Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

Science.gov (United States)

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

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.…

Integrating financial and strategic planning.

Science.gov (United States)

Pivnicny, V C

1989-09-01

As hospitals face mounting profitability and liquidity concerns, the need to integrate strategic and financial planning also will continue to grow. This article describes a process for integrating these planning functions and the ideal organizational framework to facilitate the process. Obstacles to the integration of these planning processes also are discussed.

Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans

International Nuclear Information System (INIS)

Siebers, Jeffrey V.; Keall, Paul J.; Wu Qiuwen; Williamson, Jeffrey F.; Schmidt-Ullrich, Rupert K.

2005-01-01

Purpose: The purpose of this study is to determine dose delivery errors that could result from random and systematic setup errors for head-and-neck patients treated using the simultaneous integrated boost (SIB)-intensity-modulated radiation therapy (IMRT) technique. Methods and Materials: Twenty-four patients who participated in an intramural Phase I/II parotid-sparing IMRT dose-escalation protocol using the SIB treatment technique had their dose distributions reevaluated to assess the impact of random and systematic setup errors. The dosimetric effect of random setup error was simulated by convolving the two-dimensional fluence distribution of each beam with the random setup error probability density distribution. Random setup errors of σ = 1, 3, and 5 mm were simulated. Systematic setup errors were simulated by randomly shifting the patient isocenter along each of the three Cartesian axes, with each shift selected from a normal distribution. Systematic setup error distributions with Σ = 1.5 and 3.0 mm along each axis were simulated. Combined systematic and random setup errors were simulated for σ = Σ = 1.5 and 3.0 mm along each axis. For each dose calculation, the gross tumor volume (GTV) received by 98% of the volume (D 98 ), clinical target volume (CTV) D 90 , nodes D 90 , cord D 2 , and parotid D 50 and parotid mean dose were evaluated with respect to the plan used for treatment for the structure dose and for an effective planning target volume (PTV) with a 3-mm margin. Results: Simultaneous integrated boost-IMRT head-and-neck treatment plans were found to be less sensitive to random setup errors than to systematic setup errors. For random-only errors, errors exceeded 3% only when the random setup error σ exceeded 3 mm. Simulated systematic setup errors with Σ = 1.5 mm resulted in approximately 10% of plan having more than a 3% dose error, whereas a Σ = 3.0 mm resulted in half of the plans having more than a 3% dose error and 28% with a 5% dose error

SU-G-TeP4-06: An Integrated Application for Radiation Therapy Treatment Plan Directives, Management, and Reporting

Energy Technology Data Exchange (ETDEWEB)

Matuszak, M; Anderson, C; Lee, C; Vineberg, K; Green, M; Younge, K; Moran, J; Mayo, C [University of Michigan, Ann Arbor, MI (United States)

2016-06-15

Purpose: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. Methods: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record. Using the Eclipse Scripting Application Programming Interface, a plug-in script with an associated domain-specific SQL Server database was created to manage the information in (i)–(iv). The system’s user interface and database were designed by a team of physicians, clinical physicists, database experts, and software engineers to ensure usability and robustness for clinical use. Results: The resulting system has been fully integrated within the TPS via a custom script and database. Planning scenario templates, version control, approvals, and logic-based quality control allow this system to fully track and document the planning process as well as physician approval of tradeoffs while improving the consistency of the data. Multiple plans and prescriptions are supported along with non-traditional dose objectives and evaluation such as biologically corrected models, composite dose limits, and management of localization goals. User-specific custom views were developed for the attending physician review, physicist plan checks, treating therapists, and peer review in chart rounds. Conclusion: A method was developed to maintain cohesive information throughout the planning process within one integrated system by using a custom treatment planning management application that

Hanford Site waste treatment/storage/disposal integration

International Nuclear Information System (INIS)

MCDONALD, K.M.

1999-01-01

In 1998 Waste Management Federal Services of Hanford, Inc. began the integration of all low-level waste, mixed waste, and TRU waste-generating activities across the Hanford site. With seven contractors, dozens of generating units, and hundreds of waste streams, integration was necessary to provide acute waste forecasting and planning for future treatment activities. This integration effort provides disposition maps that account for waste from generation, through processing, treatment and final waste disposal. The integration effort covers generating facilities from the present through the life-cycle, including transition and deactivation. The effort is patterned after the very successful DOE Complex EM Integration effort. Although still in the preliminary stages, the comprehensive onsite integration effort has already reaped benefits. These include identifying significant waste streams that had not been forecast, identifying opportunities for consolidating activities and services to accelerate schedule or save money; and identifying waste streams which currently have no path forward in the planning baseline. Consolidation/integration of planned activities may also provide opportunities for pollution prevention and/or avoidance of secondary waste generation. A workshop was held to review the waste disposition maps, and to identify opportunities with potential cost or schedule savings. Another workshop may be held to follow up on some of the long-term integration opportunities. A change to the Hanford waste forecast data call would help to align the Solid Waste Forecast with the new disposition maps

The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

Science.gov (United States)

Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

2015-01-01

Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

Planning integration FY 1996 program plan. Revision 1

International Nuclear Information System (INIS)

1995-09-01

This Multi-Year Program Plan (MAP) Planning Integration Program, Work Breakdown Structure (WBS) Element 1.8.2, is the primary management tool to document the technical, schedule, and cost baseline for work directed by the US Department of Energy (DOE), Richland Operations Office (RL). As an approved document, it establishes an agreement between RL and the performing contractors for the work to be performed. It was prepared by Westinghouse Hanford Company (WHC) and Pacific Northwest Laboratory (PNL). The MYPPs for the Hanford Site programs are to provide a picture from fiscal year (FY) 1996 through FY 2002. At RL Planning and Integration Division (PID) direction, only the FY 1996 Planning Integration Program work scope has been planned and presented in this MAP. Only those known significant activities which occur after FY 1996 are portrayed in this MAP. This is due to the uncertainty of who will be accomplishing what work scope when, following the award of the Management and Integration (M ampersand I) contract

Integrating cervical cancer screening and preventive treatment with family planning and HIV-related services.

Science.gov (United States)

White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia

2017-07-01

Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Is long-term planning obsolete? A discussion of integrated resource planning in the Pacific Northwest U.S. and a scenario for its demise

International Nuclear Information System (INIS)

Morlan, T.H.

1995-01-01

Slides presented at The Power of Change Conference in Vancouver, British Columbia, Canada in April 1995 dealing with integrated resource planning were provided. The creation of the Northwest Power Planning Council and the Northwest Power Act were described, including the goals that the the Act is expected to achieve. The Council's planning innovations were listed including the first regional integrated resource plan, a consistent and comprehensive treatment of demand side resources, and development of risk- averse plans through explicit treatment of uncertain demands. Resource planning analytical framework, modelling approach and resource strategy components were described. Major policy thrusts of the first regional power plan were presented. Factors promoting a competitive power supply industry, characteristics of that industry, and its effects on existing utilities were identified. Implications of integrated resource planning on long-term planning were assessed. A list of yet unanswered questions were appended to stimulate thought and discussion

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

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

the patient's initial fields and boost, respectively. Case illustrations are shown. Conclusions: We have successfully integrated multimodality imaging into our treatment-planning system, and its routine use is increasing. Multimodality imaging holds out the promise of improving treatment planning accuracy and, thus, takes maximum advantage of three dimensional treatment planning systems.

Integration of BOLD-fMRI and DTI into radiation treatment planning for high-grade gliomas located near the primary motor cortexes and corticospinal tracts

International Nuclear Information System (INIS)

Wang, Minglei; Ma, Hui; Wang, Xiaodong; Guo, Yanhong; Xia, Xinshe; Xia, Hechun; Guo, Yulin; Huang, Xueying; He, Hong; Jia, Xiaoxiong; Xie, Yan

2015-01-01

The main objective of this study was to evaluate the efficacy of integrating the blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI) data into radiation treatment planning for high-grade gliomas located near the primary motor cortexes (PMCs) and corticospinal tracts (CSTs). A total of 20 patients with high-grade gliomas adjacent to PMCs and CSTs between 2012 and 2014 were recruited. The bilateral PMCs and CSTs were located in the normal regions without any overlapping with target volume of the lesions. BOLD-fMRI, DTI and conventional MRI were performed on patients (Karnofsky performance score ≥ 70) before radical radiotherapy treatment. Four different imaging studies were conducted in each patient: a planning computed tomography (CT), an anatomical MRI, a DTI and a BOLD-fMRI. For each case, three treatment plans (3DCRT, IMRT and IMRT-PMC&CST) were developed by 3 different physicists using the Pinnacle planning system. Our study has shown that there was no significant difference between the 3DCRT and IMRT plans in terms of dose homogeneity, but IMRT displayed better planning target volume (PTV) dose conformity. In addition, we have found that the Dmax and Dmean to the ipsilateral and contralateral PMC and CST regions were considerably decreased in IMRT-PMC&CST group (p < 0.001). In conclusion, integration of BOLD-fMRI and DTI into radiation treatment planning is feasible and beneficial. With the assistance of the above-described techniques, the bilateral PMCs and CSTs adjacent to the target volume could be clearly marked as OARs and spared during treatment

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

Space shuttle operations integration plan

Science.gov (United States)

1975-01-01

The Operations Integration Plan is presented, which is to provide functional definition of the activities necessary to develop and integrate shuttle operating plans and facilities to support flight, flight control, and operations. It identifies the major tasks, the organizations responsible, their interrelationships, the sequence of activities and interfaces, and the resultant products related to operations integration.

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)

Intensity-modulated arc therapy with simultaneous integrated boost in the treatment of primary irresectable cervical cancer. Treatment planning, quality control, and clinical implementation

Energy Technology Data Exchange (ETDEWEB)

Vandecasteele, Katrien; De Neve, Wilfried; De Gersem, Werner; Paelinck, Leen; Fonteyne, Valerie; De Wagter, Carlos; De Meerleer, Gert [Dept. of Radiotherapy, Ghent Univ. Hospital (Belgium); Delrue, Louke; Villeirs, Geert [Dept. of Radiology, Ghent Univ. Hospital (Belgium); Makar, Amin [Dept. of Gynecology, Ghent Univ. Hospital (Belgium)

2009-12-15

Purpose: to report on the planning procedure, quality control, and clinical implementation of intensity-modulated arc therapy (IMAT) delivering a simultaneous integrated boost (SIB) in patients with primary irresectable cervix carcinoma. Patients and methods: six patients underwent PET-CT (positron emission tomography-computed tomography) and MRI (magnetic resonance imaging) before treatment planning. Prescription (25 fractions) was (1) a median dose (D{sub 50}) of 62, 58 and 56 Gy to the primary tumor (GTVcervix), primary clinical target volume (CTVcervix) and its planning target volume (PTVcervix), respectively; (2) a D{sub 50} of 60 Gy to the PET-positive lymph nodes (GTVnodes); (3) a minimal dose (D{sub 98}) of 45 Gy to the planning target volume of the elective lymph nodes (PTVnodes). IMAT plans were generated using an anatomy-based exclusion tool with the aid of weight and leaf position optimization. The dosimetric delivery of IMAT was validated preclinically using radiochromic film dosimetry. Results: five to nine arcs were needed to create valid IMAT plans. Dose constraints on D{sub 50} were not met in two patients (both GTVcervix: 1 Gy and 3 Gy less). D{sub 98} for PTVnodes was not met in three patients (1 Gy each). Film dosimetry showed excellent gamma evaluation. There were no treatment interruptions. Conclusion: IMAT allows delivering an SIB to the macroscopic tumor without compromising the dose to the elective lymph nodes or the organs at risk. The clinical implementation is feasible. (orig.)

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)

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...

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...

Groundwater regulation and integrated planning

Science.gov (United States)

Quevauviller, Philippe; Batelaan, Okke; Hunt, Randall J.

2016-01-01

The complex nature of groundwater and the diversity of uses and environmental interactions call for emerging groundwater problems to be addressed through integrated management and planning approaches. Planning requires different levels of integration dealing with: the hydrologic cycle (the physical process) including the temporal dimension; river basins and aquifers (spatial integration); socioeconomic considerations at regional, national and international levels; and scientific knowledge. The great natural variation in groundwater conditions obviously affects planning needs and options as well as perceptions from highly localised to regionally-based approaches. The scale at which planning is done therefore needs to be carefully evaluated against available policy choices and options in each particular setting. A solid planning approach is based on River Basin Management Planning (RBMP), which covers: (1) objectives that management planning are designed to address; (2) the way various types of measures fit into the overall management planning; and (3) the criteria against which the success or failure of specific strategies or interventions can be evaluated (e.g. compliance with environmental quality standards). A management planning framework is to be conceived as a “living” or iterated document that can be updated, refined and if necessary changed as information and experience are gained. This chapter discusses these aspects, providing an insight into European Union (EU), United States and Australia groundwater planning practices.

SU-F-T-199: A New Strategy for Integrating Photon with Proton and Carbon Ion in the Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Chen, Z; Wang, J; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

2016-06-15

Purpose: The aim of this study was to develop a viable strategy to integrate photon plan and proton/carbon ion plan based on deformable registration. Methods: Two prostate cancer patients were enrolled in this study. Each patient has 2 CTs, which were input in the Raystation radiotherapy treatment planning system (TPS). CT1 was deformed to the second CT2 using the Hybrid deformation method. The dice similarity coefficient (DSC) parameter was used to evaluate the difference between the actual structures (bladder, rectum and CTV) and the corresponding deformed structures on CT2. The prescription dose was 63.02GyE to CTV, which included 49.32GyE for CTV1 with carbon and boost 13.7Gy for CTV2 with photon. The carbon plan was made first in Syngo TPS (Syngo PT Planning system, version VB10. Siemens, Germany) on CT1 and transferred to Raystation TPS. Selected Isodoses (23.5Gy, 36.8Gy, 39.1Gy, 47.0Gy and 49.3Gy) of carbon plan were converted to contours and then deformed to CT2, which was used as normal tissues for photon plan optimization on CT2. The final plan was the combination of photon plan and the carbon deformation plan on the CT2. The plan from this strategy was compared with direct optimization of the photon plan on CT2 added some clinical endpoints from carbon plan on CT1. Results: The new strategy with deformable registration is tested and combined plans were successfully obtained for the 2 patients. This strategy obtained both integrated DVH and dose distribution information. For patient 1, the rectum V30, V60 and bladder V63 were 45.8, 10.3 and 9.7 for the combined plan with deformation and 48.1, 11.0 and 12.0 for the direct photon plan. Conclusion: The new strategy for combining photon and carbon/proton is feasible. However, the clinical accuracy is still need more evaluation.

TH-A-BRF-09: Integration of High-Resolution MRSI Into Glioblastoma Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Schreibmann, E; Cordova, J; Shu, H; Crocker, I; Curran, W; Holder, C; Shim, H [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA (United States)

2014-06-15

Purpose: Identification of a metabolite signature that shows significant tumor cell infiltration into normal brain in regions that do not appear abnormal on standard MRI scans would be extremely useful for radiation oncologists to choose optimal regions of brain to treat, and to quantify response beyond the MacDonald criteria. We report on integration of high-resolution magnetic resonance spectroscopic imaging (HR-MRSI) with radiation dose escalation treatment planning to define and target regions at high risk for recurrence. Methods: We propose to supplement standard MRI with a special technique performed on an MRI scanner to measure the metabolite levels within defined volumes. Metabolite imaging was acquired using an advanced MRSI technique combining 3D echo-planar spectroscopic imaging (EPSI) with parallel acquisition (GRAPPA) using a multichannel head coil that allows acquisition of whole brain metabolite maps with 108 μl resolution in 12 minutes implemented on a 3T MR scanner. Elevation in the ratio of two metabolites, choline (Cho, elevated in proliferating high-grade gliomas) and N-acetyl aspartate (NAA, a normal neuronal metabolite), was used to image infiltrating high-grade glioma cells in vivo. Results: The metabolite images were co-registered with standard contrast-enhanced T1-weighted MR images using in-house registration software and imported into the treatment-planning system. Regions with tumor infiltration are identified on the metabolic images and used to create adaptive IMRT plans that deliver a standard dose of 60 Gy to the standard target volume and an escalated dose of 75 Gy (or higher) to the most suspicious regions, identified as areas with elevated Cho/NAA ratio. Conclusion: We have implemented a state-of-the-art HR-MRSI technology that can generate metabolite maps of the entire brain in a clinically acceptable scan time, coupled with introduction of an imaging co-registration/ analysis program that combines MRSI data with standard imaging

TH-A-BRF-09: Integration of High-Resolution MRSI Into Glioblastoma Treatment Planning

International Nuclear Information System (INIS)

Schreibmann, E; Cordova, J; Shu, H; Crocker, I; Curran, W; Holder, C; Shim, H

2014-01-01

Purpose: Identification of a metabolite signature that shows significant tumor cell infiltration into normal brain in regions that do not appear abnormal on standard MRI scans would be extremely useful for radiation oncologists to choose optimal regions of brain to treat, and to quantify response beyond the MacDonald criteria. We report on integration of high-resolution magnetic resonance spectroscopic imaging (HR-MRSI) with radiation dose escalation treatment planning to define and target regions at high risk for recurrence. Methods: We propose to supplement standard MRI with a special technique performed on an MRI scanner to measure the metabolite levels within defined volumes. Metabolite imaging was acquired using an advanced MRSI technique combining 3D echo-planar spectroscopic imaging (EPSI) with parallel acquisition (GRAPPA) using a multichannel head coil that allows acquisition of whole brain metabolite maps with 108 μl resolution in 12 minutes implemented on a 3T MR scanner. Elevation in the ratio of two metabolites, choline (Cho, elevated in proliferating high-grade gliomas) and N-acetyl aspartate (NAA, a normal neuronal metabolite), was used to image infiltrating high-grade glioma cells in vivo. Results: The metabolite images were co-registered with standard contrast-enhanced T1-weighted MR images using in-house registration software and imported into the treatment-planning system. Regions with tumor infiltration are identified on the metabolic images and used to create adaptive IMRT plans that deliver a standard dose of 60 Gy to the standard target volume and an escalated dose of 75 Gy (or higher) to the most suspicious regions, identified as areas with elevated Cho/NAA ratio. Conclusion: We have implemented a state-of-the-art HR-MRSI technology that can generate metabolite maps of the entire brain in a clinically acceptable scan time, coupled with introduction of an imaging co-registration/ analysis program that combines MRSI data with standard imaging

Integration of Three-Dimensional Rotational Angiography in Radiosurgical Treatment Planning of Cerebral Arteriovenous Malformations

International Nuclear Information System (INIS)

Conti, Alfredo; Pontoriero, Antonio; Farago, Giuseppe; Midili, Federica; Siragusa, Carmelo; Granata, Francesca; Pitrone, Antonio; De Renzis, Costantino; Longo, Marcello; Tomasello, Francesco

2011-01-01

Purpose: Accuracy in delineating the target volume is a major issue for successful stereotactic radiosurgery for arteriovenous malformations. The aim of the present study was to describe a method to integrate three-dimensional (3D) rotational angiography ( (3DRA)) into CyberKnife treatment planning and to investigate its potential advantages compared with computed tomography angiography (CTA) and magnetic resonance angiography. Methods and Materials: A total of 20 patients with a diagnosis of cerebral arteriovenous malformation were included in the present study. All patients underwent multislice computed tomography and 3D-volumetric CTA, (3DRA), and 3D magnetic resonance angiography. The contouring of the target and critical volumes was done separately using CTA and thereafter directly using (3DRA). The composite, conjoint, and disjoint volumes were measured. Results: The use of CTA or (3DRA) resulted in significant differences in the target and critical volumes. The target volume averaged 3.49 ± 3.01 mL measured using CTA and 3.26 ± 2.93 mL measured using (3DRA), for a difference of 8% (p < .05). The conjoint and disjoint volume analysis showed an 88% volume overlap. The qualitative evaluation showed that the excess volume obtained using CTA was mostly tissue surrounding the nidus and venous structures. The mean contoured venous volume was 0.67 mL measured using CTA and 0.88 mL (range, 0.1-2.7) measured using (3DRA) (p < .05). Conclusions: (3DRA) is a volumetric angiographic study that can be integrated into computer-based treatment planning. Although whether (3DRA) provides superior accuracy has not yet been proved, its high spatial resolution is attractive and offers a superior 3D view. This allows a better 3D understanding of the target volume and distribution of the radiation doses within the volume. Additional technical efforts to improve the temporal resolution and the development of software tools aimed at improving the performance of 3D contouring are

Flexible integration of path-planning capabilities

Science.gov (United States)

Stobie, Iain C.; Tambe, Milind; Rosenbloom, Paul S.

1993-05-01

Robots pursuing complex goals must plan paths according to several criteria of quality, including shortness, safety, speed and planning time. Many sources and kinds of knowledge, such as maps, procedures and perception, may be available or required. Both the quality criteria and sources of knowledge may vary widely over time, and in general they will interact. One approach to address this problem is to express all criteria and goals numerically in a single weighted graph, and then to search this graph to determine a path. Since this is problematic with symbolic or uncertain data and interacting criteria, we propose that what is needed instead is an integration of many kinds of planning capabilities. We describe a hybrid approach to integration, based on experiments with building simulated mobile robots using Soar, an integrated problem-solving and learning system. For flexibility, we have implemented a combination of internal planning, reactive capabilities and specialized tools. We illustrate how these components can complement each other's limitations and produce plans which integrate geometric and task knowledge.

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)

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)

Planning for Integrating Teaching Technologies

Directory of Open Access Journals (Sweden)

Mandie Aaron

2004-06-01

Full Text Available Teaching technologies offer pedagogical advantages which vary with specific contexts. Successfully integrating them hinges on clearly identifying pedagogical goals, then planning for the many decisions that technological change demands. In examining different ways of organizing this process, we have applied planning tools from other domains - Fault Tree Analysis and Capability Maturity Modeling- at the school and college levels. In another approach, we have examined attempts to broadly model the integration process at the university level. Our studies demonstrate that the use of a variety of tools and techniques can render the integration of teaching technologies more systematic.

Integrated Facilities and Infrastructure Plan.

Energy Technology Data Exchange (ETDEWEB)

Reisz Westlund, Jennifer Jill

2017-03-01

Our facilities and infrastructure are a key element of our capability-based science and engineering foundation. The focus of the Integrated Facilities and Infrastructure Plan is the development and implementation of a comprehensive plan to sustain the capabilities necessary to meet national research, design, and fabrication needs for Sandia National Laboratories’ (Sandia’s) comprehensive national security missions both now and into the future. A number of Sandia’s facilities have reached the end of their useful lives and many others are not suitable for today’s mission needs. Due to the continued aging and surge in utilization of Sandia’s facilities, deferred maintenance has continued to increase. As part of our planning focus, Sandia is committed to halting the growth of deferred maintenance across its sites through demolition, replacement, and dedicated funding to reduce the backlog of maintenance needs. Sandia will become more agile in adapting existing space and changing how space is utilized in response to the changing requirements. This Integrated Facilities & Infrastructure (F&I) Plan supports the Sandia Strategic Plan’s strategic objectives, specifically Strategic Objective 2: Strengthen our Laboratories’ foundation to maximize mission impact, and Strategic Objective 3: Advance an exceptional work environment that enables and inspires our people in service to our nation. The Integrated F&I Plan is developed through a planning process model to understand the F&I needs, analyze solution options, plan the actions and funding, and then execute projects.

AIS ASM Operational Integration Plan

Science.gov (United States)

2013-08-01

Rack mount computer AIS Radio Interface Ethernet Switch 192.168.0.x Firewall Cable Modem 192.168.0.1 VTS Accred. Boundary AIS ASM Operational... AIS ASM Operational Integration Plan Distribution Statement A: Approved for public release; distribution is unlimited. August 2013 Report No...CD-D-07-15 AIS ASM Operational Integration Plan ii UNCLAS//Public | CG-926 R&DC | I. Gonin, et al. | Public August 2013 N O T I C

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

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

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

Integrated Planning: Why is it so hard?

International Nuclear Information System (INIS)

Hesser, A.

1994-01-01

In this paper, the Manager of Planning integration at DOE-Richland and the Program Manager for Hanford Mission Planning at Pacific Northwest Laboratory and Westinghouse Hanford Company describe some of the reasons why integrated planning is so hard and what can be done to correct the situation. The authors use experiences from the last three years at Hanford to illustrate some of the difficulties in site integrated planning. The authors argue that integrated planning was not a major part of the previous diverse Site missions, but the change of mission has not resulted in a corresponding change of attitude about the need for such planning. Moreover, the DOE-RL staff is not structured or manned for planning, and a site perspective is the exception, rather than the norm. Contributing to this situation is the compartmentalization of funding and decision making and the diffusion of responsibility. The decision-making process at DOE sites is often not clear because of the evolving role of stakeholders, and agencies outside the DOE, especially regulators, are co-decision makers. The regulatory process and the requirements of environmental impact statements contribute to the diffusion of authority

Integration of family planning services into HIV care and treatment in Kenya: a cluster-randomized trial.

Science.gov (United States)

Grossman, Daniel; Onono, Maricianah; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Shade, Starley B; Steinfeld, Rachel L; Cohen, Craig R

2013-10-01

To determine whether integrating family planning services into HIV care is associated with increased use of more effective contraceptive methods (sterilization, intrauterine device, implant, injectable or oral contraceptives). Cluster-randomized trial. Eighteen public HIV clinics in Nyanza Province, Kenya. Women aged 18-45 years receiving care at participating HIV clinics; 5682 clinical encounters from baseline period (December 2009-February 2010) and 12,531 encounters from end-line period (July 2011-September 2011, 1 year after site training). Twelve sites were randomized to integrate family planning services into the HIV clinic, whereas six clinics were controls where clients desiring contraception were referred to family planning clinics at the same facility. Increase in use of more effective contraceptive methods between baseline and end-line periods. Pregnancy rates during the follow-up year (October 2010-September 2011) were also compared. Women seen at integrated sites were significantly more likely to use more effective contraceptive methods at the end of the study [increased from 16.7 to 36.6% at integrated sites, compared to increase from 21.1 to 29.8% at controls; odds ratio (OR) 1.81, 95% confidence interval (CI) 1.24-2.63]. Condom use decreased non-significantly at intervention sites compared to controls (OR 0.64, 95% CI 0.35-1.19). No difference was observed in incident pregnancy in the first year after integration comparing intervention to control sites (incidence rate ratio 0.90; 95% CI 0.68-1.20). Integration of family planning services into HIV care clinics increased use of more effective contraceptive methods with a non-significant reduction in condom use. Although no significant reduction in pregnancy incidence was observed during the study, 1 year may be too short a period of observation for this outcome.

Integration of strategic environmental assessment in spatial planning

DEFF Research Database (Denmark)

Kørnøv, Lone

The paper explores the similarities between the content of the EU directive, SEA practice and the existing spatial planning in Denmark, and how SEA can be integrated into plan making and plan implementation.......The paper explores the similarities between the content of the EU directive, SEA practice and the existing spatial planning in Denmark, and how SEA can be integrated into plan making and plan implementation....

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.)

Buried Waste Integrated Demonstration FY-95 Deployment Plan

Energy Technology Data Exchange (ETDEWEB)

Stacey, D.E.

1995-03-01

The Buried Waste Integrated Demonstration (BWID) is a program funded by the U.S. Department of Energy Office of Technology Development. BWID supports the applied research, development, demonstration, testing, and evaluation of a suite of advanced technologies that together form a comprehensive remediation system for the effective and efficient remediation of buried waste. The FY-95 effort will fund 24 technologies in five areas of buried waste site remediation: site characterization, waste characterization, retrieval, treatment, and containment/stabilization. Ten of these technologies will take part in the integrated field demonstration that will take place at the Idaho National Engineering Laboratory (INEL) facilities in the summer of 1995. This document is the basic operational planning document for deployment of all BWID projects funded in FY-95. Discussed in this document are the BWID preparations for the INEL integrated field demonstration, INEL research and development (R&D) demonstrations, non-INEL R&D demonstrations, and office research and technical review meetings. Each project will have a test plan detailing the specific procedures, objectives, and tasks of the test. Therefore, information that is specific to testing each technology is intentionally limited in this document.

Buried Waste Integrated Demonstration FY-95 Deployment Plan

International Nuclear Information System (INIS)

Stacey, D.E.

1995-03-01

The Buried Waste Integrated Demonstration (BWID) is a program funded by the U.S. Department of Energy Office of Technology Development. BWID supports the applied research, development, demonstration, testing, and evaluation of a suite of advanced technologies that together form a comprehensive remediation system for the effective and efficient remediation of buried waste. The FY-95 effort will fund 24 technologies in five areas of buried waste site remediation: site characterization, waste characterization, retrieval, treatment, and containment/stabilization. Ten of these technologies will take part in the integrated field demonstration that will take place at the Idaho National Engineering Laboratory (INEL) facilities in the summer of 1995. This document is the basic operational planning document for deployment of all BWID projects funded in FY-95. Discussed in this document are the BWID preparations for the INEL integrated field demonstration, INEL research and development (R ampersand D) demonstrations, non-INEL R ampersand D demonstrations, and office research and technical review meetings. Each project will have a test plan detailing the specific procedures, objectives, and tasks of the test. Therefore, information that is specific to testing each technology is intentionally limited in this document

Customer-focused planning: Beyond integrated resource planning

International Nuclear Information System (INIS)

Hastings, P.C.

1992-01-01

Integrated resource planning (IRP) evolved from the growing recognition by utilities and regulators that efforts to influence the use of electricity by customers could be more cost-effective than simply expanding the generation system. Improvements in IRP methodology are taking many different forms. One major effort is to move planning closer to the customer. Customer-focused planning (CFP) starts with customer values and uses these to drive decision-making within the utility. CFP is process- rather than product- oriented and typically operates at the bulk power system level. Options available to meet customer needs include electricity, alternative fuels, capital substitution, and end-use management or control. The customer selects the option(s) based on a value set that typically includes safety, reliability, convenience, and cost. There are also four possible levels of decision-making: the end-use; customer/power meter; transmission/distribution interface; and the utility bulk power system. Challenges of implementing CFP include identifying customer wants, needs, and values; integration of utility planning efforts; and the dynamics of the CFP process, in which costs can change with each modification of the transmission and distribution system. Two examples of recent moves toward CFP at Central Maine Power are reviewed. 2 refs., 1 fig

National conference on integrated resource planning: Proceedings

Energy Technology Data Exchange (ETDEWEB)

1991-12-31

Until recently, state regulators have focused most of their attention on the development of least-cost or integrated resource planning (IRP) processes for electric utilities. A number of commissions are beginning to scrutinize the planning processes of local gas distribution companies (LDCs) because of the increased control that LDCs have over their purchased gas costs (as well as the associated risks) and because of questions surrounding the role and potential of gas end-use efficiency options. Traditionally, resource planning (LDCs) has concentrated on options for purchasing and storing gas. Integrated resource planning involves the creation of a process in which supply-side and demand-side options are integrated to create a resource mix that reliably satisfies customers` short-term and long-term energy service needs at the lowest cost. As applied to gas utilities, an integrated resource plan seeks to balance cost and reliability, and should not be interpreted simply as the search for lowest commodity costs. The National Association of Regulatory Utility Commissioners` (NARUC) Energy Conservation committee asked Lawrence Berkeley Laboratory (LBL) to survey state PUCs to determine the extent to which they have undertaken least cost planning for gas utilities. The survey included the following topics: status of state PUC least-cost planning regulations and practices for gas utilities; type and scope of natural gas DSM programs in effect, including fuel substitution; economic tests and analysis methods used to evaluate DSM programs; relationship between prudency reviews of gas utility purchasing practices and integrated resource planning; key regulatory issued facing gas utilities during the next five years.

National conference on integrated resource planning: Proceedings

Energy Technology Data Exchange (ETDEWEB)

1991-01-01

Until recently, state regulators have focused most of their attention on the development of least-cost or integrated resource planning (IRP) processes for electric utilities. A number of commissions are beginning to scrutinize the planning processes of local gas distribution companies (LDCs) because of the increased control that LDCs have over their purchased gas costs (as well as the associated risks) and because of questions surrounding the role and potential of gas end-use efficiency options. Traditionally, resource planning (LDCs) has concentrated on options for purchasing and storing gas. Integrated resource planning involves the creation of a process in which supply-side and demand-side options are integrated to create a resource mix that reliably satisfies customers' short-term and long-term energy service needs at the lowest cost. As applied to gas utilities, an integrated resource plan seeks to balance cost and reliability, and should not be interpreted simply as the search for lowest commodity costs. The National Association of Regulatory Utility Commissioners' (NARUC) Energy Conservation committee asked Lawrence Berkeley Laboratory (LBL) to survey state PUCs to determine the extent to which they have undertaken least cost planning for gas utilities. The survey included the following topics: status of state PUC least-cost planning regulations and practices for gas utilities; type and scope of natural gas DSM programs in effect, including fuel substitution; economic tests and analysis methods used to evaluate DSM programs; relationship between prudency reviews of gas utility purchasing practices and integrated resource planning; key regulatory issued facing gas utilities during the next five years.

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

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.

Healthcare succession planning: an integrative review.

Science.gov (United States)

Carriere, Brian K; Muise, Melanie; Cummings, Greta; Newburn-Cook, Chris

2009-12-01

Succession planning is a business strategy that has recently gained attention in the healthcare literature, primarily because of nursing shortage concerns and the demand for retaining knowledgeable personnel to meet organizational needs. Little research has been conducted in healthcare settings that clearly defines best practices for succession planning frameworks. To effectively carry out such organizational strategies during these challenging times, an integrative review of succession planning in healthcare was performed to identify consistencies in theoretical approaches and strategies for chief nursing officers and healthcare managers to initiate. Selected articles were compared with business succession planning to determine whether healthcare strategies were similar to best practices already established in business contexts. The results of this integrative review will aid leaders and managers to use succession planning as a tool in their recruitment, retention, mentoring, and administration activities and also provide insights for future development of healthcare succession planning frameworks.

Spent nuclear fuel project integrated schedule plan

International Nuclear Information System (INIS)

Squires, K.G.

1995-01-01

The Spent Nuclear Fuel Integrated Schedule Plan establishes the organizational responsibilities, rules for developing, maintain and status of the SNF integrated schedule, and an implementation plan for the integrated schedule. The mission of the SNFP on the Hanford site is to provide safe, economic, environmentally sound management of Hanford SNF in a manner which stages it to final disposition. This particularly involves K Basin fuel

Spent nuclear fuel project integrated schedule plan

Energy Technology Data Exchange (ETDEWEB)

Squires, K.G.

1995-03-06

The Spent Nuclear Fuel Integrated Schedule Plan establishes the organizational responsibilities, rules for developing, maintain and status of the SNF integrated schedule, and an implementation plan for the integrated schedule. The mission of the SNFP on the Hanford site is to provide safe, economic, environmentally sound management of Hanford SNF in a manner which stages it to final disposition. This particularly involves K Basin fuel.

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

Diagnosis, treatment planning, and full-mouth rehabilitation in a case of amelogenesis imperfecta

Directory of Open Access Journals (Sweden)

Mayuri Naik

2018-01-01

Full Text Available Amelogenesis imperfecta is a genetic condition affecting the teeth resulting in aberrations of the structure and clinical appearance of enamel. The treatment of amelogenesis imperfecta involves a multidisciplinary treatment approach requiring a comprehensive examination, diagnosis, and effective treatment planning strategy along with satisfaction of patient-related factors. The clinical case described here involves judicious involvement of different disciplines to formulate a treatment plan best suitable to confirm with the patient's needs and expectations, at the same time maintaining the integrity and harmony of associated hard and soft tissues.

Heart dose reduction in breast cancer treatment with simultaneous integrated boost. Comparison of treatment planning and dosimetry for a novel hybrid technique and 3D-CRT

International Nuclear Information System (INIS)

Joest, Vincent; Kretschmer, Matthias; Sabatino, Marcello; Wuerschmidt, Florian; Dahle, Joerg; Lorenzen, Joern; Ueberle, Friedrich

2015-01-01

The present study compares in silico treatment plans of clinically established three-dimensional conformal radiotherapy (3D-CRT) with a hybrid technique consisting of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) during normally fractionated radiation of mammary carcinomas with simultaneous integrated boost on the basis of dose-volume histogram (DVH) parameters. Radiation treatment planning was performed with a hybrid and a 3D-CRT treatment plan for 20 patients. Hybrid plans were implemented with two tangential IMRT fields and a VMAT field in the angular range of the tangents. Verification of the plan was performed with a manufacturer-independent measurement system consisting of a detector array and rotation unit. The mean values of the heart dose for the entire patient collective were 3.6 ± 2.5 Gy for 3D-CRT and 2.9 ± 2.1 Gy for the hybrid technique (p < 0.01). For the left side (n = 10), the mean values for the left anterior descending artery were 21.8 ± 7.4 Gy for 3D-CRT and 17.6 ± 7.4 Gy for the hybrid technique (p < 0.01). The mean values of the ipsilateral lung were 11.9 ± 1.6 Gy for 3D-CRT and 10.5 ± 1.3 Gy for the hybrid technique (p < 0.01). Calculated dose distributions in the hybrid arm were in good accordance with measured dose (on average 95.6 ± 0.5 % for γ < 1 and 3 %/3 mm). The difference of the mean treatment time per fraction was 7 s in favor of 3D-CRT. Compared with the established 3D-CRT technique, the hybrid technique allows for a decrease in dose, particularly of the mean heart and lung dose with comparable target volume acquisition and without disadvantageous low-dose load of contralateral structures. Uncomplicated implementation of the hybrid technique was demonstrated in this context. The hybrid technique combines the advantages of tangential IMRT with the superior sparing of organs at risk by VMAT. (orig.) [de

Mixed Waste Integrated Program Quality Assurance requirements plan

International Nuclear Information System (INIS)

1994-01-01

Mixed Waste Integrated Program (MWIP) is sponsored by the US Department of Energy (DOE), Office of Technology Development, Waste Management Division. The strategic objectives of MWIP are defined in the Mixed Waste Integrated Program Strategic Plan, and expanded upon in the MWIP Program Management Plan. This MWIP Quality Assurance Requirement Plan (QARP) applies to mixed waste treatment technologies involving both hazardous and radioactive constituents. As a DOE organization, MWIP is required to develop, implement, and maintain a written Quality Assurance Program in accordance with DOE Order 4700.1 Project Management System, DOE Order 5700.6C, Quality Assurance, DOE Order 5820.2A Radioactive Waste Management, ASME NQA-1 Quality Assurance Program Requirements for Nuclear Facilities and ANSI/ASQC E4-19xx Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs. The purpose of the MWIP QA program is to establish controls which address the requirements in 5700.6C, with the intent to minimize risks and potential environmental impacts; and to maximize environmental protection, health, safety, reliability, and performance in all program activities. QA program controls are established to assure that each participating organization conducts its activities in a manner consistent with risks posed by those activities

Mixed Waste Integrated Program Quality Assurance requirements plan

Energy Technology Data Exchange (ETDEWEB)

1994-04-15

Mixed Waste Integrated Program (MWIP) is sponsored by the US Department of Energy (DOE), Office of Technology Development, Waste Management Division. The strategic objectives of MWIP are defined in the Mixed Waste Integrated Program Strategic Plan, and expanded upon in the MWIP Program Management Plan. This MWIP Quality Assurance Requirement Plan (QARP) applies to mixed waste treatment technologies involving both hazardous and radioactive constituents. As a DOE organization, MWIP is required to develop, implement, and maintain a written Quality Assurance Program in accordance with DOE Order 4700.1 Project Management System, DOE Order 5700.6C, Quality Assurance, DOE Order 5820.2A Radioactive Waste Management, ASME NQA-1 Quality Assurance Program Requirements for Nuclear Facilities and ANSI/ASQC E4-19xx Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs. The purpose of the MWIP QA program is to establish controls which address the requirements in 5700.6C, with the intent to minimize risks and potential environmental impacts; and to maximize environmental protection, health, safety, reliability, and performance in all program activities. QA program controls are established to assure that each participating organization conducts its activities in a manner consistent with risks posed by those activities.

Reliability criteria selection for integrated resource planning

International Nuclear Information System (INIS)

Ruiu, D.; Ye, C.; Billinton, R.; Lakhanpal, D.

1993-01-01

A study was conducted on the selection of a generating system reliability criterion that ensures a reasonable continuity of supply while minimizing the total costs to utility customers. The study was conducted using the Institute for Electronic and Electrical Engineers (IEEE) reliability test system as the study system. The study inputs and results for conditions and load forecast data, new supply resources data, demand-side management resource data, resource planning criterion, criterion value selection, supply side development, integrated resource development, and best criterion values, are tabulated and discussed. Preliminary conclusions are drawn as follows. In the case of integrated resource planning, the selection of the best value for a given type of reliability criterion can be done using methods similar to those used for supply side planning. The reliability criteria values previously used for supply side planning may not be economically justified when integrated resource planning is used. Utilities may have to revise and adopt new, and perhaps lower supply reliability criteria for integrated resource planning. More complex reliability criteria, such as energy related indices, which take into account the magnitude, frequency and duration of the expected interruptions are better adapted than the simpler capacity-based reliability criteria such as loss of load expectation. 7 refs., 5 figs., 10 tabs

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.)

Integration and test planning patterns in different organizations

NARCIS (Netherlands)

Jong, de I.S.M.; Boumen, R.; Mortel - Fronczak, van de J.M.; Rooda, J.E.; Tretmans, J.

2007-01-01

Planning an integration and test phase is often done by experts in the visited organizations. These experts have a thorough knowledge about the system, integration and testing and the business drivers of an organization. An integration and test plan developedfor an airplane is different than the

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...

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.

Integrating design and production planning with knowledge-based inspection planning system

International Nuclear Information System (INIS)

Abbasi, Ghaleb Y.; Ketan, Hussein S.; Adil, Mazen B.

2005-01-01

In this paper an intelligent environment to integrate design and inspection earlier to the design stage. A hybrid knowledge-based approach integrating computer-aided design (CAD) and computer-aided inspection planning (CAIP) was developed, thereafter called computer-aided design and inspection planning (CADIP). CADIP was adopted for automated dimensional inspection planning. Critical functional features were screened based on certain attributes for part features for inspection planning application. Testing the model resulted in minimizing the number of probing vectors associated with the most important features in the inspected prismatic part, significant reduction in inspection costs and release of human labor. In totality, this tends to increase customer satisfaction as a final goal of the developed system. (author)

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

Integrated Care Planning for Cancer Patients: A Scoping Review

Directory of Open Access Journals (Sweden)

Anum Irfan Khan

2017-11-01

Full Text Available Introduction: There has been a growing emphasis on the use of integrated care plans to deliver cancer care. However little is known about how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact. Methods: Given limited consensus around what constitutes an integrated care plan for cancer patients, a scoping review was conducted to explore the components of integrated care plans and contextual factors that influence design and uptake. Results: Five types of integrated care plans based on the stage of cancer care: surgical, systemic, survivorship, palliative and comprehensive (involving a transition between stages are described in current literature. Breast, esophageal and colorectal cancers were common disease sites. Multi-disciplinary teams, patient needs assessment and transitional planning emerged as key features. Provider buy-in and training alongside informational technology support served as important facilitators for plan uptake. Provider-level measurement was considerably less robust compared to patient and system-level indicators. Conclusions: Similarities in design features, components and facilitators across the various types of integrated care plans indicates opportunities to leverage shared features and enable a management lens that spans the trajectory of a patient’s journey rather than a phase-specific silo approach to care.

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

Integrated High-Level Waste System Planning - Utilizing an Integrated Systems Planning Approach to Ensure End-State Definitions are Met and Executed - 13244

Energy Technology Data Exchange (ETDEWEB)

Ling, Lawrence T. [URS-Savannah River Remediation, Savannah River Site, Building 766-H Room 2205, Aiken, SC 29808 (United States); Chew, David P. [URS-Savannah River Remediation, Savannah River Site, Building 766-H Room 2426, Aiken, SC 29808 (United States)

2013-07-01

The Savannah River Site (SRS) is a Department of Energy site which has produced nuclear materials for national defense, research, space, and medical programs since the 1950's. As a by-product of this activity, approximately 37 million gallons of high-level liquid waste containing approximately 292 million curies of radioactivity is stored on an interim basis in 45 underground storage tanks. Originally, 51 tanks were constructed and utilized to support the mission. Four tanks have been closed and taken out of service and two are currently undergoing the closure process. The Liquid Waste System is a highly integrated operation involving safely storing liquid waste in underground storage tanks; removing, treating, and dispositioning the low-level waste fraction in grout; vitrifying the higher activity waste at the Defense Waste Processing Facility; and storing the vitrified waste in stainless steel canisters until permanent disposition. After waste removal and processing, the storage and processing facilities are decontaminated and closed. A Liquid Waste System Plan (hereinafter referred to as the Plan) was developed to integrate and document the activities required to disposition legacy and future High-Level Waste and to remove from service radioactive liquid waste tanks and facilities. It establishes and records a planning basis for waste processing in the liquid waste system through the end of the program mission. The integrated Plan which recognizes the challenges of constrained funding provides a path forward to complete the liquid waste mission within all regulatory and legal requirements. The overarching objective of the Plan is to meet all Federal Facility Agreement and Site Treatment Plan regulatory commitments on or ahead of schedule while preserving as much life cycle acceleration as possible through incorporation of numerous cost savings initiatives, elimination of non-essential scope, and deferral of other scope not on the critical path to compliance

Integrated High-Level Waste System Planning - Utilizing an Integrated Systems Planning Approach to Ensure End-State Definitions are Met and Executed - 13244

International Nuclear Information System (INIS)

Ling, Lawrence T.; Chew, David P.

2013-01-01

The Savannah River Site (SRS) is a Department of Energy site which has produced nuclear materials for national defense, research, space, and medical programs since the 1950's. As a by-product of this activity, approximately 37 million gallons of high-level liquid waste containing approximately 292 million curies of radioactivity is stored on an interim basis in 45 underground storage tanks. Originally, 51 tanks were constructed and utilized to support the mission. Four tanks have been closed and taken out of service and two are currently undergoing the closure process. The Liquid Waste System is a highly integrated operation involving safely storing liquid waste in underground storage tanks; removing, treating, and dispositioning the low-level waste fraction in grout; vitrifying the higher activity waste at the Defense Waste Processing Facility; and storing the vitrified waste in stainless steel canisters until permanent disposition. After waste removal and processing, the storage and processing facilities are decontaminated and closed. A Liquid Waste System Plan (hereinafter referred to as the Plan) was developed to integrate and document the activities required to disposition legacy and future High-Level Waste and to remove from service radioactive liquid waste tanks and facilities. It establishes and records a planning basis for waste processing in the liquid waste system through the end of the program mission. The integrated Plan which recognizes the challenges of constrained funding provides a path forward to complete the liquid waste mission within all regulatory and legal requirements. The overarching objective of the Plan is to meet all Federal Facility Agreement and Site Treatment Plan regulatory commitments on or ahead of schedule while preserving as much life cycle acceleration as possible through incorporation of numerous cost savings initiatives, elimination of non-essential scope, and deferral of other scope not on the critical path to compliance

Integrating fire management analysis into land management planning

Science.gov (United States)

Thomas J. Mills

1983-01-01

The analysis of alternative fire management programs should be integrated into the land and resource management planning process, but a single fire management analysis model cannot meet all planning needs. Therefore, a set of simulation models that are analytically separate from integrated land management planning models are required. The design of four levels of fire...

Snakes: An Integrated Unit Plan.

Science.gov (United States)

Lawrence, Lisa

This document presents an integrated unit plan on snakes targeting second grade students. Objectives of the unit include developing concepts of living things, understanding the contribution and importance of snakes to the environment, and making connections between different disciplines. The unit integrates the topic of snakes into the areas of…

Integrated maintenance planning in manufacturing systems

CERN Document Server

Al-Turki, Umar M; Yilbas, Bekir Sami; Sahin, Ahmet Ziyaettin

2014-01-01

This book introduces the concept of integrated planning for maintenance and production taken into account quality and safety for high global socio-economic impact. It provides insight into the planning process at a global level starting from the business level and ending with the operational level where the plan is implemented and controlled.

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.

Integration of air quality-related planning processes : report

International Nuclear Information System (INIS)

2004-05-01

Several communities in British Columbia have conducted air quality, greenhouse gas, or community energy management plans. This report explored the possibility of integrating 3 community-based air quality-related planning processes into a single process and evaluated the use of these 3 processes by local governments and First Nations in identifying and addressing air quality-related objectives, and determined to what extent they could be integrated to achieve planning objectives for air quality, greenhouse gas emissions, and energy supply and conservation. The lessons learned from 9 case studies in British Columbia were presented. The purpose of the case studies was to examine how communities handled emissions and energy related inventory and planning work, as well as their experiences with, or considerations for, an integrated process. The lessons were grouped under several key themes including organization and stakeholder involvement; messaging and focus; leadership/champions; and resources and capacity. The report also outlined a framework for an integrated planning process and provided recommendations regarding how an integrated or complementary process could be performed. A number of next steps were also offered for the provincial government to move the concept of an integrated process forward with the assistance of other partners. These included identifying the resources required to support communities engaging in an integrated process as well as discussing the series of options for provincial support with key stakeholders. refs., tabs., figs

Measuring resilience in integrated planning

DEFF Research Database (Denmark)

Apneseth, K.; Wahl, A. M.; Hollnagel, E.

2013-01-01

This chapter demonstrates how a Resilience Analysis Grid (RAG) can be used to profile the performance of a company in terms of the four abilities that characterize a resilient organization. It describes the development of a new, RAG-based tool founded on Resilience Engineering principles that can...... be used to assess an organization's resilience. The tool was tested in a case study involving a company in the offshore oil and gas industry. The company had decided to adopt an Integrated Operations (IO) approach to operations and maintenance planning and the tool was used to evaluate the impact...... of the Integrated Planning (IPL) process on its resilience....

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

Integration of on-line imaging, plan adaptation and radiation delivery: proof of concept using digital tomosynthesis

International Nuclear Information System (INIS)

Mestrovic, Ante; Otto, Karl; Nichol, Alan; Clark, Brenda G

2009-01-01

The main objective of this manuscript is to propose a new approach to on-line adaptive radiation therapy (ART) in which daily image acquisition, plan adaptation and radiation delivery are integrated together and performed concurrently. A method is described in which on-line ART is performed based on intra-fractional digital tomosynthesis (DTS) images. Intra-fractional DTS images were reconstructed as the gantry rotated between treatment positions. An edge detection algorithm was used to automatically segment the DTS images as the gantry arrived at each treatment position. At each treatment position, radiation was delivered based on the treatment plan re-optimized for the most recent DTS image contours. To investigate the feasibility of this method, a model representing a typical prostate, bladder and rectum was used. To simulate prostate deformations, three clinically relevant, non-rigid deformations (small, medium and large) were modeled by systematically deforming the original anatomy. Using our approach to on-line ART, the original treatment plan was successfully adapted to arrive at a clinically acceptable plan for all three non-rigid deformations. In conclusion, we have proposed a new approach to on-line ART in which plan adaptation is performed based on intra-fractional DTS images. The study findings indicate that this approach can be used to re-optimize the original treatment plan to account for non-rigid anatomical deformations. The advantages of this approach are 1) image acquisition and radiation delivery are integrated in a single gantry rotation around the patient, reducing the treatment time, and 2) intra-fractional DTS images can be used to detect and correct for patient motion prior to the delivery of each beam (intra-fractional patient motion).

A template for integrated community sustainability planning.

Science.gov (United States)

Ling, Christopher; Hanna, Kevin; Dale, Ann

2009-08-01

This article describes a template for implementing an integrated community sustainability plan. The template emphasizes community engagement and outlines the components of a basic framework for integrating ecological, social and economic dynamics into a community plan. The framework is a series of steps that support a sustainable community development process. While it reflects the Canadian experience, the tools and techniques have applied value for a range of environmental planning contexts around the world. The research is case study based and draws from a diverse range of communities representing many types of infrastructure, demographics and ecological and geographical contexts. A critical path for moving local governments to sustainable community development is the creation and implementation of integrated planning approaches. To be effective and to be implemented, a requisite shift to sustainability requires active community engagement processes, political will, and a commitment to political and administrative accountability, and measurement.

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

Primer on gas integrated resource planning

Energy Technology Data Exchange (ETDEWEB)

Goldman, C.; Comnes, G.A.; Busch, J.; Wiel, S. [Lawrence Berkeley Lab., CA (United States)

1993-12-01

This report discusses the following topics: gas resource planning: need for IRP; gas integrated resource planning: methods and models; supply and capacity planning for gas utilities; methods for estimating gas avoided costs; economic analysis of gas utility DSM programs: benefit-cost tests; gas DSM technologies and programs; end-use fuel substitution; and financial aspects of gas demand-side management programs.

Planning integration FY 1995 Multi-Year Program Plan (MYPP)/Fiscal Year Work Plan (FYWP)

International Nuclear Information System (INIS)

1994-09-01

This Multi-Year Program Plan (MYPP) for the Planning Integration Program, Work Breakdown structure (WBS) Element 1.8.2, is the primary management tool to document the technical, schedule, and cost baseline for work directed by the US Department of Energy (DOE), Richland Operations Office (RL). As an approved document, it establishes a binding agreement between RL and the performing contractors for the work to be performed. It was prepared by the Westinghouse Hanford Company (WHC) and the Pacific Northwest Laboratory (PNL). This MYPP provides a picture from fiscal year 1995 through FY 2001 for the Planning Integration Program. The MYPP provides a window of detailed information for the first three years. It also provides 'execution year' work plans. The MYPP provides summary information for the next four years, documenting the same period as the Activity Data Sheets

Planning integration FY 1995 Multi-Year Program Plan (MYPP)/Fiscal Year Work Plan (FYWP)

Energy Technology Data Exchange (ETDEWEB)

1994-09-01

This Multi-Year Program Plan (MYPP) for the Planning Integration Program, Work Breakdown structure (WBS) Element 1.8.2, is the primary management tool to document the technical, schedule, and cost baseline for work directed by the US Department of Energy (DOE), Richland Operations Office (RL). As an approved document, it establishes a binding agreement between RL and the performing contractors for the work to be performed. It was prepared by the Westinghouse Hanford Company (WHC) and the Pacific Northwest Laboratory (PNL). This MYPP provides a picture from fiscal year 1995 through FY 2001 for the Planning Integration Program. The MYPP provides a window of detailed information for the first three years. It also provides `execution year` work plans. The MYPP provides summary information for the next four years, documenting the same period as the Activity Data Sheets.

Integrated operations plan for the MFTF-B Mirror Fusion Test Facility. Volume II. Integrated operations plan

Energy Technology Data Exchange (ETDEWEB)

1981-12-01

This document defines an integrated plan for the operation of the Lawrence Livermore National Laboratory (LLNL) Mirror Fusion Test Facility (MFTF-B). The plan fulfills and further delineates LLNL policies and provides for accomplishing the functions required by the program. This plan specifies the management, operations, maintenance, and engineering support responsibilities. It covers phasing into sustained operations as well as the sustained operations themselves. Administrative and Plant Engineering support, which are now being performed satisfactorily, are not part of this plan unless there are unique needs.

Integrated operations plan for the MFTF-B Mirror Fusion Test Facility. Volume II. Integrated operations plan

International Nuclear Information System (INIS)

1981-12-01

This document defines an integrated plan for the operation of the Lawrence Livermore National Laboratory (LLNL) Mirror Fusion Test Facility (MFTF-B). The plan fulfills and further delineates LLNL policies and provides for accomplishing the functions required by the program. This plan specifies the management, operations, maintenance, and engineering support responsibilities. It covers phasing into sustained operations as well as the sustained operations themselves. Administrative and Plant Engineering support, which are now being performed satisfactorily, are not part of this plan unless there are unique needs

Integrated resource planning in Danish electricity supply

International Nuclear Information System (INIS)

1994-01-01

Integrated Resource Planning in Danish Electricity Supply is a development project run by a cooperation of Danish electric power companies. It takes environmental issues, such as energy conservation, into consideration in addition to the European Union's proposal for a directive on the introduction of competition within the common energy market. The concept of integrated resource planning is described as a tool that can be used for a total cost minimization of the activities on the supply side and the demand side, this concept is further elucidated. It is explained that there must be an economic balance between the efforts on both sides and that this will ensure a total cost minimization. Preconditions, related for example to socio-economics, and procedures (step-by-step planning), functional barriers, a definition of roles and international influence and dialogue are also discussed. Satisfaction is expressed for this method of integrated resource planning, yet uncertainty as to the future structure of the free electricity market implies a cautious implementation. (AB)

A class solution for RapidArc prostate planning with simultaneous integrated boost

International Nuclear Information System (INIS)

Jolly, David; Alahakone, D.; Meyer, J.

2010-01-01

Full text: Standardised treatment planning procedures make the planning process for rotational IMRT more efficient and consistent. This may be achieved by applying the same planning strategy, or class solution, for each patient. In doing so it may be possible to achieve acceptable plans for each patient within a relatively short timeframe, whilst time consuming individual optimisation of the planning parameters can be avoided. Methods Tn this work, a robust and streamlined planning strategy is established with an emphasis on treating prostate patients with a simultaneous integrated boost RapidArc plan. This planning strategy outlines the field set up, recommended starting objectives, required user interactions to be made throughout optimisation and post optimisation adjustments. A comparative planning study-with static gantry IMRT -is then presented for ten prostate patients as justification for the planning strategy itself. Results A variety of parameters are evaluated relating to both the planning itself and the plans that result. Results of this comparative study are in line with previously published data and the planning process is streamlined to a point where the RapidArc optimisation and calculation time is 16.7 1.5 min collectively. Discussion and Conclusion Application of this planning strategy reduces the dependence of the produced plan on the experience of the planner and has the potential to streamline the planning process within radiotherapy departments. Modified applications of the strategy have also proved to be useful for the planning of other treatment sites.

Optimal planning of integrated multi-energy systems

DEFF Research Database (Denmark)

van Beuzekom, I.; Gibescu, M.; Pinson, Pierre

2017-01-01

In this paper, a mathematical approach for the optimal planning of integrated energy systems is proposed. In order to address the challenges of future, RES-dominated energy systems, the model deliberates between the expansion of traditional energy infrastructures, the integration...... and sustainability goals for 2030 and 2045. Optimal green- and brownfield designs for a district's future integrated energy system are compared using a one-step, as well as a two-step planning approach. As expected, the greenfield designs are more cost efficient, as their results are not constrained by the existing...

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

Groundwater/Vadose Zone Integration Project Management Plan

International Nuclear Information System (INIS)

Hughes, M. C.

1999-01-01

This Project Management Plan (PMP) defines the authorities, roles, and responsibilities of the US Department of Energy (DOE), Richland Operations Office (RL) and those contractor organizations participating in the Hanford Site' s Groundwater/Vadose Zone (GW/VZ) Integration Project. The PMP also describes the planning and control systems, business processes, and other management tools needed to properly and consistently conduct the Integration Project scope of work

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

TU-G-210-01: Modeling for Breast and Brain HIFU Treatment Planning

International Nuclear Information System (INIS)

Christensen, D.

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)

TU-G-210-01: Modeling for Breast and Brain HIFU Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Christensen, D. [University of Utah (United States)

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)

Integrated sustainable development and energy resource planning

OpenAIRE

Virgiliu NICULA

2011-01-01

Integrated sustainable development of a country cannot be conceived and begun without considering in an intricate tandem environmental protection and economic development. No one can exist without a natural material support of the life he or she enjoys. All economic development plans must include environmental and human civilization’s protection implicitly. Integrated resource planning must be done in an absolutely judicious manner, so we can all leave as a legacy for future generations both ...

Integrated Wind Power Planning Tool

DEFF Research Database (Denmark)

Rosgaard, M. H.; Giebel, Gregor; Nielsen, T. S.

2012-01-01

model to be developed in collaboration with ENFOR A/S; a danish company that specialises in forecasting and optimisation for the energy sector. This integrated prediction model will allow for the description of the expected variability in wind power production in the coming hours to days, accounting......This poster presents the current state of the public service obligation (PSO) funded project PSO 10464, with the working title "Integrated Wind Power Planning Tool". The project commenced October 1, 2011, and the goal is to integrate a numerical weather prediction (NWP) model with purely...

Plan-provider integration, premiums, and quality in the Medicare Advantage market.

Science.gov (United States)

Frakt, Austin B; Pizer, Steven D; Feldman, Roger

2013-12-01

To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan-provider integration. With the exception of Medigap premium data, all data were publicly available. We ascertained plan-provider integration through examination of plans' websites and governance documents. We found that integrated plan-providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Current policy encourages plan-provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). © Health Research and Educational Trust.

Figure/ground analogy for integrated sustainability & planning

CSIR Research Space (South Africa)

Beyers, C

2006-12-01

Full Text Available This article proposes a figure ground analogy as alternative way of conceptually integrating sustainability and planning. Within this framework planners are challenged to creatively consider planning practice and thought against a background...

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

plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI 100 = 1.09 and CI 50 = 4.07) were better than VMAT conformity indices (CI 100 = 1.30 and CI 50 = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI 100 and CI 50 conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI 100 and CI 50 conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans

Integrated operations plan for the MFTF-B Mirror Fusion Test Facility. Volume I. Organization plan

International Nuclear Information System (INIS)

1981-12-01

This plan and the accompanying MFTF-B Integrated Operations Plan are submitted in response to UC/LLNL Purchase Order 3883801, dated July 1981. The organization plan also addresses the specific tasks and trade studies directed by the scope of work. The Integrated Operations Plan, which includes a reliability, quality assurance, and safety plan and an integrated logistics plan, comprises the burden of the report. In the first section of this volume, certain underlying assumptions and observations are discussed setting the requirements and limits for organization. Section B presents the recommended structure itself. Section C Device Availability vs Maintenance and Support Efforts and Section D Staffing Levels and Skills provide backup detail and justification. Section E is a trade study on maintenance and support by LLNL staff vs subcontract and Section F is a plan for transitioning from the construction phase into operation. A brief summary of schedules and estimated costs concludes the volume

Treatment of breast cancer with simultaneous integrated boost in hybrid plan technique. Influence of flattening filter-free beams

Energy Technology Data Exchange (ETDEWEB)

Bahrainy, Marzieh; Kretschmer, Matthias; Joest, Vincent; Kasch, Astrid; Wuerschmidt, Florian; Dahle, Joerg; Lorenzen, Joern [Radiologische Allianz, Hamburg (Germany)

2016-05-15

The present study compares in silico treatment plans using hybrid plan technique during hypofractionated radiation of mammary carcinoma with simultaneous integrated boost (SIB). The influence of 6 MV photon radiation in flattening filter free (FFF) mode against the clinical standard flattening filter (FF) mode is to be examined. RT planning took place with FF and FFF radiation plans for 10 left-sided breast cancer patients. Hybrid plans were realised with two tangential IMRT fields and one VMAT field. The dose prescription was in line with the guidelines in the ARO-2010-01 study. The dosimetric verification took place with a manufacturer-independent measurement system. Required dose prescriptions for the planning target volumes (PTV) were achieved for both groups. The average dose values of the ipsi- and contralateral lung and the heart did not differ significantly. The overall average incidental dose to the left anterior descending artery (LAD) of 8.24 ± 3.9 Gy in the FFF group and 9.05 ± 3.7 Gy in the FF group (p < 0.05) were found. The dosimetric verifications corresponded to the clinical requirements. FFF-based RT plans reduced the average treatment time by 17 s/fraction. In comparison to the FF-based hybrid plan technique the FFF mode allows further reduction of the average LAD dose for comparable target volume coverage without adverse low-dose exposure of contralateral structures. The combination of hybrid plan technique and 6 MV photon radiation in the FFF mode is suitable for use with hypofractionated dose schemes. The increased dose rate allows a substantial reduction of treatment time and thus beneficial application of the deep inspiration breath hold technique. (orig.) [German] Vergleich der ''In-silico''-Bestrahlungsplaene der klinisch etablierten Hybridplan-Technik bei hypofraktionierter Bestrahlung des Mammakarzinoms mit simultan integriertem Boost (SIB). Untersucht wird der Einfluss von 6MV-Photonenstrahlung im Flattening

Integrating Robot Task Planning into Off-Line Programming Systems

DEFF Research Database (Denmark)

Sun, Hongyan; Kroszynski, Uri

1988-01-01

a system architecture for integrated robot task planning. It identifies and describes the components considered necessary for implementation. The focus is on functionality of these elements as well as on the information flow. A pilot implementation of such an integrated system architecture for a robot......The addition of robot task planning in off-line programming systems aims at improving the capability of current state-of-the-art commercially available off-line programming systems, by integrating modeling, task planning, programming and simulation together under one platform. This article proposes...... assembly task is discussed....

Buried waste integrated demonstration FY 94 deployment plan

International Nuclear Information System (INIS)

Hyde, R.A.; Walker, S.; Garcia, M.M.

1994-05-01

The Buried Waste Integrated Demonstration (BWID) is a program funded by the U.S. Department of Energy Office of Technology Development. BWID supports the applied research, development, demonstration, testing, and evaluation of a suite of advanced technologies that together form a comprehensive remediation system for the effective and efficient remediation of buried waste. The fiscal year (FY) 1994 effort will fund thirty-eight technologies in five areas of buried waste site remediation: site characterization, waste characterization, retrieval, treatment, and containment/stabilization. This document is the basic operational planning document for deployment of all BWID projects. Discussed in this document are the BWID preparations for INEL field demonstrations, INEL laboratory demonstrations, non-INEL demonstrations, and paper studies. Each technology performing tests will prepare a test plan to detail the specific procedures, objectives, and tasks of each test. Therefore, information specific to testing each technology is intentionally omitted from this document

49 CFR 1106.4 - The Safety Integration Plan process.

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false The Safety Integration Plan process. 1106.4 Section 1106.4 Transportation Other Regulations Relating to Transportation (Continued) SURFACE... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS...

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

An Integrated Extravehicular Activity Research Plan

Science.gov (United States)

Abercromby, Andrew F. J.; Ross, Amy J.; Cupples, J. Scott

2016-01-01

Multiple organizations within NASA and outside of NASA fund and participate in research related to extravehicular activity (EVA). In October 2015, representatives of the EVA Office, the Crew and Thermal Systems Division (CTSD), and the Human Research Program (HRP) at NASA Johnson Space Center agreed on a formal framework to improve multi-year coordination and collaboration in EVA research. At the core of the framework is an Integrated EVA Research Plan and a process by which it will be annually reviewed and updated. The over-arching objective of the collaborative framework is to conduct multi-disciplinary cost-effective research that will enable humans to perform EVAs safely, effectively, comfortably, and efficiently, as needed to enable and enhance human space exploration missions. Research activities must be defined, prioritized, planned and executed to comprehensively address the right questions, avoid duplication, leverage other complementary activities where possible, and ultimately provide actionable evidence-based results in time to inform subsequent tests, developments and/or research activities. Representation of all appropriate stakeholders in the definition, prioritization, planning and execution of research activities is essential to accomplishing the over-arching objective. A formal review of the Integrated EVA Research Plan will be conducted annually. External peer review of all HRP EVA research activities including compilation and review of published literature in the EVA Evidence Book is already performed annually. Coordination with stakeholders outside of the EVA Office, CTSD, and HRP is already in effect on a study-by-study basis; closer coordination on multi-year planning with other EVA stakeholders including academia is being actively pursued. Details of the current Integrated EVA Research Plan are presented including description of ongoing and planned research activities in the areas of: Benchmarking; Anthropometry and Suit Fit; Sensors; Human

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

Comparison of dosimetry distribution between three-dimension conformal and intensity modulated plan integrated with breath motion in postoperative radiation of gastric cancer

International Nuclear Information System (INIS)

Sun Wenjie; Zhang Zhen; Hu Weigang; Gu Weilie; Zhu Ji; Li Guichao; Cai Gang; Ma Xuejun

2010-01-01

Objective: To compare the dose distribution of the target and normal tissues in gastric cancers between three-dimension conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) plan when respiratory motion factors integrated in the plan. Methods: From January 2005 to November 2006, 10 patients with post-operatively radiation of gastric cancer were enrolled in this study. Planning CT were acquired conventionally with free-breath mode and the static treatment plans of the 3DCRT and IMRT were designed respectively. Probability distribution functions (PDF) were generated and convoluted with the static dose distributions from 3DCRT and IMRT plans to obtain the integrated plans. The dose distributions of the target and normal tissues were compared between 3DCRT and IMRT integration treatment plans, such as V 45 of clinical target volume, V 40 of liver and V 15 , V 18 of left and right kidney. Results: In the respiratory integrated treatment planning, the target volume coverage and homogeneity with IMRT are superior to those with 3DCRT ((V 45 98% : 87% (t = -3.35, P =0.010), mean dose 46.81 Gy ±0.75 Gy : 45.99 Gy ± 1.12 Gy (t = -0.31, P=0.020)). The V 40 of the liver in IMRT are smaller than those in 3DCRT ( 12% : 16%; t=3.75, P=0.010). For the left kidney, the V 15 and V 18 in IMRT are smaller than those in 3DCRT ((34% : 50% (t = 2.17, P = 0.050) and 27% : 46% (t = 3.11, P = 0.020) ),but for the right kidney, V 15 and V 18 in 3DCRT are smaller than those in IMRT ((15% : 21% (t = - 2.42, P=0.040) and 11% : 15% (t= -2.71, P=0.030)). Conclusions: When respiratory motion factor integrated in the treatment plan, IMRT showed advantage both in target coverage and normal tissue sparing in the high dose region of liver and left kidney. (authors)

[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.

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

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

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

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

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.

An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder: An Educational Review.

Science.gov (United States)

Ross, David A; Arbuckle, Melissa R; Travis, Michael J; Dwyer, Jennifer B; van Schalkwyk, Gerrit I; Ressler, Kerry J

2017-04-01

Posttraumatic stress disorder (PTSD) is a common psychiatric illness, increasingly in the public spotlight in the United States due its prevalence in the soldiers returning from combat in Iraq and Afghanistan. This educational review presents a contemporary approach for how to incorporate a modern neuroscience perspective into an integrative case formulation. The article is organized around key neuroscience "themes" most relevant for PTSD. Within each theme, the article highlights how seemingly diverse biological, psychological, and social perspectives all intersect with our current understanding of neuroscience. Any contemporary neuroscience formulation of PTSD should include an understanding of fear conditioning, dysregulated circuits, memory reconsolidation, epigenetics, and genetic factors. Fear conditioning and other elements of basic learning theory offer a framework for understanding how traumatic events can lead to a range of behaviors associated with PTSD. A circuit dysregulation framework focuses more broadly on aberrant network connectivity, including between the prefrontal cortex and limbic structures. In the process of memory reconsolidation, it is now clear that every time a memory is reactivated it becomes momentarily labile-with implications for the genesis, maintenance, and treatment of PTSD. Epigenetic changes secondary to various experiences, especially early in life, can have long-term effects, including on the regulation of the hypothalamic-pituitary-adrenal axis, thereby affecting an individual's ability to regulate the stress response. Genetic factors are surprisingly relevant: PTSD has been shown to be highly heritable despite being definitionally linked to specific experiences. The relevance of each of these themes to current clinical practice and its potential to transform future care are discussed. Together, these perspectives contribute to an integrative, neuroscience-informed approach to case formulation and treatment planning. This may

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

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

Developing a revenue integrity improvement plan.

Science.gov (United States)

Banks, Kate

2010-11-01

A revenue integrity plan should address five key areas: Accuracy of patient information. Verification of payer information and policies. Accuracy of documentation. Processing of claims. Accuracy of payment.

Integrated multi-resource planning and scheduling in engineering project

Directory of Open Access Journals (Sweden)

Samer Ben Issa

2017-01-01

Full Text Available Planning and scheduling processes in project management are carried out sequentially in prac-tice, i.e. planning project activities first without visibility of resource limitation, and then schedul-ing the project according to these pre-planned activities. This is a need to integrate these two pro-cesses. In this paper, we use Branch and Bound approach for generating all the feasible and non-feasible project schedules with/without activity splitting, and with a new criterion called “the Minimum Moments of Resources Required around X-Y axes (MMORR”, we select the best feasible project schedule to integrate plan processing and schedule processing for engineering projects. The results illustrate that this integrated approach can effectively select the best feasible project schedule among alternatives, improves the resource utilization, and shortens the project lead time.

Integrating components of culture in curriculum planning

Directory of Open Access Journals (Sweden)

Grace Chibiko Offorma

2016-05-01

Full Text Available Culture is seen from different perspectives but the focus of this paper is on the totality of people’s way of life; those things that bind the society together. In this paper, the key concepts of curriculum, culture, and curriculum planning are explained. The components of culture, namely, universals of culture, specialties of culture and alternatives of culture are discussed. Integration is briefly presented and how to integrate culture in the curriculum planning is discussed. This can be done through situational analysis to identify the necessary cultural contents to be included or integrated in the curriculum. Different modes of delivery to be used are role play, dramatization, collaboration, field trips, games and simulation, and other interactive modes that make learning meaningful and worthwhile.

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...

DNFSB recommendation 94-1 Hanford site integrated stabilization management plan

Energy Technology Data Exchange (ETDEWEB)

McCormack, R.L.

1997-05-07

In May 1994, the Defense Nuclear Facilities Safety Board (DNFSB) issued DNFSB Recommendation 94-1 (Conway 1994), which identified concerns related to US Department of Energy (DOE) management of legacy fissile materials remaining from past defense production activities. The DNFSB expressed concern about the existing storage conditions for these materials and the slow pace at which the conditions were being remediated. The DNFSB also expressed its belief that additional delays in stabilizing these fissile materials would be accompanied by further deterioration of safety and unnecessary increased risks to workers and the public. In February 1995, DOE issued the DNFSB Recommendation 94-1 Implementation Plan (O`Leary 1995) to address the concerns identified in DNFSB Recommendation 94-1. The Implementation Plan (IP) identifies several DOE commitments to achieve safe interim storage for the legacy fissile materials, and constitutes DOE`s baseline DNFSB Recommendation 94-1 Integrated Program Plan (IPP). The IPP describes the actions DOE plans to implement within the DOE complex to convert its excess fissile materials to forms or conditions suitable for safe interim storage. The IPP was subsequently supplemented with an Integrated Facilities Plan and a Research and Development Plan, which further develop complex-wide research and development and long-range facility requirements and plans. The additions to the baseline IPP were developed based on a systems engineering approach that integrated facilities and capabilities at the various DOE sites and focused on attaining safe interim storage with minimum safety risks and environmental impacts. Each affected DOE site has developed a Site Integrated Stabilization Management Plan (SISMP) to identify individual site plans to implement the DNFSB Recommendation 94-1 IPP. The SISMPs were developed based on the objectives, requirements, and commitments identified in the DNFSB Recommendation 94-1 IP. The SISMPs also supported

DNFSB recommendation 94-1 Hanford site integrated stabilization management plan

International Nuclear Information System (INIS)

McCormack, R.L.

1997-01-01

In May 1994, the Defense Nuclear Facilities Safety Board (DNFSB) issued DNFSB Recommendation 94-1 (Conway 1994), which identified concerns related to US Department of Energy (DOE) management of legacy fissile materials remaining from past defense production activities. The DNFSB expressed concern about the existing storage conditions for these materials and the slow pace at which the conditions were being remediated. The DNFSB also expressed its belief that additional delays in stabilizing these fissile materials would be accompanied by further deterioration of safety and unnecessary increased risks to workers and the public. In February 1995, DOE issued the DNFSB Recommendation 94-1 Implementation Plan (O'Leary 1995) to address the concerns identified in DNFSB Recommendation 94-1. The Implementation Plan (IP) identifies several DOE commitments to achieve safe interim storage for the legacy fissile materials, and constitutes DOE's baseline DNFSB Recommendation 94-1 Integrated Program Plan (IPP). The IPP describes the actions DOE plans to implement within the DOE complex to convert its excess fissile materials to forms or conditions suitable for safe interim storage. The IPP was subsequently supplemented with an Integrated Facilities Plan and a Research and Development Plan, which further develop complex-wide research and development and long-range facility requirements and plans. The additions to the baseline IPP were developed based on a systems engineering approach that integrated facilities and capabilities at the various DOE sites and focused on attaining safe interim storage with minimum safety risks and environmental impacts. Each affected DOE site has developed a Site Integrated Stabilization Management Plan (SISMP) to identify individual site plans to implement the DNFSB Recommendation 94-1 IPP. The SISMPs were developed based on the objectives, requirements, and commitments identified in the DNFSB Recommendation 94-1 IP. The SISMPs also supported

NCTPlan. The new PC version of MacNCTPlan improvements and validation of the treatment planning system

International Nuclear Information System (INIS)

Gonzalez, S.J.; Santa Cruz, Gustavo A.; Yam, C.S.

2003-01-01

Full text: The treatment planning system that has been used routinely in phase-I clinical trials of BNCT at Harvard/MIT consists of the MacNCTPlan interactive planning software coupled to the MCNP 4B Monte Carlo radiation transport code. The physical and mathematical principles of MacNCTPlan as well as its architecture, operation and application have been previously described elsewhere. The use of this software in clinical trials together with a detailed analysis of the code led to the identification of some limitations and deficiencies. The motivation for this PC version, Neutron Capture Therapy Planning, relies basically in two major reasons: the need to integrate the different steps for making a plan and the need to improve some features of the Macintosh version. NCTPlan aims to reproduce all the features and capabilities present in the Macintosh version. Working on this, some deficiencies were corrected and several changes in the interface were performed in order to provide a more friendly and reliable program. Among the changes intended to facilitate the treatment planning process, the most important are the integration of the auxiliary program MPREP to NCTPlan and a great improvement in the visualization of isodose contours. NCTPlan has the ability to show the isodose distributions superimposed on two orthogonal planes of the CT volume, these planes being updated in real time as the orientation of the planes is changed. The major modifications to the mathematical algorithms concerned the material assignment in the geometric model, dose distribution calculations and three-dimensional dose-volume histogram (DVH) derivation. Therefore, NCTPlan provides a user-friendly interface thanks to the integration of the different steps involved in treatment planning. Complete control of the MCNP radiation transport code is under study. Cross-validation of NCTPlan against reference calculations made apparent the improvements performed on the mathematical algorithms

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

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.

Planning principles as integral tool of financial planning implementation at enterprise

Directory of Open Access Journals (Sweden)

A.V. Overchuk

2016-09-01

Full Text Available The main problems of using financial planning tools, namely its principles, in order to achieve an effective system of financial planning at the enterprise are considered. Planning is an integral part of management and provides achievement of sustainable enterprise development, that is why, effective financial planning is the necessary means of realization of the main objective of the company – profit maximization. It is determined that the principles of financial planning are the objective category of planning science, which serves as a starting fundamental concept that expresses the cumulative effect of a number of laws. In addition, on the base of the aggregation and analysis of planning principles the system of financial planning principles is specified, providing efficient financial planning and control functions use, achievement of the mission and objectives of the economic entity activity management and ensuring of its profitability. The scientific novelty of the research lies in the specification of financial planning principles defining at the enterprise and their semantic characteristics

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

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.)

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.)

Integrated Instrumentation and Control Upgrade Plan

International Nuclear Information System (INIS)

Wilkinson, D.; Sun, B.; Wray, L.; Smith, J.

1992-02-01

This document presents the first industry-wide integrated research and development plan to support upgrading instrumentation and control (I ampersand C) systems in nuclear power plants in the United States. The plan encompasses both solving obsolescence problems and introducing modern I ampersand C technology into the industry. Accomplishing this plan will provide the technological base to modernize existing plants, as well as bridge the gap to meet Advanced Light Water Reactor (ALWR) requirements for modern I ampersand C systems. This plan defines Research and Development tasks to meet the identified needs for the following technical elements: Instrumentation, Control and Protection, Man-Machine Support Systems, Maintenance, Communications, Verification and Validation, and Specifications and Standards

Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging.

NARCIS (Netherlands)

Swennen, G.R.J.; Mollemans, W.; Schutyser, F.A.C.

2009-01-01

PURPOSE: The aim of this report was to present an integrated 3-dimensional (3D) virtual approach toward cone-beam computed tomography-based treatment planning of orthognathic surgery in the clinical routine. MATERIALS AND METHODS: We have described the different stages of the workflow process for

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.

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.)

Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

Science.gov (United States)

Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

2011-01-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

49 CFR 244.11 - Contents of a Safety Integration Plan.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Contents of a Safety Integration Plan. 244.11 Section 244.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD...

Integration of family planning with poverty alleviation.

Science.gov (United States)

Peng, P

1996-12-01

The Chinese Communist Central Committee and the State Council aim to solve food and clothing problems among impoverished rural people by the year 2000. This goal was a priority on the agenda of the recent October 1996 National Conference on Poverty Alleviation and Development and the 1996 National Conference of the State Family Planning Commission. Poverty is attributed to rapid population growth and underdevelopment. Poverty is concentrated in parts of 18 large provinces. These provinces are characterized by Family Planning Minister Peng as having high birth rates, early marriage and childbearing, unplanned births, and multiple births. Overpopulation is tied to overconsumption, depletion of resources, deforestation, soil erosion, pollution, shortages of water, decreases in shares of cultivated land, degraded grasslands, and general destruction of the environment. Illiteracy in poor areas is over 20%, compared to the national average of 15%. Mortality and morbidity are higher. Family planning is harder to enforce in poor areas. Pilot programs in Sichuan and Guizhou provinces are promoting integration of family planning with poverty alleviation. Several conferences have addressed the integrated program strategies. Experience has shown that poverty alleviation occurs by controlled population growth and improved quality of life. Departments should "consolidate" their development efforts under Communist Party leadership at all levels. Approaches should emphasize self-reliance and public mobilization. The emphasis should be on women's participation in development. Women's income should be increased. Family planning networks at the grassroots level need to be strengthened simultaneously with increased poverty alleviation and development. The government strategy is to strengthen leadership, mobilize the public, and implement integrated programs.

Technical aspects of the integration of three-dimensional treatment planning dose parameters (GEC-ESTRO Working Group) into pre-implant planning for LDR gynecological interstitial brachytherapy.

Science.gov (United States)

Chi, A; Gao, M; Nguyen, N P; Albuquerque, K

2009-06-01

This study investigates the technical feasibility of pre-implant image-based treatment planning for LDR GYN interstitial brachytherapy(IB) based on the GEC-ESTRO guidelines. Initially, a virtual plan is generated based on the prescription dose and GEC-ESTRO defined OAR dose constraints with a pre-implant CT. After the actual implant, a regular diagnostic CT was obtained and fused with our pre-implant scan/initial treatment plan in our planning software. The Flexi-needle position changes, and treatment plan modifications were made if needed. Dose values were normalized to equivalent doses in 2 Gy fractions (LQED 2 Gy) derived from the linear-quadratic model with alpha/beta of 3 for late responding tissues and alpha/beta of 10 for early responding tissues. D(90) to the CTV, which was gross tumor (GTV) at the time of brachytherapy with a margin to count for microscopic disease, was 84.7 +/- 4.9% of the prescribed dose. The OAR doses were evaluated by D(2cc) (EBRT+IB). Mean D(2cc) values (LQED(2Gy)) for the rectum, bladder, sigmoid, and small bowel were the following: 63.7 +/- 8.4 Gy, 61.2 +/- 6.9 Gy, 48.0 +/- 3.5 Gy, and 49.9 +/- 4.2 Gy. This study confirms the feasibility of applying the GEC-ESTRO recommended dose parameters in pre-implant CT-based treatment planning in GYN IB. In the process, this pre-implant technique also demonstrates a good approximation of the target volume dose coverage, and doses to the OARs.

Concept for individualized patient allocation: ReCompare—remote comparison of particle and photon treatment plans

International Nuclear Information System (INIS)

Lühr, Armin; Baumann, Michael; Löck, Steffen; Roth, Klaus; Helmbrecht, Stephan; Jakobi, Annika; Petersen, Jørgen B; Just, Uwe; Krause, Mechthild; Enghardt, Wolfgang

2014-01-01

Identifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy. The individualized identification requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish procedures for the decision process, and to implement means for the remote exchange of relevant patient information. In this work, we want to contribute a practical concept that addresses these requirements. We proposed a concept for individualized patient allocation to photon or particle beam therapy at a non-particle radiotherapy institution that bases on remote treatment plan comparison. We translated this concept into the web-based software tool ReCompare (REmote COMparison of PARticlE and photon treatment plans). We substantiated the feasibility of the proposed concept by demonstrating remote exchange of treatment plans between radiotherapy institutions and the direct comparison of photon and particle treatment plans in photon treatment planning systems. ReCompare worked with several tested standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow. Our concept supports non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by providing expertise from a particle therapy center. The software tool ReCompare may help to improve and standardize this personalized treatment decision. It will be available from our website when proton therapy is operational at our facility

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

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)

Airspace Integration Plan for Unmanned Aviation

National Research Council Canada - National Science Library

2004-01-01

The Office of the Secretary of Defense Airspace Integration Plan for Unmanned Aviation outlines the key issues that must be addressed to achieve the goal of safe, routine use of the National Airspace System (NAS...

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

Double-shell tank waste transfer facilities integrity assessment plan

International Nuclear Information System (INIS)

Hundal, T.S.

1998-01-01

This document presents the integrity assessment plan for the existing double-shell tank waste transfer facilities system in the 200 East and 200 West Areas of Hanford Site. This plan identifies and proposes the integrity assessment elements and techniques to be performed for each facility. The integrity assessments of existing tank systems that stores or treats dangerous waste is required to be performed to be in compliance with the Washington State Department of Ecology Dangerous Waste Regulations, Washington Administrative Code WAC-173-303-640 requirements

Payload crew activity planning integration. Task 2: Inflight operations and training for payloads

Science.gov (United States)

Hitz, F. R.

1976-01-01

The primary objectives of the Payload Crew Activity Planning Integration task were to: (1) Determine feasible, cost-effective payload crew activity planning integration methods. (2) Develop an implementation plan and guidelines for payload crew activity plan (CAP) integration between the JSC Orbiter planners and the Payload Centers. Subtask objectives and study activities were defined as: (1) Determine Crew Activity Planning Interfaces. (2) Determine Crew Activity Plan Type and Content. (3) Evaluate Automated Scheduling Tools. (4) Develop a draft Implementation Plan for Crew Activity Planning Integration. The basic guidelines were to develop a plan applicable to the Shuttle operations timeframe, utilize existing center resources and expertise as much as possible, and minimize unnecessary data exchange not directly productive in the development of the end-product timelines.

Operational antecedents of integrated patient planning in hospitals

NARCIS (Netherlands)

Drupsteen, Justin; van der Vaart, T.; van Donk, Dirk

2016-01-01

Purpose - Hospitals struggle to integrate the planning from different departments; resulting in unacceptable waiting times for patients. The literature mainly addresses general, organizational factors inhibiting or enabling integration and omits important factors stemming from the care delivery

Integrated Wind Power Planning Tool

DEFF Research Database (Denmark)

Rosgaard, M. H.; Hahmann, Andrea N.; Nielsen, T. S.

This poster describes the status as of April 2012 of the Public Service Obligation (PSO) funded project PSO 10464 \\Integrated Wind Power Planning Tool". The project goal is to integrate a meso scale numerical weather prediction (NWP) model with a statistical tool in order to better predict short...... term power variation from off shore wind farms, as well as to conduct forecast error assessment studies in preparation for later implementation of such a feature in an existing simulation model. The addition of a forecast error estimation feature will further increase the value of this tool, as it...

Load Forecasting in Electric Utility Integrated Resource Planning

Energy Technology Data Exchange (ETDEWEB)

Carvallo, Juan Pablo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Larsen, Peter H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sanstad, Alan H [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-07-19

Integrated resource planning (IRP) is a process used by many vertically-integrated U.S. electric utilities to determine least-cost/risk supply and demand-side resources that meet government policy objectives and future obligations to customers and, in many cases, shareholders. Forecasts of energy and peak demand are a critical component of the IRP process. There have been few, if any, quantitative studies of IRP long-run (planning horizons of two decades) load forecast performance and its relationship to resource planning and actual procurement decisions. In this paper, we evaluate load forecasting methods, assumptions, and outcomes for 12 Western U.S. utilities by examining and comparing plans filed in the early 2000s against recent plans, up to year 2014. We find a convergence in the methods and data sources used. We also find that forecasts in more recent IRPs generally took account of new information, but that there continued to be a systematic over-estimation of load growth rates during the period studied. We compare planned and procured resource expansion against customer load and year-to-year load growth rates, but do not find a direct relationship. Load sensitivities performed in resource plans do not appear to be related to later procurement strategies even in the presence of large forecast errors. These findings suggest that resource procurement decisions may be driven by other factors than customer load growth. Our results have important implications for the integrated resource planning process, namely that load forecast accuracy may not be as important for resource procurement as is generally believed, that load forecast sensitivities could be used to improve the procurement process, and that management of load uncertainty should be prioritized over more complex forecasting techniques.

Treatment planning strategy for whole-brain radiotherapy with hippocampal sparing and simultaneous integrated boost for multiple brain metastases using intensity-modulated arc therapy

Energy Technology Data Exchange (ETDEWEB)

Pokhrel, Damodar, E-mail: dpokhrel@kumc.edu; Sood, Sumit; McClinton, Christopher; Shen, Xinglei; Lominska, Christopher; Saleh, Habeeb; Badkul, Rajeev; Jiang, Hongyu; Mitchell, Melissa; Wang, Fen

2016-01-01

Purpose: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). Materials and methods: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set. The hippocampal avoidance zone (HAZ) was generated using a 5-mm uniform margin around the paired hippocampi. The m-BM planning target volumes (PTVs) were contoured on T1/T2-weighted MRI registered with the 3D planning computed tomography (CT). The whole-brain planning target volume (WB-PTV) was defined as the whole-brain tissue volume minus HAZ and m-BM PTVs. Highly conformal IMAT plans were generated in the Eclipse treatment planning system for Novalis-TX linear accelerator consisting of high-definition multileaf collimators (HD-MLCs: 2.5-mm leaf width at isocenter) and 6-MV beam. Prescription dose was 30 Gy for WB-PTV and 45 Gy for each m-BM in 10 fractions. Three full coplanar arcs with orbit avoidance sectors were used. Treatment plans were evaluated using homogeneity (HI) and conformity indices (CI) for target coverage and dose to organs at risk (OAR). Dose delivery efficiency and accuracy of each IMAT plan was assessed via quality assurance (QA) with a MapCHECK device. Actual beam-on time was recorded and a gamma index was used to compare dose agreement between the planned and measured doses. Results: All 5 HS-WBRT with SIB plans met WB-PTV D{sub 2%}, D{sub 98%}, and V{sub 30} {sub Gy} NRG-CC001 requirements. The plans demonstrated highly conformal and homogenous coverage of the WB-PTV with mean HI and CI values of 0.33 ± 0.04 (range: 0.27 to 0.36), and 0.96 ± 0.01 (range: 0.95 to 0.97), respectively. All 5

Treatment planning strategy for whole-brain radiotherapy with hippocampal sparing and simultaneous integrated boost for multiple brain metastases using intensity-modulated arc therapy

International Nuclear Information System (INIS)

Pokhrel, Damodar; Sood, Sumit; McClinton, Christopher; Shen, Xinglei; Lominska, Christopher; Saleh, Habeeb; Badkul, Rajeev; Jiang, Hongyu; Mitchell, Melissa; Wang, Fen

2016-01-01

Purpose: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). Materials and methods: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set. The hippocampal avoidance zone (HAZ) was generated using a 5-mm uniform margin around the paired hippocampi. The m-BM planning target volumes (PTVs) were contoured on T1/T2-weighted MRI registered with the 3D planning computed tomography (CT). The whole-brain planning target volume (WB-PTV) was defined as the whole-brain tissue volume minus HAZ and m-BM PTVs. Highly conformal IMAT plans were generated in the Eclipse treatment planning system for Novalis-TX linear accelerator consisting of high-definition multileaf collimators (HD-MLCs: 2.5-mm leaf width at isocenter) and 6-MV beam. Prescription dose was 30 Gy for WB-PTV and 45 Gy for each m-BM in 10 fractions. Three full coplanar arcs with orbit avoidance sectors were used. Treatment plans were evaluated using homogeneity (HI) and conformity indices (CI) for target coverage and dose to organs at risk (OAR). Dose delivery efficiency and accuracy of each IMAT plan was assessed via quality assurance (QA) with a MapCHECK device. Actual beam-on time was recorded and a gamma index was used to compare dose agreement between the planned and measured doses. Results: All 5 HS-WBRT with SIB plans met WB-PTV D 2% , D 98% , and V 30 Gy NRG-CC001 requirements. The plans demonstrated highly conformal and homogenous coverage of the WB-PTV with mean HI and CI values of 0.33 ± 0.04 (range: 0.27 to 0.36), and 0.96 ± 0.01 (range: 0.95 to 0.97), respectively. All 5 hippocampal sparing

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

Integrated resource planning-concepts and principles

Energy Technology Data Exchange (ETDEWEB)

Atkinson, S.

1994-12-31

The concepts and principles of integrated resource planning (IRP) are outlined. The following topics are discussed: utility opportunities and methodologies, application considerations, ambitious energy-efficient programs, the future of IRP, three methods to study resource alternatives, the load adjustment method, simultaneous optimization, static analysis, utility profile data, load forecasts and shapes, load data, conversion, variable costs, external analysis, internal analysis, DSM objectives, supply-side prescreening, DSM screening analysis, DSM evaluation, the IRP process, risk analysis, collaborative planning process, and load shape objectives.

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

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

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)

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

Integration of molecular imaging in treatment planning and delivery of modern radiotherapy

International Nuclear Information System (INIS)

Jacob, V.; Wilkens, J.J.

2011-01-01

Among various imaging modalities currently available, positron emission tomography (PET) has the potential to visualize processes on a molecular level. Molecular imaging, often also referred to as functional or biological imaging, brought a new dimension to diagnostics and therapy of cancer by providing images of metabolism and other processes in the human body and in tumours. PET was first applied for diagnostics and staging of various tumours with high diagnostic precision. Modern radiotherapy asks increasingly for individualized treatment strategies, taking molecular imaging into account. Technical developments over the last years, in particular methods to register various imaging modalities within software packages for treatment planning and target delineation, facilitated the use of PET imaging in radiotherapy. In order to exploit the full potential of modern high-precision radiotherapy, exact imaging procedures are necessary, for example for precise target volume definition. In the long run, concepts employing an inhomogeneous dose prescription based on biological imaging may become routine in clinical applications, leading to individualized, biologically adaptive therapy. (orig.)

Integration of Family Planning Counselling to Mass Screening Campaign for Cervical Cancer: Experience from Guinea

Directory of Open Access Journals (Sweden)

D. W. A. Leno

2018-01-01

Full Text Available Aim. To assess feasibility of integrating family planning counselling into mass screening for cervical cancer in Guinea. Methodology. This was a descriptive cross-sectional study conducted over a month in Guinea regional capital cities. The targeted population comprised women aged 15 to 49 years. Nearly 4000 women were expected for the screening campaigns that utilized VIA and VIL methods with confirmation of positive tests through biopsy. A local treatment was immediately performed when the patient was eligible. Results. Overall 5673 women aged 15 to 60 years were received, a surplus of 42% of the expected population. 92.3% of women were aged 15–49 years and 90.1% were 25–49 years. Long-acting methods were the most utilized (89.2% of family planning users. 154 precancerous and cancerous lesions were screened, a global positivity rate of 2.7%. Conclusion. Integration of counselling and family planning services provision during cervical cancer mass screening is a feasible strategy. A cost-effective analysis of this approach would help a better planning of future campaigns and its replication in other contexts.

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.

Integrated Transport Planning Framework Involving Combined Utility Regret Approach

DEFF Research Database (Denmark)

Wang, Yang; Monzon, Andres; Di Ciommo, Floridea

2014-01-01

Sustainable transport planning requires an integrated approach involving strategic planning, impact analysis, and multicriteria evaluation. This study aimed at relaxing the utility-based decision-making assumption by newly embedding anticipated-regret and combined utility regret decision mechanisms...... in a framework for integrated transport planning. The framework consisted of a two-round Delphi survey, integrated land use and transport model for Madrid, and multicriteria analysis. Results show that (a) the regret-based ranking has a similar mean but larger variance than the utility-based ranking does, (b......) the least-regret scenario forms a compromise between the desired and the expected scenarios, (c) the least-regret scenario can lead to higher user benefits in the short term and lower user benefits in the long term, (d) the utility-based, the regret-based, and the combined utility- and regret...

A pre-feasibility case study on integrated resource planning including renewables

International Nuclear Information System (INIS)

Yilmaz, Pelin; Hakan Hocaoglu, M.; Konukman, Alp Er S.

2008-01-01

In recent years, economical and environmental constraints force governments and energy policy decision-makers to change the prominent characteristics of the electricity markets. Accordingly, depending on local conditions on the demand side, usage of integrated resource planning approaches in conjunction with renewable technologies has gained more importance. In this respect, an integrated resource planning option, which includes the design and optimization of grid-connected renewable energy plants, should be evaluated to facilitate a cost-effective and green solution to a sustainable future. In this paper, an integrated resource planning case is studied for an educational campus, located in Gebze, Turkey. It is found that for the considered campus, the integrated resource planning scenario that includes renewables as a supply-side option with existing time-of-use tariff may provide a cost-effective energy production, particularly for the high penetration level of the renewables

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

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

Strategic plan modelling by hospital senior administration to integrate diversity management.

Science.gov (United States)

Newhouse, John J

2010-11-01

Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.

Demand side integration aspects in active distribution planning

DEFF Research Database (Denmark)

Silvestro, Federico; Baitch, Alex; Pilo, Fabrizio

2013-01-01

will be implemented in practice? How will regulatory frameworks and connection agreements evolve to support ADSs? The present work provides some information about the closer and closer integration between network planning and Demand Side Integration that is foreseen in the future and shows the necessity to develop...

Treatment of pathological gambling - integrative systemic model.

Science.gov (United States)

Mladenović, Ivica; Lažetić, Goran; Lečić-Toševski, Dušica; Dimitrijević, Ivan

2015-03-01

Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of

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

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

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

Ontario Hydro's integrated air management plan

International Nuclear Information System (INIS)

Kalvins, A.K.; Brown, D.; Camacho, F.; Howes, H.; Jantzi, B.; Lin, X.; Lui, P.; Melo, O.T.; Mortimer, W.P.; Reuber, B.

1992-01-01

Ontario Hydro is developing an integrated air management plan as a tool for comparing the environmental impacts of fossil-fuel power generation options. The goal is to relate equipment, location, emissions, and impacts and to identify the optimum way to manage the utility's fossil generation system in view of upcoming environmental regulations and public expectations. The eight steps of the plan are briefly described: definition of power generation scenarios (upgrading, conversion to natural gas, non-utility generation, alternative technologies); estimation of emissions for each generation and fuel option studied; identification of impact of air emissions on building materials, agriculture, forests, lakes, and fisheries; modelling of air emissions dispersion; quantification of damage to pollution receptors; quantification of full fuel cycle effects; and comparison of the scenarios. The scenario having the lowest overall environmental impact involved upgrading the existing fossil-fuel system with additional air emissions controls and two integrated gasification combined cycle plants. 9 refs., 3 figs., 3 tabs

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

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.

Analyzing an Integrated Planning Approach Among Planning Scale and Sector a Case Study of Malang City's Vision as the City of Education

OpenAIRE

Amirudin, Akhmad; Fefta Wijaya, Andy; Yossomsakdi, Samrit

2014-01-01

Integrated planning is more needed by government today because of the complexity of problems and limited resources. Integrated planning can undertake the problems by giving comprehensive solution and provide how much resources are needed to reach the goal. Integrated planning approach is implied to provide better tools to guide actions towards the development of cities, improvement of human conditions, and ultimately a better urbanism. So the research focused on integrated planning in Malang ...

Curriculum Integration Using Enterprise Resource Planning: An Integrative Case Approach

Science.gov (United States)

Cannon, David M.; Klein, Helen A; Koste, Lori L.; Magal, Simha R.

2004-01-01

Efforts to achieve greater curriculum integration in schools of business have included team teaching, student group projects, multidisciplinary cases, and, more recently, the use of enterprise resource planning (ERP) systems. Although these approaches are beneficial, they tend to be implemented on an ad hoc basis rather than through curriculum…

Integrating Planning, Assessment, and Improvement in Higher Education

Science.gov (United States)

Sherlock, Barbara J.

2009-01-01

Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

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

Decision support for integrated water-energy planning.

Energy Technology Data Exchange (ETDEWEB)

Tidwell, Vincent Carroll; Malczynski, Leonard A.; Kobos, Peter Holmes; Castillo, Cesar; Hart, William Eugene; Klise, Geoffrey T.

2009-10-01

Currently, electrical power generation uses about 140 billion gallons of water per day accounting for over 39% of all freshwater withdrawals thus competing with irrigated agriculture as the leading user of water. Coupled to this water use is the required pumping, conveyance, treatment, storage and distribution of the water which requires on average 3% of all electric power generated. While water and energy use are tightly coupled, planning and management of these fundamental resources are rarely treated in an integrated fashion. Toward this need, a decision support framework has been developed that targets the shared needs of energy and water producers, resource managers, regulators, and decision makers at the federal, state and local levels. The framework integrates analysis and optimization capabilities to identify trade-offs, and 'best' alternatives among a broad list of energy/water options and objectives. The decision support framework is formulated in a modular architecture, facilitating tailored analyses over different geographical regions and scales (e.g., national, state, county, watershed, NERC region). An interactive interface allows direct control of the model and access to real-time results displayed as charts, graphs and maps. Ultimately, this open and interactive modeling framework provides a tool for evaluating competing policy and technical options relevant to the energy-water nexus.

Prostate stereotactic body radiotherapy with simultaneous integrated boost: which is the best planning method?

International Nuclear Information System (INIS)

Tree, Alison; Jones, Caroline; Sohaib, Aslam; Khoo, Vincent; As, Nicholas van

2013-01-01

The delivery of a simultaneous integrated boost to the intra-prostatic tumour nodule may improve local control. The ability to deliver such treatments with hypofractionated SBRT was attempted using RapidArc (Varian Medical systems, Palo Alto, CA) and Multiplan (Accuray inc, Sunnyvale, CA). 15 patients with dominant prostate nodules had RapidArc and Multiplan plans created using a 5 mm isotropic margin, except 3 mm posteriorly, aiming to deliver 47.5 Gy in 5 fractions to the boost whilst treating the whole prostate to 36.25 Gy in 5 fractions. An additional RapidArc plan was created using an 8 mm isotropic margin, except 5 mm posteriorly, to account for lack of intrafraction tracking. Both RapidArc and Multiplan can produce clinically acceptable boost plans to a dose of 47.5 Gy in 5 fractions. The mean rectal doses were lower for RapidArc plans (D50 13.2 Gy vs 15.5 Gy) but the number of missed constraints was the same for both planning methods (11/75). When the margin was increased to 8 mm/5 mm for the RapidArc plans to account for intrafraction motion, 37/75 constraints were missed. RapidArc and Multiplan can produce clinically acceptable simultaneous integrated boost plans, but the mean rectal D50 and D20 with RapidArc are lower. If the margins are increased to account for intrafraction motion, the RapidArc plans exceed at least one dose constraint in 13/15 cases. Delivering a simultaneous boost with hypofractionation appears feasible, but requires small margins needing intrafraction motion tracking

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

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

Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?

Science.gov (United States)

La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S

2018-04-01

As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.

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

Integrated action planning for biodiversity conservation and sustainable use of highland aquatic resources

DEFF Research Database (Denmark)

Bunting, Stuart W.; Luo, S.; Cai, K.

2016-01-01

The need for enhanced environmental planning and management for highland aquatic resources is described and rationale for integrated action planning presented. Past action planning initiatives for biodiversity conservation and wetland management are reviewed. A reflective account is given...... of integrated action planning from five sites in China, India and Vietnam. Eight planning phases are described encompassing: stakeholder assessment and partner selection; rapport building and agreement on collaboration; integrated biodiversity, ecosystem services, livelihoods and policy assessment; problem...... analysis and target setting; strategic planning; planning and organisation of activities; coordinated implementation and monitoring; evaluation and revised target-setting. The scope and targeting of actions was evaluated using the DPSIR framework and compatibility with biodiversity conservation and socio...

Integrating human resources and program-planning strategies.

Science.gov (United States)

Smith, J E

1989-06-01

The integration of human resources management (HRM) strategies with long-term program-planning strategies in hospital pharmacy departments is described. HRM is a behaviorally based, comprehensive strategy for the effective management and use of people that seeks to achieve coordination and integration with overall planning strategies and other managerial functions. It encompasses forecasting of staffing requirements; determining work-related factors that are strong "motivators" and thus contribute to employee productivity and job satisfaction; conducting a departmental personnel and skills inventory; employee career planning and development, including training and education programs; strategies for promotion and succession, including routes of advancement that provide alternatives to the managerial route; and recruitment and selection of new personnel to meet changing departmental needs. Increased competitiveness among hospitals and a shortage of pharmacists make it imperative that hospital pharmacy managers create strategies to attract, develop, and retain the right individuals to enable the department--and the hospital as a whole--to grow and change in response to the changing health-care environment in the United States. Pharmacy managers would be greatly aided in this mission by the establishment of a well-defined, national strategic plan for pharmacy programs and services that includes an analysis of what education and training are necessary for their successful accomplishment. Creation of links between overall program objectives and people-planning strategies will aid hospital pharmacy departments in maximizing the long-term effectiveness of their practice.

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

Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

Energy Technology Data Exchange (ETDEWEB)

Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States); Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); McNutt, Todd [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States); Zahurak, Marianna [Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, Maryland (United States); Simari, Patricio [Autodesk Research, Toronto, ON (Canada); Pang, Dalong [Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States); Taylor, Russell [Department of Computer Science, Johns Hopkins University, Baltimore, Maryland (United States); Sanguineti, Giuseppe [Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States)

2012-12-01

Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.

Fully Automated Simultaneous Integrated Boosted–Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

International Nuclear Information System (INIS)

Wu Binbin; McNutt, Todd; Zahurak, Marianna; Simari, Patricio; Pang, Dalong; Taylor, Russell; Sanguineti, Giuseppe

2012-01-01

Purpose: To prospectively determine whether overlap volume histogram (OVH)–driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.

Integrated nonthermal treatment system study

International Nuclear Information System (INIS)

Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

1997-01-01

This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs

Integrated nonthermal treatment system study

Energy Technology Data Exchange (ETDEWEB)

Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)

1997-01-01

This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

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

The Mixed Waste Management Facility. Design basis integrated operations plan (Title I design)

International Nuclear Information System (INIS)

1994-12-01

The Mixed Waste Management Facility (MWMF) will be a fully integrated, pilotscale facility for the demonstration of low-level, organic-matrix mixed waste treatment technologies. It will provide the bridge from bench-scale demonstrated technologies to the deployment and operation of full-scale treatment facilities. The MWMF is a key element in reducing the risk in deployment of effective and environmentally acceptable treatment processes for organic mixed-waste streams. The MWMF will provide the engineering test data, formal evaluation, and operating experience that will be required for these demonstration systems to become accepted by EPA and deployable in waste treatment facilities. The deployment will also demonstrate how to approach the permitting process with the regulatory agencies and how to operate and maintain the processes in a safe manner. This document describes, at a high level, how the facility will be designed and operated to achieve this mission. It frequently refers the reader to additional documentation that provides more detail in specific areas. Effective evaluation of a technology consists of a variety of informal and formal demonstrations involving individual technology systems or subsystems, integrated technology system combinations, or complete integrated treatment trains. Informal demonstrations will typically be used to gather general operating information and to establish a basis for development of formal demonstration plans. Formal demonstrations consist of a specific series of tests that are used to rigorously demonstrate the operation or performance of a specific system configuration

Recovery post treatment: plans, barriers and motivators.

Science.gov (United States)

Duffy, Paul; Baldwin, Helen

2013-01-30

capital'. Competing recovery goals and activities can leave people feeling under pressure and at risk of taking on or being pushed to do too much too soon. The breadth of re-integration and future plans at this stage is limited primarily to the recovery community and treatment sector. Services and commissioners should ensure that this does not become a limiting factor in individuals' long term recovery journeys.

Recovery post treatment: plans, barriers and motivators

Directory of Open Access Journals (Sweden)

Duffy Paul

2013-01-01

maintaining aspects of a ‘normal’ life i.e. ‘social and physical capital’. Competing recovery goals and activities can leave people feeling under pressure and at risk of taking on or being pushed to do too much too soon. The breadth of re-integration and future plans at this stage is limited primarily to the recovery community and treatment sector. Services and commissioners should ensure that this does not become a limiting factor in individuals’ long term recovery journeys.

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

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

Science.gov (United States)

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

Science.gov (United States)

Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-04-27

Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

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.

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.

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.

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.

Prostate IMRT fractionation strategies. Two-phase treatment versus simultaneous integrated boost

International Nuclear Information System (INIS)

Stavrev, P.; Hristov, D.

2003-01-01

Background. The purpose of the study was to investigate the radiobiological effect of the number of fractions, position uncertainties and clonogen spread (microscopic disease) on two different inverse treatment planning alternatives: (a) 2-phase strategy; (b) simultaneous integrated boost (SIB). Material and methods. The tumour control probability (TCP) and normal tissue complication probability (NTCP) were calculated for the 2-phase strategy, which has well defined fractionation scheme and compared to the TCP and NTCP for the SIB strategy calculated as a function of the number of fractions. For a 7-beam IMRT prostate treatment, we have performed inverse treatment planning for the two different strategies following the above method. Results. When the position uncertainties and clonogen spread were accounted for in the TCP calculation a drop as large as 10% was found. A drop of 5-7% in the TCP was obtained for the SIB strategy, if delivered in the same number of fractions as the 2-phased one. Conclusions. The potential of inverse planning to design tight conformal dose distributions is fully revealed in the SIB optimization process. The optimized SIB superior dose distributions require modification of the delivered dose per fraction and therefore careful selection of the fractionation regime. Hence physically optimized SIB treatments may not always lead to better tumour control and tissue sparing. (author)

Integrated thermal treatment system study. Phase 2. Addendum system A8

International Nuclear Information System (INIS)

Biagi, C.; Teheranian, B.; Quapp, W.J.; Schwinkendorf, W.E.

1996-05-01

This is an addendum to the Integrated Treatment System Study - Phase 2 Results report. This addendum describes the technology and the operation of System A-8, Rotary Kiln, Air Combustion Gas, Dry-Wet APC, and Grout Stabilization. A process flow diagram, functional allocation diagrams, and plan views and perspective views for this system are attached. Detailed cost information for this subsystem is reported in Appendix A of this addendum

US Department of Energy Integrated Resource Planning Program: Accomplishments and opportunities

Energy Technology Data Exchange (ETDEWEB)

White, D.L. [Oak Ridge National Lab., TN (United States); Mihlmester, P.E. [Aspen Systems Corp., Oak Ridge, TN (United States)

1993-12-17

The US Department of Energy Integrated Resource Planning Program supports many activities and projects that enhance the process by which utilities assess demand and supply options and, subsequently, evaluate and select resources. The US Department of Energy program coordinates integrated resource planning in risk and regulatory analysis; utility and regional planning; evaluation and verification; information transfer/technological assistance; and demand-side management. Professional staff from the National Renewable Energy Laboratory, Oak Ridge National Laboratory, Lawrence Berkeley Laboratory, and Pacific Northwest Laboratories collaborate with peers and stakeholders, in particular, the National Association of Regulatory Utility Commissioners, and conduct research and activities for the US Department of Energy. Twelve integrated resource planning activities and projects are summarized in this report. The summaries reflect the diversity of planning and research activities supported by the Department. The summaries also reflect the high levels of collaboration and teaming that are required by the Program and practiced by the researchers. It is concluded that the Program is achieving its objectives by encouraging innovation and improving planning and decision making. Furthermore, as the Department continues to implement planned improvements in the Program, the Department is effectively positioned to attain its ambitious goals.

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

Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

Science.gov (United States)

Noble, Bram F

2004-03-01

Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

Comprehensive integrated planning: A process for the Oak Ridge Reservation, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

1998-05-01

The Oak Ridge Comprehensive Integrated Plan is intended to assist the US Department of Energy (DOE) and contractor personnel in implementing a comprehensive integrated planning process consistent with DOE Order 430.1, Life Cycle Asset Management and Oak Ridge Operations Order 430. DOE contractors are charged with developing and producing the Comprehensive Integrated Plan, which serves as a summary document, providing information from other planning efforts regarding vision statements, missions, contextual conditions, resources and facilities, decision processes, and stakeholder involvement. The Comprehensive Integrated Plan is a planning reference that identifies primary issues regarding major changes in land and facility use and serves all programs and functions on-site as well as the Oak Ridge Operations Office and DOE Headquarters. The Oak Ridge Reservation is a valuable national resource and is managed on the basis of the principles of ecosystem management and sustainable development and how mission, economic, ecological, social, and cultural factors are used to guide land- and facility-use decisions. The long-term goals of the comprehensive integrated planning process, in priority order, are to support DOE critical missions and to stimulate the economy while maintaining a quality environment

Comprehensive integrated planning: A process for the Oak Ridge Reservation, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-05-01

The Oak Ridge Comprehensive Integrated Plan is intended to assist the US Department of Energy (DOE) and contractor personnel in implementing a comprehensive integrated planning process consistent with DOE Order 430.1, Life Cycle Asset Management and Oak Ridge Operations Order 430. DOE contractors are charged with developing and producing the Comprehensive Integrated Plan, which serves as a summary document, providing information from other planning efforts regarding vision statements, missions, contextual conditions, resources and facilities, decision processes, and stakeholder involvement. The Comprehensive Integrated Plan is a planning reference that identifies primary issues regarding major changes in land and facility use and serves all programs and functions on-site as well as the Oak Ridge Operations Office and DOE Headquarters. The Oak Ridge Reservation is a valuable national resource and is managed on the basis of the principles of ecosystem management and sustainable development and how mission, economic, ecological, social, and cultural factors are used to guide land- and facility-use decisions. The long-term goals of the comprehensive integrated planning process, in priority order, are to support DOE critical missions and to stimulate the economy while maintaining a quality environment.

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

Towards an integration of process planning and production planning and control for flexible manufacturing systems

NARCIS (Netherlands)

Gaalman, GJC; Slomp, J; Suresh, NC

This introduction article attempts to present some major issues relating to the integration of process planning and production planning and control (PPC) for flexible manufacturing systems (FMSs). It shows that the performance of an FMS can be significantly improved and FMS capabilities more

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.)

Buried Waste Integrated Demonstration Plan

International Nuclear Information System (INIS)

Kostelnik, K.M.

1991-12-01

This document presents the plan of activities for the Buried Waste Integrated Demonstration (BWID) program which supports the environmental restoration (ER) objectives of the Department of Energy (DOE) Complex. Discussed in this plan are the objectives, organization, roles and responsibilities, and the process for implementing and managing BWID. BWID is hosted at the Idaho National Engineering Laboratory (INEL), but involves participants from throughout the DOE Complex, private industry, universities, and the international community. These participants will support, demonstrate, and evaluate a suite of advanced technologies representing a comprehensive remediation system for the effective and efficient remediation of buried waste. The processes for identifying technological needs, screening candidate technologies for applicability and maturity, selecting appropriate technologies for demonstration, field demonstrating, evaluation of results and transferring technologies to environmental restoration programs are also presented. This document further describes the elements of project planning and control that apply to BWID. It addresses the management processes, operating procedures, programmatic and technical objectives, and schedules. Key functions in support of each demonstration such as regulatory coordination, safety analyses, risk evaluations, facility requirements, and data management are presented

Feasibility of using intensity-modulated radiotherapy to improve lung sparing in treatment planning for distal esophageal cancer

International Nuclear Information System (INIS)

Chandra, Anurag; Guerrero, Thomas M.; Liu, H. Helen; Tucker, Susan L.; Liao Zhongxing; Wang Xiaochun; Murshed, Hasan; Bonnen, Mark D.; Garg, Amit K.; Stevens, Craig W.; Chang, Joe Y.; Jeter, Melinda D.; Mohan, Radhe; Cox, James D.; Komaki, Ritsuko

2005-01-01

Background and purpose: To evaluate the feasibility whether intensity-modulated radiotherapy (IMRT) can be used to reduce doses to normal lung than three-dimensional conformal radiotherapy (3DCRT) in treating distal esophageal malignancies. Patients and methods: Ten patient cases with cancer of the distal esophagus were selected for a retrospective treatment-planning study. IMRT plans using four, seven, and nine beams (4B, 7B, and 9B) were developed for each patient and compared with the 3DCRT plan used clinically. IMRT and 3DCRT plans were evaluated with respect to PTV coverage and dose-volumes to irradiated normal structures, with statistical comparison made between the two types of plans using the Wilcoxon matched-pair signed-rank test. Results: IMRT plans (4B, 7B, 9B) reduced total lung volume treated above 10 Gy (V 1 ), 20 Gy (V 2 ), mean lung dose (MLD), biological effective volume (V eff ), and lung integral dose (P 1 , 5% for V 2 , and 2.5 Gy for MLD. IMRT improved the PTV heterogeneity (P<0.05), yet conformity was better with 7B-9B IMRT plans. No clinically meaningful differences were observed with respect to the irradiated volumes of spinal cord, heart, liver, or total body integral doses. Conclusions: Dose-volume of exposed normal lung can be reduced with IMRT, though clinical investigations are warranted to assess IMRT treatment outcome of esophagus cancers

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

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

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

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)

An integration programme of poverty alleviation and development with family planning.

Science.gov (United States)

1997-04-01

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors. full text

Integration plan required by performance agreement SM 7.2.1

International Nuclear Information System (INIS)

Diediker, L.P.

1997-01-01

Fluor Daniel Hanford, Inc. and its major subcontractors are in agreement that environmental monitoring performed under the Project Hanford Management Contract is to be done in accordance with a single, integrated program. The purpose of this Integration Plan for Environmental Monitoring is to document the policies, systems, and processes being put in place to meet one key objective: manage and integrate a technically competent, multi-media ambient environmental monitoring program, in an efficient, cost effective manner. Fluor Daniel Hanford, Inc. and its major subcontractors also commit to conducting business in a manner consistent with the International Standards Organization 14000 Environmental Management System concepts. Because the integration of sitewide groundwater monitoring activities is managed by the Environmental Restoration Contractor, groundwater monitoring it is outside the scope of this document. Therefore, for the purpose of this Integration Plan for Environmental Monitoring, the Integrated Environmental Monitoring Program is defined as applicable to all environmental media except groundwater. This document provides recommendations on future activities to better integrate the overall environmental monitoring program, with emphasis on the near-field program. In addition, included is the Fluor Daniel Hanford, Inc. team review of the environmental monitoring activities on the Hanford Site, with concurrence of Pacific Northwest National Laboratory and Bechtel Hanford, Inc. (The narrative provided later in the Discussion Section describes the review and consideration given to each topic.) This document was developed to meet the requirements of the Project Hanford Management Contract performance agreement (SM7.2) and the tenets of the U.S. Department of Energy's Effluent and Environmental Monitoring Planning Process. This Plan is prepared for the U.S. Department of Energy, Richland Operations Office, Environmental Assurance, Permits, and Policy Division

The Marketing Plan: An Integrative Device for Teaching Marketing Management.

Science.gov (United States)

Berdine, W. R.; Petersen, James C.

1980-01-01

The importance of the marketing plan is stressed as an integrative device for teaching marketing management, and a structure is presented to assist students in designing a marketing plan. Components of this plan include marketing objectives, targeting market and buying motives, external environment and competition, product, price, and promotion.…

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

Comparative study of plans for integrated residue management of construction: an analysis documental

OpenAIRE

Júnior, Jorge Henrique e Silva; Vieira, Elizângela de Jesus Oliveira de Sousa; Monte, Maria José Soares; Carvalho, Moisés Lopes; Oliveira, Francílio de Carvalho; Carvalho, Jancineide Oliveira de

2013-01-01

Objective: The present study is a comparative study of integrated plans in four cities, highlighting the points that are in accordance with Resolution 307/2002 of CONAMA. Methods: This is a bibliographic and documentary research as having scientific articles sources Plans and Integrated Solid Waste Management Construction of five Brazilian cities: Curitiba, Cuiaba, Florianopolis, Rio de Janeiro and São Paulo. Results: The resolution foresees the Integrated Management of Residues Plan for Cons...

49 CFR 1106.3 - Actions for which Safety Integration Plan is required.

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Actions for which Safety Integration Plan is required. 1106.3 Section 1106.3 Transportation Other Regulations Relating to Transportation (Continued... TRANSPORTATION BOARD CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS...

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)

Optimization of rotational radiotherapy treatment planning

International Nuclear Information System (INIS)

Tulovsky, Vladimir; Ringor, Michael; Papiez, Lech

1995-01-01

Purpose: Rotational therapy treatment planning for rotationally symmetric geometry of tumor and healthy tissue provides an important example of testing various approaches to optimizing dose distributions for therapeutic x-ray irradiations. In this article, dose distribution optimization is formulated as a variational problem. This problem is solved analytically and numerically. Methods and Materials: The classical Lagrange method is used to derive equations and inequalities that give necessary conditions for minimizing the mean-square deviation between the ideal dose distribution and the achievable dose distribution. The solution of the resulting integral equation with Cauchy kernel is used to derive analytical formulas for the minimizing irradiation intensity function. Results: The solutions are evaluated numerically and the graphs of the minimizing intensity functions and the corresponding dose distributions are presented. Conclusions: The optimal solutions obtained using the mean-square criterion lead to significant underdosage in some areas of the tumor volume. Possible solutions to this shortcoming are investigated and medically more appropriate criteria for optimization are proposed for future investigations

High precision bladder cancer irradiation by integrating a library planning procedure of 6 prospectively generated SIB IMRT plans with image guidance using lipiodol markers

International Nuclear Information System (INIS)

Meijer, Gert Johan; Toorn, Peter-Paul van der; Bal, Matthieu; Schuring, Danny; Weterings, Jan; Wildt, Michel de

2012-01-01

Purpose: To increase local control and decrease side effects for urinary bladder cancer patients by integrating a library planning procedure with image guidance using lipiodol markers. Methods and materials: Twenty patients with T2-T4N0M0 grade 2–3 invasive bladder carcinoma were treated according to an online adaptive protocol. Initially, the gross tumour volume (GTV) was demarcated during cystoscopy by injecting several drops of lipiodol in the submucosa around the tumour. Subsequently two CT scans were acquired with a full bladder and a voided bladder. On both scans, the boost volume (GTV) and the low-risk bladder volume were delineated. Using an interpolation tool, six concomitant boost IMRT plans with increasing bladder volumes were generated. For each fraction the procedure at the treatment unit was as follows: Firstly, a ConeBeam-CT was acquired and based on the amount of bladder filling the best fitting bladder contours and corresponding GTV and IMRT plans were selected. Secondly, the lipiodol markers were registered using the corresponding GTV contours and it was verified that the corresponding 95%-isodose surface covered the entire bladder. Finally, an online setup correction was applied based on this registration and the corresponding treatment plan was irradiated. Results: The lipiodol markers were very useful in outlining the GTV at the planning CT and for daily setup correction. While the patients strived for a full bladder filling at time of the treatment, this was seldom accomplished. Due to our protocol an appropriate plan with adequate coverage of the PTV and without excessive dose to healthy tissue was delivered every day. The treatment was very well tolerated by all patients. At the end of the treatment no grade 3 urinary or gastro-intestinal toxicity was observed. After a median follow-up of 28 months two local relapses occurred. Conclusion: Using the library planning approach combined with online image guidance using lipiodol markers, we

High precision bladder cancer irradiation by integrating a library planning procedure of 6 prospectively generated SIB IMRT plans with image guidance using lipiodol markers.

Science.gov (United States)

Meijer, Gert Johan; van der Toorn, Peter-Paul; Bal, Matthieu; Schuring, Danny; Weterings, Jan; de Wildt, Michel

2012-11-01

To increase local control and decrease side effects for urinary bladder cancer patients by integrating a library planning procedure with image guidance using lipiodol markers. Twenty patients with T2-T4N0M0 grade 2-3 invasive bladder carcinoma were treated according to an online adaptive protocol. Initially, the gross tumour volume (GTV) was demarcated during cystoscopy by injecting several drops of lipiodol in the submucosa around the tumour. Subsequently two CT scans were acquired with a full bladder and a voided bladder. On both scans, the boost volume (GTV) and the low-risk bladder volume were delineated. Using an interpolation tool, six concomitant boost IMRT plans with increasing bladder volumes were generated. For each fraction the procedure at the treatment unit was as follows: Firstly, a ConeBeam-CT was acquired and based on the amount of bladder filling the best fitting bladder contours and corresponding GTV and IMRT plans were selected. Secondly, the lipiodol markers were registered using the corresponding GTV contours and it was verified that the corresponding 95%-isodose surface covered the entire bladder. Finally, an online setup correction was applied based on this registration and the corresponding treatment plan was irradiated. The lipiodol markers were very useful in outlining the GTV at the planning CT and for daily setup correction. While the patients strived for a full bladder filling at time of the treatment, this was seldom accomplished. Due to our protocol an appropriate plan with adequate coverage of the PTV and without excessive dose to healthy tissue was delivered every day. The treatment was very well tolerated by all patients. At the end of the treatment no grade 3 urinary or gastro-intestinal toxicity was observed. After a median follow-up of 28 months two local relapses occurred. Using the library planning approach combined with online image guidance using lipiodol markers, we were able to deliver a highly conformal dose distribution

Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

Science.gov (United States)

Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

2009-01-01

Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

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

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

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

Practical education in family planning: integrative review

Directory of Open Access Journals (Sweden)

Creusa Ferreira da Silva

2017-07-01

Full Text Available Objectives: To identify educational practices in family planning, facilitating factors, difficulties and resulting impacts. Method: This is an integrative literature review, using the three descriptors: "family planning", "health education" and "contraception"; In the databases of the Scientific Electronic Library Online (SciELO, Latin American and Caribbean Literature in Health Sciences (LILACS and Nursing Database (BDENF, were searched in January and February 2016. Results: Regarding the accomplishment of educational practices, most of the studies pointed out its accomplishment. The difficulties and facilitators aspects were related to the management of the health service, professional competence and users. Guarantee of family rights and autonomy were the impacts pointed out. Conclusion: The study showed that educational practices in family planning are tools to be encouraged as a guarantee and respect for sexual and reproductive rights. Descriptors: family planning; education in health; contraception.

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

Integrated thermal treatment system study: Phase 1 results. Volume 1

International Nuclear Information System (INIS)

Feizollahi, F.; Quapp, W.J.; Hempill, H.G.; Groffie, F.J.

1994-07-01

An integrated systems engineering approach is used for uniform comparison of widely varying thermal treatment technologies proposed for management of contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. Ten different systems encompassing several incineration design options are studied. All subsystems, including facilities, equipment, and methods needed for integration of each of the ten systems are identified. Typical subsystems needed for complete treatment of MLLW are incoming waste receiving and preparation (characterization, sorting, sizing, and separation), thermal treatment, air pollution control, primary and secondary stabilization, metal decontamination, metal melting, mercury recovery, lead recovery, and special waste and aqueous waste treatment. The evaluation is performed by developing a preconceptual design package and planning life-cycle cost (PLCC) estimates for each system. As part of the preconceptual design process, functional and operational requirements, flow sheets and mass balances, and conceptual equipment layouts are developed for each system. The PLCC components estimated are technology development, production facility construction, pre-operation, operation and maintenance, and decontamination and decommissioning. Preconceptual design data and other technology information gathered during the study are examined and areas requiring further development, testing, and evaluation are identified and recommended. Using a qualitative method, each of the ten systems are ranked

Treatment planning and smile design using composite resin.

Science.gov (United States)

Marus, Robert

2006-05-01

Recent advances in dental materials and adhesive protocols have expanded the restorative procedures available to today's clinicians. Used in combination with proper treatment planning, these innovations enable dental professionals to provide enhanced aesthetic care that achieves the increasing expectations of their patients. Using a case presentation, this article will document the steps required to harmoniously integrate smile design, material selection, and patient communication that are involved in the provisional of aesthetic dental care. This article discusses the utilization of composite resin as a tool to enhance the patient's smile. Upon reading this article, the reader should: Become familiar with a smile-enhancing technique which can be completed in one office visit. Realize the benefits that intraoral composite mockups offer in terms of prototyping and confirming patient satisfaction.

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

Standardized evaluation of simultaneous integrated boost plans on volumetric modulated arc therapy

International Nuclear Information System (INIS)

Yang Wensha; Jones, Ryan; Read, Paul; Benedict, Stanley; Sheng Ke

2011-01-01

The purpose of this paper is to quantify the capability of the RapidArc (RA) planning system to deliver highly heterogeneous doses for simultaneous integrated boost (SIB) in both a phantom and patients. A cylindrical planning target volume (PTV) with a diameter of 6 cm was created in a cylindrical phantom. A smaller boost tumor volume (BTV) in the PTV with varying diameters (0.625-2.5 cm), positions and shapes was also created. Five previously treated patients with brain tumors were included in the study. Original gross tumor volumes (average 41.8 cm 3 ) and PTVs (average 316 cm 3 ) were adopted as the BTV and the PTV in the new plans. 30 Gy was prescribed to the PTV. Doses varying from 35 to 90 Gy were prescribed to the BTV. Both SIB and sequential boost (SEQ) plans were created on RA to meet the prescription. A set of reference plans was also created on the helical tomotherapy (HT) platform. Normalized dose contrast (NDC) and the integral dose were used to evaluate the quality of plans. NDC was defined as the dose contrast between BTV and PTV-BTV, normalizing to the ideal scenario where the contrast is the ratio between prescribed doses to the BTV and PTV. NDC above 90% was observed with BTV dose less than 60 Gy. NDC was minimally affected by the size of BTV but adversely affected by the complexity of the shape of the BTV. In the phantom plans, a peak of NDC was observed with 45 Gy (150% of PTV dose) to the BTV; for BTVs at the center of the PTV, the increase in the integral dose was less than 2% and remained constant for all dose levels in the phantom plans but a linear increase in the integral dose was observed with the HT plans. In the patient plans, an 11% average increase in the integral dose was observed with SIB plans and 60 Gy to the BTV, lower than the 30% average increase in the SEQ plans by RA and 25% by HT. The study showed not only that SIB by RA can achieve superior plans compared with SEQ plans on the same platform and SIB plans on HT, but also the

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)

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

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.

Analyzing an Integrated Planning Approach Among Planning Scale and Sector A Case Study of Malang City’s Vision as The City of Education

Directory of Open Access Journals (Sweden)

Akhmad Amirudin

2014-04-01

Full Text Available Integrated planning is more needed by government today because of the complexity of problems and limited resources. Integrated planning can undertake the problems by giving comprehensive solution and provide how much resources are needed to reach the goal. Integrated planning approach is implied to provide better tools to guide actions towards the development of cities, improvement of human conditions, and ultimately a better urbanism. So the research focused on integrated planning in Malang City based on Malang City’s vision, strategic planning, operational planning, budgeting planning in Malang City to achieve Malang City’s vision as the city of Education. In this study, researcher used qualitative method with descriptive research, which is a research process aims to describe the exact nature / something happened and took place on the research conducted. The research purpose is to identify and describe and analyze the process of Malang City Planning Agency integrate other planning scale and sector in developing planning; and to identify, describe and analyze the process of Malang City Planning Agency integrated all stakeholders in Integrated Planning process. This research use descriptive research method. The reason to use descriptive research method in this study because the principle objectives of this study aimed to describe, illustrate in a systematic, factual and accurate statement of the facts and the relationship between phenomenon. Then qualitative method was directed at the individual's background and a holistic (whole. So in this case should not isolate the individual or organization into a variable or hypothesis, but should view it as part of wholeness. The result of this research in the case study of Malang City has shown thatThe case study of Malang City showed that various sectors recognized but did not pay much attention to Malang City’s vision as City of Education in their plans; however, Regional Mid-term Development

DNFSB Recommendation 94-1 Hanford Site Integrated Stabilization Management Plan. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Gerber, E.W.

1995-10-01

The US Department of Energy (DOE) has developed an Integrated Program Plan (IPP) to address concerns identified in Defense Nuclear Facilities Safety Board Recommendation 94-1. The IPP describes the actions that DOE plans to implement at its various sites to convert excess fissile materials to forms or conditions suitable for safe interim storage. The baseline IPP was issued as DOE`s Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1 Implementation Plan (IP), which was transmitted to the DNFSB on February 28, 1995. The IPP is being further developed to include complex-wide requirements for research and development and a long-range facility requirements section. The planned additions to the baseline IPP are being developed based on a systems engineering approach that integrates facilities and capabilities at the various DOE sites and focuses on attaining safe interim storage with minimum safety risks and environmental impacts. Each affected DOE site has developed a Site Integrated Stabilization Management Plan (SISMP) to identify individual site plans to implement the DNFSB Recommendation 94-1 and to provide a basis for formulating planned additions to the IPP. The SISMPs were developed based on the objectives, requirements, and commitments identified in the baseline DNFSB Recommendation 94-1 IPP. The SISMPs will be periodically updated to reflect improved integration between DOE sites as identified during the IPP systems engineering evaluations.

DNFSB Recommendation 94-1 Hanford Site Integrated Stabilization Management Plan. Volume 1

International Nuclear Information System (INIS)

Gerber, E.W.

1995-10-01

The US Department of Energy (DOE) has developed an Integrated Program Plan (IPP) to address concerns identified in Defense Nuclear Facilities Safety Board Recommendation 94-1. The IPP describes the actions that DOE plans to implement at its various sites to convert excess fissile materials to forms or conditions suitable for safe interim storage. The baseline IPP was issued as DOE's Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1 Implementation Plan (IP), which was transmitted to the DNFSB on February 28, 1995. The IPP is being further developed to include complex-wide requirements for research and development and a long-range facility requirements section. The planned additions to the baseline IPP are being developed based on a systems engineering approach that integrates facilities and capabilities at the various DOE sites and focuses on attaining safe interim storage with minimum safety risks and environmental impacts. Each affected DOE site has developed a Site Integrated Stabilization Management Plan (SISMP) to identify individual site plans to implement the DNFSB Recommendation 94-1 and to provide a basis for formulating planned additions to the IPP. The SISMPs were developed based on the objectives, requirements, and commitments identified in the baseline DNFSB Recommendation 94-1 IPP. The SISMPs will be periodically updated to reflect improved integration between DOE sites as identified during the IPP systems engineering evaluations

Integrated production-distribution planning optimization models: A review in collaborative networks context

Directory of Open Access Journals (Sweden)

Beatriz Andres

2017-01-01

Full Text Available Researchers in the area of collaborative networks are more and more aware of proposing collaborative approaches to address planning processes, due to the advantages associated when enterprises perform integrated planning models. Collaborative production-distribution planning, among the supply network actors, is considered a proper mechanism to support enterprises on dealing with uncertainties and dynamicity associated to the current markets. Enterprises, and especially SMEs, should be able to overcome the continuous changes of the market by increasing their agility. Carrying out collaborative planning allows enterprises to enhance their readiness and agility for facing the market turbulences. However, SMEs have limited access when incorporating optimization tools to deal with collaborative planning, reducing their ability to respond to the competition. The problem to solve is to provide SMEs affordable solutions to support collaborative planning. In this regard, new optimisation algorithms are required in order to improve the collaboration within the supply network partners. As part of the H2020 Cloud Collaborative Manufacturing Networks (C2NET research project, this paper presents a study on integrated production and distribution plans. The main objective of the research is to identify gaps in current optimization models, proposed to address integrated planning, taking into account the requirements and needs of the industry. Thus, the needs of the companies belonging to the industrial pilots, defined in the C2NET project, are identified; analysing how these needs are covered by the optimization models proposed in the literature, to deal with the integrated production-distribution planning.

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

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

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

Nevada National Security Site Integrated Groundwater Sampling Plan, Revision 0

Energy Technology Data Exchange (ETDEWEB)

Marutzky, Sam; Farnham, Irene

2014-10-01

The purpose of the Nevada National Security Site (NNSS) Integrated Sampling Plan (referred to herein as the Plan) is to provide a comprehensive, integrated approach for collecting and analyzing groundwater samples to meet the needs and objectives of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Underground Test Area (UGTA) Activity. Implementation of this Plan will provide high-quality data required by the UGTA Activity for ensuring public protection in an efficient and cost-effective manner. The Plan is designed to ensure compliance with the UGTA Quality Assurance Plan (QAP). The Plan’s scope comprises sample collection and analysis requirements relevant to assessing the extent of groundwater contamination from underground nuclear testing. This Plan identifies locations to be sampled by corrective action unit (CAU) and location type, sampling frequencies, sample collection methodologies, and the constituents to be analyzed. In addition, the Plan defines data collection criteria such as well-purging requirements, detection levels, and accuracy requirements; identifies reporting and data management requirements; and provides a process to ensure coordination between NNSS groundwater sampling programs for sampling of interest to UGTA. This Plan does not address compliance with requirements for wells that supply the NNSS public water system or wells involved in a permitted activity.

Integrated Program of Experimental Diagnostics at the NNSS: An Integrated, Prioritized Work Plan for Diagnostic Development and Maintenance and Supporting Capability

International Nuclear Information System (INIS)

2010-01-01

This Integrated Program of Experimental Diagnostics at the NNSS is an integrated prioritized work plan for the Nevada National Security Site (NNSS), formerly the Nevada Test Site (NTS), program that is independent of individual National Security Enterprise Laboratories (Labs) requests or specific Subprograms being supported. This prioritized work plan is influenced by national priorities presented in the Predictive Capability Framework (PCF) and other strategy documents (Primary and Secondary Assessment Technologies Plans and the Plutonium Experiments Plan). This document satisfies completion criteria for FY 2010 MRT milestone No.3496: Document an integrated, prioritized work plan for diagnostic development, maintenance, and supporting capability. This document is an update of the 3-year NNSS plan written a year ago, September 21, 2009, to define and understand Lab requests for diagnostic implementation. This plan is consistent with Lab interpretations of the PCF, Primary Assessment Technologies, and Plutonium Experiment plans.

Bladder radiotherapy treatment: A retrospective comparison of 3-dimensional conformal radiotherapy, intensity-modulated radiation therapy, and volumetric-modulated arc therapy plans

Energy Technology Data Exchange (ETDEWEB)

Pasciuti, Katia, E-mail: k.pasciuti@virgilio.it [Department of Radiotherapy Physics, Royal Free Hospital, London (United Kingdom); Kuthpady, Shrinivas [Department of Radiotherapy, Royal Free Hospital, London (United Kingdom); Anderson, Anne; Best, Bronagh [Department of Radiotherapy Physics, Royal Free Hospital, London (United Kingdom); Waqar, Saleem; Chowdhury, Subhra [Department of Radiotherapy, Royal Free Hospital, London (United Kingdom)

2017-04-01

To examine tumor's and organ's response when different radiotherapy plan techniques are used. Ten patients with confirmed bladder tumors were first treated using 3-dimensional conformal radiotherapy (3DCRT) and subsequently the original plans were re-optimized using the intensity-modulated radiation treatment (IMRT) and volumetric-modulated arc therapy (VMAT)-techniques. Targets coverage in terms of conformity and homogeneity index, TCP, and organs' dose limits, including integral dose analysis were evaluated. In addition, MUs and treatment delivery times were compared. Better minimum target coverage (1.3%) was observed in VMAT plans when compared to 3DCRT and IMRT ones confirmed by a statistically significant conformity index (CI) results. Large differences were observed among techniques in integral dose results of the femoral heads. Even if no statistically significant differences were reported in rectum and tissue, a large amount of energy deposition was observed in 3DCRT plans. In any case, VMAT plans provided better organs and tissue sparing confirmed also by the normal tissue complication probability (NTCP) analysis as well as a better tumor control probability (TCP) result. Our analysis showed better overall results in planning using VMAT techniques. Furthermore, a total time reduction in treatment observed among techniques including gantry and collimator rotation could encourage using the more recent one, reducing target movements and patient discomfort.

Identifying influential factors on integrated marketing planning using information technology

Directory of Open Access Journals (Sweden)

Karim Hamdi

2014-07-01

Full Text Available This paper presents an empirical investigation to identify important factors influencing integrated marketing planning using information technology. The proposed study designs a questionnaire for measuring integrated marketing planning, which consists of three categories of structural factors, behavioral factors and background factors. There are 40 questions associated with the proposed study in Likert scale. Cronbach alphas have been calculated for structural factors, behavioral factors and background factors as 0.89, 0.86 and 0.83, respectively. Using some statistical test, the study has confirmed the effects of three factors on integrated marketing. In addition, the implementation of Freedman test has revealed that structural factors were the most important factor followed by background factors and behavioral factors.

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

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.

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.

Integral dose investigation of non-coplanar treatment beam geometries in radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Dan; Dong, Peng; Ruan, Dan; Low, Daniel A.; Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, University of California, Los Angeles, California 90095 (United States); Long, Troy; Romeijn, Edwin [Department of Industrial and Operations, University of Michigan, Ann Arbor, Michigan 48109 (United States)

2014-01-15

Purpose: Automated planning and delivery of non-coplanar plans such as 4π radiotherapy involving a large number of fields have been developed to take advantage of the newly available automated couch and gantry on C-arm gantry linacs. However, there is an increasing concern regarding the potential changes in the integral dose that needs to be investigated. Methods: A digital torso phantom and 22 lung and liver stereotactic body radiation therapy (SBRT) patients were included in the study. The digital phantom was constructed as a water equivalent elliptical cylinder with a major axis length of 35.4 cm and minor axis of 23.6 cm. A 4.5 cm diameter target was positioned at varying depths along the major axis. Integral doses from intensity modulated, non-coplanar beams forming a conical pattern were compared against the equally spaced coplanar beam plans. Integral dose dependence on the phantom geometry and the beam number was also quantified. For the patient plans, the non-coplanar and coplanar beams and fluences were optimized using a column generation and pricing approach and compared against clinical VMAT plans using two full (lung) or partial coplanar arcs (liver) entering at the side proximal to the tumor. Both the average dose to the normal tissue volume and the total volumes receiving greater than 2 Gy (V2) and 5 Gy (V5) were evaluated and compared. Results: The ratio of integral dose from the non-coplanar and coplanar plans depended on the tumor depth for the phantom; for tumors shallower than 10 cm, the non-coplanar integral doses were lower than coplanar integral doses for non-coplanar angles less than 60°. Similar patterns were observed in the patient plans. The smallest non-coplanar integral doses were observed for tumor 6–8 cm deep. For the phantom, the integral dose was independent of the number of beams, consistent with the liver SBRT patients but the lung SBRT patients showed slight increase in the integral dose when more beams were used. Larger

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)

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.

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.

Integrated formal operations plan

Energy Technology Data Exchange (ETDEWEB)

Cort, G.; Dearholt, W.; Donahue, S.; Frank, J.; Perkins, B.; Tyler, R.; Wrye, J.

1994-01-05

The concept of formal operations (that is, a collection of business practices to assure effective, accountable operations) has vexed the Laboratory for many years. To date most attempts at developing such programs have been based upon rigid, compliance-based interpretations of a veritable mountain of Department of Energy (DOE) orders, directives, notices, and standards. These DOE dictates seldom take the broad view but focus on highly specialized programs isolated from the overall context of formal operations. The result is a confusing array of specific, and often contradictory, requirements that produce a patchwork of overlapping niche programs. This unnecessary duplication wastes precious resources, dramatically increases the complexity of our work processes, and communicates a sense of confusion to our customers and regulators. Coupled with the artificial divisions that have historically existed among the Laboratory`s formal operations organizations (quality assurance, configuration management, records management, training, etc.), this approach has produced layers of increasingly vague and complex formal operations plans, each of which interprets its parent and adds additional requirements of its own. Organizational gridlock ensues whenever an activity attempts to implement these bureaucratic monstrosities. The integrated formal operations plan presented is to establish a set of requirements that must be met by an integrated formal operations program, assign responsibilities for implementation and operation of the program, and specify criteria against which the performance of the program will be measured. The accountable line manager specifies the items, processes, and information (the controlled elements) to which the formal operations program specified applies. The formal operations program is implemented using a graded approach based on the level of importance of the various controlled elements and the scope of the activities in which they are involved.

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...

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

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

A Needs Analysis for Technology Integration Plan: Challenges and Needs of Teachers

Science.gov (United States)

Vatanartiran, Sinem; Karadeniz, Sirin

2015-01-01

Lack of technology leadership and technology integration plans are important obstacles for using technology effectively in schools. We carried out a large-scale study to be able to design a technology integration plan for one of the pilot provinces that Fatih Project was initiated. The purpose of this research is to examine the perceived…

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

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

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.

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.)

Integrated National Energy Planning (INEP) in developing countries

International Nuclear Information System (INIS)

Munasinghe, M.

1989-01-01

Issues of coordinated energy planning are emphasized, with particular reference to interrelationships among the policies adopted in various energy sub-sectors such as electric power (including hydro, nuclear, geothermal, oil and coal sources), petroleum, natural gas, coal, non-conventional (solar, bio-gas, mini-hydro) and traditional fuels (woodfuel, bagasse or vegetable residue). The scope and objectives of integrated national energy planning, the policy tools available, and constraints particular to the developing countries are discussed next. Section 3.0 outlines how energy planning is carried out, while the problems of implementing the resulting policy conclusions are examined in section 4.0. 5 refs, 4 figs

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

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

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

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

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

SU-D-BRB-04: Plan Quality Comparison of Intracranial Stereotactic Radiosurgery (SRS) for Gamma Knife and VMAT Treatments

Energy Technology Data Exchange (ETDEWEB)

Keeling, V; Algan, O; Ahmad, S; Hossain, S [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

2015-06-15

Purpose: To compare treatment plan quality of intracranial stereotactic radiosurgery (SRS) for VMAT (RapidArc) and Gamma Knife (GK) systems. Methods: Ten patients with 24 tumors (seven with 1–2 and three with 4–6 lesions), previously treated with GK 4C (prescription doses ranging from 14–23 Gy) were re-planned for RapidArc. Identical contour sets were kept on MRI images for both plans with tissues assigned a CT number of zero. RapidArc plans were performed using 6 MV flattening-filter-free (FFF) beams with dose rate of 1400 MU/minute using two to eight arcs with the following combinations: 2 full coplanar arcs and the rest non-coplanar half arcs. Beam selection was based on target depth. Areas that penetrated more than 10 cm of tissue were avoided by creating smaller arcs or using avoidance sectors in optimization. Plans were optimized with jaw tracking and a high weighting to the normal-brain-tissue and Normal-Tissue-Objective without compromising PTV coverage. Plans were calculated on a 1 mm grid size using AAA algorithm and then normalized so that 99% of each target volume received the prescription dose. Plan quality was assessed by target coverage using Paddick Conformity Index (PCI), sparing of normal-brain-tissue through analysis of V4, V8, and V12 Gy, and integral dose. Results: In all cases critical structure dose criteria were met. RapidArc had a higher PCI than GK plans for 23 out of 24 lesions. The average PCI was 0.76±0.21 for RapidArc and 0.46±0.20 for GK plans (p≤0.001), respectively. Integral dose and normal-brain-tissue doses for all criteria were lower for RapidArc in nearly all patients. The average ratio of GK to RapidArc plans was 1.28±0.27 (p=0.018), 1.31±0.25 (p=0.017), 1.81±0.43 (p=0.005), and 1.50±0.61 (p=0.006) for V4, V8, and V12 Gy, and integral dose, respectively. Conclusion: VMAT was capable of producing higher quality treatment plans than GK when using optimal beam geometries and proper optimization techniques.

Background Information for the Nevada National Security Site Integrated Sampling Plan, Revision 0

Energy Technology Data Exchange (ETDEWEB)

Farnham, Irene; Marutzky, Sam

2014-12-01

This document describes the process followed to develop the Nevada National Security Site (NNSS) Integrated Sampling Plan (referred to herein as the Plan). It provides the Plan’s purpose and objectives, and briefly describes the Underground Test Area (UGTA) Activity, including the conceptual model and regulatory requirements as they pertain to groundwater sampling. Background information on other NNSS groundwater monitoring programs—the Routine Radiological Environmental Monitoring Plan (RREMP) and Community Environmental Monitoring Program (CEMP)—and their integration with the Plan are presented. Descriptions of the evaluations, comments, and responses of two Sampling Plan topical committees are also included.

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

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

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

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

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.

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)

Integrated assignment and path planning

Science.gov (United States)

Murphey, Robert A.

2005-11-01

A surge of interest in unmanned systems has exposed many new and challenging research problems across many fields of engineering and mathematics. These systems have the potential of transforming our society by replacing dangerous and dirty jobs with networks of moving machines. This vision is fundamentally separate from the modern view of robotics in that sophisticated behavior is realizable not by increasing individual vehicle complexity, but instead through collaborative teaming that relies on collective perception, abstraction, decision making, and manipulation. Obvious examples where collective robotics will make an impact include planetary exploration, space structure assembly, remote and undersea mining, hazardous material handling and clean-up, and search and rescue. Nonetheless, the phenomenon driving this technology trend is the increasing reliance of the US military on unmanned vehicles, specifically, aircraft. Only a few years ago, following years of resistance to the use of unmanned systems, the military and civilian leadership in the United States reversed itself and have recently demonstrated surprisingly broad acceptance of increasingly pervasive use of unmanned platforms in defense surveillance, and even attack. However, as rapidly as unmanned systems have gained acceptance, the defense research community has discovered the technical pitfalls that lie ahead, especially for operating collective groups of unmanned platforms. A great deal of talent and energy has been devoted to solving these technical problems, which tend to fall into two categories: resource allocation of vehicles to objectives, and path planning of vehicle trajectories. An extensive amount of research has been conducted in each direction, yet, surprisingly, very little work has considered the integrated problem of assignment and path planning. This dissertation presents a framework for studying integrated assignment and path planning and then moves on to suggest an exact

Optimal integration and test plans for software releases of lithographic systems

NARCIS (Netherlands)

Boumen, R.; Jong, de I.S.M.; Mortel - Fronczak, van de J.M.; Rooda, J.E.

2007-01-01

This paper describes a method to determine the optimal integration and test plan for embedded systems software releases. The method consists of four steps: 1)describe the integration and test problem in an integration and test model which is introduced in this paper, 2) determine possible test

Operations and maintenance plan : Dallas Integrated Corridor Management (ICM) demonstration project.

Science.gov (United States)

2014-01-01

This Operations and Maintenance (O&M) Plan describes how the Integrated Corridor Management System (ICMS) will be used in daily transportation operations and maintenance activities. The Plan addresses the activities needed to effectively operate the ...

Adaptive treatment-length optimization in spatiobiologically integrated radiotherapy

Science.gov (United States)

Ajdari, Ali; Ghate, Archis; Kim, Minsun

2018-04-01

Recent theoretical research on spatiobiologically integrated radiotherapy has focused on optimization models that adapt fluence-maps to the evolution of tumor state, for example, cell densities, as observed in quantitative functional images acquired over the treatment course. We propose an optimization model that adapts the length of the treatment course as well as the fluence-maps to such imaged tumor state. Specifically, after observing the tumor cell densities at the beginning of a session, the treatment planner solves a group of convex optimization problems to determine an optimal number of remaining treatment sessions, and a corresponding optimal fluence-map for each of these sessions. The objective is to minimize the total number of tumor cells remaining (TNTCR) at the end of this proposed treatment course, subject to upper limits on the biologically effective dose delivered to the organs-at-risk. This fluence-map is administered in future sessions until the next image is available, and then the number of sessions and the fluence-map are re-optimized based on the latest cell density information. We demonstrate via computer simulations on five head-and-neck test cases that such adaptive treatment-length and fluence-map planning reduces the TNTCR and increases the biological effect on the tumor while employing shorter treatment courses, as compared to only adapting fluence-maps and using a pre-determined treatment course length based on one-size-fits-all guidelines.

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.

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.

Integrating self-regulated learning and discovery learning into English lesson plan

Directory of Open Access Journals (Sweden)

Sayukti Ni Kadek Heny

2018-01-01

Full Text Available The notion of learner-centeredness has been embedded in the National Curriculum of Indonesia, 2013 Curriculum. However, most of the teachers seem to be hardly acquainted with the concept of Self-Regulated Learning (SRL and discovery learning in the lesson planning. Considering the phenomenon, this study intends to explore the concept of Self-Regulated Learning in the lesson plan of English subject for a tenth-grade level by employing a qualitative design with data obtained from a teacher-made lesson plan and a semi-structured interview. The researcher used content analysis to analyze the lesson plan. Meanwhile, the qualitative data from interview result were preceded through a coding sheet and transcribed modified figure. The findings revealed an integration of SRL cyclical phase and discovery learning in the teacher-made lesson plan. Based on the discussion, the results need to be applied in a considerably large context, in order to see thoroughly dynamic integration between Self-Regulated Learning model, lesson planning and the concept of learner autonomy.

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

Helical tomotherapy for SIB and hypo-fractionated treatments in lung carcinomas: A 4D Monte Carlo treatment planning study

International Nuclear Information System (INIS)

Sterpin, Edmond; Janssens, Guillaume; Orban de Xivry, Jonathan; Goossens, Samuel; Wanet, Marie; Lee, John A.; Delor, Antoine; Bol, Vanesa; Vynckier, Stefaan; Gregoire, Vincent; Geets, Xavier

2012-01-01

Purpose: To evaluate the impact of intra-fraction motion induced by regular breathing on treatment quality for helical tomotherapy treatments. Material and methods: Four patients treated by simultaneous-integrated boost (SIB) and three by hypo-fractionated stereotactic treatments (hypo-fractionated, 18 Gy/fraction) were included. All patients were coached to ensure regular breathing. For the SIB group, the tumor volume was delineated using CT information only (CTV CT ) and the boost region was based on PET information (GTV PET , no CTV extension). In the hypo-fractionated group, a GTV based on CT information was contoured. In both groups, ITVs were defined according to 4D data. The PTV included the ITV plus a setup error margin. The treatment was planned using the tomotherapy TPS on 3D CT images. In order to verify the impact of intra-fraction motion and interplay effects, dose calculations were performed using a previously validated Monte Carlo model of tomotherapy (TomoPen): first on the planning 3D CT (“planned dose”) and second, on the 10 phases of the 4D scan. For the latter, two dose distributions, termed “interplay simulated” or “no interplay” were computed with and without beamlet-phase correlation over the 10 phases and combined using deformable dose registration. Results: In all cases, DVHs of “interplay simulated” dose distributions complied within 1% of the original clinical objectives used for planning, defined according to ICRU (report 83) and RTOG (trials 0236 and 0618) recommendations, for SIB and hypo-fractionated groups, respectively. For one patient in the hypo-fractionated group, D mean to the CTV CT was 2.6% and 2.5% higher than “planned” for “interplay simulated” and “no interplay”, respectively. Conclusion: For the patients included in this study, assuming regular breathing, the results showed that interplay of breathing and tomotherapy delivery motions did not affect significantly plan delivery accuracy. Hence

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

Inverse treatment planning for intensity modulated radiation therapy: CDVH treatment prescription with integral cost function

International Nuclear Information System (INIS)

Carol, M.P.; Nash, R.; Campbell, R.C.; Huber, R.

1997-01-01

obtained that were case independent. These results included 1) achieving all target goals or 2) observing all structure limits or 3) allowing structure limits to exceed desired by a known amount in order to produce a significant improvement in target dose; for instance, values for the variables were identified such that the actual CDVH for a sensitive structure would be allowed to exceed the desired by as much as 10% if the result was an improvement in target dose of better than 20%. Conclusion: By specifying a prescription with partial volume data and using predetermined but user-selectable values assigned to variables used in the cost function, a simulated annealing optimization can be performed that is intuitive and that produces predictable results for intensity modulated treatment plans. Successful clinical application of this approach requires knowledge of the partial volume tolerances of structures and partial volume goals for tumors

Supply chain planning with sustainability considerations: an integrative framework

DEFF Research Database (Denmark)

Wang, Yang; Akkerman, Renzo; Birkved, Morten

2011-01-01

This paper proposes a modelling framework for combining supply chain planning and sustainability assessment, illustrating how sustainability assessments of logistic activities can be improved by supply chain planning input, and supply chain planning can in turn make use of the results from sustai...... produced on industrial scale, studying several important planning decisions like temperature treatments and choice of packaging materials.......This paper proposes a modelling framework for combining supply chain planning and sustainability assessment, illustrating how sustainability assessments of logistic activities can be improved by supply chain planning input, and supply chain planning can in turn make use of the results from...

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)

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.

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.

The DOE Office of Environmental Restoration and Waste Management comprehensive integrated planning process

International Nuclear Information System (INIS)

Aiken, R.J.; Draffin, C.W. Jr.; Pflock, K.T.

1992-01-01

This paper reports that comprehensive integrated planning is critical to the ultimate success of the DOE Office of Environmental Restoration and Waste Management's (EM) program because of the significant technical and institutional complexities, the tens of billions of dollars required, the regulatory and fiscal uncertainty, and the multitude of federal, state, and private sector organizations involved. Using the philosophy that sound and forward looking planning should guide budgetary and management decisionmaking, and that clear priorities are essential to program success, EM's comprehensive approach includes strategic planning, the annually updated EM Five-Year Plan, the EM Management Plan, and Site Specific Plans. Roadmaps (which facilitate issue identification and resolution), Activity Data Sheets, prioritization methodologies, and installation-specific Progress Charts are among the tools employed in support of the EM integrated planning process

DNFSB Recommendation 94-1 Hanford site integrated stabilization management plan, volumes 1 and 2

International Nuclear Information System (INIS)

Gerber, E.W.

1996-01-01

This document comprises the Hanford Site Integrated Stabilization Management Plan (SISMP). This document describes the DOE's plans at the Hanford Site to address concerns identified in Defense Nuclear Facilites Safety Board (DNFSB) Recommendation 94-1. This document also identifies plans for other spent nuclear fuel (SNF) inventories at the Hanford Site which are not within the scope of DNFSB Recommendation 94-1 for reference purposes because of their interrelationship with plans for SNF within the scope of DNFSB Recommendation 94-1. The SISMP was also developed to assist DOE in initial formulation of the Research and Development Plan and the Integrated Facilities Plan

Integrating fuel treatment into ecosystem management: A proposed project planning process

Science.gov (United States)

Keith D. Stockmann; Kevin D. Hyde; J. Greg Jones; Dan R. Loeffler; Robin P. Silverstein

2010-01-01

Concern over increased wildland fire threats on public lands throughout the western United States makes fuel reduction activities the primary driver of many management projects. This single-issue focus recalls a management planning process practiced frequently in recent decades - a least-harm approach where the primary objective is first addressed and then plans are...

Integrative medicine for cancer treatment

Science.gov (United States)

... gov/ency/patientinstructions/000932.htm Integrative medicine for cancer treatment To use the sharing features on this page, ... help relieve common side effects of cancer or cancer treatment, such as fatigue, anxiety, pain, and nausea. Some ...

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)

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

LANDSAT supports data needs for EPA 208 planning. [water quality control and waste treatment management

Science.gov (United States)

1979-01-01

Excerpts from federal legislation and regulations mandating areawide waster treatment management as a means of restoring and maintaining the integrity of the nation's water are presented along with requirements for grants to the states for water quality planning, management, and implementation. Experiences using LANDSAT to identify nonpoint sources of water pollution as well as land/use/land cover features in South Dakota, Kentucky, Georgia, New Jersey, and Texas are described. Present activities suggest that this type of remote sensing is an efficient, effective tool for areawide water quality planning. Interaction with cognizant federal, state, and local government personnel involved in EPA section 208 planning activities can guide the development of new capabilities and enhance their utility and prospect for use.

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

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

DNFSB Recommendation 94-1 Hanford Site Integrated Stabilization Management Plan. Volume 2

International Nuclear Information System (INIS)

Gerber, E.W.

1995-10-01

The Hanford Site Integrated Stabilization Management Plan (SISMP) was developed in support of the US Department of Energy's (DOE) Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1 Integrated Program Plan (IPP). Volume 1 of the SISMP identifies the technical scope and costs associated with Hanford Site plans to resolve concerns identified in DNFSB Recommendation 94-1. Volume 2 of the SISMP provides the Resource Loaded Integrated Schedules for Spent Nuclear Fuel Project and Plutonium Finishing Plant activities identified in Volume 1 of the SISMP. Appendix A provides the schedules and progress curves related to spent nuclear fuel management. Appendix B provides the schedules and progress curves related to plutonium-bearing material management. Appendix C provides programmatic logic diagrams that were referenced in Volume 1 of the SISMP

Nuclear power programme planning: An integrated approach

International Nuclear Information System (INIS)

2001-12-01

The International Atomic Energy Agency (IAEA) has published material on different policy considerations in the introduction of nuclear power, primarily addressed to top level decision makers in government and industry in Member States. Several Member States and experts recommended to the IAEA to address the aspects of an integrated approach to nuclear power programme planning and to serve as guidance to those countries wishing to embark on a nuclear power programme. As a follow-up, the present publication is primarily intended to serve as guidance for executives and managers in Member States in planning for possible introduction of nuclear power plants in their electricity generating systems. Nuclear power programme planning, as dealt with in this publication, includes all activities that need to be carried out up to a well-founded decision to proceed with a project feasibility study. Project implementation beyond this decision is not in the scope of this publication. Although it is possible to use nuclear energy as a heat source for industrial processes, desalination and other heat applications, it is assumed in this publication that the planning is aimed towards nuclear power for electricity generation. Much of the information given would, however, also be relevant for planning of nuclear reactors for heat production. The publication was prepared within the framework of the IAEA programme on nuclear power planning, implementation and performance as a joint activity of the Nuclear Power Engineering Section and the Planning and Economic Studies Section (Division of Nuclear Power)

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

Integrated Monitoring Plan for the Hanford Groundwater Monitoring Project

International Nuclear Information System (INIS)

Newcomer, D.R.; Thornton, E.C.; Hartman, M.J.; Dresel, P.E.

1999-01-01

Groundwater is monitored at the Hanford Site to fulfill a variety of state and federal regulations, including the Atomic Energy Act of 1954 the Resource Conservation and Recovery Act of 1976 the Comprehensive Environmental Response, Compensation, and Liability Act of 1980; and Washington Administrative Code. Separate monitoring plans are prepared for various requirements, but sampling is coordinated and data are shared among users to avoid duplication of effort. The US Department of Energy manages these activities through the Hanford Groundwater Monitoring Project. This document is an integrated monitoring plan for the groundwater project. It documents well and constituent lists for monitoring required by the Atomic Energy Act of 1954 and its implementing orders; includes other, established monitoring plans by reference; and appends a master well/constituent/frequency matrix for the entire site. The objectives of monitoring fall into three general categories plume and trend tracking, treatment/storage/disposal unit monitoring, and remediation performance monitoring. Criteria for selecting Atomic Energy Act of 1954 monitoring networks include locations of wells in relation to known plumes or contaminant sources, well depth and construction, historical data, proximity to the Columbia River, water supplies, or other areas of special interest, and well use for other programs. Constituent lists were chosen based on known plumes and waste histories, historical groundwater data, and, in some cases, statistical modeling. Sampling frequencies were based on regulatory requirements, variability of historical data, and proximity to key areas. For sitewide plumes, most wells are sampled every 3 years. Wells monitoring specific waste sites or in areas of high variability will be sampled more frequently

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.

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

10 years of make-up water treatment with integrated reverse osmosis at Grosskraftwerk Mannheim

International Nuclear Information System (INIS)

Spindler, K.; Bloechl, H.; Bursik, A.

1993-01-01

Since 1982, at Grosskraftwerk Mannheim, a make-up water treatment in which three reverse osmosis plants are integrated, has been operating. The original high-pressure hollow fibre module of these plants has been replaced by low-pressure coil modules. The reasons for the change in system are described in the paper. In the low-pressure plant, coil modules have been installed by several manufacturers. The paper reports on experience with the low-pressure elements. The experience gained has been streamed into the planning proposals for the new make-up water treatment plant. (orig.) [de

Dosimetric comparison of standard three-dimensional conformal radiotherapy followed by intensity-modulated radiotherapy boost schedule (sequential IMRT plan) with simultaneous integrated boost-IMRT (SIB IMRT) treatment plan in patients with localized carcinoma prostate.

Science.gov (United States)

Bansal, A; Kapoor, R; Singh, S K; Kumar, N; Oinam, A S; Sharma, S C

2012-07-01

DOSIMETERIC AND RADIOBIOLOGICAL COMPARISON OF TWO RADIATION SCHEDULES IN LOCALIZED CARCINOMA PROSTATE: Standard Three-Dimensional Conformal Radiotherapy (3DCRT) followed by Intensity Modulated Radiotherapy (IMRT) boost (sequential-IMRT) with Simultaneous Integrated Boost IMRT (SIB-IMRT). Thirty patients were enrolled. In all, the target consisted of PTV P + SV (Prostate and seminal vesicles) and PTV LN (lymph nodes) where PTV refers to planning target volume and the critical structures included: bladder, rectum and small bowel. All patients were treated with sequential-IMRT plan, but for dosimetric comparison, SIB-IMRT plan was also created. The prescription dose to PTV P + SV was 74 Gy in both strategies but with different dose per fraction, however, the dose to PTV LN was 50 Gy delivered in 25 fractions over 5 weeks for sequential-IMRT and 54 Gy delivered in 27 fractions over 5.5 weeks for SIB-IMRT. The treatment plans were compared in terms of dose-volume histograms. Also, Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) obtained with the two plans were compared. The volume of rectum receiving 70 Gy or more (V > 70 Gy) was reduced to 18.23% with SIB-IMRT from 22.81% with sequential-IMRT. SIB-IMRT reduced the mean doses to both bladder and rectum by 13% and 17%, respectively, as compared to sequential-IMRT. NTCP of 0.86 ± 0.75% and 0.01 ± 0.02% for the bladder, 5.87 ± 2.58% and 4.31 ± 2.61% for the rectum and 8.83 ± 7.08% and 8.25 ± 7.98% for the bowel was seen with sequential-IMRT and SIB-IMRT plans respectively. For equal PTV coverage, SIB-IMRT markedly reduced doses to critical structures, therefore should be considered as the strategy for dose escalation. SIB-IMRT achieves lesser NTCP than sequential-IMRT.

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

Scoping study of integrated resource planning needs in the public utility sector

Energy Technology Data Exchange (ETDEWEB)

Garrick, C J; Garrick, J M; Rue, D R [NEOS Corp., Lakewood, CO (United States)

1993-06-01

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

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

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.