for the first clinical treatments at the European Synchrotron Radiation Facility in Grenoble (France) and a dosimetry method based on radiochromic films was created to validate planned doses with measurements on a micrometre scale. Finally, experiments were carried out on a cellular level in order to correlate the physically planned doses with the biological damage caused in the tissue. The differences between Monte Carlo dose and dosimetry are less than 10% in the valley and 5% in the peak regions. Developed alternative faster dose calculation methods deviate from the computational intensive MC simulations by less than 15% and are able to determine the dose within a few minutes. The experiments in cell biology revealed an significant influence of intercellular signalling on the survival of cells close to radiation boundaries. These observations may not only be important for MRT but also for conventional radiotherapy.

  11. Federal Facility Compliance Act: Conceptual Site Treatment Plan for Lawrence Livermore National Laboratory, Livermore, California

    International Nuclear Information System (INIS)

    1993-10-01

    The Department of Energy (DOE) is required by section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (the Act), to prepare plans describing the development of treatment capacities and technologies for treating mixed waste. The Act requires site treatment plans (STPs or plans) to be developed for each site at which DOE generates or stores mixed waste and submitted to the State or EPA for approval, approval with modification, or disapproval. The Lawrence Livermore National Laboratory (LLNL) Conceptual Site Treatment Plan (CSTP) is the preliminary version of the plan required by the Act and is being provided to California, the US Environmental Protection Agency (EPA), and others for review. A list of the other DOE sites preparing CSTPs is included in Appendix 1.1 of this document. Please note that Appendix 1.1 appears as Appendix A, pages A-1 and A-2 in this document

  12. Current calibration, treatment, and treatment planning techniques among institutions participating in the Children's Oncology Group

    International Nuclear Information System (INIS)

    Urie, Marcia; FitzGerald, T.J.; Followill, David; Laurie, Fran; Marcus, Robert; Michalski, Jeff

    2003-01-01

    Purpose: To report current technology implementation, radiation therapy physics and treatment planning practices, and results of treatment planning exercises among 261 institutions belonging to the Children's Oncology Group (COG). Methods and Materials: The Radiation Therapy Committee of the newly formed COG mandated that each institution demonstrate basic physics and treatment planning abilities by satisfactorily completing a questionnaire and four treatment planning exercises designed by the Quality Assurance Review Center. The planning cases are (1) a maxillary sinus target volume (for two-dimensional planning), (2) a Hodgkin's disease mantle field (for irregular-field and off-axis dose calculations), (3) a central axis blocked case, and (4) a craniospinal irradiation case. The questionnaire and treatment plans were submitted (as of 1/30/02) by 243 institutions and completed satisfactorily by 233. Data from this questionnaire and analyses of the treatment plans with monitor unit calculations are presented. Results: Of the 243 clinics responding, 54% use multileaf collimators routinely, 94% use asymmetric jaws routinely, and 13% use dynamic wedges. Nearly all institutions calibrate their linear accelerators following American Association of Physicists in Medicine protocols, currently 16% with TG-51 and 81% with TG-21 protocol. Treatment planning systems are relied on very heavily for all calculations, including monitor units. Techniques and results of each of the treatment planning exercises are presented. Conclusions: Together, these data provide a unique compilation of current (2001) radiation therapy practices in institutions treating pediatric patients. Overall, the COG facilities have the equipment and the personnel to perform high-quality radiation therapy. With ongoing quality assurance review, radiation therapy compliance with COG protocols should be high

  13. WE-FG-201-02: Automated Treatment Planning for Low-Resource Settings

    Energy Technology Data Exchange (ETDEWEB)

    Court, L. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd.

  14. WE-FG-201-02: Automated Treatment Planning for Low-Resource Settings

    International Nuclear Information System (INIS)

    Court, L.

    2016-01-01

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd

  15. Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle"3 scripting and Auto-Planning functions

    International Nuclear Information System (INIS)

    Speer, Stefan; Weiss, Alexander; Bert, Christoph; Klein, Andreas; Kober, Lukas; Yohannes, Indra

    2017-01-01

    Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle"3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced. (orig.) [de

  16. Automation of radiation treatment planning : Evaluation of head and neck cancer patient plans created by the Pinnacle3 scripting and Auto-Planning functions.

    Science.gov (United States)

    Speer, Stefan; Klein, Andreas; Kober, Lukas; Weiss, Alexander; Yohannes, Indra; Bert, Christoph

    2017-08-01

    Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle 3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced.

  17. IMRT treatment plans and functional planning with functional lung imaging from 4D-CT for thoracic cancer patients

    Directory of Open Access Journals (Sweden)

    Huang Tzung-Chi

    2013-01-01

    Full Text Available Abstract Background and purpose Currently, the inhomogeneity of the pulmonary function is not considered when treatment plans are generated in thoracic cancer radiotherapy. This study evaluates the dose of treatment plans on highly-functional volumes and performs functional treatment planning by incorporation of ventilation data from 4D-CT. Materials and methods Eleven patients were included in this retrospective study. Ventilation was calculated using 4D-CT. Two treatment plans were generated for each case, the first one without the incorporation of the ventilation and the second with it. The dose of the first plans was overlapped with the ventilation and analyzed. Highly-functional regions were avoided in the second treatment plans. Results For small targets in the first plans (PTV  Conclusion Radiation treatments affect functional lung more seriously in large tumor cases. With compromise of dose to other critical organs, functional treatment planning to reduce dose in highly-functional lung volumes can be achieved

  18. Clinical trials radiotherapy treatment plan review software : is this the first quantified assessment

    International Nuclear Information System (INIS)

    Hatton, J.A.; Cornes, D.A.

    2011-01-01

    Full text: Clinical trials require robust quality assurance (QA) procedures to ensure commonality of all treatments, with independent reviews to assess compliance with trial protocols. All clinical trials tools, including QA software, require testing for validity and reliability. enabling inter- and intra-trial comparison. Unlike clinical radiotherapy treatment planning (RTP) systems, review software has no published guidelines. This study describes the design and development of a test suite to quantify the performance of review software in TROG clinical trials. Test areas are image handling and reconstruction; geometric accuracy; dosimetric accuracy; dose-volume histogram (DVH) calculation; display of plan parameters. TROG have developed tests for commissioning plan review software, assessed with SWAN 2.3, and CMS Elekta FocalPro. While image handling tests were based on published guidelines for RTP systems, dosimetric tests used the TROG QA case review requirements. Treatment plans represented systems of all manufacturers (Pinnacle, Eclipse, Xio and Oncentra) used in Australasian centres. The test suite identified areas for SW A software development, including the DVH algorithm, changed to reduce calculation time. Results, in Fig. I, for known volumes of varying shapes and sizes, demonstrate differences between SWAN 2.1 and 2.3 when compared with Eclipse. Liaison with SWAN programmers enabled re-instatement of 2.1 algorithm. The test suite has quantified the RTP review software, prioritised areas for development with the programmers, and improved the user experience.

  19. Computerized property prediction and process planning in heat treatment of steels

    Energy Technology Data Exchange (ETDEWEB)

    Gergely, M. (Steel Advisory Centre for Industrial Technologies (SACIT), Budapest (Hungary)); Somogyi, S. (Steel Advisory Centre for Industrial Technologies (SACIT), Budapest (Hungary)); Kohlheb, R. (Steel Advisory Centre for Industrial Technologies (SACIT), Budapest (Hungary))

    1994-01-01

    Recent years have seen widespread interest in the establishment of prediction methods, based on phenomenological description and computer simulation of transformation processes during heat treatment, and in the introduction of software for technological planning. The steady development of this approach is aimed at meeting the requirement of metallurgists, design engineers dealing with material selection and dimensioning, and technologists planning heat treatment processes. Research in this field of computer simulation has been concentrated so far on two main areas of interest: . Modelling of transformation processes and the prediction of microstructures and/or properties, . Developing program packages to help solve concrete tasks such as material selection, on-line process control and monitoring, and the design of heat-treating operations. During the last two decades in the field of heat treatment, various mathematical models with different accuracy and complexity have been developed. In this paper, an attempt is made to outline some important results in computer simulation and computerized property prediction without aiming at completeness. The topic is restricted to quenched and tempered, and case-hardened steels. (orig.)

  20. Hanford Site Development Plan

    International Nuclear Information System (INIS)

    Hathaway, H.B.; Daly, K.S.; Rinne, C.A.; Seiler, S.W.

    1992-05-01

    The Hanford Site Development Plan (HSDP) provides an overview of land use, infrastructure, and facility requirements to support US Department of Energy (DOE) programs at the Hanford Site. The HSDP's primary purpose is to inform senior managers and interested parties of development activities and issues that require a commitment of resources to support the Hanford Site. The HSDP provides a land use plan for the Hanford Site and presents a picture of what is currently known and anticipated in accordance with DOE Order 4320.1B. Site Development Planning. The HSDP wig be updated annually as future decisions further shape the mission and overall site development process. Further details about Hanford Site development are defined in individual area development plans

  1. [Application of digital design of orthodontic-prosthodontic multidisciplinary treatment plan in esthetic rehabilitation of anterior teeth].

    Science.gov (United States)

    Liu, Y S; Li, Z; Zhao, Y J; Ye, H Q; Zhou, Y Q; Hu, W J; Liu, Y S; Xun, C L; Zhou, Y S

    2018-02-18

    To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. The medians of scores of DP treatment plan and OP treatment plan were calculated and

  2. Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

    Science.gov (United States)

    Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

    2011-12-01

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Comparison of IMRT Treatment Plans Between Linac and Helical Tomotherapy Based on Integral Dose and Inhomogeneity Index

    International Nuclear Information System (INIS)

    Shi Chengyu; Penagaricano, Jose; Papanikolaou, Niko

    2008-01-01

    Intensity modulated radiotherapy (IMRT) is an advanced treatment technology for radiation therapy. There are several treatment planning systems (TPS) that can generate IMRT plans. These plans may show different inhomogeneity indices to the planning target volume (PTV) and integral dose to organs at risk (OAR). In this study, we compared clinical cases covering different anatomical treatment sites, including head and neck, brain, lung, prostate, pelvis, and cranio-spinal axis. Two treatment plans were developed for each case using Pinnacle 3 and helical tomotherapy (HT) TPS. The inhomogeneity index of the PTV and the non-tumor integral dose (NTID) were calculated and compared for each case. Despite the difference in the number of effective beams, in several cases, NTID did not increase from HT as compared to the step-and-shoot delivery method. Six helical tomotherapy treatment plans for different treatment sites have been analyzed and compared against corresponding step-and-shoot plans generated with the Pinnacle 3 planning system. Results show that HT may produce plans with smaller integral doses to healthy organs, and fairly homogeneous doses to the target as compared to linac-based step-and-shoot IMRT planning in special treatment site such as cranio-spinal

  4. CT treatment planning of the liver

    International Nuclear Information System (INIS)

    Lim, M.

    1988-01-01

    The article deals with CT treatment planning of the liver to maximize the dose to the liver but minimize the dose to the right kidney, spinal cord, and bowels. (The left kidney is out of the field due to the oblique angles of the fields.) This is achieved by right kidney shielding reconstruction from multislice CT treatment planning and by the oblique angles of the fields. Without CT, it is not possible to utilize oblique fields to cover the liver. With conventional AP-PA fields, not only is the whole liver treated but also most of the right kidney, half of the left kidney, bowels and spinal cord. Tolerance dose to the kidneys is exceeded if adequate dose is delivered to the liver. Some new computer algorithms display a bird's eye view of the shielding but this paper presents for the first time, a technique for actual shielding reconstruction from multislice CT treatment planning for use by the radiation oncologist when shielding blocks are drawn on the simulator films

  5. Explicit optimization of plan quality measures in intensity-modulated radiation therapy treatment planning.

    Science.gov (United States)

    Engberg, Lovisa; Forsgren, Anders; Eriksson, Kjell; Hårdemark, Björn

    2017-06-01

    To formulate convex planning objectives of treatment plan multicriteria optimization with explicit relationships to the dose-volume histogram (DVH) statistics used in plan quality evaluation. Conventional planning objectives are designed to minimize the violation of DVH statistics thresholds using penalty functions. Although successful in guiding the DVH curve towards these thresholds, conventional planning objectives offer limited control of the individual points on the DVH curve (doses-at-volume) used to evaluate plan quality. In this study, we abandon the usual penalty-function framework and propose planning objectives that more closely relate to DVH statistics. The proposed planning objectives are based on mean-tail-dose, resulting in convex optimization. We also demonstrate how to adapt a standard optimization method to the proposed formulation in order to obtain a substantial reduction in computational cost. We investigated the potential of the proposed planning objectives as tools for optimizing DVH statistics through juxtaposition with the conventional planning objectives on two patient cases. Sets of treatment plans with differently balanced planning objectives were generated using either the proposed or the conventional approach. Dominance in the sense of better distributed doses-at-volume was observed in plans optimized within the proposed framework. The initial computational study indicates that the DVH statistics are better optimized and more efficiently balanced using the proposed planning objectives than using the conventional approach. © 2017 American Association of Physicists in Medicine.

  6. 1994 Site Development Plan: A plan with vision

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    The 1994 Lawrence Livermore National Laboratory Site Development Plan has been developed during a period of great change and uncertainty. Our goal is to make possible the best use of the Laboratory`s resources to meet shifting national priorities in the post-Cold War world. Site Planning is an important component of the overall Laboratory strategic planning process. This plan focuses on opportunities for the Laboratory as well as on key site development issues including facility construction, redevelopment and reuse, site accessibility, and security. A major challenge is to achieve sufficient stability in the site planning and execution so that the processes of construction can occur efficiently while at the same time providing sufficient flexibility in site facilities so that a range of changing national needs can be accommodated. We are closely coupled to the DOE strategic planning process to meet this challenge.

  7. Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

    Energy Technology Data Exchange (ETDEWEB)

    Vandewouw, Marlee M., E-mail: marleev@mie.utoronto.ca; Aleman, Dionne M. [Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S 3G8 (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario M5G 2M9 (Canada)

    2016-08-15

    Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, are used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.

  8. Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

    International Nuclear Information System (INIS)

    Vandewouw, Marlee M.; Aleman, Dionne M.; Jaffray, David A.

    2016-01-01

    Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, are used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.

  9. 71: Three dimensional radiation treatment planning system

    International Nuclear Information System (INIS)

    Purdy, J.A.; Wong, J.W.; Harms, W.B.; Drzymala, R.E.; Emami, B.

    1987-01-01

    A prototype 3-dimensional (3-D) radiation treatment planning (RTP) system has been developed and is in use. The system features a real-time display device and an array processor for computer intensive computations. The dose distribution can be displayed as 2-D isodose distributions superimposed on 2-D gray scale images of the patient's anatomy for any arbitrary plane and as a display of isodose surfaces in 3-D. In addition, dose-volume histograms can be generated. 7 refs.; 2 figs

  10. MRI-based treatment planning for radiotherapy: Dosimetric verification for prostate IMRT

    International Nuclear Information System (INIS)

    Chen, Lili; Price, Robert A.; Wang Lu; Li Jinsheng; Qin Lihong; McNeeley, Shawn; Ma, C.-M. Charlie; Freedman, Gary M.; Pollack, Alan

    2004-01-01

    Purpose: Magnetic resonance (MR) and computed tomography (CT) image fusion with CT-based dose calculation is the gold standard for prostate treatment planning. MR and CT fusion with CT-based dose calculation has become a routine procedure for intensity-modulated radiation therapy (IMRT) treatment planning at Fox Chase Cancer Center. The use of MRI alone for treatment planning (or MRI simulation) will remove any errors associated with image fusion. Furthermore, it will reduce treatment cost by avoiding redundant CT scans and save patient, staff, and machine time. The purpose of this study is to investigate the dosimetric accuracy of MRI-based treatment planning for prostate IMRT. Methods and materials: A total of 30 IMRT plans for 15 patients were generated using both MRI and CT data. The MRI distortion was corrected using gradient distortion correction (GDC) software provided by the vendor (Philips Medical System, Cleveland, OH). The same internal contours were used for the paired plans. The external contours were drawn separately between CT-based and MR imaging-based plans to evaluate the effect of any residual distortions on dosimetric accuracy. The same energy, beam angles, dose constrains, and optimization parameters were used for dose calculations for each paired plans using a treatment optimization system. The resulting plans were compared in terms of isodose distributions and dose-volume histograms (DVHs). Hybrid phantom plans were generated for both the CT-based plans and the MR-based plans using the same leaf sequences and associated monitor units (MU). The physical phantom was then irradiated using the same leaf sequences to verify the dosimetry accuracy of the treatment plans. Results: Our results show that dose distributions between CT-based and MRI-based plans were equally acceptable based on our clinical criteria. The absolute dose agreement for the planning target volume was within 2% between CT-based and MR-based plans and 3% between measured dose

  11. WE-AB-209-05: Development of an Ultra-Fast High Quality Whole Breast Radiotherapy Treatment Planning System

    International Nuclear Information System (INIS)

    Sheng, Y; Li, T; Yoo, S; Yin, F; Blitzblau, R; Horton, J; Palta, M; Hahn, C; Wu, Q; Ge, Y

    2016-01-01

    Purpose: To enable near-real-time (<20sec) and interactive planning without compromising quality for whole breast RT treatment planning using tangential fields. Methods: Whole breast RT plans from 20 patients treated with single energy (SE, 6MV, 10 patients) or mixed energy (ME, 6/15MV, 10 patients) were randomly selected for model training. Additional 20 cases were used as validation cohort. The planning process for a new case consists of three fully automated steps:1. Energy Selection. A classification model automatically selects energy level. To build the energy selection model, principle component analysis (PCA) was applied to the digital reconstructed radiographs (DRRs) of training cases to extract anatomy-energy relationship.2. Fluence Estimation. Once energy is selected, a random forest (RF) model generates the initial fluence. This model summarizes the relationship between patient anatomy’s shape based features and the output fluence. 3. Fluence Fine-tuning. This step balances the overall dose contribution throughout the whole breast tissue by automatically selecting reference points and applying centrality correction. Fine-tuning works at beamlet-level until the dose distribution meets clinical objectives. Prior to finalization, physicians can also make patient-specific trade-offs between target coverage and high-dose volumes.The proposed method was validated by comparing auto-plans with manually generated clinical-plans using Wilcoxon Signed-Rank test. Results: In 19/20 cases the model suggested the same energy combination as clinical-plans. The target volume coverage V100% was 78.1±4.7% for auto-plans, and 79.3±4.8% for clinical-plans (p=0.12). Volumes receiving 105% Rx were 69.2±78.0cc for auto-plans compared to 83.9±87.2cc for clinical-plans (p=0.13). The mean V10Gy, V20Gy of the ipsilateral lung was 24.4±6.7%, 18.6±6.0% for auto plans and 24.6±6.7%, 18.9±6.1% for clinical-plans (p=0.04, <0.001). Total computational time for auto-plans was

  12. WE-AB-209-05: Development of an Ultra-Fast High Quality Whole Breast Radiotherapy Treatment Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Y [Duke University, Durham, NC (United States); Li, T [Thomas Jefferson University, Philadelphia, PA (United States); Yoo, S; Yin, F; Blitzblau, R; Horton, J; Palta, M; Hahn, C; Wu, Q [Duke University Medical Center, Durham, NC (United States); Ge, Y [University of North Carolina at Charlotte, Charlotte, NC (United States)

    2016-06-15

    Purpose: To enable near-real-time (<20sec) and interactive planning without compromising quality for whole breast RT treatment planning using tangential fields. Methods: Whole breast RT plans from 20 patients treated with single energy (SE, 6MV, 10 patients) or mixed energy (ME, 6/15MV, 10 patients) were randomly selected for model training. Additional 20 cases were used as validation cohort. The planning process for a new case consists of three fully automated steps:1. Energy Selection. A classification model automatically selects energy level. To build the energy selection model, principle component analysis (PCA) was applied to the digital reconstructed radiographs (DRRs) of training cases to extract anatomy-energy relationship.2. Fluence Estimation. Once energy is selected, a random forest (RF) model generates the initial fluence. This model summarizes the relationship between patient anatomy’s shape based features and the output fluence. 3. Fluence Fine-tuning. This step balances the overall dose contribution throughout the whole breast tissue by automatically selecting reference points and applying centrality correction. Fine-tuning works at beamlet-level until the dose distribution meets clinical objectives. Prior to finalization, physicians can also make patient-specific trade-offs between target coverage and high-dose volumes.The proposed method was validated by comparing auto-plans with manually generated clinical-plans using Wilcoxon Signed-Rank test. Results: In 19/20 cases the model suggested the same energy combination as clinical-plans. The target volume coverage V100% was 78.1±4.7% for auto-plans, and 79.3±4.8% for clinical-plans (p=0.12). Volumes receiving 105% Rx were 69.2±78.0cc for auto-plans compared to 83.9±87.2cc for clinical-plans (p=0.13). The mean V10Gy, V20Gy of the ipsilateral lung was 24.4±6.7%, 18.6±6.0% for auto plans and 24.6±6.7%, 18.9±6.1% for clinical-plans (p=0.04, <0.001). Total computational time for auto-plans was

  13. In Vivo Diode Dosimetry for Imrt Treatments Generated by Pinnacle Treatment Planning System

    International Nuclear Information System (INIS)

    Alaei, Parham; Higgins, Patrick D.; Gerbi, Bruce J.

    2009-01-01

    Dose verification using diodes has been proposed and used for intensity modulated radiation therapy (IMRT) treatments. We have previously evaluated diode response for IMRT deliveries planned with the Eclipse/Helios treatment planning system. The Pinnacle treatment planning system generates plans that are delivered in a different fashion than Eclipse. Whereas the Eclipse-generated segments are delivered in organized progression from one side of each field to the other, Pinnacle-generated segments are delivered in a much more randomized fashion to different areas within the field. This makes diode measurements at a point more challenging because the diode may be exposed fully or partially to multiple small segments during one single field's treatment as opposed to being exposed to very few segments scanning across the diode during an Eclipse-generated delivery. We have evaluated in vivo dosimetry for Pinnacle-generated IMRT plans and characterized the response of the diode to various size segments on phantom. We present results of patient measurements on approximately 300 fields, which show that 76% of measurements agree to within 10% of the treatment-plan generated calculated doses. Of the other 24%, about 11% are within 15% of the calculated dose. Comparison of these with phantom measurements indicates that many of the discrepancies are due to diode positioning on patients and increased diode response at short source-to-surface distances (SSDs), with the remainder attributable to other factors such as segment size and partial irradiation of the diode

  14. 300 Area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    LUKE, S.N.

    1999-01-01

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999

  15. 300 Area waste acid treatment system closure plan

    Energy Technology Data Exchange (ETDEWEB)

    LUKE, S.N.

    1999-05-17

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999.

  16. Method of radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Hodes, L.

    1976-01-01

    A technique of radiation therapy treatment planning designed to allow the assignment of dosage limits directly to chosen points in the computer-displayed cross-section of the patient. These dosage limits are used as constraints in a linear programming attempt to solve for beam strengths, minimizing integral dosage. If a feasible plan exists, the optimized plan will be displayed for approval as an isodose pattern. If there is no feasible plan, the operator/therapist can designate some of the point dosage constraints as ''relaxed.'' Linear programming will then optimize for minimum deviation at the relaxed points. This process can be iterated and new points selected until an acceptable plan is realized. In this manner the plan is optimized for uniformity as well as overall low dosage. 6 claims, 6 drawing figures

  17. Treatment planning systems

    International Nuclear Information System (INIS)

    Fontenla, D.P.

    2008-01-01

    All aspects of treatment planning in radiotherapy are discussed in detail. Included are, among others, machine data and their acquisition, photon dose calculations and tests thereof, criteria of acceptability, sources of uncertainties, from 2D to 3D and from 3D to IMRT, dosimetric measurements for RTP validation, frequency of QA tests and suggested tolerances for TPS, time and staff requirements, model based segmentation, multi-dimensional radiotherapy (MD C RT), and biological IMRT process. (P.A.)

  18. Ongoing development of digital radiotherapy plan review tools

    International Nuclear Information System (INIS)

    Ebert, M.A.; Hatton, J.; Cornes, D.

    2011-01-01

    Full text: To describe ongoing development of software to support the review of radiotherapy treatment planning system (TPS) data. The 'SWAN' software program was conceived in 2000 and initially developed for the RADAR (TROG 03.04) prostate radiotherapy trial. Validation of the SWAN program has been occurring via implementation by TROG in support of multiple clinical trials. Development has continued and the SWAN software program is now supported by modular components which comprise the 'SW AN system'. This provides a comprehensive set of tools for the review, analysis and archive of TPS exports. The SWAN system has now been used in support of over 20 radiotherapy trials and to review the plans of over 2,000 trial participants. The use of the system for the RADAR trial is now culminating in the derivation of dose-outcomes indices for prostate treatment toxicity. Newly developed SWAN tools include enhanced remote data archive/retrieval, display of dose in both relative and absolute modes, and interfacing to a Matlab-based add-on ('VAST') that allows quantitative analysis of delineated volumes including regional overlap statistics for multi-observer studies. Efforts are continuing to develop the SWAN system in the context of international collaboration aimed at harmonising the quality-assurance activities of collaborative trials groups. Tools such as the SWAN system are essential for ensuring the collection of accurate and reliable evidence to guide future radiotherapy treatments. One of the principal challenges of developing such a tool is establishing a development path that will ensure its validity and applicability well into the future.

  19. Planning and developing medical tourism in megalopolis Shiraz

    Directory of Open Access Journals (Sweden)

    Masoud Safaeepour

    2015-01-01

    Full Text Available Medical tourism is an international phenomenon where some tourists travel long to reach treatment-therapeutic services because of high expenses, long waits, lacking in insurance, and applying services and insufficient access to health services in the destination. This industry, now, by making 60 billion dollars annually in international level, has been considered as one the most profitable markets and the number of countries to provide facilities and treatment services for foreign tourists tend to increase. Many countries provide applicable and legal plans for development of this industry. This paper aims at planning and improving medical tourism in megalopolis Shiraz. The dominating approach in the present study is developmental-applied and the method is descriptive, analytical and survey study. To analyze the data and to test the research hypothesis, the linear Pearson correlation and ANOVA were used. The results of the present study have indicated that all quality factors of treatment and tourism services, culture, facilities, medical and tourist equipment and ICT, had positive and direct correlation with developing medical tourism and the factor of price had negative and reverse correlation with it. In other words, the higher the price is, the less the medical tourism development is and vice versa. Also, the ANOVA showed that among medical tourists from various countries regarding satisfaction with the price of treatment and tourist services, the quality of treatment and tourist services, culture, facilities, medical and tourist equipment and ICT, there are significant differences and Kuwaiti tourists were the most satisfied tourists and Afghani ones were the least satisfied.

  20. Conversion of helical tomotherapy plans to step-and-shoot IMRT plans--Pareto front evaluation of plans from a new treatment planning system.

    Science.gov (United States)

    Petersson, Kristoffer; Ceberg, Crister; Engström, Per; Benedek, Hunor; Nilsson, Per; Knöös, Tommy

    2011-06-01

    The resulting plans from a new type of treatment planning system called SharePlan have been studied. This software allows for the conversion of treatment plans generated in a TomoTherapy system for helical delivery, into plans deliverable on C-arm linear accelerators (linacs), which is of particular interest for clinics with a single TomoTherapy unit. The purpose of this work was to evaluate and compare the plans generated in the SharePlan system with the original TomoTherapy plans and with plans produced in our clinical treatment planning system for intensity-modulated radiation therapy (IMRT) on C-arm linacs. In addition, we have analyzed how the agreement between SharePlan and TomoTherapy plans depends on the number of beams and the total number of segments used in the optimization. Optimized plans were generated for three prostate and three head-and-neck (H&N) cases in the TomoTherapy system, and in our clinical treatment planning systems (TPS) used for IMRT planning with step-and-shoot delivery. The TomoTherapy plans were converted into step-and-shoot IMRT plans in SharePlan. For each case, a large number of Pareto optimal plans were created to compare plans generated in SharePlan with plans generated in the Tomotherapy system and in the clinical TPS. In addition, plans were generated in SharePlan for the three head-and-neck cases to evaluate how the plan quality varied with the number of beams used. Plans were also generated with different number of beams and segments for other patient cases. This allowed for an evaluation of how to minimize the number of required segments in the converted IMRT plans without compromising the agreement between them and the original TomoTherapy plans. The plans made in SharePlan were as good as or better than plans from our clinical system, but they were not as good as the original TomoTherapy plans. This was true for both the head-and-neck and the prostate cases, although the differences between the plans for the latter were

  1. Incorporating model parameter uncertainty into inverse treatment planning

    International Nuclear Information System (INIS)

    Lian Jun; Xing Lei

    2004-01-01

    Radiobiological treatment planning depends not only on the accuracy of the models describing the dose-response relation of different tumors and normal tissues but also on the accuracy of tissue specific radiobiological parameters in these models. Whereas the general formalism remains the same, different sets of model parameters lead to different solutions and thus critically determine the final plan. Here we describe an inverse planning formalism with inclusion of model parameter uncertainties. This is made possible by using a statistical analysis-based frameset developed by our group. In this formalism, the uncertainties of model parameters, such as the parameter a that describes tissue-specific effect in the equivalent uniform dose (EUD) model, are expressed by probability density function and are included in the dose optimization process. We found that the final solution strongly depends on distribution functions of the model parameters. Considering that currently available models for computing biological effects of radiation are simplistic, and the clinical data used to derive the models are sparse and of questionable quality, the proposed technique provides us with an effective tool to minimize the effect caused by the uncertainties in a statistical sense. With the incorporation of the uncertainties, the technique has potential for us to maximally utilize the available radiobiology knowledge for better IMRT treatment

  2. IMRT treatment planning-A comparative inter-system and inter-centre planning exercise of the ESTRO QUASIMODO group

    International Nuclear Information System (INIS)

    Bohsung, Joerg; Gillis, Sofie; Arrans, Rafael; Bakai, Annemarie; De Wagter, Carlos; Knoeoes, Tommy; Mijnheer, Ben J.; Paiusco, Marta; Perrin, Bruce A.; Welleweerd, Hans; Williams, Peter

    2005-01-01

    Background and purpose: The purpose of this work was a comparison of realistic IMRT plans based on the same CT-image data set and a common predefined set of dose objectives for the planning target volume and the organs at risk. This work was part of the larger European QUASIMODO IMRT verification project. Materials and methods: Eleven IMRT plans were produced by nine different European groups, each applying a representative set of clinically used IMRT treatment planning systems. The plans produced were to be deliverable in a clinically acceptable treatment time with the local technical equipment. All plans were characterized using a set of different quality measures such as dose-volume histograms, number of monitor units and treatment time. Results: Only one plan was able to fulfil all dose objectives strictly; six plans failed some of the objectives but were still considered to be clinically acceptable; four plans were not able to reach the objectives. Additional quality scores such as the number of monitor units and treatment time showed large variations, which mainly depend on the delivery technique. Conclusion: The presented planning study showed that with nearly all presently available IMRT planning and delivery systems comparable dose distributions could be achieved if the planning goals are clearly defined in advance

  3. A novel implementation of mARC treatment for non-dedicated planning systems using converted IMRT plans

    International Nuclear Information System (INIS)

    Dzierma, Yvonne; Nuesken, Frank; Licht, Norbert; Ruebe, Christian

    2013-01-01

    The modulated arc (mARC) technique has recently been introduced by Siemens as an analogue to VMAT treatment. However, up to now only one certified treatment planning system supports mARC planning. We therefore present a conversion algorithm capable of converting IMRT plans created by any treatment planning system into mARC plans, with the hope of expanding the availability of mARC to a larger range of clinical users and researchers. As additional advantages, our implementation offers improved functionality for planning hybrid arcs and provides an equivalent step-and-shoot plan for each mARC plan, which can be used as a back-up concept in institutions where only one linac is equipped with mARC. We present a feasibility study to outline a practical implementation of mARC plan conversion using Philips Pinnacle and Prowess Panther. We present examples for three different kinds of prostate and head-and-neck plans, for 6 MV and flattening-filter-free (FFF) 7 MV photon energies, which are dosimetrically verified. It is generally more difficult to create good quality IMRT plans in Pinnacle using a large number of beams and few segments. We present different ways of optimization as examples. By careful choosing the beam and segment arrangement and inversion objectives, we achieve plan qualities similar to our usual IMRT plans. The conversion of the plans to mARC format yields functional plans, which can be irradiated without incidences. Absolute dosimetric verification of both the step-and-shoot and mARC plans by point dose measurements showed deviations below 5% local dose, mARC plans deviated from step-and-shoot plans by no more than 1%. The agreement between GafChromic film measurements of planar dose before and after mARC conversion is excellent. The comparison of the 3D dose distribution measured by PTW Octavius 729 2D-Array with the step-and-shoot plans and with the TPS is well above the pass criteria of 90% of the points falling within 5% local dose and 3 mm distance

  4. Technical development of graphite waste treatment in NUPEC

    International Nuclear Information System (INIS)

    Saishu, S.; Inoue, T.

    2001-01-01

    In Japan, Tokai Power Station, which is a Gas Cooled Reactor and uses graphite as moderator, ceased operation at the end of March in 1998 and it is planned to transfer to decommissioning stage. In this decommissioning stage it is very important to be able to treat and dispose the graphite waste in order to carry out the decommissioning safely and economically. NUPEC has been developing the graphite treatment and disposal technology since 1997 and we introduce the outline of the technical development. For the technology on high density packing into disposal container, the high density packing method and the assessment method on nuclide leaching characteristics were developed, and the cementing test for graphite powder by using Tokai spare graphite was performed and the hydrophobic characteristics between graphite and cement was grasped and the accelerator candidature for affinity was selected. From the view point of economical treatment, the incinerating technology was selected as candidature, and the methods for incinerating graphite and treating off gas are developed. The method of collecting C-14 in off gas was selected for reducing the off gas radiation level. The applicability of actual graphite treatment technology was considered from the view point of safety, economics and preparation of technical standard; the technical theme appeared, the developing planning items were established, and the detailed and actual scale tests will be carried out according to the planning. (author)

  5. Volume rendering in treatment planning for moving targets

    Energy Technology Data Exchange (ETDEWEB)

    Gemmel, Alexander [GSI-Biophysics, Darmstadt (Germany); Massachusetts General Hospital, Boston (United States); Wolfgang, John A.; Chen, George T.Y. [Massachusetts General Hospital, Boston (United States)

    2009-07-01

    Advances in computer technologies have facilitated the development of tools for 3-dimensional visualization of CT-data sets with volume rendering. The company Fovia has introduced a high definition volume rendering engine (HDVR trademark by Fovia Inc., Palo Alto, USA) that is capable of representing large CT data sets with high user interactivity even on standard PCs. Fovia provides a software development kit (SDK) that offers control of all the features of the rendering engine. We extended the SDK by functionalities specific to the task of treatment planning for moving tumors. This included navigation of the patient's anatomy in beam's eye view, fast point-and-click measurement of lung tumor trajectories as well as estimation of range perturbations due to motion by calculation of (differential) water equivalent path lengths for protons and carbon ions on 4D-CT data sets. We present patient examples to demonstrate the advantages and disadvantages of volume rendered images as compared to standard 2-dimensional axial plane images. Furthermore, we show an example of a range perturbation analysis. We conclude that volume rendering is a powerful technique for the representation and analysis of large time resolved data sets in treatment planning.

  6. Generating AN Optimum Treatment Plan for External Beam Radiation Therapy.

    Science.gov (United States)

    Kabus, Irwin

    1990-01-01

    The application of linear programming to the generation of an optimum external beam radiation treatment plan is investigated. MPSX, an IBM linear programming software package was used. All data originated from the CAT scan of an actual patient who was treated for a pancreatic malignant tumor before this study began. An examination of several alternatives for representing the cross section of the patient showed that it was sufficient to use a set of strategically placed points in the vital organs and tumor and a grid of points spaced about one half inch apart for the healthy tissue. Optimum treatment plans were generated from objective functions representing various treatment philosophies. The optimum plans were based on allowing for 216 external radiation beams which accounted for wedges of any size. A beam reduction scheme then reduced the number of beams in the optimum plan to a number of beams small enough for implementation. Regardless of the objective function, the linear programming treatment plan preserved about 95% of the patient's right kidney vs. 59% for the plan the hospital actually administered to the patient. The clinician, on the case, found most of the linear programming treatment plans to be superior to the hospital plan. An investigation was made, using parametric linear programming, concerning any possible benefits derived from generating treatment plans based on objective functions made up of convex combinations of two objective functions, however, this proved to have only limited value. This study also found, through dual variable analysis, that there was no benefit gained from relaxing some of the constraints on the healthy regions of the anatomy. This conclusion was supported by the clinician. Finally several schemes were found that, under certain conditions, can further reduce the number of beams in the final linear programming treatment plan.

  7. Planning of emergency medical treatment in nuclear power plant

    International Nuclear Information System (INIS)

    Kusama, Tomoko

    1989-01-01

    Medical staffs and health physicists have shown deep concerning at the emergency plans of nuclear power plants after the TMI nuclear accident. The most important and basic countermeasure for accidents was preparing appropriate and concrete organization and plans for treatment. We have planed emergency medical treatment for radiation workers in a nuclear power plant institute. The emergency medical treatment at institute consisted of two stages, that is on-site emergency treatment at facility medical service. In first step of planning in each stage, we selected and treatment at facility medical service. In first step of planning in each stage, we selected and analyzed all possible accidents in the institute and discussed on practical treatments for some possible accidents. The manuals of concrete procedure of emergency treatment for some accidents were prepared following discussion and facilities and equipment for medical treatment and decontamination were provided. All workers in the institute had periodical training and drilling of on-site emergency treatment and mastered technique of first aid. Decontamination and operation rooms were provided in the facillity medical service. The main functions at the facility medical service have been carried out by industrial nurses. Industrial nurses have been in close co-operation with radiation safety officers and medical doctors in regional hospital. (author)

  8. Proposed site treatment plan (PSTP) Volumes I ampersand II ampersand reference document, Revision 3

    International Nuclear Information System (INIS)

    Helmich, E.; Noller, D.K.; Wierzbicki, K.S.

    1995-01-01

    The Federal Facility Compliance Act requires the Department of Energy to undertake a national effort to develop Site Treatment Plans for each of its sites generating or storing mixed waste. Mixed waste contains both a hazardous waste subject to the Resource Conservation and Recovery Act and radioactive material subject to the Atomic Energy Act of 1954. The Site Treatment Plan for the Savannah River Site proposes how SRS will treat mixed waste that is now stored on the site and mixed waste that Will be generated in the future. Also, the Site Treatment Plan identifies Savannah River Site mixed wastes that other Department of Energy facilities could treat and mixed waste from other facilities that the Savannah River Site could treat. The Site Treatment Plan has been approved by the State of South Carolina. The Department of Energy Will enter into a consent order with the State of South Carolina by October 6, 1995. The consent order will contain enforceable commitments to treat mixed waste

  9. Environmental development plan. LWR commercial waste management

    International Nuclear Information System (INIS)

    1980-08-01

    This Environmental Development Plan (EDP) identifies the planning and managerial requirements and schedules needed to evaluate and assess the environmental, health and safety (EH and S) aspects of the Commercial Waste Management Program (CWM). Environment is defined in its broadest sense to include environmental, health (occupational and public), safety, socioeconomic, legal and institutional aspects. This plan addresses certain present and potential Federal responsibilities for the storage, treatment, transfer and disposal of radioactive waste materials produced by the nuclear power industry. The handling and disposal of LWR spent fuel and processed high-level waste (in the event reprocessing occurs) are included in this plan. Defense waste management activities, which are addressed in detail in a separate EDP, are considered only to the extent that such activities are common to the commercial waste management program. This EDP addresses three principal elements associated with the disposal of radioactive waste materials from the commercial nuclear power industry, namely Terminal Isolation Research and Development, Spent Fuel Storage and Waste Treatment Technology. The major specific concerns and requirements addressed are assurance that (1) radioactivity will be contained during waste transport, interim storage or while the waste is considered as retrievable from a repository facility, (2) the interim storage facilities will adequately isolate the radioactive material from the biosphere, (3) the terminal isolation facility will isolate the wastes from the biosphere over a time period allowing the radioactivity to decay to innocuous levels, (4) the terminal isolation mode for the waste will abbreviate the need for surveillance and institutional control by future generations, and (5) the public will accept the basic waste management strategy and geographical sites when needed

  10. Efficient photon treatment planning by the use of Swiss Monte Carlo Plan

    International Nuclear Information System (INIS)

    Fix, M K; Manser, P; Frei, D; Volken, W; Mini, R; Born, E J

    2007-01-01

    Currently photon Monte Carlo treatment planning (MCTP) for a patient stored in the patient database of a treatment planning system (TPS) usually can only be performed using a cumbersome multi-step procedure where many user interactions are needed. Automation is needed for usage in clinical routine. In addition, because of the long computing time in MCTP, optimization of the MC calculations is essential. For these purposes a new GUI-based photon MC environment has been developed resulting in a very flexible framework, namely the Swiss Monte Carlo Plan (SMCP). Appropriate MC transport methods are assigned to different geometric regions by still benefiting from the features included in the TPS. In order to provide a flexible MC environment the MC particle transport has been divided into different parts: source, beam modifiers, and patient. The source part includes: Phase space-source, source models, and full MC transport through the treatment head. The beam modifier part consists of one module for each beam modifier. To simulate the radiation transport through each individual beam modifier, one out of three full MC transport codes can be selected independently. Additionally, for each beam modifier a simple or an exact geometry can be chosen. Thereby, different complexity levels of radiation transport are applied during the simulation. For the patient dose calculation two different MC codes are available. A special plug-in in Eclipse providing all necessary information by means of Dicom streams was used to start the developed MC GUI. The implementation of this framework separates the MC transport from the geometry and the modules pass the particles in memory, hence no files are used as interface. The implementation is realized for 6 and 15 MV beams of a Varian Clinac 2300 C/D. Several applications demonstrate the usefulness of the framework. Apart from applications dealing with the beam modifiers, three patient cases are shown. Thereby, comparisons between MC

  11. Dependence of Achievable Plan Quality on Treatment Technique and Planning Goal Refinement: A Head-and-Neck Intensity Modulated Radiation Therapy Application

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Ruan, Dan; Lee, Steve P.; Pham, Andrew; Kupelian, Patrick; Low, Daniel A.; Steinberg, Michael; Demarco, John

    2015-01-01

    Purpose: To develop a practical workflow for retrospectively analyzing target and normal tissue dose–volume endpoints for various intensity modulated radiation therapy (IMRT) delivery techniques; to develop technique-specific planning goals to improve plan consistency and quality when feasible. Methods and Materials: A total of 165 consecutive head-and-neck patients from our patient registry were selected and retrospectively analyzed. All IMRT plans were generated using the same dose–volume guidelines for TomoTherapy (Tomo, Accuray), TrueBeam (TB, Varian) using fixed-field IMRT (TB-IMRT) or RAPIDARC (TB-RAPIDARC), or Siemens Oncor (Siemens-IMRT, Siemens). A MATLAB-based dose–volume extraction and analysis tool was developed to export dosimetric endpoints for each patient. With a fair stratification of patient cohort, the variation of achieved dosimetric endpoints was analyzed among different treatment techniques. Upon identification of statistically significant variations, technique-specific planning goals were derived from dynamically accumulated institutional data. Results: Retrospective analysis showed that although all techniques yielded comparable target coverage, the doses to the critical structures differed. The maximum cord doses were 34.1 ± 2.6, 42.7 ± 2.1, 43.3 ± 2.0, and 45.1 ± 1.6 Gy for Tomo, TB-IMRT, TB-RAPIDARC, and Siemens-IMRT plans, respectively. Analyses of variance showed significant differences for the maximum cord doses but no significant differences for other selected structures among the investigated IMRT delivery techniques. Subsequently, a refined technique-specific dose–volume guideline for maximum cord dose was derived at a confidence level of 95%. The dosimetric plans that failed the refined technique-specific planning goals were reoptimized according to the refined constraints. We observed better cord sparing with minimal variations for the target coverage and other organ at risk sparing for the Tomo cases, and higher

  12. Radiobiologically based treatment plan evaluation for prostate seed implants

    Directory of Open Access Journals (Sweden)

    Sotirios Stathakis

    2011-07-01

    Full Text Available Purpose: Accurate prostate low dose-rate brachytherapy treatment plan evaluation is important for future care decisions. Presently, an evaluation is based on dosimetric quantifiers for the tumor and organs at risk. However, these do not account for effects of varying dose-rate, tumor repopulation and other biological effects. In this work, incorporation of the biological response is used to obtain more clinically relevant treatment plan evaluation.Material and methods: Eleven patients were evaluated. Each patient received a 145 Gy implant. Iodine-125 seeds were used and the treatment plans were created on the Prowess system. Based on CT images the post-implant plan was created. In the post-plan, the tumor, urethra, bladder and rectum were contoured. The biologically effective dose was used to determine the tumor control probability and the normal tissue complication probabilities for the urethra, bladder, rectum and surrounding tissue. Results: The average tumor control probability and complication probabilities for the urethra, bladder, rectum and surrounding tissue were 99%, 29%, 0%, 12% and 6%, respectively. These measures provide a simpler means for evaluation and since they include radiobiological factors, they provide more reliable estimation of the treatment outcome. Conclusions: The goal of this work was to create more clinically relevant prostate seed-implant evaluation by incorporating radiobiological measures. This resulted in a simpler descriptor of treatment plan quality and was consistent with patient outcomes.

  13. SU-D-BRD-04: The Impact of Automatic Radiation Therapy Plan Checks in Treatment Planning

    International Nuclear Information System (INIS)

    Gopan, O; Yang, F; Ford, E

    2015-01-01

    Purpose: The physics plan check verifies various aspects of a treatment plan after dosimetrists have finished creating the plan. Some errors in the plan which are caught by the physics check could be caught earlier in the departmental workflow. The purpose of this project was to evaluate a plan checking script that can be run within the treatment planning system (TPS) by the dosimetrists prior to plan approval and export to the record and verify system. Methods: A script was created in the Pinnacle TPS to automatically check 15 aspects of a plan for clinical practice conformity. The script outputs a list of checks which the plan has passed and a list of checks which the plan has failed so that appropriate adjustments can be made. For this study, the script was run on a total of 108 plans: IMRT (46/108), VMAT (35/108) and SBRT (27/108). Results: Of the plans checked by the script, 77/108 (71%) failed at least one of the fifteen checks. IMRT plans resulted in more failed checks (91%) than VMAT (51%) or SBRT (63%), due to the high failure rate of an IMRT-specific check, which checks that no IMRT segment < 5 MU. The dose grid size and couch removal checks caught errors in 10% and 14% of all plans – errors that ultimately may have resulted in harm to the patient. Conclusion: Approximately three-fourths of the plans being examined contain errors that could be caught by dosimetrists running an automated script embedded in the TPS. The results of this study will improve the departmental workflow by cutting down on the number of plans that, due to these types of errors, necessitate re-planning and re-approval of plans, increase dosimetrist and physician workload and, in urgent cases, inconvenience patients by causing treatment delays

  14. SU-E-T-595: Design of a Graphical User Interface for An In-House Monte Carlo Based Treatment Planning System: Planning and Contouring Tools

    International Nuclear Information System (INIS)

    EMAM, M; Eldib, A; Lin, M; Li, J; Chibani, O; Ma, C

    2014-01-01

    Purpose: An in-house Monte Carlo based treatment planning system (MC TPS) has been developed for modulated electron radiation therapy (MERT). Our preliminary MERT planning experience called for a more user friendly graphical user interface. The current work aimed to design graphical windows and tools to facilitate the contouring and planning process. Methods: Our In-house GUI MC TPS is built on a set of EGS4 user codes namely MCPLAN and MCBEAM in addition to an in-house optimization code, which was named as MCOPTIM. Patient virtual phantom is constructed using the tomographic images in DICOM format exported from clinical treatment planning systems (TPS). Treatment target volumes and critical structures were usually contoured on clinical TPS and then sent as a structure set file. In our GUI program we developed a visualization tool to allow the planner to visualize the DICOM images and delineate the various structures. We implemented an option in our code for automatic contouring of the patient body and lungs. We also created an interface window displaying a three dimensional representation of the target and also showing a graphical representation of the treatment beams. Results: The new GUI features helped streamline the planning process. The implemented contouring option eliminated the need for performing this step on clinical TPS. The auto detection option for contouring the outer patient body and lungs was tested on patient CTs and it was shown to be accurate as compared to that of clinical TPS. The three dimensional representation of the target and the beams allows better selection of the gantry, collimator and couch angles. Conclusion: An in-house GUI program has been developed for more efficient MERT planning. The application of aiding tools implemented in the program is time saving and gives better control of the planning process

  15. Image registration: An essential part of radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Rosenman, Julian G.; Miller, Elizabeth P.; Tracton, Gregg; Cullip, Tim J.

    1998-01-01

    Purpose: We believe that a three-dimensional (3D) registration of nonplanning (diagnostic) imaging data with the planning computed tomography (CT) offers a substantial improvement in tumor target identification for many radiation therapy patients. The purpose of this article is to review and discuss our experience to date. Methods and Materials: We reviewed the charts and treatment planning records of all patients that underwent 3D radiation treatment planning in our department from June 1994 to December 1995, to learn which patients had image registration performed and why it was thought they would benefit from this approach. We also measured how much error would have been introduced into the target definition if the nonplanning imaging data had not been available and only the planning CT had been used. Results: Between June 1994 and December 1995, 106 of 246 (43%) of patients undergoing 3D treatment planning had image registration. Four reasons for performing registration were identified. First, some tumor volumes have better definition on magnetic resonance imaging (MRI) than on CT. Second, a properly contrasted diagnostic CT sometimes can show the tumor target better than can the planning CT. Third, the diagnostic CT or MR may have been preoperative, with the postoperative planning CT no longer showing the tumor. Fourth, the patient may have undergone cytoreductive chemotherapy so that the postchemotherapy planning CT no longer showed the original tumor volume. In patients in whom the planning CT did not show the tumor volume well an analysis was done to determine how the treatment plan was changed with the addition of a better tumor-defining nonplanning CT or MR. We have found that the use of this additional imaging modality changed the tumor location in the treatment plan at least 1.5 cm for half of the patients, and up to 3.0 cm for ((1)/(4)) of the patients. Conclusions: Multimodality and/or sequential imaging can substantially aid in better tumor

  16. Savannah River Site mixed waste Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and reference document: Revision 2

    International Nuclear Information System (INIS)

    Helmich, E.; Noller, D.K.; Wierzbicki, K.S.; Bailey, L.L.

    1995-01-01

    The DOE is required by the Resource Conservation and Recovery Act to prepare site treatment plans describing the development of treatment capacities and technologies for treating mixed waste. This proposed plan contains Savannah River Site's preferred options and schedules for constructing new facilities, and otherwise obtaining treatment for mixed wastes. The proposed plan consists of 2 volumes. Volume 1, Compliance Plan, identifies the capacity to be developed and the schedules as required. Volume 2, Background, provides a detailed discussion of the preferred options with technical basis, plus a description of the specific waste streams. Chapters are: Introduction; Methodology; Mixed low level waste streams; Mixed transuranic waste; High level waste; Future generation of mixed waste streams; Storage; Process for evaluation of disposal issues in support of the site treatment plans discussions; Treatment facilities and treatment technologies; Offsite waste streams for which SRS treatment is the Preferred Option (Naval reactor wastes); Summary information; and Acronyms and glossary. This revision does not contain the complete revised report, but only those pages that have been revised

  17. Clinical treatment planning for stereotactic radiotherapy, evaluation by Monte Carlo simulation

    International Nuclear Information System (INIS)

    Kairn, T.; Aland, T.; Kenny, J.; Knight, R.T.; Crowe, S.B.; Langton, C.M.; Franich, R.D.; Johnston, P.N.

    2010-01-01

    Full text: This study uses re-evaluates the doses delivered by a series of clinical stereotactic radiotherapy treatments, to test the accuracy of treatment planning predictions for very small radiation fields. Stereotactic radiotherapy treatment plans for meningiomas near the petrous temporal bone and the foramen magnum (incorp rating fields smaller than I c m2) were examined using Monte Carlo simulations. Important differences between treatment planning predictions and Monte Carlo calculations of doses delivered to stereotactic radiotherapy patients are apparent. For example, in one case the Monte Carlo calculation shows that the delivery a planned meningioma treatment would spare the patient's critical structures (eyes, brainstem) more effectively than the treatment plan predicted, and therefore suggests that this patient could safely receive an increased dose to their tumour. Monte Carlo simulations can be used to test the dose predictions made by a conventional treatment planning system, for dosimetrically challenging small fields, and can thereby suggest valuable modifications to clinical treatment plans. This research was funded by the Wesley Research Institute, Australia. The authors wish to thank Andrew Fielding and David Schlect for valuable discussions of aspects of this work. The authors are also grateful to Muhammad Kakakhel, for assisting with the design and calibration of our linear accelerator model, and to the stereotactic radiation therapy team at Premion, who designed the treatment plans. Computational resources and services used in this work were provided by the HPC and Research Support Unit, QUT, Brisbane, Australia. (author)

  18. MO-H-19A-01: FEATURED PRESENTATION - Treatment Planning Tool for Radiotherapy with Very High-Energy Electron Beams

    International Nuclear Information System (INIS)

    Bazalova, M; Qu, B; Palma, B; Loo, B; Maxim, P; Hynning, E; Hardemark, B

    2014-01-01

    Purpose: To develop a tool for treatment planning optimization for fast radiotherapy delivered with very high-energy electron beams (VHEE) and to compare VHEE plans to state-of-the-art plans for challenging pelvis and H'N cases. Methods: Treatment planning for radiotherapy delivered with VHEE scanning pencil beams was performed by integrating EGSnrc Monte Carlo (MC) dose calculations with spot scanning optimization run in a research version of RayStation. A Matlab GUI for MC beamlet generation was developed, in which treatment parameters such as the pencil beam size and spacing, energy and number of beams can be selected. Treatment planning study for H'N and pelvis cases was performed and the effect of treatment parameters on the delivered dose distributions was evaluated and compared to the clinical treatment plans. The pelvis case with a 691cm3 PTV was treated with 2-arc 15MV VMAT and the H'N case with four PTVs with total volume of 531cm3 was treated with 4-arc 6MV VMAT. Results: Most studied VHEE plans outperformed VMAT plans. The best pelvis 80MeV VHEE plan with 25 beams resulted in 12% body dose sparing and 8% sparing to the bowel and right femur compared to the VMAT plan. The 100MeV plan was superior to the 150MeV plan. Mixing 100 and 150MeV improved dose sparing to the bladder by 7% compared to either plan. Plans with 16 and 36 beams did not significantly affect the dose distributions compared to 25 beam plans. The best H'N 100MeV VHEE plan decreased mean doses to the brainstem, chiasm, and both globes by 10-42% compared to the VMAT plan. Conclusion: The pelvis and H'N cases suggested that sixteen 100MeV beams might be sufficient specifications of a novel VHEE treatment machine. However, optimum machine parameters will be determined with the presented VHEE treatment-planning tool for a large number of clinical cases. BW Loo and P Maxim received research support from RaySearch Laboratories. E Hynning and B Hardemark are employees of

  19. SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

    Energy Technology Data Exchange (ETDEWEB)

    Masi, K; Ditman, M; Marsh, R; Archer, P; Matuszak, M [University of Michigan, Ann Arbor, MI (United States); Dai, J [Alpena Cancer Center, Alpena, MI (United States); Huberts, M [McLaren Greater Lansing, Lansing, MI (United States); Khadija, M [Metro Health, Wyoming, MI (United States); Tatro, D [Allegiance Health, Jackson, MI (United States)

    2016-06-15

    Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned using an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved target

  20. SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

    International Nuclear Information System (INIS)

    Masi, K; Ditman, M; Marsh, R; Archer, P; Matuszak, M; Dai, J; Huberts, M; Khadija, M; Tatro, D

    2016-01-01

    Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned using an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved target

  1. Treatment planning, optimization, and beam delivery technqiues for intensity modulated proton therapy

    Science.gov (United States)

    Sengbusch, Evan R.

    Physical properties of proton interactions in matter give them a theoretical advantage over photons in radiation therapy for cancer treatment, but they are seldom used relative to photons. The primary barriers to wider acceptance of proton therapy are the technical feasibility, size, and price of proton therapy systems. Several aspects of the proton therapy landscape are investigated, and new techniques for treatment planning, optimization, and beam delivery are presented. The results of these investigations suggest a means by which proton therapy can be delivered more efficiently, effectively, and to a much larger proportion of eligible patients. An analysis of the existing proton therapy market was performed. Personal interviews with over 30 radiation oncology leaders were conducted with regard to the current and future use of proton therapy. In addition, global proton therapy market projections are presented. The results of these investigations serve as motivation and guidance for the subsequent development of treatment system designs and treatment planning, optimization, and beam delivery methods. A major factor impacting the size and cost of proton treatment systems is the maximum energy of the accelerator. Historically, 250 MeV has been the accepted value, but there is minimal quantitative evidence in the literature that supports this standard. A retrospective study of 100 patients is presented that quantifies the maximum proton kinetic energy requirements for cancer treatment, and the impact of those results with regard to treatment system size, cost, and neutron production is discussed. This study is subsequently expanded to include 100 cranial stereotactic radiosurgery (SRS) patients, and the results are discussed in the context of a proposed dedicated proton SRS treatment system. Finally, novel proton therapy optimization and delivery techniques are presented. Algorithms are developed that optimize treatment plans over beam angle, spot size, spot spacing

  2. Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor

    International Nuclear Information System (INIS)

    Shirato, Hiroki; Shimizu, Shinichi; Kitamura, Kei; Nishioka, Takeshi; Kagei, Kenji; Hashimoto, Seiko; Aoyama, Hidefumi; Kunieda, Tatsuya; Shinohara, Nobuo; Dosaka-Akita, Hirotoshi; Miyasaka, Kazuo

    2000-01-01

    Purpose: To achieve precise three-dimensional (3D) conformal radiotherapy for mobile tumors, a new radiotherapy system and its treatment planning system were developed and used for clinical practice. Methods and Materials: We developed a linear accelerator synchronized with a fluoroscopic real-time tumor tracking system by which 3D coordinates of a 2.0-mm gold marker in the tumor can be determined every 0.03 second. The 3D relationships between the marker and the tumor at different respiratory phases are evaluated using CT image at each respiratory phase, whereby the optimum phase can be selected to synchronize with irradiation (4D treatment planning). The linac is triggered to irradiate the tumor only when the marker is located within the region of the planned coordinates relative to the isocenter. Results: The coordinates of the marker were detected with an accuracy of ± 1 mm during radiotherapy in the phantom experiment. The time delay between recognition of the marker position and the start or stop of megavoltage X-ray irradiation was 0.03 second. Fourteen patients with various tumors were treated by conformal radiotherapy with a 'tight' planning target volume (PTV) margin. They were surviving without relapse or complications with a median follow-up of 6 months. Conclusion: Fluoroscopic real-time tumor tracking radiotherapy following 4D treatment planning was developed and shown to be feasible to improve the accuracy of the radiotherapy for mobile tumors

  3. Clinical Investigations of a CT-based reconstruction and 3D-Treatment planning system in interstitial brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kolotas, C; Zamboglou, N [Strahlenklinik, Stadtische Kliniken Offenbach, Offenbach (Germany)

    1999-12-31

    Purpose: Development, application and evaluation of a CT-guided implantation technique and a fully CT based treatment planning procedure for brachytherapy. Methods and Materials : A brachytherapy procedure based on CT-guided implantation technique and CT based treatment planning has been developed and clinically evaluated. For this purpose a software system (PROMETHEUS) for the 3D reconstruction of brachytherapy catheters and patient anatomy using only CT scans has been developed. An interface for the Nucletron Plato BPS treatment planning system for the optimisation and calculation of dose distribution has been devised. The planning target volume(s) are defined as sets of points using contouring tools and are for optimisation of the 3D dose distribution. Dose-volume histogram-based analysis of the dose distribution enables a clinically realistic evaluation of the brachytherapy application to be made. The CT-guided implantation of catheters and the CT-based treatment planning procedure has been performed for interstitial brachytherapy and for different tumour and anatomical localizations in 197 patients between 1996 and 1997. Results : The accuracy of the CT reconstruction was tested using a quality assurance phantom an an interstitial implant of 12 needles and compared with the results of reconstruction using radiographs[hs. Both methods give comparable results with regard to accuracy. The CT based reconstruction was faster. Clinical feasibility has been proven in pre-irradiated recurrences of brain tumour, in pre-treated recurrences or metastatic disease, and in breast carcinomas. The tumour volume treated ranged from 5.1 - 2741 cm3. Analysis of the implant quality showed a slight significant lower COIN value for the bone implants, but no differences in respect to the planning target volume. Conclusions : With the integration of CT imaging in the treatment planning and documentation of brachytherapy, we have a new CT based quality assurance method to evaluate

  4. Clinical Investigations of a CT-based reconstruction and 3D-Treatment planning system in interstitial brachytherapy

    International Nuclear Information System (INIS)

    Kolotas, C.; Zamboglou, N.

    1998-01-01

    Purpose: Development, application and evaluation of a CT-guided implantation technique and a fully CT based treatment planning procedure for brachytherapy. Methods and Materials : A brachytherapy procedure based on CT-guided implantation technique and CT based treatment planning has been developed and clinically evaluated. For this purpose a software system (PROMETHEUS) for the 3D reconstruction of brachytherapy catheters and patient anatomy using only CT scans has been developed. An interface for the Nucletron Plato BPS treatment planning system for the optimisation and calculation of dose distribution has been devised. The planning target volume(s) are defined as sets of points using contouring tools and are for optimisation of the 3D dose distribution. Dose-volume histogram-based analysis of the dose distribution enables a clinically realistic evaluation of the brachytherapy application to be made. The CT-guided implantation of catheters and the CT-based treatment planning procedure has been performed for interstitial brachytherapy and for different tumour and anatomical localizations in 197 patients between 1996 and 1997. Results : The accuracy of the CT reconstruction was tested using a quality assurance phantom an an interstitial implant of 12 needles and compared with the results of reconstruction using radiographs[hs. Both methods give comparable results with regard to accuracy. The CT based reconstruction was faster. Clinical feasibility has been proven in pre-irradiated recurrences of brain tumour, in pre-treated recurrences or metastatic disease, and in breast carcinomas. The tumour volume treated ranged from 5.1 - 2741 cm3. Analysis of the implant quality showed a slight significant lower COIN value for the bone implants, but no differences in respect to the planning target volume. Conclusions : With the integration of CT imaging in the treatment planning and documentation of brachytherapy, we have a new CT based quality assurance method to evaluate

  5. Evaluation tests of treatment planning systems concerning 3D dose calculation

    International Nuclear Information System (INIS)

    Simonian-Sauve, M.; Smart, C.

    1998-01-01

    The development of irradiation techniques in radiotherapy shows a clear tendency towards the systematic use of three-dimensional (3D) information. Great efforts are being made to set up 3D conformal radiotherapy. Consequently, in the aim of greater coherence and accuracy, 'the dosimetric tool' must also meet the requirements of 3D radiotherapy, as it plays a role in the treatment chain. To know if the treatment planning system is a '3D', '2D', or even '1D' system, one should not be satisfied with reading the technical documentation and the program algorithm description not entirely trust the constructor's assertions. It is essential to clearly and precisely evaluate the possibilities of the treatment planning system. Even if it is proved not to satisfy perfectly all the tests which would qualify it as a real 3D calculation system, the study of the test results helps to give clear explanations of the dosimetric results. Two series of test cases are proposed. The first series allows us to understand in which conditions the treatment planning system takes into account the scatter influence in a volume. The second series is designed to inform us about the capacity of the dose calculation algorithm when the medium encloses non-homogeneities. These test cases do not constitute an exhaustive 'check-list' able to tackle completely the question of 3D calculation. They are submitted as examples and should be considered as an evaluation methodology for the software implanted in the treatment planning system. (authors)

  6. Treatment plan modification using voxel-based weighting factors/dose prescription

    International Nuclear Information System (INIS)

    Wu Chuan; Olivera, Gustavo H; Jeraj, Robert; Keller, Harry; Mackie, Thomas R

    2003-01-01

    Under various clinical situations, it is desirable to modify the original treatment plan to better suit the clinical goals. In this work, a method to help physicians modify treatment plans based on their clinical preferences is proposed. The method uses a weighted quadratic dose objective function. The commonly used organ-/ROI-based weighting factors are expanded to a set of voxel-based weighting factors in order to obtain greater flexibility in treatment plan modification. Two different but equivalent modification schemes based on Rustem's quadratic programming algorithms -modification of a weighting matrix and modification of prescribed doses - are presented. Case studies demonstrated the effectiveness of the two methods with regard to their capability to fine-tune treatment plans

  7. The Trimeric Model: A New Model of Periodontal Treatment Planning

    Science.gov (United States)

    Tarakji, Bassel

    2014-01-01

    Treatment of periodontal disease is a complex and multidisciplinary procedure, requiring periodontal, surgical, restorative, and orthodontic treatment modalities. Several authors attempted to formulate models for periodontal treatment that orders the treatment steps in a logical and easy to remember manner. In this article, we discuss two models of periodontal treatment planning from two of the most well-known textbook in the specialty of periodontics internationally. Then modify them to arrive at a new model of periodontal treatment planning, The Trimeric Model. Adding restorative and orthodontic interrelationships with periodontal treatment allows us to expand this model into the Extended Trimeric Model of periodontal treatment planning. These models will provide a logical framework and a clear order of the treatment of periodontal disease for general practitioners and periodontists alike. PMID:25177662

  8. Artificial neural network analysis applied to simplifying bioeffect radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Purnomo, A.B.

    2001-01-01

    Full text: A bioeffect planning system has been developed by Wigg and Nicholls in the Departments of Clinical Radiobiology and Medical Physics, at the Royal Adelaide Hospital. The system has been developed to be an experimental tool by means of which bioeffect plans may be compared with conventional isodose plans in radiotherapy. Limitations of isodose planning, in many common clinical circumstances, have been apparent for sometime (Wigg and Wilson, Australasian Radiology, 1981, 25: 205-212). There are many reasons why bioeffect planning has been slow in developing. These include concerns about the clinical application of theoretical radiobiology models, the uncertainty of normal tissue and tumour parameter values, and the non-availability of suitable computer systems capable of performing bioeffect planning. These concerns are fully justified and isodose planning must remain, for the foreseeable future, the gold standard for clinical treatment. However, these concerns must be judged against the certainty that isodose planning, in which the only variable usually considered is the total dose, can be substantially misleading. Unfortunately, a typical Tumour Control Probability (TCP) equation for bioeffect planning is complex with 12 parameters. Consequently, the equation is difficult to implement in practice. Can the equation be simplified by ignoring the variability of some of the parameters? To test this possibility, we have attempted a neural network analysis of the problem. The capability of artificial neural network (ANN) analysis to solve classification problems was explored in which a weight space analysis was conducted. It led to the reduction of the number of parameters. The training data for the ANN analysis was generated using the above equation and practical data from many publications. The performance of the optimized ANN and the reduced-parameter ANN were tested using other treatment data. The optimized ANN results closely matched with those of the

  9. Hazardous Waste Development, Demonstration, and Disposal (HAZWDDD) program plan: Executive summary

    International Nuclear Information System (INIS)

    McGinnis, C.P.; Eisenhower, B.M.; Reeves, M.E.; DePaoli, S.M.; Stinton, L.H.; Harrington, E.H.

    1989-02-01

    The Hazardous Waste Development, Demonstration, and Disposal (HAZWDDD) Program Plan provides a strategy for management of hazardous and mixed wastes generated by the five Department of Energy (DOE) installations managed by Martin Marietta Energy Systems, Inc. (Energy Systems). This integrated corporate plan is based on the individual installation plans, which identify waste streams, facility capabilities, problem wastes, future needs, and funding needs. Using this information, the corporate plan identifies common concerns and technology/facility needs over the next 10 years. The overall objective of this corporate plan is to ensure that treatment, storage, and disposal (TSD) needs for all hazardous and mixed wastes generated by Energy Systems installations have been identified and planned for. Specific objectives of the program plan are to (1) identify all hazardous and mixed waste streams; (2) identify hazardous and mixed waste TSD requirements; (3) identify any unresolved technical issues preventing implementation of the strategy; (4) develop schedules for studies, demonstrations, and facilities to resolve the issues; and (5) define the interfaces with the Low-Level Waste Disposal Development and Demonstration (LLWDDD) Program. 10 refs., 7 figs

  10. Conformal three dimensional radiotherapy treatment planning in Lund

    International Nuclear Information System (INIS)

    Knoos, T.; Nilsson, P.; Anders, A.

    1995-01-01

    The use of conformal therapy is based on 3-dimensional treatment planning as well as on methods and routines for 3-dimensional patient mapping, 3-dimensional virtual simulation and others. The management of patients at the Radiotherapy Department at the University Hospital in Lund (Sweden) is discussed. About 2100 new patients are annually treated with external radiotherapy using seven linear accelerators. Three of the accelerators have dual photon energies and electron treatment facilities. A multi-leaf collimator as well as an electronic portal imaging device are available on one machine. Two simulators and an in-house CT-scanner are used for treatment planning. From 1988 to 1992 Scandiplan (Umplan) was used. Since 1992, the treatment planning system is TMS (HELAX AB, Sweden), which is based on the pencil beam algorithm of Ahnesjo. The calculations use patient modulated accelerator specific energy fluence spectra which are compiled with pencil beams from Monte Carlo generated energy absorption kernels. Heterogeneity corrections are performed with results close to conventional algorithms. Irregular fields, either from standard or individual blocks and from multi-leaf collimators are handled by the treatment planning system. The field shape is determined conveniently using the beam's eye view. The final field shape is exported electronically to either the block cutting machine or the multileaf collimator control computer. All patient fields are checked against the beam's eye view during simulation using manual methods. Treatment verification is performed by portal films and in vivo dosimetry with silicon diodes or TL-dosimetry. Up to now, approximately 4400 patients have received a highly individualized 3-dimensional conformal treatment

  11. Technical Note: Improving the VMERGE treatment planning algorithm for rotational radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gaddy, Melissa R., E-mail: mrgaddy@ncsu.edu; Papp, Dávid, E-mail: dpapp@ncsu.edu [Department of Mathematics, North Carolina State University, Raleigh, North Carolina 27695-8205 (United States)

    2016-07-15

    Purpose: The authors revisit the VMERGE treatment planning algorithm by Craft et al. [“Multicriteria VMAT optimization,” Med. Phys. 39, 686–696 (2012)] for arc therapy planning and propose two changes to the method that are aimed at improving the achieved trade-off between treatment time and plan quality at little additional planning time cost, while retaining other desirable properties of the original algorithm. Methods: The original VMERGE algorithm first computes an “ideal,” high quality but also highly time consuming treatment plan that irradiates the patient from all possible angles in a fine angular grid with a highly modulated beam and then makes this plan deliverable within practical treatment time by an iterative fluence map merging and sequencing algorithm. We propose two changes to this method. First, we regularize the ideal plan obtained in the first step by adding an explicit constraint on treatment time. Second, we propose a different merging criterion that comprises of identifying and merging adjacent maps whose merging results in the least degradation of radiation dose. Results: The effect of both suggested modifications is evaluated individually and jointly on clinical prostate and paraspinal cases. Details of the two cases are reported. Conclusions: In the authors’ computational study they found that both proposed modifications, especially the regularization, yield noticeably improved treatment plans for the same treatment times than what can be obtained using the original VMERGE method. The resulting plans match the quality of 20-beam step-and-shoot IMRT plans with a delivery time of approximately 2 min.

  12. HWMA/RCRA Closure Plan for the Basin Facility Basin Water Treatment System - Voluntary Consent Order NEW-CPP-016 Action Plan

    International Nuclear Information System (INIS)

    Evans, S. K.

    2007-01-01

    This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the Basin Water Treatment System located in the Basin Facility (CPP-603), Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Laboratory Site, was developed to meet future milestones established under the Voluntary Consent Order. The system to be closed includes units and associated ancillary equipment included in the Voluntary Consent Order NEW-CPP-016 Action Plan and Voluntary Consent Order SITE-TANK-005 Tank Systems INTEC-077 and INTEC-078 that were determined to have managed hazardous waste. The Basin Water Treatment System will be closed in accordance with the requirements of the Hazardous Waste Management Act/Resource Conservation and Recovery Act, as implemented by the Idaho Administrative Procedures Act 58.01.05.009 and 40 Code of Federal Regulations 265, to achieve 'clean closure' of the tank system. This closure plan presents the closure performance standards and methods of achieving those standards for the Basin Water Treatment Systems

  13. HWMA/RCRA Closure Plan for the Basin Facility Basin Water Treatment System - Voluntary Consent Order NEW-CPP-016 Action Plan

    Energy Technology Data Exchange (ETDEWEB)

    Evans, S. K.

    2007-11-07

    This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the Basin Water Treatment System located in the Basin Facility (CPP-603), Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Laboratory Site, was developed to meet future milestones established under the Voluntary Consent Order. The system to be closed includes units and associated ancillary equipment included in the Voluntary Consent Order NEW-CPP-016 Action Plan and Voluntary Consent Order SITE-TANK-005 Tank Systems INTEC-077 and INTEC-078 that were determined to have managed hazardous waste. The Basin Water Treatment System will be closed in accordance with the requirements of the Hazardous Waste Management Act/Resource Conservation and Recovery Act, as implemented by the Idaho Administrative Procedures Act 58.01.05.009 and 40 Code of Federal Regulations 265, to achieve "clean closure" of the tank system. This closure plan presents the closure performance standards and methods of achieving those standards for the Basin Water Treatment Systems.

  14. Volumetric visualization of anatomy for treatment planning

    International Nuclear Information System (INIS)

    Pelizzari, Charles A.; Grzeszczuk, Robert; Chen, George T. Y.; Heimann, Ruth; Haraf, Daniel J.; Vijayakumar, Srinivasan; Ryan, Martin J.

    1996-01-01

    Purpose: Delineation of volumes of interest for three-dimensional (3D) treatment planning is usually performed by contouring on two-dimensional sections. We explore the usage of segmentation-free volumetric rendering of the three-dimensional image data set for tumor and normal tissue visualization. Methods and Materials: Standard treatment planning computed tomography (CT) studies, with typically 5 to 10 mm slice thickness, and spiral CT studies with 3 mm slice thickness were used. The data were visualized using locally developed volume-rendering software. Similar to the method of Drebin et al., CT voxels are automatically assigned an opacity and other visual properties (e.g., color) based on a probabilistic classification into tissue types. Using volumetric compositing, a projection into the opacity-weighted volume is produced. Depth cueing, perspective, and gradient-based shading are incorporated to achieve realistic images. Unlike surface-rendered displays, no hand segmentation is required to produce detailed renditions of skin, muscle, or bony anatomy. By suitable manipulation of the opacity map, tissue classes can be made transparent, revealing muscle, vessels, or bone, for example. Manually supervised tissue masking allows irrelevant tissues overlying tumors or other structures of interest to be removed. Results: Very high-quality renditions are produced in from 5 s to 1 min on midrange computer workstations. In the pelvis, an anteroposterior (AP) volume rendered view from a typical planning CT scan clearly shows the skin and bony anatomy. A muscle opacity map permits clear visualization of the superficial thigh muscles, femoral veins, and arteries. Lymph nodes are seen in the femoral triangle. When overlying muscle and bone are cut away, the prostate, seminal vessels, bladder, and rectum are seen in 3D perspective. Similar results are obtained for thorax and for head and neck scans. Conclusion: Volumetric visualization of anatomy is useful in treatment

  15. Tumor and normal structures volume localization and quantitation in 3D radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Anselmi, R.; Andreucci, L.

    1995-01-01

    Improvements in imaging technology have significantly enhanced the ability of the radiation oncologist to stage and to evaluate the response of tumor during and after treatment. Over the last few year, in fact, computed tomography (CT), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), single photon emission computed tomography (SPECT) imaging radiolabelled monoclonal tumor antibodies have allowed tumor definition and evaluation. Concerning the above mentioned techniques accurate methods for the integration of morphological (CT, MRI) and functional (PET, SPECT, MRS) information can be very useful for volumes definition. In fact three-dimensional treatment planning depends heavily on volume displays and calculation based on volumes to convey information to the radiation oncologist, physicist and dosimetrist. The accuracy and reproducibility of the methods for creating these volumes are fundamental limitations of current treatment planning systems. Slice by slice manual contouring, which is extremely labor-intensive, and automatic edge detection, which has a high failure rate and requires human intervention are representative of the current standard of practice. The aim of our work is both to develop methods of image data integration and automatic segmentation, and to make the treatment planning system able to combine these multiple information in unified data set in order to get a better tumor volume definition and dose distribution calculation. Then the possibility of using morphological and functional images and other information coming from MR spectroscopy and electronic or confocal microscopy can allow the development into the treatment planning system of biological calculation models for evaluating tumor and normal tissue control probabilities (TCP, NTCP). The definitive use of these models into the 3-D treatment plannings will offer a considerable improvement in the biological efficacy of radiotherapy and it will constitute the object

  16. Monte Carlo based dosimetry and treatment planning for neutron capture therapy of brain tumors

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Clement, S.D.; Harling, O.K.; Brenner, J.F.; Wazer, D.E.; Madoc-Jones, H.; Yanch, J.C.

    1990-01-01

    Monte Carlo based dosimetry and computer-aided treatment planning for neutron capture therapy have been developed to provide the necessary link between physical dosimetric measurements performed on the MITR-II epithermal-neutron beams and the need of the radiation oncologist to synthesize large amounts of dosimetric data into a clinically meaningful treatment plan for each individual patient. Monte Carlo simulation has been employed to characterize the spatial dose distributions within a skull/brain model irradiated by an epithermal-neutron beam designed for neutron capture therapy applications. The geometry and elemental composition employed for the mathematical skull/brain model and the neutron and photon fluence-to-dose conversion formalism are presented. A treatment planning program, NCTPLAN, developed specifically for neutron capture therapy, is described. Examples are presented illustrating both one and two-dimensional dose distributions obtainable within the brain with an experimental epithermal-neutron beam, together with beam quality and treatment plan efficacy criteria which have been formulated for neutron capture therapy. The incorporation of three-dimensional computed tomographic image data into the treatment planning procedure is illustrated. The experimental epithermal-neutron beam has a maximum usable circular diameter of 20 cm, and with 30 ppm of B-10 in tumor and 3 ppm of B-10 in blood, it produces a beam-axis advantage depth of 7.4 cm, a beam-axis advantage ratio of 1.83, a global advantage ratio of 1.70, and an advantage depth RBE-dose rate to tumor of 20.6 RBE-cGy/min (cJ/kg-min). These characteristics make this beam well suited for clinical applications, enabling an RBE-dose of 2,000 RBE-cGy/min (cJ/kg-min) to be delivered to tumor at brain midline in six fractions with a treatment time of approximately 16 minutes per fraction

  17. Federal Facilities Compliance Act, Conceptual Site Treatment Plan. Part 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-10-29

    This Conceptual Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed in this document include: general discussion of the plan, including the purpose and scope; technical aspects of preparing plans, including the rationale behind the treatability groupings and a discussion of characterization issues; treatment technology needs and treatment options for specific waste streams; low-level mixed waste options; TRU waste options; and future waste generation from restoration activities.

  18. SU-F-T-37: Dosimetric Evaluation of Planned Versus Decay Corrected Treatment Plans for the Treatment of Tandem-Based Cervical HDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, M [Texas Oncology, PA, Fort Worth, TX (United States); Shobhit University, Meerut, Uttar Pradesh (India); Manjhi, J; Rai, D [Shobhit University, Meerut, Uttar Pradesh (India); Kehwar, T [Pinnacle Health Cancer Center, Mechanicsburg, PA (United States); Barker, J; Heintz, B; Shide, K [Texas Oncology, PA, Fort Worth, TX (United States)

    2016-06-15

    Purpose: This study evaluated dosimetric parameters for actual treatment plans versus decay corrected treatment plans for cervical HDR brachytherapy. Methods: 125 plans of 25 patients, who received 5 fractions of HDR brachytherapy, were evaluated in this study. Dose was prescribed to point A (ICRU-38) and High risk clinical tumor volume (HR-CTV) and organs at risk (OAR) were, retrospectively, delineated on original CT images by treating physician. First HDR plan was considered as reference plan and decay correction was applied to calculate treatment time for subsequent fractions, and was applied, retrospectively, to determine point A, HR-CTV D90, and rectum and bladder doses. Results: The differences between mean point A reference doses and the point A doses of the plans computed using decay times were found to be 1.05%±0.74% (−2.26% to 3.26%) for second fraction; −0.25%±0.84% (−3.03% to 3.29%) for third fraction; 0.04%±0.70% (−2.68% to 2.56%) for fourth fraction and 0.30%±0.81% (−3.93% to 2.67%) for fifth fraction. Overall mean point A dose difference, for all fractions, was 0.29%±0.38% (within ± 5%). Mean rectum and bladder dose differences were calculated to be −3.46%±0.12% and −2.47%±0.09%, for points, respectively, and −1.72%±0.09% and −0.96%±0.06%, for D2cc, respectively. HR-CTV D90 mean dose difference was found to be −1.67% ± 0.11%. There was no statistically significant difference between the reference planned point A doses and that calculated using decay time to the subsequent fractions (p<0.05). Conclusion: This study reveals that a decay corrected treatment will provide comparable dosimetric results and can be utilized for subsequent fractions of cervical HDR brachytherapy instead of actual treatment planning. This approach will increase efficiency, decrease workload, reduce patient observation time between applicator insertion and treatment delivery. This would be particularly useful for institutions with limited

  19. Towards biology-oriented treatment planning in hadrontherapy

    Czech Academy of Sciences Publication Activity Database

    Kundrát, Pavel

    2006-01-01

    Roč. 122, 1-4 (2006), s. 480-482 ISSN 0144-8420 R&D Projects: GA ČR GA202/05/2728 Institutional research plan: CEZ:AV0Z10100502 Keywords : treatment planning * hadron radiotherapy Subject RIV: BF - Elementary Particles and High Energy Physics Impact factor: 0.446, year: 2006

  20. Conventional treatment planning optimization using simulated annealing

    International Nuclear Information System (INIS)

    Morrill, S.M.; Langer, M.; Lane, R.G.

    1995-01-01

    Purpose: Simulated annealing (SA) allows for the implementation of realistic biological and clinical cost functions into treatment plan optimization. However, a drawback to the clinical implementation of SA optimization is that large numbers of beams appear in the final solution, some with insignificant weights, preventing the delivery of these optimized plans using conventional (limited to a few coplanar beams) radiation therapy. A preliminary study suggested two promising algorithms for restricting the number of beam weights. The purpose of this investigation was to compare these two algorithms using our current SA algorithm with the aim of producing a algorithm to allow clinically useful radiation therapy treatment planning optimization. Method: Our current SA algorithm, Variable Stepsize Generalized Simulated Annealing (VSGSA) was modified with two algorithms to restrict the number of beam weights in the final solution. The first algorithm selected combinations of a fixed number of beams from the complete solution space at each iterative step of the optimization process. The second reduced the allowed number of beams by a factor of two at periodic steps during the optimization process until only the specified number of beams remained. Results of optimization of beam weights and angles using these algorithms were compared using a standard cadre of abdominal cases. The solution space was defined as a set of 36 custom-shaped open and wedged-filtered fields at 10 deg. increments with a target constant target volume margin of 1.2 cm. For each case a clinically-accepted cost function, minimum tumor dose was maximized subject to a set of normal tissue binary dose-volume constraints. For this study, the optimized plan was restricted to four (4) fields suitable for delivery with conventional therapy equipment. Results: The table gives the mean value of the minimum target dose obtained for each algorithm averaged over 5 different runs and the comparable manual treatment

  1. MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

    International Nuclear Information System (INIS)

    Chang, J.

    2015-01-01

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  2. MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

    Energy Technology Data Exchange (ETDEWEB)

    Chang, J. [New York Weill Cornell Medical Ctr (United States)

    2015-06-15

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  3. Treatment planning with ion beams

    International Nuclear Information System (INIS)

    Foss, M.H.

    1985-01-01

    Ions have higher linear energy transfer (LET) near the end of their range and lower LET away from the end of their range. Mixing radiations of different LET complicates treatment planning because radiation kills cells in two statistically independent ways. In some cases, cells are killed by a single-particle, which causes a linear decrease in log survival at low dosage. When the linear decrease is subtracted from the log survival curve, the remaining curve has zero slope at zero dosage. This curve is the log survival curve for cells that are killed only by two or more particles. These two mechanisms are statistically independent. To calculate survival, these two kinds of doses must be accumulated separately. The effect of each accumulated dosage must be read from its survival curve, and the logarithms of the two effects added to get the log survival. Treatment plans for doses of protons, He 3 ions, and He 4 ions suggest that these ions will be useful therapeutic modalities

  4. Comparison of step and shoot IMRT treatment plans generated by three inverse treatment planning systems; Comparacion de tratamientos de IMRT estatica generados por tres sistemas de planificacion inversa

    Energy Technology Data Exchange (ETDEWEB)

    Perez Moreno, J. M.; Zucca Aparicio, D.; Fernandez leton, P.; Garcia Ruiz-Zorrilla, J.; Minambres Moro, A.

    2011-07-01

    One of the most important issues of intensity modulated radiation therapy (IMRT) treatments using the step-and-shoot technique is the number of segments and monitor units (MU) for treatment delivery. These parameters depend heavily on the inverse optimization module of the treatment planning system (TPS) used. Three commercial treatment planning systems: CMS XiO, iPlan and Prowess Panther have been evaluated. With each of them we have generated a treatment plan for the same group of patients, corresponding to clinical cases. Dosimetric results, MU calculated and number of segments were compared. Prowess treatment planning system generates plans with a number of segments significantly lower than other systems, while MU are less than a half. It implies important reductions in leakage radiation and delivery time. Degradation in the final dose calculation of dose is very small, because it directly optimizes positions of multileaf collimator (MLC). (Author) 13 refs.

  5. TU-FG-201-03: Automatic Pre-Delivery Verification Using Statistical Analysis of Consistencies in Treatment Plan Parameters by the Treatment Site and Modality

    International Nuclear Information System (INIS)

    Liu, S; Wu, Y; Chang, X; Li, H; Yang, D

    2016-01-01

    Purpose: A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), has been developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. Methods: APDV is designed to continuously monitor new DICOM plan files on the TMS computer at the treatment console. When new plans to be delivered are detected, APDV checks the consistencies of plan parameters and high-level plan statistics using underlying rules and statistical properties based on given treatment site, technique and modality. These rules were quantitatively derived by retrospectively analyzing all the EBRT treatment plans of the past 8 years at authors’ institution. Therapists and physicists will be notified with a warning message displayed on the TMS computer if any critical errors are detected, and check results, confirmation, together with dismissal actions will be saved into database for further review. Results: APDV was implemented as a stand-alone program using C# to ensure required real time performance. Mean values and standard deviations were quantitatively derived for various plan parameters including MLC usage, MU/cGy radio, beam SSD, beam weighting, and the beam gantry angles (only for lateral targets) per treatment site, technique and modality. 2D-based rules of combined MU/cGy ratio and averaged SSD values were also derived using joint probabilities of confidence error ellipses. The statistics of these major treatment plan parameters quantitatively evaluate the consistency of any treatment plans which facilitates automatic APDV checking procedures. Conclusion: APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries. Future plan including automatic patient identify and patient setup checks after patient daily images are acquired by the machine and become available on the TMS computer. This project is supported by the

  6. TU-FG-201-03: Automatic Pre-Delivery Verification Using Statistical Analysis of Consistencies in Treatment Plan Parameters by the Treatment Site and Modality

    Energy Technology Data Exchange (ETDEWEB)

    Liu, S; Wu, Y; Chang, X; Li, H; Yang, D [Washington University School of Medicine, St. Louis, MO (United States)

    2016-06-15

    Purpose: A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), has been developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. Methods: APDV is designed to continuously monitor new DICOM plan files on the TMS computer at the treatment console. When new plans to be delivered are detected, APDV checks the consistencies of plan parameters and high-level plan statistics using underlying rules and statistical properties based on given treatment site, technique and modality. These rules were quantitatively derived by retrospectively analyzing all the EBRT treatment plans of the past 8 years at authors’ institution. Therapists and physicists will be notified with a warning message displayed on the TMS computer if any critical errors are detected, and check results, confirmation, together with dismissal actions will be saved into database for further review. Results: APDV was implemented as a stand-alone program using C# to ensure required real time performance. Mean values and standard deviations were quantitatively derived for various plan parameters including MLC usage, MU/cGy radio, beam SSD, beam weighting, and the beam gantry angles (only for lateral targets) per treatment site, technique and modality. 2D-based rules of combined MU/cGy ratio and averaged SSD values were also derived using joint probabilities of confidence error ellipses. The statistics of these major treatment plan parameters quantitatively evaluate the consistency of any treatment plans which facilitates automatic APDV checking procedures. Conclusion: APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries. Future plan including automatic patient identify and patient setup checks after patient daily images are acquired by the machine and become available on the TMS computer. This project is supported by the

  7. Clinical Realization of Sector Beam Intensity Modulation for Gamma Knife Radiosurgery: A Pilot Treatment Planning Study

    International Nuclear Information System (INIS)

    Ma, Lijun; Mason, Erica; Sneed, Penny K.; McDermott, Michael; Polishchuk, Alexei; Larson, David A.; Sahgal, Arjun

    2015-01-01

    Purpose: To demonstrate the clinical feasibility and potential benefits of sector beam intensity modulation (SBIM) specific to Gamma Knife stereotactic radiosurgery (GKSRS). Methods and Materials: SBIM is based on modulating the confocal beam intensities from individual sectors surrounding an isocenter in a nearly 2π geometry. This is in contrast to conventional GKSRS delivery, in which the beam intensities from each sector are restricted to be either 0% or 100% and must be identical for any given isocenter. We developed a SBIM solution based on available clinical planning tools, and we tested it on a cohort of 12 clinical cases as a proof of concept study. The SBIM treatment plans were compared with the original clinically delivered treatment plans to determine dosimetric differences. The goal was to investigate whether SBIM would improve the dose conformity for these treatment plans without prohibitively lengthening the treatment time. Results: A SBIM technique was developed. On average, SBIM improved the Paddick conformity index (PCI) versus the clinically delivered plans (clinical plan PCI = 0.68 ± 0.11 vs SBIM plan PCI = 0.74 ± 0.10, P=.002; 2-tailed paired t test). The SBIM plans also resulted in nearly identical target volume coverage (mean, 97 ± 2%), total beam-on times (clinical plan 58.4 ± 38.9 minutes vs SBIM 63.5 ± 44.7 minutes, P=.057), and gradient indices (clinical plan 3.03 ± 0.27 vs SBIM 3.06 ± 0.29, P=.44) versus the original clinical plans. Conclusion: The SBIM method is clinically feasible with potential dosimetric gains when compared with conventional GKSRS

  8. Dose prescription and treatment planning based on FMISO-PET hypoxia

    International Nuclear Information System (INIS)

    Toma-Dasu, Iuliana; Antonovic, Laura; Uhrdin, Johan; Dasu, Alexandru; Nuyts, Sandra; Dirix, Piet; Haustermans, Karin; Brahme, Anders

    2012-01-01

    Purpose. The study presents the implementation of a novel method for incorporating hypoxia information from PET-CT imaging into treatment planning and estimates the efficiency of various optimization approaches. Its focuses on the feasibility of optimizing treatment plans based on the non-linear conversion of PET hypoxia images into radiosensitivity maps from the uptake properties of the tracers used. Material and methods. PET hypoxia images of seven head-and-neck cancer patients were used to determine optimal dose distributions needed to counteract the radiation resistance associated with tumor hypoxia assuming various scenarios regarding the evolution of the hypoxic compartment during the treatment. A research planning system for advanced studies has been used to optimize IMRT plans based on hypoxia information from patient PET images. These resulting plans were compared in terms of target coverage for the same fulfilled constraints regarding the organs at risk. Results. The results of a planning study indicated the clinical feasibility of the proposed method for treatment planning based on PET hypoxia. Antihypoxic strategies would lead to small improvements in all the patients, but higher effects are expected for the fraction of patients with hypoxic tumors. For these, individualization of the treatment based on hypoxia PET imaging could lead to improved treatment outcome while creating the premises for limiting the irradiation of the surrounding normal tissues. Conclusions. The proposed approach offers the possibility of improved treatment results as it takes into consideration the heterogeneity and the dynamics of the hypoxic regions. It also provides early identification of the clinical cases that might benefit from dose escalation as well as the cases that could benefit from other counter-hypoxic measures

  9. Conformal three dimensional radiotherapy treatment planning in Lund

    Energy Technology Data Exchange (ETDEWEB)

    Knoos, T; Nilsson, P [Lund Univ. (Sweden). Dept. of Radiation Physics; Anders, A [Lund Univ. (Sweden). Dept. of Oncology

    1995-12-01

    The use of conformal therapy is based on 3-dimensional treatment planning as well as on methods and routines for 3-dimensional patient mapping, 3-dimensional virtual simulation and others. The management of patients at the Radiotherapy Department at the University Hospital in Lund (Sweden) is discussed. About 2100 new patients are annually treated with external radiotherapy using seven linear accelerators. Three of the accelerators have dual photon energies and electron treatment facilities. A multi-leaf collimator as well as an electronic portal imaging device are available on one machine. Two simulators and an in-house CT-scanner are used for treatment planning. From 1988 to 1992 Scandiplan (Umplan) was used. Since 1992, the treatment planning system is TMS (HELAX AB, Sweden), which is based on the pencil beam algorithm of Ahnesjo. The calculations use patient modulated accelerator specific energy fluence spectra which are compiled with pencil beams from Monte Carlo generated energy absorption kernels. Heterogeneity corrections are performed with results close to conventional algorithms. Irregular fields, either from standard or individual blocks and from multi-leaf collimators are handled by the treatment planning system. The field shape is determined conveniently using the beam`s eye view. The final field shape is exported electronically to either the block cutting machine or the multileaf collimator control computer. All patient fields are checked against the beam`s eye view during simulation using manual methods. Treatment verification is performed by portal films and in vivo dosimetry with silicon diodes or TL-dosimetry. Up to now, approximately 4400 patients have received a highly individualized 3-dimensional conformal treatment.

  10. Split-Volume Treatment Planning of Multiple Consecutive Vertebral Body Metastases for Cyberknife Image-Guided Robotic Radiosurgery

    International Nuclear Information System (INIS)

    Sahgal, Arjun; Chuang, Cynthia; Larson, David; Huang, Kim; Petti, Paula; Weinstein, Phil; Ma Lijun

    2008-01-01

    Cyberknife treatment planning of multiple consecutive vertebral body metastases is challenging due to large target volumes adjacent to critical normal tissues. A split-volume treatment planning technique was developed to improve the treatment plan quality of such lesions. Treatment plans were generated for 1 to 5 consecutive thoracic vertebral bodies (CVBM) prescribing a total dose of 24 Gy in 3 fractions. The planning target volume (PTV) consisted of the entire vertebral body(ies). Treatment plans were generated considering both the de novo clinical scenario (no prior radiation), imposing a dose limit of 8 Gy to 1 cc of spinal cord, and the retreatment scenario (prior radiation) with a dose limit of 3 Gy to 1 cc of spinal cord. The split-volume planning technique was compared with the standard full-volume technique only for targets ranging from 2 to 5 CVBM in length. The primary endpoint was to obtain best PTV coverage by the 24 Gy prescription isodose line. A total of 18 treatment plans were generated (10 standard and 8 split-volume). PTV coverage by the 24-Gy isodose line worsened consistently as the number of CVBM increased for both the de novo and retreatment scenario. Split-volume planning was achieved by introducing a 0.5-cm gap, splitting the standard full-volume PTV into 2 equal length PTVs. In every case, split-volume planning resulted in improved PTV coverage by the 24-Gy isodose line ranging from 4% to 12% for the de novo scenario and, 8% to 17% for the retreatment scenario. We did not observe a significant trend for increased monitor units required, or higher doses to spinal cord or esophagus, with split-volume planning. Split-volume treatment planning significantly improves Cyberknife treatment plan quality for CVBM, as compared to the standard technique. This technique may be of particular importance in clinical situations where stringent spinal cord dose limits are required

  11. A Monte Carlo-based treatment-planning tool for ion beam therapy

    CERN Document Server

    Böhlen, T T; Dosanjh, M; Ferrari, A; Haberer, T; Parodi, K; Patera, V; Mairan, A

    2013-01-01

    Ion beam therapy, as an emerging radiation therapy modality, requires continuous efforts to develop and improve tools for patient treatment planning (TP) and research applications. Dose and fluence computation algorithms using the Monte Carlo (MC) technique have served for decades as reference tools for accurate dose computations for radiotherapy. In this work, a novel MC-based treatment-planning (MCTP) tool for ion beam therapy using the pencil beam scanning technique is presented. It allows single-field and simultaneous multiple-fields optimization for realistic patient treatment conditions and for dosimetric quality assurance for irradiation conditions at state-of-the-art ion beam therapy facilities. It employs iterative procedures that allow for the optimization of absorbed dose and relative biological effectiveness (RBE)-weighted dose using radiobiological input tables generated by external RBE models. Using a re-implementation of the local effect model (LEM), theMCTP tool is able to perform TP studies u...

  12. Integration of second cancer risk calculations in a radiotherapy treatment planning system

    International Nuclear Information System (INIS)

    Hartmann, M; Schneider, U

    2014-01-01

    Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

  13. Large shaft development test plan

    International Nuclear Information System (INIS)

    Krug, A.D.

    1984-03-01

    This test plan proposes the conduct of a large shaft development test at the Hanford site in support of the repository development program. The purpose and objective of the test plan is to obtain the information necessary to establish feasibility and to predict the performance of the drilling system used to drill large diameter shafts. The test plan is based upon drilling a 20 ft diameter shaft to a depth of 1,000 feet. The test plan specifies series of tests to evaluate the performance of the downhole assembly, the performance of the rig, and the ability of the system to cope with geologic hazards. The quality of the hole produced will also be determined. This test plan is considered to be preliminary in that it was prepared as input for the decision to determine if development testing is required in this area. Should the decision be made to proceed with development testing, this test plan shall be updated and revised. 6 refs., 2 figs., 3 tabs

  14. EDITORIAL: International Workshop on Current Topics in Monte Carlo Treatment Planning

    Science.gov (United States)

    Verhaegen, Frank; Seuntjens, Jan

    2005-03-01

    The use of Monte Carlo particle transport simulations in radiotherapy was pioneered in the early nineteen-seventies, but it was not until the eighties that they gained recognition as an essential research tool for radiation dosimetry, health physics and later on for radiation therapy treatment planning. Since the mid-nineties, there has been a boom in the number of workers using MC techniques in radiotherapy, and the quantity of papers published on the subject. Research and applications of MC techniques in radiotherapy span a very wide range from fundamental studies of cross sections and development of particle transport algorithms, to clinical evaluation of treatment plans for a variety of radiotherapy modalities. The International Workshop on Current Topics in Monte Carlo Treatment Planning took place at Montreal General Hospital, which is part of McGill University, halfway up Mount Royal on Montreal Island. It was held from 3-5 May, 2004, right after the freezing winter has lost its grip on Canada. About 120 workers attended the Workshop, representing 18 countries. Most of the pioneers in the field were present but also a large group of young scientists. In a very full programme, 41 long papers were presented (of which 12 were invited) and 20 posters were on display during the whole meeting. The topics covered included the latest developments in MC algorithms, statistical issues, source modelling and MC treatment planning for photon, electron and proton treatments. The final day was entirely devoted to clinical implementation issues. Monte Carlo radiotherapy treatment planning has only now made a slow entrée in the clinical environment, taking considerably longer than envisaged ten years ago. Of the twenty-five papers in this dedicated special issue, about a quarter deal with this topic, with probably many more studies to follow in the near future. If anything, we hope the Workshop served as an accelerator for more clinical evaluation of MC applications. The

  15. Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT).

    Science.gov (United States)

    Men, Chunhua; Romeijn, H Edwin; Jia, Xun; Jiang, Steve B

    2010-11-01

    To develop a novel aperture-based algorithm for volumetric modulated are therapy (VMAT) treatment plan optimization with high quality and high efficiency. The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequential way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.

  16. Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 05: A novel respiratory motion simulation program for VMAT treatment plans: a phantom validation study

    Energy Technology Data Exchange (ETDEWEB)

    Hubley, Emily; Pierce, Greg; Ploquin, Nicolas [University of Calgary, Tom Baker Cancer Centre, Tom Baker Cancer Centre (Canada)

    2016-08-15

    Purpose: To develop and validate a computational method to simulate craniocaudal respiratory motion in a VMAT treatment plan. Methods: Three 4DCTs of the QUASAR respiratory motion phantom were acquired with a 2cm water-density spherical tumour embedded in cedar to simulate lung. The phantom was oscillating sinusoidally with an amplitude of 2cm and periods of 3, 4, and 5 seconds. An ITV was contoured and 5mm PTV margin was added. High and a low modulation factor VMAT plans were created for each scan. An in-house program was developed to simulate respiratory motion in the treatment plans by shifting the MLC leaf positions relative to the phantom. Each plan was delivered to the phantom and the dose was measured using Gafchromic film. The measured and calculated plans were compared using an absolute dose gamma analysis (3%/3mm). Results: The average gamma pass rate for the low modulation plan and high modulation plans were 91.1% and 51.4% respectively. The difference between the high and low modulation plans gamma pass rates is likely related to the different sampling frequency of the respiratory curve and the higher MLC leaf speeds in the high modulation plan. A high modulation plan has a slower gantry speed and therefore samples the breathing cycle at a coarser frequency leading to inaccuracies between the measured and planned doses. Conclusion: A simple program, including a novel method for increasing sampling frequency beyond the control point frequency, has been developed to simulate respiratory motion in VMAT plans by shifting the MLC leaf positions.

  17. Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 05: A novel respiratory motion simulation program for VMAT treatment plans: a phantom validation study

    International Nuclear Information System (INIS)

    Hubley, Emily; Pierce, Greg; Ploquin, Nicolas

    2016-01-01

    Purpose: To develop and validate a computational method to simulate craniocaudal respiratory motion in a VMAT treatment plan. Methods: Three 4DCTs of the QUASAR respiratory motion phantom were acquired with a 2cm water-density spherical tumour embedded in cedar to simulate lung. The phantom was oscillating sinusoidally with an amplitude of 2cm and periods of 3, 4, and 5 seconds. An ITV was contoured and 5mm PTV margin was added. High and a low modulation factor VMAT plans were created for each scan. An in-house program was developed to simulate respiratory motion in the treatment plans by shifting the MLC leaf positions relative to the phantom. Each plan was delivered to the phantom and the dose was measured using Gafchromic film. The measured and calculated plans were compared using an absolute dose gamma analysis (3%/3mm). Results: The average gamma pass rate for the low modulation plan and high modulation plans were 91.1% and 51.4% respectively. The difference between the high and low modulation plans gamma pass rates is likely related to the different sampling frequency of the respiratory curve and the higher MLC leaf speeds in the high modulation plan. A high modulation plan has a slower gantry speed and therefore samples the breathing cycle at a coarser frequency leading to inaccuracies between the measured and planned doses. Conclusion: A simple program, including a novel method for increasing sampling frequency beyond the control point frequency, has been developed to simulate respiratory motion in VMAT plans by shifting the MLC leaf positions.

  18. Treatment planning for SBRT using automated field delivery: A case study

    International Nuclear Information System (INIS)

    Ritter, Timothy A.; Owen, Dawn; Brooks, Cassandra M.; Stenmark, Matthew H.

    2015-01-01

    Stereotactic body radiation therapy (SBRT) treatment planning and delivery can be accomplished using a variety of techniques that achieve highly conformal dose distributions. Herein, we describe a template-based automated treatment field approach that enables rapid delivery of more than 20 coplanar fields. A case study is presented to demonstrate how modest adaptations to traditional SBRT planning can be implemented to take clinical advantage of this technology. Treatment was planned for a left-sided lung lesion adjacent to the chest wall using 25 coplanar treatment fields spaced at 11° intervals. The plan spares the contralateral lung and is in compliance with the conformality standards set forth in Radiation Therapy and Oncology Group protocol 0915, and the dose tolerances found in the report of the American Association of Physicists in Medicine Task Group 101. Using a standard template, treatment planning was accomplished in less than 20 minutes, and each 10 Gy fraction was delivered in approximately 5.4 minutes. For those centers equipped with linear accelerators capable of automated treatment field delivery, the use of more than 20 coplanar fields is a viable SBRT planning approach and yields excellent conformality and quality combined with rapid planning and treatment delivery. Although the case study discusses a laterally located lung lesion, this technique can be applied to centrally located tumors with similar results

  19. Incorporating organ movements in IMRT treatment planning for prostate cancer: Minimizing uncertainties in the inverse planning process

    International Nuclear Information System (INIS)

    Unkelbach, Jan; Oelfke, Uwe

    2005-01-01

    We investigate an off-line strategy to incorporate inter fraction organ movements in IMRT treatment planning. Nowadays, imaging modalities located in the treatment room allow for several CT scans of a patient during the course of treatment. These multiple CT scans can be used to estimate a probability distribution of possible patient geometries. This probability distribution can subsequently be used to calculate the expectation value of the delivered dose distribution. In order to incorporate organ movements into the treatment planning process, it was suggested that inverse planning could be based on that probability distribution of patient geometries instead of a single snapshot. However, it was shown that a straightforward optimization of the expectation value of the dose may be insufficient since the expected dose distribution is related to several uncertainties: first, this probability distribution has to be estimated from only a few images. And second, the distribution is only sparsely sampled over the treatment course due to a finite number of fractions. In order to obtain a robust treatment plan these uncertainties should be considered and minimized in the inverse planning process. In the current paper, we calculate a 3D variance distribution in addition to the expectation value of the dose distribution which are simultaniously optimized. The variance is used as a surrogate to quantify the associated risks of a treatment plan. The feasibility of this approach is demonstrated for clinical data of prostate patients. Different scenarios of dose expectation values and corresponding variances are discussed

  20. Treatment plan for aqueous/organic/decontamination wastes under the Oak Ridge Reservation FFCA Development, Demonstration, Testing, and Evaluation Program

    International Nuclear Information System (INIS)

    Backus, P.M.; Benson, C.E.; Gilbert, V.P.

    1994-08-01

    The U.S. Department of Energy (DOE) Oak Ridge Operations Office and the U.S. Environmental Protection Agency (EPA)-Region IV have entered into a Federal Facility Compliance Agreement (FFCA) which seeks to facilitate the treatment of low-level mixed wastes currently stored at the Oak Ridge Reservation (ORR) in violation of the Resource, Conservation and Recovery Act Land Disposal Restrictions. The FFCA establishes schedules for DOE to identify treatment for wastes, referred to as Appendix B wastes, that current have no identified or existing capacity for treatment. A development, demonstration, testing, and evaluation (DDT ampersand E) program was established to provide the support necessary to identify treatment methods for mixed was meeting the Appendix B criteria. The Program has assembled project teams to address treatment development needs for major categories of the Appendix B wastes based on the waste characteristics and possible treatment technologies. The Aqueous, Organic, and Decontamination (A OE D) project team was established to identify pretreatment options for aqueous and organic wastes which will render the waste acceptable for treatment in existing waste treatment facilities and to identify the processes to decontaminate heterogeneous debris waste. In addition, the project must also address the treatment of secondary waste generated by other DDT ampersand E projects. This report details the activities to be performed under the A OE D Project in support of the identification, selection, and evaluation of treatment processes. The goals of this plan are (1) to determine the major aqueous and organic waste streams requiring treatment, (2) to determine the treatment steps necessary to make the aqueous and organic waste acceptable for treatment in existing treatment facilities on the ORR or off-site, and (3) to determine the processes necessary to decontaminate heterogeneous wastes that are considered debris

  1. Prostate intensity-modulated radiotherapy planning in seven mouse clicks: Development of a class solution for cancer.

    Science.gov (United States)

    Wood, Maree; Fonseca, Amara; Sampson, David; Kovendy, Andrew; Westhuyzen, Justin; Shakespeare, Thomas; Turnbull, Kirsty

    2016-01-01

    The aim of the retrospective study was to develop a planning class solution for prostate intensity-modulated radiotherapy (IMRT) that achieved target and organs-at-risk (OAR) doses within acceptable departmental protocol criteria using the Monaco treatment planning system (Elekta-CMS Software, MO, USA). Advances in radiation therapy technology have led to a re-evaluation of work practices. Class solutions have the potential to produce highly conformal plans in a time-efficient manner. Using data from intermediate and high risk prostate cancer patients, a stepwise quality improvement model was employed. Stage 1 involved the development of a broadly based treatment template developed across 10 patients. Stage 2 involved template refinement and clinical audit ( n  = 20); Stage 3, template review ( n  = 50) and Stage 4 an assessment of a revised template against the actual treatment plan involving 72 patients. The computer algorithm that comprised the Stage 4 template met clinical treatment criteria for 82% of patients. Minor template changes were required for a further 13% of patients. Major changes were required in 4%; one patient could not be assessed. The average calculation time was 13 min and involved seven mouse clicks by the planner. Thus, the new template met treatment criteria or required only minor changes in 95% of prostate patients; this is an encouraging result suggesting improvements in planning efficiency and consistency. It is feasible to develop a class solution for prostate IMRT using a stepwise quality improvement model which delivers clinically acceptable plans in the great majority of prostate cases.

  2. SU-E-J-70: Feasibility Study of Dynamic Arc and IMRT Treatment Plans Utilizing Vero Treatment Unit and IPlan Planning Computer for SRS/FSRT Brain Cancer Patients

    International Nuclear Information System (INIS)

    Huh, S; Lee, S; Dagan, R; Malyapa, R; Mendenhall, N; Mendenhall, W; Ho, M; Hough, D; Yam, M; Li, Z

    2014-01-01

    Purpose: To investigate the feasibility of utilizing Dynamic Arc (DA) and IMRT with 5mm MLC leaf of VERO treatment unit for SRS/FSRT brain cancer patients with non-invasive stereotactic treatments. The DA and IMRT plans using the VERO unit (BrainLab Inc, USA) are compared with cone-based planning and proton plans to evaluate their dosimetric advantages. Methods: The Vero treatment has unique features like no rotational or translational movements of the table during treatments, Dynamic Arc/IMRT, tracking of IR markers, limitation of Ring rotation. Accuracies of the image fusions using CBCT, orthogonal x-rays, and CT are evaluated less than ∼ 0.7mm with a custom-made target phantom with 18 hidden targets. 1mm margin is given to GTV to determine PTV for planning constraints considering all the uncertainties of planning computer and mechanical uncertainties of the treatment unit. Also, double-scattering proton plans with 6F to 9F beams and typical clinical parameters, multiple isocenter plans with 6 to 21 isocenters, and DA/IMRT plans are evaluated to investigate the dosimetric advantages of the DA/IMRT for complex shape of targets. Results: 3 Groups of the patients are divided: (1) Group A (complex target shape), CI's are same for IMRT, and DGI of the proton plan are better by 9.5% than that of the IMRT, (2) Group B, CI of the DA plans (1.91+/−0.4) are better than cone-based plan, while DGI of the DA plan is 4.60+/−1.1 is better than cone-based plan (5.32+/−1.4), (3) Group C (small spherical targets), CI of the DA and cone-based plans are almost the same. Conclusion: For small spherical targets, cone-based plans are superior to other 2 plans: DS proton and DA plans. For complex or irregular plans, dynamic and IMRT plans are comparable to cone-based and proton plans for complex targets

  3. Compass model-based quality assurance for stereotactic VMAT treatment plans.

    Science.gov (United States)

    Valve, Assi; Keyriläinen, Jani; Kulmala, Jarmo

    2017-12-01

    To use Compass as a model-based quality assurance (QA) tool for stereotactic body radiation therapy (SBRT) and stereotactic radiation therapy (SRT) volumetric modulated arc therapy (VMAT) treatment plans calculated with Eclipse treatment planning system (TPS). Twenty clinical stereotactic VMAT SBRT and SRT treatment plans were blindly selected for evaluation. Those plans included four different treatment sites: prostate, brain, lung and body. The plans were evaluated against dose-volume histogram (DVH) parameters and 2D and 3D gamma analysis. The dose calculated with Eclipse treatment planning system (TPS) was compared to Compass calculated dose (CCD) and Compass reconstructed dose (CRD). The maximum differences in mean dose of planning target volume (PTV) were 2.7 ± 1.0% between AAA and Acuros XB calculation algorithm TPS dose, -7.6 ± 3.5% between Eclipse TPS dose and CCD dose and -5.9 ± 3.7% between Eclipse TPS dose and CRD dose for both Eclipse calculation algorithms, respectively. 2D gamma analysis was not able to identify all the cases that 3D gamma analysis specified for further verification. Compass is suitable for QA of SBRT and SRT treatment plans. However, the QA process should include wide set of DVH-based dose parameters and 3D gamma analysis should be the preferred method when performing clinical patient QA. The results suggest that the Compass should not be used for smaller field sizes than 3 × 3 cm 2 or the beam model should be adjusted separately for both small (FS ≤ 3 cm) and large (FS > 3 cm) field sizes. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. SU-E-T-465: Implementation of An Automated Collision Detection Program Using Open Source Software for the Pinnacle Treatment Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Tanny, S; Bogue, J; Parsai, E; Sperling, N [University of Toledo Medical Center, Toledo, OH (United States)

    2015-06-15

    Purpose: Potential collisions between the gantry head and the patient or table assembly are difficult to detect in most treatment planning systems. We have developed and implemented a novel software package for the representation of potential gantry collisions with the couch assembly at the time of treatment planning. Methods: Physical dimensions of the Varian Edge linear accelerator treatment head were measured and reproduced using the Visual Python display package. A script was developed for the Pinnacle treatment planning system to generate a file with the relevant couch, gantry, and isocenter positions for each beam in a planning trial. A python program was developed to parse the information from the TPS and produce a representative model of the couch/gantry system. Using the model and the Visual Python libraries, a rendering window is generated for each beam that allows the planner to evaluate the possibility of a collision. Results: Comparison against heuristic methods and direct verification on the machine validated the collision model generated by the software. Encounters of <1 cm between the gantry treatment head and table were visualized as collisions in our virtual model. Visual windows were created depicting the angle of collision for each beam, including the anticipated table coordinates. Visual rendering of a 6 arc trial with multiple couch positions was completed in under 1 minute, with network bandwidth being the primary bottleneck. Conclusion: The developed software allows for quick examination of possible collisions during the treatment planning process and helps to prevent major collisions prior to plan approval. The software can easily be implemented on future planning systems due to the versatility and platform independence of the Python programming language. Further integration of the software with the treatment planning system will allow the possibility of patient-gantry collision detection for a range of treatment machines.

  5. SU-E-T-465: Implementation of An Automated Collision Detection Program Using Open Source Software for the Pinnacle Treatment Planning System

    International Nuclear Information System (INIS)

    Tanny, S; Bogue, J; Parsai, E; Sperling, N

    2015-01-01

    Purpose: Potential collisions between the gantry head and the patient or table assembly are difficult to detect in most treatment planning systems. We have developed and implemented a novel software package for the representation of potential gantry collisions with the couch assembly at the time of treatment planning. Methods: Physical dimensions of the Varian Edge linear accelerator treatment head were measured and reproduced using the Visual Python display package. A script was developed for the Pinnacle treatment planning system to generate a file with the relevant couch, gantry, and isocenter positions for each beam in a planning trial. A python program was developed to parse the information from the TPS and produce a representative model of the couch/gantry system. Using the model and the Visual Python libraries, a rendering window is generated for each beam that allows the planner to evaluate the possibility of a collision. Results: Comparison against heuristic methods and direct verification on the machine validated the collision model generated by the software. Encounters of <1 cm between the gantry treatment head and table were visualized as collisions in our virtual model. Visual windows were created depicting the angle of collision for each beam, including the anticipated table coordinates. Visual rendering of a 6 arc trial with multiple couch positions was completed in under 1 minute, with network bandwidth being the primary bottleneck. Conclusion: The developed software allows for quick examination of possible collisions during the treatment planning process and helps to prevent major collisions prior to plan approval. The software can easily be implemented on future planning systems due to the versatility and platform independence of the Python programming language. Further integration of the software with the treatment planning system will allow the possibility of patient-gantry collision detection for a range of treatment machines

  6. Inverse optimization of objective function weights for treatment planning using clinical dose-volume histograms

    Science.gov (United States)

    Babier, Aaron; Boutilier, Justin J.; Sharpe, Michael B.; McNiven, Andrea L.; Chan, Timothy C. Y.

    2018-05-01

    We developed and evaluated a novel inverse optimization (IO) model to estimate objective function weights from clinical dose-volume histograms (DVHs). These weights were used to solve a treatment planning problem to generate ‘inverse plans’ that had similar DVHs to the original clinical DVHs. Our methodology was applied to 217 clinical head and neck cancer treatment plans that were previously delivered at Princess Margaret Cancer Centre in Canada. Inverse plan DVHs were compared to the clinical DVHs using objective function values, dose-volume differences, and frequency of clinical planning criteria satisfaction. Median differences between the clinical and inverse DVHs were within 1.1 Gy. For most structures, the difference in clinical planning criteria satisfaction between the clinical and inverse plans was at most 1.4%. For structures where the two plans differed by more than 1.4% in planning criteria satisfaction, the difference in average criterion violation was less than 0.5 Gy. Overall, the inverse plans were very similar to the clinical plans. Compared with a previous inverse optimization method from the literature, our new inverse plans typically satisfied the same or more clinical criteria, and had consistently lower fluence heterogeneity. Overall, this paper demonstrates that DVHs, which are essentially summary statistics, provide sufficient information to estimate objective function weights that result in high quality treatment plans. However, as with any summary statistic that compresses three-dimensional dose information, care must be taken to avoid generating plans with undesirable features such as hotspots; our computational results suggest that such undesirable spatial features were uncommon. Our IO-based approach can be integrated into the current clinical planning paradigm to better initialize the planning process and improve planning efficiency. It could also be embedded in a knowledge-based planning or adaptive radiation therapy framework to

  7. Evaluation of a commercial biologically based IMRT treatment planning system

    International Nuclear Information System (INIS)

    Semenenko, Vladimir A.; Reitz, Bodo; Day, Ellen; Qi, X. Sharon; Miften, Moyed; Li, X. Allen

    2008-01-01

    A new inverse treatment planning system (TPS) for external beam radiation therapy with high energy photons is commercially available that utilizes both dose-volume-based cost functions and a selection of cost functions which are based on biological models. The purpose of this work is to evaluate quality of intensity-modulated radiation therapy (IMRT) plans resulting from the use of biological cost functions in comparison to plans designed using a traditional TPS employing dose-volume-based optimization. Treatment planning was performed independently at two institutions. For six cancer patients, including head and neck (one case from each institution), prostate, brain, liver, and rectal cases, segmental multileaf collimator IMRT plans were designed using biological cost functions and compared with clinically used dose-based plans for the same patients. Dose-volume histograms and dosimetric indices, such as minimum, maximum, and mean dose, were extracted and compared between the two types of treatment plans. Comparisons of the generalized equivalent uniform dose (EUD), a previously proposed plan quality index (fEUD), target conformity and heterogeneity indices, and the number of segments and monitor units were also performed. The most prominent feature of the biologically based plans was better sparing of organs at risk (OARs). When all plans from both institutions were combined, the biologically based plans resulted in smaller EUD values for 26 out of 33 OARs by an average of 5.6 Gy (range 0.24 to 15 Gy). Owing to more efficient beam segmentation and leaf sequencing tools implemented in the biologically based TPS compared to the dose-based TPS, an estimated treatment delivery time was shorter in most (five out of six) cases with some plans showing up to 50% reduction. The biologically based plans were generally characterized by a smaller conformity index, but greater heterogeneity index compared to the dose-based plans. Overall, compared to plans based on dose

  8. Migration check tool: automatic plan verification following treatment management systems upgrade and database migration.

    Science.gov (United States)

    Hadley, Scott W; White, Dale; Chen, Xiaoping; Moran, Jean M; Keranen, Wayne M

    2013-11-04

    Software upgrades of the treatment management system (TMS) sometimes require that all data be migrated from one version of the database to another. It is necessary to verify that the data are correctly migrated to assure patient safety. It is impossible to verify by hand the thousands of parameters that go into each patient's radiation therapy treatment plan. Repeating pretreatment QA is costly, time-consuming, and may be inadequate in detecting errors that are introduced during the migration. In this work we investigate the use of an automatic Plan Comparison Tool to verify that plan data have been correctly migrated to a new version of a TMS database from an older version. We developed software to query and compare treatment plans between different versions of the TMS. The same plan in the two TMS systems are translated into an XML schema. A plan comparison module takes the two XML schemas as input and reports any differences in parameters between the two versions of the same plan by applying a schema mapping. A console application is used to query the database to obtain a list of active or in-preparation plans to be tested. It then runs in batch mode to compare all the plans, and a report of success or failure of the comparison is saved for review. This software tool was used as part of software upgrade and database migration from Varian's Aria 8.9 to Aria 11 TMS. Parameters were compared for 358 treatment plans in 89 minutes. This direct comparison of all plan parameters in the migrated TMS against the previous TMS surpasses current QA methods that relied on repeating pretreatment QA measurements or labor-intensive and fallible hand comparisons.

  9. Very high-energy electron (VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.

    Science.gov (United States)

    Schüler, Emil; Eriksson, Kjell; Hynning, Elin; Hancock, Steven L; Hiniker, Susan M; Bazalova-Carter, Magdalena; Wong, Tony; Le, Quynh-Thu; Loo, Billy W; Maxim, Peter G

    2017-06-01

    The aim of this study was to evaluate the performance of very high-energy electron beams (VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer (HNC)). The VHEE beams were calculated in the EGSnrc/DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk (OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher

  10. Uncertainties in model-based outcome predictions for treatment planning

    International Nuclear Information System (INIS)

    Deasy, Joseph O.; Chao, K.S. Clifford; Markman, Jerry

    2001-01-01

    Purpose: Model-based treatment-plan-specific outcome predictions (such as normal tissue complication probability [NTCP] or the relative reduction in salivary function) are typically presented without reference to underlying uncertainties. We provide a method to assess the reliability of treatment-plan-specific dose-volume outcome model predictions. Methods and Materials: A practical method is proposed for evaluating model prediction based on the original input data together with bootstrap-based estimates of parameter uncertainties. The general framework is applicable to continuous variable predictions (e.g., prediction of long-term salivary function) and dichotomous variable predictions (e.g., tumor control probability [TCP] or NTCP). Using bootstrap resampling, a histogram of the likelihood of alternative parameter values is generated. For a given patient and treatment plan we generate a histogram of alternative model results by computing the model predicted outcome for each parameter set in the bootstrap list. Residual uncertainty ('noise') is accounted for by adding a random component to the computed outcome values. The residual noise distribution is estimated from the original fit between model predictions and patient data. Results: The method is demonstrated using a continuous-endpoint model to predict long-term salivary function for head-and-neck cancer patients. Histograms represent the probabilities for the level of posttreatment salivary function based on the input clinical data, the salivary function model, and the three-dimensional dose distribution. For some patients there is significant uncertainty in the prediction of xerostomia, whereas for other patients the predictions are expected to be more reliable. In contrast, TCP and NTCP endpoints are dichotomous, and parameter uncertainties should be folded directly into the estimated probabilities, thereby improving the accuracy of the estimates. Using bootstrap parameter estimates, competing treatment

  11. EMI Registry Development Plan

    CERN Document Server

    Memon, S.; Szigeti, G.; Field, L.

    2012-01-01

    This documents describes the overall development plan of the EMI Registry product, the plan focuses on the realisation of the EMI Registry specification as defined in the document. It is understood that during the course of the development phase the specification will likely evolve and the changes will be fed into the specification document.

  12. SU-E-T-337: Treatment Planning Study of Craniospinal Irradiation with Spot Scanning Proton Therapy

    International Nuclear Information System (INIS)

    Tasson, A; Beltran, C; Laack, N; Childs, S; Tryggestad, E; Whitaker, T

    2014-01-01

    Purpose: To develop a treatment planning technique that achieves optimal robustness against systematic position and range uncertainties, and interfield position errors for craniospinal irradiation (CSI) using spot scanning proton radiotherapy. Methods: Eighteen CSI patients who had previously been treated using photon radiation were used for this study. Eight patients were less than 10 years old. The prescription dose was 23.4Gy in 1.8Gy fractions. Two different field arrangement types were investigated: 1 posterior field per isocenter and 2 posterior oblique fields per isocenter. For each field type, two delivery configurations were used: 5cm bolus attached to the treatment table and a 4.5cm range shifter located inside the nozzle. The target for each plan was the whole brain and thecal sac. For children under the age of 10, all plan types were repeated with an additional dose of 21Gy prescribed to the vertebral bodies. Treatment fields were matched by stepping down the dose in 10% increments over 9cm. Robustness against 3% and 3mm uncertainties, as well as a 3mm inter-field error was analyzed. Dose coverage of the target and critical structure sparing for each plan type will be considered. Ease of planning and treatment delivery was also considered for each plan type. Results: The mean dose volume histograms show that the bolus plan with posterior beams gave the best overall plan, and all proton plans were comparable to or better than the photon plans. The plan type that was the most robust against the imposed uncertainties was also the bolus plan with posterior beams. This is also the plan configuration that is the easiest to deliver and plan. Conclusion: The bolus plan with posterior beams achieved optimal robustness against systematic position and range uncertainties, as well as inter-field position errors

  13. Development Plans and Life Plans: Knowledge Sharing?

    Directory of Open Access Journals (Sweden)

    Juan José Vieco Albarracín

    2010-02-01

    Full Text Available This article explores the possibilities of establishing knowledge sharing between governmental development plans and the “life plans” (planes de vida made by indigenous organizations, in particular the life plan of the Asociación de Autoridades Indígenas del Resguardo Tikuna, Cocama, Yagua (Aticoya, municipality of Puerto Nariño, Amazonas, Colombia. Colombia’s Constitution of 1991 created the ETI (Entidad Territorial Indígena,“indigenous territorial entity” as a territorial unit, just like municipalities, departments, and districts. This means that indigenous reservations (or “reserves” or “preserves” and associations should manage public funds, for which they must design a life plan. This inclusion and recognition of indigenous peoples entails that those life plans should articulate with the municipal, departmental, and national development plans. The article illustrates this situation by comparing two welfare programs –Resa (Red de Seguridad Alimentaria “Food Security Network” and Familias Guardabosques (“Forest Ranger Families”– and two income-generating productive and service (tourism projects carried out by Aticoya and the local indigenous councils of communities on the Amazon and Loretoyacu Rivers.

  14. Test Plan: Sludge Treatment Project Corrosion Process Chemistry Follow-on Testing

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, Calvin H.; Schmidt, Andrew J.; Poloski, Adam P.

    2007-08-17

    This test plan was prepared by the Pacific Northwest National Laboratory (PNNL) under contract with Fluor Hanford (FH). The test plan describes the scope and conditions to be used to perform laboratory-scale testing of the Sludge Treatment Project (STP) hydrothermal treatment of K Basin sludge. The STP, managed for the U. S. Department of Energy (DOE) by FH, was created to design and operate a process to eliminate uranium metal from the sludge prior to packaging for Waste Isolation Pilot Plant (WIPP) by using high temperature liquid water to accelerate the reaction, produce uranium dioxide from the uranium metal, and safely discharge the hydrogen. The proposed testing builds on the approach and laboratory test findings for both K Basin sludge and simulated sludge garnered during prior testing from September 2006 to March 2007. The outlined testing in this plan is designed to yield further understanding of the nature of the chemical reactions, the effects of compositional and process variations and the effectiveness of various strategies to mitigate the observed high shear strength phenomenon observed during the prior testing. These tests are designed to provide process validation and refinement vs. process development and design input. The expected outcome is to establish a level of understanding of the chemistry such that successful operating strategies and parameters can be implemented within the confines of the existing STP corrosion vessel design. In July 2007, the DOE provided direction to FH regarding significant changes to the scope of the overall STP. As a result of the changes, FH directed PNNL to stop work on most of the planned activities covered in this test plan. Therefore, it is unlikely the testing described here will be performed. However, to preserve the test strategy and details developed to date, the test plan has been published.

  15. Developing a Mobile App for Prevention and Treatment of Pressure Injuries.

    Science.gov (United States)

    Salomé, Geraldo Magela; Ferreira, Lydia Masako

    2018-02-01

    This descriptive study describes the planning and development of a mobile application (app) for prevention and treatment of pressure injuries for use by providers in a university research center. The app delineates risk factors for pressure injury development, provides an evaluation of the wound, recommends wound cleansing procedures, performs pressure injury staging, and recommends treatment interventions. A mobile app was developed using a contextualized instructional design, which involves a constructivist proposal and planning, developing, and applying specific didactic situations, thus incorporating mechanisms that favor contextualization. A literature search was conducted to identify relevant studies for the construction of the mobile app. The development process involved the selection of app tools, definition of the navigation structure, and planning of the environment configuration. The environment for downloading the app software on the Internet and installing it on the mobile device was created. The literature search yielded 18 articles, 2 books, and 1 master's degree thesis. A mobile app was created with an easy-to-use graphic interface. The app stores the patient's demographic characteristics and provides an evaluation of his/her wound, a list of risk factors for pressure injury development, wound cleansing procedures, and treatment interventions. The developed app may be useful in clinical practice, helping to prevent pressure injuries and promote select nursing interventions for the treatment of patients with pressure injury.

  16. A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Guthier, C; Aschenbrenner, K P; Buergy, D; Ehmann, M; Wenz, F; Hesser, J W

    2015-01-01

    This work discusses a novel strategy for inverse planning in low dose rate brachytherapy. It applies the idea of compressed sensing to the problem of inverse treatment planning and a new solver for this formulation is developed. An inverse planning algorithm was developed incorporating brachytherapy dose calculation methods as recommended by AAPM TG-43. For optimization of the functional a new variant of a matching pursuit type solver is presented. The results are compared with current state-of-the-art inverse treatment planning algorithms by means of real prostate cancer patient data. The novel strategy outperforms the best state-of-the-art methods in speed, while achieving comparable quality. It is able to find solutions with comparable values for the objective function and it achieves these results within a few microseconds, being up to 542 times faster than competing state-of-the-art strategies, allowing real-time treatment planning. The sparse solution of inverse brachytherapy planning achieved with methods from compressed sensing is a new paradigm for optimization in medical physics. Through the sparsity of required needles and seeds identified by this method, the cost of intervention may be reduced. (paper)

  17. A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning

    Science.gov (United States)

    Guthier, C.; Aschenbrenner, K. P.; Buergy, D.; Ehmann, M.; Wenz, F.; Hesser, J. W.

    2015-03-01

    This work discusses a novel strategy for inverse planning in low dose rate brachytherapy. It applies the idea of compressed sensing to the problem of inverse treatment planning and a new solver for this formulation is developed. An inverse planning algorithm was developed incorporating brachytherapy dose calculation methods as recommended by AAPM TG-43. For optimization of the functional a new variant of a matching pursuit type solver is presented. The results are compared with current state-of-the-art inverse treatment planning algorithms by means of real prostate cancer patient data. The novel strategy outperforms the best state-of-the-art methods in speed, while achieving comparable quality. It is able to find solutions with comparable values for the objective function and it achieves these results within a few microseconds, being up to 542 times faster than competing state-of-the-art strategies, allowing real-time treatment planning. The sparse solution of inverse brachytherapy planning achieved with methods from compressed sensing is a new paradigm for optimization in medical physics. Through the sparsity of required needles and seeds identified by this method, the cost of intervention may be reduced.

  18. [Endodontically treated teeth. Success--failure. Endorestorative treatment plan].

    Science.gov (United States)

    Zabalegui, B

    1990-01-01

    More and more often the general dentist is finding the presence of endodontically treated teeth during his treatment planning procedure. He has to ask himself if the endo-treated tooth functions and will continue to function function successfully, when deciding which final endo-restorative procedure to apply. For this reason the dentist or the endodontist with whom he works should clinically evaluate these teeth, establish a diagnostic criteria of their success or failure and a treatment plan according to the prognosis. The purpose of this article is to offer an organized clinical view of the steps to follow when evaluating an endodontically treated tooth and how to establish a final endo-restorative plan.

  19. MO-D-BRB-00: Pediatric Radiation Therapy Planning, Treatment, and Late Effects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa

  20. Treatment planning for carcinoma of the cervix: a patterns of care study report

    International Nuclear Information System (INIS)

    Ling, C. Clifton; Smith, Alfred R.; Hanlon, Alexandra L.; Owen, Jean B.; Brickner, Theodore J.; Hanks, Gerald E.

    1996-01-01

    Purpose: The Patterns of Care Study (PCS) of patients treated in 1988-89 included 'patterns of treatment planning' for radiotherapy of carcinoma of the uterine cervix. A Consensus Committee of radiation physicists and oncologists established current guidelines and developed questionnaires to assess the treatment planning process (i.e., the general structure, methodology, and tools) of institutions involved in the Patterns of Care Study. This paper reports the findings of the assessment. Methods and Materials: The PCS surveyed 73 radiotherapy facilities, of which 21 are academic institutions (AC), 26 hospital-based facilities (HB), and 26 free-standing centers (FS). In total, 242 cases were assessed with 39% from academic centers, 33% from hospital-based centers, and 28% from free-standing centers. The survey collected treatment planning information such as the use of computed tomography (CT), simulation procedure, contouring of patient outline, tumor or target delineation, identification of critical structures, method of dose prescription (point or isodose), etc. Data was also obtained concerning implant boosts, e.g., radioisotope used, use of midline block for external beam treatment, availability of remote afterloader, practice of interstitial implants, combination with hyperthermia, etc. Results: There is a high degree of compliance relative to the basic treatment planning standards. For example, 171 cases (out of 173) from AC and HB institutions included simulation and 169 used port film; for cases from FS centers, 61 out of 69 involved simulation and 66 out of 69 included port film. Most institutions used linacs (231 out of 242); in five cases, Co-60 units and in six cases betatron was used. In terms of treatment planning, 53% used skin contours, but only 14% had target volume delineation, with AC and HB being slightly more conscientious in these efforts. Critical organs did not appear to be explicitly considered in external beam treatment planning, with only

  1. Optimization of Gamma Knife treatment planning via guided evolutionary simulated annealing

    International Nuclear Information System (INIS)

    Zhang Pengpeng; Dean, David; Metzger, Andrew; Sibata, Claudio

    2001-01-01

    We present a method for generating optimized Gamma Knife trade mark sign (Elekta, Stockholm, Sweden) radiosurgery treatment plans. This semiautomatic method produces a highly conformal shot packing plan for the irradiation of an intracranial tumor. We simulate optimal treatment planning criteria with a probability function that is linked to every voxel in a volumetric (MR or CT) region of interest. This sigmoidal P + parameter models the requirement of conformality (i.e., tumor ablation and normal tissue sparing). After determination of initial radiosurgery treatment parameters, a guided evolutionary simulated annealing (GESA) algorithm is used to find the optimal size, position, and weight for each shot. The three-dimensional GESA algorithm searches the shot parameter space more thoroughly than is possible during manual shot packing and provides one plan that is suitable to the treatment criteria of the attending neurosurgeon and radiation oncologist. The result is a more conformal plan, which also reduces redundancy, and saves treatment administration time

  2. Predicting objective function weights from patient anatomy in prostate IMRT treatment planning

    International Nuclear Information System (INIS)

    Lee, Taewoo; Hammad, Muhannad; Chan, Timothy C. Y.; Craig, Tim; Sharpe, Michael B.

    2013-01-01

    Purpose: Intensity-modulated radiation therapy (IMRT) treatment planning typically combines multiple criteria into a single objective function by taking a weighted sum. The authors propose a statistical model that predicts objective function weights from patient anatomy for prostate IMRT treatment planning. This study provides a proof of concept for geometry-driven weight determination. Methods: A previously developed inverse optimization method (IOM) was used to generate optimal objective function weights for 24 patients using their historical treatment plans (i.e., dose distributions). These IOM weights were around 1% for each of the femoral heads, while bladder and rectum weights varied greatly between patients. A regression model was developed to predict a patient's rectum weight using the ratio of the overlap volume of the rectum and bladder with the planning target volume at a 1 cm expansion as the independent variable. The femoral head weights were fixed to 1% each and the bladder weight was calculated as one minus the rectum and femoral head weights. The model was validated using leave-one-out cross validation. Objective values and dose distributions generated through inverse planning using the predicted weights were compared to those generated using the original IOM weights, as well as an average of the IOM weights across all patients. Results: The IOM weight vectors were on average six times closer to the predicted weight vectors than to the average weight vector, usingl 2 distance. Likewise, the bladder and rectum objective values achieved by the predicted weights were more similar to the objective values achieved by the IOM weights. The difference in objective value performance between the predicted and average weights was statistically significant according to a one-sided sign test. For all patients, the difference in rectum V54.3 Gy, rectum V70.0 Gy, bladder V54.3 Gy, and bladder V70.0 Gy values between the dose distributions generated by the

  3. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Commissioning of radiotherapy treatment planning systems: Testing for typical external beam treatment techniques. Report of the Coordinated Research Project (CRP) on Development of Procedures for Quality Assurance of Dosimetry Calculations in Radiotherapy

    International Nuclear Information System (INIS)

    2008-01-01

    Quality Assurance (QA) in the radiation therapy treatment planning process is essential to ensure accurate dose delivery to the patient and to minimize the possibility of accidental exposure. Computerized radiotherapy treatment planning systems (RTPSs) are now widely available in both industrialised and developing countries so, it is of special importance to support hospitals in the IAEA Member States in developing procedures for acceptance testing, commissioning and ongoing QA of their RTPSs. Responding to these needs, a group of experts developed a comprehensive report, the IAEA Technical Reports Series No 430 'Commissioning and quality assurance of computerized planning systems for radiation treatment of cancer', that provides the general framework and describes a large number of tests and procedures to be considered by the RTPS users. To provide practical guidance for implementation of IAEA Technical Reports Series No. 430 in radiotherapy hospitals and particularly in those with limited resources, a coordinated research project (CRP E2.40.13) 'Development of procedures for dosimetry calculation in radiotherapy' was established. The main goal of the project was to create a set of practical acceptance and commissioning tests for dosimetry calculations in radiotherapy, defined in a dedicated protocol. Two specific guidance publications that were developed in the framework of the Coordinated Research Project E2.40.13 are based on guidelines described in the IAEA Technical Report Series No. 430 and provide a step-by-step description for users at hospitals or cancer centres how to implement acceptance and commissioning procedures for their RTPSs. The first publication, 'Specification and acceptance testing of radiotherapy treatment planning systems' IAEA-TECDOC-1540 uses the International Electrotechnical Commission (IEC) standard IEC 62083 as its basis and addresses the procedures for specification and acceptance testing of RTPSs to be used by both manufacturers and

  5. 94: Treatment plan optimization for conformal therapy

    International Nuclear Information System (INIS)

    Rosen, I.I.; Lane, R.G.

    1987-01-01

    Computer-controlled conformal radiation therapy techniques can deliver complex treatments utilizing large numbers of beams, gantry angles and beam shapes. Linear programming is well-suited for planning conformal treatments. Given a list of available treatment beams, linear programming calculates the relative weights of the beams such that the objective function is optimized and doses to constraint points are within the prescribed limits. 5 refs.; 3 figs

  6. MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

    Energy Technology Data Exchange (ETDEWEB)

    DiCostanzo, D; Woollard, J; Gupta, N; Ayan, A [Ohio State University, Columbus, OH (United States); Thompson, S [Santa Cruz Radiation Oncology, Santa Cruz, CA (United States)

    2015-06-15

    Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactions with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication

  7. MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

    International Nuclear Information System (INIS)

    DiCostanzo, D; Woollard, J; Gupta, N; Ayan, A; Thompson, S

    2015-01-01

    Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactions with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication

  8. Large shaft development test plan

    International Nuclear Information System (INIS)

    Krug, A.D.

    1984-03-01

    This test plan proposes the conduct of shaft liner tests as part of the large shaft development test proposed for the Hanford Site in support of the repository development program. The objectives of these tests are to develop techniques for measuring liner alignment (straightness), both construction assembly alignment and downhole cumulative alignment, and to assess the alignment information as a real time feedback to aid the installation procedure. The test plan is based upon installing a 16 foot ID shaft liner into a 20 foot diameter shaft to a depth of 1000 feet. This test plan is considered to be preliminary in that it was prepared as input for the decision to determine if development testing is required in this area. Should the decision be made to proceed with development testing, this test plan shall be updated and revised. 6 refs., 2 figs

  9. Radiotherapy treatment planning linear-quadratic radiobiology

    CERN Document Server

    Chapman, J Donald

    2015-01-01

    Understand Quantitative Radiobiology from a Radiation Biophysics PerspectiveIn the field of radiobiology, the linear-quadratic (LQ) equation has become the standard for defining radiation-induced cell killing. Radiotherapy Treatment Planning: Linear-Quadratic Radiobiology describes tumor cell inactivation from a radiation physics perspective and offers appropriate LQ parameters for modeling tumor and normal tissue responses.Explore the Latest Cell Killing Numbers for Defining Iso-Effective Cancer TreatmentsThe book compil

  10. An investigation into positron emission tomography contouring methods across two treatment planning systems

    International Nuclear Information System (INIS)

    Young, Tony; Som, Seu; Sathiakumar, Chithradevi; Holloway, Lois

    2013-01-01

    Positron emission tomography (PET) imaging has been used to provide additional information regarding patient tumor location, size, and staging for radiotherapy treatment planning purposes. This additional information reduces interobserver variability and produces more consistent contouring. It is well recognized that different contouring methodology for PET data results in different contoured volumes. The goal of this study was to compare the difference in PET contouring methods for 2 different treatment planning systems using a phantom dataset and a series of patient datasets. Contouring methodology was compared on the ADAC Pinnacle Treatment Planning System and the CMS XiO Treatment Planning System. Contours were completed on the phantom and patient datasets using a number of PET contouring methods—the standardized uptake value 2.5 method, 30%, 40%, and 50% of the maximum uptake method and the signal to background ratio method. Differences of >15% were observed for PET-contoured volumes between the different treatment planning systems for the same data and the same PET contouring methodology. Contoured volume differences between treatment planning systems were caused by differences in data formatting and display and the different contouring tools available. Differences in treatment planning system as well as contouring methodology should be considered carefully in dose-volume contouring and reporting, especially between centers that may use different treatment planning systems or those that have several different treatment planning systems

  11. Reducing DNACPR complaints to zero: designing and implementing a treatment escalation plan using quality improvement methodology.

    Science.gov (United States)

    Shermon, Elizabeth; Munglani, Laura; Oram, Sarah; William, Linda; Abel, Julian

    2017-01-01

    Do Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form. We aimed to develop a TEP document to reduce resuscitation-related complaints by improving communication and documentation. Qualitative and quantitative data were collected over 2 years and used to develop plan-do-study-act (PDSA) cycles using quality improvement methodology. Main barriers to improvement included time constraints and clinician's resistance. Analysis of patient liaison services data showed a progressive reduction in complaints regarding resuscitation, with no complaints having been received for the final six months of the project. Through use of a standardised form including treatment prompts, the quality of discussions and plans improved. Qualitative feedback demonstrated increased patient and relative satisfaction. In addition, junior doctors report the plans are helpful when making out-of-hours decisions. Development of a user-friendly form to document patient-guided TEPs helped junior doctors to lead advanced care planning discussions. The use of PDSA cycles demonstrated improvement in the quality of forms, which in turn improved communication, documentation and satisfaction. Future developments could include involvement of specialist teams to ensure TEP forms remain relevant to all clinical areas. In addition, with widespread use of the TEP forms, the traditional tick-box DNAR could be replaced to focus on patient-led care planning.

  12. MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

    International Nuclear Information System (INIS)

    Kapur, A.

    2015-01-01

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  13. MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, A. [Long Island Jewish Medical Center (United States)

    2015-06-15

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi

  14. Latest development in project site radwaste treatment facility (SRTF) Sanmen

    International Nuclear Information System (INIS)

    Mennicken, K.; Lohmann, P.

    2015-01-01

    Westinghouse Electric Germany GmbH (WEG) was successful in being awarded a contract as to the planning, delivery, installation and commissioning of radwaste treatment systems for the AP1000 units at Sanmen site, PR China. Operational low and intermediate level radioactive waste will be processed in the Site Radwaste Treatment Facility (SRTF). This paper explains the latest developments of the project, especially the experience with customer-hired Chinese planning partners, installation companies and Customer operating personnel. (authors)

  15. Use of a radiation therapy treatment planning computer in a hospital health physics program

    International Nuclear Information System (INIS)

    Addison, S.J.

    1984-01-01

    An onsite treatment planning computer has become state of the art in the care of radiation therapy patients, but in most installations the computer is used for therapy planning a diminutive amount of the day. At St. Mary's Hospital, arrangements have been negotiated for part time use of the treatment planning computer for health physics purposes. Computerized Medical Systems, Inc. (CMS) produces the Modulex radiotherapy planning system which is programmed in MUMPS, a user oriented language specially adapted for handling text string information. St. Mary's Hospital's CMS computer has currently been programmed to assist in data collection and write-up of diagnostic x-ray surveys, meter calibrations, and wipe/leak tests. The computer is setup to provide timely reminders of tests and surveys, and billing for consultation work. Programs are currently being developed for radionuclide inventories. Use of a therapy planning computer for health physics purposes can enhance the radiation safety program and provide additional grounds for the acquisition of such a computer system

  16. Web-based tool for visualization of electric field distribution in deep-seated body structures and planning of electroporation-based treatments.

    Science.gov (United States)

    Marčan, Marija; Pavliha, Denis; Kos, Bor; Forjanič, Tadeja; Miklavčič, Damijan

    2015-01-01

    Treatments based on electroporation are a new and promising approach to treating tumors, especially non-resectable ones. The success of the treatment is, however, heavily dependent on coverage of the entire tumor volume with a sufficiently high electric field. Ensuring complete coverage in the case of deep-seated tumors is not trivial and can in best way be ensured by patient-specific treatment planning. The basis of the treatment planning process consists of two complex tasks: medical image segmentation, and numerical modeling and optimization. In addition to previously developed segmentation algorithms for several tissues (human liver, hepatic vessels, bone tissue and canine brain) and the algorithms for numerical modeling and optimization of treatment parameters, we developed a web-based tool to facilitate the translation of the algorithms and their application in the clinic. The developed web-based tool automatically builds a 3D model of the target tissue from the medical images uploaded by the user and then uses this 3D model to optimize treatment parameters. The tool enables the user to validate the results of the automatic segmentation and make corrections if necessary before delivering the final treatment plan. Evaluation of the tool was performed by five independent experts from four different institutions. During the evaluation, we gathered data concerning user experience and measured performance times for different components of the tool. Both user reports and performance times show significant reduction in treatment-planning complexity and time-consumption from 1-2 days to a few hours. The presented web-based tool is intended to facilitate the treatment planning process and reduce the time needed for it. It is crucial for facilitating expansion of electroporation-based treatments in the clinic and ensuring reliable treatment for the patients. The additional value of the tool is the possibility of easy upgrade and integration of modules with new

  17. Radiation treatment planning using a microcomputer

    International Nuclear Information System (INIS)

    Lunsqui, A.R.; Calil, S.J.; Rocha, J.R.O.; Alexandre, A.C.

    1990-01-01

    The radiation treatment planning requires a lenght manipulation of data from isodose charts to obtain the best irradiation technique. Over the past 25 years this tedious operation has been replaced by computerized methods. These can reduce the working time by at least 20 times. It is being developed at the Biomedical Engineering Center a software to generate a polychromatic image of dose distribution. By means of a digitizing board, the patient contour and the beam data are transfered to the computer and stored as polinomial and Fourier series respectively. To calculate the dose distribution, the irradiated region is represented by a variable size bidimensional dot matrix. The dose at each point is calculated by correcting and adding the stored data for each beam. An algorithm for color definition according to the dose intensity was developed to display on a computer monitor the resultant matrix. A hard copy can be obtained be means of a six color plotter. (author)

  18. A study of the plan dosimetric evaluation on the rectal cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hyun Hak; An, Beom Seok; Kim, Dae Il; Lee, Yang Hoon; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-12-15

    In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has 0 degrees, 270 degrees, 90 degrees and 0 degrees, 95 degrees, 45 degrees, 315 degrees, 265 degrees gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar 360 degrees 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H

  19. Orthodontic treatment plan changed by 3D images

    International Nuclear Information System (INIS)

    Yordanova, G.; Stanimirov, P.

    2014-01-01

    Clinical application of CBCT is most often enforced in dental phenomenon of impacted teeth, hyperodontia, transposition, ankyloses or root resorption and other pathologies in the maxillofacial area. The goal, we put ourselves, is to show how the information from 3D images changes the protocol of the orthodontic treatment. The material, we presented six our clinical cases and the change in the plan of the treatment, which has used after analyzing the information carried on the three planes of CBCT. These cases are casuistic in the orthodontic practice and require individual approach to each of them during their analysis and decision taken. The discussion made by us is in line with reveal of the impacted teeth, where we need to evaluate their vertical depth and mediodistal ratios with the bond structures. At patients with hyperodontia, the assessment is of outmost importance to decide which of the teeth to be extracted and which one to be arranged into the dental arch. The conclusion we make is that diagnostic information is essential for decisions about treatment plan. The exact graphs will lead to better treatment plan and more predictable results. (authors) Key words: CBCT. IMPACTED CANINES. HYPERODONTIA. TRANSPOSITION

  20. Fast treatment plan modification with an over-relaxed Cimmino algorithm

    International Nuclear Information System (INIS)

    Wu Chuan; Jeraj, Robert; Lu Weiguo; Mackie, Thomas R.

    2004-01-01

    A method to quickly modify a treatment plan in adaptive radiotherapy was proposed and studied. The method is based on a Cimmino-type algorithm in linear programming. The fast convergence speed is achieved by over-relaxing the algorithm relaxation parameter from its sufficient convergence range of (0, 2) to (0, ∞). The algorithm parameters are selected so that the over-relaxed Cimmino (ORC) algorithm can effectively approximate an unconstrained re-optimization process in adaptive radiotherapy. To demonstrate the effectiveness and flexibility of the proposed method in adaptive radiotherapy, two scenarios with different organ motion/deformation of one nasopharyngeal case were presented with comparisons made between this method and the re-optimization method. In both scenarios, the ORC algorithm modified treatment plans have dose distributions that are similar to those given by the re-optimized treatment plans. It takes us using the ORC algorithm to finish a treatment plan modification at least three times faster than the re-optimization procedure compared

  1. Expected treatment dose construction and adaptive inverse planning optimization: Implementation for offline head and neck cancer adaptive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yan Di; Liang Jian [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan 48073 (United States)

    2013-02-15

    Purpose: To construct expected treatment dose for adaptive inverse planning optimization, and evaluate it on head and neck (h and n) cancer adaptive treatment modification. Methods: Adaptive inverse planning engine was developed and integrated in our in-house adaptive treatment control system. The adaptive inverse planning engine includes an expected treatment dose constructed using the daily cone beam (CB) CT images in its objective and constrains. Feasibility of the adaptive inverse planning optimization was evaluated retrospectively using daily CBCT images obtained from the image guided IMRT treatment of 19 h and n cancer patients. Adaptive treatment modification strategies with respect to the time and the number of adaptive inverse planning optimization during the treatment course were evaluated using the cumulative treatment dose in organs of interest constructed using all daily CBCT images. Results: Expected treatment dose was constructed to include both the delivered dose, to date, and the estimated dose for the remaining treatment during the adaptive treatment course. It was used in treatment evaluation, as well as in constructing the objective and constraints for adaptive inverse planning optimization. The optimization engine is feasible to perform planning optimization based on preassigned treatment modification schedule. Compared to the conventional IMRT, the adaptive treatment for h and n cancer illustrated clear dose-volume improvement for all critical normal organs. The dose-volume reductions of right and left parotid glands, spine cord, brain stem and mandible were (17 {+-} 6)%, (14 {+-} 6)%, (11 {+-} 6)%, (12 {+-} 8)%, and (5 {+-} 3)% respectively with the single adaptive modification performed after the second treatment week; (24 {+-} 6)%, (22 {+-} 8)%, (21 {+-} 5)%, (19 {+-} 8)%, and (10 {+-} 6)% with three weekly modifications; and (28 {+-} 5)%, (25 {+-} 9)%, (26 {+-} 5)%, (24 {+-} 8)%, and (15 {+-} 9)% with five weekly modifications. Conclusions

  2. Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards

    Directory of Open Access Journals (Sweden)

    Charles S. Mayo, PhD

    2017-07-01

    Conclusions: Statistical DVH offers an easy-to-read, detailed, and comprehensive way to visualize the quantitative comparison with historical experiences and among institutions. WES and GEM metrics offer a flexible means of incorporating discrete threshold-prioritizations and historic context into a set of standardized scoring metrics. Together, they provide a practical approach for incorporating big data into clinical practice for treatment plan evaluations.

  3. Retrieval with Clustering in a Case-Based Reasoning System for Radiotherapy Treatment Planning

    Science.gov (United States)

    Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

    2015-05-01

    Radiotherapy treatment planning aims to deliver a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour surrounding area. This is a trial and error process highly dependent on the medical staff's experience and knowledge. Case-Based Reasoning (CBR) is an artificial intelligence tool that uses past experiences to solve new problems. A CBR system has been developed to facilitate radiotherapy treatment planning for brain cancer. Given a new patient case the existing CBR system retrieves a similar case from an archive of successfully treated patient cases with the suggested treatment plan. The next step requires adaptation of the retrieved treatment plan to meet the specific demands of the new case. The CBR system was tested by medical physicists for the new patient cases. It was discovered that some of the retrieved cases were not suitable and could not be adapted for the new cases. This motivated us to revise the retrieval mechanism of the existing CBR system by adding a clustering stage that clusters cases based on their tumour positions. A number of well-known clustering methods were investigated and employed in the retrieval mechanism. Results using real world brain cancer patient cases have shown that the success rate of the new CBR retrieval is higher than that of the original system.

  4. Retrieval with Clustering in a Case-Based Reasoning System for Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

    2015-01-01

    Radiotherapy treatment planning aims to deliver a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour surrounding area. This is a trial and error process highly dependent on the medical staff's experience and knowledge. Case-Based Reasoning (CBR) is an artificial intelligence tool that uses past experiences to solve new problems. A CBR system has been developed to facilitate radiotherapy treatment planning for brain cancer. Given a new patient case the existing CBR system retrieves a similar case from an archive of successfully treated patient cases with the suggested treatment plan. The next step requires adaptation of the retrieved treatment plan to meet the specific demands of the new case. The CBR system was tested by medical physicists for the new patient cases. It was discovered that some of the retrieved cases were not suitable and could not be adapted for the new cases. This motivated us to revise the retrieval mechanism of the existing CBR system by adding a clustering stage that clusters cases based on their tumour positions. A number of well-known clustering methods were investigated and employed in the retrieval mechanism. Results using real world brain cancer patient cases have shown that the success rate of the new CBR retrieval is higher than that of the original system. (paper)

  5. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Williams, C; Crowley, E; Wolfgang, J

    2016-01-01

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on

  6. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Williams, C [Brigham and Women’s Hospital & Dana Farber Cancer Institute, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Crowley, E; Wolfgang, J [Harvard Medical School, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States)

    2016-06-15

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on

  7. Low Impact Development Master Plan

    Energy Technology Data Exchange (ETDEWEB)

    Loftin, Samuel R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-10-02

    This project creates a Low Impact Development (LID) Master Plan to guide and prioritize future development of LID projects at Los Alamos National Laboratory (LANL or the Laboratory). The LID Master Plan applies to developed areas across the Laboratory and focuses on identifying opportunities for storm water quality and hydrological improvements in the heavily urbanized areas of Technical Areas 03, 35 and 53. The LID Master Plan is organized to allow the addition of LID projects for other technical areas as time and funds allow in the future.

  8. 2: Local area networks as a multiprocessor treatment planning system

    International Nuclear Information System (INIS)

    Neblett, D.L.; Hogan, S.E.

    1987-01-01

    The creation of a local area network (LAN) of interconnected computers provides an environment of multi computer processors that adds a new dimension to treatment planning. A LAN system provides the opportunity to have two or more computers working on the plan in parallel. With high speed interprocessor transfer, events such as the time consuming task of correcting several individual beams for contours and inhomogeneities can be performed simultaneously; thus, effectively creating a parallel multiprocessor treatment planning system

  9. Application for verification of monitor units of the treatment planning system

    International Nuclear Information System (INIS)

    Suero Rodrigo, M. A.; Marques Fraguela, E.

    2011-01-01

    Current estimates algorithms achieve acceptable degree of accuracy. However, operate on the basis of un intuitive models. It is therefore necessary to verify the calculation of monitor units of the treatment planning system (TPS) with those obtained by other independent formalisms. To this end, we have developed an application based on factorization formalism that automates the calculation of dose.

  10. A Monte Carlo dose calculation tool for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Ma, C.-M.; Li, J.S.; Pawlicki, T.; Jiang, S.B.; Deng, J.; Lee, M.C.; Koumrian, T.; Luxton, M.; Brain, S.

    2002-01-01

    A Monte Carlo user code, MCDOSE, has been developed for radiotherapy treatment planning (RTP) dose calculations. MCDOSE is designed as a dose calculation module suitable for adaptation to host RTP systems. MCDOSE can be used for both conventional photon/electron beam calculation and intensity modulated radiotherapy (IMRT) treatment planning. MCDOSE uses a multiple-source model to reconstruct the treatment beam phase space. Based on Monte Carlo simulated or measured beam data acquired during commissioning, source-model parameters are adjusted through an automated procedure. Beam modifiers such as jaws, physical and dynamic wedges, compensators, blocks, electron cut-outs and bolus are simulated by MCDOSE together with a 3D rectilinear patient geometry model built from CT data. Dose distributions calculated using MCDOSE agreed well with those calculated by the EGS4/DOSXYZ code using different beam set-ups and beam modifiers. Heterogeneity correction factors for layered-lung or layered-bone phantoms as calculated by both codes were consistent with measured data to within 1%. The effect of energy cut-offs for particle transport was investigated. Variance reduction techniques were implemented in MCDOSE to achieve a speedup factor of 10-30 compared to DOSXYZ. (author)

  11. An inexact multi-objective programming approach for strategic environmental assessment on regional development plan

    Institute of Scientific and Technical Information of China (English)

    WANG Jihua; GUO Huaicheng; LIU Lei; HAO Mingjia; ZHANG Ming; LU Xiaojian; XING Kexia

    2004-01-01

    This paper presents the development of an inexact multi-objective programming (IMOP) model and its application to the strategic environmental assessment (SEA) for the regional development plan for the Hunnan New Zone (HNZ) in Shenyang City, China. Inexact programming and multi-objective programming methods are employed to effectively account for extensive uncertainties in the study system and to reflect various interests from different stakeholders, respectively. In the case study, balancing-economy-and-environment scenario and focusing-industry-development scenario are analyzed by the interactive solution process for addressing the preferences from local authorities and compromises among different objectives. Through interpreting the model solutions under both scenarios, analysis of industrial structure, waste water treatment plant(WWTP) expansion, water consumption and pollution generation and treatment are undertaken for providing a solid base to justify and evaluate the HNZ regional development plan. The study results show that the developed IMOP-SEA framework is feasible and applicable in carrying comprehensive environmental impact assessments for development plan in a more effective and efficient manner.

  12. A multicriteria framework with voxel-dependent parameters for radiotherapy treatment plan optimization

    International Nuclear Information System (INIS)

    Zarepisheh, Masoud; Uribe-Sanchez, Andres F.; Li, Nan; Jia, Xun; Jiang, Steve B.

    2014-01-01

    allowing for the generation of plans with better trade-offs among different clinical objectives. Conclusions: The authors have developed a mathematical framework for radiotherapy treatment optimization using voxel-based parameters. The authors can improve the plan quality by adjusting voxel-based weighting factors and exploring the unique and large Pareto surface which include all the Pareto surfaces that can be generated by organ-based model using different objective functions

  13. Patient geometry-driven information retrieval for IMRT treatment plan quality control

    International Nuclear Information System (INIS)

    Wu Binbin; Ricchetti, Francesco; Sanguineti, Giuseppe; Kazhdan, Misha; Simari, Patricio; Chuang Ming; Taylor, Russell; Jacques, Robert; McNutt, Todd

    2009-01-01

    Purpose: Intensity modulated radiation therapy (IMRT) treatment plan quality depends on the planner's level of experience and the amount of time the planner invests in developing the plan. Planners often unwittingly accept plans when further sparing of the organs at risk (OARs) is possible. The authors propose a method of IMRT treatment plan quality control that helps planners to evaluate the doses of the OARs upon completion of a new plan. Methods: It is achieved by comparing the geometric configurations of the OARs and targets of a new patient with those of prior patients, whose plans are maintained in a database. They introduce the concept of a shape relationship descriptor and, specifically, the overlap volume histogram (OVH) to describe the spatial configuration of an OAR with respect to a target. The OVH provides a way to infer the likely DVHs of the OARs by comparing the relative spatial configurations between patients. A database of prior patients is built to serve as an external reference. At the conclusion of a new plan, planners search through the database and identify related patients by comparing the OAR-target geometric relationships of the new patient with those of prior patients. The treatment plans of these related patients are retrieved from the database and guide planners in determining whether lower doses delivered to the OARs in the new plan are feasible. Results: Preliminary evaluation is promising. In this evaluation, they applied the analysis to the parotid DVHs of 32 prior head-and-neck patients, whose plans are maintained in a database. Each parotid was queried against the other 63 parotids to determine whether a lower dose was possible. The 17 parotids that promised the greatest reduction in D 50 (DVH dose at 50% volume) were flagged. These 17 parotids came from 13 patients. The method also indicated that the doses of the other nine parotids of the 13 patients could not be reduced, so they were included in the replanning process as

  14. Audit of an automated checklist for quality control of radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Breen, Stephen L.; Zhang Beibei

    2010-01-01

    Purpose: To assess the effect of adding an automated checklist to the treatment planning process for head and neck intensity-modulated radiotherapy. Methods: Plans produced within our treatment planning system were evaluated at the planners' discretion with an automated checklist of more than twenty planning parameters. Plans were rated as accepted or rejected for treatment, during regular review by radiation oncologists and physicists as part of our quality control program. The rates of errors and their types were characterised prior to the implementation of the checklist and with the checklist. Results: Without the checklist, 5.9% of plans were rejected; the use of the checklist reduced the rejection rate to 3.1%. The checklist was used for 64.7% of plans. Pareto analysis of the causes of rejection showed that the checklist reduced the number of causes of rejections from twelve to seven. Conclusions: The use of an automated checklist has reduced the need for reworking of treatment plans. With the use of the checklist, most rejections were due to errors in prescription or inadequate dose distributions. Use of the checklist by planners must be increased to maximise improvements in planning efficiency.

  15. Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

    Science.gov (United States)

    Yap, Glenn A; Platonova, Elena A; Musa, Philip F

    2006-02-01

    An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

  16. Application of super-omni wedge concept to conformal radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Dai Jianrong; Fu Weihua; Hu Yimin

    2004-01-01

    Objective: To describe a method which can optimize beam weight, wedge angle, and wedge orientation simultaneously by combining the super-omni wedge (SOW) concept with the function of beam weight optimization provided by a commercial treatment planning system. Methods: A five-step procedure including: Step 1. To set up four 60 degree nominal wedged beams for each beam direction with the wedge orientations of 'LEFT', 'IN', 'RIGHT', 'OUT', respectively; Step 2. To define an optimization request, including an optimization goal and constraints. Authors use CMS Focus treatment planning system which allows us to choose 'maximize target dose' or 'minimize critical structure dose' as the optimization goal, and to set minimum target dose, maximum target dose, and maximum average dose of critical structures as constraints. Then the optimization process was launched as step 3; Step 4. To evaluate the plan using isodose distributions and dose-volume histograms. If acceptable, go to Step 5. Otherwise, go back to Step 2 to modify optimization constraints; and Step 5. Transform the SOW beams into the beams of omni wedge so as to reduce the number of to-be-delivered beams. Results: This procedure was found being able to demonstrate successfully in two clinical cases: an esophageal carcinoma and a brain tumor. Compared with manually designed plan, the optimized plan showed better dose homogeneity in the targets and better sparing of the critical structures. Conclusions: This method described is able to optimize beam weights while working with a treatment planning system. Not only does it improve treatment plans' quality, but also shorten the treatment planning process

  17. Statistical control process to compare and rank treatment plans in radiation oncology: impact of heterogeneity correction on treatment planning in lung cancer.

    Science.gov (United States)

    Chaikh, Abdulhamid; Balosso, Jacques

    2016-12-01

    This study proposes a statistical process to compare different treatment plans issued from different irradiation techniques or different treatment phases. This approach aims to provide arguments for discussion about the impact on clinical results of any condition able to significantly alter dosimetric or ballistic related data. The principles of the statistical investigation are presented in the framework of a clinical example based on 40 fields of radiotherapy for lung cancers. Two treatment plans were generated for each patient making a change of dose distribution due to variation of lung density correction. The data from 2D gamma index (γ) including the pixels having γ≤1 were used to determine the capability index (Cp) and the acceptability index (Cpk) of the process. To measure the strength of the relationship between the γ passing rates and the Cp and Cpk indices, the Spearman's rank non-parametric test was used to calculate P values. The comparison between reference and tested plans showed that 95% of pixels have γ≤1 with criteria (6%, 6 mm). The values of the Cp and Cpk indices were lower than one showing a significant dose difference. The data showed a strong correlation between γ passing rates and the indices with P>0.8. The statistical analysis using Cp and Cpk, show the significance of dose differences resulting from two plans in radiotherapy. These indices can be used for adaptive radiotherapy to measure the difference between initial plan and daily delivered plan. The significant changes of dose distribution could raise the question about the continuity to treat the patient with the initial plan or the need for adjustments.

  18. Momentum: "Developing Masterful Marketing Plans."

    Science.gov (United States)

    Meservey, Lynne D.

    1988-01-01

    Describes how directors can plan and develop a written marketing plan which can increase enrollment at child care centers. Components of successful marketing plans include parent retention; program merchandising; staff and director training; sales promotions; networking; and enrichment programs/fundraising. (NH)

  19. Specification and acceptance testing of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    2007-04-01

    Quality assurance (QA) in the radiation therapy treatment planning process is essential to ensure accurate dose delivery to the patient and to minimize the possibility of accidental exposure. The computerized radiotherapy treatment planning systems (RTPSs) are now widely available in industrialized and developing countries and it is of special importance to support hospitals in Member States in developing procedures for acceptance testing, commissioning and QA of their RTPSs. Responding to these needs, a group of experts developed an IAEA publication with such recommendations, which was published in 2004 as IAEA Technical Reports Series No. 430. This report provides a general framework and describes a large number of tests and procedures that should be considered by the users of new RTPSs. However, small hospitals with limited resources or large hospitals with high patient load and limited staff are not always able to perform complete characterization, validation and software testing of algorithms used in RTPSs. Therefore, the IAEA proposed more specific guidelines that provide a step-by-step recommendation for users at hospitals or cancer centres how to implement acceptance and commissioning procedures for newly purchased RTPSs. The current publication was developed in the framework of the Coordinated Research Project on Development of Procedures for Quality Assurance for Dosimetry Calculations in Radiotherapy and uses the International Electrotechnical Commission (IEC) standard IEC 62083, Requirements for the Safety of Radiotherapy Treatment Planning Systems as its basis. The report addresses the procedures for specification and acceptance testing of RTPSs to be used by both manufacturers and users at the hospitals. Recommendations are provided for specific tests to be performed at the manufacturing facility known as type tests, and for acceptance tests to be performed at the hospital known as site tests. The purpose of acceptance testing is to demonstrate to the

  20. Automatic treatment planning implementation using a database of previously treated patients

    International Nuclear Information System (INIS)

    Moore, J A; Evans, K; Yang, W; Herman, J; McNutt, T

    2014-01-01

    Purpose: Using a database of prior treated patients, it is possible to predict the dose to critical structures for future patients. Automatic treatment planning speeds the planning process by generating a good initial plan from predicted dose values. Methods: A SQL relational database of previously approved treatment plans is populated via an automated export from Pinnacle 3 . This script outputs dose and machine information and selected Regions of Interests as well as its associated Dose-Volume Histogram (DVH) and Overlap Volume Histograms (OVHs) with respect to the target structures. Toxicity information is exported from Mosaiq and added to the database for each patient. The SQL query is designed to ask the system for the lowest achievable dose for a specified region of interest (ROI) for each patient with a given volume of that ROI being as close or closer to the target than the current patient. Results: The additional time needed to calculate OVHs is approximately 1.5 minutes for a typical patient. Database lookup of planning objectives takes approximately 4 seconds. The combined additional time is less than that of a typical single plan optimization (2.5 mins). Conclusions: An automatic treatment planning interface has been successfully used by dosimetrists to quickly produce a number of SBRT pancreas treatment plans. The database can be used to compare dose to individual structures with the toxicity experienced and predict toxicities before planning for future patients.

  1. Target volume delineation and treatment planning for particle therapy a practical guide

    CERN Document Server

    Leeman, Jonathan E; Cahlon, Oren; Sine, Kevin; Jiang, Guoliang; Lu, Jiade J; Both, Stefan

    2018-01-01

    This handbook is designed to enable radiation oncologists to treat patients appropriately and confidently by means of particle therapy. The orientation and purpose are entirely practical, in that the focus is on the physics essentials of delivery and treatment planning , illustration of the clinical target volume (CTV) and associated treatment planning for each major malignancy when using particle therapy, proton therapy in particular. Disease-specific chapters provide guidelines and concise knowledge on CTV selection and delineation and identify aspects that require the exercise of caution during treatment planning. The treatment planning techniques unique to proton therapy for each disease site are clearly described, covering beam orientation, matching/patching field techniques, robustness planning, robustness plan evaluation, etc. The published data on the use of particle therapy for a given disease site are also concisely reported. In addition to fully meeting the needs of radiation oncologists, this "kn...

  2. Effects of spot parameters in pencil beam scanning treatment planning.

    Science.gov (United States)

    Kraan, Aafke Christine; Depauw, Nicolas; Clasie, Ben; Giunta, Marina; Madden, Tom; Kooy, Hanne M

    2018-01-01

    Spot size σ (in air at isocenter), interspot spacing d, and spot charge q influence dose delivery efficiency and plan quality in Intensity Modulated Proton Therapy (IMPT) treatment planning. The choice and range of parameters varies among different manufacturers. The goal of this work is to demonstrate the influence of the spot parameters on dose quality and delivery in IMPT treatment plans, to show their interdependence, and to make practitioners aware of the spot parameter values for a certain facility. Our study could help as a guideline to make the trade-off between treatment quality and time in existing PBS centers and in future systems. We created plans for seven patients and a phantom, with different tumor sites and volumes, and compared the effect of small-, medium-, and large-spot widths (σ = 2.5, 5, and 10 mm) and interspot distances (1σ, 1.5σ, and 1.75σ) on dose, spot charge, and treatment time. Moreover, we quantified how postplanning charge threshold cuts affect plan quality and the total number of spots to deliver, for different spot widths and interspot distances. We show the effect of a minimum charge (or MU) cutoff value for a given proton delivery system. Spot size had a strong influence on dose: larger spots resulted in more protons delivered outside the target region. We observed dose differences of 2-13 Gy (RBE) between 2.5 mm and 10 mm spots, where the amount of extra dose was due to dose penumbra around the target region. Interspot distance had little influence on dose quality for our patient group. Both parameters strongly influence spot charge in the plans and thus the possible impact of postplanning charge threshold cuts. If such charge thresholds are not included in the treatment planning system (TPS), it is important that the practitioner validates that a given combination of lower charge threshold, interspot spacing, and spot size does not result in a plan degradation. Low average spot charge occurs for small spots, small interspot

  3. BNCT-RTPE: BNCT radiation treatment planning environment

    International Nuclear Information System (INIS)

    Wessol, D.E.; Wheeler, F.J.; Babcock, R.S.

    1995-01-01

    Several improvements have been developed for the BNCT radiation treatment planning environment (BNCT-Rtpe) during 1994. These improvements have been incorporated into Version 1.0 of BNCT-Rtpe which is currently installed at the INEL, BNL, Japanese Research Center (JRC), and Finland's Technical Research Center. Platforms supported by this software include Hewlett-Packard (HP), SUN, International Business Machines (IBM), and Silicon Graphics Incorporated (SGI). A draft version of the BNCT-Rtpe user manual is available. Version 1.1 of BNCT-Rtpe is scheduled for release in March 1995. It is anticipated that Version 2.x of BNCT-Rtpe, which includes the nonproprietary NURBS library and data structures, will be released in September 1995

  4. Trust, but verify - Accuracy of clinical commercial radiation Treatment Planning Systems

    Science.gov (United States)

    Lehmann, J.; Kenny, J.; Lye, J.; Dunn, L.; Williams, I.

    2014-03-01

    Computer based Treatment Planning Systems (TPS) are used worldwide to design and calculate treatment plans for treating radiation therapy patients. TPS are generally well designed and thoroughly tested by their developers and local physicists prior to clinical use. However, the wide-reaching impact of their accuracy warrants ongoing vigilance. This work reviews the findings of the Australian national audit system and provides recommendations for checks of TPS. The Australian Clinical Dosimetry Service (ACDS) has designed and implemented a national system of audits, currently in a three year test phase. The Level III audits verify the accuracy of a beam model of a facility's TPS through a comparison of measurements with calculation at selected points in an anthropomorphic phantom. The plans are prescribed by the ACDS and all measurement equipment is brought in for independent onsite measurements. In this first version of audits, plans are comparatively simple, involving asymmetric fields, wedges and inhomogeneities. The ACDS has performed 14 Level III audits to-date. Six audits returned at least one measurement at Action Level, indicating that the measured dose differed more than 3.3% (but less than 5%) from the planned dose. Two audits failed (difference >5%). One fail was caused by a data transmission error coupled with quality assurance (QA) not being performed. The second fail was investigated and reduced to Action Level with the onsite audit team finding phantom setup at treatment a contributing factor. The Action Level results are attributed to small dose calculation deviations within the TPS, which are investigated and corrected by the facilities. Small deviations exist in clinical TPS which can add up and can combine with output variations to result in unacceptable variations. Ongoing checks and independent audits are recommended.

  5. Plutonium Finishing Plan (PFP) Treatment and Storage Unit Interim Status Closure Plan

    International Nuclear Information System (INIS)

    PRIGNANO, A.L.

    2000-01-01

    This document describes the planned activities and performance standards for closing the Plutonium Finishing Plant (PFP) Treatment and Storage Unit. The PFP Treatment and Storage Unit is located within the 234-52 Building in the 200 West Area of the Hanford Facility. Although this document is prepared based upon Title 40 Code of Federal Regulations (CFR), Part 265, Subpart G requirements, closure of the unit will comply with Washington Administrative Code (WAC) 173-303-610 regulations pursuant to Section 5.3 of the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Action Plan (Ecology et al. 1996). Because the PFP Treatment and Storage Unit manages transuranic mixed (TRUM) waste, there are many controls placed on management of the waste. Based on the many controls placed on management of TRUM waste, releases of TRUM waste are not anticipated to occur in the PFP Treatment and Storage Unit. Because the intention is to clean close the PFP Treatment and Storage Unit, postclosure activities are not applicable to this closure plan. To clean close the unit, it will be demonstrated that dangerous waste has not been left onsite at levels above the closure performance standard for removal and decontamination. If it is determined that clean closure is not possible or is environmentally impractical, the closure plan will be modified to address required postclosure activities. The PFP Treatment and Storage Unit will be operated to immobilize and/or repackage plutonium-bearing waste in a glovebox process. The waste to be processed is in a solid physical state (chunks and coarse powder) and will be sealed into and out of the glovebox in closed containers. The containers of immobilized waste will be stored in the glovebox and in additional permitted storage locations at PFP. The waste will be managed to minimize the potential for spills outside the glovebox, and to preclude spills from reaching soil. Containment surfaces will be maintained to ensure

  6. SU-E-T-512: Evaluation of Treatment Planning Dose Calculation Accuracy at the Interface of Prosthetic Devices.

    Science.gov (United States)

    Paulu, D; Alaei, P

    2012-06-01

    To evaluate the ability of treatment planning algorithm to accurately predict dose delivered at the interface of high density implanted devices. A high density (7.6 g/cc) Cobalt-Chromium-Molybdenum hip prosthesis was molded into an epoxy-based cylindrical leg phantom. The phantom was designed to be separated in half to access the prosthesis and to place the TLDs. Using MVCT to image the apparatus, a simple treatment plan was developed using the Philips Pinnacle treatment planning system. Wires were placed in the molded epoxy to allow for accurate definition of measurement sites (TLD positions) along the surface of the prosthesis. Micro-cube TLDs (1 mm 3 ) were placed at six measurement locations for which the dose had been calculated by the treatment planning system. An Elekta Synergy linear accelerator was used to deliver a 400 cGy plan to the phantom with 6 MV photons in a single fraction. A total of four 10 cm × 21 cm fields were used at 0, 90, 180, and 270 degree gantry rotations. Initial results indicate that the measured dose is 7-17% lower than the dose calculated by the treatment planning system. Further study using high energy beams are also in progress. Initial results indicate that the treatment planning system does predict the dose near a high density prosthetic device within 10-15% but underestimates the dose. The results of this study could help in designing treatment plans which would reduce the uncertainty of the dose delivered in the vicinity of prosthetic hip implants and similar devices. © 2012 American Association of Physicists in Medicine.

  7. Treatment planning for prostate brachytherapy using region of interest adjoint functions and a greedy heuristic

    International Nuclear Information System (INIS)

    Yoo, Sua; Kowalok, Michael E; Thomadsen, Bruce R; Henderson, Douglass L

    2003-01-01

    We have developed an efficient treatment-planning algorithm for prostate implants that is based on region of interest (ROI) adjoint functions and a greedy heuristic. For this work, we define the adjoint function for an ROI as the sensitivity of the average dose in the ROI to a unit-strength brachytherapy source at any seed position. The greedy heuristic uses a ratio of target and critical structure adjoint functions to rank seed positions according to their ability to irradiate the target ROI while sparing critical structure ROIs. This ratio is computed once for each seed position prior to the optimization process. Optimization is performed by a greedy heuristic that selects seed positions according to their ratio values. With this method, clinically acceptable treatment plans are obtained in less than 2 s. For comparison, a branch-and-bound method to solve a mixed integer-programming model took more than 50 min to arrive at a feasible solution. Both methods achieved good treatment plans, but the speedup provided by the greedy heuristic was a factor of approximately 1500. This attribute makes this algorithm suitable for intra-operative real-time treatment planning

  8. Software to support planning for future waste treatment, storage, transport, and disposal requirements

    International Nuclear Information System (INIS)

    Holter, G.M.; Shay, M.R.; Stiles, D.L.

    1990-04-01

    Planning for adequate and appropriate treatment, storage, transport and disposal of wastes to be generated or received in the future is a complex but critical task that can be significantly enhanced by the development and use of appropriate software. This paper describes a software system that has been developed at Pacific Northwest Laboratory to aid in such planning. The basic needs for such a system are outlined, and the approach adopted in developing the software is described. The individual components of the system, and their integration into a unified system, are discussed. Typical analytical applications of this type of software are summarized. Conclusions concerning the development of such software systems and the necessary supporting data are then presented. 2 figs

  9. Helical Tomotherapy-Based STAT Stereotactic Body Radiation Therapy: Dosimetric Evaluation for a Real-Time SBRT Treatment Planning and Delivery Program

    International Nuclear Information System (INIS)

    Dunlap, Neal; McIntosh, Alyson; Sheng Ke; Yang Wensha; Turner, Benton; Shoushtari, Asal; Sheehan, Jason; Jones, David R.; Lu Weigo; Ruchala, Keneth; Olivera, Gustavo; Parnell, Donald; Larner, James L.; Benedict, Stanley H.; Read, Paul W.

    2010-01-01

    Stereotactic body radiation therapy (SBRT) treatments have high-dose gradients and even slight patient misalignment from the simulation to treatment could lead to target underdosing or organ at risk (OAR) overdosing. Daily real-time SBRT treatment planning could minimize the risk of geographic miss. As an initial step toward determining the clinical feasibility of developing real-time SBRT treatment planning, we determined the calculation time of helical TomoTherapy-based STAT radiation therapy (RT) treatment plans for simple liver, lung, and spine SBRT treatments to assess whether the planning process was fast enough for practical clinical implementation. Representative SBRT planning target volumes for hypothetical liver, peripheral lung, and thoracic spine lesions and adjacent OARs were contoured onto a planning computed tomography scan (CT) of an anthropomorphic phantom. Treatment plans were generated using both STAT RT 'full scatter' and conventional helical TomoTherapy 'beamlet' algorithms. Optimized plans were compared with respect to conformality index (CI), heterogeneity index (HI), and maximum dose to regional OARs to determine clinical equivalence and the number of required STAT RT optimization iterations and calculation times were determined. The liver and lung dosimetry for the STAT RT and standard planning algorithms were clinically and statistically equivalent. For the liver lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.04 and 1.04 and HI of 1.03 and 1.03, respectively. For the lung lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.05 and 1.03 and HI of 1.05and 1.05, respectively. For spine lesions, 'full scatter' and 'beamlet' algorithms showed a CI of 1.15 and 1.14 and HI of 1.22 and 1.14, respectively. There was no difference between treatment algorithms with respect to maximum doses to the OARs. The STAT RT iteration time with current treatment planning systems is 45 sec, and the treatment planning required 3

  10. Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle{sup 3} scripting and Auto-Planning functions

    Energy Technology Data Exchange (ETDEWEB)

    Speer, Stefan; Weiss, Alexander; Bert, Christoph [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Erlangen (Germany); Klein, Andreas [EKS Engineering GmbH, Fuerth (Germany); Kober, Lukas [Strahlentherapie Tauber-Franken, Bad Mergentheim (Germany); Yohannes, Indra [Rinecker Proton Therapy Center, Munich (Germany)

    2017-08-15

    Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle{sup 3} treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced. (orig.) [German] Intensitaetsmodulierte Strahlentherapie (IMRT) hat sich als Standard durchgesetzt. Mit IMRT oder volumenmodulierter Arc-Therapie (VMAT) lassen sich

  11. Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

    International Nuclear Information System (INIS)

    Purdie, Thomas G.; Dinniwell, Robert E.; Fyles, Anthony; Sharpe, Michael B.

    2014-01-01

    Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented

  12. SU-F-SPS-10: The Dosimetric Comparison of GammaKnife and Cyberknife Treatment Plans for Brain SRS Treatment

    International Nuclear Information System (INIS)

    Sanli, E; Mabhouti, H; Cebe, M; Codel, G; Pacaci, P; Serin, E; Kucuk, N; Kucukmorkoc, E; Doyuran, M; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H

    2016-01-01

    Purpose: Brain stereotactic radiosurgery (SRS) involves the use of precisely directed, single session radiation to create a desired radiobiologic response within the brain target with acceptable minimal effects on surrounding structures or tissues. In this study, the dosimetric comparison of GammaKnife perfection and Cyberknife M6 treatment plans were made. Methods: Treatment plannings were done for GammaKnife perfection unit using Gammaplan treatment planning system (TPS) on the CT scan of head and neck randophantom simulating the treatment of sterotactic treatments for one brain metastasis. The dose distribution were calculated using TMR 10 algorithm. The treatment planning for the same target were also done for Cyberknife M6 machine using Multiplan (TPS) with Monte Carlo algorithm. Using the same film batch, the net OD to dose calibration curve was obtained using both machine by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. Dose distribution were measured using EBT3 film dosimeter. The measured and calculated doses were compared. Results: The dose distribution in the target and 2 cm beyond the target edge were calculated on TPSs and measured using EBT3 film. For cyberknife treatment plans, the gamma analysis passing rates between measured and calculated dose distributions were 99.2% and 96.7% for target and peripheral region of target respectively. For gammaknife treatment plans, the gamma analysis passing rates were 98.9% and 93.2% for target and peripheral region of target respectively. Conclusion: The study shows that dosimetrically comparable plans are achievable with Cyberknife and GammaKnife. Although TMR 10 algorithm predicts the target dose

  13. SU-F-SPS-10: The Dosimetric Comparison of GammaKnife and Cyberknife Treatment Plans for Brain SRS Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Sanli, E; Mabhouti, H; Cebe, M; Codel, G; Pacaci, P; Serin, E; Kucuk, N; Kucukmorkoc, E; Doyuran, M; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H [Medipol University, Istanbul, Istanbul (Turkey)

    2016-06-15

    Purpose: Brain stereotactic radiosurgery (SRS) involves the use of precisely directed, single session radiation to create a desired radiobiologic response within the brain target with acceptable minimal effects on surrounding structures or tissues. In this study, the dosimetric comparison of GammaKnife perfection and Cyberknife M6 treatment plans were made. Methods: Treatment plannings were done for GammaKnife perfection unit using Gammaplan treatment planning system (TPS) on the CT scan of head and neck randophantom simulating the treatment of sterotactic treatments for one brain metastasis. The dose distribution were calculated using TMR 10 algorithm. The treatment planning for the same target were also done for Cyberknife M6 machine using Multiplan (TPS) with Monte Carlo algorithm. Using the same film batch, the net OD to dose calibration curve was obtained using both machine by delivering 0- 800 cGy. Films were scanned 48 hours after irradiation using an Epson 1000XL flatbed scanner. Dose distribution were measured using EBT3 film dosimeter. The measured and calculated doses were compared. Results: The dose distribution in the target and 2 cm beyond the target edge were calculated on TPSs and measured using EBT3 film. For cyberknife treatment plans, the gamma analysis passing rates between measured and calculated dose distributions were 99.2% and 96.7% for target and peripheral region of target respectively. For gammaknife treatment plans, the gamma analysis passing rates were 98.9% and 93.2% for target and peripheral region of target respectively. Conclusion: The study shows that dosimetrically comparable plans are achievable with Cyberknife and GammaKnife. Although TMR 10 algorithm predicts the target dose.

  14. Treatment planning with intensity modulated particle therapy for multiple targets in stage IV non-small cell lung cancer

    Science.gov (United States)

    Anderle, Kristjan; Stroom, Joep; Vieira, Sandra; Pimentel, Nuno; Greco, Carlo; Durante, Marco; Graeff, Christian

    2018-01-01

    Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios. The results from our algorithm were compared to clinical stereotactic body radiation treatment (SBRT) plans. The study included eight patients with 24 lesions in total. Intended dose regimen for SBRT was 24 Gy in one fraction, but lower fractionated doses had to be delivered in three cases due to OAR constraints or failed plan quality assurance. The resulting IMPT treatment plans had no significant difference in target coverage compared to SBRT treatment plans. Average maximum point dose and dose to specific volume in OARs were on average 65% and 22% smaller with IMPT. IMPT could also deliver 24 Gy in one fraction in a patient where SBRT was limited due to the OAR vicinity. The developed algorithm shows the potential of IMPT in treatment of multiple moving targets in a complex geometry.

  15. Feasibility of Proton Beam Therapy for Ocular Melanoma Using a Novel 3D Treatment Planning Technique

    Energy Technology Data Exchange (ETDEWEB)

    Hartsell, William F., E-mail: whartsell@chicagocancer.org [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Kapur, Rashmi [Retina Consultants, Des Plaines, Illinois (United States); Hartsell, Siobhan O' Connor; Sweeney, Patrick [Northwestern Medicine Chicago Proton Center, Warrenville, Illinois (United States); Lopes, Caitlin [Rush Medical College, Chicago, Illinois (United States); Duggal, Amanda [Northwestern Medicine Chicago Proton Center, Warrenville, Illinois (United States); Cohen, Jack [Department of Ophthalmology, Rush University, Chicago, Illinois (United States); Chang, John [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Polasani, Rajeev S. [Northwestern Medicine Central DuPage Hospital, Winfield, Illinois (United States); Dunn, Megan [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Pankuch, Mark [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States)

    2016-05-01

    Purpose: We evaluated sparing of normal structures using 3-dimensional (3D) treatment planning for proton therapy of ocular melanomas. Methods and Materials: We evaluated 26 consecutive patients with choroidal melanomas on a prospective registry. Ophthalmologic work-up included fundoscopic photographs, fluorescein angiography, ultrasonographic evaluation of tumor dimensions, and magnetic resonance imaging of orbits. Three tantalum clips were placed as fiducial markers to confirm eye position for treatment. Macula, fovea, optic disc, optic nerve, ciliary body, lacrimal gland, lens, and gross tumor volume were contoured on treatment planning compute tomography scans. 3D treatment planning was performed using noncoplanar field arrangements. Patients were typically treated with 3 fields, with at least 95% of planning target volume receiving 50 GyRBE in 5 fractions. Results: Tumor stage was T1a in 10 patients, T2a in 10 patients, T2b in 1 patient, T3a in 2 patients, T3b in 1 patient, and T4a in 2 patients. Acute toxicity was mild. All patients completed treatment as planned. Mean optic nerve dose was 10.1 Gy relative biological effectiveness (RBE). Ciliary body doses were higher for nasal (mean: 11.4 GyRBE) than temporal tumors (5.8 GyRBE). Median follow-up was 31 months (range: 18-40 months). Six patients developed changes which required intraocular bevacizumab or corticosteroid therapy, but only 1 patient developed neovascular glaucoma. Five patients have since died: 1 from metastatic disease and 4 from other causes. Two patients have since required enucleation: 1 due to tumor and 1 due to neovascular glaucoma. Conclusions: 3D treatment planning can be used to obtain appropriate coverage of choroidal melanomas. This technique is feasible with relatively low doses to anterior structures, and appears to have acceptable rates of local control with low risk of enucleation. Further evaluation and follow-up is needed to determine optimal dose-volume relationships for

  16. Feasibility of Proton Beam Therapy for Ocular Melanoma Using a Novel 3D Treatment Planning Technique

    International Nuclear Information System (INIS)

    Hartsell, William F.; Kapur, Rashmi; Hartsell, Siobhan O'Connor; Sweeney, Patrick; Lopes, Caitlin; Duggal, Amanda; Cohen, Jack; Chang, John; Polasani, Rajeev S.; Dunn, Megan; Pankuch, Mark

    2016-01-01

    Purpose: We evaluated sparing of normal structures using 3-dimensional (3D) treatment planning for proton therapy of ocular melanomas. Methods and Materials: We evaluated 26 consecutive patients with choroidal melanomas on a prospective registry. Ophthalmologic work-up included fundoscopic photographs, fluorescein angiography, ultrasonographic evaluation of tumor dimensions, and magnetic resonance imaging of orbits. Three tantalum clips were placed as fiducial markers to confirm eye position for treatment. Macula, fovea, optic disc, optic nerve, ciliary body, lacrimal gland, lens, and gross tumor volume were contoured on treatment planning compute tomography scans. 3D treatment planning was performed using noncoplanar field arrangements. Patients were typically treated with 3 fields, with at least 95% of planning target volume receiving 50 GyRBE in 5 fractions. Results: Tumor stage was T1a in 10 patients, T2a in 10 patients, T2b in 1 patient, T3a in 2 patients, T3b in 1 patient, and T4a in 2 patients. Acute toxicity was mild. All patients completed treatment as planned. Mean optic nerve dose was 10.1 Gy relative biological effectiveness (RBE). Ciliary body doses were higher for nasal (mean: 11.4 GyRBE) than temporal tumors (5.8 GyRBE). Median follow-up was 31 months (range: 18-40 months). Six patients developed changes which required intraocular bevacizumab or corticosteroid therapy, but only 1 patient developed neovascular glaucoma. Five patients have since died: 1 from metastatic disease and 4 from other causes. Two patients have since required enucleation: 1 due to tumor and 1 due to neovascular glaucoma. Conclusions: 3D treatment planning can be used to obtain appropriate coverage of choroidal melanomas. This technique is feasible with relatively low doses to anterior structures, and appears to have acceptable rates of local control with low risk of enucleation. Further evaluation and follow-up is needed to determine optimal dose-volume relationships for

  17. SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Y; Tan, J; Jiang, S; Albuquerque, K; Jia, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this system for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.

  18. SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

    International Nuclear Information System (INIS)

    Zhou, Y; Tan, J; Jiang, S; Albuquerque, K; Jia, X

    2016-01-01

    Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this system for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.

  19. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study

    International Nuclear Information System (INIS)

    Kline, Robert W.; Smith, Alfred R.; Coia, Lawrence R.; Owen, Jean B.; Hanlon, Alexandra; Wallace, Marsha; Hanks, Gerald

    1997-01-01

    Purpose: To conduct a study of the process of treatment planning and treatment of adenocarcinoma of the rectum and sigmoid in the United States, and to compare survey results to consensus guidelines. Methods and Materials: A consensus committee developed guidelines for the radiotherapeutic management of adenocarcinoma of the rectum and sigmoid, and also developed a survey form that was used to gather data to evaluate the practice patterns for patients treated in 1989 and 1990 against the consensus guidelines. Seventy-three facilities were randomly selected for site visits from the 1321 radiation therapy facilities in the US: 21 academic, 26 hospital based, and 26 free standing. During the site visits, the radiotherapy records were examined by the surveyor physicist and radiation oncologist to extract and record the required data. Data collected included items related to treatment specific parameters, including treatment planning considerations. Analyses included stratification as to the types of institutions, academic, hospital based, or free standing. Results: For many treatment parameters there are discrepancies between the patterns of practice determined by the surveys and the consensus guidelines for radiotherapy treatment of adenocarcinoma of the rectum and sigmoid. Significant differences in practice among the stratified institution types were found in only a few parameters

  20. Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

    International Nuclear Information System (INIS)

    Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

    2011-01-01

    Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

  1. WE-F-BRB-02: Setting the Stage for Incorporation of Toxicity Measures in Treatment Plan Assessments

    International Nuclear Information System (INIS)

    Mayo, C.

    2015-01-01

    Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

  2. Virtual reality image applications for treatment planning in prosthodontic dentistry.

    Science.gov (United States)

    Ogawa, Takumi; Ikawa, Tomoko; Shigeta, Yuko; Kasama, Shintaro; Ando, Eriko; Fukushima, Shunji; Hattori, Asaki; Suzuki, Naoki

    2011-01-01

    For successful occlusal reconstruction, the prosthodontists must take several points into consideration, such as those involving issues with functional and morphological findings and aesthetics. They then must unify this information into a coherent treatment plan. In this present study we focused on prosthodontic treatment and investigated how treatment planning and simulation could be applied to two cases. The personal occlusion condition can be reproduced on the virtual articulator in VR space. In addition, various simulations can be performed that involve prosthetesis design.

  3. Personalized Monte Carlo dosimetry for the planning and evaluation of internal radiotherapy treatments: development and application to selective internal radiotherapy (SIRT)

    International Nuclear Information System (INIS)

    Petitguillaume, Alice

    2014-01-01

    Medical techniques in full expansion arousing high therapeutic expectations, targeted radionuclide therapies (TRT) consist of administering a radiopharmaceutical to selectively treat tumors. Nowadays, the activity injected to the patient is generally standardized. However, in order to establish robust dose-effect relationships and to optimize treatments while sparing healthy tissues at best, a personalized dosimetry must be performed, just like actual clinical practice in external beam radiotherapy. In that context, this PhD main objective was to develop, using the OEDIPE software, a methodology for personalized dosimetry based on direct Monte Carlo calculations. The developed method enables to calculate the tridimensional distribution of absorbed doses depending on the patient anatomy, defined from CT or MRI data, and on the patient-specific activity biodistribution, defined from SPECT or PET data. Radiobiological aspects, such as differences in radiosensitivities and repair time constants between tumoral and healthy tissues, have also been integrated through the linear-quadratic model. This methodology has been applied to the selective internal radiation therapy (SIRT) which consists in the injection of 90 Y-microspheres to selectively treat unresectable hepatic cancers. Distributions of absorbed doses and biologically effective doses (BED) along with the equivalent uniform biologically effective doses (EUD) to hepatic lesions have been calculated from 99m Tc-MAA activity distributions obtained during the evaluation step for 18 patients treated at Hopital Europeen Georges Pompidou. Those results have been compared to classical methods used in clinics and the interest of accurate and personalized dosimetry for treatment planning has been investigated. On the one hand, the possibility to increase the activity in a personalized way has been highlighted with the calculation of the maximal activity that could be injected to the patient while meeting tolerance criteria

  4. Multi-institutional comparison of simulated treatment delivery errors in ssIMRT, manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

    DEFF Research Database (Denmark)

    Pogson, Elise M; Aruguman, Sankar; Hansen, Christian R

    2017-01-01

    PURPOSE: To quantify the impact of simulated errors for nasopharynx radiotherapy across multiple institutions and planning techniques (auto-plan generated Volumetric Modulated Arc Therapy (ap-VMAT), manually planned VMAT (mp-VMAT) and manually planned step and shoot Intensity Modulated Radiation...... Therapy (mp-ssIMRT)). METHODS: Ten patients were retrospectively planned with VMAT according to three institution's protocols. Within one institution two further treatment plans were generated using differing treatment planning techniques. This resulted in mp-ssIMRT, mp-VMAT, and ap-VMAT plans. Introduced...

  5. 3D Computer aided treatment planning in endodontics.

    Science.gov (United States)

    van der Meer, Wicher J; Vissink, Arjan; Ng, Yuan Ling; Gulabivala, Kishor

    2016-02-01

    Obliteration of the root canal system due to accelerated dentinogenesis and dystrophic calcification can challenge the achievement of root canal treatment goals. This paper describes the application of 3D digital mapping technology for predictable navigation of obliterated canal systems during root canal treatment to avoid iatrogenic damage of the root. Digital endodontic treatment planning for anterior teeth with severely obliterated root canal systems was accomplished with the aid of computer software, based on cone beam computer tomography (CBCT) scans and intra-oral scans of the dentition. On the basis of these scans, endodontic guides were created for the planned treatment through digital designing and rapid prototyping fabrication. The custom-made guides allowed for an uncomplicated and predictable canal location and management. The method of digital designing and rapid prototyping of endodontic guides allows for reliable and predictable location of root canals of teeth with calcifically metamorphosed root canal systems. The endodontic directional guide facilitates difficult endodontic treatments at little additional cost. Copyright © 2016. Published by Elsevier Ltd.

  6. Development and evaluation of a clinical model for lung cancer patients using stereotactic body radiotherapy (SBRT) within a knowledge-based algorithm for treatment planning.

    Science.gov (United States)

    Chin Snyder, Karen; Kim, Jinkoo; Reding, Anne; Fraser, Corey; Gordon, James; Ajlouni, Munther; Movsas, Benjamin; Chetty, Indrin J

    2016-11-08

    The purpose of this study was to describe the development of a clinical model for lung cancer patients treated with stereotactic body radiotherapy (SBRT) within a knowledge-based algorithm for treatment planning, and to evaluate the model performance and applicability to different planning techniques, tumor locations, and beam arrangements. 105 SBRT plans for lung cancer patients previously treated at our institution were included in the development of the knowledge-based model (KBM). The KBM was trained with a combination of IMRT, VMAT, and 3D CRT techniques. Model performance was validated with 25 cases, for both IMRT and VMAT. The full KBM encompassed lesions located centrally vs. peripherally (43:62), upper vs. lower (62:43), and anterior vs. posterior (60:45). Four separate sub-KBMs were created based on tumor location. Results were compared with the full KBM to evaluate its robustness. Beam templates were used in conjunction with the optimizer to evaluate the model's ability to handle suboptimal beam placements. Dose differences to organs-at-risk (OAR) were evaluated between the plans gener-ated by each KBM. Knowledge-based plans (KBPs) were comparable to clinical plans with respect to target conformity and OAR doses. The KBPs resulted in a lower maximum spinal cord dose by 1.0 ± 1.6 Gy compared to clinical plans, p = 0.007. Sub-KBMs split according to tumor location did not produce significantly better DVH estimates compared to the full KBM. For central lesions, compared to the full KBM, the peripheral sub-KBM resulted in lower dose to 0.035 cc and 5 cc of the esophagus, both by 0.4Gy ± 0.8Gy, p = 0.025. For all lesions, compared to the full KBM, the posterior sub-KBM resulted in higher dose to 0.035 cc, 0.35 cc, and 1.2 cc of the spinal cord by 0.2 ± 0.4Gy, p = 0.01. Plans using template beam arrangements met target and OAR criteria, with an increase noted in maximum heart dose (1.2 ± 2.2Gy, p = 0.01) and GI (0.2 ± 0.4, p = 0.01) for the nine

  7. Computer-aided beam arrangement based on similar cases in radiation treatment-planning databases for stereotactic lung radiation therapy

    International Nuclear Information System (INIS)

    Magome, Taiki; Shioyama, Yoshiyuki; Arimura, Hidetaka

    2013-01-01

    The purpose of this study was to develop a computer-aided method for determination of beam arrangements based on similar cases in a radiotherapy treatment-planning database for stereotactic lung radiation therapy. Similar-case-based beam arrangements were automatically determined based on the following two steps. First, the five most similar cases were searched, based on geometrical features related to the location, size and shape of the planning target volume, lung and spinal cord. Second, five beam arrangements of an objective case were automatically determined by registering five similar cases with the objective case, with respect to lung regions, by means of a linear registration technique. For evaluation of the beam arrangements five treatment plans were manually created by applying the beam arrangements determined in the second step to the objective case. The most usable beam arrangement was selected by sorting the five treatment plans based on eight plan evaluation indices, including the D95, mean lung dose and spinal cord maximum dose. We applied the proposed method to 10 test cases, by using an RTP database of 81 cases with lung cancer, and compared the eight plan evaluation indices between the original treatment plan and the corresponding most usable similar-case-based treatment plan. As a result, the proposed method may provide usable beam arrangements, which have no statistically significant differences from the original beam arrangements (P>0.05) in terms of the eight plan evaluation indices. Therefore, the proposed method could be employed as an educational tool for less experienced treatment planners. (author)

  8. Electron Density Calibration for Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Herrera-Martinez, F.; Rodriguez-Villafuerte, M.; Martinez-Davalos, A.; Ruiz-Trejo, C.; Celis-Lopez, M. A.; Larraga-Gutierrez, J. M.; Garcia-Garduno, A.

    2006-01-01

    Computed tomography (CT) images are used as basic input data for most modern radiosurgery treatment planning systems (TPS). CT data not only provide anatomic information to delineate target volumes, but also allow the introduction of corrections for tissue inhomogeneities into dose calculations during the treatment planning procedure. These corrections involve the determination of a relationship between tissue electron density (ρe) and their corresponding Hounsfield Units (HU). In this work, an elemental analysis of different commercial tissue equivalent materials using Scanning Electron Microscopy was carried out to characterize their chemical composition. The tissue equivalent materials were chosen to ensure a large range of ρe to be included in the CT scanner calibration. A phantom was designed and constructed with these materials to simulate the size of a human head

  9. A non-voxel-based broad-beam (NVBB) framework for IMRT treatment planning.

    Science.gov (United States)

    Lu, Weiguo

    2010-12-07

    We present a novel framework that enables very large scale intensity-modulated radiation therapy (IMRT) planning in limited computation resources with improvements in cost, plan quality and planning throughput. Current IMRT optimization uses a voxel-based beamlet superposition (VBS) framework that requires pre-calculation and storage of a large amount of beamlet data, resulting in large temporal and spatial complexity. We developed a non-voxel-based broad-beam (NVBB) framework for IMRT capable of direct treatment parameter optimization (DTPO). In this framework, both objective function and derivative are evaluated based on the continuous viewpoint, abandoning 'voxel' and 'beamlet' representations. Thus pre-calculation and storage of beamlets are no longer needed. The NVBB framework has linear complexities (O(N(3))) in both space and time. The low memory, full computation and data parallelization nature of the framework render its efficient implementation on the graphic processing unit (GPU). We implemented the NVBB framework and incorporated it with the TomoTherapy treatment planning system (TPS). The new TPS runs on a single workstation with one GPU card (NVBB-GPU). Extensive verification/validation tests were performed in house and via third parties. Benchmarks on dose accuracy, plan quality and throughput were compared with the commercial TomoTherapy TPS that is based on the VBS framework and uses a computer cluster with 14 nodes (VBS-cluster). For all tests, the dose accuracy of these two TPSs is comparable (within 1%). Plan qualities were comparable with no clinically significant difference for most cases except that superior target uniformity was seen in the NVBB-GPU for some cases. However, the planning time using the NVBB-GPU was reduced many folds over the VBS-cluster. In conclusion, we developed a novel NVBB framework for IMRT optimization. The continuous viewpoint and DTPO nature of the algorithm eliminate the need for beamlets and lead to better plan

  10. A non-voxel-based broad-beam (NVBB) framework for IMRT treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Lu Weiguo, E-mail: wlu@tomotherapy.co [TomoTherapy Inc., 1240 Deming Way, Madison, WI 53717 (United States)

    2010-12-07

    We present a novel framework that enables very large scale intensity-modulated radiation therapy (IMRT) planning in limited computation resources with improvements in cost, plan quality and planning throughput. Current IMRT optimization uses a voxel-based beamlet superposition (VBS) framework that requires pre-calculation and storage of a large amount of beamlet data, resulting in large temporal and spatial complexity. We developed a non-voxel-based broad-beam (NVBB) framework for IMRT capable of direct treatment parameter optimization (DTPO). In this framework, both objective function and derivative are evaluated based on the continuous viewpoint, abandoning 'voxel' and 'beamlet' representations. Thus pre-calculation and storage of beamlets are no longer needed. The NVBB framework has linear complexities (O(N{sup 3})) in both space and time. The low memory, full computation and data parallelization nature of the framework render its efficient implementation on the graphic processing unit (GPU). We implemented the NVBB framework and incorporated it with the TomoTherapy treatment planning system (TPS). The new TPS runs on a single workstation with one GPU card (NVBB-GPU). Extensive verification/validation tests were performed in house and via third parties. Benchmarks on dose accuracy, plan quality and throughput were compared with the commercial TomoTherapy TPS that is based on the VBS framework and uses a computer cluster with 14 nodes (VBS-cluster). For all tests, the dose accuracy of these two TPSs is comparable (within 1%). Plan qualities were comparable with no clinically significant difference for most cases except that superior target uniformity was seen in the NVBB-GPU for some cases. However, the planning time using the NVBB-GPU was reduced many folds over the VBS-cluster. In conclusion, we developed a novel NVBB framework for IMRT optimization. The continuous viewpoint and DTPO nature of the algorithm eliminate the need for beamlets

  11. Orthognathic Surgery: Planning and treatment with illustration on six cases

    International Nuclear Information System (INIS)

    AiRuhaimi, K; Nwoku, A. L; Shaikh, H. S

    1991-01-01

    Almost all conferences for plastic and maxillofacial surgery discuss reports on several methods of orthognathic surgery, planning, success results, and complications of the different procedures carried out to correct patient's soft and hard tissues frontal profiles and occlusal discrepancies. Various principles are involved in the diagnosis and treatment of facial deformities. However, the most important consideration, after all, is the final accepted aesthetic and functional requirements and stability of the moved segments. The objective of this paper is to give the basic principles of treatment planning for correcting facial discrepancies, surgical approach to different cases, and the methods to increase stability of the moved segments. Six cases are included to illustrate the different aspects of treatment planning, surgical management, and stabilization methods. (author)

  12. Evaluation of a Machine-Learning Algorithm for Treatment Planning in Prostate Low-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nicolae, Alexandru [Department of Physics, Ryerson University, Toronto, Ontario (Canada); Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Morton, Gerard; Chung, Hans; Loblaw, Andrew [Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Jain, Suneil; Mitchell, Darren [Department of Clinical Oncology, The Northern Ireland Cancer Centre, Belfast City Hospital, Antrim, Northern Ireland (United Kingdom); Lu, Lin [Department of Radiation Therapy, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Helou, Joelle; Al-Hanaqta, Motasem [Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Heath, Emily [Department of Physics, Carleton University, Ottawa, Ontario (Canada); Ravi, Ananth, E-mail: ananth.ravi@sunnybrook.ca [Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)

    2017-03-15

    Purpose: This work presents the application of a machine learning (ML) algorithm to automatically generate high-quality, prostate low-dose-rate (LDR) brachytherapy treatment plans. The ML algorithm can mimic characteristics of preoperative treatment plans deemed clinically acceptable by brachytherapists. The planning efficiency, dosimetry, and quality (as assessed by experts) of preoperative plans generated with an ML planning approach was retrospectively evaluated in this study. Methods and Materials: Preimplantation and postimplantation treatment plans were extracted from 100 high-quality LDR treatments and stored within a training database. The ML training algorithm matches similar features from a new LDR case to those within the training database to rapidly obtain an initial seed distribution; plans were then further fine-tuned using stochastic optimization. Preimplantation treatment plans generated by the ML algorithm were compared with brachytherapist (BT) treatment plans in terms of planning time (Wilcoxon rank sum, α = 0.05) and dosimetry (1-way analysis of variance, α = 0.05). Qualitative preimplantation plan quality was evaluated by expert LDR radiation oncologists using a Likert scale questionnaire. Results: The average planning time for the ML approach was 0.84 ± 0.57 minutes, compared with 17.88 ± 8.76 minutes for the expert planner (P=.020). Preimplantation plans were dosimetrically equivalent to the BT plans; the average prostate V150% was 4% lower for ML plans (P=.002), although the difference was not clinically significant. Respondents ranked the ML-generated plans as equivalent to expert BT treatment plans in terms of target coverage, normal tissue avoidance, implant confidence, and the need for plan modifications. Respondents had difficulty differentiating between plans generated by a human or those generated by the ML algorithm. Conclusions: Prostate LDR preimplantation treatment plans that have equivalent quality to plans created

  13. Evaluation of a Machine-Learning Algorithm for Treatment Planning in Prostate Low-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Nicolae, Alexandru; Morton, Gerard; Chung, Hans; Loblaw, Andrew; Jain, Suneil; Mitchell, Darren; Lu, Lin; Helou, Joelle; Al-Hanaqta, Motasem; Heath, Emily; Ravi, Ananth

    2017-01-01

    Purpose: This work presents the application of a machine learning (ML) algorithm to automatically generate high-quality, prostate low-dose-rate (LDR) brachytherapy treatment plans. The ML algorithm can mimic characteristics of preoperative treatment plans deemed clinically acceptable by brachytherapists. The planning efficiency, dosimetry, and quality (as assessed by experts) of preoperative plans generated with an ML planning approach was retrospectively evaluated in this study. Methods and Materials: Preimplantation and postimplantation treatment plans were extracted from 100 high-quality LDR treatments and stored within a training database. The ML training algorithm matches similar features from a new LDR case to those within the training database to rapidly obtain an initial seed distribution; plans were then further fine-tuned using stochastic optimization. Preimplantation treatment plans generated by the ML algorithm were compared with brachytherapist (BT) treatment plans in terms of planning time (Wilcoxon rank sum, α = 0.05) and dosimetry (1-way analysis of variance, α = 0.05). Qualitative preimplantation plan quality was evaluated by expert LDR radiation oncologists using a Likert scale questionnaire. Results: The average planning time for the ML approach was 0.84 ± 0.57 minutes, compared with 17.88 ± 8.76 minutes for the expert planner (P=.020). Preimplantation plans were dosimetrically equivalent to the BT plans; the average prostate V150% was 4% lower for ML plans (P=.002), although the difference was not clinically significant. Respondents ranked the ML-generated plans as equivalent to expert BT treatment plans in terms of target coverage, normal tissue avoidance, implant confidence, and the need for plan modifications. Respondents had difficulty differentiating between plans generated by a human or those generated by the ML algorithm. Conclusions: Prostate LDR preimplantation treatment plans that have equivalent quality to plans created

  14. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Ghobadi, Kimia; Ghaffari, Hamid R.; Aleman, Dionne M.; Jaffray, David A.; Ruschin, Mark [Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, Ontario M5S 3G8 (Canada); Department of Radiation Oncology, University of Toronto, Radiation Medicine Program, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada)

    2012-06-15

    Purpose: The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife{sup Registered-Sign} Perfexion Trade-Mark-Sign (PFX) for intracranial targets. Methods: The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. Results: In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was -0.12 (range: -0.27 to +0.03) and +0.08 (range: 0.00-0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V{sub 100}) between forward and inverse plans was 0.2% (range: -2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V{sub 100}), the mean difference in dose to 1 mm{sup 3} of brainstem between forward and inverse plans was -0.24 Gy (range: -2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: -17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an

  15. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms.

    Science.gov (United States)

    Ghobadi, Kimia; Ghaffari, Hamid R; Aleman, Dionne M; Jaffray, David A; Ruschin, Mark

    2012-06-01

    The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife(®) Perfexion™ (PFX) for intracranial targets. The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was -0.12 (range: -0.27 to +0.03) and +0.08 (range: 0.00-0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V(100)) between forward and inverse plans was 0.2% (range: -2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V(100)), the mean difference in dose to 1 mm(3) of brainstem between forward and inverse plans was -0.24 Gy (range: -2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: -17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an average of 215 min. PFX inverse planning can be performed using

  16. Automated treatment planning for a dedicated multi-source intracranial radiosurgery treatment unit using projected gradient and grassfire algorithms

    International Nuclear Information System (INIS)

    Ghobadi, Kimia; Ghaffari, Hamid R.; Aleman, Dionne M.; Jaffray, David A.; Ruschin, Mark

    2012-01-01

    Purpose: The purpose of this work is to develop a framework to the inverse problem for radiosurgery treatment planning on the Gamma Knife ® Perfexion™ (PFX) for intracranial targets. Methods: The approach taken in the present study consists of two parts. First, a hybrid grassfire and sphere-packing algorithm is used to obtain shot positions (isocenters) based on the geometry of the target to be treated. For the selected isocenters, a sector duration optimization (SDO) model is used to optimize the duration of radiation delivery from each collimator size from each individual source bank. The SDO model is solved using a projected gradient algorithm. This approach has been retrospectively tested on seven manually planned clinical cases (comprising 11 lesions) including acoustic neuromas and brain metastases. Results: In terms of conformity and organ-at-risk (OAR) sparing, the quality of plans achieved with the inverse planning approach were, on average, improved compared to the manually generated plans. The mean difference in conformity index between inverse and forward plans was −0.12 (range: −0.27 to +0.03) and +0.08 (range: 0.00–0.17) for classic and Paddick definitions, respectively, favoring the inverse plans. The mean difference in volume receiving the prescribed dose (V 100 ) between forward and inverse plans was 0.2% (range: −2.4% to +2.0%). After plan renormalization for equivalent coverage (i.e., V 100 ), the mean difference in dose to 1 mm 3 of brainstem between forward and inverse plans was −0.24 Gy (range: −2.40 to +2.02 Gy) favoring the inverse plans. Beam-on time varied with the number of isocenters but for the most optimal plans was on average 33 min longer than manual plans (range: −17 to +91 min) when normalized to a calibration dose rate of 3.5 Gy/min. In terms of algorithm performance, the isocenter selection for all the presented plans was performed in less than 3 s, while the SDO was performed in an average of 215 min

  17. Developing an acceptability assessment of preventive dental treatments.

    Science.gov (United States)

    Hyde, Susan; Gansky, Stuart A; Gonzalez-Vargas, Maria J; Husting, Sheila R; Cheng, Nancy F; Millstein, Susan G; Adams, Sally H

    2009-01-01

    Early childhood caries (ECC) is very prevalent among young Hispanic children. ECC is amenable to a variety of preventive procedures, yet many Hispanic families underutilize dental services. Acceptability research may assist in health care planning and resource allocation by identifying patient preferences among efficacious treatments with the goal of improving their utilization. The purposes of this study were (a) to develop a culturally competent acceptability assessment instrument, directed toward the caregivers of young Hispanic children, for five preventive dental treatments for ECC and (b) to test the instrument's reliability and validity. An instrument of five standard treatments known to prevent ECC was developed, translated, reviewed by focus groups, and pilot tested, then tested for reliability The instrument included illustrated cards, brief video clips, and samples of the treatments and was culturally appropriate for low-income Hispanic caregivers. In addition to determining the acceptability of the five treatments individually, the treatments were also presented as paired comparisons. Focus groups and debriefing interviews following the pilot tests established that the instrument has good face validity. The illustrated cards, product samples, and video demonstrations of the five treatments resulted in an instrument possessing good content validity. The instrument has good to excellent test-retest reliability, with identical time 1-time 2 responses for each of the five treatments 92 percent of the time (range 87 to 97 percent), and the same treatment of the paired comparisons preferred 75 percent of the time (range 61 to 90 percent). The acceptability instrument described is reliable and valid and may be useful in program planning efforts to identify and increase the utilization of preferred ECC preventive treatments for target populations.

  18. Advances in 4D treatment planning for scanned particle beam therapy - report of dedicated workshops.

    Science.gov (United States)

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-12-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue.

  19. Treatment planning for MLC based robotic radiosurgery for brain metastases: plan comparison with circular fields and suggestions for planning strategies

    Directory of Open Access Journals (Sweden)

    Schmitt Daniela

    2017-09-01

    Full Text Available To evaluate the possible range of application of the new InCise2 MLC for the CyberKnife M6 system in brain radiosurgery, a plan comparison was made for 10 brain metastases sized between 1.5 and 9cm3 in 10 patients treated in a single fraction each. The target volumes consist of a PTV derived by expanding the GTV by 1mm and were chosen to have diversity in the cohort regarding regularity of shape, location and the structures needed to be blocked for beam transmission in the vicinity. For each case, two treatment plans were optimized: one using the MLC and one using the IRIS-collimator providing variable circular fields. Plan re-quirements were: dose prescription to the 70% isodose line (18 or 20Gy, 100% GTV coverage, ≥98% PTV coverage, undisturbed central high dose region (95% of maximum dose and a conformity index as low as possible. Plan com-parison parameters were: conformity index (CI, high-dose gradient index (GIH, low-dose gradient index (GIL, total number of monitor units (MU and expected treatment time (TT. For all cases, clinically acceptable plans could be gen-erated with the following results (mean±SD for CI, GIH, GIL, MU and TT, respectively for the MLC plans: 1.09±0.03, 2.77±0.26, 2.61±0.08, 4514±830MU and 27±5min and for the IRIS plans: 1.05±0.01, 3.00±0.35, 2.46±0.08, 8557±1335MU and 42±7min. In summary, the MLC plans were on average less conformal and had a shallower dose gradient in the low dose region, but a steeper dose gradient in the high dose region. This is accompanied by a smaller vol-ume receiving 10Gy. A plan by plan comparison shows that usage of the MLC can spare about one half of the MUs and one third of treatment time. From these experiences and results suggestions for MLC planning strategy can be de-duced.

  20. Clinical use of the hyperthermia treatment planning system HyperPlan to predict effectiveness and toxicity

    International Nuclear Information System (INIS)

    Sreenivasa, Geetha; Gellermann, Johanna; Rau, Beate; Nadobny, Jacek; Schlag, Peter; Deuflhard, Peter; Felix, Roland; Wust, Peter

    2003-01-01

    Purpose: The main aim is to prove the clinical practicability of the hyperthermia treatment planning system HyperPlan on a β-test level. Data and observations obtained from clinical hyperthermia are compared with the numeric methods FE (finite element) and FDTD (finite difference time domain), respectively. Methods and Materials: The planning system HyperPlan is built on top of the modular, object-oriented platform for visualization and model generation AMIRA. This system already contains powerful algorithms for image processing, geometric modeling, and three-dimensional graphics display. A number of hyperthermia-specific modules are provided, enabling the creation of three-dimensional tetrahedral patient models suitable for treatment planning. Two numeric methods, FE and FDTD, are implemented in HyperPlan for solving Maxwell's equations. Both methods base their calculations on segmented (contour based) CT or MR image data. A tetrahedral grid is generated from the segmented tissue boundaries, consisting of approximately 80,000 tetrahedrons per patient. The FE method necessitates, primarily, this tetrahedral grid for the calculation of the E-field. The FDTD method, on the other hand, calculates the E-field on a cubical grid, but also requires a tetrahedral grid for correction at electrical interfaces. In both methods, temperature distributions are calculated on the tetrahedral grid by solving the bioheat transfer equation with the FE method. Segmentation, grid generation, E-field, and temperature calculation can be carried out in clinical practice at an acceptable time expenditure of about 1-2 days. Results: All 30 patients we analyzed with cervical, rectal, and prostate carcinoma exhibit a good correlation between the model calculations and the attained clinical data regarding acute toxicity (hot spots), prediction of easy-to-heat or difficult-to-heat patients, and the dependency on various other individual parameters. We could show sufficient agreement between

  1. Influence of planning time and treatment complexity on radiation therapy errors.

    Science.gov (United States)

    Gensheimer, Michael F; Zeng, Jing; Carlson, Joshua; Spady, Phil; Jordan, Loucille; Kane, Gabrielle; Ford, Eric C

    2016-01-01

    Radiation treatment planning is a complex process with potential for error. We hypothesized that shorter time from simulation to treatment would result in rushed work and higher incidence of errors. We examined treatment planning factors predictive for near-miss events. Treatments delivered from March 2012 through October 2014 were analyzed. Near-miss events were prospectively recorded and coded for severity on a 0 to 4 scale; only grade 3-4 (potentially severe/critical) events were studied in this report. For 4 treatment types (3-dimensional conformal, intensity modulated radiation therapy, stereotactic body radiation therapy [SBRT], neutron), logistic regression was performed to test influence of treatment planning time and clinical variables on near-miss events. There were 2257 treatment courses during the study period, with 322 grade 3-4 near-miss events. SBRT treatments had more frequent events than the other 3 treatment types (18% vs 11%, P = .04). For the 3-dimensional conformal group (1354 treatments), univariate analysis showed several factors predictive of near-miss events: longer time from simulation to first treatment (P = .01), treatment of primary site versus metastasis (P < .001), longer treatment course (P < .001), and pediatric versus adult patient (P = .002). However, on multivariate regression only pediatric versus adult patient remained predictive of events (P = 0.02). For the intensity modulated radiation therapy, SBRT, and neutron groups, time between simulation and first treatment was not found to be predictive of near-miss events on univariate or multivariate regression. When controlling for treatment technique and other clinical factors, there was no relationship between time spent in radiation treatment planning and near-miss events. SBRT and pediatric treatments were more error-prone, indicating that clinical and technical complexity of treatments should be taken into account when targeting safety interventions. Copyright © 2015 American

  2. WE-D-BRB-02: Proton Treatment Planning and Beam Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Pankuch, M. [Northwestern Medicine Proton Center (United States)

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  3. Analysis of Development Plans from Communications Perspective

    Directory of Open Access Journals (Sweden)

    Zohreh Shahghasemi

    2016-12-01

    Full Text Available The movement towards the goals of "Vision plan 1404" needs the perception of the requirements to prepare plans for achieving the favorite objectives of development. With the advent of the information age, the rules of development policy-making strongly have changed in the world and also unique opportunities areprovided by variables of communications for countries that have been in early stages of development. Based on this, considering the communications in macro-level and in the political, social, economic and cultural development plans is important and necessary. This requires a review and pathology of previous plans and evaluation of their strengths and weaknesses for preparing of more comprehensive future plans. Themain question of this study is: what is the approach of development plans to communications section after Islamic revolution?  Which aspects of communications are considered, and what aspects are ignored?  This study analyzes five development plans after the revolution, by using of qualitative content analysis. Results show that in all five-year plans the focus was on hardware and quantitative dimensions of communication development and media, but qualitative and content aspects, such as the right to universal access to information, freedom to obtain and disseminate information within the constitution, freedom of speech and press, a move towards the information society and knowledge-based, also other dimensions of communications such as human, traditional and social communication has been less considered. In the fourth development plan that is "knowledge" – centered, new fields of communications has been studied comprehensively in comparison to other plans. According to these approaches and new scientific and experimental perspectives, this paper suggests further engagement in communications necessity for development policy-making.

  4. Analytical incorporation of fractionation effects in probabilistic treatment planning for intensity-modulated proton therapy.

    Science.gov (United States)

    Wahl, Niklas; Hennig, Philipp; Wieser, Hans-Peter; Bangert, Mark

    2018-04-01

    We show that it is possible to explicitly incorporate fractionation effects into closed-form probabilistic treatment plan analysis and optimization for intensity-modulated proton therapy with analytical probabilistic modeling (APM). We study the impact of different fractionation schemes on the dosimetric uncertainty induced by random and systematic sources of range and setup uncertainty for treatment plans that were optimized with and without consideration of the number of treatment fractions. The APM framework is capable of handling arbitrarily correlated uncertainty models including systematic and random errors in the context of fractionation. On this basis, we construct an analytical dose variance computation pipeline that explicitly considers the number of treatment fractions for uncertainty quantitation and minimization during treatment planning. We evaluate the variance computation model in comparison to random sampling of 100 treatments for conventional and probabilistic treatment plans under different fractionation schemes (1, 5, 30 fractions) for an intracranial, a paraspinal and a prostate case. The impact of neglecting the fractionation scheme during treatment planning is investigated by applying treatment plans that were generated with probabilistic optimization for 1 fraction in a higher number of fractions and comparing them to the probabilistic plans optimized under explicit consideration of the number of fractions. APM enables the construction of an analytical variance computation model for dose uncertainty considering fractionation at negligible computational overhead. It is computationally feasible (a) to simultaneously perform a robustness analysis for all possible fraction numbers and (b) to perform a probabilistic treatment plan optimization for a specific fraction number. The incorporation of fractionation assumptions for robustness analysis exposes a dose to uncertainty trade-off, i.e., the dose in the organs at risk is increased for a

  5. Comparison of various online IGRT strategies: The benefits of online treatment plan re-optimization

    International Nuclear Information System (INIS)

    Schulze, Derek; Liang, Jian; Yan, Di; Zhang Tiezhi

    2009-01-01

    Purpose: To compare the dosimetric differences of various online IGRT strategies and to predict potential benefits of online re-optimization techniques in prostate cancer radiation treatments. Materials and methods: Nine prostate patients were recruited in this study. Each patient has one treatment planning CT images and 10-treatment day CT images. Five different online IGRT strategies were evaluated which include 3D conformal with bone alignment, 3D conformal re-planning via aperture changes, intensity modulated radiation treatment (IMRT) with bone alignment, IMRT with target alignment and IMRT daily re-optimization. Treatment planning and virtual treatment delivery were performed. The delivered doses were obtained using in-house deformable dose mapping software. The results were analyzed using equivalent uniform dose (EUD). Results: With the same margin, rectum and bladder doses in IMRT plans were about 10% and 5% less than those in CRT plans, respectively. Rectum and bladder doses were reduced as much as 20% if motion margin is reduced by 1 cm. IMRT is more sensitive to organ motion. Large discrepancies of bladder and rectum doses were observed compared to the actual delivered dose with treatment plan predication. The therapeutic ratio can be improved by 14% and 25% for rectum and bladder, respectively, if IMRT online re-planning is employed compared to the IMRT bone alignment approach. The improvement of target alignment approach is similar with 11% and 21% dose reduction to rectum and bladder, respectively. However, underdosing in seminal vesicles was observed on certain patients. Conclusions: Online treatment plan re-optimization may significantly improve therapeutic ratio in prostate cancer treatments mostly due to the reduction of PTV margin. However, for low risk patient with only prostate involved, online target alignment IMRT treatment would achieve similar results as online re-planning. For all IGRT approaches, the delivered organ-at-risk doses may be

  6. Records needed for orthodontic diagnosis and treatment planning: a systematic review.

    Directory of Open Access Journals (Sweden)

    Robine J Rischen

    Full Text Available BACKGROUND: Traditionally, dental models, facial and intra-oral photographs and a set of two-dimensional radiographs are used for orthodontic diagnosis and treatment planning. As evidence is lacking, the discussion is ongoing which specific records are needed for the process of making an orthodontic treatment plan. OBJECTIVE: To estimate the contribution and importance of different diagnostic records for making an orthodontic diagnosis and treatment plan. DATA SOURCES: An electronic search in PubMed (1948-July 2012, EMBASE Excerpta Medica (1980-July 2012, CINAHL (1982-July 2012, Web of Science (1945-July 2012, Scopus (1996-July 2012, and Cochrane Library (1993-July 2012 was performed. Additionally, a hand search of the reference lists of included studies was performed to identify potentially eligible studies. There was no language restriction. STUDY SELECTION: The patient, intervention, comparator, outcome (pico question formulated for this study was as follows: for patients who need orthodontic treatment (P, will the use of record set X (I compared with record set Y (C change the treatment plan (O? Only primary publications were included. DATA EXTRACTION: Independent extraction of data and quality assessment was performed by two observers. RESULTS: Of the 1041 publications retrieved, 17 met the inclusion criteria. Of these, 4 studies were of high quality. Because of the limited number of high quality studies and the differences in study designs, patient characteristics, and reference standard or index test, a meta-analysis was not possible. CONCLUSION: Cephalograms are not routinely needed for orthodontic treatment planning in Class II malocclusions, digital models can be used to replace plaster casts, and cone-beam computed tomography radiographs can be indicated for impacted canines. Based on the findings of this review, the minimum record set required for orthodontic diagnosis and treatment planning could not be defined. SYSTEMATIC REVIEW

  7. Idaho National Engineering Laboratory Conceptual Site Treatment Plan. Tables 8.1 and 8.2, Appendices A, B, C

    International Nuclear Information System (INIS)

    Eaton, D.

    1993-10-01

    The US Department of Energy (DOE) is required by Section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (FFCAct), to prepare plans describing the development of treatment capacities and technologies for treating mixed waste. The FFCAct requires site treatment plans (STPs or plans) to be developed for each site at which DOE generates or stores mixed waste and submitted to the host state or the US Environmental Protection Agency (EPA) for either approval, approval with modification, or disapproval. The Idaho National Engineering Laboratory (INEL) Conceptual Site Treatment Plan (CSTP) is the preliminary version of the plan required by the FFCAct and is being provided to the State of Idaho, the EPA, and others for review. A list of the other DOE sites preparing CSTPs is included in Appendix A of this document. In addition to aiding the INEL in formulating its Final Proposed STP, this CSTP will also provide information to other DOE sites for use in identifying common technology needs and potential options for treating their wastes. The INEL CSTP is also intended to be used in conjunction with CSTPs from other sites as a basis for nationwide discussions among state regulators, the EPA, and other interested parties on treatment strategies and options, and on technical and equity issues associated with DOE's mixed waste

  8. Idaho National Engineering Laboratory Conceptual Site Treatment Plan. Tables 8.1 and 8.2, Appendices A, B, C

    Energy Technology Data Exchange (ETDEWEB)

    Eaton, D.

    1993-10-01

    The US Department of Energy (DOE) is required by Section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (FFCAct), to prepare plans describing the development of treatment capacities and technologies for treating mixed waste. The FFCAct requires site treatment plans (STPs or plans) to be developed for each site at which DOE generates or stores mixed waste and submitted to the host state or the US Environmental Protection Agency (EPA) for either approval, approval with modification, or disapproval. The Idaho National Engineering Laboratory (INEL) Conceptual Site Treatment Plan (CSTP) is the preliminary version of the plan required by the FFCAct and is being provided to the State of Idaho, the EPA, and others for review. A list of the other DOE sites preparing CSTPs is included in Appendix A of this document. In addition to aiding the INEL in formulating its Final Proposed STP, this CSTP will also provide information to other DOE sites for use in identifying common technology needs and potential options for treating their wastes. The INEL CSTP is also intended to be used in conjunction with CSTPs from other sites as a basis for nationwide discussions among state regulators, the EPA, and other interested parties on treatment strategies and options, and on technical and equity issues associated with DOE`s mixed waste.

  9. Multi-centre audit of VMAT planning and pre-treatment verification.

    Science.gov (United States)

    Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

    2017-08-01

    We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. A quality assurance index for brachytherapy treatment plan verification

    International Nuclear Information System (INIS)

    Simpson, J.B.; Clarke, J.P.

    2000-01-01

    A method is described which provides an independent verification of a brachytherapy treatment plan. The method is applicable to any common geometric configuration and utilises a simple equation derived from a common form of nonlinear regression. The basis for the index value is the relationship between the treatment time, prescribed dose, source strength and plan geometry. This relationship may be described mathematically as: Total Treatment Time ∝ Prescribed Dose/Source Strength x (a geometric term) with the geometric term incorporating three geometric components, namely the distance from source positions to points of dose normalisation (d), the total length of the dwell positions (L), and the number of source trains or catheters (N). A general equation of the form GF = k (d) -α (L) -β (N) -y is used to describe the plan geometry, where GF is what we have termed the geometric factor, k is a constant of proportionality and the exponents are derived from the non-linear regression process. The resulting index is simple to calculate prior to patient treatment and sensitive enough to identify significant error whilst being robust enough to allow for a normal degree of geometric distortion

  11. Development of model plans in three dimensional conformal radiotherapy for brain tumors

    International Nuclear Information System (INIS)

    Pyo, Hongryull; Kim, Gwieon; Keum, Kichang; Chang, Sekyung; Suh, Changok; Lee, Sanghoon

    2002-01-01

    Three dimensional conformal radiotherapy planning is being used widely for the treatment of patients with brain tumor. However, it takes much time to develop an optimal treatment plan, therefore, it is difficult to apply this technique to all patients. To increase the efficiency of this technique, we need to develop standard radiotherapy plans for each site of the brain. Therefore we developed several 3 dimensional conformal radiotherapy plans (3D plans) for tumors at each site of brain, compared them with each other, and with 2 dimensional radiotherapy plans. Finally model plans for each site of the brain were decided. Imaginary tumors, with sizes commonly observed in the clinic, were designed for each site of the brain and drawn on CT images. The planning target volumes (PTVs) were as follows; temporal tumor-5.7 x 8.2 x 7.6 cm, suprasellar tumor-3 x 4 x 4.1 cm, thalamic tumor-3.1 x 5.9 x 3.7 cm, frontoparietal tumor-5.5 x 7 x 5.5 cm, and occipitoparietal tumor-5 x 5.5 x 5 cm. Plans using parallel opposed 2-portals and/or 3 portals including fronto-vertex and 2 lateral fields were developed manually as the conventional 2D plans, and 3D noncoplanar conformal plans were developed using beam's eye view and the automatic block drawing tool. Total tumor dose was 54 Gy for a suprasellar tumor, 59.4 Gy and 72 Gy for the other tumors. All dose plans (including 2D plans) were calculated using 3D plan software. Developed plans were compared with each other using dose-volume histograms (DVH), normal tissue complication probabilities (NTCP) and variable dose statistic values (minimum, maximum and mean dose, D5, V83, V85 and V95). Finally a best radiotherapy plan for each site of brain was selected. 1) Temporal tumor; NTCPs and DVHs of the normal tissue of all 3D plans were superior to 2D plans and this trend was more definite when total dose was escalated to 72 Gy (NTCPs of normal brain 2D plans: 27%, 8% → 3D plans: 1%, 1%). Various dose statistic values did not show any

  12. SU-E-T-213: Comparison of Treatment Efficiency of Gamma Knife SRS Plans for Brain Metastases with Different Planning Methods

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Y [East Carolina Univ, Greenville, NC (United States); Huang, Z [East Carolina University, Greenville, NC (United States); Lo, S [Case Western Reserve University, Cleveland, OH (United States); Mayr, N; Yuh, W [University of Washington, Seattle, WA (United States)

    2015-06-15

    Purpose: To improve Gamma Knife SRS treatment efficiency for brain metastases and compare the differences of treatment time and radiobiological effects between two different planning methods of automatic filling and manual placement of shots with inverse planning. Methods: T1-weighted MRI images with gadolinium contrast from five patients with a single brain metastatic-lesion were used in this retrospective study. Among them, two were from primary breast cancer, two from primary melanoma cancer and one from primary prostate cancer. For each patient, two plans were generated in Leksell GammaPlan10.1.1 for radiosurgical treatment with a Leksell GammaKnife Perfexion machine: one with automatic filling, automatic sector configuration and inverse optimization (Method1); and the other with manual placement of shots, manual setup of collimator sizes, manual setup of sector blocking and inverse optimization (Method2). Dosimetric quality of the plans was evaluated with parameters of Coverage, Selectivity, Gradient-Index and DVH. Beam-on Time, Number-of-Shots and Tumor Control Probability(TCP) were compared for the two plans while keeping their dosimetric quality very similar. Relative reduction of Beam-on Time and Number-of-Shots were calculated as the ratios among the two plans and used for quantitative analysis. Results: With very similar dosimetric and radiobiological plan quality, plans created with Method 2 had significantly reduced treatment time. Relative reduction of Beam-on Time ranged from 20% to 51 % (median:29%,p=0.001), and reduction of Number-of-Shots ranged from 5% to 67% (median:40%,p=0.0002), respectively. Time of plan creation for Method1 and Method2 was similar, approximately 20 minutes, excluding the time for tumor delineation. TCP calculated for the tumors from differential DVHs did not show significant difference between the two plans (p=0.35). Conclusion: The method of manual setup combined with inverse optimization in LGP for treatment of brain

  13. SU-E-T-213: Comparison of Treatment Efficiency of Gamma Knife SRS Plans for Brain Metastases with Different Planning Methods

    International Nuclear Information System (INIS)

    Feng, Y; Huang, Z; Lo, S; Mayr, N; Yuh, W

    2015-01-01

    Purpose: To improve Gamma Knife SRS treatment efficiency for brain metastases and compare the differences of treatment time and radiobiological effects between two different planning methods of automatic filling and manual placement of shots with inverse planning. Methods: T1-weighted MRI images with gadolinium contrast from five patients with a single brain metastatic-lesion were used in this retrospective study. Among them, two were from primary breast cancer, two from primary melanoma cancer and one from primary prostate cancer. For each patient, two plans were generated in Leksell GammaPlan10.1.1 for radiosurgical treatment with a Leksell GammaKnife Perfexion machine: one with automatic filling, automatic sector configuration and inverse optimization (Method1); and the other with manual placement of shots, manual setup of collimator sizes, manual setup of sector blocking and inverse optimization (Method2). Dosimetric quality of the plans was evaluated with parameters of Coverage, Selectivity, Gradient-Index and DVH. Beam-on Time, Number-of-Shots and Tumor Control Probability(TCP) were compared for the two plans while keeping their dosimetric quality very similar. Relative reduction of Beam-on Time and Number-of-Shots were calculated as the ratios among the two plans and used for quantitative analysis. Results: With very similar dosimetric and radiobiological plan quality, plans created with Method 2 had significantly reduced treatment time. Relative reduction of Beam-on Time ranged from 20% to 51 % (median:29%,p=0.001), and reduction of Number-of-Shots ranged from 5% to 67% (median:40%,p=0.0002), respectively. Time of plan creation for Method1 and Method2 was similar, approximately 20 minutes, excluding the time for tumor delineation. TCP calculated for the tumors from differential DVHs did not show significant difference between the two plans (p=0.35). Conclusion: The method of manual setup combined with inverse optimization in LGP for treatment of brain

  14. Evaluating the influence of setup uncertainties on treatment planning for focal liver tumors

    International Nuclear Information System (INIS)

    Balter, J.M.; Brock, K.K.; Lam, K.L.; Dawson, L.A.; McShan, D.L.; Ten Haken, R.K.

    2001-01-01

    Purpose: A mechanism has been developed to evaluate the influence of systematic and random setup variations on dose during treatment planning. The information available for studying these factors shifts from population-based models towards patient-specific data as treatment progresses and setup measurements for an individual patient become available. This study evaluates the influence of population as well as patient-specific setup distributions on treatment plans for focal liver tumors. Materials and Methods: 8 patients with focal liver tumors were treated on a protocol that involved online setup measurement and adjustment, as well as ventilatory immobilization. Summary statistics from these treatments yielded individual and population distributions of position at initial setup for each fraction as well as after setup adjustment. A convolution model for evaluation of the influence of random setup variation on calculated dose distributions has been previously described and investigated for application to focal liver radiotherapy by our department. Individual patient doses based on initial setup positions were calculated by applying the measured systematic offset to the initial treatment plan, and then convolving the calculated dose distribution with an anisotropic probability distribution function representing the individual patient's random variations. A separate calculation with no offset and convolution using population averaged random variations was performed. Individual beam apertures were then adjusted to provide plans that ensured proper dose to the clinical target volume (CTV) following convolution with population distributions prior to and following setup adjustment. Results: Input distributions comprised 262 position measurements. Individual patient setup distributions for the course of treatment had systematic offsets ranging from (σ) 1.1 to 4.1 mm (LR), -2.0 to 1.4 mm (AP), and 5.6 to 1.7 mm (IS). Individual random setup variations ranged from 2.5 to 5

  15. SU-F-BRA-13: Knowledge-Based Treatment Planning for Prostate LDR Brachytherapy Based On Principle Component Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Roper, J; Bradshaw, B; Godette, K; Schreibmann, E [Winship Cancer Institute of Emory University, Atlanta, GA (United States); Chanyavanich, V [Rocky Mountain Cancer Centers, Denver, CO (United States)

    2015-06-15

    Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process and then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.

  16. Can field-in-field technique replace wedge filter in radiotherapy treatment planning: a comparative analysis in various treatment sites

    International Nuclear Information System (INIS)

    Prabhakar, R.; Julka, P.K.; Rath, G.K.

    2008-01-01

    The aim of the study was to show whether field-in-field (FIF) technique can be used to replace wedge filter in radiation treatment planning. The study was performed in cases where wedges are commonly used in radiotherapy treatment planning. Thirty patients with different malignancies who received radiotherapy were studied. This includes patients with malignancies of brain, head and neck, breast, upper and lower abdomen. All the patients underwent computed tomography scanning and the datasets were transferred to the treatment planning system. Initially, wedge based planning was performed to achieve the best possible dose distribution inside the target volume with multileaf collimators (Plan1). Wedges were removed from a copy of the same plan and FIF plan was generated (Plan2). The two plans were then evaluated and compared for mean dose, maximum dose, median dose, doses to 2% (D 2 ) and 98% (D 9 8) of the target volume, volume receiving greater than 107% of the prescribed dose (V>107%), volume receiving less than 95% of the prescribed dose (V 2 , V>107% and CI for more of the sites with statistically significant reduction in monitor units. FIF results in better dose distribution in terms of homogeneity in most of the sites. It is feasible to replace wedge filter with FIF in radiotherapy treatment planning.

  17. Evaluation of a software module for adaptive treatment planning and re-irradiation.

    Science.gov (United States)

    Richter, Anne; Weick, Stefan; Krieger, Thomas; Exner, Florian; Kellner, Sonja; Polat, Bülent; Flentje, Michael

    2017-12-28

    The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4-35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to

  18. A new column-generation-based algorithm for VMAT treatment plan optimization

    International Nuclear Information System (INIS)

    Peng Fei; Epelman, Marina A; Romeijn, H Edwin; Jia Xun; Gu Xuejun; Jiang, Steve B

    2012-01-01

    We study the treatment plan optimization problem for volumetric modulated arc therapy (VMAT). We propose a new column-generation-based algorithm that takes into account bounds on the gantry speed and dose rate, as well as an upper bound on the rate of change of the gantry speed, in addition to MLC constraints. The algorithm iteratively adds one aperture at each control point along the treatment arc. In each iteration, a restricted problem optimizing intensities at previously selected apertures is solved, and its solution is used to formulate a pricing problem, which selects an aperture at another control point that is compatible with previously selected apertures and leads to the largest rate of improvement in the objective function value of the restricted problem. Once a complete set of apertures is obtained, their intensities are optimized and the gantry speeds and dose rates are adjusted to minimize treatment time while satisfying all machine restrictions. Comparisons of treatment plans obtained by our algorithm to idealized IMRT plans of 177 beams on five clinical prostate cancer cases demonstrate high quality with respect to clinical dose–volume criteria. For all cases, our algorithm yields treatment plans that can be delivered in around 2 min. Implementation on a graphic processing unit enables us to finish the optimization of a VMAT plan in 25–55 s. (paper)

  19. Implementation of pencil kernel and depth penetration algorithms for treatment planning of proton beams

    International Nuclear Information System (INIS)

    Russell, K.R.; Saxner, M.; Ahnesjoe, A.; Montelius, A.; Grusell, E.; Dahlgren, C.V.

    2000-01-01

    The implementation of two algorithms for calculating dose distributions for radiation therapy treatment planning of intermediate energy proton beams is described. A pencil kernel algorithm and a depth penetration algorithm have been incorporated into a commercial three-dimensional treatment planning system (Helax-TMS, Helax AB, Sweden) to allow conformal planning techniques using irregularly shaped fields, proton range modulation, range modification and dose calculation for non-coplanar beams. The pencil kernel algorithm is developed from the Fermi-Eyges formalism and Moliere multiple-scattering theory with range straggling corrections applied. The depth penetration algorithm is based on the energy loss in the continuous slowing down approximation with simple correction factors applied to the beam penumbra region and has been implemented for fast, interactive treatment planning. Modelling of the effects of air gaps and range modifying device thickness and position are implicit to both algorithms. Measured and calculated dose values are compared for a therapeutic proton beam in both homogeneous and heterogeneous phantoms of varying complexity. Both algorithms model the beam penumbra as a function of depth in a homogeneous phantom with acceptable accuracy. Results show that the pencil kernel algorithm is required for modelling the dose perturbation effects from scattering in heterogeneous media. (author)

  20. Fuels planning: science synthesis and integration; economic uses fact sheet 04: My Fuel Treatment Planner

    Science.gov (United States)

    Rocky Mountain Research Station USDA Forest Service

    2004-01-01

    In the face of rapidly changing public and political attitudes toward fire and fuel planning, one thing remains constant: the fuel planner is ultimately responsible for making decisions on the land. This fact sheet discusses the options for fuel treatments, and the need, development, and use of the MS Excel-based tool, My Fuel Treatment Planner.

  1. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    International Nuclear Information System (INIS)

    1992-11-01

    The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, as well as for activities associated with nuclear energy development. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. The 3718-F Alkali Metal Treatment and Storage Facility (3718-F Facility), located in the 300 Area, was used to store and treat alkali metal wastes. Therefore, it is subject to the regulatory requirements for the storage and treatment of dangerous wastes. Closure will be conducted pursuant to the requirements of the Washington Administrative Code (WAC) 173-303-610 (Ecology 1989) and 40 CFR 270.1. Closure also will satisfy the thermal treatment facility closure requirements of 40 CFR 265.381. This closure plan presents a description of the 3718-F Facility, the history of wastes managed, and the approach that will be followed to close the facility. Only hazardous constituents derived from 3718-F Facility operations will be addressed

  2. Radiation treatment planning techniques for lymphoma of the stomach

    International Nuclear Information System (INIS)

    Della Biancia, Cesar; Hunt, Margie; Furhang, Eli; Wu, Elisa; Yahalom, Joachim

    2005-01-01

    Purpose: Involved-field radiation therapy of the stomach is often used in the curative treatment of gastric lymphoma. Yet, the optimal technique to irradiate the stomach with minimal morbidity has not been well established. This study was designed to evaluate treatment planning alternatives for stomach irradiation, including intensity-modulated radiation therapy (IMRT), to determine which approach resulted in improved dose distribution and to identify patient-specific anatomic factors that might influence a treatment planning choice. Methods and Materials: Fifteen patients with lymphoma of the stomach (14 mucosa-associated lymphoid tissue lymphomas and 1 diffuse large B-cell lymphoma) were categorized into 3 types, depending on the geometric relationship between the planning target volume (PTV) and kidneys. AP/PA and 3D conformal radiation therapy (3DCRT) plans were generated for each patient. IMRT was planned for 4 patients with challenging geometric relationship between the PTV and the kidneys to determine whether it was advantageous to use IMRT. Results: For type I patients (no overlap between PTV and kidneys), there was essentially no benefit from using 3DCRT over AP/PA. However, for patients with PTVs in close proximity to the kidneys (type II) or with high degree of overlap (type III), the 4-field 3DCRT plans were superior, reducing the kidney V 15Gy by approximately 90% for type II and 50% for type III patients. For type III, the use of a 3DCRT plan rather than an AP/PA plan decreased the V 15Gy by approximately 65% for the right kidney and 45% for the left kidney. In the selected cases, IMRT led to a further decrease in left kidney dose as well as in mean liver dose. Conclusions: The geometric relationship between the target and kidneys has a significant impact on the selection of the optimum beam arrangement. Using 4-field 3DCRT markedly decreases the kidney dose. The addition of IMRT led to further incremental improvements in the left kidney and liver

  3. Patient dose simulation in X-ray CT using a radiation treatment-planning system

    International Nuclear Information System (INIS)

    Nakae, Yasuo; Oda, Masahiko; Minamoto, Takahiro

    2003-01-01

    Medical irradiation dosage has been increasing with the development of new radiological equipment and new techniques like interventional radiology. It is fair to say that patient dose has been increased as a result of the development of multi-slice CT. A number of studies on the irradiation dose of CT have been reported, and the computed tomography dose index (CTDI) is now used as a general means of determining CT dose. However, patient dose distribution in the body varies with the patient's constitution, bowel gas in the body, and conditions of exposure. In this study, patient dose was analyzed from the viewpoint of dose distribution, using a radiation treatment-planning computer. Percent depth dose (PDD) and the off-center ratio (OCR) of the CT beam are needed to calculate dose distribution by the planning computer. Therefore, X-ray CT data were measured with various apparatuses, and beam data were sent to the planning computer. Measurement and simulation doses in the elliptical phantom (Mix-Dp: water equivalent material) were collated, and the CT irradiation dose was determined for patient dose simulation. The rotational radiation treatment technique was used to obtain the patient dose distribution of CT, and patient dose was evaluated through simulation of the dose distribution. CT images of the thorax were sent to the planning computer and simulated. The result was that the patient dose distribution of the thorax was obtained for CT examination. (author)

  4. Consistency and Reconciliation Model In Regional Development Planning

    Directory of Open Access Journals (Sweden)

    Dina Suryawati

    2016-10-01

    Full Text Available The aim of this study was to identify the problems and determine the conceptual model of regional development planning. Regional development planning is a systemic, complex and unstructured process. Therefore, this study used soft systems methodology to outline unstructured issues with a structured approach. The conceptual models that were successfully constructed in this study are a model of consistency and a model of reconciliation. Regional development planning is a process that is well-integrated with central planning and inter-regional planning documents. Integration and consistency of regional planning documents are very important in order to achieve the development goals that have been set. On the other hand, the process of development planning in the region involves technocratic system, that is, both top-down and bottom-up system of participation. Both must be balanced, do not overlap and do not dominate each other. regional, development, planning, consistency, reconciliation

  5. The development of a 4D treatment planning methodology to simulate the tracking of central lung tumors in an MRI-linac.

    Science.gov (United States)

    Al-Ward, Shahad M; Kim, Anthony; McCann, Claire; Ruschin, Mark; Cheung, Patrick; Sahgal, Arjun; Keller, Brian M

    2018-01-01

    Targeting and tracking of central lung tumors may be feasible on the Elekta MRI-linac (MRL) due to the soft-tissue visualization capabilities of MRI. The purpose of this work is to develop a novel treatment planning methodology to simulate tracking of central lung tumors with the MRL and to quantify the benefits in OAR sparing compared with the ITV approach. Full 4D-CT datasets for five central lung cancer patients were selected to simulate the condition of having 4D-pseudo-CTs derived from 4D-MRI data available on the MRL with real-time tracking capabilities. We used the MRL treatment planning system to generate two plans: (a) with a set of MLC-defined apertures around the target at each phase of the breathing ("4D-MRL" method); (b) with a fixed set of fields encompassing the maximum inhale and exhale of the breathing cycle ("ITV" method). For both plans, dose accumulation was performed onto a reference phase. To further study the potential benefits of a 4D-MRL method, the results were stratified by tumor motion amplitude, OAR-to-tumor proximity, and the relative OAR motion (ROM). With the 4D-MRL method, the reduction in mean doses was up to 3.0 Gy and 1.9 Gy for the heart and the lung. Moreover, the lung's V12.5 Gy was spared by a maximum of 300 cc. Maximum doses to serial organs were reduced by up to 6.1 Gy, 1.5 Gy, and 9.0 Gy for the esophagus, spinal cord, and the trachea, respectively. OAR dose reduction with our method depended on the tumor motion amplitude and the ROM. Some OARs with large ROMs and in close proximity to the tumor benefited from tracking despite small tumor amplitudes. We developed a novel 4D tracking methodology for the MRL for central lung tumors and quantified the potential dosimetric benefits compared with our current ITV approach. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  6. Trust, but verify – accuracy of clinical commercial radiation treatment planning systems

    International Nuclear Information System (INIS)

    Lehmann, J; Kenny, J; Lye, J; Dunn, L; Williams, I

    2014-01-01

    Computer based Treatment Planning Systems (TPS) are used worldwide to design and calculate treatment plans for treating radiation therapy patients. TPS are generally well designed and thoroughly tested by their developers and local physicists prior to clinical use. However, the wide-reaching impact of their accuracy warrants ongoing vigilance. This work reviews the findings of the Australian national audit system and provides recommendations for checks of TPS. The Australian Clinical Dosimetry Service (ACDS) has designed and implemented a national system of audits, currently in a three year test phase. The Level III audits verify the accuracy of a beam model of a facility's TPS through a comparison of measurements with calculation at selected points in an anthropomorphic phantom. The plans are prescribed by the ACDS and all measurement equipment is brought in for independent onsite measurements. In this first version of audits, plans are comparatively simple, involving asymmetric fields, wedges and inhomogeneities. The ACDS has performed 14 Level III audits to-date. Six audits returned at least one measurement at Action Level, indicating that the measured dose differed more than 3.3% (but less than 5%) from the planned dose. Two audits failed (difference >5%). One fail was caused by a data transmission error coupled with quality assurance (QA) not being performed. The second fail was investigated and reduced to Action Level with the onsite audit team finding phantom setup at treatment a contributing factor. The Action Level results are attributed to small dose calculation deviations within the TPS, which are investigated and corrected by the facilities. Small deviations exist in clinical TPS which can add up and can combine with output variations to result in unacceptable variations. Ongoing checks and independent audits are recommended.

  7. Treatment planning of electroporation-based medical interventions: electrochemotherapy, gene electrotransfer and irreversible electroporation

    International Nuclear Information System (INIS)

    Zupanic, Anze; Kos, Bor; Miklavcic, Damijan

    2012-01-01

    In recent years, cancer electrochemotherapy (ECT), gene electrotransfer for gene therapy and DNA vaccination (GET) and tissue ablation with irreversible electroporation (IRE) have all entered clinical practice. We present a method for a personalized treatment planning procedure for ECT, GET and IRE, based on medical image analysis, numerical modelling of electroporation and optimization with the genetic algorithm, and several visualization tools for treatment plan assessment. Each treatment plan provides the attending physician with optimal positions of electrodes in the body and electric pulse parameters for optimal electroporation of the target tissues. For the studied case of a deep-seated tumour, the optimal treatment plans for ECT and IRE require at least two electrodes to be inserted into the target tissue, thus lowering the necessary voltage for electroporation and limiting damage to the surrounding healthy tissue. In GET, it is necessary to place the electrodes outside the target tissue to prevent damage to target cells intended to express the transfected genes. The presented treatment planning procedure is a valuable tool for clinical and experimental use and evaluation of electroporation-based treatments. (paper)

  8. Treatment planning for laser-accelerated very-high energy electrons

    International Nuclear Information System (INIS)

    Fuchs, T; Szymanowski, H; Oelfke, U; Glinec, Y; Rechatin, C; Faure, J; Malka, V

    2009-01-01

    In recent experiments, quasi-monoenergetic and well-collimated very-high energy electron (VHEE) beams were obtained by laser-plasma accelerators. We investigate their potential use for radiation therapy. Monte Carlo simulations are used to study the influence of the experimental characteristics such as beam energy, energy spread and initial angular distribution on the dose distributions. It is found that magnetic focusing of the electron beam improves the lateral penumbra. The dosimetric properties of the laser-accelerated VHEE beams are implemented in our inverse treatment planning system for intensity-modulated treatments. The influence of the beam characteristics on the quality of a prostate treatment plan is evaluated. In comparison to a clinically approved 6 MV IMRT photon plan, a better target coverage is achieved. The quality of the sparing of organs at risk is found to be dependent on the depth. The bladder and rectum are better protected due to the sharp lateral penumbra at low depths, whereas the femoral heads receive a larger dose because of the large scattering amplitude at larger depths.

  9. Margins for treatment planning of proton therapy

    International Nuclear Information System (INIS)

    Thomas, Simon J

    2006-01-01

    For protons and other charged particles, the effect of set-up errors on the position of isodoses is considerably less in the direction of the incident beam than it is laterally. Therefore, the margins required between the clinical target volume (CTV) and planning target volume (PTV) can be less in the direction of the incident beam than laterally. Margins have been calculated for a typical head plan and a typical prostate plan, for a single field, a parallel opposed and a four-field arrangement of protons, and compared with margins calculated for photons, assuming identical geometrical uncertainties for each modality. In the head plan, where internal motion was assumed negligible, the CTV-PTV margin reduced from approximately 10 mm to 3 mm in the axial direction for the single field and parallel opposed plans. For a prostate plan, where internal motion cannot be ignored, the corresponding reduction in margin was from 11 mm to 7 mm. The planning organ at risk (PRV) margin in the axial direction reduced from 6 mm to 2 mm for the head plan, and from 7 mm to 4 mm for the prostate plan. No reduction was seen on the other axes, or for any axis of the four-field plans. Owing to the shape of proton dose distributions, there are many clinical cases in which good dose distributions can be obtained with one or two fields. When this is done, it is possible to use smaller PTV and PRV margins. This has the potential to convert untreatable cases, in which the PTV and PRV overlap, into cases with a gap between PTV and PRV of adequate size for treatment planning

  10. SU-C-202-05: Pilot Study of Online Treatment Evaluation and Adaptive Re-Planning for Laryngeal SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Mao, W [The University of Texas Southwestern Medical Ctr, Dallas, TX (United States); Henry Ford Health System, Detroit, MI (United States); Liu, C; Zhong, H [Henry Ford Health System, Detroit, MI (United States); Rozario, T; Lu, W; Gu, X; Yan, Y; Jia, X; Sumer, B; Schwartz, D [The University of Texas Southwestern Medical Ctr, Dallas, TX (United States)

    2016-06-15

    Purpose: We have instigated a phase I trial of 5-fraction stereotactic body radiotherapy (SBRT) for advanced-stage laryngeal cancer. We conducted this pilot dosimetric study to confirm the potential utility of online adaptive re-planning to preserve treatment quality. Methods: Ten cases of larynx cancer were evaluated. Baseline and daily SBRT treatment plans were generated per trial protocol. Daily volumetric images were acquired prior to every fraction of treatment. Reference simulation CT images were deformably registered to daily volumetric images using Eclipse. Planning contours were then deformably propagated to daily images. Reference SBRT plans were directly copied to calculate delivered dose distributions on deformed reference CT images. In-house software platform has been developed to calculate cumulative dose over a course of treatment in four steps: 1) deforming delivered dose grid to reference CT images using deformation information exported from Eclipse; 2) generating tetrahedrons using deformed dose grid as vertices; 3) resampling dose to a high resolution within every tetrahedron; 4) calculating dose-volume histograms. Our inhouse software was benchmarked with a commercial software, Mirada. Results: In all ten cases including 49 fractions of treatments, delivered daily doses were completely evaluated and treatment could be re-planned within 10 minutes. Prescription dose coverage of PTV was less than intended in 53% of fractions of treatment (mean: 94%, range: 84%–98%) while minimum coverage of CTV and GTV was 94% and 97%, respectively. Maximum bystander point dose limits to arytenoids, parotids, and spinal cord remained respected in all cases, although variances in carotid artery doses were observed in a minority of cases. Conclusion: Although GTV and CTV coverage is preserved by in-room 3D image guidance of larynx SBRT, PTV coverage can vary significantly from intended plans. Online adaptive treatment evaluation and re-planning is potentially

  11. Environment: Development plan 1993

    International Nuclear Information System (INIS)

    1992-01-01

    The concept of sustainable development is gradually being incorporated into the activities of Hydro-Quebec as part of that utility's environmental policy. In its proposed development plan, Hydro-Quebec's principal strategic environmental orientations comprise making environmental concerns an integral part of the planning process, managing impacts associated with the construction of generating and transmission facilities, and evaluating the utility's environmental performance. The approaches used, tools to be developed, and information required in each of these orientations are described. Issues considered include the strategic choices available for meeting electricity requirements, including renewable energy sources; the evaluation of environmental externalities; the use of environmental impact assessment studies and environmental monitoring; relationships with native peoples and mitigation of the social impacts of northern hydroelectric development; protection and management of natural and human habitats; the utility's contribution to regional development; management of wastes and rights-of-way; and environmental auditing. 1 tab

  12. Neutral-beam development plan, FY 1982-1987

    International Nuclear Information System (INIS)

    1981-09-01

    The following chapters are included: (1) status of BNL negative ion source development, (2) source development program plan, (3) status of beam transport and acceleration, (4) accelerator development program plan, (5) neutralizer concepts, (6) neutralization program plan, (7) neutral beam systems, (8) test facilities, (9) program milestones and time schedules, (10) organization and Grumman participation, and (11) funding tables

  13. Optimization of tomotherapy treatment planning for patients with bilateral hip prostheses.

    Science.gov (United States)

    Chapman, David; Smith, Shaun; Barnett, Rob; Bauman, Glenn; Yartsev, Slav

    2014-02-04

    To determine the effect of different imaging options and the most efficient imaging strategy for treatment planning of patients with hip prostheses. The planning kilovoltage CT (kVCT) and daily megavoltage CT (MVCT) studies for three prostate cancer patients with bilateral hip prostheses were used for creating hybrid kVCT/MVCT image sets. Treatment plans were created for kVCT images alone, hybrid kVCT/MVCT images, and MVCT images alone using the same dose prescription and planning parameters. The resulting dose volume histograms were compared. The orthopedic metal artifact reduction (O-MAR) reconstruction tool for kVCT images and different MVCT options were investigated with a water tank fit with double hip prostheses. Treatment plans were created for all imaging options and calculated dose was compared with the one measured by a pin-point ion chamber. On average for three patients, the D35% for the bladder was 8% higher in plans based on MVCT images and 7% higher in plans based on hybrid images, compared to the plans based on kVCT images alone. Likewise, the D35% for the rectum was 3% higher than the kVCT based plan for both hybrid and MVCT plans. The average difference in planned D99% in the PTV compared to kVCT plans was 0.9% and 0.1% for MVCT and hybrid plans, respectively. For the water tank with hip prostheses phantom, the kVCT plan with O-MAR correction applied showed better agreement between the measured and calculated dose than the original image set, with a difference of -1.9% compared to 3.3%. The measured doses for the MVCT plans were lower than the calculated dose due to image size limitations. The best agreement was for the kVCT/MVCT hybrid plans with the difference between calculated and measured dose around 1%. MVCT image provides better visualization of patient anatomy and hybrid kVCT/MVCT study enables more accurate calculations using updated MVCT relative electron density calibration.

  14. Optimization of tomotherapy treatment planning for patients with bilateral hip prostheses

    International Nuclear Information System (INIS)

    Chapman, David; Smith, Shaun; Barnett, Rob; Bauman, Glenn; Yartsev, Slav

    2014-01-01

    To determine the effect of different imaging options and the most efficient imaging strategy for treatment planning of patients with hip prostheses. The planning kilovoltage CT (kVCT) and daily megavoltage CT (MVCT) studies for three prostate cancer patients with bilateral hip prostheses were used for creating hybrid kVCT/MVCT image sets. Treatment plans were created for kVCT images alone, hybrid kVCT/MVCT images, and MVCT images alone using the same dose prescription and planning parameters. The resulting dose volume histograms were compared. The orthopedic metal artifact reduction (O-MAR) reconstruction tool for kVCT images and different MVCT options were investigated with a water tank fit with double hip prostheses. Treatment plans were created for all imaging options and calculated dose was compared with the one measured by a pin-point ion chamber. On average for three patients, the D 35% for the bladder was 8% higher in plans based on MVCT images and 7% higher in plans based on hybrid images, compared to the plans based on kVCT images alone. Likewise, the D 35% for the rectum was 3% higher than the kVCT based plan for both hybrid and MVCT plans. The average difference in planned D99% in the PTV compared to kVCT plans was 0.9% and 0.1% for MVCT and hybrid plans, respectively. For the water tank with hip prostheses phantom, the kVCT plan with O-MAR correction applied showed better agreement between the measured and calculated dose than the original image set, with a difference of -1.9% compared to 3.3%. The measured doses for the MVCT plans were lower than the calculated dose due to image size limitations. The best agreement was for the kVCT/MVCT hybrid plans with the difference between calculated and measured dose around 1%. MVCT image provides better visualization of patient anatomy and hybrid kVCT/MVCT study enables more accurate calculations using updated MVCT relative electron density calibration

  15. [Treatment strategy and planning for pilon fractures].

    Science.gov (United States)

    Mittlmeier, Thomas; Wichelhaus, Alice

    2017-08-01

    Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms. The aim of the present analysis was to display the strategy variations for the treatment of pilon fractures taking into account the advantages and disadvantages of the corresponding treatment concepts. A staged procedure including primary closed reduction employing ligamentotaxis and fixation of the joints of the hindfoot via tibiocalcaneal metatarsal fixation offers a safe basis for consecutive imaging and the selection of specific approaches for definitive reconstruction. A simultaneous reconstruction and fixation of the fibula during the primary intervention are generally not recommended in order to avoid any limitations for subsequent reconstructive procedures. A time frame for definitive reconstruction covers a period of up to 3 weeks after trauma and allows a detailed planning considering the individual dynamics of the soft tissue situation and any logistic requirements. For the choice of the definitive treatment concept a wide range of procedures and implants are available. There are also valid concepts for primary treatment of defined fracture constellations while primary arthrodesis represents a solution in cases of major destruction of the joint surface. Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture.

  16. SU-F-T-99: Data Visualization From a Treatment Planning Tracking System for Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Cline, K; Kabat, C; Li, Y; Ha, C; Kirby, N; Stathakis, S [University of Texas HSC SA, San Antonio, TX (United States)

    2016-06-15

    Purpose: A treatment planning process tracker database with input forms and a TV-viewable display webpage was developed and implemented in our clinic to collect time data points throughout the process. Tracking plan times is important because it directly affects the patient quality of care. Simply, the longer a patient waits after their initial simulation CT for treatment to begin, the more time the cancer has to progress. The tracker helps to drive workflow through the clinic, while the data collected can be used to understand and manage the process to find and eliminate inefficiencies. Methods: The overall process steps tracked are CT-simulation, mark patient, draw normal contours, draw target volumes, create plan, and review/approve plan. Time stamps for task completion were extracted and used to generate a set of clinic metrics, among which include average time for each step in the process split apart by type of treatment, average time to completion for plans started in a given week, and individual overall completion time per plan. Results: Trends have been tracked for fourteen weeks of clinical data (196 plans). On average, drawing normal contours and target volumes is taking 2–5 times as long as creating the plan itself. This is potentially an issue because it could mean the process is taking too long initially, and it could be forcing the planning step to be done in a short amount of time. We also saw from our graphs that there appears to be no clear trend on the average amount of time per plan week-to-week. Conclusion: A tracker of this type has the potential to provide insight into how time is utilized in our clinic. By equipping our dosimetrists, radiation oncologists, and physicists with individualized metric sets, the tracker can help provide visibility and drive workflow. Funded in part by CPRIT (RP140105).

  17. Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

    Directory of Open Access Journals (Sweden)

    Afolabi Olusegun Emmanuel

    2015-06-01

    Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

  18. Full Monte Carlo-Based Biologic Treatment Plan Optimization System for Intensity Modulated Carbon Ion Therapy on Graphics Processing Unit.

    Science.gov (United States)

    Qin, Nan; Shen, Chenyang; Tsai, Min-Yu; Pinto, Marco; Tian, Zhen; Dedes, Georgios; Pompos, Arnold; Jiang, Steve B; Parodi, Katia; Jia, Xun

    2018-01-01

    One of the major benefits of carbon ion therapy is enhanced biological effectiveness at the Bragg peak region. For intensity modulated carbon ion therapy (IMCT), it is desirable to use Monte Carlo (MC) methods to compute the properties of each pencil beam spot for treatment planning, because of their accuracy in modeling physics processes and estimating biological effects. We previously developed goCMC, a graphics processing unit (GPU)-oriented MC engine for carbon ion therapy. The purpose of the present study was to build a biological treatment plan optimization system using goCMC. The repair-misrepair-fixation model was implemented to compute the spatial distribution of linear-quadratic model parameters for each spot. A treatment plan optimization module was developed to minimize the difference between the prescribed and actual biological effect. We used a gradient-based algorithm to solve the optimization problem. The system was embedded in the Varian Eclipse treatment planning system under a client-server architecture to achieve a user-friendly planning environment. We tested the system with a 1-dimensional homogeneous water case and 3 3-dimensional patient cases. Our system generated treatment plans with biological spread-out Bragg peaks covering the targeted regions and sparing critical structures. Using 4 NVidia GTX 1080 GPUs, the total computation time, including spot simulation, optimization, and final dose calculation, was 0.6 hour for the prostate case (8282 spots), 0.2 hour for the pancreas case (3795 spots), and 0.3 hour for the brain case (6724 spots). The computation time was dominated by MC spot simulation. We built a biological treatment plan optimization system for IMCT that performs simulations using a fast MC engine, goCMC. To the best of our knowledge, this is the first time that full MC-based IMCT inverse planning has been achieved in a clinically viable time frame. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Evaluation of Plan Implementation: Peri-urban Development and the Shanghai Master Plan 1999-2020

    Directory of Open Access Journals (Sweden)

    Jinghuan He

    2015-01-01

    Full Text Available Since the 1980s China has experienced unprecedented urbanisation as a result of a series of reforms promoting rapid economic development. Shanghai, like the other big cities along China’s coastline, has witnessed extraordinary growth in its economy and population with industrial development and rural-to-urban migration generating extensive urban expansion. Shanghai’s GDP growth rate has been over 10 per cent for more than 15 years. Its population in 2013 was estimated at 23.47 million, which is double its size in 1979. The urban area enlarged by four times from 644 to 2,860 km2 between 1977 and 2010. Such demanding growth and dramatic changes present big challenges for urban planning practice in Shanghai. Plans have not kept up with development and the mismatch between the proposals in plans and the actual spatial development has gradually increased, reaching a critical level since 2000. The mismatch in the periurban areas is more notable than that in the existing urban area, but there has not been a systematic review of the relationship between plan and implementation. Indeed, there are few studies on the evaluation of plan implementation in China generally. Although many plans at numerous spatial levels are successively prepared and revised, only few of them have been evaluated in terms of their effectiveness and implementation.  This particularly demanding context for planning where spatial development becomes increasingly unpredictable and more difficult to influence presents an opportunity to investigate the role of plans under conditions of rapid urbanisation. The research project asks to what extent have spatial plans influenced the actual spatial development in the peri-urban areas of Shanghai? The research pays particular attention to the role of the Shanghai Master Plan 1999-2020 (Plan 1999. By answering the main research question this study seeks to contribute to a better understanding of present planning practice in Shanghai

  20. Clinical treatment planning for subjects undergoing boron neutron capture therapy at Harvard-MIT

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Palmer, M.R.; Buse, P.M.

    2001-01-01

    Treatment planning is a crucial component of the Harvard-MIT boron neutron capture therapy (BNCT) clinical trials. Treatment planning can be divided into five stages: (1) pre-planning, based on CT and MRI scans obtained when the subject arrives at the hospital and on assumed boron-10 distribution parameters; (2) subject set-up, or simulation, in the MITR-II medical therapy room to determine the boundary conditions for possible set-up configurations; (3) re-planning, following the subject simulation; (4) final localization of the subject in the medical therapy room for BNCT; and (5) final post facto recalculation of the doses delivered based on firm knowledge of the blood boron-10 concentration profiles and the neutron flux histories from precise online monitoring. The computer-assisted treatment planning is done using a specially written BNCT treatment planning code called MacNCTPLAN. The code uses the Los Alamos National Laboratory's Monte Carlo n-particle radiation transport code MCNPv.4b as the dose calculation engine and advanced anatomical model simulation based on an automatic evaluation of CT scan data. Results are displayed as isodose contours and dose-volume histograms, the latter correlated precisely with corresponding anatomical CT or MRI image planes. Examples of typical treatment planning scenarios will be presented. (author)

  1. Application of Multimodality Imaging Fusion Technology in Diagnosis and Treatment of Malignant Tumors under the Precision Medicine Plan.

    Science.gov (United States)

    Wang, Shun-Yi; Chen, Xian-Xia; Li, Yi; Zhang, Yu-Ying

    2016-12-20

    The arrival of precision medicine plan brings new opportunities and challenges for patients undergoing precision diagnosis and treatment of malignant tumors. With the development of medical imaging, information on different modality imaging can be integrated and comprehensively analyzed by imaging fusion system. This review aimed to update the application of multimodality imaging fusion technology in the precise diagnosis and treatment of malignant tumors under the precision medicine plan. We introduced several multimodality imaging fusion technologies and their application to the diagnosis and treatment of malignant tumors in clinical practice. The data cited in this review were obtained mainly from the PubMed database from 1996 to 2016, using the keywords of "precision medicine", "fusion imaging", "multimodality", and "tumor diagnosis and treatment". Original articles, clinical practice, reviews, and other relevant literatures published in English were reviewed. Papers focusing on precision medicine, fusion imaging, multimodality, and tumor diagnosis and treatment were selected. Duplicated papers were excluded. Multimodality imaging fusion technology plays an important role in tumor diagnosis and treatment under the precision medicine plan, such as accurate location, qualitative diagnosis, tumor staging, treatment plan design, and real-time intraoperative monitoring. Multimodality imaging fusion systems could provide more imaging information of tumors from different dimensions and angles, thereby offing strong technical support for the implementation of precision oncology. Under the precision medicine plan, personalized treatment of tumors is a distinct possibility. We believe that multimodality imaging fusion technology will find an increasingly wide application in clinical practice.

  2. Treatment planning for multicatheter interstitial brachytherapy of breast cancer – from Paris system to anatomy-based inverse planning

    Directory of Open Access Journals (Sweden)

    Tibor Major

    2017-02-01

    Full Text Available In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented.

  3. MO-F-CAMPUS-T-04: Development and Evaluation of a Knowledge-Based Model for Treatment Planning of Lung Cancer Patients Using Stereotactic Body Radiotherapy (SBRT)

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, K; Kim, J; Reding, A; Fraser, C; Lu, S; Gordon, J; Ajlouni, M; Movsas, B; Chetty, I [Henry Ford Health System, Detroit, MI (United States)

    2015-06-15

    Purpose: To describe the development of a knowledge-based treatment planning model for lung cancer patients treated with SBRT, and to evaluate the model performance and applicability to different planning techniques and tumor locations. Methods: 105 lung SBRT plans previously treated at our institution were included in the development of the model using Varian’s RapidPlan DVH estimation algorithm. The model was trained with a combination of IMRT, VMAT, and 3D–CRT techniques. Tumor locations encompassed lesions located centrally vs peripherally (43:62), upper vs lower (62:43), and anterior vs posterior lobes (60:45). The model performance was validated with 25 cases independent of the training set, for both IMRT and VMAT. Model generated plans were created with only one optimization and no planner intervention. The original, general model was also divided into four separate models according to tumor location. The model was also applied using different beam templates to further improve workflow. Dose differences to targets and organs-at-risk were evaluated. Results: IMRT and VMAT RapidPlan generated plans were comparable to clinical plans with respect to target coverage and several OARs. Spinal cord dose was lowered in the model-based plans by 1Gy compared to the clinical plans, p=0.008. Splitting the model according to tumor location resulted in insignificant differences in DVH estimation. The peripheral model decreased esophagus dose to the central lesions by 0.5Gy compared to the original model, p=0.025, and the posterior model increased dose to the spinal cord by 1Gy compared to the anterior model, p=0.001. All template beam plans met OAR criteria, with 1Gy increases noted in maximum heart dose for the 9-field plans, p=0.04. Conclusion: A RapidPlan knowledge-based model for lung SBRT produces comparable results to clinical plans, with increased consistency and greater efficiency. The model encompasses both IMRT and VMAT techniques, differing tumor locations

  4. Treatment Planning Systems for BNCT Requirements and Peculiarities

    CERN Document Server

    Daquino, G G

    2003-01-01

    The main requirements and peculiarities expected from the BNCT-oriented treatment planning system (TPS) are summarized in this paper. The TPS is a software, which can be integrated or composed by several auxiliary programs. It plays important roles inside the whole treatment planning of the patient's organ in BNCT. However, the main goal is the simulation of the irradiation, in order to obtain the optimal configuration, in terms of neutron spectrum, patient positioning and dose distribution in the tumour and healthy tissues. The presence of neutrons increases the level of complexity, because much more nuclear reactions need to be monitored and properly calculated during the simulation of the patient's treatment. To this purposes several 3D geometry reconstruction techniques, generally based on the CT scanning data, are implemented and Monte Carlo codes are normally used. The TPSs are expected to show also the results (basically doses and fluences) in a proper format, such as isocurves (or isosurfaces) along t...

  5. Application of a dummy eye shield for electron treatment planning

    International Nuclear Information System (INIS)

    Kang, Sei-Kwon; Park, Soah; Hwang, Taejin; Cheong, Kwang-Ho; Han, Taejin; Kim, Haeyoung; Lee, Me-Yeon; Kim, Kyoung Ju; Oh, Do Hoon; Bae, Hoonsik

    2013-01-01

    Metallic eye shields have been widely used for near-eye treatments to protect critical regions, but have never been incorporated into treatment plans because of the unwanted appearance of the metal artifacts on CT images. The purpose of this work was to test the use of an acrylic dummy eye shield as a substitute for a metallic eye shield during CT scans. An acrylic dummy shield of the same size as the tungsten eye shield was machined and CT scanned. The BEAMnrc and the DOSXYZnrc were used for the Monte Carlo (MC) simulation, with the appropriate material information and density for the aluminum cover, steel knob and tungsten body of the eye shield. The Pinnacle adopting the Hogstrom electron pencil-beam algorithm was used for the one-port 6-MeV beam plan after delineation and density override of the metallic parts. The results were confirmed with the metal oxide semiconductor field effect transistor (MOSFET) detectors and the Gafchromic EBT2 film measurements. For both the maximum eyelid dose over the shield and the maximum dose under the shield, the MC results agreed with the EBT2 measurements within 1.7%. For the Pinnacle plan, the maximum dose under the shield agreed with the MC within 0.3%; however, the eyelid dose differed by -19.3%. The adoption of the acrylic dummy eye shield was successful for the treatment plan. However, the Pinnacle pencil-beam algorithm was not sufficient to predict the eyelid dose on the tungsten shield, and more accurate algorithms like MC should be considered for a treatment plan. (author)

  6. Assessing the quality of conformal treatment planning: a new tool for quantitative comparison

    International Nuclear Information System (INIS)

    Menhel, J; Levin, D; Alezra, D; Symon, Z; Pfeffer, R

    2006-01-01

    We develop a novel radiotherapy plan comparison index, critical organ scoring index (COSI), which is a measure of both target coverage and critical organ overdose. COSI is defined as COSI = 1 - (V(OAR) >tol /TC), where V(OAR) >tol is the fraction of volume of organ at risk receiving more than tolerance dose, and TC is the target coverage, V T,PI /V T , where V T,PI is the target volume receiving at a least prescription dose and V T is the total target volume. COSI approaches unity when the critical structure is completely spared and the target coverage is unity. We propose a two-dimensional, graphical representation of COSI versus conformity index (CI), where CI is a measure of a normal tissue overdose. We show that this 2D representation is a reliable, visual quantitative tool for evaluating competing plans. We generate COSI-CI plots for three sites: head and neck, cavernous sinus, and pancreas, and evaluate competing non-coplanar 3D and IMRT treatment plans. For all three sites this novel 2D representation assisted the physician in choosing the optimal plan, both in terms of target coverage and in terms of critical organ sparing. We verified each choice by analysing individual DVHs and isodose lines. Comparing our results to the widely used conformation number, we found that in all cases where there were discrepancies in the choice of the best treatment plan, the COSI-CI choice was considered the correct one, in several cases indicating that a non-coplanar 3D plan was superior to the IMRT plans. The choice of plan was quick, simple and accurate using the new graphical representation

  7. Forward-Looking Planning of Technology Development

    Directory of Open Access Journals (Sweden)

    Katarzyna Halicka

    2015-12-01

    Full Text Available The main aim of this article is to adapt the Future-Oriented Technology Analysis (FTA to prospective planning of technology development. Firstly, the article presents the assumptions, methods and idea, as well as the concept of the FTA method. Moreover, selected publications on the use of this method were analysed. Then, an original, base model of forward-looking planning of technology development was constructed and presented. The end result of this process will be the development of the localized in time, presented in graphic form, action plan referred to as the route of technology development. Basing on the literature review and the research projects a preliminary route of development of arbitrarily chosen technology was also built and presented.

  8. TU-G-210-00: Treatment Planning Strategies, Modeling, Control

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Modeling can play a vital role in predicting, optimizing and analyzing the results of therapeutic ultrasound treatments. Simulating the propagating acoustic beam in various targeted regions of the body allows for the prediction of the resulting power deposition and temperature profiles. In this session we will apply various modeling approaches to breast, abdominal organ and brain treatments. Of particular interest is the effectiveness of procedures for correcting for phase aberrations caused by intervening irregular tissues, such as the skull in transcranial applications or inhomogeneous breast tissues. Also described are methods to compensate for motion in targeted abdominal organs such as the liver or kidney. Douglas Christensen – Modeling for Breast and Brain HIFU Treatment Planning Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Learning Objectives: Understand the role of acoustic beam modeling for predicting the effectiveness of therapeutic ultrasound treatments. Apply acoustic modeling to specific breast, liver, kidney and transcranial anatomies. Determine how to obtain appropriate acoustic modeling parameters from clinical images. Understand the separate role of absorption and scattering in energy delivery to tissues. See how organ motion can be compensated for in ultrasound therapies. Compare simulated data with clinical temperature measurements in transcranial applications. Supported by NIH R01 HL172787 and R01 EB013433 (DC); EU Seventh Framework Programme (FP7/2007-2013) under 270186 (FUSIMO) and 611889 (TRANS-FUSIMO)(TP); and P01 CA159992, GE, FUSF and InSightec (UV)

  9. TU-G-210-00: Treatment Planning Strategies, Modeling, Control

    International Nuclear Information System (INIS)

    2015-01-01

    Modeling can play a vital role in predicting, optimizing and analyzing the results of therapeutic ultrasound treatments. Simulating the propagating acoustic beam in various targeted regions of the body allows for the prediction of the resulting power deposition and temperature profiles. In this session we will apply various modeling approaches to breast, abdominal organ and brain treatments. Of particular interest is the effectiveness of procedures for correcting for phase aberrations caused by intervening irregular tissues, such as the skull in transcranial applications or inhomogeneous breast tissues. Also described are methods to compensate for motion in targeted abdominal organs such as the liver or kidney. Douglas Christensen – Modeling for Breast and Brain HIFU Treatment Planning Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Learning Objectives: Understand the role of acoustic beam modeling for predicting the effectiveness of therapeutic ultrasound treatments. Apply acoustic modeling to specific breast, liver, kidney and transcranial anatomies. Determine how to obtain appropriate acoustic modeling parameters from clinical images. Understand the separate role of absorption and scattering in energy delivery to tissues. See how organ motion can be compensated for in ultrasound therapies. Compare simulated data with clinical temperature measurements in transcranial applications. Supported by NIH R01 HL172787 and R01 EB013433 (DC); EU Seventh Framework Programme (FP7/2007-2013) under 270186 (FUSIMO) and 611889 (TRANS-FUSIMO)(TP); and P01 CA159992, GE, FUSF and InSightec (UV)

  10. SU-F-T-440: The Feasibility Research of Checking Cervical Cancer IMRT Pre- Treatment Dose Verification by Automated Treatment Planning Verification System

    Energy Technology Data Exchange (ETDEWEB)

    Liu, X; Yin, Y; Lin, X [Shandong Cancer Hospital and Institute, China, Jinan, Shandong (China)

    2016-06-15

    Purpose: To assess the preliminary feasibility of automated treatment planning verification system in cervical cancer IMRT pre-treatment dose verification. Methods: The study selected randomly clinical IMRT treatment planning data for twenty patients with cervical cancer, all IMRT plans were divided into 7 fields to meet the dosimetric goals using a commercial treatment planning system(PianncleVersion 9.2and the EclipseVersion 13.5). The plans were exported to the Mobius 3D (M3D)server percentage differences of volume of a region of interest (ROI) and dose calculation of target region and organ at risk were evaluated, in order to validate the accuracy automated treatment planning verification system. Results: The difference of volume for Pinnacle to M3D was less than results for Eclipse to M3D in ROI, the biggest difference was 0.22± 0.69%, 3.5±1.89% for Pinnacle and Eclipse respectively. M3D showed slightly better agreement in dose of target and organ at risk compared with TPS. But after recalculating plans by M3D, dose difference for Pinnacle was less than Eclipse on average, results were within 3%. Conclusion: The method of utilizing the automated treatment planning system to validate the accuracy of plans is convenientbut the scope of differences still need more clinical patient cases to determine. At present, it should be used as a secondary check tool to improve safety in the clinical treatment planning.

  11. Independent verification of monitor unit calculation for radiation treatment planning system.

    Science.gov (United States)

    Chen, Li; Chen, Li-Xin; Huang, Shao-Min; Sun, Wen-Zhao; Sun, Hong-Qiang; Deng, Xiao-Wu

    2010-02-01

    To ensure the accuracy of dose calculation for radiation treatment plans is an important part of quality assurance (QA) procedures for radiotherapy. This study evaluated the Monitor Units (MU) calculation accuracy of a third-party QA software and a 3-dimensional treatment planning system (3D TPS), to investigate the feasibility and reliability of independent verification for radiation treatment planning. Test plans in a homogenous phantom were designed with 3-D TPS, according to the International Atomic Energy Agency (IAEA) Technical Report No. 430, including open, blocked, wedge, and multileaf collimator (MLC) fields. Test plans were delivered and measured in the phantom. The delivered doses were input to the QA software and the independent calculated MUs were compared with delivery. All test plans were verified with independent calculation and phantom measurements separately, and the differences of the two kinds of verification were then compared. The deviation of the independent calculation to the measurements was (0.1 +/- 0.9)%, the biggest difference fell onto the plans that used block and wedge fields (2.0%). The mean MU difference between the TPS and the QA software was (0.6 +/- 1.0)%, ranging from -0.8% to 2.8%. The deviation in dose of the TPS calculation compared to the measurements was (-0.2 +/- 1.7)%, ranging from -3.9% to 2.9%. MU accuracy of the third-party QA software is clinically acceptable. Similar results were achieved with the independent calculations and the phantom measurements for all test plans. The tested independent calculation software can be used as an efficient tool for TPS plan verification.

  12. Novel hyperthermia applicator system allows adaptive treatment planning: Preliminary clinical results in tumour-bearing animals.

    Science.gov (United States)

    Dressel, S; Gosselin, M-C; Capstick, M H; Carrasco, E; Weyland, M S; Scheidegger, S; Neufeld, E; Kuster, N; Bodis, S; Rohrer Bley, C

    2017-09-11

    Hyperthermia (HT) as an adjuvant to radiation therapy (RT) is a multimodality treatment method to enhance therapeutic efficacy in different tumours. High demands are placed on the hardware and treatment planning software to guarantee adequately planned and applied HT treatments. The aim of this prospective study was to determine the effectiveness and safety of the novel HT system in tumour-bearing dogs and cats in terms of local response and toxicity as well as to compare planned with actual achieved data during heating. A novel applicator with a flexible number of elements and integrated closed-loop temperature feedback control system, and a tool for patient-specific treatment planning were used in a combined thermoradiotherapy protocol. Good agreement between predictions from planning and clinical outcome was found in 7 of 8 cases. Effective HT treatments were planned and verified with the novel system and provided improved quality of life in all but 1 patient. This individualized treatment planning and controlled heat exposure allows adaptive, flexible and safe HT treatments in palliatively treated animal patients. © 2017 John Wiley & Sons Ltd.

  13. The role of PET/CT in radiation treatment planning for cancer patient treatment

    International Nuclear Information System (INIS)

    2008-10-01

    Positron emission tomography (PET) and, more recently, integrated positron emission tomography/X ray computed tomography (PET/CT) have appeared as significant diagnostic imaging systems in clinical medicine. Accurate recognition of cancers in patients by means of PET scanning with Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) has illustrated a need to determine a mode of therapy to achieve better prognoses. The clinical management of cancer patients has improved dramatically with the introduction of clinical PET. For treatment of cancer patients, on the other hand, radiation therapy (RT) plays an important role as a non-invasive therapy. It is crucial that cancers are encompassed by high dose irradiation, particularly in cases of curative RT. Irradiation should precisely target the entire tumour and aim to minimise the size of microscopic extensions of the cancer, as well as minimize radiation damage to normal tissues. A new imaging technique has therefore been sought to allow precise delineation of the cancer target to be irradiated. Clinical PET, combined with utilization of 18 F-FDG, may have an important role in radiation treatment planning (RTP) in lung cancer. In addition to determining if RT is appropriate and whether therapy will be given with curative or palliative intent, 18 F-FDG-PET is useful for determining therapy ports. It can be used both to limit ports to spare normal tissue and to include additional involved regions. Several studies have shown that PET has an impact on RTP in an important proportion of patients. It is to be hoped that treatment plans that include all the 18 F-FDG-avid lesions or the 18 F-FDG-avid portions of a complex mass will result in more effective local control with less unnecessary tissue being treated. The IAEA has placed emphasis on the issue of application of clinical PET for radiation treatment planning in various cancer patients. Two consultants meetings were held in 2006 and their results are summarized into this IAEA

  14. Deliverable navigation for multicriteria IMRT treatment planning by combining shared and individual apertures

    International Nuclear Information System (INIS)

    Fredriksson, Albin; Bokrantz, Rasmus

    2013-01-01

    We consider the problem of deliverable Pareto surface navigation for step-and-shoot intensity-modulated radiation therapy. This problem amounts to calculation of a collection of treatment plans with the property that convex combinations of plans are directly deliverable. Previous methods for deliverable navigation impose restrictions on the number of apertures of the individual plans, or require that all treatment plans have identical apertures. We introduce simultaneous direct step-and-shoot optimization of multiple plans subject to constraints that some of the apertures must be identical across all plans. This method generalizes previous methods for deliverable navigation to allow for treatment plans with some apertures from a collective pool and some apertures that are individual. The method can also be used as a post-processing step to previous methods for deliverable navigation in order to improve upon their plans. By applying the method to subsets of plans in the collection representing the Pareto set, we show how it can enable convergence toward the unrestricted (non-navigable) Pareto set where all apertures are individual. (paper)

  15. MO-F-CAMPUS-T-05: SQL Database Queries to Determine Treatment Planning Resource Usage

    International Nuclear Information System (INIS)

    Fox, C; Gladstone, D

    2015-01-01

    Purpose: A radiation oncology clinic’s treatment capacity is traditionally thought to be limited by the number of machines in the clinic. As the number of fractions per course decrease and the number of adaptive plans increase, the question of how many treatment plans a clinic can plan becomes increasingly important. This work seeks to lay the ground work for assessing treatment planning resource usage. Methods: Care path templates were created using the Aria 11 care path interface. Care path tasks included key steps in the treatment planning process from the completion of CT simulation through the first radiation treatment. SQL Server Management Studio was used to run SQL queries to extract task completion time stamps along with care path template information and diagnosis codes from the Aria database. 6 months of planning cycles were evaluated. Elapsed time was evaluated in terms of work hours within Monday – Friday, 7am to 5pm. Results: For the 195 validated treatment planning cycles, the average time for planning and MD review was 22.8 hours. Of those cases 33 were categorized as urgent. The average planning time for urgent plans was 5 hours. A strong correlation between diagnosis code and range of elapsed planning time was as well as between elapsed time and select diagnosis codes was observed. It was also observed that tasks were more likely to be completed on the date due than the time that they were due. Follow-up confirmed that most users did not look at the due time. Conclusion: Evaluation of elapsed planning time and other tasks suggest that care paths should be adjusted to allow for different contouring and planning times for certain diagnosis codes and urgent cases. Additional clinic training around task due times vs dates or a structuring of care paths around due dates is also needed

  16. MO-F-CAMPUS-T-05: SQL Database Queries to Determine Treatment Planning Resource Usage

    Energy Technology Data Exchange (ETDEWEB)

    Fox, C; Gladstone, D [Dartmouth Hitchcock-Medical Center, Hanover, NH (United States)

    2015-06-15

    Purpose: A radiation oncology clinic’s treatment capacity is traditionally thought to be limited by the number of machines in the clinic. As the number of fractions per course decrease and the number of adaptive plans increase, the question of how many treatment plans a clinic can plan becomes increasingly important. This work seeks to lay the ground work for assessing treatment planning resource usage. Methods: Care path templates were created using the Aria 11 care path interface. Care path tasks included key steps in the treatment planning process from the completion of CT simulation through the first radiation treatment. SQL Server Management Studio was used to run SQL queries to extract task completion time stamps along with care path template information and diagnosis codes from the Aria database. 6 months of planning cycles were evaluated. Elapsed time was evaluated in terms of work hours within Monday – Friday, 7am to 5pm. Results: For the 195 validated treatment planning cycles, the average time for planning and MD review was 22.8 hours. Of those cases 33 were categorized as urgent. The average planning time for urgent plans was 5 hours. A strong correlation between diagnosis code and range of elapsed planning time was as well as between elapsed time and select diagnosis codes was observed. It was also observed that tasks were more likely to be completed on the date due than the time that they were due. Follow-up confirmed that most users did not look at the due time. Conclusion: Evaluation of elapsed planning time and other tasks suggest that care paths should be adjusted to allow for different contouring and planning times for certain diagnosis codes and urgent cases. Additional clinic training around task due times vs dates or a structuring of care paths around due dates is also needed.

  17. Wanted: A World Development Plan

    NARCIS (Netherlands)

    J. Tinbergen (Jan)

    1968-01-01

    textabstractDevelopment planning has become a routine activity for large numbers of corporations as well as for public authorities at various levels, particularly national governments. In quite a few national planning agencies extensive analyses of the probable expansion of world supply and demand

  18. Independent calculation of dose distributions for helical tomotherapy using a conventional treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Klüter, Sebastian, E-mail: sebastian.klueter@med.uni-heidelberg.de; Schubert, Kai; Lissner, Steffen; Sterzing, Florian; Oetzel, Dieter; Debus, Jürgen [Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany, and Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany, and German Consortium for Translational Cancer Research (DKTK), Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Schlegel, Wolfgang [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Oelfke, Uwe [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany and Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG (United Kingdom); Nill, Simeon [Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG (United Kingdom)

    2014-08-15

    Purpose: The dosimetric verification of treatment plans in helical tomotherapy usually is carried out via verification measurements. In this study, a method for independent dose calculation of tomotherapy treatment plans is presented, that uses a conventional treatment planning system with a pencil kernel dose calculation algorithm for generation of verification dose distributions based on patient CT data. Methods: A pencil beam algorithm that directly uses measured beam data was configured for dose calculation for a tomotherapy machine. Tomotherapy treatment plans were converted into a format readable by an in-house treatment planning system by assigning each projection to one static treatment field and shifting the calculation isocenter for each field in order to account for the couch movement. The modulation of the fluence for each projection is read out of the delivery sinogram, and with the kernel-based dose calculation, this information can directly be used for dose calculation without the need for decomposition of the sinogram. The sinogram values are only corrected for leaf output and leaf latency. Using the converted treatment plans, dose was recalculated with the independent treatment planning system. Multiple treatment plans ranging from simple static fields to real patient treatment plans were calculated using the new approach and either compared to actual measurements or the 3D dose distribution calculated by the tomotherapy treatment planning system. In addition, dose–volume histograms were calculated for the patient plans. Results: Except for minor deviations at the maximum field size, the pencil beam dose calculation for static beams agreed with measurements in a water tank within 2%/2 mm. A mean deviation to point dose measurements in the cheese phantom of 0.89% ± 0.81% was found for unmodulated helical plans. A mean voxel-based deviation of −0.67% ± 1.11% for all voxels in the respective high dose region (dose values >80%), and a mean local

  19. Independent calculation of dose distributions for helical tomotherapy using a conventional treatment planning system

    International Nuclear Information System (INIS)

    Klüter, Sebastian; Schubert, Kai; Lissner, Steffen; Sterzing, Florian; Oetzel, Dieter; Debus, Jürgen; Schlegel, Wolfgang; Oelfke, Uwe; Nill, Simeon

    2014-01-01

    Purpose: The dosimetric verification of treatment plans in helical tomotherapy usually is carried out via verification measurements. In this study, a method for independent dose calculation of tomotherapy treatment plans is presented, that uses a conventional treatment planning system with a pencil kernel dose calculation algorithm for generation of verification dose distributions based on patient CT data. Methods: A pencil beam algorithm that directly uses measured beam data was configured for dose calculation for a tomotherapy machine. Tomotherapy treatment plans were converted into a format readable by an in-house treatment planning system by assigning each projection to one static treatment field and shifting the calculation isocenter for each field in order to account for the couch movement. The modulation of the fluence for each projection is read out of the delivery sinogram, and with the kernel-based dose calculation, this information can directly be used for dose calculation without the need for decomposition of the sinogram. The sinogram values are only corrected for leaf output and leaf latency. Using the converted treatment plans, dose was recalculated with the independent treatment planning system. Multiple treatment plans ranging from simple static fields to real patient treatment plans were calculated using the new approach and either compared to actual measurements or the 3D dose distribution calculated by the tomotherapy treatment planning system. In addition, dose–volume histograms were calculated for the patient plans. Results: Except for minor deviations at the maximum field size, the pencil beam dose calculation for static beams agreed with measurements in a water tank within 2%/2 mm. A mean deviation to point dose measurements in the cheese phantom of 0.89% ± 0.81% was found for unmodulated helical plans. A mean voxel-based deviation of −0.67% ± 1.11% for all voxels in the respective high dose region (dose values >80%), and a mean local

  20. Long term planning for wind energy development

    International Nuclear Information System (INIS)

    Trinick, M.

    1995-01-01

    In a planning system intended to be governed primarily by policies in statutory plans a reasonable horizon for long term planning is 10 years or longer. Because of statutory requirements, developers have no option but to pay due regard to, and take a full part in, long term planning. The paper examines the type of policies which have emerged in the last few years to cater for wind energy development. It canvasses the merits of different types of policies. Finally, it discusses the policy framework which may emerge to cater for development outside NFFO. (Author)

  1. Epilepsy Treatment Simplified through Mobile Ketogenic Diet Planning.

    Science.gov (United States)

    Li, Hanzhou; Jauregui, Jeffrey L; Fenton, Cagla; Chee, Claire M; Bergqvist, A G Christina

    2014-07-01

    The Ketogenic Diet (KD) is an effective, alternative treatment for refractory epilepsy. This high fat, low protein and carbohydrate diet mimics the metabolic and hormonal changes that are associated with fasting. To maximize the effectiveness of the KD, each meal is precisely planned, calculated, and weighed to within 0.1 gram for the average three-year duration of treatment. Managing the KD is time-consuming and may deter caretakers and patients from pursuing or continuing this treatment. Thus, we investigated methods of planning KD faster and making the process more portable through mobile applications. Nutritional data was gathered from the United States Department of Agriculture (USDA) Nutrient Database. User selected foods are converted into linear equations with n variables and three constraints: prescribed fat content, prescribed protein content, and prescribed carbohydrate content. Techniques are applied to derive the solutions to the underdetermined system depending on the number of foods chosen. The method was implemented on an iOS device and tested with varieties of foods and different number of foods selected. With each case, the application's constructed meal plan was within 95% precision of the KD requirements. In this study, we attempt to reduce the time needed to calculate a meal by automating the computation of the KD via a linear algebra model. We improve upon previous KD calculators by offering optimal suggestions and incorporating the USDA database. We believe this mobile application will help make the KD and other dietary treatment preparations less time consuming and more convenient.

  2. Issues in regional planning and development in Nigeria

    Directory of Open Access Journals (Sweden)

    Oladayo Ramon Ibrahim

    2017-10-01

    Full Text Available Till date,Nigeria can not boast of a specific, well-formulated, clear regional development policy framework despite several urban planning, development and governance initiatives including passage of regulations at both federal and state government levels that have been undertaken since independence by successive post- colonial governments. Most of the country's claims of regional development are products of other policies, and intentions, which do not have any bearing on, deliberate regional planning policies. Policy and decision-making on development planning often do not incorporate the implications of the ways in which we use land and the consequences for different places (economic planning. The neglect of place, in particular, the way that different policies combine to affect places in different ways (regional planning, has contributed to a range of negative economic, social and environmental outcomes. This paper relies mainly on the secondary data and literature exploration to demonstrate that the little role accorded to spatial planning, especially, regional planning, in the development efforts is largely responsible for the underdevelopment, imbalance, and inequalities in the country, as well as poverty of the citizens. The conclusion of the paper is that regional planning should be an integral part and complementary to economic planning in the national development planning of the country. For regional planning to aid in the development of the country and promote the well-being of the citizens, appropriate recommendations have been included in the paper.

  3. Treatment planning for heavy ion radiotherapy: calculation and optimization of biologically effective dose

    International Nuclear Information System (INIS)

    Kraemer, M.; Scholz, M.

    2000-09-01

    We describe a novel approach to treatment planning for heavy ion radiotherapy based on the local effect model (LEM) which allows to calculate the biologically effective dose not only for the target region but for the entire irradiation volume. LEM is ideally suited to be used as an integral part of treatment planning code systems for active dose shaping devices like the GSI raster scan system. Thus, it has been incorporated into our standard treatment planning system for ion therapy (TRiP). Single intensity modulated fields can be optimized with respect to homogeneous biologically effective dose. The relative biological effectiveness (RBE) is calculated separately for each voxel of the patient CT. Our radiobiologically oriented code system is in use since 1995 for the planning of irradiation experiments with cell cultures and animals such as rats and minipigs. Since 1997 it is in regular and successful use for patient treatment planning. (orig.)

  4. Upright 3D Treatment Planning Using a Vertical CT

    International Nuclear Information System (INIS)

    Shah, Anand P.; Strauss, Jonathan B.; Kirk, Michael C.; Chen, Sea S.; Kroc, Thomas K.; Zusag, Thomas W.

    2009-01-01

    In this report, we describe a novel technique used to plan and administer external beam radiation therapy to a patient in the upright position. A patient required reirradiation for thymic carcinoma but was unable to tolerate the supine position due to bilateral phrenic nerve injury and paralysis of the diaphragm. Computed tomography (CT) images in the upright position were acquired at the Northern Illinois University Institute for Neutron Therapy at Fermilab. The CT data were imported into a standard 3-dimensional (3D) treatment planning system. Treatment was designed to deliver 24 Gy to the target volume while respecting normal tissue tolerances. A custom chair that locked into the treatment table indexing system was constructed for immobilization, and port films verified the reproducibility of setup. Radiation was administered using mixed photon and electron AP fields

  5. High-resolution temperature-based optimization for hyperthermia treatment planning

    International Nuclear Information System (INIS)

    Kok, H P; Haaren, P M A van; Kamer, J B Van de; Wiersma, J; Dijk, J D P Van; Crezee, J

    2005-01-01

    In regional hyperthermia, optimization techniques are valuable in order to obtain amplitude/phase settings for the applicators to achieve maximal tumour heating without toxicity to normal tissue. We implemented a temperature-based optimization technique and maximized tumour temperature with constraints on normal tissue temperature to prevent hot spots. E-field distributions are the primary input for the optimization method. Due to computer limitations we are restricted to a resolution of 1 x 1 x 1 cm 3 for E-field calculations, too low for reliable treatment planning. A major problem is the fact that hot spots at low-resolution (LR) do not always correspond to hot spots at high-resolution (HR), and vice versa. Thus, HR temperature-based optimization is necessary for adequate treatment planning and satisfactory results cannot be obtained with LR strategies. To obtain HR power density (PD) distributions from LR E-field calculations, a quasi-static zooming technique has been developed earlier at the UMC Utrecht. However, quasi-static zooming does not preserve phase information and therefore it does not provide the HR E-field information required for direct HR optimization. We combined quasi-static zooming with the optimization method to obtain a millimetre resolution temperature-based optimization strategy. First we performed a LR (1 cm) optimization and used the obtained settings to calculate the HR (2 mm) PD and corresponding HR temperature distribution. Next, we performed a HR optimization using an estimation of the new HR temperature distribution based on previous calculations. This estimation is based on the assumption that the HR and LR temperature distributions, though strongly different, respond in a similar way to amplitude/phase steering. To verify the newly obtained settings, we calculate the corresponding HR temperature distribution. This method was applied to several clinical situations and found to work very well. Deviations of this estimation method for

  6. Treatment-Planning Study of Prostate Cancer Intensity-Modulated Radiotherapy With a Varian Clinac Operated Without a Flattening Filter

    International Nuclear Information System (INIS)

    Vassiliev, Oleg N.; Kry, Stephen F.; Kuban, Deborah A.; Salehpour, Mohammad; Mohan, Radhe; Titt, Uwe

    2007-01-01

    Purpose: To assess the feasibility of intensity-modulated radiotherapy for prostate cancer using photon beams from an accelerator operated without a flattening filter; and to determine potential benefits and drawbacks of using unflattened beams for this type of treatment. Methods and Materials: Intensity-modulated radiotherapy plans were generated for 10 patients with early-stage prostate cancer. For each patient, four plans were generated: with and without the flattening filter, at 6 and 18 MV. The prescription dose was 75.6 Gy to 98% of the planning target volume. The number of beams, their orientations, and optimization constraints were the same for all plans. Plans were generated with Eclipse 8.0 (Varian Medical Systems). Results: All the plans developed with unflattened beams were clinically acceptable. In terms of patient dose distributions, plans with unflattened beams were similar to the corresponding plans with flattened beams. Plans with unflattened beams required fewer monitor units (MUs) per plan: on average, by a factor of 2.0 at 6 MV and 2.6 at 18 MV, assuming that removal of the flattening filter was not followed by recalibration of MUs. Conclusions: Clinically acceptable intensity-modulated radiotherapy plans for prostate cancer can be developed with unflattened beams at both 6 and 18 MV. Dosimetrically, flattened and unflattened beams generated similar treatment plans. The plans with unflattened beams required substantially fewer MUs. The reduction in the number of MUs indicates corresponding reduction in beam-on time and in the amount of radiation outside the target

  7. Suitability of point kernel dose calculation techniques in brachytherapy treatment planning

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Thilagam

    2010-01-01

    Full Text Available Brachytherapy treatment planning system (TPS is necessary to estimate the dose to target volume and organ at risk (OAR. TPS is always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in applicators. However, most brachytherapy TPS software packages estimate the absorbed dose at a point, taking care of only the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. There are some degrees of uncertainties in dose rate estimations under realistic clinical conditions. In this regard, an attempt is made to explore the suitability of point kernels for brachytherapy dose rate calculations and develop new interactive brachytherapy package, named as BrachyTPS, to suit the clinical conditions. BrachyTPS is an interactive point kernel code package developed to perform independent dose rate calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. The primary aim of this study is to validate the developed point kernel code package integrated with treatment planning computational systems against the Monte Carlo (MC results. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, namely (i Board of Radiation Isotope and Technology (BRIT low dose rate (LDR applicator and (ii Fletcher Green type LDR applicator (iii Fletcher Williamson high dose rate (HDR applicator, are studied to test the accuracy of the software. Dose rates computed using the developed code are compared with the relevant results of the MC simulations. Further, attempts are also made to study the dose rate distribution around the commercially available shielded vaginal applicator set (Nucletron. The percentage deviations of BrachyTPS computed dose rate values from the MC results are observed to be within plus/minus 5

  8. Quality assurance in dosimetry and treatment planning

    International Nuclear Information System (INIS)

    Cunningham, J.R.

    1984-01-01

    The considerations of tissue response to radiation absorbed dose suggest a need for an accuracy of +/-5% in its delivery. This is very demanding and its regular achievement requires careful quality control. There are three distinct phases to the delivery of the planned treatment: calibration of the radiation beam in a reference situation, calculation of the dose distribution for a patient relative to the reference dose and the delivery of the radiation to the patient as planned. Each has distinctly different quality assurance requirements and must be diligently observed if the desired accuracy is to be achieved

  9. Safety Improvement in Radiotherapy Treatment Plan. Planning vs Redundant Check vs in vivo Dosimetry

    International Nuclear Information System (INIS)

    Torres Diaz, J.; Ascencion Ybarra, Y.; La Fuentes Rosales, L. de; Lara Mas, E.; Larrinaga Cortinas, E.

    2013-01-01

    In Cuba it is mandatory to have an independent monitor units check before any radiotherapy treatment is started. The main objective of this paper is to enhance the safety of the radiotherapy planning by developing and testing a practical tool to double check the monitor units calculation for external beam high energy photon therapy. A software for monitor units (MUs) verification was designed and coded. It considers the common in clinical practice isocentric set-ups. The in vivo dosimetry measurements were done with a silicon diode system for 6 MV photon beams to support the validation of the software. The results show a discrepancy within 5% between the 3 methods which is in accordance with international recommendations. (Author)

  10. Planning for transit-supportive development : a practitioner's guide. Section 4 : corridor planning and transit-supportive development.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  11. Planning for transit-supportive development : a practitioner's guide. Section 5 : local planning and transit-supportive development.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  12. Planning for transit-supportive development : a practitioner's guide. Section 2 : general transit-supportive development planning topics.

    Science.gov (United States)

    2014-06-01

    Planning for Transit-Supportive Development: A Practitioners Guide is a toolkit of practical and innovative measures to help : Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected o...

  13. SU-F-T-617: Remotely Pre-Planned Stereotactic Ablative Radiation Therapy: Validation of Treatment Plan Quality

    International Nuclear Information System (INIS)

    Juang, T; Bush, K; Loo, B; Gensheimer, M

    2016-01-01

    Purpose: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors. Methods: Target/normal structures were contoured on dxCT; a plan was created and approved by the physician. Structures were transferred to simCT using deformable image registration and the plan was re-optimized on simCT. Plan quality was evaluated through comparison to gold-standard structures contoured on simCT and a gold-standard plan based on these structures. Workflow-generated plan quality in this study represents a worst-case scenario as these patients were not treated using custom immobilization to match dxCT position as would be done when the workflow is implemented clinically. Results: 5/6 plans created through the pre-planning workflow were clinically acceptable. For all six plans, the gold-standard GTV received full prescription dose, along with median PTV V95%=95.2% and median PTV D95%=95.4%. Median GTV DSC=0.80, indicating high degree of similarity between the deformed and gold-standard GTV contours despite small GTV sizes (mean=3.0cc). One outlier (DSC=0.49) resulted in inadequate PTV coverage (V95%=62.9%) in the workflow plan; in clinical practice, this mismatch between deformed/gold-standard GTV would be revised by the physician after deformable registration. For all patients, normal tissue doses were comparable to the gold-standard plan and well within constraints. Conclusion: Pre-planning SABR cases on diagnostic imaging generated

  14. Automated gamma knife radiosurgery treatment planning with image registration, data-mining, and Nelder-Mead simplex optimization

    International Nuclear Information System (INIS)

    Lee, Kuan J.; Barber, David C.; Walton, Lee

    2006-01-01

    Gamma knife treatments are usually planned manually, requiring much expertise and time. We describe a new, fully automatic method of treatment planning. The treatment volume to be planned is first compared with a database of past treatments to find volumes closely matching in size and shape. The treatment parameters of the closest matches are used as starting points for the new treatment plan. Further optimization is performed with the Nelder-Mead simplex method: the coordinates and weight of the isocenters are allowed to vary until a maximally conformal plan specific to the new treatment volume is found. The method was tested on a randomly selected set of 10 acoustic neuromas and 10 meningiomas. Typically, matching a new volume took under 30 seconds. The time for simplex optimization, on a 3 GHz Xeon processor, ranged from under a minute for small volumes ( 30 000 cubic mm,>20 isocenters). In 8/10 acoustic neuromas and 8/10 meningiomas, the automatic method found plans with conformation number equal or better than that of the manual plan. In 4/10 acoustic neuromas and 5/10 meningiomas, both overtreatment and undertreatment ratios were equal or better in automated plans. In conclusion, data-mining of past treatments can be used to derive starting parameters for treatment planning. These parameters can then be computer optimized to give good plans automatically

  15. CT-image-based conformal brachytherapy of breast cancer. The significance of semi-3-D and 3-D treatment planning.

    Science.gov (United States)

    Polgár, C; Major, T; Somogyi, A; Takácsi-Nagy, Z; Mangel, L C; Forrai, G; Sulyok, Z; Fodor, J; Németh, G

    2000-03-01

    To compare the conventional 2-D, the simulator-guided semi-3-D and the recently developed CT-guided 3-D brachytherapy treatment planning in the interstitial radiotherapy of breast cancer. In 103 patients with T1-2, N0-1 breast cancer the tumor bed was clipped during breast conserving surgery. Fifty-two of them received boost brachytherapy after 46 to 50 Gy teletherapy and 51 patients were treated with brachytherapy alone via flexible implant tubes. Single, double and triple plane implant was used in 6, 89 and 8 cases, respectively. The dose of boost brachytherapy and sole brachytherapy prescribed to dose reference points was 3 times 4.75 Gy and 7 times 5.2 Gy, respectively. The positions of dose reference points varied according to the level (2-D, semi-3-D and 3-D) of treatment planning performed. The treatment planning was based on the 3-D reconstruction of the surgical clips, implant tubes and skin points. In all cases the implantations were planned with a semi-3-D technique aided by simulator. In 10 cases a recently developed CT-guided 3-D planning system was used. The semi-3-D and 3-D treatment plans were compared to hypothetical 2-D plans using dose-volume histograms and dose non-uniformity ratios. The values of mean central dose, mean skin dose, minimal clip dose, proportion of underdosaged clips and mean target surface dose were evaluated. The accuracy of tumor bed localization and the conformity of planning target volume and treated volume were also analyzed in each technique. With the help of conformal semi-3-D and 3-D brachytherapy planning we could define reference dose points, active source positions and dwell times individually. This technique decreased the mean skin dose with 22.2% and reduced the possibility of geographical miss. We could achieve the best conformity between the planning target volume and the treated volume with the CT-image based 3-D treatment planning, at the cost of worse dose homogeneity. The mean treated volume was reduced by 25

  16. Dosimetric parameters of enhanced dynamic wedge for treatment planning and verification

    International Nuclear Information System (INIS)

    Leavitt, Dennis D.; Lee, Wing Lok; Gaffney, David K.

    1996-01-01

    Purpose/Objective: Enhanced Dynamic Wedge (EDW) is an intensity-modulated radiotherapy technique in which one collimating jaw sweeps across the field to define a desired wedge dose distribution while dose rate is modified according to jaw position. This tool enables discrete or continuous wedge angles from zero to sixty degrees for field widths from three cm to 30 cm in the direction of the wedge, and up to 40 cm perpendicular to the wedge direction. Additionally, asymmetric wedge fields not centered on the line through isocenter can be created for applications such as tangential breast irradiation. The unique range of field shapes and wedge angles introduce a new set of dosimetric challenges to be resolved before routine clinical use of EDW, and especially require that a simple set of independent dose calculation and verification techniques be developed to check computerized treatment planning results. Using terminology in common use in treatment planning, this work defines the effective wedge factor vs. field width and wedge angle, evaluates the depth dose vs. open field values, defines primary intensity functions from which specific dynamic wedges can be calculated in treatment planning systems, and describes the technique for independent calculation of Monitor Units for EDW fields. Materials and Methods: Using 6- and 18-MV beams from a CI2100C, EDW beam profiles were measured in water phantom for depths from near-surface to 30 cm for the full range of field widths and wedge angles using a linear detector array of 25 energy-compensated diodes. Asymmetric wedge field profiles were likewise measured. Depth doses were measured in water phantom using an ionization chamber sequentially positioned to depths of 30 cm. Effective wedge factors for the full range of field widths and wedge angles were measured using an ionization chamber in water-equivalent plastic at a depth of 10 cm on central axis. Dose profiles were calculated by computer as the summation of a series

  17. Interactive dose shaping - efficient strategies for CPU-based real-time treatment planning

    International Nuclear Information System (INIS)

    Ziegenhein, P; Kamerling, C P; Oelfke, U

    2014-01-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  18. Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q.

    2015-01-01

    Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery

  19. Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Taoran, E-mail: taoran.li.duke@gmail.com; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q. [Department of Radiation Oncology, Duke University Medical Center Durham, North Carolina 27710 (United States)

    2015-01-15

    Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery

  20. Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation.

    Science.gov (United States)

    Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q

    2015-01-01

    An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system's performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Online adapted plans were

  1. Equal employment opportunity plan development guidance

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-09-01

    The purpose of this publication is to provide instructions for the development of EEO Plans for Fiscal Year 1979. It supplements the National EEO Plan for the Department of Energy issued in August 1978 (DOE/S-0002). The material included should be used immediately as guidance to develop, document, and implement subordinate echelon commitments to EEO. A schedule for the development and submission of EEO Plans is included. Most of the continuing requirements will be published at a later date as part of the directives system. Any comments or helpful suggestions concerned with the program outlined would be appreciated by the Office of Equal Opportunity.

  2. Use of Monte Carlo computation in benchmarking radiotherapy treatment planning system algorithms

    International Nuclear Information System (INIS)

    Lewis, R.D.; Ryde, S.J.S.; Seaby, A.W.; Hancock, D.A.; Evans, C.J.

    2000-01-01

    Radiotherapy treatments are becoming more complex, often requiring the dose to be calculated in three dimensions and sometimes involving the application of non-coplanar beams. The ability of treatment planning systems to accurately calculate dose under a range of these and other irradiation conditions requires evaluation. Practical assessment of such arrangements can be problematical, especially when a heterogeneous medium is used. This work describes the use of Monte Carlo computation as a benchmarking tool to assess the dose distribution of external photon beam plans obtained in a simple heterogeneous phantom by several commercially available 3D and 2D treatment planning system algorithms. For comparison, practical measurements were undertaken using film dosimetry. The dose distributions were calculated for a variety of irradiation conditions designed to show the effects of surface obliquity, inhomogeneities and missing tissue above tangential beams. The results show maximum dose differences of 47% between some planning algorithms and film at a point 1 mm below a tangentially irradiated surface. Overall, the dose distribution obtained from film was most faithfully reproduced by the Monte Carlo N-Particle results illustrating the potential of Monte Carlo computation in evaluating treatment planning system algorithms. (author)

  3. Optimization of stereotactic body radiotherapy treatment planning using a multicriteria optimization algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Ghandour, Sarah; Cosinschi, Adrien; Mazouni, Zohra; Pachoud, Marc; Matzinger, Oscar [Riviera-Chablais Hospital, Vevey (Switzerland). Cancer Center, Radiotherapy Dept.

    2016-07-01

    To provide high-quality and efficient dosimetric planning for various types of stereotactic body radiotherapy (SBRT) for tumor treatment using a multicriteria optimization (MCO) technique fine-tuned with direct machine parameter optimization (DMPO). Eighteen patients with lung (n = 11), liver (n = 5) or adrenal cell cancer (n = 2) were treated using SBRT in our clinic between December 2014 and June 2015. Plans were generated using the RayStation trademark Treatment Planning System (TPS) with the VMAT technique. Optimal deliverable SBRT plans were first generated using an MCO algorithm to find a well-balanced tradeoff between tumor control and normal tissue sparing in an efficient treatment planning time. Then, the deliverable plan was post-processed using the MCO solution as the starting point for the DMPO algorithm to improve the dose gradient around the planning target volume (PTV) while maintaining the clinician's priorities. The dosimetric quality of the plans was evaluated using dose-volume histogram (DVH) parameters, which account for target coverage and the sparing of healthy tissue, as well as the CI100 and CI50 conformity indexes. Using a combination of the MCO and DMPO algorithms showed that the treatment plans were clinically optimal and conformed to all organ risk dose volume constraints reported in the literature, with a computation time of approximately one hour. The coverage of the PTV (D99% and D95%) and sparing of organs at risk (OAR) were similar between the MCO and MCO + DMPO plans, with no significant differences (p > 0.05) for all the SBRT plans. The average CI100 and CI50 values using MCO + DMPO were significantly better than those with MCO alone (p < 0.05). The MCO technique allows for convergence on an optimal solution for SBRT within an efficient planning time. The combination of the MCO and DMPO techniques yields a better dose gradient, especially for lung tumors.

  4. Development of a transportation planning tool

    International Nuclear Information System (INIS)

    Funkhouser, B.R.; Moyer, J.W.; Ballweg, E.L.

    1994-01-01

    This paper describes the application of simulation modeling and logistics techniques to the development of a planning tool for the Department of Energy (DOE). The focus of the Transportation Planning Model (TPM) tool is to aid DOE and Sandia analysts in the planning of future fleet sizes, driver and support personnel sizes, base site locations, and resource balancing among the base sites. The design approach is to develop a rapid modeling environment which will allow analysts to easily set up a shipment scenario and perform multiple ''what if'' evaluations. The TPM is being developed on personal computers using commercial off-the shelf (COTS) software tools under the WINDOWS reg-sign operating environment. Prototype development of the TPM has been completed

  5. Dosimetric verification of a software for planning of radio therapeutical treatments

    International Nuclear Information System (INIS)

    Alfonso, R.; Huerta, U.; Alfonso, J.L.; Torres, M.

    1995-01-01

    A software for radiation treatment planning was recently developed by medical physicists at the Hermanos Ameijeiras Hospital in Havana. Selected locations in head and neck region were used to evaluate the reliability of calculated dose distributions in patients, taking as a reference the results of dosimetric measurements with TLD-700 powder in a RANDO type phantom. The different options is shown. Causes of discrepancies are analyzed and recommendations are made for the use of data acquisitions options

  6. A knowledge-based approach to improving and homogenizing intensity modulated radiation therapy planning quality among treatment centers: an example application to prostate cancer planning.

    Science.gov (United States)

    Good, David; Lo, Joseph; Lee, W Robert; Wu, Q Jackie; Yin, Fang-Fang; Das, Shiva K

    2013-09-01

    Intensity modulated radiation therapy (IMRT) treatment planning can have wide variation among different treatment centers. We propose a system to leverage the IMRT planning experience of larger institutions to automatically create high-quality plans for outside clinics. We explore feasibility by generating plans for patient datasets from an outside institution by adapting plans from our institution. A knowledge database was created from 132 IMRT treatment plans for prostate cancer at our institution. The outside institution, a community hospital, provided the datasets for 55 prostate cancer cases, including their original treatment plans. For each "query" case from the outside institution, a similar "match" case was identified in the knowledge database, and the match case's plan parameters were then adapted and optimized to the query case by use of a semiautomated approach that required no expert planning knowledge. The plans generated with this knowledge-based approach were compared with the original treatment plans at several dose cutpoints. Compared with the original plan, the knowledge-based plan had a significantly more homogeneous dose to the planning target volume and a significantly lower maximum dose. The volumes of the rectum, bladder, and femoral heads above all cutpoints were nominally lower for the knowledge-based plan; the reductions were significantly lower for the rectum. In 40% of cases, the knowledge-based plan had overall superior (lower) dose-volume histograms for rectum and bladder; in 54% of cases, the comparison was equivocal; in 6% of cases, the knowledge-based plan was inferior for both bladder and rectum. Knowledge-based planning was superior or equivalent to the original plan in 95% of cases. The knowledge-based approach shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced institutions. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Environmental development plan: magnetic fusion

    International Nuclear Information System (INIS)

    1979-09-01

    This Environmental Development Plan (EDP) identifies the planning and management requirements and schedules needed to evaluate and assess the environmental, health and safety (EH and S) aspects of the Magnetic Fusion Energy Program (MFE). Environment is defined to include the environmental, health (occupational and public), and safety aspects

  8. SU-G-201-09: Evaluation of a Novel Machine-Learning Algorithm for Permanent Prostate Brachytherapy Treatment Planning

    International Nuclear Information System (INIS)

    Nicolae, A; Lu, L; Morton, G; Chung, H; Helou, J; Al Hanaqta, M; Loblaw, A; Ravi, A; Heath, E

    2016-01-01

    Purpose: A novel, automated, algorithm for permanent prostate brachytherapy (PPB) treatment planning has been developed. The novel approach uses machine-learning (ML), a form of artificial intelligence, to substantially decrease planning time while simultaneously retaining the clinical intuition of plans created by radiation oncologists. This study seeks to compare the ML algorithm against expert-planned PPB plans to evaluate the equivalency of dosimetric and clinical plan quality. Methods: Plan features were computed from historical high-quality PPB treatments (N = 100) and stored in a relational database (RDB). The ML algorithm matched new PPB features to a highly similar case in the RDB; this initial plan configuration was then further optimized using a stochastic search algorithm. PPB pre-plans (N = 30) generated using the ML algorithm were compared to plan variants created by an expert dosimetrist (RT), and radiation oncologist (MD). Planning time and pre-plan dosimetry were evaluated using a one-way Student’s t-test and ANOVA, respectively (significance level = 0.05). Clinical implant quality was evaluated by expert PPB radiation oncologists as part of a qualitative study. Results: Average planning time was 0.44 ± 0.42 min compared to 17.88 ± 8.76 min for the ML algorithm and RT, respectively, a significant advantage [t(9), p = 0.01]. A post-hoc ANOVA [F(2,87) = 6.59, p = 0.002] using Tukey-Kramer criteria showed a significantly lower mean prostate V150% for the ML plans (52.9%) compared to the RT (57.3%), and MD (56.2%) plans. Preliminary qualitative study results indicate comparable clinical implant quality between RT and ML plans with a trend towards preference for ML plans. Conclusion: PPB pre-treatment plans highly comparable to those of an expert radiation oncologist can be created using a novel ML planning model. The use of an ML-based planning approach is expected to translate into improved PPB accessibility and plan uniformity.

  9. SU-G-201-09: Evaluation of a Novel Machine-Learning Algorithm for Permanent Prostate Brachytherapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Nicolae, A [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Canada); Department of Physics, Ryerson University, Toronto, ON (Canada); Lu, L; Morton, G; Chung, H; Helou, J; Al Hanaqta, M; Loblaw, A; Ravi, A [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Canada); Heath, E [Carleton Laboratory for Radiotherapy Physics, Carleton University, Ottawa, ON, CA (Canada)

    2016-06-15

    Purpose: A novel, automated, algorithm for permanent prostate brachytherapy (PPB) treatment planning has been developed. The novel approach uses machine-learning (ML), a form of artificial intelligence, to substantially decrease planning time while simultaneously retaining the clinical intuition of plans created by radiation oncologists. This study seeks to compare the ML algorithm against expert-planned PPB plans to evaluate the equivalency of dosimetric and clinical plan quality. Methods: Plan features were computed from historical high-quality PPB treatments (N = 100) and stored in a relational database (RDB). The ML algorithm matched new PPB features to a highly similar case in the RDB; this initial plan configuration was then further optimized using a stochastic search algorithm. PPB pre-plans (N = 30) generated using the ML algorithm were compared to plan variants created by an expert dosimetrist (RT), and radiation oncologist (MD). Planning time and pre-plan dosimetry were evaluated using a one-way Student’s t-test and ANOVA, respectively (significance level = 0.05). Clinical implant quality was evaluated by expert PPB radiation oncologists as part of a qualitative study. Results: Average planning time was 0.44 ± 0.42 min compared to 17.88 ± 8.76 min for the ML algorithm and RT, respectively, a significant advantage [t(9), p = 0.01]. A post-hoc ANOVA [F(2,87) = 6.59, p = 0.002] using Tukey-Kramer criteria showed a significantly lower mean prostate V150% for the ML plans (52.9%) compared to the RT (57.3%), and MD (56.2%) plans. Preliminary qualitative study results indicate comparable clinical implant quality between RT and ML plans with a trend towards preference for ML plans. Conclusion: PPB pre-treatment plans highly comparable to those of an expert radiation oncologist can be created using a novel ML planning model. The use of an ML-based planning approach is expected to translate into improved PPB accessibility and plan uniformity.

  10. Evaluation of IMRT plans of prostate carcinoma from four treatment planning systems based on Monte Carlo

    International Nuclear Information System (INIS)

    Chi Zifeng; Han Chun; Liu Dan; Cao Yankun; Li Runxiao

    2011-01-01

    Objective: With the Monte Carlo method to recalculate the IMRT dose distributions from four TPS to provide a platform for independent comparison and evaluation of the plan quality.These results will help make a clinical decision as which TPS will be used for prostate IMRT planning. Methods: Eleven prostate cancer cases were planned with the Corvus, Xio, Pinnacle and Eclipse TPS. The plans were recalculated by Monte Carlo using leaf sequences and MUs for individual plans. Dose-volume-histograms and isodose distributions were compared. Other quantities such as D min (the minimum dose received by 99% of CTV/PTV), D max (the maximum dose received by 1% of CTV/PTV), V 110% , V 105% , V 95% (the volume of CTV/PTV receiving 110%, 105%, 95% of the prescription dose), the volume of rectum and bladder receiving >65 Gy and >40 Gy, and the volume of femur receiving >50 Gy were evaluated. Total segments and MUs were also compared. Results: The Monte Carlo results agreed with the dose distributions from the TPS to within 3%/3 mm. The Xio, Pinnacle and Eclipse plans show less target dose heterogeneity and lower V 65 and V 40 for the rectum and bladder compared to the Corvus plans. The PTV D min is about 2 Gy lower for Xio plans than others while the Corvus plans have slightly lower female head V 50 (0.03% and 0.58%) than others. The Corvus plans require significantly most segments (187.8) and MUs (1264.7) to deliver and the Pinnacle plans require fewest segments (82.4) and MUs (703.6). Conclusions: We have tested an independent Monte Carlo dose calculation system for dose reconstruction and plan evaluation. This system provides a platform for the fair comparison and evaluation of treatment plans to facilitate clinical decision making in selecting a TPS and beam delivery system for particular treatment sites. (authors)

  11. Effect of MLC leaf width on the planning and delivery of SMLC IMRT using the CORVUS inverse treatment planning system

    International Nuclear Information System (INIS)

    Burmeister, Jay; McDermott, Patrick N.; Bossenberger, Todd; Ben-Josef, Edgar; Levin, Kenneth; Forman, Jeffrey D.

    2004-01-01

    This study investigates the influence of multileaf collimator (MLC) leaf width on intensity modulated radiation therapy (IMRT) plans delivered via the segmented multileaf collimator (SMLC) technique. IMRT plans were calculated using the Corvus treatment planning system for three brain, three prostate, and three pancreas cases using leaf widths of 0.5 and 1 cm. Resulting differences in plan quality and complexity are presented here. Plans calculated using a 1 cm leaf width were chosen over the 0.5 cm leaf width plans in seven out of nine cases based on clinical judgment. Conversely, optimization results revealed a superior objective function result for the 0.5 cm leaf width plans in seven out of the nine comparisons. The 1 cm leaf width objective function result was superior only for very large target volumes, indicating that expanding the solution space for plan optimization by using narrower leaves may result in a decreased probability of finding the global minimum. In the remaining cases, we can conclude that we are often not utilizing the objective function as proficiently as possible to meet our clinical goals. There was often no apparent clinically significant difference between the two plans, and in such cases the issue becomes one of plan complexity. A comparison of plan complexity revealed that the average 1 cm leaf width plan required roughly 60% fewer segments and over 40% fewer monitor units than required by 0.5 cm leaf width plans. This allows a significant decrease in whole body dose and total treatment time. For very complex IMRT plans, the treatment delivery time may affect the biologically effective dose. A clinically significant improvement in plan quality from using narrower leaves was evident only in cases with very small target volumes or those with concavities that are small with respect to the MLC leaf width. For the remaining cases investigated in this study, there was no clinical advantage to reducing the MLC leaf width from 1 to 0.5 cm. In

  12. Treatment planning for conformation therapy using a multi-leaf collimator

    International Nuclear Information System (INIS)

    Boesecke, R.; Doll, J.; Bauer, B.; Schlegel, W.; Pastyr, O.; Lorenz, W.J.

    1988-01-01

    In high energy photon therapy an optimum dose distribution is achieved with an irradiation from several directions, thus adapting the field shape to the target volume. Some methods of irradiation planning using these techniques are presented. The result of such a treatment planning is demonstrated. (orig.) [de

  13. A dose homogeneity and conformity evaluation between ViewRay and pinnacle-based linear accelerator IMRT treatment plans

    International Nuclear Information System (INIS)

    Saenz, Daniel L.; Paliwal, Bhudatt R.; Bayouth, John E.

    2014-01-01

    ViewRay, a novel technology providing soft-tissue imaging during radiotherapy is investigated for treatment planning capabilities assessing treatment plan dose homogeneity and conformity compared with linear accelerator plans. ViewRay offers both adaptive radiotherapy and image guidance. The combination of cobalt-60 ( 60 Co) with 0.35 Tesla magnetic resonance imaging (MRI) allows for magnetic resonance (MR)-guided intensity-modulated radiation therapy (IMRT) delivery with multiple beams. This study investigated head and neck, lung, and prostate treatment plans to understand what is possible on ViewRay to narrow focus toward sites with optimal dosimetry. The goal is not to provide a rigorous assessment of planning capabilities, but rather a first order demonstration of ViewRay planning abilities. Images, structure sets, points, and dose from treatment plans created in Pinnacle for patients in our clinic were imported into ViewRay. The same objectives were used to assess plan quality and all critical structures were treated as similarly as possible. Homogeneity index (HI), conformity index (CI), and volume receiving 60 Co ViewRay treatments planned with its Monte Carlo treatment planning software were comparable with 6 MV plans computed with convolution superposition algorithm on Pinnacle treatment planning system. (author)

  14. A dose homogeneity and conformity evaluation between ViewRay and pinnacle-based linear accelerator IMRT treatment plans.

    Science.gov (United States)

    Saenz, Daniel L; Paliwal, Bhudatt R; Bayouth, John E

    2014-04-01

    ViewRay, a novel technology providing soft-tissue imaging during radiotherapy is investigated for treatment planning capabilities assessing treatment plan dose homogeneity and conformity compared with linear accelerator plans. ViewRay offers both adaptive radiotherapy and image guidance. The combination of cobalt-60 (Co-60) with 0.35 Tesla magnetic resonance imaging (MRI) allows for magnetic resonance (MR)-guided intensity-modulated radiation therapy (IMRT) delivery with multiple beams. This study investigated head and neck, lung, and prostate treatment plans to understand what is possible on ViewRay to narrow focus toward sites with optimal dosimetry. The goal is not to provide a rigorous assessment of planning capabilities, but rather a first order demonstration of ViewRay planning abilities. Images, structure sets, points, and dose from treatment plans created in Pinnacle for patients in our clinic were imported into ViewRay. The same objectives were used to assess plan quality and all critical structures were treated as similarly as possible. Homogeneity index (HI), conformity index (CI), and volume receiving ViewRay treatments planned with its Monte Carlo treatment planning software were comparable with 6 MV plans computed with convolution superposition algorithm on Pinnacle treatment planning system.

  15. 7 CFR 22.306 - Financing rural development planning.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Financing rural development planning. 22.306 Section... Responsibilities of State Governments § 22.306 Financing rural development planning. States will be required to finance rural development planning through their own resources, revenue-sharing allocations, or the...

  16. Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

    International Nuclear Information System (INIS)

    Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

    2007-01-01

    Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

  17. Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

    Science.gov (United States)

    Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

    2015-06-01

    The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

  18. Modelling of treatment couch top with prowess panther treatment planning system for external beam radiotherapy

    International Nuclear Information System (INIS)

    Owusu-Agyapong, Linus

    2016-07-01

    The aim of this work is to evaluate the attenuation effects of a treatment couch and to alternatively model the couch top material with a Prowess Panther treatment planning system which does not support couch top modelling. The Hounsfield Unit classification of the couch structure was determined using a PMMA phantom by comparing ion chamber measurements with the dose forecasted by the treatment planning system (TPS). The transmission factor (TF) of the couch top was determined and was used as a TF for a treatment accessory that represented the treatment couch in the TPS. A treatment plan was done for various angles with and without the interference of the couch top and a simulated treatment was done using the PMMA phantom. Ion chamber measurement were made and compared with dose predicted by the TPS to evaluate the accuracy of the couch top modelling in the treatment planning system TPS. These investigations were done for various field sizes. The ideal set of HU for the couch was established to be -674. The measured TF was 0.956042 and the TPS calculated Transmission factor was 0.951456. The percentage difference between the measured and calculated TFs was 0.48% and this agrees perfectly with the IAEA recommended tolerance of 2%. Relative attenuation measurements were as high as 54.16% and as low as 0.63% for the beams that exited the couch before interacting with the phantom. In comparing couch modelling by couch simulation and couch TF insert, it was observed that the normalized doses were the same for 5×5 square field but deviated approximately 1% for the other field sizes. The highest deviation was observed at 10×10 square field. This study demonstrates that the couch simulation method of couch modelling is the best method that can be used to account for the effect of the treatment couch top on intersecting posterior beam fields. Thus, the attenuation effects of the treatment couch was effectively evaluated and the couch top material accurately modelled in

  19. Participatory development planning in Botswana: Exploring the ...

    African Journals Online (AJOL)

    the significance of public participation in planning is the ... to participatory planning, Botswana's planning system remains non-participatory. What is perceived as a ..... Administration. Despite the above, the. Tribal Administration remains important to the development planning efforts in Botswana. This could be attributed.

  20. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    International Nuclear Information System (INIS)

    Bernard, E.A.

    1995-01-01

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX sm , Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE's mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM's Office of Technology Development, has funded this work

  1. Independent technique of verifying high-dose rate (HDR) brachytherapy treatment plans

    International Nuclear Information System (INIS)

    Saw, Cheng B.; Korb, Leroy J.; Darnell, Brenda; Krishna, K. V.; Ulewicz, Dennis

    1998-01-01

    Purpose: An independent technique for verifying high-dose rate (HDR) brachytherapy treatment plans has been formulated and validated clinically. Methods and Materials: In HDR brachytherapy, dwell times at respective dwell positions are computed, using an optimization algorithm in a HDR treatment-planning system to deliver a specified dose to many target points simultaneously. Because of the variability of dwell times, concerns have been expressed regarding the ability of the algorithm to compute the correct dose. To address this concern, a commercially available low-dose rate (LDR) algorithm was used to compute the doses at defined distances, based on the dwell times obtained from the HDR treatment plans. The percent deviation between doses computed using the HDR and LDR algorithms were reviewed for HDR procedures performed over the last year. Results: In this retrospective study, the difference between computed doses using the HDR and LDR algorithms was found to be within 5% for about 80% of the HDR procedures. All of the reviewed procedures have dose differences of less than 10%. Conclusion: An independent technique for verifying HDR brachytherapy treatment plans has been validated based on clinical data. Provided both systems are available, this technique is universal in its applications and not limited to either a particular implant applicator, implant site, or implant type

  2. Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, S.; Hinkelbein, W. [Dept. of Radiooncology, Charite Univ. Medicine, Berlin (Germany); Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H. [Eye Tumor Therapy, Hahn-Meitner Inst., Berlin (Germany); Bendl, R. [Dept. of Medical Physics, German Cancer Research Center (DKFZ), Heidelberg (Germany); Lemke, A.J. [Dept. of Diagnostic Radiology, Charite Univ. Medicine, Berlin (Germany); Bechrakis, N.E.; Foerster, M.H. [Dept. of Ophthalmology, Charite Univ. Medicine, Berlin (Germany)

    2006-07-15

    Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

  3. Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

    International Nuclear Information System (INIS)

    Marnitz, S.; Hinkelbein, W.; Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H.; Bendl, R.; Lemke, A.J.; Bechrakis, N.E.; Foerster, M.H.

    2006-01-01

    Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

  4. 4D Proton treatment planning strategy for mobile lung tumors

    International Nuclear Information System (INIS)

    Kang Yixiu; Zhang Xiaodong; Chang, Joe Y.; Wang He; Wei Xiong; Liao Zhongxing; Komaki, Ritsuko; Cox, James D.; Balter, Peter A.; Liu, Helen; Zhu, X. Ronald; Mohan, Radhe; Dong Lei

    2007-01-01

    Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE R IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE R IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE R IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors

  5. Information Communication Technology Planning in Developing Countries

    Science.gov (United States)

    Malapile, Sandy; Keengwe, Jared

    2014-01-01

    This article explores major issues related to Information Communication Technology (ICT) in education and technology planning. Using the diffusion of innovation theory, the authors examine technology planning opportunities and challenges in Developing countries (DCs), technology planning trends in schools, and existing technology planning models…

  6. The influence of cephalometrics on orthodontic treatment planning

    NARCIS (Netherlands)

    Nijkamp, P.G.; Habets, L.L.M.H.; Aartman, I.H.A.; Zentner, A.

    2008-01-01

    SUMMARY Since its introduction, cephalometrics, i.e. cephalometric radiography and analysis, has been used for orthodontic treatment planning. However, the effectiveness of this diagnostic method remains questionable. A randomized crossover study was designed to assess the infl uence of

  7. Fred: a GPU-accelerated fast-Monte Carlo code for rapid treatment plan recalculation in ion beam therapy

    Science.gov (United States)

    Schiavi, A.; Senzacqua, M.; Pioli, S.; Mairani, A.; Magro, G.; Molinelli, S.; Ciocca, M.; Battistoni, G.; Patera, V.

    2017-09-01

    Ion beam therapy is a rapidly growing technique for tumor radiation therapy. Ions allow for a high dose deposition in the tumor region, while sparing the surrounding healthy tissue. For this reason, the highest possible accuracy in the calculation of dose and its spatial distribution is required in treatment planning. On one hand, commonly used treatment planning software solutions adopt a simplified beam-body interaction model by remapping pre-calculated dose distributions into a 3D water-equivalent representation of the patient morphology. On the other hand, Monte Carlo (MC) simulations, which explicitly take into account all the details in the interaction of particles with human tissues, are considered to be the most reliable tool to address the complexity of mixed field irradiation in a heterogeneous environment. However, full MC calculations are not routinely used in clinical practice because they typically demand substantial computational resources. Therefore MC simulations are usually only used to check treatment plans for a restricted number of difficult cases. The advent of general-purpose programming GPU cards prompted the development of trimmed-down MC-based dose engines which can significantly reduce the time needed to recalculate a treatment plan with respect to standard MC codes in CPU hardware. In this work, we report on the development of fred, a new MC simulation platform for treatment planning in ion beam therapy. The code can transport particles through a 3D voxel grid using a class II MC algorithm. Both primary and secondary particles are tracked and their energy deposition is scored along the trajectory. Effective models for particle-medium interaction have been implemented, balancing accuracy in dose deposition with computational cost. Currently, the most refined module is the transport of proton beams in water: single pencil beam dose-depth distributions obtained with fred agree with those produced by standard MC codes within 1-2% of the

  8. Constrained treatment planning using sequential beam selection

    International Nuclear Information System (INIS)

    Woudstra, E.; Storchi, P.R.M.

    2000-01-01

    In this paper an algorithm is described for automated treatment plan generation. The algorithm aims at delivery of the prescribed dose to the target volume without violation of constraints for target, organs at risk and the surrounding normal tissue. Pre-calculated dose distributions for all candidate orientations are used as input. Treatment beams are selected in a sequential way. A score function designed for beam selection is used for the simultaneous selection of beam orientations and weights. In order to determine the optimum choice for the orientation and the corresponding weight of each new beam, the score function is first redefined to account for the dose distribution of the previously selected beams. Addition of more beams to the plan is stopped when the target dose is reached or when no additional dose can be delivered without violating a constraint. In the latter case the score function is modified by importance factor changes to enforce better sparing of the organ with the limiting constraint and the algorithm is run again. (author)

  9. SU-E-T-157: CARMEN: A MatLab-Based Research Platform for Monte Carlo Treatment Planning (MCTP) and Customized System for Planning Evaluation

    International Nuclear Information System (INIS)

    Baeza, J.A.; Ureba, A.; Jimenez-Ortega, E.; Barbeiro, A.R.; Plaza, A. Leal; Lagares, J.I.

    2015-01-01

    Purpose: Although there exist several radiotherapy research platforms, such as: CERR, the most widely used and referenced; SlicerRT, which allows treatment plan comparison from various sources; and MMCTP, a full MCTP system; it is still needed a full MCTP toolset that provides users complete control of calculation grids, interpolation methods and filters in order to “fairly” compare results from different TPSs, supporting verification with experimental measurements. Methods: This work presents CARMEN, a MatLab-based platform including multicore and GPGPU accelerated functions for loading RT data; designing treatment plans; and evaluating dose matrices and experimental data.CARMEN supports anatomic and functional imaging in DICOM format, as well as RTSTRUCT, RTPLAN and RTDOSE. Besides, it contains numerous tools to accomplish the MCTP process, managing egs4phant and phase space files.CARMEN planning mode assist in designing IMRT, VMAT and MERT treatments via both inverse and direct optimization. The evaluation mode contains a comprehensive toolset (e.g. 2D/3D gamma evaluation, difference matrices, profiles, DVH, etc.) to compare datasets from commercial TPS, MC simulations (i.e. 3ddose) and radiochromic film in a user-controlled manner. Results: CARMEN has been validated against commercial RTPs and well-established evaluation tools, showing coherent behavior of its multiple algorithms. Furthermore, CARMEN platform has been used to generate competitive complex treatment that has been published in comparative studies. Conclusion: A new research oriented MCTP platform with a customized validation toolset has been presented. Despite of being coded with a high-level programming language, CARMEN is agile due to the use of parallel algorithms. The wide-spread use of MatLab provides straightforward access to CARMEN’s algorithms to most researchers. Similarly, our platform can benefit from the MatLab community scientific developments as filters, registration algorithms

  10. SU-E-T-157: CARMEN: A MatLab-Based Research Platform for Monte Carlo Treatment Planning (MCTP) and Customized System for Planning Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Baeza, J.A.; Ureba, A.; Jimenez-Ortega, E.; Barbeiro, A.R.; Plaza, A. Leal [Universidad de Sevilla, Departamento de Fisiologia Medica y Biofisica, Seville (Spain); Lagares, J.I. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT), Madrid (Spain)

    2015-06-15

    Purpose: Although there exist several radiotherapy research platforms, such as: CERR, the most widely used and referenced; SlicerRT, which allows treatment plan comparison from various sources; and MMCTP, a full MCTP system; it is still needed a full MCTP toolset that provides users complete control of calculation grids, interpolation methods and filters in order to “fairly” compare results from different TPSs, supporting verification with experimental measurements. Methods: This work presents CARMEN, a MatLab-based platform including multicore and GPGPU accelerated functions for loading RT data; designing treatment plans; and evaluating dose matrices and experimental data.CARMEN supports anatomic and functional imaging in DICOM format, as well as RTSTRUCT, RTPLAN and RTDOSE. Besides, it contains numerous tools to accomplish the MCTP process, managing egs4phant and phase space files.CARMEN planning mode assist in designing IMRT, VMAT and MERT treatments via both inverse and direct optimization. The evaluation mode contains a comprehensive toolset (e.g. 2D/3D gamma evaluation, difference matrices, profiles, DVH, etc.) to compare datasets from commercial TPS, MC simulations (i.e. 3ddose) and radiochromic film in a user-controlled manner. Results: CARMEN has been validated against commercial RTPs and well-established evaluation tools, showing coherent behavior of its multiple algorithms. Furthermore, CARMEN platform has been used to generate competitive complex treatment that has been published in comparative studies. Conclusion: A new research oriented MCTP platform with a customized validation toolset has been presented. Despite of being coded with a high-level programming language, CARMEN is agile due to the use of parallel algorithms. The wide-spread use of MatLab provides straightforward access to CARMEN’s algorithms to most researchers. Similarly, our platform can benefit from the MatLab community scientific developments as filters, registration algorithms

  11. Assessment of Uncertainties in Treatment Planning for Scanned Ion Beam Therapy of Moving Tumors

    International Nuclear Information System (INIS)

    Hild, Sebastian; Durante, Marco; Bert, Christoph

    2013-01-01

    Purpose: To provide methods for quantification of uncertainties in 4-dimensional (4D) treatment during treatment planning. Methods and Materials: Uncertainty information was generated by multiple 4D treatment simulations with varying parameters. Sampled data were analyzed using uncertainty visualization methods that have been added to common treatment plan evaluation methods (eg, dose-volume histogram and dose distribution analysis). To illustrate the potential of the introduced methods, uncertainty analysis was completed for a single lung cancer case using 3 motion mitigation techniques: gating, slice-by-slice rescanning, and breath-controlled rescanning. Results: By repeating 4D dose calculations with varying parameters, we were able to show local uncertainties in dose distributions and to evaluate the stability of treatment setups. The new methods were found suitable for uncertainty evaluation in 4D treatment planning of moving tumors. Calculation time of the uncertainty base data was time consuming but contrivable overnight. Conclusions: Uncertainty analysis and visualization for 4D treatment planning provide an important tool in the decision process for an optimal treatment approach.

  12. Hemangiopericytoma - The need for a protocol-based treatment plan

    Directory of Open Access Journals (Sweden)

    Murugesan Krishnan

    2011-01-01

    Full Text Available Hemangiopericytoma is a vascular tumor which comprises only 1% of all vascular tumors. The frequency of occurrence in the head and neck accounts for about 16-33% of all hemangiopericytomas. In this paper we discuss the surgical management, the difficulties in decision-making and treatment-planning in a case of a maxillary tumor in a five-year-old boy with a two-year follow-up. A five-year-old boy presented with a large unilateral maxillary tumor with nasal obstruction. Computed tomography revealed a heterogeneous mass completely occupying the right maxillary sinus and displacing the lateral wall of the nose and nasal septum. The lesion was diagnosed as hemangiopericytoma after histopathological confirmation. The option of surgical resection (total maxillectomy was carried out after evaluating the available literature. Various treatment modalities like surgery, chemotherapy and radiotherapy were taken into consideration as the tumor has an aggressive nature. Due to the inadequate literature on definitive treatment options for these types of tumors, there was difficulty in arriving at a protocol-based treatment plan.

  13. Governance in regional development planning?

    DEFF Research Database (Denmark)

    Galland, Daniel

    2008-01-01

    The purpose of this paper is to lay part of the groundwork for a new project aimed at exploring governance aspects concerned with regional development planning (RDP) in Denmark. The fundamental objective is to help establish and clarify a number of research questions to delve into the conditions...... and opportunities for anchoring and implementing such RDP. The paper mainly adopts a descriptive approach to portray tentative pathways to explore and discuss regional governance structures, procedures and practices that are being developed in establishing new RDP processes, strategies and plans....

  14. Planning developments in British Nuclear Fuels Ltd

    Energy Technology Data Exchange (ETDEWEB)

    Roper, D A [British Nuclear Fuels Ltd., Risley

    1978-10-01

    The state of the corporate planning art in British Nuclear Fuels Ltd. was described by N.R.Geary (Long Range Planning, September (1973)) just 2 years after Company formation. This article discusses more recent planning developments over the period to date during which the Company adopted a Divisionalized structure (from October 1974) and has been required to submit an annual Company plan to the Department of Energy (from November 1975). Background information on the origin and nature of the BNFL and its business, and the particular features of the Company which reflect into the nature and method of its planning were given in the 1973 article and only a brief introductory updating of the Company position is included here. Subsequently the features and problems of BNFL's operating and development planning system are described. Finally, messages arising from BNFL's planning experience to date which may be of general application and therefore of value to other practitioners of planning are listed.

  15. BrachyTPS -Interactive point kernel code package for brachytherapy treatment planning of gynaecological cancers

    International Nuclear Information System (INIS)

    Thilagam, L.; Subbaiah, K.V.

    2008-01-01

    Brachytherapy treatment planning systems (TPS) are always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in Intracavitary brachytherapy (ICBT) applicators. Most of the commercially available brachytherapy TPS softwares estimate the absorbed dose at a point, only taking care of the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. So the doses estimated by them are not much accurate under realistic clinical conditions. In this regard, interactive point kernel rode (BrachyTPS) has been developed to perform independent dose calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. As primary input data, the code takes patients' planning data including the source specifications, dwell positions, dwell times and it computes the doses at reference points by dose point kernel formalisms, with multi-layer shield build-up factors accounting for the contributions from scattered radiation. In addition to performing dose distribution calculations, this code package is capable of displaying an isodose distribution curve into the patient anatomy images. The primary aim of this study is to validate the developed point kernel code integrated with treatment planning systems against the other tools which are available in the market. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, Board of Radiation Isotope and Technology (BRIT) made low dose rate (LDR) applicator, Fletcher Green type LDR applicator and Fletcher Williamson high dose rate (HDR) applicator were studied to test the accuracy of the software

  16. Stereotactic intensity-modulated radiation therapy (IMRT) and inverse treatment planning for advanced pleural mesothelioma. Feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Muenter, M.W.; Thilmann, C.; Hof, H.; Debus, J. [Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg (Germany); Nill, S.; Hoess, A.; Partridge, M. [Dept. of Medical Physics, German Cancer Research Center (dkfz), Heidelberg (Germany); Haering, P. [Dept. of Central Dosimetry, German Cancer Research Center (dkfz), Heidelberg (Germany); Manegold, C. [Dept. of Medical Oncology/Internal Medicine, Thoraxklinik Heidelberg gGmbH, Heidelberg (Germany); Wannenmacher, M. [Dept. of Clinical Radiology, Univ. of Heidelberg, Heidelberg (Germany)

    2003-08-01

    Background and Purpose: Complex-shaped malignant pleural mesotheliomas (MPMs) with challenging volumes are extremely difficult to treat by conventional radiotherapy due to tolerance doses of the surrounding normal tissue. In a feasibility study, we evaluated if inversely planned stereotactic intensity-modulated radiation therapy (IMRT) could be applied in the treatment of MPM. Patients and Methods: Eight patients with unresectable lesions were treated after failure of chemotherapy. All patients were positioned using noninvasive patient fixation techniques which can be attached to the applied extracranial stereotactic system. Due to craniocaudal extension of the tumor, it was necessary to develop a special software attached to the inverse planning program KonRad, which can connect two inverse treatment plans and consider the applied dose of the first treatment plan in the area of the matchline of the second treatment plan. Results: Except for one patient, in whom radiotherapy was canceled due to abdominal metastasis, treatment could be completed in all patients and was well tolerated. Median survival after diagnosis was 20 months and after IMRT 6.5 months. Therefore, both the 1-year actuarial overall survival from the start of radiotherapy and the 2-year actuarial overall survival since diagnosis were 28%. IMRT did not result in clinically significant acute side effects. By using the described inverse planning software, over- or underdosage in the region of the field matchline could be prevented. Pure treatment time ranged between 10 and 21 min. Conclusion: This study showed that IMRT is feasible in advanced unresectable MPM. The presented possibilities of stereotactic IMRT in the treatment of MPM will justify the evaluation of IMRT in early-stage pleural mesothelioma combined with chemotherapy in a study protocol, in order to improve the outcome of these patients. Furthermore, dose escalation should be possible by using IMRT. (orig.)

  17. Vega library for processing DICOM data required in Monte Carlo verification of radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Locke, C.; Zavgorodni, S.; British Columbia Cancer Agency, Vancouver Island Center, Victoria BC

    2008-01-01

    Monte Carlo (MC) methods provide the most accurate to-date dose calculations in heterogeneous media and complex geometries, and this spawns increasing interest in incorporating MC calculations into treatment planning quality assurance process. This involves MC dose calculations for clinically produced treatment plans. To perform these calculations, a number of treatment plan parameters specifying radiation beam

  18. MO-D-BRB-02: SBRT Treatment Planning and Delivery

    International Nuclear Information System (INIS)

    Yang, Y.

    2016-01-01

    Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

  19. MO-D-BRB-02: SBRT Treatment Planning and Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Y. [Stanford University Cancer Center (United States)

    2016-06-15

    Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

  20. The Development of a Minority Recruitment Plan for Cancer Clinical Trials.

    Science.gov (United States)

    Trevino, Monica; Padalecki, Susan; Karnad, Anand; Parra, Alberto; Weitman, Steve; Nashawati, Melissa; Pollock, Brad H; Ramirez, Amelie; Thompson, Ian M

    2013-09-01

    Cancer does not occur in all ethnic and racial groups at similar rates. In addition, responses to treatment also vary in certain ethnic and racial groups. For Hispanics, the overall cancer incidence is generally lower yet for some specific tumor types, the incidence rates are higher compared to other populations. Although disparities are recognized for treatment outcomes and prevention methodologies for Hispanics and other minority populations, specific recruiting and reporting of minorities remains a challenge. In order to circumvent this problem, the Cancer Therapy and Research Center (CTRC) has developed a new minority recruitment plan for all cancer related clinical trials at this Institute. The overall goal of this initiative is to increase the accrual of minorities in cancer clinical trials by implementing several key interventions. The Cancer Therapy & Research Center (CTRC) at the University of Texas Health Science Center at San Antonio established the Clinical Trials Accrual Task Force to develop and monitor interventions designed to increase accrual to cancer clinical trials, specifically the accrual of minorities with a focus on the Hispanic population that makes up 68% of the CTRC's catchment area. A Minority Accrual Plan (MAP) was implemented in March 2013 as part of the process for initiating and conducting cancer-related clinical trials at the CTRC. The Minority Accrual Plan focuses on Hispanic enrollment due to the characteristics of the South Texas population served by the CTRC but could be easily adapted to other populations. The CTRC has designed a process to prospectively address the challenge of deliberately enrolling minority subjects and accurately accounting for the results by implementing a Minority Accrual Plan for every cancer-related clinical trial at CTRC.