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Sample records for specific treatment planning

  1. Specification and acceptance testing of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    2007-04-01

    Quality assurance (QA) in the radiation therapy treatment planning process is essential to ensure accurate dose delivery to the patient and to minimize the possibility of accidental exposure. The computerized radiotherapy treatment planning systems (RTPSs) are now widely available in industrialized and developing countries and it is of special importance to support hospitals in Member States in developing procedures for acceptance testing, commissioning and QA of their RTPSs. Responding to these needs, a group of experts developed an IAEA publication with such recommendations, which was published in 2004 as IAEA Technical Reports Series No. 430. This report provides a general framework and describes a large number of tests and procedures that should be considered by the users of new RTPSs. However, small hospitals with limited resources or large hospitals with high patient load and limited staff are not always able to perform complete characterization, validation and software testing of algorithms used in RTPSs. Therefore, the IAEA proposed more specific guidelines that provide a step-by-step recommendation for users at hospitals or cancer centres how to implement acceptance and commissioning procedures for newly purchased RTPSs. The current publication was developed in the framework of the Coordinated Research Project on Development of Procedures for Quality Assurance for Dosimetry Calculations in Radiotherapy and uses the International Electrotechnical Commission (IEC) standard IEC 62083, Requirements for the Safety of Radiotherapy Treatment Planning Systems as its basis. The report addresses the procedures for specification and acceptance testing of RTPSs to be used by both manufacturers and users at the hospitals. Recommendations are provided for specific tests to be performed at the manufacturing facility known as type tests, and for acceptance tests to be performed at the hospital known as site tests. The purpose of acceptance testing is to demonstrate to the

  2. 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)

  3. 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

  4. Site specific plan

    International Nuclear Information System (INIS)

    Hutchison, J.; Jernigan, G.

    1989-12-01

    The Environmental Restoration and Waste Management Five-Year Plan (FYP) covers the period for FY 1989 through FY 1995. The plan establishes a Department of Energy -- Headquarters (DOE-HQ) agenda for cleanup and compliance against which overall progress can be measured. The FYP covers three areas: Corrective Activities, Environmental Restoration, and Waste Management Operations. Corrective Activities are those activities necessary to bring active or standby facilities into compliance with local, state, and federal environmental regulations. Environmental restoration activities include the assessment and cleanup of surplus facilities and inactive waste sites. Waste management operations includes the treatment, storage, and disposal of wastes which are generated as a result of ongoing operations. This Site Specific Plan (SSP) has been prepared by the Savannah River Site (SRS) in order to show how environmental restoration and waste management activities that were identified during the preparation of the FYP will be implemented, tracked, and reported. The SSP describes DOE Savannah River (DOE-SR) and operating contractor, Westinghouse Savannah River Company (WSRC), organizations that are responsible, for undertaking the activities identified in this plan. The SSP has been prepared in accordance with guidance received from DOE-HQ. DOE-SR is accountable to DOE-HQ for the implementation of this plan. 8 refs., 46 figs., 23 tabs

  5. Patient-specific three-dimensional printing for pre-surgical planning in hepatocellular carcinoma treatment.

    Science.gov (United States)

    Perica, Elizabeth; Sun, Zhonghua

    2017-12-01

    outcomes indicate that there is minimal value in utilizing the 3D printed models in diagnostic radiology. The potential usefulness of utilizing patient-specific 3D printed liver models as tools in surgical planning and intraoperative guidance for HCC treatment is verified. However, the feasibility of this application is currently challenged by identified limitations in 3D model production, including the cost and time required for model production, and inaccuracies potentially introduced at each stage of model fabrication.

  6. 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.)

  7. Clinical decision support of radiotherapy treatment planning: A data-driven machine learning strategy for patient-specific dosimetric decision making.

    Science.gov (United States)

    Valdes, Gilmer; Simone, Charles B; Chen, Josephine; Lin, Alexander; Yom, Sue S; Pattison, Adam J; Carpenter, Colin M; Solberg, Timothy D

    2017-12-01

    Clinical decision support systems are a growing class of tools with the potential to impact healthcare. This study investigates the construction of a decision support system through which clinicians can efficiently identify which previously approved historical treatment plans are achievable for a new patient to aid in selection of therapy. Treatment data were collected for early-stage lung and postoperative oropharyngeal cancers treated using photon (lung and head and neck) and proton (head and neck) radiotherapy. Machine-learning classifiers were constructed using patient-specific feature-sets and a library of historical plans. Model accuracy was analyzed using learning curves, and historical treatment plan matching was investigated. Learning curves demonstrate that for these datasets, approximately 45, 60, and 30 patients are needed for a sufficiently accurate classification model for radiotherapy for early-stage lung, postoperative oropharyngeal photon, and postoperative oropharyngeal proton, respectively. The resulting classification model provides a database of previously approved treatment plans that are achievable for a new patient. An exemplary case, highlighting tradeoffs between the heart and chest wall dose while holding target dose constant in two historical plans is provided. We report on the first artificial-intelligence based clinical decision support system that connects patients to past discrete treatment plans in radiation oncology and demonstrate for the first time how this tool can enable clinicians to use past decisions to help inform current assessments. Clinicians can be informed of dose tradeoffs between critical structures early in the treatment process, enabling more time spent on finding the optimal course of treatment for individual patients. Copyright © 2017. Published by Elsevier B.V.

  8. Impact of tissue specific parameters on the predition of the biological effectiveness for treatment planning in ion beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gruen, Rebecca Antonia

    2014-06-03

    Treatment planning in ion beam therapy requires a reliable estimation of the relative biological effectiveness (RBE) of the irradiated tissue. For the pilot project at GSI Helmholtzzentrum fuer Schwerionenforschung GmbH and at other European ion beam therapy centers RBE prediction is based on a biophysical model, the Local Effect Model (LEM). The model version in use, LEM I, is optimized to give a reliable estimation of RBE in the target volume for carbon ion irradiation. However, systematic deviations are observed for the entrance channel of carbon ions and in general for lighter ions. Thus, the LEM has been continuously developed to improve accuracy. The recent version LEM IV has proven to better describe in-vitro cell experiments. Thus, for the clinical application of LEM IV it is of interest to analyze potential differences compared to LEM I under treatment-like conditions. The systematic analysis presented in this work is aiming at the comparison of RBE-weighted doses resulting from different approaches and model versions for protons and carbon ions. This will facilitate the assessment of consequences for clinical application and the interpretation of clinical results from different institutions. In the course of this thesis it has been shown that the RBE-weighted doses predicted on the basis of LEM IV for typical situations representing chordoma treatments differ on average by less than 10 % to those based on LEM I and thus also allow a consistent interpretation of the clinical results. At Japanese ion beam therapy centers the RBE is estimated using their clinical experience from neutron therapy in combination with in-vitro measurements for carbon ions (HIMAC approach). The methods presented in this work allow direct comparison of the HIMAC approach and the LEM and thus of the clinical results obtained at Japanese and European ion beam therapy centers. Furthermore, the sensitivity of the RBE on the model parameters was evaluated. Among all parameters the

  9. Impact of tissue specific parameters on the predition of the biological effectiveness for treatment planning in ion beam therapy

    International Nuclear Information System (INIS)

    Gruen, Rebecca Antonia

    2014-01-01

    Treatment planning in ion beam therapy requires a reliable estimation of the relative biological effectiveness (RBE) of the irradiated tissue. For the pilot project at GSI Helmholtzzentrum fuer Schwerionenforschung GmbH and at other European ion beam therapy centers RBE prediction is based on a biophysical model, the Local Effect Model (LEM). The model version in use, LEM I, is optimized to give a reliable estimation of RBE in the target volume for carbon ion irradiation. However, systematic deviations are observed for the entrance channel of carbon ions and in general for lighter ions. Thus, the LEM has been continuously developed to improve accuracy. The recent version LEM IV has proven to better describe in-vitro cell experiments. Thus, for the clinical application of LEM IV it is of interest to analyze potential differences compared to LEM I under treatment-like conditions. The systematic analysis presented in this work is aiming at the comparison of RBE-weighted doses resulting from different approaches and model versions for protons and carbon ions. This will facilitate the assessment of consequences for clinical application and the interpretation of clinical results from different institutions. In the course of this thesis it has been shown that the RBE-weighted doses predicted on the basis of LEM IV for typical situations representing chordoma treatments differ on average by less than 10 % to those based on LEM I and thus also allow a consistent interpretation of the clinical results. At Japanese ion beam therapy centers the RBE is estimated using their clinical experience from neutron therapy in combination with in-vitro measurements for carbon ions (HIMAC approach). The methods presented in this work allow direct comparison of the HIMAC approach and the LEM and thus of the clinical results obtained at Japanese and European ion beam therapy centers. Furthermore, the sensitivity of the RBE on the model parameters was evaluated. Among all parameters the

  10. Specificities of sustainable tourism planning

    Directory of Open Access Journals (Sweden)

    Jegdić Vaso

    2013-01-01

    Full Text Available In the past two decades, companies have been mentioning achievement of sustainability in their activities as a target of companies, governments and non-profit organizations, although measuring the degree to which an organization conducts its activities in a sustainable manner, can be very difficult. Sustainable tourism development requires a process of planning and management that will unite the interests of various stakeholders in a sustainable and strategic way. It requires an understanding of the meaning of sustainable development and guiding values for promoting sustainable tourism. The paper points to the importance of cross-sector partnerships and the roles of different stakeholders in the planning of sustainable tourism projects. Special importance is given to the community of which a willingness to understand the impacts of tourism industry is expected, as well as various procedures of engagement in participatory planning, consensus building and conflict resolution among all stakeholders. The aim of this research is to find an optimal model of planning of sustainable tourism projects that would take into consideration the interests of all stakeholders and reflect the specificities imposed by the acceptance of the concept of sustainable development by all participants in the project.

  11. Toward Online Adaptive Hyperthermia Treatment Planning: Correlation Between Measured and Simulated Specific Absorption Rate Changes Caused by Phase Steering in Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kok, H. Petra, E-mail: H.P.Kok@amc.uva.nl [Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Ciampa, Silvia [Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Department of Civil Engineering and Computer Science, University of Rome Tor Vergata, Rome (Italy); Kroon-Oldenhof, Rianne de; Steggerda-Carvalho, Eva J.; Stam, Gerard van; Zum Vörde Sive Vörding, Paul J.; Stalpers, Lukas J.A.; Geijsen, Elisabeth D. [Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Bardati, Fernando [Department of Civil Engineering and Computer Science, University of Rome Tor Vergata, Rome (Italy); Bel, Arjan; Crezee, Johannes [Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2014-10-01

    Purpose: Hyperthermia is the clinical application of heat, in which tumor temperatures are raised to 40°C to 45°C. This proven radiation and chemosensitizer significantly improves clinical outcome for several tumor sites. Earlier studies of the use of pre-treatment planning for hyperthermia showed good qualitative but disappointing quantitative reliability. The purpose of this study was to investigate whether hyperthermia treatment planning (HTP) can be used more reliably for online adaptive treatment planning during locoregional hyperthermia treatments. Methods and Materials: This study included 78 treatment sessions for 15 patients with non-muscle-invasive bladder cancer. At the start of treatments, temperature rise measurements were performed with 3 different antenna settings optimized for each patient, from which the absorbed power (specific absorption rate [SAR]) was derived. HTP was performed based on a computed tomography (CT) scan in treatment position with the bladder catheter in situ. The SAR along the thermocouple tracks was extracted from the simulated SAR distributions. Correlations between measured and simulated (average) SAR values were determined. To evaluate phase steering, correlations between the changes in simulated and measured SAR values averaged over the thermocouple probe were determined for all 3 combinations of antenna settings. Results: For 42% of the individual treatment sessions, the correlation coefficient between measured and simulated SAR profiles was higher than 0.5, whereas 58% showed a weak correlation (R of <0.5). The overall correlation coefficient between measured and simulated average SAR was weak (R=0.31; P<.001). The measured and simulated changes in average SAR after adapting antenna settings correlated much better (R=0.70; P<.001). The ratio between the measured and simulated quotients of maximum and average SARs was 1.03 ± 0.26 (mean ± SD), indicating that HTP can also correctly predict the relative amplitude of

  12. Model Commissioning Plan and Guide Specifications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The objectives of Model Commissioning Plan and Guide Specifications are to ensure that the design team applies commissioning concepts to the design and prepares commissioning specifications and a commission plan for inclusion in the bid construction documents.

  13. Project Specific Quality Assurance Plan

    International Nuclear Information System (INIS)

    Pedersen, K.S.

    1995-01-01

    This Quality Assurance Project Plan (QAPP) identifies the Westinghouse Hanford Co. (WHC) Quality Assurance (QA) program requirements for all contractors involved in the planning and execution of the design, construction, testing and inspection of the 200 Area Effluent BAT/AKART Implementation, Project W-291

  14. Integral multidisciplinary rehabilitation treatment planning

    NARCIS (Netherlands)

    Braaksma, Aleida; Kortbeek, Nikky; Post, Gerhard F.; Nollet, F.

    2014-01-01

    This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure

  15. Integral multidisciplinary rehabilitation treatment planning

    NARCIS (Netherlands)

    Braaksma, Aleida; Kortbeek, Nikky; Post, Gerhard F.; Nollet, Frans

    This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  17. SU-G-JeP2-10: On the Need for a Dynamic Model for Patient-Specific Distortion Corrections for MR-Only Pelvis Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Glide-Hurst, C; Zheng, W [Henry Ford Health System, Detroit, MI (United States); Stehning, C; Weiss, S; Renisch, S [Philips Research Laboratories, Hamburg (Germany)

    2016-06-15

    Purpose: Patient-specific distortions, particularly near tissue/air interfaces, require assessment and possible corrections for MRI-only radiation treatment planning (RTP). However, patients are dynamic due to changes in physiological status and motion during imaging sessions. This work investigated the need for dynamic patient-specific distortion corrections to support pelvis MR-only RTP. Methods: The pelvises of healthy volunteers were imaged at 1.0T, 1.5T, and 3.0T. Patient-specific distortion field maps were generated using a dual-echo gradient-recalled echo (GRE) sequence with B0 field maps obtained from the phase difference between the two echoes acquired at two timepoints: empty and full bladders. To quantify changes arising from respiratory state, end-inhalation and end-expiration data were acquired. Distortion map differences were computed between the empty/full bladder and inhalation/expiration to characterize local changes. The normalized frequency distortion distributions in T2-weighted TSE images were characterized, particularly for simulated prostate planning target volumes (PTVs). Results: Changes in rectal and bowel air location were observed, likely due to changes in bladder filling. Within the PTVs, displacement differences (mean ± stdev, range) were −0.02 ± 0.02 mm (−0.13 to 0.07 mm) for 1.0T, −0.1 ± 0.2 mm (−0.92 to 0.74 mm) for 1.5T, and −0.20 ± 0.03 mm (−0.61 to 0.38 mm) for 3.0T. Local changes of ∼1 mm at the prostate-rectal interface were observed for an extreme case at 1.5T. For end-inhale and end-exhale scans at 3.0T, 99% of the voxels had Δx differences within ±0.25mm, thus the displacement differences due to respiratory state appear negligible in the pelvis. Conclusion: Our work suggests that transient bowel/rectal gas due to bladder filling may yield non-negligible patient-specific distortion differences near the prostate/rectal interface, whereas respiration had minimal effect. A temporal patient model for patient-specific

  18. Savannah River Site's Site Specific Plan

    International Nuclear Information System (INIS)

    1991-01-01

    This Site Specific Plan (SSP) has been prepared by the Savannah River Site (SRS) in order to show the Environmental Restoration and Waste Management activities that were identified during the preparation of the Department of Energy-Headquarters (DOE-HQ) Environmental Restoration and Waste Management Five-Year Plan (FYP) for FY 1992--1996. The SSP has been prepared in accordance with guidance received from DOE-HQ. DOE-SR is accountable to DOE-HQ for the implementation of this plan. The purpose of the SSP is to develop a baseline for policy, budget, and schedules for the DOE Environmental Restoration and Waste Management activities. The plan explains accomplishments since the Fiscal Year (FY) 1990 plan, demonstrates how present and future activities are prioritized, identifies currently funded activities and activities that are planned to be funded in the upcoming fiscal year, and describes future activities that SRS is considering

  19. Interactively exploring optimized treatment plans.

    Science.gov (United States)

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

    2005-02-01

    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. 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. 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 for the minimum PTV dose. Based on the root

  20. Treatment planning for restorative implantology.

    Science.gov (United States)

    Boyce, Ricardo A; Klemons, Gary

    2015-04-01

    In this article, current literature on fixed and removable prosthodontics is reviewed along with evidence-based systematic reviews, including advice from those in the dental profession with years of experience, which help restorative dentists manage and treat their cases successfully. Treatment planning for restorative implantology should be looked at in 4 sections: (1) review of past medical history, (2) oral examination and occlusion, (3) dental imaging (ie, cone-beam computed tomography), and (4) fixed versus removable prosthodontics. These 4 concepts of treatment planning, along with proper surgical placements of the implant(s), result in successful cases. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Failure mode and effect analysis oriented to risk-reduction interventions in intraoperative electron radiation therapy: the specific impact of patient transportation, automation, and treatment planning availability.

    Science.gov (United States)

    López-Tarjuelo, Juan; Bouché-Babiloni, Ana; Santos-Serra, Agustín; Morillo-Macías, Virginia; Calvo, Felipe A; Kubyshin, Yuri; Ferrer-Albiach, Carlos

    2014-11-01

    Industrial companies use failure mode and effect analysis (FMEA) to improve quality. Our objective was to describe an FMEA and subsequent interventions for an automated intraoperative electron radiotherapy (IOERT) procedure with computed tomography simulation, pre-planning, and a fixed conventional linear accelerator. A process map, an FMEA, and a fault tree analysis are reported. The equipment considered was the radiance treatment planning system (TPS), the Elekta Precise linac, and TN-502RDM-H metal-oxide-semiconductor-field-effect transistor in vivo dosimeters. Computerized order-entry and treatment-automation were also analyzed. Fifty-seven potential modes and effects were identified and classified into 'treatment cancellation' and 'delivering an unintended dose'. They were graded from 'inconvenience' or 'suboptimal treatment' to 'total cancellation' or 'potentially wrong' or 'very wrong administered dose', although these latter effects were never experienced. Risk priority numbers (RPNs) ranged from 3 to 324 and totaled 4804. After interventions such as double checking, interlocking, automation, and structural changes the final total RPN was reduced to 1320. FMEA is crucial for prioritizing risk-reduction interventions. In a semi-surgical procedure like IOERT double checking has the potential to reduce risk and improve quality. Interlocks and automation should also be implemented to increase the safety of the procedure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Failure mode and effect analysis oriented to risk-reduction interventions in intraoperative electron radiation therapy: The specific impact of patient transportation, automation, and treatment planning availability

    International Nuclear Information System (INIS)

    López-Tarjuelo, Juan; Bouché-Babiloni, Ana; Santos-Serra, Agustín; Morillo-Macías, Virginia; Calvo, Felipe A.; Kubyshin, Yuri

    2014-01-01

    Background and purpose: Industrial companies use failure mode and effect analysis (FMEA) to improve quality. Our objective was to describe an FMEA and subsequent interventions for an automated intraoperative electron radiotherapy (IOERT) procedure with computed tomography simulation, pre-planning, and a fixed conventional linear accelerator. Material and methods: A process map, an FMEA, and a fault tree analysis are reported. The equipment considered was the radiance treatment planning system (TPS), the Elekta Precise linac, and TN-502RDM-H metal–oxide-semiconductor-field-effect transistor in vivo dosimeters. Computerized order-entry and treatment-automation were also analyzed. Results: Fifty-seven potential modes and effects were identified and classified into ‘treatment cancellation’ and ‘delivering an unintended dose’. They were graded from ‘inconvenience’ or ‘suboptimal treatment’ to ‘total cancellation’ or ‘potentially wrong’ or ‘very wrong administered dose’, although these latter effects were never experienced. Risk priority numbers (RPNs) ranged from 3 to 324 and totaled 4804. After interventions such as double checking, interlocking, automation, and structural changes the final total RPN was reduced to 1320. Conclusions: FMEA is crucial for prioritizing risk-reduction interventions. In a semi-surgical procedure like IOERT double checking has the potential to reduce risk and improve quality. Interlocks and automation should also be implemented to increase the safety of the procedure

  3. Concepts of radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Mackie, R.T.

    2000-01-01

    Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission tomographic (PET) imaging is beginning to be used to determine tumor proliferation and the presence of distant disease. It is likely that accurate RTP in conjunction with CT simulators will eliminate traditional treatment simulators in the future. Traditionally, patient dose calculation algorithms have been based on correcting measured dose in water phantoms to take into account beam modifiers, patient surface contours and internal tissue inhomogeneities. Recently, model-based algorithms have been computing the dose directly in the patient representation using the CT to obtain a voxel-by-voxel density map. The convolution/superposition method, which uses a Monte Carlo-derived transport kernel, is the current state-of-the-art algorithm for dose computation. Soon direct Monte Carlo simulation will be used in model-based dose computation. Model-based dose computations enable a simpler monitor unit calculation formulation. The other major breakthrough in RTP is computer-based optimization. The goals of the treatment are specified as

  4. 1994 INEL site-specific plan

    Energy Technology Data Exchange (ETDEWEB)

    Couch, B.

    1994-05-01

    This report presents plans for environmental restoration and waste management activities at the Idaho National Engineering Laboratory for fiscal year 1994. This years`s plan focuses on issues affecting the Environmental Restoration and Waste Management Programs. The Environmental Restoration Program is concerned with all aspects of assessment and cleanup of inactive operations. It involves assessing and cleaning up (where necessary) inactive INEL waste areas that could release harmful substances into the environment, as well as safely managing surplus nuclear facilities. The Waste Management program involves treatment, storage, and disposal of radioactive, hazardous, mixed, and industrial waste by DOE activities. This program is designed to protect the safety of INEL employees, the public, and the environment in the design, construction, maintenance, and operation of INEL treatment, storage, and disposal facilities. It operates facilities in a cost-effective, environmentally sound, regulatory compliant, and publicly acceptable manner.

  5. 1994 INEL site-specific plan

    International Nuclear Information System (INIS)

    Couch, B.

    1994-01-01

    This report presents plans for environmental restoration and waste management activities at the Idaho National Engineering Laboratory for fiscal year 1994. This years's plan focuses on issues affecting the Environmental Restoration and Waste Management Programs. The Environmental Restoration Program is concerned with all aspects of assessment and cleanup of inactive operations. It involves assessing and cleaning up (where necessary) inactive INEL waste areas that could release harmful substances into the environment, as well as safely managing surplus nuclear facilities. The Waste Management program involves treatment, storage, and disposal of radioactive, hazardous, mixed, and industrial waste by DOE activities. This program is designed to protect the safety of INEL employees, the public, and the environment in the design, construction, maintenance, and operation of INEL treatment, storage, and disposal facilities. It operates facilities in a cost-effective, environmentally sound, regulatory compliant, and publicly acceptable manner

  6. 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...

  7. 100 Areas water treatment specifications

    Energy Technology Data Exchange (ETDEWEB)

    Greninger, A.B.

    1952-07-11

    This memorandum discussed review of the data from tests using alum in the treatment of pile process water, and using activated silica as a coagulant aid during period of low water temperature, which shows that this method should be substituted for the present method of treating pile process water in all 100 Areas. It was recommended that the water treatment procedures and specifications attached to this memorandum be initiated as standard practice in all 100 Areas as soon as it is possible to make the necessary equipment modifications and installations.

  8. 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

  9. Planning, optimisation and evaluation of hyperthermia treatments

    NARCIS (Netherlands)

    Kok, H. P.; Kotte, A. N. T. J.; Crezee, J.

    2017-01-01

    Background: Hyperthermia treatment planning using dedicated simulations of power and temperature distributions is very useful to assist in hyperthermia applications. This paper describes an advanced treatment planning software package for a wide variety of applications. Methods: The in-house

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-10-29

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

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

    International Nuclear Information System (INIS)

    1993-01-01

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

  12. Treatment planning with ion beams

    International Nuclear Information System (INIS)

    Foss, M.H.

    1985-01-01

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

  13. Computer-assisted treatment planning and analysis.

    Science.gov (United States)

    Beers, A C; Choi, W; Pavlovskaia, E

    2003-01-01

    The Invisalign orthodontic system (Align Technology, Inc, Santa Clara, CA) is a series of clear removable appliances that is worn by a patient to correct malocclusions. Introduced in 1999, it has been applied to successfully correct an increasingly wide variety of malocclusions. Part of the success of the system is because of the innovative technologies inherent in the design of the appliances. During the development of the system, many challenges and issues needed to be overcome to realize the product. Many of these issues were not specific to Invisalign, and represented general problems in the area of computer-aided orthodontics. The general problems of developing a virtual model of a patient's dentition appropriate for use in orthodontics, performing a treatment plan on a virtual dentition model, and analyzing how accurately the virtual treatment plan executed in the patient's mouth are presented.

  14. Business System Planning Project System Requirements Specification

    Energy Technology Data Exchange (ETDEWEB)

    NELSON, R.E.

    2000-09-08

    The purpose of the Business Systems Planning Project System Requirements Specification (SRS) is to provide the outline and contents of the requirements for the CH2M HILL Hanford Group, Inc. (CHG) integrated business and technical information systems. The SRS will translate proposed objectives into the statement of the functions that are to be performed and data and information flows that they require. The requirements gathering methodology will use (1) facilitated group requirement sessions; (2) individual interviews; (3) surveys; and (4) document reviews. The requirements will be verified and validated through coordination of the technical requirement team and CHG Managers. The SRS document used the content and format specified in Lockheed Martin Services, Inc. Organization Standard Software Practices in conjunction with the Institute of Electrical and Electronics Engineers Standard 8340-1984 for Systems Requirements Documents.

  15. Pediatric radiotherapy planning and treatment

    CERN Document Server

    Olch, Arthur J

    2013-01-01

    "This is a very well-written and -organized book covering the planning and delivery aspects unique to pediatric radiotherapy. The author is a respected and well-known medical physicist with extensive pediatric radiotherapy experience. … a very useful book for any clinical physicist treating pediatric cases and seeking contextual and historical perspective. … a great reference for medical physicists who may not see many pediatric cases and can look to this text as a one-stop shop for not only a comprehensive overview, but detailed explanation for specific pediatric disease sites. Overall, it is a great addition to the reference library of any radiation therapy physicist."-Medical Physics, April 2014.

  16. 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...

  17. Treatment planning optimisation in proton therapy

    Science.gov (United States)

    McGowan, S E; Burnet, N G; Lomax, A J

    2013-01-01

    ABSTRACT. The goal of radiotherapy is to achieve uniform target coverage while sparing normal tissue. In proton therapy, the same sources of geometric uncertainty are present as in conventional radiotherapy. However, an important and fundamental difference in proton therapy is that protons have a finite range, highly dependent on the electron density of the material they are traversing, resulting in a steep dose gradient at the distal edge of the Bragg peak. Therefore, an accurate knowledge of the sources and magnitudes of the uncertainties affecting the proton range is essential for producing plans which are robust to these uncertainties. This review describes the current knowledge of the geometric uncertainties and discusses their impact on proton dose plans. The need for patient-specific validation is essential and in cases of complex intensity-modulated proton therapy plans the use of a planning target volume (PTV) may fail to ensure coverage of the target. In cases where a PTV cannot be used, other methods of quantifying plan quality have been investigated. A promising option is to incorporate uncertainties directly into the optimisation algorithm. A further development is the inclusion of robustness into a multicriteria optimisation framework, allowing a multi-objective Pareto optimisation function to balance robustness and conformity. The question remains as to whether adaptive therapy can become an integral part of a proton therapy, to allow re-optimisation during the course of a patient's treatment. The challenge of ensuring that plans are robust to range uncertainties in proton therapy remains, although these methods can provide practical solutions. PMID:23255545

  18. 7 CFR 1724.53 - Preparation of plans and specifications.

    Science.gov (United States)

    2010-01-01

    ..., including: (A) A plot plan showing the location of the proposed building plus paving and site development... 7 Agriculture 11 2010-01-01 2010-01-01 false Preparation of plans and specifications. 1724.53... PROCEDURES Electric System Design § 1724.53 Preparation of plans and specifications. The provisions of this...

  19. 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.

  20. Project Specific Quality Assurance Plan (QAPP)

    International Nuclear Information System (INIS)

    Huston, J.J.

    1994-11-01

    The Project QAPP's describe the program and the planned actions which WHC will implement to demonstrate and ensure that the project meets the requirements of DOE Order 5700.6C. The Project involves retrieving the high-heat waste from Tank 241-C-106 to close the safety issue associate with the tank, demonstrate initial waste retrieval technology for a Single Shell Tank, and provide feed for the Hanford Waste Vitrification Plant

  1. 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.

  2. 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

  3. Implant treatment planning: endodontic considerations.

    Science.gov (United States)

    Simonian, Krikor; Frydman, Alon; Verdugo, Fernando; Roges, Rafael; Kar, Kian

    2014-12-01

    Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible.

  4. Training Psychotherapists in Hierarchical Treatment Planning

    OpenAIRE

    MAKOVER, RICHARD B.

    1992-01-01

    Treatment planning is a central and persistent challenge in psychotherapy. This paper outlines a four-level planning hierarchy that encourages the therapist to conceptualize a desired overall outcome (the "aim") that can be realized through subsidiary objectives (the "goals"). The "strategies" by which goals are pursued and the "tactics" that carry out those strategies are subordinate and instrumental elements of the treatment process. Greater emphasis on this type of ...

  5. 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

  6. 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

  7. Emergency Planning for Municipal Wastewater Treatment Facilities.

    Science.gov (United States)

    Lemon, R. A.; And Others

    This manual for the development of emergency operating plans for municipal wastewater treatment systems was compiled using information provided by over two hundred municipal treatment systems. It covers emergencies caused by natural disasters, civil disorders and strikes, faulty maintenance, negligent operation, and accidents. The effects of such…

  8. Accuracy requirements in radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Buzdar, S. A.; Afzal, M.; Nazir, A.; Gadhi, M. A.

    2013-01-01

    Radiation therapy attempts to deliver ionizing radiation to the tumour and can improve the survival chances and/or quality of life of patients. There are chances of errors and uncertainties in the entire process of radiotherapy that may affect the accuracy and precision of treatment management and decrease degree of conformation. All expected inaccuracies, like radiation dose determination, volume calculation, complete evaluation of the full extent of the tumour, biological behaviour of specific tumour types, organ motion during radiotherapy, imaging, biological/molecular uncertainties, sub-clinical diseases, microscopic spread of the disease, uncertainty in normal tissue responses and radiation morbidity need sound appreciation. Conformity can be increased by reduction of such inaccuracies. With the yearly increase in computing speed and advancement in other technologies the future will provide the opportunity to optimize a greater number of variables and reduce the errors in the treatment planning process. In multi-disciplined task of radiotherapy, efforts are needed to overcome the errors and uncertainty, not only by the physicists but also by radiologists, pathologists and oncologists to reduce molecular and biological uncertainties. The radiation therapy physics is advancing towards an optimal goal that is definitely to improve accuracy where necessary and to reduce uncertainty where possible. (author)

  9. [Planning guidelines for prosthodontic treatment].

    Science.gov (United States)

    Shiga, Hiroshi; Terada, Yoshihiro; Shinya, Akiyoshi; Ikebe, Kazunori; Tamazawa, Yoshinori; Nagadome, Hatsumi; Akagawa, Yasumasa

    2008-01-01

    In recent years "practice guidelines" based on EBM techniques have even been attracting attention at a societal level, and guidelines modeled after the procedure for preparing practice guideline (described at http://www.niph.go.jp/glgl-4.3rev.htm) have begun to be drafted and made public. With the aim of ensuring the quality and presenting the basic concepts of prosthodontic therapy, the Japan Prosthodontic Society, which bears a great obligation and responsibility toward society and the Japanese public, has decided to undertake the formulation of guidelines related to prosthodontic therapy, and decided to first undertake the formulation of "Practice guideline for denture relining and rebasing", and to prepare a guideline model. We tried to prepare the guidelines according to the "Procedure for preparing practice guidelines", but because of the scientific uniqueness of prosthodontic treatment and dentistry, research to elucidate the basis of treatment has been insufficient, and we ultimately reconfirmed the current state of affairs in which it is difficult to perform. We therefore prepared the guidelines based on the limited evidence obtained in a search of the scientific literature and on the consensus of experts. The Japan Prosthodontic Society has investigated and prepared a Society guideline "model" to the extent possible at the present time, and it has prepared "Guidelines for adhesion bridge" and "Practice guidelines for denture prosthodontics" based on it. Nevertheless, the fact of the matter is that we are faced with numerous problems, and we think that in the future new bases and clinical knowledge will be accumulated by promoting scientific clinical research, and that the guidelines should be revised regularly based on them.

  10. Tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1985-10-01

    Data for the tolerance of normal tissues or organs to (low-LET) radiation has been compiled from a number of sources which are referenced at the end of this document. This tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD 5 ) or 50% (TD 50 ) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represents doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same endpoint. The data from some sources shows a tendancy to be quantized in 5 Gy increments. This reflects the size of possible round off errors. It is believed that all these data have been accumulated without the benefit of 3-D dose distributions and therefore the estimates of the size of the volume and/or the uniformity of the irradiation may be less accurate than is now possible. 19 refs., 4 figs

  11. Tolerance doses for treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Lyman, J.T.

    1985-10-01

    Data for the tolerance of normal tissues or organs to (low-LET) radiation has been compiled from a number of sources which are referenced at the end of this document. This tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD/sub 5/) or 50% (TD/sub 50/) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represents doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same endpoint. The data from some sources shows a tendancy to be quantized in 5 Gy increments. This reflects the size of possible round off errors. It is believed that all these data have been accumulated without the benefit of 3-D dose distributions and therefore the estimates of the size of the volume and/or the uniformity of the irradiation may be less accurate than is now possible. 19 refs., 4 figs.

  12. 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

  13. 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

  14. Pinellas Plant FY1990 site specific implementation plan

    International Nuclear Information System (INIS)

    Klein, R.D.

    1990-02-01

    This Site Specific Implementation Plan describes the Corrective Action, Environmental Restoration, and Waste Management activities to be performed at the Pinellas Plant in FY1990 (October 1, 1989 to September 30, 1989). These FY1990 activities are described in the Pinellas Plant FY1991--95 Five-Year Plan. The information used to prepare this plan reflects the best estimate of the project scope, schedules, regulatory, and funding requirements at the time of plan preparation. The Environmental Restoration/Waste Management Five-Year Plan is a dynamic document and will be modified each year; the Site Specific Implementation Plan will, in turn, be modified each year to reflect new findings, information, and knowledge of the various projects. 4 figs., 11 tabs

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

    International Nuclear Information System (INIS)

    Nigg, David Waler

    2003-01-01

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

  16. The evolution of brachytherapy treatment planning

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  17. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    D`Amelio, J.

    1994-08-30

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

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

    International Nuclear Information System (INIS)

    D'Amelio, J.

    1994-01-01

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

  20. Radiotherapy treatment planning linear-quadratic radiobiology

    CERN Document Server

    Chapman, J Donald

    2015-01-01

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

  1. Savannah River Site's Site Specific Plan

    Energy Technology Data Exchange (ETDEWEB)

    1991-08-01

    This Site Specific Plan (SSP) has been prepared by the Savannah River Site (SRS) in order to show the Environmental Restoration and Waste Management activities that were identified during the preparation of the Department of Energy-Headquarters (DOE-HQ) Environmental Restoration and Waste Management Five-Year Plan (FYP) for FY 1992--1996. The SSP has been prepared in accordance with guidance received from DOE-HQ. DOE-SR is accountable to DOE-HQ for the implementation of this plan. The purpose of the SSP is to develop a baseline for policy, budget, and schedules for the DOE Environmental Restoration and Waste Management activities. The plan explains accomplishments since the Fiscal Year (FY) 1990 plan, demonstrates how present and future activities are prioritized, identifies currently funded activities and activities that are planned to be funded in the upcoming fiscal year, and describes future activities that SRS is considering.

  2. Dosimetry treatment planning with uncertainty evaluation

    International Nuclear Information System (INIS)

    Henriquez, Francisco Cutanda; Castrillyn, Silvia Vargas

    2010-01-01

    Treatment planning results can be presented as a dosimetry report, consisting of a number of images, curves, indices, etc. and in a prescription for the delivery of the planned treatment. A complex decision process is needed in order to decide which the optimal plan is. Since this decision is based on dose computations with their associated uncertainty, a modern treatment planning process has to deal with the effects of uncertainty to achieve maximum accuracy. Several tools are presented allowing the user to work with uncertainty. Modified dose volume histograms can help evaluate competing plans so that a proper hierarchy can be established amongst different goals. Material/Methods: A central estimate of a dose volume histogram curve and two limit curves define an 'indifference' band in the dose volume plane. Every plan within this band can be considered not better than the initial one, because uncertainty does not allow telling them apart. If a DVH goal is met within the indifference band, the user can aim to improve a different goal. Results: The methods proposed in this work are easily introduced in clinical practice. They are compatible with an iterative optimization process adding few steps to the computation. Conclusion: Accuracy requirements in radiation therapy keep on increasing, while accuracy in dose measurement or modeling is only moderately improving. Although it is a minor part in the overall uncertainty budget for the treatment, computation uncertainty affects decision making. Our method help make decisions with a maximum of information. This novel method can also provide quantitative measures of the probability of achieving the goals.(Author)

  3. A study of planning dose constraints for treatment of nasopharyngeal carcinoma using a commercial inverse treatment planning system.

    Science.gov (United States)

    Xia, Ping; Lee, Nancy; Liu, Yu-Ming; Poon, Ian; Weinberg, Vivian; Shin, Edward; Quivey, Jeanne M; Verhey, Lynn J

    2004-07-01

    The purpose of this study was to develop and test planning dose constraint templates for tumor and normal structures in the treatment of nasopharyngeal carcinoma (NPC) using a specific commercial inverse treatment planning system. Planning dose constraint templates were developed based on the analyses of dose-volume histograms (DVHs) of tumor targets and adjacent sensitive structures by clinically approved treatment plans of 9 T1-2 and 16 T3-4 NPC patients treated with inverse planned intensity-modulated radiation therapy (IP-IMRT). DVHs of sensitive structures were analyzed by examining multiple defined endpoints, based on the characteristics of each sensitive structure. For each subgroup of patients with T1-2 and T3-4 NPC, the resulting mean values of these defined endpoint doses were considered as templates for planning dose constraints and subsequently applied to a second group of patients, 5 with T1-2 NPC and 5 with T3-4 NPC. The 10 regenerated plans (called new plans) were compared to the original clinical plans that were used to treat the second group of patients, based on plan conformity index and DVHs. The conformity indices of the new plans were comparable to the original plans with no statistical difference (p = 0.85). Among the serial sensitive structures evaluated, there was a significant decrease with the new plans in the dose to the spinal cord when analyzed by the maximum dose (p = 0.001), doses encompassing 1 cc of the spinal cord volume (p = 0.001) and 3 cc of the spinal cord volume (p = 0.001). There was no significant difference in the mean maximum dose to the brainstem between the new plans and the original plans (p = 0.36). However, a significant difference in the mean maximum dose to the brainstem was seen among the different T-stages (p = 0.04). A decrease with the new plan to the brainstem in the doses encompassing 5% and 10% of the volume was of borderline statistical significance (p = 0.08 and p = 0.06, respectively). There were no

  4. Automated radiotherapy treatment plan integrity verification

    International Nuclear Information System (INIS)

    Yang Deshan; Moore, Kevin L.

    2012-01-01

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

  5. Planning is not sufficient - Reliable computers need good requirements specifications

    International Nuclear Information System (INIS)

    Matras, J.R.

    1992-01-01

    Computer system reliability is the assurance that a computer system will perform its functions when required to do so. To ensure such reliability, it is important to plan the activities needed for computer system development. These development activities, in turn, require a Computer Quality Assurance Plan (CQAP) that provides the following: a Configuration Management Plan, a Verification and Validation (V and V) Plan, documentation requirements, a defined life cycle, review requirements, and organizational responsibilities. These items are necessary for system reliability; ultimately, however, they are not enough. Development of a reliable system is dependent on the requirements specification. This paper discusses how to use existing industry standards to develop a CQAP. In particular, the paper emphasizes the importance of the requirements specification and of methods for establishing reliability goals. The paper also describes how the revision of ANSI/IEE-ANS-7-4.3.2, Application Criteria for Digital Computer Systems of Nuclear Power Generating Stations, has addressed these issues

  6. Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer.

    Science.gov (United States)

    Hansen, Christian Rønn; Nielsen, Morten; Bertelsen, Anders Smedegaard; Hazell, Irene; Holtved, Eva; Zukauskaite, Ruta; Bjerregaard, Jon Kroll; Brink, Carsten; Bernchou, Uffe

    2017-11-01

    The quality of radiotherapy planning has improved substantially in the last decade with the introduction of intensity modulated radiotherapy. The purpose of this study was to analyze the plan quality and efficacy of automatically (AU) generated VMAT plans for inoperable esophageal cancer patients. Thirty-two consecutive inoperable patients with esophageal cancer originally treated with manually (MA) generated volumetric modulated arc therapy (VMAT) plans were retrospectively replanned using an auto-planning engine. All plans were optimized with one full 6MV VMAT arc giving 60 Gy to the primary target and 50 Gy to the elective target. The planning techniques were blinded before clinical evaluation by three specialized oncologists. To supplement the clinical evaluation, the optimization time for the AU plan was recorded along with DVH parameters for all plans. Upon clinical evaluation, the AU plan was preferred for 31/32 patients, and for one patient, there was no difference in the plans. In terms of DVH parameters, similar target coverage was obtained between the two planning methods. The mean dose for the spinal cord increased by 1.8 Gy using AU (p = .002), whereas the mean lung dose decreased by 1.9 Gy (p plans were more modulated as seen by the increase of 12% in mean MUs (p = .001). The median optimization time for AU plans was 117 min. The AU plans were in general preferred and showed a lower mean dose to the lungs. The automation of the planning process generated esophageal cancer treatment plans quickly and with high quality.

  7. Treatment of specific phobia in older adults

    Directory of Open Access Journals (Sweden)

    Nancy A Pachana

    2007-10-01

    Full Text Available Nancy A Pachana1, Rana M Woodward1, Gerard JA Byrne21School of Psychology, University of Queensland, Brisbane, Australia 2School of Medicine, University of Queensland, Brisbane, AustraliaAbstract: Phobias are common in later life, yet treatment research in this population remains scant. The efficacy of exposure therapy, in combination with other Cognitive-Behavioral Therapy (CBT components, in the treatment of specific phobia with a middle and older aged sample was examined. Sixteen adults aged 45–68 with DSM-IV diagnosis of a specific phobia received a manualized intervention over ten weeks, and were compared with a control group. Results indicated significant time effects in the treatment group for the primary outcome variables of phobic severity and avoidance as well as secondary outcome variables including depression and anxiety. Symptom presence and severity also significantly declined in the treatment group. No significant changes in state anxiety were noted across the treatment period. Such results provide support for the efficacy of exposure combined with CBT treatment for specific phobia in middle to older aged adults.Keywords: anxiety, phobia, older adults, cognitive behavioral therapy

  8. Knowledge-based IMRT planning for individual liver cancer patients using a novel specific model.

    Science.gov (United States)

    Yu, Gang; Li, Yang; Feng, Ziwei; Tao, Cheng; Yu, Zuyi; Li, Baosheng; Li, Dengwang

    2018-03-27

    The purpose of this work is to benchmark RapidPlan against clinical plans for liver Intensity-modulated radiotherapy (IMRT) treatment of patients with special anatomical characteristics, and to investigate the prediction capability of the general model (Model-G) versus our specific model (Model-S). A library consisting of 60 liver cancer patients with IMRT planning was used to set up two models (Model-S, Model-G), using the RapidPlan knowledge-based planning system. Model-S consisted of 30 patients with special anatomical characteristics where the distance from planning target volume (PTV) to the right kidney was less than three centimeters and Model-G was configurated using all 60 patients in this library. Knowledge-based IMRT plans were created for the evaluation group formed of 13 patients similar to those included in Model-S by Model-G, Model-S and manually (M), named RPG-plans, RPS-plans and M-plans, respectively. The differences in the dose-volume histograms (DVHs) were compared, not only between RP-plans and their respective M-plans, but also between RPG-plans and RPS-plans. For all 13 patients, RapidPlan could automatically produce clinically acceptable plans. Comparing RP-plans to M-plans, RP-plans improved V 95% of PTV and had greater dose sparing in the right kidney. For the normal liver, RPG-plans delivered similar doses, while RPS-plans delivered a higher dose than M-plans. With respect to RapidPlan models, RPS-plans had better conformity index (CI) values and delivered lower doses to the right kidney V 20Gy and maximizing point doses to spinal cord, while delivering higher doses to the normal liver. The study shows that RapidPlan can create high-quality plans, and our specific model can improve the CI of PTV, resulting in more sparing of OAR in IMRT for individual liver cancer patients.

  9. 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

  10. Collision detection and avoidance during treatment planning

    International Nuclear Information System (INIS)

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

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  12. Automatic liver contouring for radiotherapy treatment planning

    Science.gov (United States)

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

    2015-09-01

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

  13. Electron Density Calibration for Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Herrera-Martinez, F.; Rodriguez-Villafuerte, M.; Martinez-Davalos, A.; Ruiz-Trejo, C.; Celis-Lopez, M. A.; Larraga-Gutierrez, J. M.; Garcia-Garduno, A.

    2006-01-01

    Computed tomography (CT) images are used as basic input data for most modern radiosurgery treatment planning systems (TPS). CT data not only provide anatomic information to delineate target volumes, but also allow the introduction of corrections for tissue inhomogeneities into dose calculations during the treatment planning procedure. These corrections involve the determination of a relationship between tissue electron density (ρe) and their corresponding Hounsfield Units (HU). In this work, an elemental analysis of different commercial tissue equivalent materials using Scanning Electron Microscopy was carried out to characterize their chemical composition. The tissue equivalent materials were chosen to ensure a large range of ρe to be included in the CT scanner calibration. A phantom was designed and constructed with these materials to simulate the size of a human head

  14. 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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  16. Real-time interactive treatment planning

    International Nuclear Information System (INIS)

    Otto, Karl

    2014-01-01

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

  17. Conventional treatment planning optimization using simulated annealing

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  18. Beam-specific planning volumes for scattered-proton lung radiotherapy

    Science.gov (United States)

    Flampouri, S.; Hoppe, B. S.; Slopsema, R. L.; Li, Z.

    2014-08-01

    This work describes the clinical implementation of a beam-specific planning treatment volume (bsPTV) calculation for lung cancer proton therapy and its integration into the treatment planning process. Uncertainties incorporated in the calculation of the bsPTV included setup errors, machine delivery variability, breathing effects, inherent proton range uncertainties and combinations of the above. Margins were added for translational and rotational setup errors and breathing motion variability during the course of treatment as well as for their effect on proton range of each treatment field. The effect of breathing motion and deformation on the proton range was calculated from 4D computed tomography data. Range uncertainties were considered taking into account the individual voxel HU uncertainty along each proton beamlet. Beam-specific treatment volumes generated for 12 patients were used: a) as planning targets, b) for routine plan evaluation, c) to aid beam angle selection and d) to create beam-specific margins for organs at risk to insure sparing. The alternative planning technique based on the bsPTVs produced similar target coverage as the conventional proton plans while better sparing the surrounding tissues. Conventional proton plans were evaluated by comparing the dose distributions per beam with the corresponding bsPTV. The bsPTV volume as a function of beam angle revealed some unexpected sources of uncertainty and could help the planner choose more robust beams. Beam-specific planning volume for the spinal cord was used for dose distribution shaping to ensure organ sparing laterally and distally to the beam.

  19. Strategic planning of treatment for hyperthyroid disease

    International Nuclear Information System (INIS)

    Hoeffer, R.

    1994-01-01

    Strategic planning of treatment of hyperthyroid disease must correspond to the pathophysiological mechanism of elevation of thyroid hormone serum concentration, i.e. excess stimulation, autonomous thyroid function, destruction induced hyperthyoroxinemia. In cases of excess stimulation one should go to extremes to save the essentially 'normal' thyroid gland and life-long antithyroid drug treatment confronts with total ablation of the thyroid gland in non remitting disease. Size and quantity of regions of autonomously functioning follicles/cells will be the determinant of therapeutic strategy in cases of autonomous thyroid function. Selective surgery confronts with radioiodine treatment aiming at 'restitutio ad integrum'. In destruction induced hyperthyroxinemia antiintlammatory and symptomatic measures may help to bridge the time to the return of normal hormone concentrations. Based on these considerations a detailed therapeutic strategy for hyperthyroid disease can be designed. (author)

  20. 3-D CT for cardiovascular treatment planning

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  1. Intracavitary radiation treatment planning and dose evaluation

    International Nuclear Information System (INIS)

    Anderson, L.L.; Masterson, M.E.; Nori, D.

    1987-01-01

    Intracavitary radiation therapy with encapsulated radionuclide sources has generally involved, since the advent of afterloading techniques, inserting the sources in tubing previously positioned within a body cavity near the region to be treated. Because of the constraints on source locations relative to the target region, the functions of treatment planning and dose evaluation, usually clearly separable in interstitial brachytherapy, tend to merge in intracavitary therapy. Dose evaluation is typically performed for multiple source-strength configurations in the process of planning and thus may be regarded as complete when a particular configuration has been selected. The input data for each dose evaluation, of course, must include reliable dose distribution information for the source-applicator combinations used. Ultimately, the goal is to discover the source-strength configuration that results in the closest possible approach to the dose distribution desired

  2. Current status of quality assurance of treatment planning systems

    International Nuclear Information System (INIS)

    Mijnheer, B.J.

    1997-01-01

    A review is given of the current status of quality assurance of treatment planning systems. At this moment only one comprehensive report is available. In order to review national activities a questionnaire has been distributed amongst national societies of medical physicists. From the 23 responding countries, 8 indicated that only limited efforts are underway, 8 answered that a working group is evaluating their specific national requirements while in 5 countries a document is drafted. The highlights of these reports have been summarized. (author)

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

    Science.gov (United States)

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

    2013-12-21

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  6. 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.

  7. Treatment Plan Adherence for Your Child With JA

    Science.gov (United States)

    ... or her treatment plan with the best of intentions. Anxious for their child with juvenile arthritis to ... or her treatment plan with the best of intentions. Anxious for their child with juvenile arthritis to ...

  8. 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...

  9. Audel carpenter's and builder's math, plans, and specifications

    CERN Document Server

    Miller, Mark Richard

    2005-01-01

    You can count on a good planA successful building or remodeling job requires not only a plan, but also the skill to interpret it and an understanding of the mathematics behind it. Whether you are a builder by trade or a do-it-yourself carpenter by choice, turn to this newly updated guide for easy explanations of the math involved and clear instructions on developing and using the necessary plans and specifications.* Explore the different types of wood products and learn what is best for your purpose* Choose appropriate building materials for weather and other natural factors* Refresh your knowledge of fractions, ratios, geometry, and measurement* Understand how to use basic surveying tools* Become familiar with the design process and recognize various styles of architecture* Learn to read architectural drawings and work with computer design

  10. 49: 3-D treatment planning. 3

    International Nuclear Information System (INIS)

    Fraass, B.A.; McShan, D.L.; Weeks, K.J.

    1987-01-01

    For practical 3-D treatment planning, one of the most important perspectives to be used is the 'beam's-eye-view' (BEV), since it displays the relationship of the target volume with the proposed radiation beams. Several BEV features comprise the 3-D planning system U-MPlan, including BEV displays which include contour and shaded solid surfaces of defined anatomy, block entry using joystick and digitizer tablet, automatic block and multi-leaf collimator design, output of block coordinates to hard copy devices, direct output to a computer-controlled block and compensator cutter, use of video digitized radiographs as a backdrop for the BEV graphics, image analysis of digitized films, complete image correlation between BEV-type imaging and CT, MR, PET, etc., and a photon dose calculation algorithm which makes accurate and fast calculations in BEV planes and under blocks. The correlation and use of radiographs and other BEV-type images with CT-type information allows a new degree of precision to be incorporated into radiation therapy planning. 9 refs.; 3 figs

  11. Volume definition system for treatment planning

    International Nuclear Information System (INIS)

    Alakuijala, Jyrki; Pekkarinen, Ari; Puurunen, Harri

    1997-01-01

    Purpose: Volume definition is a difficult and time consuming task in 3D treatment planning. We have studied a systems approach for constructing an efficient and reliable set of tools for volume definition. Our intent is to automate body outline, air cavities and bone volume definition and accelerate definition of other anatomical structures. An additional focus is on assisting in definition of CTV and PTV. The primary goals of this work are to cut down the time used in contouring and to improve the accuracy of volume definition. Methods: We used the following tool categories: manual, semi-automatic, automatic, structure management, target volume definition, and visualization tools. The manual tools include mouse contouring tools with contour editing possibilities and painting tools with a scaleable circular brush and an intelligent brush. The intelligent brush adapts its shape to CT value boundaries. The semi-automatic tools consist of edge point chaining, classical 3D region growing of single segment and competitive volume growing of multiple segments. We tuned the volume growing function to take into account both local and global region image values, local volume homogeneity, and distance. Heuristic seeding followed with competitive volume growing finds the body outline, couch and air automatically. The structure management tool stores ICD-O coded structures in a database. The codes have predefined volume growing parameters and thus are able to accommodate the volume growing dissimilarity function for different volume types. The target definition tools include elliptical 3D automargin for CTV to PTV transformation and target volume interpolation and extrapolation by distance transform. Both the CTV and the PTV can overlap with anatomical structures. Visualization tools show the volumes as contours or color wash overlaid on an image and displays voxel rendering or translucent triangle mesh rendering in 3D. Results: The competitive volume growing speeds up the

  12. Recovery post treatment: plans, barriers and motivators

    Directory of Open Access Journals (Sweden)

    Duffy Paul

    2013-01-01

    Full Text Available Abstract Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital or facilitators of (presence of capital sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and

  13. Constrained treatment planning using sequential beam selection

    International Nuclear Information System (INIS)

    Woudstra, E.; Storchi, P.R.M.

    2000-01-01

    In this paper an algorithm is described for automated treatment plan generation. The algorithm aims at delivery of the prescribed dose to the target volume without violation of constraints for target, organs at risk and the surrounding normal tissue. Pre-calculated dose distributions for all candidate orientations are used as input. Treatment beams are selected in a sequential way. A score function designed for beam selection is used for the simultaneous selection of beam orientations and weights. In order to determine the optimum choice for the orientation and the corresponding weight of each new beam, the score function is first redefined to account for the dose distribution of the previously selected beams. Addition of more beams to the plan is stopped when the target dose is reached or when no additional dose can be delivered without violating a constraint. In the latter case the score function is modified by importance factor changes to enforce better sparing of the organ with the limiting constraint and the algorithm is run again. (author)

  14. Novel tracer for radiation treatment planning

    International Nuclear Information System (INIS)

    Schwarzenboeck, S.; Krause, B.J.; Herrmann, K.; Gaertner, F.; Souvatzoglou, M.; Klaesner, B.

    2011-01-01

    PET and PET/CT with innovative tracers gain increasing importance in diagnosis and therapy management, and radiation treatment planning in radio-oncology besides the widely established FDG. The introduction of [ 18 F]Fluorothymidine ([ 18 F]FLT) as marker of proliferation, [ 18 F]Fluoromisonidazole ([ 18 F]FMISO) and [ 18 F]Fluoroazomycin-Arabinoside ([ 18 F]FAZA) as tracer of hypoxia, [ 18 F]Fluoroethyltyrosine ([ 18 F]FET) and [ 11 C]Methionine for brain tumour imaging, [ 68 Ga]DOTATOC for somatostatin receptor imaging, [ 18 F]FDOPA for dopamine synthesis and radioactively labeled choline derivatives for imaging phospholipid metabolism have opened novel approaches to tumour imaging. Some of these tracers have already been implemented into radio-oncology: Amino acid PET and PET/CT have the potential to optimise radiation treatment planning of brain tumours through accurate delineation of tumour tissue from normal tissue, necrosis and edema. Hypoxia represents a major therapeutic problem in radiation therapy. Hypoxia imaging is very attractive as it may allow to increase the dose in hypoxic tumours potentially allowing for a better tumour control. Advances in hybrid imaging, i.e. the introduction of MR/PET, may also have an impact in radio-oncology through synergies related to the combination of molecular signals of PET and a high soft tissue contrast of MRI as well as functional MRI capabilities. (orig.)

  15. 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

  16. Conformal three dimensional radiotherapy treatment planning in Lund

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  17. Oral diagnosis and treatment planning: part 6. Preventive and treatment planning for periodontal disease.

    Science.gov (United States)

    Corbet, E; Smales, R

    2012-09-01

    A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.

  18. Hexone Storage and Treatment Facility closure plan

    International Nuclear Information System (INIS)

    1992-11-01

    The HSTF is a storage and treatment unit subject to the requirements for the storage and treatment of dangerous waste. Closure is being conducted under interim status and will be completed pursuant to the requirements of Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and WAC 173-303-640. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. The known hazardous/dangerous waste remaining at the site before commencing other closure activities consists of the still vessels, a tarry sludge in the storage tanks, and residual contamination in equipment, piping, filters, etc. The treatment and removal of waste at the HSTF are closure activities as defined in the Resource Conservation and Recovery Act (RCRA) of 1976 and WAC 173-303

  19. Radiation treatment planning using a microcomputer

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  20. 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

  1. 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

  2. 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

  3. Incorporating model parameter uncertainty into inverse treatment planning

    International Nuclear Information System (INIS)

    Lian Jun; Xing Lei

    2004-01-01

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

  4. A treatment planning classification for oligodontia.

    Science.gov (United States)

    Singer, Steven L; Henry, Patrick J; Lander, Ian D

    2010-01-01

    The aim of this research was to provide a classification for patients with oligodontia that could act as an aid in treatment planning. Panoramic radiograph records of 70 patients with oligodontia were used to categorize the extent of the disability and treatment modality. Patients were classified into types 1 through 3 depending on the number of missing primary and permanent teeth, as well as in relation to their prosthodontic requirements. The radiographs were then assessed independently on two separate occasions by three experienced clinicians to validate the classification. There was a high level of intrarater consistency in allocating patients into the three different types with a Kappa (k) score of 0.77 for clinician 1, 0.87 for clinician 2, and 0.94 for clinician 3. There was also a strong interrater agreement (overall k score: 0.88). A k score greater then 0.6 is regarded as being good and greater than 0.8 as being very good. Oligodontia is a heterogeneous condition. Patients with oligodontia can be classified as having three different types according to the extent of their disability and the complexity of their prosthodontic requirements. This classification is a reliable diagnostic tool based on the positive outcome of the inter- and intrarater consistency.

  5. Volume visualization in radiation treatment planning.

    Science.gov (United States)

    Pelizzari, C A; Chen, G T

    2000-12-01

    Radiation treatment planning (RTP), historically an image-intensive discipline and one of the first areas in which 3D information from imaging was clinically applied, has become even more critically dependent on accurate 3D definition of target and non-target structures in recent years with the advent of conformal radiation therapy. In addition to the interactive display of wireframe or shaded surface models of anatomic objects, proposed radiation beams, beam modifying devices, and calculated dose distributions, recently significant use has been made of direct visualization of relevant anatomy from image data. Dedicated systems are commercially available for the purpose of geometrically optimizing beam placement, implementing in virtual reality the functionality of standard radiation therapy simulators. Such "CT simulation" systems rely heavily on 3D visualization and on reprojection of image data to produce simulated radiographs for comparison with either diagnostic-quality radiographs made on a simulator or megavoltage images made using the therapeutic beams themselves. Although calculation and analysis of dose distributions is an important component of radiation treatment design, geometric targeting with optimization based on 3D anatomic information is frequently performed as a separate step independent of dose calculations.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

    , neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy.

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

    International Nuclear Information System (INIS)

    Olch, A.

    2015-01-01

    , neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy

  8. Radiotherapy Treatment Planning for Testicular Seminoma

    International Nuclear Information System (INIS)

    Wilder, Richard B.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Beard, Clair J.

    2012-01-01

    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 × 1−2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior–posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior–posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

    abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. In the second presentation, specific focus will be on radiation therapy simulation, treatment planning guidelines, image guidance for delivery, and proton therapy for children. We will discuss uniqueness of pediatric simulation with different imaging modalities (CT, MRI, and PET). Some related issues are sedation for younger patients, radiation exposure reduction for CT, distortion and artifacts on pediatric MRI, and measuring pediatric organ motion. We will discuss the tradeoff of tumor coverage and normal tissue sparing in treatment planning using example organ data. Image guidance approaches for pediatric radiation therapy and methods for dose reduction will be reviewed. Finally, we will describe technical advances and trends in proton therapy for children. Advantages, caveats, and opportunities will be presented. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status of state-of-the-art treatment techniques for pediatric radiation therapy.

  10. Design of 4D treatment planning target volumes

    International Nuclear Information System (INIS)

    Rietzel, Eike; Liu, Arthur K. Ph.D.; Doppke, Karen P.; Wolfgang, John A.; Chen, Aileen B.; Chen, George T.Y.; Choi, Noah C.

    2006-01-01

    Purpose: When using non-patient-specific treatment planning margins, respiratory motion may lead to geometric miss of the target while unnecessarily irradiating normal tissue. Imaging different respiratory states of a patient allows patient-specific target design. We used four-dimensional computed tomography (4DCT) to characterize tumor motion and create treatment volumes in 10 patients with lung cancer. These were compared with standard treatment volumes. Methods and Materials: Four-dimensional CT and free breathing helical CT data of 10 patients were acquired. Gross target volumes (GTV) were delineated on the helical scan as well as on each phase of the 4D data. Composite GTVs were defined on 4DCT. Planning target volumes (PTV) including clinical target volume, internal margin (IM), and setup margin were generated. 4DPTVs with different IMs and standard PTVs were compared by computing centroid positions, volumes, volumetric overlap, and bounding boxes. Results: Four-dimensional PTVs and conventional PTVs differed in volume and centroid positions. Overlap between 4DPTVs generated from two extreme tumor positions only compared with 10 respiratory phases was 93.7%. Comparing PTVs with margins of 15 mm (IM 5 mm) on composite 4D target volumes to PTVs with 20 mm (IM 10 mm) on helical CT data resulted in a decrease in target volume sizes by 23% on average. Conclusion: With patient-specific characterization of tumor motion, it should be possible to decrease internal margins. Patient-specific treatment volumes can be generated using extreme tumor positions on 4DCT. To date, more than 150 patients have been treated using 4D target design

  11. Radiation treatment planning techniques for lymphoma of the stomach

    International Nuclear Information System (INIS)

    Della Biancia, Cesar; Hunt, Margie; Furhang, Eli; Wu, Elisa; Yahalom, Joachim

    2005-01-01

    Purpose: Involved-field radiation therapy of the stomach is often used in the curative treatment of gastric lymphoma. Yet, the optimal technique to irradiate the stomach with minimal morbidity has not been well established. This study was designed to evaluate treatment planning alternatives for stomach irradiation, including intensity-modulated radiation therapy (IMRT), to determine which approach resulted in improved dose distribution and to identify patient-specific anatomic factors that might influence a treatment planning choice. Methods and Materials: Fifteen patients with lymphoma of the stomach (14 mucosa-associated lymphoid tissue lymphomas and 1 diffuse large B-cell lymphoma) were categorized into 3 types, depending on the geometric relationship between the planning target volume (PTV) and kidneys. AP/PA and 3D conformal radiation therapy (3DCRT) plans were generated for each patient. IMRT was planned for 4 patients with challenging geometric relationship between the PTV and the kidneys to determine whether it was advantageous to use IMRT. Results: For type I patients (no overlap between PTV and kidneys), there was essentially no benefit from using 3DCRT over AP/PA. However, for patients with PTVs in close proximity to the kidneys (type II) or with high degree of overlap (type III), the 4-field 3DCRT plans were superior, reducing the kidney V 15Gy by approximately 90% for type II and 50% for type III patients. For type III, the use of a 3DCRT plan rather than an AP/PA plan decreased the V 15Gy by approximately 65% for the right kidney and 45% for the left kidney. In the selected cases, IMRT led to a further decrease in left kidney dose as well as in mean liver dose. Conclusions: The geometric relationship between the target and kidneys has a significant impact on the selection of the optimum beam arrangement. Using 4-field 3DCRT markedly decreases the kidney dose. The addition of IMRT led to further incremental improvements in the left kidney and liver

  12. 46 CFR 127.110 - Plans and specifications required for new construction.

    Science.gov (United States)

    2010-10-01

    ... level of crew associated with the engine department, the following plans must be submitted: (1) Plans... 46 Shipping 4 2010-10-01 2010-10-01 false Plans and specifications required for new construction... SUPPLY VESSELS CONSTRUCTION AND ARRANGEMENTS Plan Approval § 127.110 Plans and specifications required...

  13. A practical approach to assess clinical planning tradeoffs in the design of individualized IMRT treatment plans

    International Nuclear Information System (INIS)

    Monshouwer, Rene; Hoffmann, Aswin L.; Kunze-Busch, Martina; Bussink, Johan; Kaanders, Johannes H.A.M.; Huizenga, Henk

    2010-01-01

    Background and purpose: To investigate the tradeoffs between organ at risk sparing and tumour coverage for IMRT treatment of lung tumours, and to develop a tool for clinical use to graphically represent these tradeoffs. Material and methods: For 5 patients with inoperable non-small cell lung cancer (NSCLC) different IMRT plans were generated using a standard TPS. The plans were automatically generated for a range of IMRT settings (weights and dose levels of the objective functions) and were systematically evaluated, focusing on the tradeoffs between organ at risk (OAR) dose and target coverage. A method to analyze and visualize planning tradeoffs was developed and evaluated. Results: Lung and oesophagus were identified as the critical organs at risk for NSCLC, the sparing of which strongly influences PTV coverage. Systematically analyzing the tradeoffs between these organs revealed that the sparing of these organs was approximately linearly related to PTV coverage parameters. Using this property, a tool was developed to graphically present the tradeoffs between the sparing of these organs at risk and the PTV coverage. The tool is an effective method to visualize the tradeoffs. Conclusions: A tool was developed to assist IMRT plan design and selection. The clear presentation of the tradeoffs between OAR dose and coverage facilitates the optimization process and offers additional information to the clinician for a patient specific choice of the optimal IMRT plan.

  14. Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

    Science.gov (United States)

    Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

    2015-06-01

    The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

  15. ACCOUNTING TREATMENTS SPECIFIC TO COUNTERPART COMMERCIAL TRANSACTIONS

    Directory of Open Access Journals (Sweden)

    Lucia PALIU - POPA

    2010-12-01

    Full Text Available Given the lack of availability of funds in foreign currency, felt in many countries, especially in the developing and developed countries and the economic or financial crisis in the global foreign exchange, counterpart commercial transactions were imposed as a “disarming” condition of the international trade. In the counterpart a purchase transaction is combined with a sale transaction, an import with an export in order to ensure balanced trade between the partners, trade that involves eliminating or reducing the currency as a payment source and its replacement with trade of goods and services. Thus, in the context of an acute need to export of greatly industrialized countries, where the overproduction phenomenon tends to have a chronic character, the counterpart has become a highly complex and sustainable phenomenon, which has seen a steady increase in the volume of amounts, with a geographical area and large variety of forms and mechanisms of implementation. Based on the characteristics and structure of counterpart transactions, we shall describe in this paper the accounting models specific to international trade, as part of the combined foreign trade transactions without neglecting the tax treatments that influence the entry in the accounts

  16. 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

  17. Generating patient-specific pulmonary vascular models for surgical planning

    Science.gov (United States)

    Murff, Daniel; Co-Vu, Jennifer; O'Dell, Walter G.

    2015-03-01

    Each year in the U.S., 7.4 million surgical procedures involving the major vessels are performed. Many of our patients require multiple surgeries, and many of the procedures include "surgical exploration". Procedures of this kind come with a significant amount of risk, carrying up to a 17.4% predicted mortality rate. This is especially concerning for our target population of pediatric patients with congenital abnormalities of the heart and major pulmonary vessels. This paper offers a novel approach to surgical planning which includes studying virtual and physical models of pulmonary vasculature of an individual patient before operation obtained from conventional 3D X-ray computed tomography (CT) scans of the chest. These models would provide clinicians with a non-invasive, intricately detailed representation of patient anatomy, and could reduce the need for invasive planning procedures such as exploratory surgery. Researchers involved in the AirPROM project have already demonstrated the utility of virtual and physical models in treatment planning of the airways of the chest. Clinicians have acknowledged the potential benefit from such a technology. A method for creating patient-derived physical models is demonstrated on pulmonary vasculature extracted from a CT scan with contrast of an adult human. Using a modified version of the NIH ImageJ program, a series of image processing functions are used to extract and mathematically reconstruct the vasculature tree structures of interest. An auto-generated STL file is sent to a 3D printer to create a physical model of the major pulmonary vasculature generated from 3D CT scans of patients.

  18. 3-D conformal radiation therapy - Part I: Treatment planning

    International Nuclear Information System (INIS)

    Mageras, Gikas S.

    1996-01-01

    Conformal radiation therapy shapes the high-dose volume so as to conform to the target volume while minamizing the dose to surrounding normal tissues. The advances that have been achieved in conformal therapy are in part due to the development of 3-dimensional 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. The objective of this course is to 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 future trends in 3D treatment planning, such as 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 the treatment planning process

  19. Periodontal risk assessment, diagnosis and treatment planning.

    Science.gov (United States)

    Pihlstrom, B L

    2001-01-01

    The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating

  20. 105: BIODOC - a combined biological treatment planning and treatment organization system

    International Nuclear Information System (INIS)

    Baier, K.

    1987-01-01

    With biological planning in radiotherapy not only planning with regard to the total dose but also the complete consideration of dose-time relationships is understood. A combined biological planning and treatment system based on a DEC PDP 11/23 minicomputer is reported. The main functions are: biological treatment planning, organization of general activities, documentation, archiving and research

  1. 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)

  2. Target volume delineation and treatment planning for particle therapy a practical guide

    CERN Document Server

    Leeman, Jonathan E; Cahlon, Oren; Sine, Kevin; Jiang, Guoliang; Lu, Jiade J; Both, Stefan

    2018-01-01

    This handbook is designed to enable radiation oncologists to treat patients appropriately and confidently by means of particle therapy. The orientation and purpose are entirely practical, in that the focus is on the physics essentials of delivery and treatment planning , illustration of the clinical target volume (CTV) and associated treatment planning for each major malignancy when using particle therapy, proton therapy in particular. Disease-specific chapters provide guidelines and concise knowledge on CTV selection and delineation and identify aspects that require the exercise of caution during treatment planning. The treatment planning techniques unique to proton therapy for each disease site are clearly described, covering beam orientation, matching/patching field techniques, robustness planning, robustness plan evaluation, etc. The published data on the use of particle therapy for a given disease site are also concisely reported. In addition to fully meeting the needs of radiation oncologists, this "kn...

  3. Dosimetry audit of radiotherapy treatment planning systems.

    Science.gov (United States)

    Bulski, Wojciech; Chełmiński, Krzysztof; Rostkowska, Joanna

    2015-07-01

    In radiotherapy Treatment Planning Systems (TPS) various calculation algorithms are used. The accuracy of dose calculations has to be verified. Numerous phantom types, detectors and measurement methodologies are proposed to verify the TPS calculations with dosimetric measurements. A heterogeneous slab phantom has been designed within a Coordinated Research Project (CRP) of the IAEA. The heterogeneous phantom was developed in the frame of the IAEA CRP. The phantom consists of frame slabs made with polystyrene and exchangeable inhomogeneity slabs equivalent to bone or lung tissue. Special inserts allow to position thermoluminescent dosimeters (TLD) capsules within the polystyrene slabs below the bone or lung equivalent slabs and also within the lung equivalent material. Additionally, there are inserts that allow to position films or ionisation chamber in the phantom. Ten Polish radiotherapy centres (of 30 in total) were audited during on-site visits. Six different TPSs and five calculation algorithms were examined in the presence of inhomogeneities. Generally, most of the results from TLD were within 5 % tolerance. Differences between doses calculated by TPSs and measured with TLD did not exceed 4 % for bone and polystyrene equivalent materials. Under the lung equivalent material, on the beam axis the differences were lower than 5 %, whereas inside the lung equivalent material, off the beam axis, in some cases they were of around 7 %. The TLD results were confirmed with the ionisation chamber measurements. The comparison results of the calculations and the measurements allow to detect limitations of TPS calculation algorithms. The audits performed with the use of heterogeneous phantom and TLD seem to be an effective tool for detecting the limitations in the TPS performance or beam configuration errors at audited radiotherapy departments. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Implant Dentistry in General Practice Part 2: Treatment Planning.

    Science.gov (United States)

    Nicholson, Ken

    2016-01-01

    This paper, the second of a series of two, provides an introduction to treatment planning in implant dentistry for the general dental practitioner. Clinical relevance: Appropriate training has made implant placement and restoration a routine treatment option in general practice.

  5. Nevada Test Site, site treatment plan 1999 annual update

    International Nuclear Information System (INIS)

    1999-03-01

    A Site Treatment Plan (STP) is required for facilities at which the US Department of Energy Nevada Operations Office (DOE/NV) generates or stores mixed waste (MW), defined by the Federal Facility Compliance Act (FFC Act) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act (RCRA) and a radioactive material subject to the Atomic Energy Act. This STP was written to identify specific treatment facilities for treating DOE/NV generated MW and provides proposed implementation schedules. This STP was approved by the Nevada Division of Environmental Protection (NDEP) and provided the basis for the negotiation and issuance of the FFC Act Consent Order (CO) dated March 6, 1996, and revised June 15, 1998. The FFC Act CO sets forth stringent regulatory requirements to comply with the implementation of the STP

  6. 2: Local area networks as a multiprocessor treatment planning system

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  7. Nitrate Waste Treatment Sampling and Analysis Plan

    Energy Technology Data Exchange (ETDEWEB)

    Vigil-Holterman, Luciana R. [Los Alamos National Laboratory; Martinez, Patrick Thomas [Los Alamos National Laboratory; Garcia, Terrence Kerwin [Los Alamos National Laboratory

    2017-07-05

    This plan is designed to outline the collection and analysis of nitrate salt-bearing waste samples required by the New Mexico Environment Department- Hazardous Waste Bureau in the Los Alamos National Laboratory (LANL) Hazardous Waste Facility Permit (Permit).

  8. Accuracy of computerized radiation treatment planning

    International Nuclear Information System (INIS)

    Vayrynen, T.; Kiviniitty, K.; Taskinen, P.J.

    1979-01-01

    The accuracy of computerized dose planning depends essentially on the computer program. The quickest and simplest way to assess the accuracy of a commercial program is to compare the results of the computer calculations with measured values. The present report deals with the accuracy of the RADPLAN dose planning in different situations easy to control. The test methods are also applicable to other corresponding systems. (Auth.)

  9. 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

  10. Impact of cone-beam computed tomography on orthodontic diagnosis and treatment planning.

    Science.gov (United States)

    Hodges, Ryan J; Atchison, Kathryn A; White, Stuart C

    2013-05-01

    In this study, we measured the impact of cone-beam computed tomography (CBCT) on orthodontic diagnosis and treatment planning. Participant orthodontists shown traditional orthodontic records for 6 patients were asked to provide a diagnostic problem list, a hypothetical treatment plan, and a clinical certainty. They then evaluated a CBCT scan for each patient and noted any changes, confirmations, or enhancements to their diagnosis and treatment plan. The number of diagnosis and treatment plan changes varied widely by patient characteristics. The most frequently reported diagnosis and treatment plan changes occurred in patients with unerupted teeth, severe root resorption, or severe skeletal discrepancies. We found no benefit in terms of changes in treatment plan for patients when the reason for obtaining a CBCT scan was to examine for abnormalities of the temporomandibular joint or airway, or crowding. Orthodontic participants who own CBCT machines or use CBCT scans frequently in practice reported significantly more diagnosis and treatment plan changes and greater confidence after viewing the CBCT scans during the study. The results of this study support obtaining a CBCT scan before orthodontic diagnosis and treatment planning when a patient has an unerupted tooth with delayed eruption or a questionable location, severe root resorption as diagnosed with a periapical or panoramic radiograph, or a severe skeletal discrepancy. We propose that CBCT scans should be ordered only when there is clear, specific, individual clinical justification. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. 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.

  12. Automated construction of an intraoperative high-dose-rate treatment plan library for the Varian brachytherapy treatment planning system.

    Science.gov (United States)

    Deufel, Christopher L; Furutani, Keith M; Dahl, Robert A; Haddock, Michael G

    2016-01-01

    The ability to create treatment plans for intraoperative high-dose-rate (IOHDR) brachytherapy is limited by lack of imaging and time constraints. An automated method for creation of a library of high-dose-rate brachytherapy plans that can be used with standard planar applicators in the intraoperative setting is highly desirable. Nonnegative least squares algebraic methods were used to identify dwell time values for flat, rectangular planar applicators. The planar applicators ranged in length and width from 2 cm to 25 cm. Plans were optimized to deliver an absorbed dose of 10 Gy to three different depths from the patient surface: 0 cm, 0.5 cm, and 1.0 cm. Software was written to calculate the optimized dwell times and insert dwell times and positions into a .XML plan template that can be imported into the Varian brachytherapy treatment planning system. The user may import the .XML template into the treatment planning system in the intraoperative setting to match the patient applicator size and prescribed treatment depth. A total of 1587 library plans were created for IOHDR brachytherapy. Median plan generation time was approximately 1 minute per plan. Plan dose was typically 100% ± 1% (mean, standard deviation) of the prescribed dose over the entire length and width of the applicator. Plan uniformity was best for prescription depths of 0 cm and 0.5 cm from the patient surface. An IOHDR plan library may be created using automated methods. Thousands of plan templates may be optimized and prepared in a few hours to accommodate different applicator sizes and treatment depths and reduce treatment planning time. The automated method also enforces dwell time symmetry for symmetrical applicator geometries, which simplifies quality assurance. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  13. DEVELOPMENT OF A MULTIMODAL MONTE CARLO BASED TREATMENT PLANNING SYSTEM.

    Science.gov (United States)

    Kumada, Hiroaki; Takada, Kenta; Sakurai, Yoshinori; Suzuki, Minoru; Takata, Takushi; Sakurai, Hideyuki; Matsumura, Akira; Sakae, Takeji

    2017-10-26

    To establish boron neutron capture therapy (BNCT), the University of Tsukuba is developing a treatment device and peripheral devices required in BNCT, such as a treatment planning system. We are developing a new multimodal Monte Carlo based treatment planning system (developing code: Tsukuba Plan). Tsukuba Plan allows for dose estimation in proton therapy, X-ray therapy and heavy ion therapy in addition to BNCT because the system employs PHITS as the Monte Carlo dose calculation engine. Regarding BNCT, several verifications of the system are being carried out for its practical usage. The verification results demonstrate that Tsukuba Plan allows for accurate estimation of thermal neutron flux and gamma-ray dose as fundamental radiations of dosimetry in BNCT. In addition to the practical use of Tsukuba Plan in BNCT, we are investigating its application to other radiation therapies. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Virtual reality image applications for treatment planning in prosthodontic dentistry.

    Science.gov (United States)

    Ogawa, Takumi; Ikawa, Tomoko; Shigeta, Yuko; Kasama, Shintaro; Ando, Eriko; Fukushima, Shunji; Hattori, Asaki; Suzuki, Naoki

    2011-01-01

    For successful occlusal reconstruction, the prosthodontists must take several points into consideration, such as those involving issues with functional and morphological findings and aesthetics. They then must unify this information into a coherent treatment plan. In this present study we focused on prosthodontic treatment and investigated how treatment planning and simulation could be applied to two cases. The personal occlusion condition can be reproduced on the virtual articulator in VR space. In addition, various simulations can be performed that involve prosthetesis design.

  15. Integrated Waste Treatment Unit GFSI Risk Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    W. A. Owca

    2007-06-21

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP).

  16. Integrated Waste Treatment Unit GFSI Risk Management Plan

    International Nuclear Information System (INIS)

    W. A. Owca

    2007-01-01

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

    , neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy.

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

    International Nuclear Information System (INIS)

    Hua, C.

    2015-01-01

    , neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy

  19. Manpower Planning for Wastewater Treatment Plants.

    Science.gov (United States)

    Davies, J. Kenneth; And Others

    This document discusses the components necessary in the development of a forecasting process by which manpower needs can be determined and the development of action programs by which the projected needs may be satisfied. The primary focus of this manual is directed at that person in a state agency who has the responsibility for planning the…

  20. Registration and planning of radiotherapy and proton therapy treatment

    International Nuclear Information System (INIS)

    Bausse, Jerome

    2010-01-01

    Within the frame of an update and renewal project, the Orsay Proton Therapy Centre of the Curie Institute (IPCO) renews its software used for the treatment of patients by proton therapy, a radiotherapy technique which uses proton beams. High energies used in these treatments and the precision provided by proton particle characteristics require a more precise patient positioning than conventional radiotherapy: proton therapy requires a precision of about a millimetre. Thus, markers are placed on the skull which are generally well accepted by patients, but are a problem in the case of paediatric treatment, notably for the youngest children whose skull is still growing. The first objective of this research is thus to use only intrinsic information from X-ray images used when positioning the patient. A second objective is to make the new software (TPS Isogray) perfectly compatible with IPCO requirements by maintaining the strengths of the previous TPS (Treatment Planning System) and being prepared to the implementation of a new installation. After a presentation of the context and state of the art in radiotherapy and patient positioning, the author proposes an overview of 2D registration methods, presents a new method for 2x2D registration, and addresses the problem of 3D registration. Then, after a presentation of proton therapy, the author addresses different specific issues and aspects: the compensator (simulation, calculation, and tests), dose calculation, the 'Pencil-Beam' algorithm, tests, and introduced improvements [fr

  1. Radiographic stents: integrating treatment planning and implant placement.

    Science.gov (United States)

    De Kok, Ingeborg J; Thalji, Ghadeer; Bryington, Matthew; Cooper, Lyndon F

    2014-01-01

    The pivotal point in treatment planning for dental implants occurs when the location of bone is viewed radiographically in the context of the planned prosthesis. Radiographic planning for dental implant therapy should be used only after a review of the patient's systemic health, imaging history, oral health, and local oral conditions. The radiological diagnostic and planning procedure for dental implants can only be fully achieved with the use of a well-designed and -constructed radiographic guide. This article reviews several methods for construction of radiographic guides and how they may be utilized for improving implant surgery planning and performance. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Explainable and Scalable Planning with Probabilistic Temporal Logic Specifications

    Data.gov (United States)

    National Aeronautics and Space Administration — Human spaceflight operations challenge currently available planning technology. They typically rely on a large number of integrated functions including mission...

  3. Adaptive Disclosure: A Combat Specific PTSD Treatment

    Science.gov (United States)

    2017-03-31

    the early stages of the wars suggest that 10-18% of combat troops experience deployment-related psychological health problems, such as posttraumatic...also includes gestalt -therapy techniques designed to target loss and moral injury. In our open pilot trial, we demonstrated treatment acceptability...to determine whether AD is as least as effective as CPT, cognitive only version (CPT-C), in terms of its impact on deployment-related psychological

  4. 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

  5. Automated treatment planning engine for prostate seed implant brachytherapy.

    Science.gov (United States)

    Yu, Y; Zhang, J B; Brasacchio, R A; Okunieff, P G; Rubens, D J; Strang, J G; Soni, A; Messing, E M

    1999-02-01

    To develop a computer-intelligent planning engine for automated treatment planning and optimization of ultrasound- and template-guided prostate seed implants. 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). 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. An automated treatment planning engine incorporating real-time sensitivity analysis was found to be a useful tool in dosimetric planning for prostate brachytherapy.

  6. Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results.

    Science.gov (United States)

    Crowe, S B; Kairn, T; Kenny, J; Knight, R T; Hill, B; Langton, C M; Trapp, J V

    2014-09-01

    The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  8. 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

  9. 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

  10. 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

  11. Planning for the radwaste treatment facility operation

    International Nuclear Information System (INIS)

    Park, H.H.; Han, K.W.; Kim, J.H.

    1985-04-01

    In accordance with treatment of radioactive wastes from normal operation of PIEF and nuclear fuel fabrication facilities, institutions using RI, of spent fuel from nuclear power plants, the operation of RWTF is requested. Therefore the objective is to treat the radioactive wastes safely by the treatment techniques accmulated through research experiences of many years, to minimize the effect to environments and inhabitants, to establish the operation program to perform the facilities management effectively and reasonably. (Author)

  12. Site specific plan. [Environmental Restoration and Waste Management, Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Hutchison, J.; Jernigan, G.

    1989-12-01

    The Environmental Restoration and Waste Management Five-Year Plan (FYP) covers the period for FY 1989 through FY 1995. The plan establishes a Department of Energy -- Headquarters (DOE-HQ) agenda for cleanup and compliance against which overall progress can be measured. The FYP covers three areas: Corrective Activities, Environmental Restoration, and Waste Management Operations. Corrective Activities are those activities necessary to bring active or standby facilities into compliance with local, state, and federal environmental regulations. Environmental restoration activities include the assessment and cleanup of surplus facilities and inactive waste sites. Waste management operations includes the treatment, storage, and disposal of wastes which are generated as a result of ongoing operations. This Site Specific Plan (SSP) has been prepared by the Savannah River Site (SRS) in order to show how environmental restoration and waste management activities that were identified during the preparation of the FYP will be implemented, tracked, and reported. The SSP describes DOE Savannah River (DOE-SR) and operating contractor, Westinghouse Savannah River Company (WSRC), organizations that are responsible, for undertaking the activities identified in this plan. The SSP has been prepared in accordance with guidance received from DOE-HQ. DOE-SR is accountable to DOE-HQ for the implementation of this plan. 8 refs., 46 figs., 23 tabs.

  13. Towards biology-oriented treatment planning in hadrontherapy

    Czech Academy of Sciences Publication Activity Database

    Kundrát, Pavel

    2006-01-01

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

  14. 300 Area waste acid treatment system closure plan. Revision 1

    International Nuclear Information System (INIS)

    1996-03-01

    This section provides a description of the Hanford Site, identifies the proposed method of 300 Area Waste Acid Treatment System (WATS) closure, and briefly summarizes the contents of each chapter of this plan

  15. The influence of cephalometrics on orthodontic treatment planning

    NARCIS (Netherlands)

    Nijkamp, P.G.; Habets, L.L.M.H.; Aartman, I.H.A.; Zentner, A.

    2008-01-01

    SUMMARY Since its introduction, cephalometrics, i.e. cephalometric radiography and analysis, has been used for orthodontic treatment planning. However, the effectiveness of this diagnostic method remains questionable. A randomized crossover study was designed to assess the infl uence of

  16. 300 Area waste acid treatment system closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This section provides a description of the Hanford Site, identifies the proposed method of 300 Area Waste Acid Treatment System (WATS) closure, and briefly summarizes the contents of each chapter of this plan.

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

    Science.gov (United States)

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

    2018-02-18

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

  18. Three-dimensional radiation treatment planning system based on STARDENT super graphic workstation

    International Nuclear Information System (INIS)

    Ayyangar, K.M.; Suntharalingam, Nagaligam; Tupchong, Leslie; Haghbin, Mahroo; Mansfield, C.M.; Yeung, Daniel

    1991-01-01

    In this paper we have demonstrated our 3D treatment planning system developed on a commercial workstation. The system has been in routine use for planning stereotactic brain implants for the last 2 years. Also we have demonstrated a few cases of the application of our 3D planning system for external beams. In future, several patient with specific clinical indication will be designated for planning, using this system. However, in its current state, the system is not ready to replace 2D planning with 3D planning. This is partly due to the inadequacy of the system, but mostly related to the lack of manpower, commitment and inadequacy of proper technology in the treatment machines in our department. (author). 6 refs., 14 figs

  19. Analytical incorporation of fractionation effects in probabilistic treatment planning for intensity-modulated proton therapy.

    Science.gov (United States)

    Wahl, Niklas; Hennig, Philipp; Wieser, Hans-Peter; Bangert, Mark

    2018-04-01

    We show that it is possible to explicitly incorporate fractionation effects into closed-form probabilistic treatment plan analysis and optimization for intensity-modulated proton therapy with analytical probabilistic modeling (APM). We study the impact of different fractionation schemes on the dosimetric uncertainty induced by random and systematic sources of range and setup uncertainty for treatment plans that were optimized with and without consideration of the number of treatment fractions. The APM framework is capable of handling arbitrarily correlated uncertainty models including systematic and random errors in the context of fractionation. On this basis, we construct an analytical dose variance computation pipeline that explicitly considers the number of treatment fractions for uncertainty quantitation and minimization during treatment planning. We evaluate the variance computation model in comparison to random sampling of 100 treatments for conventional and probabilistic treatment plans under different fractionation schemes (1, 5, 30 fractions) for an intracranial, a paraspinal and a prostate case. The impact of neglecting the fractionation scheme during treatment planning is investigated by applying treatment plans that were generated with probabilistic optimization for 1 fraction in a higher number of fractions and comparing them to the probabilistic plans optimized under explicit consideration of the number of fractions. APM enables the construction of an analytical variance computation model for dose uncertainty considering fractionation at negligible computational overhead. It is computationally feasible (a) to simultaneously perform a robustness analysis for all possible fraction numbers and (b) to perform a probabilistic treatment plan optimization for a specific fraction number. The incorporation of fractionation assumptions for robustness analysis exposes a dose to uncertainty trade-off, i.e., the dose in the organs at risk is increased for a

  20. 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.

  1. 3D Image Modelling and Specific Treatments in Orthodontics Domain

    Directory of Open Access Journals (Sweden)

    Dionysis Goularas

    2007-01-01

    Full Text Available In this article, we present a 3D specific dental plaster treatment system for orthodontics. From computer tomography scanner images, we propose first a 3D image modelling and reconstruction method of the Mandible and Maxillary based on an adaptive triangulation allowing management of contours meant for the complex topologies. Secondly, we present two specific treatment methods directly achieved on obtained 3D model allowing the automatic correction for the setting in occlusion of the Mandible and the Maxillary, and the teeth segmentation allowing more specific dental examinations. Finally, these specific treatments are presented via a client/server application with the aim of allowing a telediagnosis and treatment.

  2. 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

  3. THE SPECIFIC ACCOUNTING TREATMENTS REGARDING STOCKS

    Directory of Open Access Journals (Sweden)

    PALIU – POPA LUCIA

    2014-10-01

    Full Text Available The process of harmonization and convergence of IFRS – U.S. GAAP represents a significant advance in the approach of internationally recognized accounting referential frames, context where the accounting system in our country – undergoing internationalization and Europeanization – also experiences the assimilation of harmonization and convergence products between the two accounting standardizations worldwide. Looking from this perspective, we can say that no nation has the right to be considered superior in accounting, as several steps need to be taken in different countries in order to reach a level of compliance on a global scale – desirable. Because companies have expanded their boundaries and tus increasing the importance of managerial communication and the increasingly deeper globalization of capital markets requires and imposes the global use of a single accounting language, we deemed it useful to conduct a study regarding the main differences between the national accounting regulations and the provisions of the international reference frame on stocks, as the users of information from the financial statements seek to evaluate the profitability of the company in general, but also in terms of its risk of illiquidity, as stocks are an important component of an entity's assets. In this respect, we will address the stocks in terms of the main differences between the national accounting regulations, the provisions of the international reference frame, and the economic and financial indicators – expression of different accounting treatments.

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

    Science.gov (United States)

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

    2010-11-01

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

  5. Coordination systems for three-dimension radiation treatment planning

    International Nuclear Information System (INIS)

    Yang Dailun; Wu Zhangwen; Luo Zhengming

    2004-01-01

    This paper describes the coordination systems of a three dimension radiation treatment plan. The coordination systems refer to the body coordination, the isocenter coordination and the beam coordination. The authors have derived the analytical equations for coordination transforms, indicated the applications of the coordination systems, and provided corresponding treating means. With strict construction and perfect structure, the systems have an important significance for increasing the whole capability of a three dimension radiation treatment plan, and can be extensively and flexibly used. (authors)

  6. Phased Startup Initiative Phases 3 and 4 Test Plan and Test Specification (OCRWM)

    International Nuclear Information System (INIS)

    PITNER, A.L.

    2000-01-01

    Construction for the Spent Nuclear Fuel (SNF) Project facilities is continuing per the Level III Baseline Schedule, and installation of the Fuel Retrieval System (FRS) and Integrated Water Treatment System (IWTS) in K West Basin is now complete. In order to accelerate the project, a phased start up strategy to initiate testing of the FRS and IWTS early in the overall project schedule was proposed (Williams 1999). Wilkinson (1999) expands the definition of the original proposal into four functional testing phases of the Phased Startup Initiative (PSI). Phases 1 and 2 are based on performing functional tests using dummy fuel. These tests are described in separate planning documents. This test plan provides overall guidance for Phase 3 and 4 tests, which are performed using actual irradiated N fuel assemblies. The overall objective of the Phase 3 and 4 testing is to verify how the FRS and IWTS respond while processing actual fuel. Conducting these tests early in the project schedule will allow identification and resolution of equipment and process problems before they become activities on the start-up critical path. The specific objectives of this test plan are to: (1) Define the test scope for the FRS and IWTS; (2) Provide detailed test requirements that can be used to write the specific test procedures; (3) Define data required and measurements to be taken. Where existing methods to obtain these do not exist, enough detail will be provided to define required additional equipment; and (4) Define specific test objectives and acceptance criteria

  7. The evolution of computerized treatment planning for brachytherapy: American contributions.

    Science.gov (United States)

    Aronowitz, Jesse N; Rivard, Mark J

    2014-06-01

    To outline the evolution of computerized brachytherapy treatment planning in the United States through a review of technological developments and clinical practice refinements. A literature review was performed and interviews were conducted with six participants in the development of computerized treatment planning for brachytherapy. Computerized brachytherapy treatment planning software was initially developed in the Physics Departments of New York's Memorial Hospital (by Nelson, Meurk and Balter), and Houston's M. D. Anderson Hospital (by Stovall and Shalek). These public-domain programs could be used by institutions with adequate computational resources; other clinics had access to them via Memorial's and Anderson's teletype-based computational services. Commercial brachytherapy treatment planning programs designed to run on smaller computers (Prowess, ROCS, MMS), were developed in the late 1980s and early 1990s. These systems brought interactive dosimetry into the clinic and surgical theatre. Brachytherapy treatment planning has evolved from systems of rigid implant rules to individualized pre- and intra-operative treatment plans, and post-operative dosimetric assessments. Brachytherapy dose distributions were initially calculated on public domain programs on large regionally located computers. With the progression of computer miniaturization and increase in processor speeds, proprietary software was commercially developed for microcomputers that offered increased functionality and integration with clinical practice.

  8. 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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  10. 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

  11. 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

  12. 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.

  13. Scanned ion beam therapy for prostate carcinoma. Comparison of single plan treatment and daily plan-adapted treatment

    International Nuclear Information System (INIS)

    Hild, Sebastian; Graeff, Christian; Rucinski, Antoni; Zink, Klemens; Habl, Gregor; Durante, Marco; Herfarth, Klaus; Bert, Christoph

    2016-01-01

    Intensity-modulated particle therapy (IMPT) for tumors showing interfraction motion is a topic of current research. The purpose of this work is to compare three treatment strategies for IMPT to determine potential advantages and disadvantages of ion prostate cancer therapy. Simulations for three treatment strategies, conventional one-plan radiotherapy (ConvRT), image-guided radiotherapy (IGRT), and online adaptive radiotherapy (ART) were performed employing a dataset of 10 prostate cancer patients with six CT scans taken at one week intervals. The simulation results, using a geometric margin concept (7-2 mm) as well as patient-specific internal target volume definitions for IMPT were analyzed by target coverage and exposure of critical structures on single fraction dose distributions. All strategies led to clinically acceptable target coverage in patients exhibiting small prostate motion (mean displacement < 4 mm), but IGRT and especially ART led to significant sparing of the rectum. In 20 % of the patients, prostate motion exceeded 4 mm causing insufficient target coverage for ConvRT (V95 mean = 0.86, range 0.63-0.99) and IGRT (V95 mean = 0.91, range 0.68-1.00), while ART maintained acceptable target coverage. IMPT of prostate cancer demands consideration of rectal sparing and adaptive treatment replanning for patients exhibiting large prostate motion. (orig.) [de

  14. Assessments for High Dose Radionuclide Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Fisher, Darrell R.

    2003-10-01

    Advances in the biotechnology of cell-specific targeting of cancer, and the increased number of clinical trials involving treatment of cancer patients with radiolabeled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high-dose radionuclide therapy procedures. Optimized radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose-limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential time points using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organs tissues of concern, for the whole body, and sometimes for selected tumors. Patient-specific factors often require that dose estimates be customized for each patient. The Food and Drug Administration regulates the experimental use of investigational new drugs and requires reasonable calculation of radiation absorbed dose to the whole body and to critical organs using methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high-dose studies in the U.S. and elsewhere shows that (1) some studies are conducted with minimal dosimetry, (2) the marrow dose is difficult to establish and is subject to large uncertainties, and (3) despite the general availability of MIRD software, internal dosimetry methods are often inconsistent from one clinical center to another

  15. A Study of Treatment Planning: Periodontal Services for the Elderly.

    Science.gov (United States)

    Milgrom, Peter; And Others

    1981-01-01

    A study undertaken to explore how dentists use patient data to plan treatment is presented. Three hundred forty-six general dentists used oral and general health findings to determine periodontal treatment for seven prototypic elderly patients. The results indicated that oral hygiene and major medications best discriminated between treatment…

  16. 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

  17. Uncertainty incorporated beam angle optimization for IMPT treatment planning.

    Science.gov (United States)

    Cao, Wenhua; Lim, Gino J; Lee, Andrew; Li, Yupeng; Liu, Wei; Ronald Zhu, X; Zhang, Xiaodong

    2012-08-01

    Beam angle optimization (BAO) by far remains an important and challenging problem in external beam radiation therapy treatment planning. Conventional BAO algorithms discussed in previous studies all focused on photon-based therapies. Impact of BAO on proton therapy is important while proton therapy increasingly receives great interests. This study focuses on potential benefits of BAO on intensity-modulated proton therapy (IMPT) that recently began available to clinical cancer treatment. The authors have developed a novel uncertainty incorporated BAO algorithm for IMPT treatment planning in that IMPT plan quality is highly sensitive to uncertainties such as proton range and setup errors. A linear programming was used to optimize robust intensity maps to scenario-based uncertainties for an incident beam angle configuration. Unlike conventional intensity-modulated radiation therapy with photons (IMXT), the search space for IMPT treatment beam angles may be relatively small but optimizing an IMPT plan may require higher computational costs due to larger data size. Therefore, a deterministic local neighborhood search algorithm that only needs a very limited number of plan objective evaluations was used to optimize beam angles in IMPT treatment planning. Three prostate cancer cases and two skull base chordoma cases were studied to demonstrate the dosimetric advantages and robustness of optimized beam angles from the proposed BAO algorithm. Two- to four-beam plans were optimized for prostate cases, and two- and three-beam plans were optimized for skull base cases. By comparing plans with conventional two parallel-opposed angles, all plans with optimized angles consistently improved sparing at organs at risks, i.e., rectum and femoral heads for prostate, brainstem for skull base, in either nominal dose distribution or uncertainty-based dose distributions. The efficiency of the BAO algorithm was demonstrated by comparing it with alternative methods including simulated

  18. Defense Industrial Base: Critical Infrastructure and Key Resources Sector-Specific Plan as Input to the National Infrastructure Protection Plan

    National Research Council Canada - National Science Library

    2007-01-01

    This Defense Industrial Base (DIB) Sector-Specific Plan (SSP), developed in collaboration with industry and government security partners, provides sector-level critical infrastructure and key resources (CI/KR...

  19. Solid Mesh Registration for Radiotherapy Treatment Planning

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Sørensen, Thomas Sangild

    2010-01-01

    We present an algorithm for solid organ registration of pre-segmented data represented as tetrahedral meshes. Registration of the organ surface is driven by force terms based on a distance field representation of the source and reference shapes. Registration of internal morphology is achieved using...... on phantom data and prostate data obtained in vivo based on fiducial marker accuracy and inverse consistency of transformations. The parallel nature of the method allows an efficient implementation on a GPU and as a result the method is very fast. All validation registrations take less than 30 seconds...... to complete. The proposed method has many potential uses in image guided radiotherapy (IGRT) which relies on registration to account for organ deformation between treatment sessions....

  20. Radiotherapy treatment planning using three dimensional CT images

    International Nuclear Information System (INIS)

    Araki, Yutaka; Isobe, Yoshihide; Ozaki, Shin; Hosoki, Takuya; Mori, Shigeru; Ikeda, Hiroshi.

    1984-01-01

    Recently superimposition of dose distribution onto CT images has become available with the use of planning computers. However, the distribution is mostly along the plane of central axis of the beam, and evaluation of the quality of planning has not been established yet. It cannot be concluded whether the planning is suitable or not, even if the dose distribution at a certain CT slice seems to be optimum. The need has been emerged to compare the treatment planning quantitatively with other ones. A computerized treatment planning system has been developed in our hospital, which can accumulate voxel dose of each lattice point, can superimpose isodose curves on multiple transverse contours, and can construct and display a 3-dimensional image of the treatment region using a ''cutting method''. In this paper, a method is proposed to evaluate the quality of treatment planning, introducing the definitions in ICRU report 29 and using the 3-dimensional computer algorism. Concepts and procedures are described in detail with some case examples. (author)

  1. Hanford Integrated Planning Process: 1993 Hanford Site-specific science and technology plan

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    This document is the FY 1993 report on Hanford Site-specific science and technology (S&T) needs for cleanup of the Site as developed via the Hanford Integrated Planning Process (HIPP). It identifies cleanup problems that lack demonstrated technology solutions and technologies that require additional development. Recommendations are provided regarding allocation of funding to address Hanford`s highest-priority technology improvement needs, technology development needs, and scientific research needs, all compiled from a Sitewide perspective. In the past, the S&T agenda for Hanford Site cleanup was sometimes driven by scientists and technologists, with minimal input from the ``problem owners`` (i.e., Westinghouse Hanford Company [WHC] staff who are responsible for cleanup activities). At other times, the problem-owners made decisions to proceed with cleanup without adequate scientific and technological inputs. Under both of these scenarios, there was no significant stakeholder involvement in the decision-making process. One of the key objectives of HIPP is to develop an understanding of the integrated S&T requirements to support the cleanup mission, (a) as defined by the needs of the problem owners, the values of the stakeholders, and the technology development expertise that exists at Hanford and elsewhere. This requires a periodic, systematic assessment of these needs and values to appropriately define a comprehensive technology development program and a complementary scientific research program. Basic to our success is a methodology that is defensible from a technical perspective and acceptable to the stakeholders.

  2. Hanford Integrated Planning Process: 1993 Hanford Site-specific science and technology plan

    International Nuclear Information System (INIS)

    1993-12-01

    This document is the FY 1993 report on Hanford Site-specific science and technology (S ampersand T) needs for cleanup of the Site as developed via the Hanford Integrated Planning Process (HIPP). It identifies cleanup problems that lack demonstrated technology solutions and technologies that require additional development. Recommendations are provided regarding allocation of funding to address Hanford's highest-priority technology improvement needs, technology development needs, and scientific research needs, all compiled from a Sitewide perspective. In the past, the S ampersand T agenda for Hanford Site cleanup was sometimes driven by scientists and technologists, with minimal input from the ''problem owners'' (i.e., Westinghouse Hanford Company [WHC] staff who are responsible for cleanup activities). At other times, the problem-owners made decisions to proceed with cleanup without adequate scientific and technological inputs. Under both of these scenarios, there was no significant stakeholder involvement in the decision-making process. One of the key objectives of HIPP is to develop an understanding of the integrated S ampersand T requirements to support the cleanup mission, (a) as defined by the needs of the problem owners, the values of the stakeholders, and the technology development expertise that exists at Hanford and elsewhere. This requires a periodic, systematic assessment of these needs and values to appropriately define a comprehensive technology development program and a complementary scientific research program. Basic to our success is a methodology that is defensible from a technical perspective and acceptable to the stakeholders

  3. Thermal treatment planning for SonoKnife focused-ultrasound thermal treatment of head and neck cancers

    Science.gov (United States)

    Chen, Xin; Chen, Duo; Xia, Rongmin; Shafirstein, Gal; Corry, Peter; Moros, Eduardo G.

    2011-03-01

    The purpose is to develop a patient-specific treatment planning method for a cylindrically-focused (i.e., SonoKnife) ultrasound thermal therapy system to optimize the thermal treatment of locally-advanced head and neck squamous cell carcinomas (HNSCC) and/or positive lymph nodes. To achieve a more efficient and effective treatment, a temperature-based treatment planning was devised, which was composed of : (1) a 3D acoustic-thermal model has been developed to simulate the acoustic field, temperature distribution, and thermal dose coverage induced by the SonoKnife applicator. (2) A 3D relevant anatomical structures (e.g. the H&N tumors, bones and cavities) were reconstructed based on multislice CT scans. A step-and-shoot strategy was devised to perform the treatment, in which the initial applied power levels, placement of the transducers, and sonication times per scan were determined by conducting a temperature-based forward simulation. The maximum temperature, thermal dose coverage of target, and thermal exposure to surrounding tissue were analyzed. For performance evaluation, the treatment planning was applied on representative examples obtained from the clinical radiation therapy of HNSCC and positive lymph nodes. This treatment planning platforms can be used to guide applicator placement, set-up configurations, and applied power levels prior to delivery of a treatment or for post-procedure analysis of temperature distributions.

  4. Computerized treatment planning systems for external photon beam radiotherapy

    International Nuclear Information System (INIS)

    Evans, M.D.C.

    2005-01-01

    Computerized treatment planning systems (TPSs) are used in external beam radiotherapy to generate beam shapes and dose distributions with the intent to maximize tumour control and minimize normal tissue complications. Patient anatomy and tumour targets can be represented as 3-D models. The entire process of treatment planning involves many steps and the medical physicist is responsible for the overall integrity of the computerized TPS to accurately and reliably produce dose distributions and associated calculations for external beam radiotherapy. The planning itself is most commonly carried out by a dosimetrist, and the plan must be approved by a radiation oncologist before implementation in actual patient treatments. Treatment planning prior to the 1970s was generally carried out through the manual manipulation of standard isodose charts on to patient body contours that were generated by direct tracing or lead wire representation, and relied heavily on the judicious choice of beam weight and wedging by an experienced dosimetrist. The simultaneous development of computed tomography (CT), along with the advent of readily accessible computing power from the 1970s on, led to the development of CT based computerized treatment planning, providing the ability to view dose distributions directly superimposed upon a patient's axial anatomy. The entire treatment planning process involves many steps, beginning from beam data acquisition and entry into the computerized TPS, through patient data acquisition, to treatment plan generation and the final transfer of data to the treatment machine. Successive improvements in treatment planning hardware and software have been most notable in the graphics, calculation and optimization aspects of current systems. Systems encompassing the 'Virtual Patient' are able to display beam's eye views (BEVs) of radiation beams and digitally reconstructed radiographs (DRRs) for arbitrary dose distributions. Dose calculations have evolved from

  5. SU-F-T-346: Dose Mimicking Inverse Planning Based On Helical Delivery Treatment Plans for Head and Neck Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kumaran Nair, C; Hoffman, D; Wright, C; Yamamoto, T; Rao, S; Benedict, S; Rong, Y [University of California Davis Medical Center, Sacramento, CA (United States); Markham, J [Raysearch Laboratories, Garden City, NY (United States)

    2016-06-15

    Purpose: We aim to evaluate a new commercial dose mimicking inverse-planning application that was designed to provide cross-platform treatment planning, for its dosimetric quality and efficiency. The clinical benefit of this application allows patients treated on O-shaped linac to receive an equivalent plan on conventional L-shaped linac as needed for workflow or machine downtime. Methods: The dose mimicking optimization process seeks to create a similar DVH of an O-shaped linac-based plans with an alternative treatment technique (IMRT or VMAT), by maintaining target conformity, and penalizing dose falloff outside the target. Ten head and neck (HN) helical delivery plans, including simple and complex cases were selected for re-planning with the dose mimicking application. All plans were generated for a 6 MV beam model, using 7-field/ 9-field IMRT and VMAT techniques. PTV coverage (D1, D99 and homogeneity index [HI]), and OARs avoidance (Dmean / Dmax) were compared. Results: The resulting dose mimicked HN plans achieved acceptable PTV coverage for HI (VMAT 7.0±2.3, 7-fld 7.3±2.4, and 9-fld 7.0±2.4), D99 (98.0%±0.7%, 97.8%±0.7%, and 98.0%±0.7%), as well as D1 (106.4%±2.1%, 106.5%±2.2%, and 106.4%±2.1%), respectively. The OAR dose discrepancy varied: brainstem (2% to 4%), cord (3% to 6%), esophagus (−4% to −8%), larynx (−4% to 2%), and parotid (4% to 14%). Mimicked plans would typically be needed for 1–5 fractions of a treatment course, and we estimate <1% variance would be introduced in target coverage while maintaining comparable low dose to OARs. All mimicked plans were approved by independent physician and passed patient specific QA within our established tolerance. Conclusion: Dose mimicked plans provide a practical alternative for responding to clinical workflow issues, and provide reliability for patient treatment. The quality of dose mimicking for HN patients highly depends on the delivery technique, field numbers and angles, as well as user

  6. Development of Planning Abilities in Normal Aging: Differential Effects of Specific Cognitive Demands

    Science.gov (United States)

    Köstering, Lena; Stahl, Christoph; Leonhart, Rainer; Weiller, Cornelius; Kaller, Christoph P.

    2014-01-01

    In line with the frontal hypothesis of aging, the ability to plan ahead undergoes substantial change during normal aging. Although impairments on the Tower of London planning task were reported earlier, associations between age-related declines and specific cognitive demands on planning have not been studied. Here we investigated the impact of…

  7. 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.

  8. 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

  9. Jefferson Proving Ground Site-Specific Sampling Design Plan

    National Research Council Canada - National Science Library

    1992-01-01

    The purpose of this document is to outline field sampling and laboratory analyses that are to be conducted as part of the Jefferson Proving Ground Site-Specific Sampling and Analysis (SSSA) program...

  10. Phase Startup Initiative Phases 3 and 4 Test Plan and Test Specification (OCRWM)

    International Nuclear Information System (INIS)

    PAJUNEN, A.L.; LANGEVIN, M.J.

    2000-01-01

    Construction for the Spent Nuclear Fuel (SNF) Project facilities is continuing per the Level III Baseline Schedule, and installation of the Fuel Retrieval System (FRS) and Integrated Water Treatment System (IWTS) in K West Basin is now complete. In order to accelerate the project, a phased start up strategy to initiate testing of the FRS and IWTS early in the overall project schedule was proposed (Williams 1999). Wilkinson (1999) expands the definition of the original proposal into four functional testing phases of the Phased Startup Initiative (PSI). Phases 1 and 2 are based on performing functional tests using dummy fuel. This test plan provides overall guidance for Phase 3 and 4 tests, which are performed using actual irradiated N fuel assemblies. The overall objective of the Phase 3 and 4 testing is to verify how the FRS and IWTS respond while processing actual fuel. Conducting these tests early in the project schedule will allow identification and resolution of equipment and process problems before they become activities on the start-up critical path. The specific objectives of this test plan are to: Define the Phase 3 and 4 test scope for the FRS and IWTS; Provide detailed test requirements that can be used to write the specific test procedures; Define data required and measurements to be taken. Where existing methods to obtain these do not exist, enough detail will be provided to define required additional equipment; and Define specific test objectives and acceptance criteria

  11. Phase Startup Initiative Phases 3 and 4 Test Plan and Test Specification ( OCRWM)

    Energy Technology Data Exchange (ETDEWEB)

    PAJUNEN, A.L.; LANGEVIN, M.J.

    2000-08-07

    Construction for the Spent Nuclear Fuel (SNF) Project facilities is continuing per the Level III Baseline Schedule, and installation of the Fuel Retrieval System (FRS) and Integrated Water Treatment System (IWTS) in K West Basin is now complete. In order to accelerate the project, a phased start up strategy to initiate testing of the FRS and IWTS early in the overall project schedule was proposed (Williams 1999). Wilkinson (1999) expands the definition of the original proposal into four functional testing phases of the Phased Startup Initiative (PSI). Phases 1 and 2 are based on performing functional tests using dummy fuel. This test plan provides overall guidance for Phase 3 and 4 tests, which are performed using actual irradiated N fuel assemblies. The overall objective of the Phase 3 and 4 testing is to verify how the FRS and IWTS respond while processing actual fuel. Conducting these tests early in the project schedule will allow identification and resolution of equipment and process problems before they become activities on the start-up critical path. The specific objectives of this test plan are to: Define the Phase 3 and 4 test scope for the FRS and IWTS; Provide detailed test requirements that can be used to write the specific test procedures; Define data required and measurements to be taken. Where existing methods to obtain these do not exist, enough detail will be provided to define required additional equipment; and Define specific test objectives and acceptance criteria.

  12. Prostate HDR brachytherapy catheter displacement between planning and treatment delivery

    International Nuclear Information System (INIS)

    Whitaker, May; Hruby, George; Lovett, Aimee; Patanjali, Nitya

    2011-01-01

    Background and purpose: HDR brachytherapy is used as a conformal boost for treating prostate cancer. Given the large doses delivered, it is critical that the volume treated matches that planned. Our outpatient protocol comprises two 9 Gy fractions, two weeks apart. We prospectively assessed catheter displacement between CT planning and treatment delivery. Materials and methods: Three fiducial markers and the catheters were implanted under transrectal ultrasound guidance. Metal marker wires were inserted into 4 reference catheters before CT; marker positions relative to each other and to the marker wires were measured from the CT scout. Measurements were repeated immediately prior to treatment delivery using pelvic X-ray with marker wires in the same reference catheters. Measurements from CT scout and film were compared. For displacements of 5 mm or more, indexer positions were adjusted prior to treatment delivery. Results: Results are based on 48 implants, in 25 patients. Median time from planning CT to treatment delivery was 254 min (range 81–367 min). Median catheter displacement was 7.5 mm (range −2.9–23.9 mm), 67% of implants had displacement of 5 mm or greater. Displacements were predominantly caudal. Conclusions: Catheter displacement can occur in the 1–3 h between the planning CT scan and treatment. It is recommended that departments performing HDR prostate brachytherapy verify catheter positions immediately prior to treatment delivery.

  13. SERA - an advanced treatment planning system for neutron therapy

    International Nuclear Information System (INIS)

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

    2001-01-01

    The technology for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT) has advanced significantly over the past few years. Because of the more complex nature of the problem, the computational methods that work well for treatment planning in photon radiotherapy are not applicable to BNCT. The necessary methods have, however, been developed and have been successfully employed both for research applications as well as human trials. Computational geometry for BNCT applications can be constructed directly from tomographic medical imagery and computed radiation dose distributions can be readily displayed in formats that are familiar to the radiotherapy community. The SERA system represents a significant advance in several areas for treatment planning. However further improvements in speed and results presentation are still needed for routine clinical applications, particularly when optimization of dose pattern is required. (author)

  14. SERA - An Advanced Treatment Planning System for Neutron Therapy

    International Nuclear Information System (INIS)

    Wemple, C. A.; Albright, C. L.; Nigg, D. W.; Wessol, D. W.; Wheeler, F. J.; Harkin, G. J.; Rossmeirer, M. B.; Cohen, M. T.; Frandsen, M. W.

    1999-01-01

    The technology for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT) has advanced significantly over the past few years. Because of the more complex nature of the problem, the computational methods that work well for treatment planning in photon radiotherapy are not applicable to BNCT. The necessary methods have, however, been developed and have been successfully employed both for research applications as well as human trials. Computational geometry for BNCT applications can be constructed directly from tomographic medical imagery and computed radiation dose distributions can be readily displayed in formats that are familiar to the radiotherapy community. The SERA system represents a significant advance in several areas for treatment planning. However further improvements in speed and results presentation are still needed for routine clinical applications, particularly when optimizations of dose pattern is required

  15. Application of DEC PRO-380 microcomputer for treatment planning. 129

    International Nuclear Information System (INIS)

    Chung-Bin, D.; Bernard, D.; Chung-Bin, A.

    1987-01-01

    Since 1974 we have used a PDP 11/45 computer manufactured by Digital Equipment Corp. for radiation therapy treatment planning. The Cunningham TAR method has been used for developing algorithms for external beam treatment planning. The Stovell and Shalek method has been used for intracavitary and interstitial implants. Recently we have implemented all this softwre on a DEC Pro 380 microcomputer with graphic input and output. This inexpensive machine has computer power comparable to that of a PDP 11/45. All the hardware is standard DEC equipment except the digitizer. This system is adequate to meet all the treatment planning needs of any moderate size radiation therapy center. It lacks the ability to input CT data directly from magnetic tape, but it can enter the contour, tumor volumes and inhomogeneity from a CT film using the back-lighted digitizer. 2 refs

  16. SERA - An Advanced Treatment Planning System for Neutron Therapy

    Energy Technology Data Exchange (ETDEWEB)

    C. A. Wemple; C. L. Albright; D. W. Nigg; D. W. Wessol; F. J. Wheeler; G. J. Harkin; M. B. Rossmeirer; M. T. Cohen; M. W. Frandsen

    1999-06-01

    The technology for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT) has advanced significantly over the past few years. Because of the more complex nature of the problem, the computational methods that work well for treatment planning in photon radiotherapy are not applicable to BNCT. The necessary methods have, however, been developed and have been successfully employed both for research applications as well as human trials. Computational geometry for BNCT applications can be constructed directly from tomographic medical imagery and computed radiation dose distributions can be readily displayed in formats that are familiar to the radiotherapy community. The SERA system represents a significant advance in several areas for treatment planning. However further improvements in speed and results presentation are still needed for routine clinical applications, particularly when optimizations of dose pattern is required.

  17. Orthognathic Surgery: Planning and treatment with illustration on six cases

    International Nuclear Information System (INIS)

    AiRuhaimi, K; Nwoku, A. L; Shaikh, H. S

    1991-01-01

    Almost all conferences for plastic and maxillofacial surgery discuss reports on several methods of orthognathic surgery, planning, success results, and complications of the different procedures carried out to correct patient's soft and hard tissues frontal profiles and occlusal discrepancies. Various principles are involved in the diagnosis and treatment of facial deformities. However, the most important consideration, after all, is the final accepted aesthetic and functional requirements and stability of the moved segments. The objective of this paper is to give the basic principles of treatment planning for correcting facial discrepancies, surgical approach to different cases, and the methods to increase stability of the moved segments. Six cases are included to illustrate the different aspects of treatment planning, surgical management, and stabilization methods. (author)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  19. 29 CFR 1926.752 - Site layout, site-specific erection plan and construction sequence.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Site layout, site-specific erection plan and construction... Steel Erection § 1926.752 Site layout, site-specific erection plan and construction sequence. (a... strength or sufficient strength to support the loads imposed during steel erection. (c) Site layout. The...

  20. 7 CFR 1724.54 - Requirements for RUS approval of plans and specifications.

    Science.gov (United States)

    2010-01-01

    ... paragraph (a) of this section. (d) Substations. (1)(i) Plans and specifications for all new substations must..., unless: (A) The substation design has been previously approved by RUS; and (B) No significant NESC... required by paragraph (a) of this section, plans and specifications for substation modifications and for...

  1. 46 CFR 91.55-5 - Plans and specifications required for new construction.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Plans and specifications required for new construction... new construction. (a) General. (1) Specifications. (2) General Arrangement Plan of decks, holds, inner... Watertight Decks. (11) *Details of Hinged Subdivision Watertight Doors and Operating Gear. (12) *Scuppers and...

  2. Tuberculosis control: decentralization, local planning and management specificities.

    Science.gov (United States)

    Trigueiro, Janaína Von Söhsten; Nogueira, Jordana de Almeida; de Sá, Lenilde Duarte; Palha, Pedro Fredemir; Villa, Tereza Cristina Scatena; Trigueiro, Débora Raquel Soares Guedes

    2011-01-01

    The goal was to analyze, according to the perception of health managers, the practices that guide tuberculosis control actions in cities in the metropolitan region of João Pessoa - PB, Brazil. This qualitative study involved eight professionals in management functions. Testimonies were collected through semi-structured interviews between May and June 2009 and organized through content analysis. Despite the acknowledged benefits of tuberculosis control action decentralization, local planning indicates the predominance of a bureaucratic model that is restricted to negotiation and supplies. Local programming is centered on the coordinator, which shows a command line and vertical management that lead to the fragmentation of the work process. Management action should follow an innovative and transformative route that surpasses bureaucratic barriers and faces the biggest challenge it is proposed: to balance professional interrelations with a view to improving health work performance.

  3. Future plans for the MP line (Both general and specific)

    International Nuclear Information System (INIS)

    Underwood, D.G.

    1988-01-01

    This talk consists of three sections. Topics range from suggestions of possible physics, which are presented to provoke thought and discussion about the distant future, to specific goals of E-704 for the next running period. The sections are on physics issues, possible upgrades of the beam and experimental apparatus, and goals for the next running period. 4 refs., 5 figs

  4. Patient Specific Simulation for Planning of Cochlear Implantation Surgery

    DEFF Research Database (Denmark)

    Vera, Sergio; Perez, Frederic; Balust, Clara

    2014-01-01

    Cochlear implantation is a surgical procedure that can restore the hearing capabilities to patients with severe or complete functional loss. However, the level of restoration varies highly between subjects and depends on patient-specific factors. This paper presents a software application for pla...

  5. Towards the Validation of a Commercial Hyperthermia Treatment Planning System

    Science.gov (United States)

    Li, Zhen; Vogel, Martin; Maccarini, Paolo F.; Arabe, Omar A.; Stakhursky, Vadim; Crawford, Devin

    2013-01-01

    Recent developments have reinvigorated clinical investigations of hyperthermia (HT) as a viable adjuvant treatment in the fight against cancer. Researchers are placing a greater emphasis on multi-modal approaches that include mild temperatures (40°C – 43°C) and standard therapies like radiation and chemotherapy than on achieving higher temperature treatments (43°C-45°C) which were pursued in the past. The emergence of robust computer simulation tools for accurate hyperthermia treatment planning has aided this resurgence by helping improve the quality of heating. This article outlines a recent collaborative study at Duke University to demonstrate the capabilities of a new suite of 3D electromagnetic and thermodynamic simulation tools for treatment planning of external hyperthermia treatments with a radio frequency (RF) phased array heat applicator. Following a brief introduction to the rationale for moderate temperature hyperthermia and current methodology for heating tissue at depth in the body, the article will present a new approach for improved heating based on treatment planning with electromagnetic simulation software tools. Procedures, benefits, and a comparison of simulated heating patterns with those measured in two clinical hyperthermia treatments of advanced fibrous histiocytoma (soft-tissue sarcoma) tumors will be presented PMID:25324585

  6. 3D Image Modelling and Specific Treatments in Orthodontics Domain

    OpenAIRE

    Goularas, Dionysis; Djemal, Khalifa; Mannoussakis, Yannis

    2007-01-01

    In this article, we present a 3D specific dental plaster treatment system for orthodontics. From computer tomography scanner images, we propose first a 3D image modelling and reconstruction method of the Mandible and Maxillary based on an adaptive triangulation allowing management of contours meant for the complex topologies. Secondly, we present two specific treatment methods directly achieved on obtained 3D model allowing the automatic correction for the setting in occlusion of the Mandible...

  7. Records needed for orthodontic diagnosis and treatment planning: a systematic review

    NARCIS (Netherlands)

    Rischen, R.J.; Breuning, K.H.; Bronkhorst, E.M.; Kuijpers-Jagtman, A.M.

    2013-01-01

    BACKGROUND: Traditionally, dental models, facial and intra-oral photographs and a set of two-dimensional radiographs are used for orthodontic diagnosis and treatment planning. As evidence is lacking, the discussion is ongoing which specific records are needed for the process of making an orthodontic

  8. The significance of accurate dielectric tissue data for hyperthermia treatment planning

    NARCIS (Netherlands)

    van de Kamer, JB; van Wieringen, N; de Leeuw, AAC; Lagendijk, JJW

    2001-01-01

    For hyperthermia treatment planning, dielectric properties of several tissue types are required. Since it is difficult to perform patient specific dielectric imaging, default values based on literature data are used. However, these show a large spread (approximate to 50%). Consequently, it is

  9. The significance of accurate dielectric tissue data for hyperthermia treatment planning

    NARCIS (Netherlands)

    van de Kamer, J. B.; van Wieringen, N.; de Leeuw, A. A.; Lagendijk, J. J.

    2001-01-01

    For hyperthermia treatment planning, dielectric properties of several tissue types are required. Since it is difficult to perform patient specific dielectric imaging, default values based on literature data are used. However, these show a large spread (approximately 50%). Consequently, it is

  10. New paradigms in prosthodontic treatment planning: a literature review.

    Science.gov (United States)

    Rich, Benedict; Goldstein, Gary R

    2002-08-01

    New treatment modalities have expanded the choices available to prosthodontists and their patients. At the same time, an explosion of data has called into question the validity and efficacy of certain forms of traditional prosthodontic treatment. Together, these factors have greatly complicated the treatment-planning process. The purpose of this article is to provide a framework for the prosthodontic treatment-planning process that incorporates the latest evidence-based information available. A review of the literature was undertaken through a Medline search. Articles published in English from 1975 through 2001 were evaluated; selected articles were chosen for review on the basis of a subjective judgment of their relevancy and significance to the clinician.

  11. Jefferson Proving Ground Site-Specific Sampling Design Plan.

    Science.gov (United States)

    1992-01-01

    The purpose of this document is to outline field sampling and laboratory analyses that are to be conducted as part of the Jefferson Proving Ground...Site-Specific Sampling and Analysis (SSSA) program. Jefferson Proving Ground (JPG) is a U.S. Army facility located in Madison, Indiana. The SSSA at JPG...will then be analyzed to determine if past activities at Jefferson Proving Ground (JPG) have caused contaminants to enter the groundwater, stream water

  12. Evaluation of a software module for adaptive treatment planning and re-irradiation.

    Science.gov (United States)

    Richter, Anne; Weick, Stefan; Krieger, Thomas; Exner, Florian; Kellner, Sonja; Polat, Bülent; Flentje, Michael

    2017-12-28

    The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4-35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to

  13. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1991-12-01

    Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references.

  14. Treatment planning aspects for tumours in the region of parotid

    International Nuclear Information System (INIS)

    Narayanan, S.S.; Saju, Sherly; Deshpande, D.D.; Agarwal, J.P.; Dinshaw, K.A.

    2001-01-01

    The treatment of carcinoma of parotid/external ear needs careful planning in respect of dose to the normal organs surrounding the tumour such as eye(s), pituitary and normal brain. In many centres, generally, manual contours are generated for a two dimensional planning, wherein Anterior-Posterior (A-P) oblique fields (patient in Lateral Position) are planned. However, such a field orientation is not always useful in terms of minimum possible dose to the said normal organs, especially for eye. In this centre, a different field arrangement has been attempted, which helps in dose reduction to the normal structures to a large extent in comparison with the conventional 2D planning method

  15. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    International Nuclear Information System (INIS)

    1991-12-01

    Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references

  16. [Treatment of removable partial dentures. 1. Legislation, rules of conduct, care plan and treatment plan

    NARCIS (Netherlands)

    Witter, D.J.; Brands, W.G.; Barl, J.C.; Creugers, N.H.J.

    2011-01-01

    An invasive treatment, such as the treatment involving a removable partial denture, requires a well-structured approach. Regulations governing the communication between a healthcare professional and a patient in the Netherlands can be found in the Dutch Medical Treatment Act and the Rules of Conduct

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

    Science.gov (United States)

    Zabalegui, B

    1990-01-01

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

  18. Robust optimization in lung treatment plans accounting for geometric uncertainty.

    Science.gov (United States)

    Zhang, Xin; Rong, Yi; Morrill, Steven; Fang, Jian; Narayanasamy, Ganesh; Galhardo, Edvaldo; Maraboyina, Sanjay; Croft, Christopher; Xia, Fen; Penagaricano, Jose

    2018-03-10

    Robust optimization generates scenario-based plans by a minimax optimization method to find optimal scenario for the trade-off between target coverage robustness and organ-at-risk (OAR) sparing. In this study, 20 lung cancer patients with tumors located at various anatomical regions within the lungs were selected and robust optimization photon treatment plans including intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans were generated. The plan robustness was analyzed using perturbed doses with setup error boundary of ±3 mm in anterior/posterior (AP), ±3 mm in left/right (LR), and ±5 mm in inferior/superior (IS) directions from isocenter. Perturbed doses for D 99 , D 98 , and D 95 were computed from six shifted isocenter plans to evaluate plan robustness. Dosimetric study was performed to compare the internal target volume-based robust optimization plans (ITV-IMRT and ITV-VMAT) and conventional PTV margin-based plans (PTV-IMRT and PTV-VMAT). The dosimetric comparison parameters were: ITV target mean dose (D mean ), R 95 (D 95 /D prescription ), Paddick's conformity index (CI), homogeneity index (HI), monitor unit (MU), and OAR doses including lung (D mean , V 20 Gy and V 15 Gy ), chest wall, heart, esophagus, and maximum cord doses. A comparison of optimization results showed the robust optimization plan had better ITV dose coverage, better CI, worse HI, and lower OAR doses than conventional PTV margin-based plans. Plan robustness evaluation showed that the perturbed doses of D 99 , D 98 , and D 95 were all satisfied at least 99% of the ITV to received 95% of prescription doses. It was also observed that PTV margin-based plans had higher MU than robust optimization plans. The results also showed robust optimization can generate plans that offer increased OAR sparing, especially for normal lungs and OARs near or abutting the target. Weak correlation was found between normal lung dose and target size, and no other correlation

  19. The Use of Videotapes in Treatment Plan Presentation Seminars.

    Science.gov (United States)

    Powell, Billy J.; And Others

    1987-01-01

    A well-received third-year seminar in dental treatment plan presentation used videotaping of student presentations for self- and peer-evaluation. Students liked the faculty-student interaction and the feedback provided in the seminar, but many felt it would be more helpful if offered earlier in the curriculum. The evaluation form is included. (MSE)

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

    International Nuclear Information System (INIS)

    Lawrence, B.

    1999-01-01

    The Compliance Plan Volume (Volume I) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information

  1. Savannah River Site approved site treatment plan, 2000 annual update

    International Nuclear Information System (INIS)

    Lawrence, B.

    2000-01-01

    The Compliance Plan Volume (Volume 1) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume 2) and is provided for information

  2. Savannah River Site approved site treatment plan, 2000 annual update

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2000-04-20

    The Compliance Plan Volume (Volume 1) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume 2) and is provided for information.

  3. Interocclusal Registration for Diagnosis and Treatment Planning for ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... implant case where multiple posterior teeth are missing and need to be replaced by implant restorations. In the case ... Keywords: Interocclusal Records, Diagnosis and Treatment Plan, Implant. Restorations. Interocclusal ... then removed to leave a window in the acrylic resin. The appliance was finished ...

  4. Incorrect dosimetric leaf separation in IMRT and VMAT treatment planning

    DEFF Research Database (Denmark)

    Sjölin, Maria; Edmund, Jens Morgenthaler

    2016-01-01

    PURPOSE: Dynamic treatment planning algorithms use a dosimetric leaf separation (DLS) parameter to model the multi-leaf collimator (MLC) characteristics. Here, we quantify the dosimetric impact of an incorrect DLS parameter and investigate whether common pretreatment quality assurance (QA) method...

  5. Brachytherapy treatment planning algorithm applied to prostate cancer

    Science.gov (United States)

    Herrera-Rodríguez, M. R.; Martínez-Dávalos, A.

    2000-10-01

    An application of Genetic Algorithms (GAs) for treatment planning optimization in prostate brachytherapy is presented. The importance of multi-objective selection criteria based on the contour of the volume of interest and radiosensitive structures such as the rectum and urethra is discussed. First results are obtained for a simple test case which presents radial symmetry.

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

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    1999-04-20

    The Compliance Plan Volume (Volume I) identifies project activity schedule milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

  7. Project W-314 specific test and evaluation plan for 241-AY-01A pump pit upgrade

    International Nuclear Information System (INIS)

    Hays, W.H.

    1998-01-01

    This Specific Test and Evaluation Plan (STEP) defines the test and evaluation activities encompassing the upgrade of the 241-AY-0IA Pump Pit for the W-314 Project. The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made to the 241-AY-01A Pump Pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system's performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation Plan (TEP)

  8. Project W-314 specific test and evaluation plan for 241-AY-02A pump pit upgrade

    International Nuclear Information System (INIS)

    Hays, W.H.

    1998-01-01

    This Specific Test and Evaluation Plan (STEP) defines the test and evaluation activities encompassing the upgrade of the 241-AY-02A Pump Pit for the W-314 Project. The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made to the 241-AY-02A Pump Pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system's performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation Plan (TEP)

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

    Science.gov (United States)

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

    2014-12-07

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

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

    Science.gov (United States)

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

    2014-12-01

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

  11. 4D Proton treatment planning strategy for mobile lung tumors

    International Nuclear Information System (INIS)

    Kang Yixiu; Zhang Xiaodong; Chang, Joe Y.; Wang He; Wei Xiong; Liao Zhongxing; Komaki, Ritsuko; Cox, James D.; Balter, Peter A.; Liu, Helen; Zhu, X. Ronald; Mohan, Radhe; Dong Lei

    2007-01-01

    Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE R IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE R IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE R IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-22

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

  15. Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

    International Nuclear Information System (INIS)

    Visser, Ruurd; Wauben, David J.L.; Groot, Martijn de; Steenbakkers, Roel J.H.M.; Bijl, Henk P.; Godart, Jeremy; Veld, Aart A. van’t; Langendijk, Johannes A.; Korevaar, Erik W.

    2014-01-01

    Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT. Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance. Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure. Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA

  16. Monte Carlo conformal treatment planning as an independent assessment

    International Nuclear Information System (INIS)

    Rincon, M.; Leal, A.; Perucha, M.; Carrasco, E.; Sanchez-Doblado, F.; Hospital Univ. Virgen Macarena, Sevilla; Arrans, R.; Sanchez-Calzado, J.A.; Errazquin, L.; Medrano, J.C.

    2001-01-01

    The wide range of possibilities available in Radiotherapy with conformal fields cannot be covered experimentally. For this reason, dosimetrical and planning procedures are based on approximate algorithms or systematic measurements. Dose distribution calculations based on Monte Carlo (MC) simulations can be used to check results. In this work, two examples of conformal field treatments are shown: A prostate carcinoma and an ocular lymphoma. The dose distributions obtained with a conventional Planning System and with MC have been compared. Some significant differences have been found. (orig.)

  17. Project W-314 Specific Test and Evaluation Plan for 200E Waste Transfer System

    International Nuclear Information System (INIS)

    HAMMERS, J.S.

    2000-01-01

    The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of the newly constructed 200E Waste Transfer System in the W-314 Project. The STEP provides the outline for test and evaluation methods that verify the system's performance and compliance to the established Project design criteria. The STEP is a ''lower tier'' document based on the W-314 Test and Evaluation Plan (TEP)

  18. Very fast simulated reannealing in radiation therapy treatment plan optimization

    International Nuclear Information System (INIS)

    Morrill, Steven M.; Lam, Kam Shing; Lane, Richard G.; Langer, Mark; Rosen, Isaac I.

    1995-01-01

    Purpose: Very Fast Simulated Reannealing is a relatively new (1989) and sophisticated algorithm for simulated annealing applications. It offers the advantages of annealing methods while requiring shorter execution times. The purpose of this investigation was to adapt Very Fast Simulated Reannealing to conformal treatment planning optimization. Methods and Materials: We used Very Fast Simulated Reannealing to optimize treatments for three clinical cases with two different cost functions. The first cost function was linear (minimum target dose) with nonlinear dose-volume normal tissue constraints. The second cost function (probability of uncomplicated local control) was a weighted product of normal tissue complication probabilities and the tumor control probability. Results: For the cost functions used in this study, the Very Fast Simulated Reannealing algorithm achieved results within 5-10% of the final solution (100,000 iterations) after 1000 iterations and within 3-5% of the final solution after 5000-10000 iterations. These solutions were superior to those produced by a conventional treatment plan based on an analysis of the resulting dose-volume histograms. However, this technique is a stochastic method and results vary in a statistical manner. Successive solutions may differ by up to 10%. Conclusion: Very Fast Simulated Reannealing, with modifications, is suitable for radiation therapy treatment planning optimization. It produced results within 3-10% of the optimal solution, produced using another optimization algorithm (Mixed Integer Programming), in clinically useful execution times

  19. Health-related quality of life in relation to gender and age in couples planning IVF treatment

    NARCIS (Netherlands)

    Fekkes, M.; Buitendijk, S.E.; Verrips, G.H.W.; Braat, D.D.M.; Brewaeys, A.M.A.; Dolfing, J.G.; Kortman, M.; Leerentveld, R.A.; Macklon, N.S.

    2003-01-01

    Background: Specific subgroups of people planning IVF might be at risk of having more psychological or health-related problems. Identification of subgroups at risk may better enable allocation of appropriate counselling. Methods: A group of 425 men and 447 women planning to undergo IVF treatment

  20. Health-related quality of life in relation to gender and age in couples planning IVF treatment

    NARCIS (Netherlands)

    Fekkes, M; Buitendijk, SE; Verrips, GHW; Braat, DDM; Brewaeys, AMA; Dolfing, JG; Kortman, M; Macklon, NS

    BACKGROUND: Specific subgroups of people planning IVF might be at risk of having more psychological or health-related problems. Identification of subgroups at risk may better enable allocation of appropriate counselling. METHODS: A group of 425 men and 447 women planning to undergo IVF treatment

  1. Adaptive Disclosure: A Combat-Specific PTSD Treatment

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-1-0810 TITLE: “Adaptive Disclosure: A Combat-Specific PTSD Treatment ” PRINCIPAL INVESTIGATOR: Brett Litz, Ph.D...Disclosure: A Combat-Specific PTSD Treatment ” 5a. CONTRACT NUMBER W81XWH-10-1-0810 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...South Huntington Avenue Boston, MA 02130 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army

  2. Pilot test specific test plan for the removal of arsenic Socorro, New Mexico.

    Energy Technology Data Exchange (ETDEWEB)

    Collins, Sue S.; Aragon, Malynda Jo; Everett, Randy L.; Siegel, Malcolm Dean; Aragon, Alicia R.; Dwyer, Brian P.; Marbury, Justin Luke

    2006-03-01

    Sandia National Laboratories (SNL) is conducting pilot scale evaluations of the performance and cost of innovative drinking water treatment technologies designed to meet the new arsenic maximum contaminant level (MCL) of 10 {micro}g/L (effective January 2006). As currently envisioned, pilots tests may include multiple phases. Phase I tests will involve side-by-side comparisons of several commercial technologies primarily using design parameters suggested by the Vendors. Subsequent tests (Phase II) may involve repeating some of the original tests, testing the same commercial technologies under different conditions and testing experimental technologies or additional commercial technologies. This Pilot Test Specific Test Plan (PTSTP) was written for Phase I of the Socorro Springs Pilot. The objectives of Phase I include evaluation of the treatment performance of five adsorptive media under ambient pH conditions (approximately 8.0) and assessment of the effect of contact time on the performance of one of the media. Addenda to the PTSTP may be written to cover Phase II studies and supporting laboratory studies. The Phase I demonstration began in the winter of 2004 and will last approximately 9 months. The information from the test will help the City of Socorro choose the best arsenic treatment technology for the Socorro Springs well. The pilot demonstration is a project of the Arsenic Water Technology Partnership program, a partnership between the American Water Works Association (AWWA) Research Foundation, SNL, and WERC (A Consortium for Environmental Education and Technology Development).

  3. Mixed modality intensity-modulated radiation therapy treatment planning for intracranial lesions

    International Nuclear Information System (INIS)

    Lee, Henry J.; Forster, Kenneth M.; Sheldon, John M.; Wood, Rudy R.; Spirou, Spiridon V.; Burman, Chandra M.; Chui, Chen-Shou; Fuks, Zvi Y.; Ling, Clifton C.; Kutcher, Gerald J.; Leibel, Steven A.

    1997-01-01

    Purpose: Intensity-modulated radiotherapy may be improved by incorporating limited-range electrons into photon beam therapy. We examined the feasibility of inverse treatment planning with intensity-modulated photon fields, either alone or combined with uniform high-energy electron fields, for intracranial tumors. Our goal was to generate dose distributions superior to those generated with conventional three-dimensional conformal techniques. Materials and Methods: Optimized three-dimensional treatment plans were compared to intensity-modulated photon plans with and without unmodulated high-energy electron fields for a cohort of previously treated brain tumors. Our in-house optimization system employed an iterative conjugate gradient search algorithm for cost function minimizing. Each set of plans was constrained to identical dose volume limits for critical non-target structures and dose prescription specifications for the planning target volume. In addition, each set used almost identical photon beam orientations to facilitate comparisons (for intensity-modulated plans, parallel opposed fields were slightly off-set to more effectively utilize the dosimetric advantages of inverse planning). Dosimetric comparisons were performed by examining planar and volumetric isodose distributions as well as dose-volume histograms. In particular, differences in integral dose to non-target brain tissue were evaluated. All plans were designed for implementation on a standard Varian 2100C with dynamic multileaf capability. Results: Peripheral targets demonstrated the greatest benefit from mixed modality intensity-modulated treatment planning. The principle dosimetric advantage was a decreased integral dose to the normal brain when calculated by taking a first moment integral of a differential dose volume histogram of normal brain tissue. The majority of this benefit was typically achieved through at least a 50% reduction in the volume of normal tissue receiving more than 80% of the

  4. Advanced care planning: the impact of Ceiling of Treatment plans in patients with Coordinate My Care.

    Science.gov (United States)

    Broadhurst, Helen Lucy; Droney, Joanne; Callender, Tom; Shaw, Amanda; Riley, Julia

    2018-03-22

    The aim of this evaluation is to describe the components and results of urgent care planning in Coordinate My Care (CMC), a digital clinical service for patients with life-limiting illness, for use if a patient is unable to make or express choices. Ceiling of treatment (CoT) plans were created detailing where the patient would like to receive their care and how aggressive medical interventions should be. A retrospective service evaluation was completed of all CMC records created between December 2015 and September 2016 (n=6854). CMC records were divided into two cohorts: those with a CoT plan and those without. The factors associated with these cohorts were reviewed including age, diagnosis, resuscitation status and preferences for place of death (PPD). Analysis of the non-mandatory free text section was carried out. Two-thirds of patients had recorded decisions about CoT. Regardless of which CoT option was chosen, for most patients, PPD was home or care home. Patients with a CoT plan were more likely to have a documented resuscitation status.Patients with a CoT were more likely to die in their PPD (82%vs71%, OR 1.79, pcare planning. Three facets of urgent care planning identified include PPD, CoT and resuscitation status. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  6. 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

  7. Records needed for orthodontic diagnosis and treatment planning: a systematic review.

    Directory of Open Access Journals (Sweden)

    Robine J Rischen

    Full Text Available BACKGROUND: Traditionally, dental models, facial and intra-oral photographs and a set of two-dimensional radiographs are used for orthodontic diagnosis and treatment planning. As evidence is lacking, the discussion is ongoing which specific records are needed for the process of making an orthodontic treatment plan. OBJECTIVE: To estimate the contribution and importance of different diagnostic records for making an orthodontic diagnosis and treatment plan. DATA SOURCES: An electronic search in PubMed (1948-July 2012, EMBASE Excerpta Medica (1980-July 2012, CINAHL (1982-July 2012, Web of Science (1945-July 2012, Scopus (1996-July 2012, and Cochrane Library (1993-July 2012 was performed. Additionally, a hand search of the reference lists of included studies was performed to identify potentially eligible studies. There was no language restriction. STUDY SELECTION: The patient, intervention, comparator, outcome (pico question formulated for this study was as follows: for patients who need orthodontic treatment (P, will the use of record set X (I compared with record set Y (C change the treatment plan (O? Only primary publications were included. DATA EXTRACTION: Independent extraction of data and quality assessment was performed by two observers. RESULTS: Of the 1041 publications retrieved, 17 met the inclusion criteria. Of these, 4 studies were of high quality. Because of the limited number of high quality studies and the differences in study designs, patient characteristics, and reference standard or index test, a meta-analysis was not possible. CONCLUSION: Cephalograms are not routinely needed for orthodontic treatment planning in Class II malocclusions, digital models can be used to replace plaster casts, and cone-beam computed tomography radiographs can be indicated for impacted canines. Based on the findings of this review, the minimum record set required for orthodontic diagnosis and treatment planning could not be defined. SYSTEMATIC REVIEW

  8. Records needed for orthodontic diagnosis and treatment planning: a systematic review.

    Science.gov (United States)

    Rischen, Robine J; Breuning, K Hero; Bronkhorst, Ewald M; Kuijpers-Jagtman, Anne Marie

    2013-01-01

    Traditionally, dental models, facial and intra-oral photographs and a set of two-dimensional radiographs are used for orthodontic diagnosis and treatment planning. As evidence is lacking, the discussion is ongoing which specific records are needed for the process of making an orthodontic treatment plan. To estimate the contribution and importance of different diagnostic records for making an orthodontic diagnosis and treatment plan. An electronic search in PubMed (1948-July 2012), EMBASE Excerpta Medica (1980-July 2012), CINAHL (1982-July 2012), Web of Science (1945-July 2012), Scopus (1996-July 2012), and Cochrane Library (1993-July 2012) was performed. Additionally, a hand search of the reference lists of included studies was performed to identify potentially eligible studies. There was no language restriction. The patient, intervention, comparator, outcome (pico) question formulated for this study was as follows: for patients who need orthodontic treatment (P), will the use of record set X (I) compared with record set Y (C) change the treatment plan (O)? Only primary publications were included. Independent extraction of data and quality assessment was performed by two observers. Of the 1041 publications retrieved, 17 met the inclusion criteria. Of these, 4 studies were of high quality. Because of the limited number of high quality studies and the differences in study designs, patient characteristics, and reference standard or index test, a meta-analysis was not possible. Cephalograms are not routinely needed for orthodontic treatment planning in Class II malocclusions, digital models can be used to replace plaster casts, and cone-beam computed tomography radiographs can be indicated for impacted canines. Based on the findings of this review, the minimum record set required for orthodontic diagnosis and treatment planning could not be defined. CRD42012002365.

  9. Patients with hip prosthesis: radiotherapy treatment planning considerations

    International Nuclear Information System (INIS)

    Ganesh, K.M.; Supe, Sanjay S.

    2000-01-01

    The number of patients with hip prosthesis undergoing radiotherapy for pelvic cancer worldwide is increasing. This might be of importance depending on the materials in the prosthesis and whether any of the treatment fields are involved in the prosthesis. Radiotherapy planning involving the pelvic region of patients having total hip prosthesis has been found to be difficult due to the effect of the prosthesis on the dose distribution. This review is intended to project dosimetric considerations and possible solutions to this uncommon problem

  10. Interactive treatment planning in toothwear: are we doing it right?

    Science.gov (United States)

    Eliyas, Shiyana; Shah, Kewal; Briggs, Peter F A

    2014-04-01

    Toothwear is now common, especially in younger patients, with high demand for the restoration of the damaged teeth which is likely to increase further over time. Fixed prosthodontic options range from direct composite resin to conventional tooth preparation and cemented indirect restorations. This paper summarizes the views of a variety of clinicians on a plan delivered to a patient with toothwear in secondary care and explores the possible reasons for the variation in decision-making in the treatment of toothwear. With levels of toothwear increasing, the clinician needs to be aware of the different treatment modalities which are appropriate.

  11. NOTE: Patient-specific planning for prevention of mechanical collisions during radiotherapy

    Science.gov (United States)

    Nioutsikou, Elena; Bedford, James L.; Webb, Steve

    2003-11-01

    A common unwanted difficulty in treatment planning, especially in non-coplanar radiotherapy set-ups, is the potential collision of the rotating gantry with the couch and/or the patient's body. A technique and computer program that detects these and signals avoidance of such beam directions is presented. The problem was approached using analytical geometry. The separate components within the treatment room have either been measured and modelled for an Elekta linear accelerator, or read out from a Pinnacle3 treatment planning system and are represented as an integer grid of points in three-dimensional (3D) space. The module is attached to the treatment planning system and can provide rejection or acceptance of unwanted beam directions in a plan. In contrast to previous work that has only used patient models, each individual patient's outlines are considered here in their actual treatment position inclusive of any immobilization device. The extremities of the patient superiorly and inferiorly to the scanned region are simulated by an expanded version of the RANDO phantom. In this way, 'potential' collisions can be detected in addition to the certain ones. Patient position is not a limiting factor for the accuracy of the collision detection anymore, as each set-up is always created around the isocentre. Maps of allowed and forbidden zones within the treatment suite have been created by running the code for all possible gantry and couch angles for three commonly arising cases: a head and neck plan utilizing a small stereotactic collimator, a prostate plan with multileaf collimators and an abdominal plan with the lead tray attached. In the last case, the 3D map permitted significantly fewer set-up combinations. Good agreement between prediction and experiment confirmed the capability of the program and introduces a promising add-on for treatment planning.

  12. Paediatric Photon and Proton Radiotherapy Treatment Planning Based on Advanced Imaging

    DEFF Research Database (Denmark)

    Kornerup, Josefine S.

    affecting the cancer cells, the treatment regimen often leads to undesired damage in healthy tissue and these treatment-induced side effects may impair the function of vital organs. The severity of the injury can range from potentially lethal to being rather easily managed with regular follow...... radiotherapy treatment planning in combination with the nuclear medicine imaging technique positron emission tomography (PET). Specifically, we investigate the potential impact on the radiotherapy treatment plans of modern radiotherapy modalities for paediatric and adolescent cancer patients, when adding...... survival of the patients and due to the increased risk of secondary cancers following the increased radiation dose. In this context, radiation oncology experts must critically assess whether the use of PET is of benefit to the patients. The low number of paediatric cancer patients and the considerable...

  13. 3D Computer aided treatment planning in endodontics.

    Science.gov (United States)

    van der Meer, Wicher J; Vissink, Arjan; Ng, Yuan Ling; Gulabivala, Kishor

    2016-02-01

    Obliteration of the root canal system due to accelerated dentinogenesis and dystrophic calcification can challenge the achievement of root canal treatment goals. This paper describes the application of 3D digital mapping technology for predictable navigation of obliterated canal systems during root canal treatment to avoid iatrogenic damage of the root. Digital endodontic treatment planning for anterior teeth with severely obliterated root canal systems was accomplished with the aid of computer software, based on cone beam computer tomography (CBCT) scans and intra-oral scans of the dentition. On the basis of these scans, endodontic guides were created for the planned treatment through digital designing and rapid prototyping fabrication. The custom-made guides allowed for an uncomplicated and predictable canal location and management. The method of digital designing and rapid prototyping of endodontic guides allows for reliable and predictable location of root canals of teeth with calcifically metamorphosed root canal systems. The endodontic directional guide facilitates difficult endodontic treatments at little additional cost. Copyright © 2016. Published by Elsevier Ltd.

  14. Implementation of enhanced dynamic wedges in pinnacle treatment planning system

    International Nuclear Information System (INIS)

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

    2005-01-01

    Enhanced dynamic wedges (EDW) provide many advantages over traditional hard wedges for linear accelerator treatments. Along with these advantages comes the responsibility of ensuring that this complex technology delivers the correct dose to patients. This involves determining the enhanced dynamic wedge factors for various field sizes and depths for use in the hand calculation of monitor units (MUs). The accurate representation of dynamic wedges in the treatment planning computer must also be ensured. This is required so that the final isodose distributions are correct and the MUs calculated by the treatment planning computer match those determined by hand calculation. We have commissioned and implemented the use of EDW in the Pinnacle radiation therapy planning system. The modeled dose profiles agree with the measured ones with a maximum difference of 2%. The MUs generated by Pinnacle are also within 2% of those calculated independently. The process of data collection and verification, beam modeling, and a discussion of a potential pitfall encountered in this process are presented in this paper

  15. Prescribing of drugs for the treatment of migraine with specific ...

    African Journals Online (AJOL)

    Migraine affects between 5.15% of males and 13,5-31% of females in South Africa. Little is known about the prescribing patterns of anti-migraine drugs in South Africa. The aim of the study was to investigate the prescribing of drugs for the treatment of migraine (ATC Group NOZC), with specific emphasis on sumatriptan, in a ...

  16. Inclusion of geometric uncertainties in treatment plan evaluation

    International Nuclear Information System (INIS)

    Herk, Marcel van; Remeijer, Peter; Lebesque, Joos V.

    2002-01-01

    Purpose: To correctly evaluate realistic treatment plans in terms of absorbed dose to the clinical target volume (CTV), equivalent uniform dose (EUD), and tumor control probability (TCP) in the presence of execution (random) and preparation (systematic) geometric errors. Materials and Methods: The dose matrix is blurred with all execution errors to estimate the total dose distribution of all fractions. To include preparation errors, the CTV is randomly displaced (and optionally rotated) many times with respect to its planned position while computing the dose, EUD, and TCP for the CTV using the blurred dose matrix. Probability distributions of these parameters are computed by combining the results with the probability of each particular preparation error. We verified the method by comparing it with an analytic solution. Next, idealized and realistic prostate plans were tested with varying margins and varying execution and preparation error levels. Results: Probability levels for the minimum dose, computed with the new method, are within 1% of the analytic solution. The impact of rotations depends strongly on the CTV shape. A margin of 10 mm between the CTV and planning target volume is adequate for three-field prostate treatments given the accuracy level in our department; i.e., the TCP in a population of patients, TCP pop , is reduced by less than 1% due to geometric errors. When reducing the margin to 6 mm, the dose must be increased from 80 to 87 Gy to maintain the same TCP pop . Only in regions with a high-dose gradient does such a margin reduction lead to a decrease in normal tissue dose for the same TCP pop . Based on a rough correspondence of 84% minimum dose with 98% EUD, a margin recipe was defined. To give 90% of patients at least 98% EUD, the planning target volume margin must be approximately 2.5 Σ + 0.7 σ - 3 mm, where Σ and σ are the combined standard deviations of the preparation and execution errors. This recipe corresponds accurately with 1% TCP

  17. IMRT head and neck treatment planning with a commercially available Monte Carlo based planning system

    International Nuclear Information System (INIS)

    Boudreau, C; Heath, E; Seuntjens, J; Ballivy, O; Parker, W

    2005-01-01

    The PEREGRINE Monte Carlo dose-calculation system (North American Scientific, Cranberry Township, PA) is the first commercially available Monte Carlo dose-calculation code intended specifically for intensity modulated radiotherapy (IMRT) treatment planning and quality assurance. In order to assess the impact of Monte Carlo based dose calculations for IMRT clinical cases, dose distributions for 11 head and neck patients were evaluated using both PEREGRINE and the CORVUS (North American Scientific, Cranberry Township, PA) finite size pencil beam (FSPB) algorithm with equivalent path-length (EPL) inhomogeneity correction. For the target volumes, PEREGRINE calculations predict, on average, a less than 2% difference in the calculated mean and maximum doses to the gross tumour volume (GTV) and clinical target volume (CTV). An average 16% ± 4% and 12% ± 2% reduction in the volume covered by the prescription isodose line was observed for the GTV and CTV, respectively. Overall, no significant differences were noted in the doses to the mandible and spinal cord. For the parotid glands, PEREGRINE predicted a 6% ± 1% increase in the volume of tissue receiving a dose greater than 25 Gy and an increase of 4% ± 1% in the mean dose. Similar results were noted for the brainstem where PEREGRINE predicted a 6% ± 2% increase in the mean dose. The observed differences between the PEREGRINE and CORVUS calculated dose distributions are attributed to secondary electron fluence perturbations, which are not modelled by the EPL correction, issues of organ outlining, particularly in the vicinity of air cavities, and differences in dose reporting (dose to water versus dose to tissue type)

  18. Scanned ion beam therapy for prostate carcinoma. Comparison of single plan treatment and daily plan-adapted treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hild, Sebastian [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Department of Biophysics, Darmstadt (Germany); University Clinic Erlangen and Friedrich- Alexander-University Erlangen-Nuernberg (FAU), Department of Radiation Oncology, Erlangen (Germany); Graeff, Christian [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Department of Biophysics, Darmstadt (Germany); Rucinski, Antoni [University Clinic Heidelberg, Heidelberg Ion-Beam Therapy Center (HIT) and Department of Radiation Oncology, Heidelberg (Germany); Sapienza Universit' a di Roma, Dipartimento di Scienze di Base e Applicate per Ingegneria, Roma (Italy); INFN, Roma (Italy); Zink, Klemens [University of Applied Sciences, Institute for Medical Physics and Radiation Protection, Giessen (Germany); University Medical Center Giessen-Marburg, Department of Radiotherapy and Radiooncology, Marburg (Germany); Habl, Gregor [University Clinic Heidelberg, Heidelberg Ion-Beam Therapy Center (HIT) and Department of Radiation Oncology, Heidelberg (Germany); Klinikum rechts der Isar, Technische Universitaet Muenchen (TUM), Department of Radiation Oncology, Munich (Germany); Durante, Marco [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Department of Biophysics, Darmstadt (Germany); Technische Universitaet Darmstadt, Faculty of Physics, Darmstadt (Germany); Herfarth, Klaus [University Clinic Heidelberg, Heidelberg Ion-Beam Therapy Center (HIT) and Department of Radiation Oncology, Heidelberg (Germany); Bert, Christoph [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Department of Biophysics, Darmstadt (Germany); University Clinic Erlangen and Friedrich- Alexander-University Erlangen-Nuernberg (FAU), Department of Radiation Oncology, Erlangen (Germany); University Hospital Erlangen, Radiation Oncology, Erlangen (Germany)

    2016-02-15

    Intensity-modulated particle therapy (IMPT) for tumors showing interfraction motion is a topic of current research. The purpose of this work is to compare three treatment strategies for IMPT to determine potential advantages and disadvantages of ion prostate cancer therapy. Simulations for three treatment strategies, conventional one-plan radiotherapy (ConvRT), image-guided radiotherapy (IGRT), and online adaptive radiotherapy (ART) were performed employing a dataset of 10 prostate cancer patients with six CT scans taken at one week intervals. The simulation results, using a geometric margin concept (7-2 mm) as well as patient-specific internal target volume definitions for IMPT were analyzed by target coverage and exposure of critical structures on single fraction dose distributions. All strategies led to clinically acceptable target coverage in patients exhibiting small prostate motion (mean displacement < 4 mm), but IGRT and especially ART led to significant sparing of the rectum. In 20 % of the patients, prostate motion exceeded 4 mm causing insufficient target coverage for ConvRT (V95{sub mean} = 0.86, range 0.63-0.99) and IGRT (V95{sub mean} = 0.91, range 0.68-1.00), while ART maintained acceptable target coverage. IMPT of prostate cancer demands consideration of rectal sparing and adaptive treatment replanning for patients exhibiting large prostate motion. (orig.) [German] Adaptive Therapieansaetze fuer sich interfraktionell bewegende Zielvolumina in der intensitaetsmodulierten Partikeltherapie (IMPT) befinden sich zurzeit in der Entwicklung. In dieser Arbeit werden drei Behandlungsstrategien auf moegliche Vor- und Nachteile in der IMPT des Prostatakarzinoms hin untersucht. Auf Basis eines anonymisierten Datensatzes aus 10 Patienten mit Prostatakarzinom wurden die drei Bestrahlungsstrategien, konventionelle Ein-Plan-Strahlentherapie (ConvRT), bildunterstuetzte Strahlentherapie (IGRT) und tagesaktuelle Strahlentherapie (adaptive radiotherapy,ART), simuliert

  19. Savannah River Site`s Site Specific Plan. Environmental restoration and waste management, fiscal year 1992

    Energy Technology Data Exchange (ETDEWEB)

    1991-08-01

    This Site Specific Plan (SSP) has been prepared by the Savannah River Site (SRS) in order to show the Environmental Restoration and Waste Management activities that were identified during the preparation of the Department of Energy-Headquarters (DOE-HQ) Environmental Restoration and Waste Management Five-Year Plan (FYP) for FY 1992--1996. The SSP has been prepared in accordance with guidance received from DOE-HQ. DOE-SR is accountable to DOE-HQ for the implementation of this plan. The purpose of the SSP is to develop a baseline for policy, budget, and schedules for the DOE Environmental Restoration and Waste Management activities. The plan explains accomplishments since the Fiscal Year (FY) 1990 plan, demonstrates how present and future activities are prioritized, identifies currently funded activities and activities that are planned to be funded in the upcoming fiscal year, and describes future activities that SRS is considering.

  20. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

    International Nuclear Information System (INIS)

    Ottosson, Rickard O.; Sjoestroem, David; Behrens, Claus F.; Karlsson, Anna; Engstroem, Per E.; Knoeoes, Tommy; Ceberg, Crister

    2009-01-01

    Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head and neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered

  1. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques.

    Science.gov (United States)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David; Behrens, Claus F; Karlsson, Anna; Knöös, Tommy; Ceberg, Crister

    2009-01-01

    Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered.

  2. Sci—Thur PM: Planning and Delivery — 06: Real-Time Interactive Treatment Planning

    International Nuclear Information System (INIS)

    Matthews, Q; Mestrovic, A; Otto, K

    2014-01-01

    Purpose: To describe and evaluate a novel system for generalized Real-Time Interactive Planning (RTIP) applied to head and neck (H and N) VMAT. Methods: The clinician interactively manipulates dose distributions using DVHs, isodoses, or rate of dose fall-off, which may be subjected to user-defined constraints. Dose is calculated using a fast Achievable Dose Estimate (ADE) algorithm, which simulates the limits of what can be achieved during treatment. After each manipulation contributing fluence elements are modified and the dose distribution updates in effectively real-time. For H and N VMAT planning, structure sets for 11 patients were imported into RTIP. Each dose distribution was interactively modified to minimize OAR dose while constraining target DVHs. The resulting RTIP DVHs were transferred to the Eclipse™ VMAT optimizer, and conventional VMAT optimization was performed. Results: Dose calculation and update times for the ADE algorithm ranged from 2.4 to 22.6 milliseconds, thus facilitating effectively real-time manipulation of dose distributions. For each of the 11 H and N VMAT cases, the RTIP process took ∼2–10 minutes. All RTIP plans exhibited acceptable PTV coverage, mean dose, and max dose. 10 of 11 RTIP plans achieved substantially improved sparing of one or more OARs without compromising dose to targets or other OARs. Importantly, 10 of the 11 RTIP plans required only one or two post-RTIP optimizations. Conclusions: RTIP is a novel system for manipulating and updating achievable dose distributions in real-time. H and N VMAT plans generated using RTIP demonstrate improved OAR sparing and planning efficiency. Disclosures: One author has a commercial interest in the presented materials

  3. Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: A systematic review.

    Science.gov (United States)

    Walter, Clemens; Schmidt, Julia C; Dula, Karl; Sculean, Anton

    2016-01-01

    The improvement in diagnostic accuracy and optimization of treatment planning in periodontology through the use of three-dimensional imaging with cone beam computed tomography (CBCT) is discussed controversially in the literature. The objective was to identify the best available external evidence for the indications of CBCT for periodontal diagnosis and treatment planning in specific clinical situations. A systematic literature search was performed for articles published by 2 March 2015 using electronic databases and hand search. Two reviewers performed the study selection, data collection, and validity assessment. PICO and PRISMA criteria were applied. From the combined search, seven studies were finally included. The case series were published from the years 2009 to 2014. Five of the included publications refer to maxillary and/or mandibular molars and two to aspects related to vertical bony defects. Two studies show a high accuracy of CBCT in detecting intrabony defect morphology when compared to periapical radiographs. Particularly, in maxillary molars, CBCT provides high accuracy for detecting furcation involvement and morphology of surrounding periodontal tissues. CBCT has demonstrated advantages, when more invasive treatment approaches were considered in terms of decision making and cost benefit. Within their limits, the available data suggest that CBCT may improve diagnostic accuracy and optimize treatment planning in periodontal defects, particularly in maxillary molars with furcation involvement, and that the higher irradiation doses and cost-benefit ratio should be carefully analyzed before using CBCT for periodontal diagnosis and treatment planning.

  4. On the quality of treatment planning systems in radiation therapy.

    Science.gov (United States)

    Panten, T; Höss, A; Bohsung, J; Becker, G; Sroka-Pérez, G

    1998-10-01

    To assist in the design of quality assurance activities of 3D treatment planning systems (TPSs), a postal survey has been carried out, addressing TPS users on quality characteristics and their relative importance in clinical routine planning. The approach as described in ISO/IEC 9126 has been used to analyze TPS quality. Both TPS quality characteristics and how these may be used to establish a quality model are included. A questionnaire on ranking of these TPS quality characteristics has been sent out to the German DEGRO members in February 1997. By the end of July 1997, 90 individual assessments (of 45 physicists, 35 physicians, and 10 radiographers) had been collected. On an importance scale from 1 (very important) to 6 (unimportant), weight factors of 1.71 (portability), 2.84 (maintainability), 3.18 (efficiency), 3.85 (usability), 4.52 (functionality) and 4.90 (reliability) have been determined from the data. From user satisfaction data also obtained from the questionnaire responses, baseline quality indices could be established from the quality model for the RTPs Cadplan, TMS Helax, and Voxelplan. The responses highlight the need for TPS quality assurance at the same time along the lines of safety-related, research-oriented, and interactive end-user software systems in radiotherapy treatment planning. Quality assurance activities must take this into account. Their effect can be monitored by using quality indices as derivable from the established quality model.

  5. Treatment planning systems dosimetry auditing project in Portugal.

    Science.gov (United States)

    Lopes, M C; Cavaco, A; Jacob, K; Madureira, L; Germano, S; Faustino, S; Lencart, J; Trindade, M; Vale, J; Batel, V; Sousa, M; Bernardo, A; Brás, S; Macedo, S; Pimparel, D; Ponte, F; Diaz, E; Martins, A; Pinheiro, A; Marques, F; Batista, C; Silva, L; Rodrigues, M; Carita, L; Gershkevitsh, E; Izewska, J

    2014-02-01

    The Medical Physics Division of the Portuguese Physics Society (DFM_SPF) in collaboration with the IAEA, carried out a national auditing project in radiotherapy, between September 2011 and April 2012. The objective of this audit was to ensure the optimal usage of treatment planning systems. The national results are presented in this paper. The audit methodology simulated all steps of external beam radiotherapy workflow, from image acquisition to treatment planning and dose delivery. A thorax CIRS phantom lend by IAEA was used in 8 planning test-cases for photon beams corresponding to 15 measuring points (33 point dose results, including individual fields in multi-field test cases and 5 sum results) in different phantom materials covering a set of typical clinical delivery techniques in 3D Conformal Radiotherapy. All 24 radiotherapy centers in Portugal have participated. 50 photon beams with energies 4-18 MV have been audited using 25 linear accelerators and 32 calculation algorithms. In general a very good consistency was observed for the same type of algorithm in all centres and for each beam quality. The overall results confirmed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy is generally acceptable with no major causes for concern. This project contributed to the strengthening of the cooperation between the centres and professionals, paving the way to further national collaborations. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  6. 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.

  7. Auditing local methods for quality assurance in radiotherapy using the same set of predefined treatment plans

    Directory of Open Access Journals (Sweden)

    Enrica Seravalli

    2018-01-01

    Full Text Available Background and purpose: Local implementation of plan-specific quality assurance (QA methods for intensity-modulated radiotherapy (IMRT and volumetric modulated arc therapy (VMAT treatment plans may vary because of dissimilarities in procedures, equipment and software. The purpose of this work is detecting possible differences between local QA findings and those of an audit, using the same set of treatment plans. Methods: A pre-defined set of clinical plans was devised and imported in the participating institute’s treatment planning system for dose computation. The dose distribution was measured using an ionisation chamber, radiochromic film and an ionisation chamber array. The centres performed their own QA, which was compared to the audit findings. The agreement/disagreement between the audit and the institute QA results were assessed along with the differences between the dose distributions measured by the audit team and computed by the institute. Results: For the majority of the cases the results of the audit were in agreement with the institute QA findings: ionisation chamber: 92%, array: 88%, film: 76% of the total measurements. In only a few of these cases the evaluated measurements failed for both: ionisation chamber: 2%, array: 4%, film: 0% of the total measurements. Conclusion: Using predefined treatment plans, we found that in approximately 80% of the evaluated measurements the results of local QA of IMRT and VMAT plans were in line with the findings of the audit. However, the percentage of agreement/disagreement depended on the characteristics of the measurement equipment used and on the analysis metric. Keywords: Quality assurance, Dosimetry audit, IMRT, VMAT, QA devices

  8. Patient selection and treatment planning for implant restorations.

    Science.gov (United States)

    Bryington, Matthew; De Kok, Ingeborg J; Thalji, Ghadeer; Cooper, Lyndon F

    2014-01-01

    Dental implants are an indispensible tool for the restoration of missing teeth. Their use has elevated the practice of dentistry by improving both our technical ability to rehabilitate patients and general quality of life. To routinely achieve the associated high expectations, diligent attention to details must be observed and addressed from the outset. Of central concern is the attainment of osseointegration and the location of implants to ideally support the intended restoration. The pivotal point in treatment planning for dental implants occurs when the location of bone is viewed radiographically in the context of the planned prosthesis. This most often requires diagnostic waxing or tooth arrangement using mounted diagnostic casts. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. [Reproductive health after cancer treatment--contraception, planning and monitoring of pregnancy].

    Science.gov (United States)

    Jokimaa, Varpu; Ekblad, Ulla

    2012-01-01

    Infertility is common after cancer treatments, but pregnancies of those treated for cancer usually proceed well. Pretreatment counseling by a fertility doctor improves posttreatment quality of life. The most important issues to be considered in pregnancy planning and monitoring include cytotoxic drug induced organ-specific insufficiencies and radiotherapy targeted at the thoracic region, whole body, or at the uterus during childhood. Hypothyroidism is the most common hormonal complication and is also significant with respect to fertility and gravidity.

  10. Transportation Systems: Critical Infrastructure and Key Resources Sector-Specific Plan as Input to the National Infrastructure Protection Plan

    Science.gov (United States)

    2007-05-01

    Intelligence Report: Weekly compilation and analysis at the FOUO/SSI level of terrorist threats, trends , incidents, and suspicious events that are...suspicious incidents. • Intelligence Notes: Classified and FOUO/SSI assessments of transportation-related threat information; terrorist trends ...and will help develop a more secure model for future eBusiness strategies and positioning. 62 Transportation Systems Sector-Specific Plan Figure

  11. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

    DEFF Research Database (Denmark)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David

    2008-01-01

    Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions...... constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics...... of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample...

  12. 3-Dimentional radiotherapy versus conventional treatment plans for gastric cancer

    Directory of Open Access Journals (Sweden)

    Aghili M

    2010-11-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The current standard of adjuvant management for gastric cancer after curative resection based on the results of intergroup 0116 is concurrent chemoradiation. Current guidelines for designing these challenging fields still include two-dimensional simulation with simple AP-PA parallel opposed design. However, the implementation of radiotherapy (RT remains a concern. Our objective was to compare three-dimensional (3D techniques to the more commonly used AP-PA technique."n"nMethods: A total of 24 patients with stages II-IV adenocarcinoma of the stomach were treated with adjuvant postoperative chemoradiation with simple AP-PA technique, using Cobalt-60. Total radiation dose was 50.4Gy. Landmark-based fields were simulated to assess PTV coverage. For each patient, three additional radiotherapy treatment plans were generated using three-dimensional (3D technique. The four treatment plans were then compared for target volume coverage and dose to normal tissues (liver, spinal cord, kidneys using dose volume histogram (DVH analysis."n"nResults: The three-dimensional planning techniques provided 10% superior PTV coverage compared to conventional AP-PA fields (p<0.001. Comparative DVHs for the right kidney, left kidney

  13. 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

  14. 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.

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

    International Nuclear Information System (INIS)

    Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

    2015-01-01

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

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

    Science.gov (United States)

    Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

    2015-05-01

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

  17. Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

    International Nuclear Information System (INIS)

    Fortunati, Valerio; Niessen, Wiro J; Veenland, Jifke F; Van Walsum, Theo; Verhaart, René F; Paulides, Margarethus M

    2015-01-01

    A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck.Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available.The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used.Using the proposed approach we improved the performance of the approach previously presented for H and N hyperthermia treatment planning, making the method suitable for clinical application. (paper)

  18. Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

    Science.gov (United States)

    Fortunati, Valerio; Verhaart, René F.; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; van Walsum, Theo

    2015-08-01

    A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck. Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available. The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used. Using the proposed approach we improved the performance of the approach previously presented for H&N hyperthermia treatment planning, making the method suitable for clinical application.

  19. Reliability and Factorial Validity of Non-Specific and Tennis-Specific Pre-Planned Agility Tests; Preliminary Analysis.

    Science.gov (United States)

    Sekulic, Damir; Uljevic, Ognjen; Peric, Mia; Spasic, Miodrag; Kondric, Miran

    2017-01-01

    Agility is an important quality in tennis, yet there is an evident lack of studies focussing on the applicability of tennis-specific agility performances and comparing them to equivalent non-specific agility performances. The aim of this study was to evaluate the reliability and factorial validity of three tests of pre-planned agility, performed in specific (with a tennis racquet) and non-specific (without a tennis racquet) conditions. The sample consisted of 33 tennis players (13 males and 20 females; age: 18.3 ± 1.1 years and 18.6 ± 1.3 years; body height: 185.4 ± 51 cm and 169.3 ± 4.2 cm, 74.0 ± 4.4 kg and 61.2 ± 3.1 kg, respectively). The variables comprised three agility tests: a 20-yard test, a T-test and the Illinois test, all performed in both specific and non-specific conditions. Between-subject and within-subject reliability were found to be high (Cronbach Alpha: 0.93 to 0.98; Coefficient of Variation: 3 to 8%), with better within-subject reliability and stability of the measurement for specific tests. Pearson's product moment correlations between the non-specific and specific agility performances were high (r ≥0.84), while factor analysis extracted only one significant latent dimension on the basis of the Guttman-Kaiser criterion. The results of the 20-yard test were better when the test was conducted in the specific conditions (t-test = 2.66; p agility, we suggest using tests of short duration (less than 10 s) and sport-specific types of locomotion.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  1. Incorporating Age-Specific Plans of Care to Achieve Optimal Perioperative Outcomes.

    Science.gov (United States)

    Mower, Juliana

    2015-10-01

    When developing a nursing plan of care, a perioperative nurse identifies nursing diagnoses during the preoperative patient assessment. The ability to identify age-specific outcomes (ie, infant/child, adolescent, adult, elderly adult) in addition to those that are universally applicable is a major responsibility of the perioperative RN. Having an individualized plan of care is one of the best ways to determine whether desired patient outcomes have been successfully attained. Nursing care plans address intraoperative and postoperative risks and allow for a smooth transfer of care throughout the perioperative experience. A good nursing care plan also includes education for the patient and his or her caregiver. Within an overall plan of care, the use of methods such as a concept or mind map can visually demonstrate the relationships between systems, nursing diagnoses, nursing interventions, and desirable outcomes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  2. Conformal Radiotherapy: Physics, Treatment Planning and Verification. Proceedings book

    Energy Technology Data Exchange (ETDEWEB)

    De Wagter, C. [ed.

    1995-12-01

    The goal of conformal radiotherapy is to establish radiation dose distributions that conform tightly to the target volume in view of limiting radiation to normal tissues. Conformal radiotherapy significantly improves both local control and palliation and thus contributes to increase survival and to improve the quality of life. The subjects covered by the symposium include : (1) conformal radiotherapy and multi-leaf collimation; (2) three dimensional imaging; (3) treatment simulation, planning and optimization; (4) quality assurance; and (5) dosimetry. The book of proceedings contains the abstracts of the invited lectures, papers and poster presentations as well as the full papers of these contributions.

  3. Conformal Radiotherapy: Physics, Treatment Planning and Verification. Proceedings book

    International Nuclear Information System (INIS)

    De Wagter, C.

    1995-12-01

    The goal of conformal radiotherapy is to establish radiation dose distributions that conform tightly to the target volume in view of limiting radiation to normal tissues. Conformal radiotherapy significantly improves both local control and palliation and thus contributes to increase survival and to improve the quality of life. The subjects covered by the symposium include : (1) conformal radiotherapy and multi-leaf collimation; (2) three dimensional imaging; (3) treatment simulation, planning and optimization; (4) quality assurance; and (5) dosimetry. The book of proceedings contains the abstracts of the invited lectures, papers and poster presentations as well as the full papers of these contributions

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  6. Treatment planning with intensity modulated particle therapy for multiple targets in stage IV non-small cell lung cancer

    Science.gov (United States)

    Anderle, Kristjan; Stroom, Joep; Vieira, Sandra; Pimentel, Nuno; Greco, Carlo; Durante, Marco; Graeff, Christian

    2018-01-01

    Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios. The results from our algorithm were compared to clinical stereotactic body radiation treatment (SBRT) plans. The study included eight patients with 24 lesions in total. Intended dose regimen for SBRT was 24 Gy in one fraction, but lower fractionated doses had to be delivered in three cases due to OAR constraints or failed plan quality assurance. The resulting IMPT treatment plans had no significant difference in target coverage compared to SBRT treatment plans. Average maximum point dose and dose to specific volume in OARs were on average 65% and 22% smaller with IMPT. IMPT could also deliver 24 Gy in one fraction in a patient where SBRT was limited due to the OAR vicinity. The developed algorithm shows the potential of IMPT in treatment of multiple moving targets in a complex geometry.

  7. A Treatment Planning Analysis of Inverse-Planned and Forward-Planned Intensity-Modulated Radiation Therapy in Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Poon, Ian M; Xia Ping; Weinberg, Vivien; Sultanem, Khalil; Akazawa, Clayton C.; Akazawa, Pamela C.; Verhey, Lynn; Quivey, Jeanne Marie; Lee, Nancy

    2007-01-01

    Purpose: To compare dose-volume histograms of target volumes and organs at risk in 57 patients with nasopharyngeal carcinoma (NPC) with inverse- (IP) or forward-planned (FP) intensity-modulated radiation treatment (IMRT). Methods and Materials: The DVHs of 57 patients with NPC with IMRT with or without chemotherapy were reviewed. Thirty-one patients underwent IP IMRT, and 26 patients underwent FP IMRT. Treatment goals were to prescribe a minimum dose of 66-70 Gy for gross tumor volume and 59.4 Gy for planning target volume to greater than 95% of the volume. Multiple selected end points were used to compare dose-volume histograms of the targets, including minimum, mean, and maximum doses; percentage of target volume receiving less than 90% (1-V90%), less than 95% (1-V95%), and greater than 105% (1-V105%). Dose-volume histograms of organs at risk were evaluated with characteristic end points. Results: Both planning methods provided excellent target coverage with no statistically significant differences found, although a trend was suggested in favor of improved target coverage with IP IMRT in patients with T3/T4 NPC (p = 0.10). Overall, IP IMRT statistically decreased the dose to the parotid gland, temporomandibular joint, brain stem, and spinal cord overall, whereas IP led to a dose decrease to the middle/inner ear in only the T1/T2 subgroup. Conclusions: Use of IP and FP IMRT can lead to good target coverage while maintaining critical structures within tolerance. The IP IMRT selectively spared these critical organs to a greater degree and should be considered the standard of treatment in patients with NPC, particularly those with T3/T4. The FP IMRT is an effective second option in centers with limited IP IMRT capacity. As a modification of conformal techniques, the human/departmental resources to incorporate FP-IMRT should be nominal

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  9. Multiobjective approach in plans for treatment of cancer by radiotherapy

    Directory of Open Access Journals (Sweden)

    Thalita Monteiro Obal

    2013-08-01

    Full Text Available Nowadays the technique of radiotherapy has been one of the main alternatives for the treatment of several types of cancer today. With technological development, especially in the case of 3D conformal radiotherapy, applications involving mathematical techniques and algorithms have been proposed to help the development a good treatment plan. This paper aims at present a model for multiobjective linear programming problem of dose intensity. The focus of the model is to determine the best dose distribution of radiation field, so that the dose delivered to the tumor to be prescribed and that affects the minimum the noble and healthy tissues. A test case of prostate cancer was used as an example of the numerical model and the Pareto-Optimal Frontier was generated using the method of weighted function.

  10. A research-oriented treatment planning program system

    International Nuclear Information System (INIS)

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

    1982-01-01

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

  11. Advances in 4D treatment planning for scanned particle beam therapy - report of dedicated workshops.

    Science.gov (United States)

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-12-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue.

  12. Treatment planning for children with attention-deficit/hyperactivity disorder: treatment utilization and family preferences

    Directory of Open Access Journals (Sweden)

    William B Brinkman

    2011-01-01

    Full Text Available William B Brinkman, Jeffery N EpsteinDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USABackground: Attention-deficit/hyperactivity disorder (ADHD is a common condition that often results in child and family functional impairments. Although there are evidence-based treatment modalities available, implementation of and persistence with treatment plans vary with patients. Family preferences also vary and may contribute to variability in treatment utilization.Objective: The objective of this study is to describe the evidence-based treatments available for ADHD, identify patterns of use for each modality, and examine patient and parent treatment preferences.Method: Literature review.Results: Treatment options differ on benefits and risks/costs. Therefore, treatment decisions are preference sensitive and depend on how an informed patient/parent values the tradeoffs between options. Literature on patient and parent ADHD treatment preferences is based on quantitative research assessing the construct of treatment acceptability and qualitative and quantitative research that assesses preferences from a broader perspective. After a child is diagnosed with ADHD, a variety of factors influence the initial selection of treatment modalities that are utilized. Initial parent and child preferences are shaped by their beliefs about the nature of the child's problems and by information (and misinformation received from a variety of sources, including social networks, the media, and health care providers. Subsequently, preferences become further informed by personal experience with various treatment modalities. Over time, treatment plans are revisited and revised as families work with their health care team to establish a treatment plan that helps their child achieve goals while minimizing harms and costs.Conclusions: Studies have not been able to determine the extent to which

  13. Simulated Prosthesis Overlay for Patient-Specific Planning of Transcatheter Aortic Valve Implantation Procedures.

    Science.gov (United States)

    Sündermann, Simon H; Gessat, Michael; Maier, Willibald; Kempfert, Jörg; Frauenfelder, Thomas; Nguyen, Thi D L; Maisano, Francesco; Falk, Volkmar

    2015-01-01

    We tested the hypothesis that simulated three-dimensional prosthesis overlay procedure planning may support valve selection in transcatheter aortic valve implantation (TAVI) procedures. Preoperative multidimensional computed tomography (MDCT) data sets from 81 consecutive TAVI patients were included in the study. A planning tool was developed, which semiautomatically creates a three-dimensional model of the aortic root from these data. Three-dimensional templates of the commonly used TAVI implants are spatially registered with the patient data and presented as graphic overlay. Fourteen physicians used the tool to perform retrospective planning of TAVI procedures. Results of prosthesis sizing were compared with the prosthesis size used in the actually performed procedure, and the patients were accordingly divided into three groups: those with equal size (concordance with retrospective planning), oversizing (retrospective planning of a smaller prosthesis), and undersizing (retrospective planning of a larger prosthesis). In the oversizing group, 85% of the patients had new pacemaker implantation. In the undersizing group, in 66%, at least mild paravalvular leakage was observed (greater than grade 1 in one third of the cases). In 46% of the patients in the equal-size group, neither of these complications was observed. Three-dimensional prosthesis overlay in MDCT-derived patient data for patient-specific planning of TAVI procedures is feasible. It may improve valve selection compared with two-dimensional MDCT planning and thus yield better outcomes.

  14. Recent developments in radiation therapy planning and treatment optimization

    International Nuclear Information System (INIS)

    Brahne, A.

    1996-01-01

    Radiation therapy of cancer is today going through a very dynamic development with the introduction of a large number of new treatment principles, new types of treatment units and new radiobiologically based optimization algorithms for treatment planning. All of these make use of the recent developments in three dimensional tumor diagnostics, molecular biology of cancer, the fractionation sensitivity of different tissues and most recently predictive assays of radiation sensitivity. The most efficient but also least developed area of treatment optimization is to use a few non uniform radiation beams directed towards the tumor. Today patient individual collimation with beam blocks or multi leaf collimators protect organs at risk laterally outside the tumor volume. Non uniform dose delivery also allows protection of normal tissues anterior, posterior and even inside the target volume by shaping the isodoses tightly around the tumor tissues and thereby also allowing longitudinal protection of normal tissues. Some of the most advanced new algorithms are even treating therapy optimization as an inverse problem where the optimal incident beam shapes are determined directly from the location of gross disease, presumed microscopic tumor spread and organs at risk. The optimization is then performed such that the probability, P+, to eradicate all clonogenic tumor cells without severely damaging healthy normal tissues is as high as possible. Already with a few non uniform beams the treatment outcome is within a few percent of what can be achieved with infinitely many co-planar beams in a dynamic mood. With such optimized non uniform treatments it should be possible to improve the treatment outcome by as much as 20% and more, particularly in patients with a local complex spread of the disease or several organs at risk. 78 refs., 1 tab., 7 figs

  15. Environmental restoration and waste management site-specific plan for Richland Operations Office

    International Nuclear Information System (INIS)

    1991-09-01

    This document was prepared to implement and support the US Department of Energy-Headquarters (DOE-HQ) national plan. The national plan, entitled Environmental Restoration and Waste Management Five-Year Plan (DOE 1990b) (hereinafter referred to as the DOE-HQ Five-Year Plan) is the cornerstone of the US Department of Energy's (DOE) long-term strategy in environmental restoration and waste management. The DOE-HQ Five-Year Plan addresses overall philosophy and environmental and waste-related activities under the responsibilities of the DOE Office of Environmental Restoration and Waste Management. The plan also reaffirms DOE-HQ goals to bring its nuclear sites into environmental compliance in cooperation with its regulators and the public, and to clean up and restore the environment by 2019 (the commitment for the Hanford Site is for one year sooner, or 2018). This document is part of the site-specific plan for the US Department of Energy-Richland Operations Office (DOE-RL). It is the first revision of the original plan, which was dated December 1989 (DOE-RL 1989a). This document is a companion document to the Overview of the Hanford Cleanup Five-Year Plan (DOE-RL 1989d) and The Hanford Site Environmental Restoration and Waste Management Five-Year Plan Activity Data Sheets (DOE-RL 1991). Although there are three documents that make up the complete DOE-RL plan, this detailed information volume was prepared so it could be used as a standalone document. 71 refs., 40 figs., 28 tabs

  16. Environmental restoration and waste management site-specific plan for Richland Operations Office. [Contains glossary

    Energy Technology Data Exchange (ETDEWEB)

    1991-09-01

    This document was prepared to implement and support the US Department of Energy-Headquarters (DOE-HQ) national plan. The national plan, entitled Environmental Restoration and Waste Management Five-Year Plan (DOE 1990b) (hereinafter referred to as the DOE-HQ Five-Year Plan) is the cornerstone of the US Department of Energy's (DOE) long-term strategy in environmental restoration and waste management. The DOE-HQ Five-Year Plan addresses overall philosophy and environmental and waste-related activities under the responsibilities of the DOE Office of Environmental Restoration and Waste Management. The plan also reaffirms DOE-HQ goals to bring its nuclear sites into environmental compliance in cooperation with its regulators and the public, and to clean up and restore the environment by 2019 (the commitment for the Hanford Site is for one year sooner, or 2018). This document is part of the site-specific plan for the US Department of Energy-Richland Operations Office (DOE-RL). It is the first revision of the original plan, which was dated December 1989 (DOE-RL 1989a). This document is a companion document to the Overview of the Hanford Cleanup Five-Year Plan (DOE-RL 1989d) and The Hanford Site Environmental Restoration and Waste Management Five-Year Plan Activity Data Sheets (DOE-RL 1991). Although there are three documents that make up the complete DOE-RL plan, this detailed information volume was prepared so it could be used as a standalone document. 71 refs., 40 figs., 28 tabs.

  17. Environmental restoration and waste management Site-Specific Plan for the Oak Ridge Reservation

    International Nuclear Information System (INIS)

    1993-01-01

    The United States Department of Energy (DOE) is committed to achieving and maintaining environmental regulatory compliance while responding to public concerns and emphasizing waste minimization. DOE publishes the Environmental Restoration and Waste Management Five-Year Plan (FYP) annually to document its progress towards these goals. The purpose of this Site-Specific Plan (SSP) is to describe the activities undertaken to implement the FYP goals at the DOE Oak Ridge Field Office (DOE/OR) installations and programs specifically for the Oak Ridge Reservation (ORR) and surrounding areas. This SSP addresses activities and goals to be accomplished during FY93 even through the FYP focuses on FY94

  18. Environmental restoration and waste management Site-Specific Plan for the Oak Ridge Reservation. FY 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-15

    The United States Department of Energy (DOE) is committed to achieving and maintaining environmental regulatory compliance while responding to public concerns and emphasizing waste minimization. DOE publishes the Environmental Restoration and Waste Management Five-Year Plan (FYP) annually to document its progress towards these goals. The purpose of this Site-Specific Plan (SSP) is to describe the activities undertaken to implement the FYP goals at the DOE Oak Ridge Field Office (DOE/OR) installations and programs specifically for the Oak Ridge Reservation (ORR) and surrounding areas. This SSP addresses activities and goals to be accomplished during FY93 even through the FYP focuses on FY94.

  19. Vega library for processing DICOM data required in Monte Carlo verification of radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Locke, C.; Zavgorodni, S.; British Columbia Cancer Agency, Vancouver Island Center, Victoria BC

    2008-01-01

    Monte Carlo (MC) methods provide the most accurate to-date dose calculations in heterogeneous media and complex geometries, and this spawns increasing interest in incorporating MC calculations into treatment planning quality assurance process. This involves MC dose calculations for clinically produced treatment plans. To perform these calculations, a number of treatment plan parameters specifying radiation beam

  20. One-Session Treatment of Specific Phobias: A Detailed Description and Review of Treatment Efficacy

    Science.gov (United States)

    Zlomke, Kimberly; Davis, Thompson E., III

    2008-01-01

    One-Session Treatment (OST) is a form of massed exposure therapy for the treatment of specific phobias. OST combines exposure, participant modeling, cognitive challenges, and reinforcement in a single session, maximized to three hours. Clients are gradually exposed to steps of their fear hierarchy using therapist-directed behavioral experiments.…

  1. Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit.

    Science.gov (United States)

    Rutonjski, Laza; Petrović, Borislava; Baucal, Milutin; Teodorović, Milan; Cudić, Ozren; Gershkevitsh, Eduard; Izewska, Joanna

    2012-09-12

    Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.

  2. Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit

    Directory of Open Access Journals (Sweden)

    Rutonjski Laza

    2012-09-01

    Full Text Available Abstract Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs. The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. Results The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. Conclusions The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.

  3. Adaptive modification of treatment planning to minimize the deleterious effects of treatment setup errors

    International Nuclear Information System (INIS)

    Yan Di; Wong, John; Vicini, Frank; Michalski, Jeff; Pan Cheng; Frazier, Arthur; Horwitz, Eric; Martinez, Alvaro

    1997-01-01

    Purpose: Using daily setup variation measured from an electronic portal imaging device (EPID), radiation treatment of the individual patient can be adaptively reoptimized during the course of therapy. In this study, daily portal images were retrospectively examined to: (a) determine the number of initial days of portal imaging required to give adequate prediction of the systematic and random setup errors; and (b) explore the potential of using the prediction as feedback to reoptimize the individual treatment part-way through the treatment course. Methods and Materials: Daily portal images of 64 cancer patients, whose treatment position was not adjusted during the course of treatment, were obtained from two independent clinics with similar setup procedures. Systematic and random setup errors for each patient were predicted using different numbers of initial portal measurements. The statistical confidence of the predictions was tested to determine the number of daily portal measurements needed to give reasonable predictions. Two treatment processes were simulated to examine the potential opportunity for setup margin reduction and dose escalation. The first process mimicked a conventional treatment. A constant margin was assigned to each treatment field to compensate for the average setup error of the patient population. A treatment dose was then prescribed with reference to a fixed normal tissue tolerance, and then fixed in the entire course of treatment. In the second process, the same treatment fields and prescribed dose were used only for the initial plan and treatment. After several initial days of treatments, the treatment field shape and position were assumed to be adaptively modified using a computer-controlled multileaf collimator (MLC) in light of the predicted systematic and random setup errors. The prescribed dose was then escalated until the same normal tissue tolerance, as determined in the first treatment process, was reached. Results: The systematic

  4. CT images and radiotherapy treatment planning of patients with breast cancer: A dataset

    Directory of Open Access Journals (Sweden)

    Mohammad Rezaei

    2017-08-01

    Full Text Available The data presented here were originally collected for the research project “CT-Scan processing and analysis in patient with breast cancer after radiotherapy”. Also, it reported in our study “Prediction of Lung Tissue Damage by Evaluating Clinical and Dosimetric Parameters in Breast Cancer Patients” (Hasanabdali et al., 2016 [1]. This article describes and directly links to 52 subjects referred to Mahdieh Oncology and Radiotherapy Center from February to August 2015. Treatment planning was done for delivering 50 Gy dose to PTV in 25 fractions. the lungs and heart objects were extracted from CT images along with compliance Dose plan. Dose-volume histogram (DVH and Dose-mass histogram (DMH extracted using CT images and dose plan matrix. Moreover, the complete clinical and dosimetric specifications of subjects is attached.

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

    Science.gov (United States)

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

    2016-06-07

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

  6. Verification of computerized treatment planning for HDR 192Ir brachytherapy for gynaecological cancer.

    Science.gov (United States)

    Buzdar, Saeed Ahmad; Gadhi, Muhammad Asghar; Rao, Muhammad Afzal; Laghari, Naeem Ahmad; Anees, Mohammad

    2009-02-01

    Treatment planning in both teletherapy and brachytherapy is time consuming practice but accurate determination of planning parameters is more important. This paper aims to verify the dose delivery time for the treatment of vaginal cancer, which is a vital parameter of High Dose Rate (HDR) brachytherapy treatment planning. Treatment time has been calculated by the computerized treatment planning system (ABACUS 3.1), and then it has been compared with the manually calculated time. The results obtained are in good agreement. Independent verification of nominal time by two different protocols assures the quality of treatment. This should always be practiced to increase the accuracy of treatment.

  7. Technical Basis for Radiological Emergency Plan Annex for WTD Emergency Response Plan: West Point Treatment Plant

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, Eva E.; Strom, Daniel J.

    2005-08-01

    Staff of the King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into the combined sanitary and storm sewer system in King County, Washington. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material (National Council on Radiation Protection and Measurements (NCRP) 2001). Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. This document, Volume 3 of PNNL-15163 is the technical basis for the Annex to the West Point Treatment Plant (WPTP) Emergency Response Plan related to responding to a radiological emergency at the WPTP. The plan primarily considers response to radioactive material that has been introduced in the other combined sanitary and storm sewer system from a radiological dispersion device, but is applicable to any accidental or deliberate introduction of materials into the system.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  10. Integration of three-dimensional magnetic resonance spectrometry to the irradiation treatment plan for glioblastomas: definition of new target volumes

    International Nuclear Information System (INIS)

    Ken, S.; Vieillevigne, L.; Cohen-Jonathan, E.M.; Laprie, A.; Ken, S.; Franceries, X.; Lotterie, J.A.; Lubrano, V.; Catalaa, I.; Celsis, P.; Berry, I.; Laprie, A.; Lotterie, J.A.; Lubrano, V.; Berry, I.; Catalaa, I.

    2010-01-01

    Based on a clinic trial, the authors report the definition of a new reliable and reproducible method to delimit and integrate targets to the treatment plan which are specific to magnetic resonance spectrometry imagery for the radiotherapy of glioblastomas, in order to perform a treatment by intensity-modulated conformational radiotherapy (IMRT). A weighted conventional MRI has been performed before radiotherapy. The importation of anatomic-metabolic images into the dose planning system comprises two steps: normalization on the whole volume of magnetic resonance spectrometry imagery, and segmentation of target volumes specific to spectrometry anomalies. This integration of target volumes is thus facilitated. Short communication

  11. 46 CFR 50.25-10 - Acceptance of piping components by specific letter or approved plan.

    Science.gov (United States)

    2010-10-01

    ... component. (6) Submit information showing compliance with the requirements of part 56, subparts 56.15, 56.20... the particular component or in the form of an approved piping system plan in which the component is... 46 Shipping 2 2010-10-01 2010-10-01 false Acceptance of piping components by specific letter or...

  12. Environmental Restoration Site-Specific Plan for the Portsmouth Gaseous Diffusion Plant, FY 93

    International Nuclear Information System (INIS)

    1993-01-01

    The purpose of this Site-Specific Plan (SSP) is to describe past, present, and future activities undertaken to implement Environmental Restoration and Waste Management goals at the Portsmouth Gaseous Diffusion Plant (PORTS). The SSP is presented in sections emphasizing Environmental Restoration description of activities, resources, and milestones

  13. Smoking-specific communication and children's smoking onset: An extension of the theory of planned behaviour

    NARCIS (Netherlands)

    Hiemstra, J.M.; Otten, R.; Schayck, C.P. van; Engels, R.C.M.E.

    2012-01-01

    The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478

  14. 77 FR 51619 - Source Specific Federal Implementation Plan for Implementing Best Available Retrofit Technology...

    Science.gov (United States)

    2012-08-24

    ... Source Specific Federal Implementation Plan for Implementing Best Available Retrofit Technology for Four... Available Retrofit Technology for Four Corners Power Plant: Navajo Nation AGENCY: Environmental Protection...-fired power plant located on the Navajo Nation near Farmington, New Mexico, to achieve emissions...

  15. A Framework for Multi-Robot Motion Planning from Temporal Logic Specifications

    DEFF Research Database (Denmark)

    Koo, T. John; Li, Rongqing; Quottrup, Michael Melholt

    2012-01-01

    -time Temporal Logic, Computation Tree Logic, and -calculus can be preserved. Motion planning can then be performed at a discrete level by considering the parallel composition of discrete abstractions of the robots with a requirement specification given in a suitable temporal logic. The bisimilarity ensures...

  16. Hellsgate Big Game Winter Range Wildlife Mitigation Site Specific Management Plan for the Hellsgate Project.

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Matthew T.; Judd, Steven L.

    1999-01-01

    This report contains a detailed site-specific management plan for the Hellsgate Winter Range Wildlife Mitigation Project. The report provides background information about the mitigation process, the review process, mitigation acquisitions, Habitat Evaluation Procedures (HEP) and mitigation crediting, current habitat conditions, desired future habitat conditions, restoration/enhancements efforts and maps.

  17. 7 CFR 1717.605 - Design standards, plans and specifications, construction standards, and RUS accepted materials.

    Science.gov (United States)

    2010-01-01

    ..., construction standards, and RUS accepted materials. 1717.605 Section 1717.605 Agriculture Regulations of the... standards, plans and specifications, construction standards, and RUS accepted materials. All borrowers... system design, construction standards, and the use of RUS accepted materials. Borrowers must comply with...

  18. A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy

    International Nuclear Information System (INIS)

    Hobbs, Robert F.; McNutt, Todd; Baechler, Sebastien; He Bin; Esaias, Caroline E.; Frey, Eric C.; Loeb, David M.; Wahl, Richard L.; Shokek, Ori; Sgouros, George

    2011-01-01

    Purpose: Effective cancer treatment generally requires combination therapy. The combination of external beam therapy (XRT) with radiopharmaceutical therapy (RPT) requires accurate three-dimensional dose calculations to avoid toxicity and evaluate efficacy. We have developed and tested a treatment planning method, using the patient-specific three-dimensional dosimetry package 3D-RD, for sequentially combined RPT/XRT therapy designed to limit toxicity to organs at risk. Methods and Materials: The biologic effective dose (BED) was used to translate voxelized RPT absorbed dose (D RPT ) values into a normalized total dose (or equivalent 2-Gy-fraction XRT absorbed dose), NTD RPT map. The BED was calculated numerically using an algorithmic approach, which enabled a more accurate calculation of BED and NTD RPT . A treatment plan from the combined Samarium-153 and external beam was designed that would deliver a tumoricidal dose while delivering no more than 50 Gy of NTD sum to the spinal cord of a patient with a paraspinal tumor. Results: The average voxel NTD RPT to tumor from RPT was 22.6 Gy (range, 1-85 Gy); the maximum spinal cord voxel NTD RPT from RPT was 6.8 Gy. The combined therapy NTD sum to tumor was 71.5 Gy (range, 40-135 Gy) for a maximum voxel spinal cord NTD sum equal to the maximum tolerated dose of 50 Gy. Conclusions: A method that enables real-time treatment planning of combined RPT-XRT has been developed. By implementing a more generalized conversion between the dose values from the two modalities and an activity-based treatment of partial volume effects, the reliability of combination therapy treatment planning has been expanded.

  19. Monte Carlo systems used for treatment planning and dose verification

    Energy Technology Data Exchange (ETDEWEB)

    Brualla, Lorenzo [Universitaetsklinikum Essen, NCTeam, Strahlenklinik, Essen (Germany); Rodriguez, Miguel [Centro Medico Paitilla, Balboa (Panama); Lallena, Antonio M. [Universidad de Granada, Departamento de Fisica Atomica, Molecular y Nuclear, Granada (Spain)

    2017-04-15

    General-purpose radiation transport Monte Carlo codes have been used for estimation of the absorbed dose distribution in external photon and electron beam radiotherapy patients since several decades. Results obtained with these codes are usually more accurate than those provided by treatment planning systems based on non-stochastic methods. Traditionally, absorbed dose computations based on general-purpose Monte Carlo codes have been used only for research, owing to the difficulties associated with setting up a simulation and the long computation time required. To take advantage of radiation transport Monte Carlo codes applied to routine clinical practice, researchers and private companies have developed treatment planning and dose verification systems that are partly or fully based on fast Monte Carlo algorithms. This review presents a comprehensive list of the currently existing Monte Carlo systems that can be used to calculate or verify an external photon and electron beam radiotherapy treatment plan. Particular attention is given to those systems that are distributed, either freely or commercially, and that do not require programming tasks from the end user. These systems are compared in terms of features and the simulation time required to compute a set of benchmark calculations. (orig.) [German] Seit mehreren Jahrzehnten werden allgemein anwendbare Monte-Carlo-Codes zur Simulation des Strahlungstransports benutzt, um die Verteilung der absorbierten Dosis in der perkutanen Strahlentherapie mit Photonen und Elektronen zu evaluieren. Die damit erzielten Ergebnisse sind meist akkurater als solche, die mit nichtstochastischen Methoden herkoemmlicher Bestrahlungsplanungssysteme erzielt werden koennen. Wegen des damit verbundenen Arbeitsaufwands und der langen Dauer der Berechnungen wurden Monte-Carlo-Simulationen von Dosisverteilungen in der konventionellen Strahlentherapie in der Vergangenheit im Wesentlichen in der Forschung eingesetzt. Im Bemuehen, Monte

  20. 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

  1. Workflow efficiency for the treatment planning process in CT-guided high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Michaud, Anthony L; Benedict, Stanley; Montemayor, Eliseo; Hunt, Jon Paul; Wright, Cari; Mathai, Mathew; Mayadev, Jyoti S

    2016-01-01

    To investigate process efficiency, we present a prospective investigation of the treatment planning phase of image-guided brachytherapy (BT) for cervical cancer using a specific checklist. From October 2012 to January 2014, 76 BT procedures were consecutively performed. Prospective data on the CT-based treatment planning process was collected using a specific checklist which details the following steps: (1) dosimetry planning, (2) physician review start, (3) physician review time, (4) dosimetry processing, (5) physics review start, (6) physics review, and (7) procedural pause. Variables examined included the use of a pre-BT MRI, clinic duty conflicts, resident teaching, and the use of specific BT planners. Analysis was performed using descriptive statistics, t-test, and analysis of variance. Seventy-five prospectively gathered checklists comprised this analysis. The mean time for treatment planning was 95 minutes (med 94, std 18). The mean intervals in the above steps were (1) = 42, (2) = 5, (3) = 19, (4) = 10, (5) = 6, (6) = 13, and (7) = 26 minutes. There was no statistical difference in patients who had a pre-BT MRI. Resident teaching did not influence time, p = 0.17. Treatment planning time was decreased with a specific planner, p = 0.0015. A skillful team approach is required for treatment planning efficiency in image-guided BT. We have found that the specific BT planners can have a significant effect on the overall planning efficiency. We continue to examine clinical and workflow-related factors that will enhance our safety and workflow process with BT. Published by Elsevier Inc.

  2. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    International Nuclear Information System (INIS)

    1992-11-01

    The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, as well as for activities associated with nuclear energy development. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. The 3718-F Alkali Metal Treatment and Storage Facility (3718-F Facility), located in the 300 Area, was used to store and treat alkali metal wastes. Therefore, it is subject to the regulatory requirements for the storage and treatment of dangerous wastes. Closure will be conducted pursuant to the requirements of the Washington Administrative Code (WAC) 173-303-610 (Ecology 1989) and 40 CFR 270.1. Closure also will satisfy the thermal treatment facility closure requirements of 40 CFR 265.381. This closure plan presents a description of the 3718-F Facility, the history of wastes managed, and the approach that will be followed to close the facility. Only hazardous constituents derived from 3718-F Facility operations will be addressed

  3. Ranking radiotherapy treatment plans using decision-analytic and heuristic techniques.

    OpenAIRE

    Jain, N. L.; Kahn, M. G.

    1991-01-01

    Radiotherapy treatment optimization is done by generating a set of tentative treatment plans, evaluating them and selecting the plan closest to achieving a set of conflicting treatment objectives. The evaluation of potential plans involves making tradeoffs among competing possible outcomes. Multiattribute decision theory provides a framework for specifying such tradeoffs and using them to select optimal actions. Using these concepts, we have developed a plan-ranking model which ranks a set of...

  4. Epidemiology and treatment of 23 musicians with task specific tremor.

    Science.gov (United States)

    Lee, André; Furuya, Shinichi; Altenmüller, Eckart

    2014-01-01

    Task specific tremors in musicians have been mainly described as primary bowing tremor in string instrumentalists in relatively small sample sizes. Our aim was to describe epidemiology, risk factors, phenomenology and treatment options of this disorder in 23 musicians of different instruments. We included 23 professional musicians (4 female, 19 male; mean age 51.5 ± 11.4 years) with a TSTM. During anamnesis, clinical examination, by mail or via telephone patients were asked for epidemiological, phenomenological information, risk factors and treatments. We then compared our findings to primary writing tremor, the most common task specific tremor. Age at onset of the TST was 44.6 ± 13.6 years and tremor appeared 35.1 ± 13.5 years after beginning to play the instrument. The majority of patients were string instrumentalists, followed by woodwind instrumentalists. Other instrumentalists were a guitarist, pianist and percussionist respectively. In contrast to primary writing tremor, we also found proximal muscles of the upper extremity involved in tremor. A positive family history was found in Prior trauma was more common than in primary writing tremor. Treatment with a positive effect on tremor were in order of efficacy: Botulinumtoxin, Primidone, Propranolol, Trihexyphenidyl. No patient had undergone deep brain stimulation. Task specific tremor in musicians is a heterogeneous disorder with a male gender predominance that shares many commonalities with PWT. The onset age as well as the time between starting to play the instrument and tremor onset has a wide range. Because previous trauma and overuse appear to be risk factors, preventive measures against playing related injuries are necessary. There appears to be a genetic predisposition for TST. No single beneficial medication exists and treatment of patients remains highly individual. It should be discussed, whether deep brain stimulation should be offered not only to patients that do not respond to

  5. A global quality assurance system for personalized radiation therapy treatment planning for the prostate (or other sites)

    Science.gov (United States)

    Nwankwo, Obioma; Sihono, Dwi Seno K.; Schneider, Frank; Wenz, Frederik

    2014-09-01

    Introduction: the quality of radiotherapy treatment plans varies across institutions and depends on the experience of the planner. For the purpose of intra- and inter-institutional homogenization of treatment plan quality, we present an algorithm that learns the organs-at-risk (OARs) sparing patterns from a database of high quality plans. Thereafter, the algorithm predicts the dose that similar organs will receive in future radiotherapy plans prior to treatment planning on the basis of the anatomies of the organs. The predicted dose provides the basis for the individualized specification of planning objectives, and for the objective assessment of the quality of radiotherapy plans. Materials and method: one hundred and twenty eight (128) Volumetric Modulated Arc Therapy (VMAT) plans were selected from a database of prostate cancer plans. The plans were divided into two groups, namely a training set that is made up of 95 plans and a validation set that consists of 33 plans. A multivariate analysis technique was used to determine the relationships between the positions of voxels and their dose. This information was used to predict the likely sparing of the OARs of the plans of the validation set. The predicted doses were visually and quantitatively compared to the reference data using dose volume histograms, the 3D dose distribution, and a novel evaluation metric that is based on the dose different test. Results: a voxel of the bladder on the average receives a higher dose than a voxel of the rectum in optimized radiotherapy plans for the treatment of prostate cancer in our institution if both voxels are at the same distance to the PTV. Based on our evaluation metric, the predicted and reference dose to the bladder agree to within 5% of the prescribed dose to the PTV in 18 out of 33 cases, while the predicted and reference doses to the rectum agree to within 5% in 28 out of the 33 plans of the validation set. Conclusion: We have described a method to predict the

  6. Treatment Study Plan for Nitrate Salt Waste Remediation Revision 1.0

    Energy Technology Data Exchange (ETDEWEB)

    Juarez, Catherine L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Funk, David John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Vigil-Holterman, Luciana R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Naranjo, Felicia Danielle [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-07

    The two stabilization treatment methods that are to be examined for their effectiveness in the treatment of both the unremediated and remediated nitrate salt wastes include (1) the addition of zeolite and (2) cementation. Zeolite addition is proposed based on the results of several studies and analyses that specifically examined the effectiveness of this process for deactivating nitrate salts. Cementation is also being assessed because of its prevalence as an immobilization method used for similar wastes at numerous facilities around the DOE complex, including at Los Alamos. The results of this Treatment Study Plan will be used to provide the basis for a Resource Conservation and Recovery Act (RCRA) permit modification request of the LANL Hazardous Waste Facility Permit for approval by the New Mexico Environment Department-Hazardous Waste Bureau (NMED-HWB) of the proposed treatment process and the associated facilities.

  7. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

    Science.gov (United States)

    Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

    2017-03-01

    One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Plans and Progress on Hanford MLLW Treatment and Disposal

    International Nuclear Information System (INIS)

    McDonald, K. M.; Blackford, L. T.; Nester, D. E.; Connolly, R. R.; McKenney, D. E.; Moy, S. K.

    2003-01-01

    Mixed low-level waste (MLLW) contains both low-level radioactive materials and low-level hazardous chemicals. The hazardous component of mixed waste has characteristics identified by any or all of the following statutes: the Resource Conservation and Recovery Act of 1976 (RCRA), as amended; the Toxic Substances Control Act of 1976; and Washington State dangerous waste regulations. The Fluor Hanford Waste Management Project (WMP) is responsible for storing, treating, and disposing of solid MLLW, which includes organic and inorganic solids, organics and inorganic lab packs, debris, lead, mercury, long-length equipment, spent melters, and remote-handled (RH) and oversized MLLW. Hanford has 7,000 cubic meters, or about 25%, of the MLLW in storage at U.S. Department of Energy (DOE) sites. Hanford plans to receive 57,000 cubic meters from on-site generators, or about 50% of DOE's newly generated MLLW. In addition, the Hanford Environment Restoration Program and off-site generators having approved Federal Facility Consent Agreement site treatment plans will most likely send 200 cubic meters of waste to be treated and returned to the generators. Volumes of off-site waste receipts will be affected when the MLLW Record of Decision is issued as part of the process for the Hanford Site Solid Waste Environmental Impact Statement (EIS). The WMP objective relative to MLLW is to treat and dispose of ∼8000 cubic meters of existing inventory and newly-generated waste by September 30, 2006

  9. Dosimetry audit simulation of treatment planning system in multicenters radiotherapy

    Science.gov (United States)

    Kasmuri, S.; Pawiro, S. A.

    2017-07-01

    Treatment Planning System (TPS) is an important modality that determines radiotherapy outcome. TPS requires input data obtained through commissioning and the potentially error occurred. Error in this stage may result in the systematic error. The aim of this study to verify the TPS dosimetry to know deviation range between calculated and measurement dose. This study used CIRS phantom 002LFC representing the human thorax and simulated all external beam radiotherapy stages. The phantom was scanned using CT Scanner and planned 8 test cases that were similar to those in clinical practice situation were made, tested in four radiotherapy centers. Dose measurement using 0.6 cc ionization chamber. The results of this study showed that generally, deviation of all test cases in four centers was within agreement criteria with average deviation about -0.17±1.59 %, -1.64±1.92 %, 0.34±1.34 % and 0.13±1.81 %. The conclusion of this study was all TPS involved in this study showed good performance. The superposition algorithm showed rather poor performance than either analytic anisotropic algorithm (AAA) and convolution algorithm with average deviation about -1.64±1.92 %, -0.17±1.59 % and -0.27±1.51 % respectively.

  10. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model.

    Science.gov (United States)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-06-21

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  11. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    International Nuclear Information System (INIS)

    Chai Xiangfei; Hulshof, Maarten; Bel, Arjan; Van Herk, Marcel; Betgen, Anja

    2012-01-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  12. The 300 area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    Luke, S.N.

    1996-01-01

    The 300 Area Waste Acid Treatment System (WATS) is located within operable units 300-FF-2 (source) and 300-FF-5 (groundwater), as designated in the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) . Operable units 300-FF-2 and 300-FF-5 are scheduled to be remediated using the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) Remedial Investigation/Feasibility Study (RI/FS) process. Thus, any remediation of the 300 Area WATS with respect to contaminants not produced by those facilities and soils and groundwater will be deferred to the CERCLA RI/FS process. Final closure activities will be completed in 3 phases and certified in accordance with the 300 Area WATS closure plan by the Washington State Department of Ecology (Ecology) and the U.S. Environmental Protection Agency (EPA). It is anticipated that the 300 Area WATS closure would take 2 years to complete

  13. CBCT analysis of three implant cases for treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk; Kim, Kwang Won; Lim, Sung Hoon [Chosun Univ. School of Dentistry, Gwangju (Korea, Republic of)

    2007-09-15

    The role of radiographic imaging in determining the size, numbers and the position of implants is very important. To perform the implant procedure, the dentist needs to evaluate the bone pathology and bone density, and to know the precise height, width, and contour of the alveolar process, as well as its relationship to the maxillary sinus and mandibular canal. The author analyzed 3 implant cases for treatment planning with the cone beam CT. All axial, panoramic, serial and buccolingual-sectioned images of 3 cases with stent including vertical marker were taken by using Mercury (Hitachi, Japan). When the curved line drawn intentionally did nor include dot image of a vertical marker on the axial image of CBCT, the image of the vertical marker was deformed on its buccolingually sectioned image. There was wide discrepancy in inclination between the alveolar bone and tooth on buccolingually sectioned image.

  14. 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.

  15. Efficient sampling algorithms for Monte Carlo based treatment planning

    International Nuclear Information System (INIS)

    DeMarco, J.J.; Solberg, T.D.; Chetty, I.; Smathers, J.B.

    1998-01-01

    Efficient sampling algorithms are necessary for producing a fast Monte Carlo based treatment planning code. This study evaluates several aspects of a photon-based tracking scheme and the effect of optimal sampling algorithms on the efficiency of the code. Four areas were tested: pseudo-random number generation, generalized sampling of a discrete distribution, sampling from the exponential distribution, and delta scattering as applied to photon transport through a heterogeneous simulation geometry. Generalized sampling of a discrete distribution using the cutpoint method can produce speedup gains of one order of magnitude versus conventional sequential sampling. Photon transport modifications based upon the delta scattering method were implemented and compared with a conventional boundary and collision checking algorithm. The delta scattering algorithm is faster by a factor of six versus the conventional algorithm for a boundary size of 5 mm within a heterogeneous geometry. A comparison of portable pseudo-random number algorithms and exponential sampling techniques is also discussed

  16. Treatment planning for adenocarcinoma of the rectum and sigmoid: a patterns of care study

    International Nuclear Information System (INIS)

    Kline, Robert W.; Smith, Alfred R.; Coia, Lawrence R.; Owen, Jean B.; Hanlon, Alexandra; Wallace, Marsha; Hanks, Gerald

    1997-01-01

    Purpose: To conduct a study of the process of treatment planning and treatment of adenocarcinoma of the rectum and sigmoid in the United States, and to compare survey results to consensus guidelines. Methods and Materials: A consensus committee developed guidelines for the radiotherapeutic management of adenocarcinoma of the rectum and sigmoid, and also developed a survey form that was used to gather data to evaluate the practice patterns for patients treated in 1989 and 1990 against the consensus guidelines. Seventy-three facilities were randomly selected for site visits from the 1321 radiation therapy facilities in the US: 21 academic, 26 hospital based, and 26 free standing. During the site visits, the radiotherapy records were examined by the surveyor physicist and radiation oncologist to extract and record the required data. Data collected included items related to treatment specific parameters, including treatment planning considerations. Analyses included stratification as to the types of institutions, academic, hospital based, or free standing. Results: For many treatment parameters there are discrepancies between the patterns of practice determined by the surveys and the consensus guidelines for radiotherapy treatment of adenocarcinoma of the rectum and sigmoid. Significant differences in practice among the stratified institution types were found in only a few parameters

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

    International Nuclear Information System (INIS)

    Kapur, A.

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    Chang, J.

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  1. 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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    , neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy.

  4. Analyzing the relationship between anthropometric and motor indices with basketball specific pre-planned and non-planned agility performances.

    Science.gov (United States)

    Pehar, Miran; Sisic, Nedim; Sekulic, Damir; Coh, Milan; Uljevic, Ognjen; Spasic, Miodrag; Krolo, Ante; Idrizovic, Kemal

    2017-05-09

    Although agility is an important quality in basketball, factors associated with basketball specific pre-planned-agility (change-of-direction-speed - CODS) and non- planned-agility (reactive agility - RA) are rarely investigated. The aim of this study was to evaluate relationship between anthropometric and motor indices with basketball-specific CODS and RA in male basketball players of high performance level. We tested 88 high-level male basketball players (height: 194.62±8.09 cm; body mass: 89.13±10.81 kg; age: 21.12±3.47 years). The sample was randomly divided into validation (n = 44) and cross-validation (n = 44) subsamples. The study variables included: broad-jump, countermovement-jump, reactive-strength-index, visual-reaction-time, body height, body mass, and body fat percentage (predictors); as well as basketball-specific CODS and RA (criteria). Univariate associations were assessed by Pearson's correlation coefficients. Multivariate relationships between the predictors and the criteria were assessed with multiple regression analysis for the validation subsample, which was then cross-validated. The established multiple regression models were successfully cross-validated for CODS (R2 = 0.40 and 0.36; p = 0.01) and RA (R2 = 0.38 and 0.41; p = 0.01, for validation and cross-validation subsample, respectively). The broad-jump (i.e., horizontal displacement) is important predictor of CODS (Beta = -0.41; p = 0.01); anthropometrics and body build are specifically associated with RA (Beta = 0.51, -0.61 and 0.41 for body height, body mass and body fat percentage, respectively; all p < 0.05), while reactive-strength-index is directly related both to CODS (Beta = -0.41, p = 0.02), and RA (Beta = -0.40, p = 0.03). While basketball players are differentially oriented toward specific game duties, specific capacities should be developed in order to meet specific sport requirements.

  5. Evaluation of an objective plan-evaluation model in the three dimensional treatment of nonsmall cell lung cancer

    International Nuclear Information System (INIS)

    Graham, Mary V.; Jain, Nilesh L.; Kahn, Michael G.; Drzymala, Robert E.; Purdy, James A.

    1996-01-01

    Purpose: Evaluation of three dimensional (3D) radiotherapy plans is difficult because it requires the review of vast amounts of data. Selecting the optimal plan from a set of competing plans involves making trade-offs among the doses delivered to the target volumes and normal tissues. The purpose of this study was to test an objective plan-evaluation model and evaluate its clinical usefulness in 3D treatment planning for nonsmall cell lung cancer. Methods and Materials: Twenty patients with inoperable nonsmall cell lung cancer treated with definitive radiotherapy were studied using full 3D techniques for treatment design and implementation. For each patient, the evaluator (the treating radiation oncologist) initially ranked three plans using room-view dose-surface isplays and dose-volume histograms, and identified the issues that needed to be improved. The three plans were then ranked by the objective plan-evaluation model. A figure of merit (FOM) was computed for each plan by combining the numerical score (utility in decision-theoretic terms) for each clinical issue. The utility was computed from a probability of occurrence of the issue and a physician-specific weight indicating its clinical relevance. The FOM was used to rank the competing plans for a patient, and the utility was used to identify issues that needed to be improved. These were compared with the initial evaluations of the physician and discrepancies were analyzed. The issues identified in the best treatment plan were then used to attempt further manual optimization of this plan. Results: For the 20 patients (60 plans) in the study, the final plan ranking produced by the plan-evaluation model had an initial 73% agreement with the ranking provided by the evaluator. After discrepant cases were reviewed by the physician, the model was usually judged more objective or 'correct'. In most cases the model was also able to correctly identify the issues that needed improvement in each plan. Subsequent

  6. Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

    International Nuclear Information System (INIS)

    Purdie, Thomas G.; Dinniwell, Robert E.; Fyles, Anthony; Sharpe, Michael B.

    2014-01-01

    Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented

  7. 45 CFR 146.180 - Treatment of non-Federal governmental plans.

    Science.gov (United States)

    2010-10-01

    ... the next business day. (3) Failure to respond timely. CMS may invalidate an election if the plan...-Federal governmental plan the right to exempt the plan in whole, or in part, from the listed requirements... 45 Public Welfare 1 2010-10-01 2010-10-01 false Treatment of non-Federal governmental plans. 146...

  8. Investigating the robustness of ion beam therapy treatment plans to uncertainties in biological treatment parameters

    CERN Document Server

    Boehlen, T T; Dosanjh, M; Ferrari, A; Fossati, P; Haberer, T; Mairani, A; Patera, V

    2012-01-01

    Uncertainties in determining clinically used relative biological effectiveness (RBE) values for ion beam therapy carry the risk of absolute and relative misestimations of RBE-weighted doses for clinical scenarios. This study assesses the consequences of hypothetical misestimations of input parameters to the RBE modelling for carbon ion treatment plans by a variational approach. The impact of the variations on resulting cell survival and RBE values is evaluated as a function of the remaining ion range. In addition, the sensitivity to misestimations in RBE modelling is compared for single fields and two opposed fields using differing optimization criteria. It is demonstrated for single treatment fields that moderate variations (up to +/-50\\%) of representative nominal input parameters for four tumours result mainly in a misestimation of the RBE-weighted dose in the planning target volume (PTV) by a constant factor and only smaller RBE-weighted dose gradients. Ensuring a more uniform radiation quality in the PTV...

  9. Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

    Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

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

    International Nuclear Information System (INIS)

    Unkelbach, Jan; Oelfke, Uwe

    2005-01-01

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

  11. Safety Improvement in Radiotherapy Treatment Plan. Planning vs Redundant Check vs in vivo Dosimetry

    International Nuclear Information System (INIS)

    Torres Diaz, J.; Ascencion Ybarra, Y.; La Fuentes Rosales, L. de; Lara Mas, E.; Larrinaga Cortinas, E.

    2013-01-01

    In Cuba it is mandatory to have an independent monitor units check before any radiotherapy treatment is started. The main objective of this paper is to enhance the safety of the radiotherapy planning by developing and testing a practical tool to double check the monitor units calculation for external beam high energy photon therapy. A software for monitor units (MUs) verification was designed and coded. It considers the common in clinical practice isocentric set-ups. The in vivo dosimetry measurements were done with a silicon diode system for 6 MV photon beams to support the validation of the software. The results show a discrepancy within 5% between the 3 methods which is in accordance with international recommendations. (Author)

  12. Plutonium Finishing Plant Treatment and Storage Unit Dangerous Waste Training Plan

    International Nuclear Information System (INIS)

    ENTROP, G.E.

    2000-01-01

    The training program for personnel performing waste management duties pertaining to the Plutonium Finishing Plant (PFP) Treatment and Storage Unit is governed by the general requirements established in the Plutonium Finishing Plant Dangerous Waste Training Plan (PFP DWTP). The PFP Treatment and Storage Unit DWTP presented below incorporates all of the components of the PFP DWTP by reference. The discussion presented in this document identifies aspects of the training program specific to the PFP Treatment and Storage Unit. The training program includes specifications for personnel instruction through both classroom and on-the-job training. Training is developed specific to waste management duties. Hanford Facility personnel directly involved with the PFP Treatment and Storage Unit will receive training to container management practices, spill response, and emergency response. These will include, for example, training in the cementation process and training pertaining to applicable elements of WAC 173-303-330(1)(d). Applicable elements from WAC 173-303-330(1)(d) for the PFP Treatment and Storage Unit include: procedures for inspecting, repairing, and replacing facility emergency and monitoring equipment; communications and alarm systems; response to fires or explosions; and shutdown of operations

  13. Reducing Patient Waiting Times for Radiation Therapy and Improving the Treatment Planning Process: a Discrete-event Simulation Model (Radiation Treatment Planning).

    Science.gov (United States)

    Babashov, V; Aivas, I; Begen, M A; Cao, J Q; Rodrigues, G; D'Souza, D; Lock, M; Zaric, G S

    2017-06-01

    We analysed the radiotherapy planning process at the London Regional Cancer Program to determine the bottlenecks and to quantify the effect of specific resource levels with the goal of reducing waiting times. We developed a discrete-event simulation model of a patient's journey from the point of referral to a radiation oncologist to the start of radiotherapy, considering the sequential steps and resources of the treatment planning process. We measured the effect of several resource changes on the ready-to-treat to treatment (RTTT) waiting time and on the percentage treated within a 14 calendar day target. Increasing the number of dosimetrists by one reduced the mean RTTT by 6.55%, leading to 84.92% of patients being treated within the 14 calendar day target. Adding one more oncologist decreased the mean RTTT from 10.83 to 10.55 days, whereas a 15% increase in arriving patients increased the waiting time by 22.53%. The model was relatively robust to the changes in quantity of other resources. Our model identified sensitive and non-sensitive system parameters. A similar approach could be applied by other cancer programmes, using their respective data and individualised adjustments, which may be beneficial in making the most effective use of limited resources. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  14. Project W-314 specific test and evaluation plan for 241-AX-B valve pit upgrade

    International Nuclear Information System (INIS)

    Hays, W.H.

    1998-01-01

    The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made to the 241-AX-B Valve Pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system's performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation Plan (TEP). Testing includes Validations and Verifications (e.g., Commercial Grade Item Dedication activities), Factory Acceptance Tests (FATs), installation tests and inspections, Construction Acceptance Tests (CATs), Acceptance Test Procedures (ATPs), Pre-Operational Test Procedures (POTPs), and Operational Test Procedures (OTPs). It should be noted that POTPs are not required for testing of the transfer line addition. The STEP will be utilized in conjunction with the TEP for verification and validation

  15. Specific schistosomiasis treatment as a strategy for disease control

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    2010-07-01

    Full Text Available The great hope for schistosomiasis treatment began with the development of oxamniquine and praziquantel. These drugs can be administered orally in a single dose and have a high curative power with minor side effects. In this study, we carried out a field experiment involving a population of 3,782 people. The population was examined at four localities in Minas Gerais within the valleys of the Doce and Jequitinhonha Rivers. In this cohort, there were 1,790 patients infected with Schistosoma mansoni (47.3% and we showed that only 1,403 (78.4% could be treated with oxamniquine in a single dose of 12.5-20 mg/kg orally. The other 387 (21.6% were not treated during the first stage because of contraindications (pregnancy or impeditive diseases, absences or refusals. It was observed that, on average, 8.8-17% of the infected patients continued to excrete S. mansoni eggs at the end of the 2nd month after treatment and 30-32% of the cohort was infected by the end of the 24th month. In one of the areas that we followed-up for a total of 30 years, the prevalence of the infection with S. mansoni fell from 60.8-19.3% and the hepatosplenic form of the disease dropped from 5.8-1.3%. We conclude that specific treatment of schistosomiasis reduces the prevalence of infection in the short-term and the morbidity due to schistosomiasis in medium to long-term time frames, but does not help to control disease transmission.

  16. Automated planning of ablation targets in atrial fibrillation treatment

    Science.gov (United States)

    Keustermans, Johannes; De Buck, Stijn; Heidbüchel, Hein; Suetens, Paul

    2011-03-01

    Catheter based radio-frequency ablation is used as an invasive treatment of atrial fibrillation. This procedure is often guided by the use of 3D anatomical models obtained from CT, MRI or rotational angiography. During the intervention the operator accurately guides the catheter to prespecified target ablation lines. The planning stage, however, can be time consuming and operator dependent which is suboptimal both from a cost and health perspective. Therefore, we present a novel statistical model-based algorithm for locating ablation targets from 3D rotational angiography images. Based on a training data set of 20 patients, consisting of 3D rotational angiography images with 30 manually indicated ablation points, a statistical local appearance and shape model is built. The local appearance model is based on local image descriptors to capture the intensity patterns around each ablation point. The local shape model is constructed by embedding the ablation points in an undirected graph and imposing that each ablation point only interacts with its neighbors. Identifying the ablation points on a new 3D rotational angiography image is performed by proposing a set of possible candidate locations for each ablation point, as such, converting the problem into a labeling problem. The algorithm is validated using a leave-one-out-approach on the training data set, by computing the distance between the ablation lines obtained by the algorithm and the manually identified ablation points. The distance error is equal to 3.8+/-2.9 mm. As ablation lesion size is around 5-7 mm, automated planning of ablation targets by the presented approach is sufficiently accurate.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-13

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

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

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  19. 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)

  20. 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)

  1. 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)

  2. 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)

  3. 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.

  4. Site specific health and safety plan for drilling in support of in situ redox manipulation

    International Nuclear Information System (INIS)

    Tuttle, B.G.

    1997-02-01

    This document contains the Site Specific Health and Safety Plan for Drilling in support of the In Situ REDOX Manipulation in the 100-HR-3 Operable Unit. Approximately eight wells will be drilled in the 100-D/DR Area using rotary, sonic, or cable tool drilling methods. Split-spoon sampling will be done in conjunction with the drilling. The drilling may be spread out over several months. Included in this document are checklists for health and safety procedures

  5. Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

    Energy Technology Data Exchange (ETDEWEB)

    Akino, Yuichi; Das, Indra J.; Bartlett, Gregory K.; Zhang Hualin; Thompson, Elizabeth; Zook, Jennifer E. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States) and Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States)

    2013-01-15

    Purpose: Dosimetric accuracy in radiation treatment of breast cancer is critical for the evaluation of cosmetic outcomes and survival. It is often considered that treatment planning systems (TPS) may not be able to provide accurate dosimetry in the buildup region. This was investigated in various treatment techniques such as tangential wedges, field-in-field (FF), electronic compensator (eComp), and intensity-modulated radiotherapy (IMRT). Methods: Under Institutional Review Board (IRB) exemption, radiotherapy treatment plans of 111 cases were retrospectively analyzed. The distance between skin surface and 95% isodose line was measured. For measurements, Gafchromic EBT2 films were used on a humanoid unsliced phantom. Multiple layers of variable thickness of superflab bolus were placed on the breast phantom and CT scanned for planning. Treatment plans were generated using four techniques with two different grid sizes (1 Multiplication-Sign 1 and 2.5 Multiplication-Sign 2.5 mm{sup 2}) to provide optimum dose distribution. Films were placed at different depths and exposed with the selected techniques. A calibration curve for dose versus pixel values was also generated on the same day as the phantom measurement was conducted. The DICOM RT image, dose, and plan data were imported to the in-house software. On axial plane of CT slices, curves were drawn at the position where EBT2 films were placed, and the dose profiles on the lines were acquired. The calculated and measured dose profiles were separated by check points which were marked on the films before irradiation. The segments of calculated profiles were stretched to match their resolutions to that of film dosimetry. Results: On review of treatment plans, the distance between skin and 95% prescribed dose was up to 8 mm for plans of 27 patients. The film measurement revealed that the medial region of phantom surface received a mere 45%-50% of prescribed dose. For wedges, FF, and eComp techniques, region around the

  6. Work Plan for Updating Double Shell Tank (DST) Sub-System Specifications (TBR 120.020)

    International Nuclear Information System (INIS)

    GRENARD, C.E.

    1999-01-01

    The DST System stores waste from the processing of nuclear material at the Hanford Nuclear Reservation. The program to dispose of this waste has been divided into several phases with Phase 1 being the demonstration of the waste disposal technology by a private contractor. Subsystem specifications are being prepared providing requirements for the subsystems that are necessary for the continued safe storage of waste in the DST System and the removal of selected waste for processing by the privatized facility during Phase 1. This document provides the detailed plans for updating subsystem specifications developed during EY99

  7. Methamphetamine treatment outcomes among gay men attending a LGBTI-specific treatment service in Sydney, Australia.

    Science.gov (United States)

    Lea, Toby; Kolstee, Johann; Lambert, Sarah; Ness, Ross; Hannan, Siobhan; Holt, Martin

    2017-01-01

    Gay and bisexual men (GBM) report higher rates of methamphetamine use compared to heterosexual men, and thus have a heightened risk of developing problems from their use. We examined treatment outcomes among GBM clients receiving outpatient counseling at a lesbian, gay, bisexual, transgender and intersex (LGBTI)-specific, harm reduction treatment service in Sydney, Australia. GBM receiving treatment for methamphetamine use from ACON's Substance Support Service between 2012-15 (n = 101) were interviewed at treatment commencement, and after 4 sessions (n = 60; follow-up 1) and 8 sessions (n = 32; follow-up 2). At each interview, clients completed measures of methamphetamine use and dependence, other substance use, injecting risk practices, psychological distress and quality of life. The median age of participants was 41 years and 56.4% identified as HIV-positive. Participants attended a median of 5 sessions and attended treatment for a median of 112 days. There was a significant reduction in the median days of methamphetamine use in the previous 4 weeks between baseline (4 days), follow-up 1 (2 days) and follow-up 2 (2 days; p = .001). There was a significant reduction in the proportion of participants reporting methamphetamine dependence between baseline (92.1%), follow-up 1 (78.3%) and follow-up 2 (71.9%, p methamphetamine use and improved psychosocial functioning over time, demonstrating the potential effectiveness of a LGBTI-specific treatment service.

  8. Project W-314 specific test and evaluation plan for 241-AN-A valve pit

    International Nuclear Information System (INIS)

    Hays, W.H.

    1997-01-01

    The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made to the 241-AN-A Valve Pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system's performance to the established Project design criteria. The STEP is a ''lower tier'' document based on the W-314 Test and Evaluation Plan (TEP) This STEP encompasses all testing activities required to demonstrate compliance to the project design criteria as it relates to the modifications of the AN-A valve pit. The Project Design Specifications (PDS) identify the specific testing activities required for the Project. Testing includes Validations and Verifications (e.g., Commercial Grade Item Dedication activities), Factory Acceptance Tests (FATs), installation tests and inspections, Construction Acceptance Tests (CATs), Acceptance Test Procedures (ATPs), Pre-Operational Test Procedures (POTPs), and Operational Test Procedures (OTPs). It should be noted that POTPs are not required for testing of the modifications to the 241-AN-A Valve Pit. The STEP will be utilized in conjunction with the TEP for verification and validation

  9. SPIDERplan: A tool to support decision-making in radiation therapy treatment plan assessment.

    Science.gov (United States)

    Ventura, Tiago; Lopes, Maria do Carmo; Ferreira, Brigida Costa; Khouri, Leila

    2016-01-01

    In this work, a graphical method for radiotherapy treatment plan assessment and comparison, named SPIDERplan, is proposed. It aims to support plan approval allowing independent and consistent comparisons of different treatment techniques, algorithms or treatment planning systems. Optimized plans from modern radiotherapy are not easy to evaluate and compare because of their inherent multicriterial nature. The clinical decision on the best treatment plan is mostly based on subjective options. SPIDERplan combines a graphical analysis with a scoring index. Customized radar plots based on the categorization of structures into groups and on the determination of individual structures scores are generated. To each group and structure, an angular amplitude is assigned expressing the clinical importance defined by the radiation oncologist. Completing the graphical evaluation, a global plan score, based on the structures score and their clinical weights, is determined. After a necessary clinical validation of the group weights, SPIDERplan efficacy, to compare and rank different plans, was tested through a planning exercise where plans had been generated for a nasal cavity case using different treatment planning systems. SPIDERplan method was applied to the dose metrics achieved by the nasal cavity test plans. The generated diagrams and scores successfully ranked the plans according to the prescribed dose objectives and constraints and the radiation oncologist priorities, after a necessary clinical validation process. SPIDERplan enables a fast and consistent evaluation of plan quality considering all targets and organs at risk.

  10. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    NARCIS (Netherlands)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-01-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is

  11. Treatment planning and dosimetry in radiotherapy for glottic cancer

    International Nuclear Information System (INIS)

    Fukudomi, Yukimi; Kawakami, Toshiaki; Fujii, Takashi; Kawamura, Masashi; Kataoka, Masaaki; Hamamoto, Ken

    1995-01-01

    To perform a precise radiotherapy and to prevent local failure as low as possible for early glottic cancer, we present data regarding the technical basis of radiotherapy. Thermoluminescent dosimeters (TLDs) were embedded at 6 locations in a hand-made Mix-Dp phantom and exposed to two lateral-opposed beams using 6 x 6 cm 2 fields. The dosimeters were irradiated using 4 MV-X, 6 MV-X and 10 MV-X with open-field, 15deg and 30deg wedge filter (WF) made of Pb or Fe, and a hand-made Mix-Dp WF compensating irregular skin surface which was placed apart from the patient's skin to preserve skin-sparing properties. Calculation of absorbed dose with a computer for treatment planning was performed. Using 6 MV-X and a 30deg WF, the dose distribution was the best in this phantom. With 10 MV-X, the absorbed dose at the anterior glottis was 6.7-11.6% lower than the administered dose. Using a Mix-Dp WF, the dose distribution was better than those using WF made of Pb or Fe. Under various types of treatments, the absorbed dose at the reference point using TLDs were 0.4-5.8% lower than the administered dose calculated with ratio-TAR method at the same point. These are believed to be due to lack of estimation of scatters and poor correcting method for WF factor. We conclude that some experimental checks are desirable to perform a precise radiotherapy for laryngeal cancer. This can be done using a number of TLDs placed at points of interest in a phantom. (author)

  12. On the quality of treatment planning systems in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Panten, T.; Sroka-Perez, G. [Radiologische Klinik der Univ. Heidelberg, Heidelberg (Germany). Abt. fuer Klinische Radiologie; Hoess, A. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Medizinische Physik; Bohsung, J. [Humboldt-Universitaet, Berlin (Germany). Abt. fuer Strahlentherapie; Becker, G. [Radiologische Universitaetsklinik, Tuebingen (Germany). Abt. fuer Strahlentherapie

    1998-10-01

    Purpose: To assist in the design of quality assurance activities of 3D treatment planning systems (TPSs), a postal survey has been carried out, addressing TPS users on quality characteristics and their relative importance in clinical routine planning. Material and methods: The approach as described in ISO/IEC 9126 has been used to analyze TPS quality. Both TPS quality characteristics and how these may be used to establish a quality model are included. A questionnaire on ranking of these TPS quality characteristics has been sent out to the German DEGRO members in February 1997. Results: By the end of July 1997, 90 individual assessments (of 45 physicists, 35 physicians, and 10 radiographers) had been collected. On an importance scale from 1 (very important) to 6 (unimportant), weight factors of 1.71 (portability), 2.84 (maintainability), 3.18 (efficiency), 3.85 (usability), 4.52 (functionality) and 4.90 (reliability) have been determined from the data. From user satisfaction data also obtained from the questionnaire responses, baseline quality indices could be established from the quality model for the RTPs Cadplan, TMS Helax, and Voxelplan. Conclusion: The responses highlight the need for TPS quality assurance at the same time along the lines of safety-related, research-oriented, and interactive end-user software systems in radiotherapy treatment planning. Quality assurance activities must take this into account. Their effect can be monitored by using quality indices as derivable from the established quality model. (orig.) [Deutsch] Ziel: Um die Planung von Qualitaetssicherungsmassnahmen an 3D-Bestrahlungsplanungssystemen (BPS) zu unterstuetzen, wurde eine postalische Umfrage unter BPS-Anwendern bezueglich der Qualitaetsmerkmale und deren relativer Wichtigkeit durchgefuehrt. Material und Methoden: Zur Analyse der Qualitaet von BPS wurde die Herangehensweise nach ISO/IEC 9126 benutzt, die sowohl die BPS-Qualitaetsmerkmale als auch ein Verfahren zu deren Verknuepfung

  13. SNF sludge treatment system preliminary project execution plan

    International Nuclear Information System (INIS)

    Flament, T.A.

    1998-01-01

    The Fluor Daniel Hanford, Inc. (FDH) Project Director for the Spent Nuclear Fuel (SNF) Project has requested Numatec Hanford Company (NHC) to define how Hanford would manage a new subproject to provide a process system to receive and chemically treat radioactive sludge currently stored in the 100 K Area fuel retention basins. The subproject, named the Sludge Treatment System (STS) Subproject, provides and operates facilities and equipment to chemically process K Basin sludge to meet Tank Waste Remediation System (TWRS) requirements. This document sets forth the NHC management approach for the STS Subproject and will comply with the requirements of the SNF Project Management Plan (HNF-SD-SNFPMP-011). This version of this document is intended to apply to the initial phase of the subproject and to evolve through subsequent revision to include all design, fabrication, and construction conducted on the project and the necessary management and engineering functions within the scope of the subproject. As Project Manager, NHC will perform those activities necessary to complete the STS Subproject within approved cost and schedule baselines and turn over to FDH facilities, systems, and documentation necessary for operation of the STS

  14. Inverse treatment planning using volume-based objective functions

    Science.gov (United States)

    Bednarz, Greg; Michalski, Darek; Anne, Pramila R.; Valicenti, Richard K.

    2004-06-01

    The results of optimization of inverse treatment plans depend on a choice of the objective function. Even when the optimal solution for a given cost function can be obtained, a better solution may exist for a given clinical scenario and it could be obtained with a revised objective function. In the approach presented in this work mixed integer programming was used to introduce a new volume-based objective function, which allowed for minimization of the number of under- or overdosed voxels in selected structures. By selecting and prioritizing components of this function the user could drive the computations towards the desired solution. This optimization approach was tested using cases of patients treated for prostate and oropharyngeal cancer. Initial solutions were obtained based on minimization/maximization of the dose to critical structures and targets. Subsequently, the volume-based objective functions were used to locate solutions, which satisfied better clinical objectives particular to each of the cases. For prostate cases, these additional solutions offered further improvements in sparing of the rectum or the bladder. For oropharyngeal cases, families of solutions were obtained satisfying an intensity modulated radiation therapy protocol for this disease site, while offering significant improvement in the sparing of selected critical structures, e.g., parotid glands. An additional advantage of the present approach was in providing a convenient mechanism to test the feasibility of the dose-volume histogram constraints.

  15. Film dosimetry of small elongated electron beams for treatment planning

    International Nuclear Information System (INIS)

    Niroomand-Rad, A.

    1989-01-01

    The characteristics of 5, 7, 10, 12, 15, and 18 Mev electron beams for small elongated fields of dimensions L x W (where L=1, 2, 3, 4, 5, and 10 cm; and W=1, 2, 3, 4, 5, and 10 cm) have been studied. Film dosimetry and parallel-plate ion chamber measurements have been used to obtain various dose parameters. Selective results of a series of systematic measurements for central axis depth dose data, uniformity index, field flatness, and relative output factors of small elongated electron beams are reported. The square-root method is employed to predict the beam data of small elongated electron fields from corresponding small square electron fields using film dosimetry. The single parameter area/perimeter radio A/P is used to characterize the relative output factors of elongated electron beams. It is our conclusion that for clinical treatment planning square-root method may be applied with caution in determining the beam characteristics of small elongated electron fields from film dosimetry. The calculated and estimated relative output factors from square-root method and A/P ratio are in good agreement and show agreement to within 1% with the measured film values

  16. Paradoxical embolism: role of imaging in diagnosis and treatment planning.

    Science.gov (United States)

    Saremi, Farhood; Emmanuel, Neelmini; Wu, Phil F; Wu, Philip F; Ihde, Lauren; Shavelle, David; Go, John L; Sánchez-Quintana, Damián

    2014-10-01

    Paradoxical embolism (PDE) is an uncommon cause of acute arterial occlusion that may have catastrophic sequelae. The possibility of its presence should be considered in all patients with an arterial embolus in the absence of a cardiac or proximal arterial source. Despite advancements in radiologic imaging technology, the use of various complementary modalities is usually necessary to exclude other possibilities from the differential diagnosis and achieve an accurate imaging-based diagnosis of PDE. In current practice, the imaging workup of a patient with symptoms of PDE usually starts with computed tomography (CT) and magnetic resonance (MR) imaging to identify the cause of the symptoms and any thromboembolic complications in target organs (eg, stroke, peripheral arterial occlusion, or visceral organ ischemia). Additional imaging studies with modalities such as peripheral venous Doppler ultrasonography (US), transcranial Doppler US, echocardiography, and CT or MR imaging are required to detect peripheral and central sources of embolism, identify cardiac and/or extracardiac shunts, and determine whether arterial disease is present. To guide radiologists in selecting the optimal modalities for use in various diagnostic settings, the article provides detailed information about the imaging of PDE, with numerous radiologic and pathologic images illustrating the wide variety of features that may accompany and contribute to the pathologic process. The roles of CT and MR imaging in the diagnosis and exclusion of PDE are described, and the use of imaging for planning surgical treatment and interventional procedures is discussed.

  17. Maxillary, mandibular, and chin advancement: treatment planning based on airway anatomy in obstructive sleep apnea.

    Science.gov (United States)

    Schendel, Stephen; Powell, Nelson; Jacobson, Richard

    2011-03-01

    Surgical correction of obstructive sleep apnea (OSA) syndrome involves understanding a number of parameters, of which the 3-dimensional airway anatomy is important. Visualization of the upper airway based on cone beam computed tomography scans and automated computer analysis is an aid in understanding normal and abnormal airway conditions and their response to surgery. The goal of surgical treatment of OSA syndrome is to enlarge the velo-oropharyngeal airway by anterior/lateral displacement of the soft tissues and musculature by maxillary, mandibular, and possibly, genioglossus advancement. Knowledge of the specific airway obstruction and characteristics based on 3-dimensional studies permits a directed surgical treatment plan that can successfully address the area or areas of airway obstruction. The end occlusal result can be improved when orthodontic treatment is combined with the surgical plan. The individual with OSA, though, is more complicated than the usual orthognathic patient, and both the medical condition and treatment length need to be judiciously managed when OSA and associated conditions are present. The perioperative management of the patient with OSA is more complex and the margin for error is reduced, and this needs to be taken into consideration and the care altered as indicated. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Reporting and analyzing statistical uncertainties in Monte Carlo-based treatment planning

    International Nuclear Information System (INIS)

    Chetty, Indrin J.; Rosu, Mihaela; Kessler, Marc L.; Fraass, Benedick A.; Haken, Randall K. ten; Kong, Feng-Ming; McShan, Daniel L.

    2006-01-01

    Purpose: To investigate methods of reporting and analyzing statistical uncertainties in doses to targets and normal tissues in Monte Carlo (MC)-based treatment planning. Methods and Materials: Methods for quantifying statistical uncertainties in dose, such as uncertainty specification to specific dose points, or to volume-based regions, were analyzed in MC-based treatment planning for 5 lung cancer patients. The effect of statistical uncertainties on target and normal tissue dose indices was evaluated. The concept of uncertainty volume histograms for targets and organs at risk was examined, along with its utility, in conjunction with dose volume histograms, in assessing the acceptability of the statistical precision in dose distributions. The uncertainty evaluation tools were extended to four-dimensional planning for application on multiple instances of the patient geometry. All calculations were performed using the Dose Planning Method MC code. Results: For targets, generalized equivalent uniform doses and mean target doses converged at 150 million simulated histories, corresponding to relative uncertainties of less than 2% in the mean target doses. For the normal lung tissue (a volume-effect organ), mean lung dose and normal tissue complication probability converged at 150 million histories despite the large range in the relative organ uncertainty volume histograms. For 'serial' normal tissues such as the spinal cord, large fluctuations exist in point dose relative uncertainties. Conclusions: The tools presented here provide useful means for evaluating statistical precision in MC-based dose distributions. Tradeoffs between uncertainties in doses to targets, volume-effect organs, and 'serial' normal tissues must be considered carefully in determining acceptable levels of statistical precision in MC-computed dose distributions

  19. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, E.A. [Sandia National Labs., Germantown, MD (United States)

    1995-12-31

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.

  20. Realizing a new paradigm in radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Ziegenhein, Peter

    2013-01-01

    This thesis investigates the feasibility of a new IMRT planning paradigm called Interactive Dose Shaping (IDS). The IDS paradigm enables the therapist to directly impose local dose features into the therapy plan. In contrast to the conventional IMRT planning approach, IDS does not employ an objective function to drive an iterative optimization procedure. In the first part of this work, the conventional IMRT plan optimization method is investigated. Concepts for a near-optimal implementation of the planning problem are provided. The second part of this work introduces the IDS concept. It is designed to overcome clinical drawbacks of the conventional method on the one hand and to provide interactive planning strategies which exploit the full potential of modern high-performance computer hardware on the other hand. The realization of the IDS concept consists of three main parts. (1)A two-step Dose Variation and Recovery (DVR) strategy which imposes localized plan features and recovers for unintentional plan modifications elsewhere. (2)A new dose calculation method (3)The design of an IDS planning framework which provides a powerful graphical user interface. It could be shown that the IDS paradigm is able to reproduce conventionally optimized therapy plans and that the IDS concepts can be realized in real-time.

  1. Verification of hyperthermia treatment planning in cervix carcinoma patients using invasive thermometry

    International Nuclear Information System (INIS)

    Haaren Van, P.M.A.; Kok, H.P.; Zum Voerde Sive Voerding, P.J.; Oldenborg, S.; Stalpers, L.J.A.; Crezee, J.; Berg Van den, C.A.T; Leeuw De, A.A.C.

    2005-01-01

    Full text: Hyperthermia treatment planning (HTP) is a useful tool for improvement of clinical hyperthermia treatments. Aim of this study was to determine the correlation between HTP and measurements during hyperthermia treatments. We compared the calculated specific absorption rate (SAR) with clinically measured SAR-values, from ΔT-measurements, in cervix carcinoma patients. General difficulties for such clinical verifications are changes in the anatomy during the different steps and possible movement of the catheters. We used one fixed invasive catheter in the tumor additional to the usual non-invasive catheters in the vagina, bladder and rectum, for insertion of multisensor thermocouple probes. A special CT-scan with the patient in treatment position and the catheters in situ was made for the HTP. We performed these verifications in a total of 11 treatments in 7 patients. The main difficulties for accurate verification were of clinical nature: difficulties arising from the use of gynaecological tampon and the limited number of measurements in tissue. Remaining air in the vagina and sub-optimal tissue contact of the catheters resulted in bad thermal contact between thermocouples and tissue, causing measurement artefacts that are difficult to correlate with calculations. These artefacts are probably not specific for thermocouple measurements, but more general for intraluminal temperature and SAR measurements. (author)

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

    Science.gov (United States)

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

    2011-02-01

    When considering prosthetic replacement of absent teeth, a treatment plan is necessary. In evaluating whether replacement of teeth is sensible, the causes and consequences of tooth loss must be considered. This concerns information about problems having to do with the patient, potential complications, purely prosthodontic problems, and specific problems. The patient-related problems require collecting data through patient history as well as a clinical and radiologic examination. Complications are risk-factors which negatively influence the prognosis of general health or of a treatment. Potential complications should be eliminated as much as possible through a preliminary treatment. Purely prosthodontic problems are conditions in the area of absence of several teeth or parts of them, and in the area of occlusal and mandibular stability and articulation. Specific problems may be related to inadequate interocclusal space and the quality of the abutment teeth. A cast metal frame removable partial denture may be a relatively inexpensive and minimally treatment alternative for an expensive and complicated treatment with 1 or more fixed partial dentures.

  3. Molecular-targeted nanotherapies in cancer: enabling treatment specificity.

    Science.gov (United States)

    Blanco, Elvin; Hsiao, Angela; Ruiz-Esparza, Guillermo U; Landry, Matthew G; Meric-Bernstam, Funda; Ferrari, Mauro

    2011-12-01

    Chemotherapy represents a mainstay and powerful adjuvant therapy in the treatment of cancer. The field has evolved from drugs possessing all-encompassing cell-killing effects to those with highly targeted, specific mechanisms of action; a direct byproduct of enhanced understanding of tumorigenic processes. However, advances regarding development of agents that target key molecules and dysregulated pathways have had only modest impacts on patient survival. Several biological barriers preclude adequate delivery of drugs to tumors, and remain a formidable challenge to overcome in chemotherapy. Currently, the field of nanomedicine is enabling the delivery of chemotherapeutics, including repositioned drugs and siRNAs, by giving rise to carriers that provide for protection from degradation, prolonged circulation times, and increased tumor accumulation, all the while resulting in reduced patient morbidity. This review aims to highlight several innovative, nanoparticle-based platforms with the potential of providing clinical translation of several novel chemotherapeutic agents. We will also summarize work regarding the development of a multistage drug delivery strategy, a robust carrier platform designed to overcome several biological barriers while en route to tumors. Copyright © 2011 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  4. Submandibular gland cancer: Specific features and treatment considerations.

    Science.gov (United States)

    Aro, Katri; Tarkkanen, Jussi; Saat, Riste; Saarilahti, Kauko; Mäkitie, Antti; Atula, Timo

    2018-01-01

    In the absence of unified treatment protocol, we evaluated the management and outcomes of submandibular gland cancers in an unselected patient series. We included all patients with resected submandibular gland cancer treated at the Helsinki University Hospital from 2000 to 2010 with a 5-year minimum follow-up. Twenty-five patients with cancer represented 30% of submandibular gland neoplasms, and most were adenoid cystic carcinomas (ACCs; 56%). At presentation, 3 patients showed clinical signs of probable malignancy. Of 22 neck dissection specimens, 5 patients (20%) had metastases with an occult metastasis rate of 4%. Cancer recurred in 11 patients (44%), of which 7 (28%) were only at a distant site. The 5-year disease-specific survival (DSS) and overall survival (OS) rates were 76%, and disease-free survival (DFS) was 68%. Most tumors were ACCs differing from the histological pattern of parotid gland cancers. Occult metastases were rare. The rarity of submandibular gland cancer, its variable histological pattern, and varying biological behavior warrant centralized management. © 2017 Wiley Periodicals, Inc.

  5. Modification of a three-dimensional treatment planning system for the use of multi-leaf collimators in conformation radiotherapy

    International Nuclear Information System (INIS)

    Boesecke, R.; Becker, G.; Alandt, K.; Pastyr, O.; Doll, J.; Schlegel, W.; Lorenz, W.J.

    1991-01-01

    The multi-leaf collimator of the DKFZ is designed as a low cost add-on device for conventional linear accelerators for radiotherapy. The technical specification of the computer controlled collimator is briefly described . A major limitation in the use of the wide capabilities of multi-leaf collimators in the clinic is still an appropriate treatment planning system. This paper describes treatment planning and dose calculation techniques for multi-leaf collimators and shows examples where the capabilities of the collimators are used extensively. (author). 18 refs.; 8 figs.; 2 tabs

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  7. SU-E-T-120: Analytic Dose Verification for Patient-Specific Proton Pencil Beam Scanning Plans

    International Nuclear Information System (INIS)

    Chang, C; Mah, D

    2015-01-01

    Purpose: To independently verify the QA dose of proton pencil beam scanning (PBS) plans using an analytic dose calculation model. Methods: An independent proton dose calculation engine is created using the same commissioning measurements as those employed to build our commercially available treatment planning system (TPS). Each proton PBS plan is exported from the TPS in DICOM format and calculated by this independent dose engine in a standard 40 x 40 x 40 cm water tank. This three-dimensional dose grid is then compared with the QA dose calculated by the commercial TPS, using standard Gamma criterion. A total of 18 measured pristine Bragg peaks, ranging from 100 to 226 MeV, are used in the model. Intermediate proton energies are interpolated. Similarly, optical properties of the spots are measured in air over 15 cm upstream and downstream, and fitted to a second-order polynomial. Multiple Coulomb scattering in water is approximated analytically using Preston and Kohler formula for faster calculation. The effect of range shifters on spot size is modeled with generalized Highland formula. Note that the above formulation approximates multiple Coulomb scattering in water and we therefore chose not use the full Moliere/Hanson form. Results: Initial examination of 3 patient-specific prostate PBS plans shows that agreement exists between 3D dose distributions calculated by the TPS and the independent proton PBS dose calculation engine. Both calculated dose distributions are compared with actual measurements at three different depths per beam and good agreements are again observed. Conclusion: Results here showed that 3D dose distributions calculated by this independent proton PBS dose engine are in good agreement with both TPS calculations and actual measurements. This tool can potentially be used to reduce the amount of different measurement depths required for patient-specific proton PBS QA

  8. Yoga treatment for chronic non-specific low back pain.

    Science.gov (United States)

    Wieland, L Susan; Skoetz, Nicole; Pilkington, Karen; Vempati, Ramaprabhu; D'Adamo, Christopher R; Berman, Brian M

    2017-01-12

    Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain. To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events. We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies. We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone. Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach. We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non-exercise interventions (two trials). All trials were at high risk of performance and detection bias because

  9. Yoga treatment for chronic non-specific low back pain

    Science.gov (United States)

    Wieland, L. Susan; Skoetz, Nicole; Pilkington, Karen; Vempati, Ramaprabhu; D’Adamo, Christopher R; Berman, Brian M

    2017-01-01

    Background Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain. Objectives To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events. Search methods We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies. Selection criteria We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone. Data collection and analysis Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach. Main results We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non

  10. Using total-variation regularization for intensity modulated radiation therapy inverse planning with field-specific numbers of segments

    International Nuclear Information System (INIS)

    Zhu Lei; Lee, Louis; Ma Yunzhi; Xing Lei; Ye Yinyu; Mazzeo, Rafe

    2008-01-01

    Currently, there are two types of treatment planning algorithms for intensity modulated radiation therapy (IMRT). The beamlet-based algorithm generates beamlet intensity maps with high complexity, resulting in large numbers of segments in the delivery after a leaf-sequencing algorithm is applied. The segment-based direct aperture optimization (DAO) algorithm includes the physical constraints of the deliverable apertures in the calculation, and achieves a conformal dose distribution using a small number of segments. However, the number of segments is pre-fixed in most of the DAO approaches, and the typical random search scheme in the optimization is computationally intensive. A regularization-based algorithm is proposed to overcome the drawbacks of the DAO method. Instead of smoothing the beamlet intensity maps as in many existing methods, we include a total-variation term in the optimization objective function to reduce the number of signal levels of the beam intensity maps. An aperture rectification algorithm is then applied to generate a significantly reduced number of deliverable apertures. As compared to the DAO algorithm, our method has an efficient form of quadratic optimization, with an additional advantage of optimizing field-specific numbers of segments based on the modulation complexity. The proposed approach is evaluated using two clinical cases. Under the condition that the clinical acceptance criteria of the treatment plan are satisfied, for the prostate patient, the total number of segments for five fields is reduced from 61 using the Eclipse planning system to 35 using the proposed algorithm; for the head and neck patient, the total number of segments for seven fields is reduced from 107 to 28. The head and neck result is also compared to that using an equal number of four segments for each field. The comparison shows that using field-specific numbers of segments achieves a much improved dose distribution.

  11. Treatment planning for heavy ion radiotherapy: physical beam model and dose optimization

    International Nuclear Information System (INIS)

    Kraemer, M.; Haberer, T.; Kraft, G.; Schardt, D.; Weber, U.

    2000-09-01

    We describe a novel code system, TRiP, dedicated to the planning of radiotherapy with energetic ions, in particular 12 C. The software is designed to cooperate with three-dimensional active dose shaping devices like the GSI raster scan system. This unique beam delivery system allows to select any combination from a list of 253 individual beam energies, 7 different beam spot sizes and 15 intensity levels. The software includes a beam model adapted to and verified for carbon ions. Inverse planning techniques are implemented in order to obtain a uniform target dose distribution from clinical input data, i.e. CT images and patient contours. This implies the automatic generation of intensity modulated fields of heavy ions with as many as 40000 raster points, where each point corresponds to a specific beam position, energy and particle fluence. This set of data is directly passed to the beam delivery and control system. The treatment planning code is in clinical use since the start of the GSI pilot project in December 1997. To this end 48 patients have been successfully planned and treated. (orig.)

  12. Treatment planning for heavy-ion radiotherapy: physical beam model and dose optimization

    Science.gov (United States)

    Krämer, M.; Jäkel, O.; Haberer, T.; Kraft, G.; Schardt, D.; Weber, U.

    2000-11-01

    We describe a novel code system, TRiP, dedicated to the planning of radiotherapy with energetic ions, in particular 12C. The software is designed to cooperate with three-dimensional active dose shaping devices like the GSI raster scan system. This unique beam delivery system allows us to select any combination from a list of 253 individual beam energies, 7 different beam spot sizes and 15 intensity levels. The software includes a beam model adapted to and verified for carbon ions. Inverse planning techniques are implemented in order to obtain a uniform target dose distribution from clinical input data, i.e. CT images and patient contours. This implies the automatic generation of intensity modulated fields of heavy ions with as many as 40 000 raster points, where each point corresponds to a specific beam position, energy and particle fluence. This set of data is directly passed to the beam delivery and control system. The treatment planning code has been in clinical use since the start of the GSI pilot project in December 1997. Forty-eight patients have been successfully planned and treated.

  13. Integrated land-use models for spatial planning support: country-specific solutions

    Directory of Open Access Journals (Sweden)

    Vilja Vaszóczik

    2017-12-01

    Full Text Available The key issue of contemporary planning is that it has to work within and respond to the scarcity of resources. The competition for land is particularly intense in growth areas, especially around cities, where suburbanisation is accelerating and causes fundamental change of the evolved settlement pattern and the structure of land use. Planning in this situation must perform the difficult role of mediator in the competition for land, guiding the growth process and at the same time saving and protecting the open spaces which are indispensable for healthy living and are significant natural heritage. The integrated decision support systems (DSS are more and more popular among spatial planners and decision makers since 2000. These systems facilitate to incorporate scientific knowledge in the decision making process. During the last years in the unit for spatial planning of the Lechner Knowledge Centre we developed for a country specific spatial decision support, the Hungary Spatial Decision Support model. This study introduces this model and how it can assist territorial planning and decision making.

  14. Specific application for Oak Ridge National Laboratory dismantlement of Building 3004. Appendix A - Quality assurance plan; Appendix B - Records management plan

    International Nuclear Information System (INIS)

    1997-03-01

    This quality assurance (QA) plan defines the QA requirements for the dismantlement and removal of Building 3004 at Oak Ridge National Laboratory (ORNL). The building is a four-story wooden trained structure with wooden siding, which resides approximately 150 ft west of the Bulk Shielding Reactor, and only several feet away from the visitors entrance to the Graphite Reactor museum. Complete descriptions and sketches are in the Performance Specification document for this project. This project is being conducted as a non-CERCLA maintenance action. This plan is an appendix to the QA plan for the ORNL Environmental Restoration (ER) Program. ORNL/ER-225, which is the source of the project QA requirements, tailors those QA requirements to the specific needs of this project as defined in ORNL/ER-225. Project-specific description and organization are also provided in this plan. Appendix B, Records Management Plan, is included

  15. 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

  16. 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

  17. Environmental Restoration and Waste Management Site-Specific Plan (SSP) for fiscal year 1992 (FY92)

    International Nuclear Information System (INIS)

    1991-09-01

    The FY-92 Site-Specific Plan (FY-92 SSP) for environmental restoration and waste management at the Idaho National Engineering Laboratory (INEL) is designed to provide the reader with easy access to the status of environmental restoration and waste management activities at INEL. The first chapter provides background on INIEL's physical environment, site history and mission, and general information about the site and its facilities. In addition, this chapter discusses the inter-relationships between the Site Specific Plan, the Environmental Restoration and Waste Management Five-Year Plan, the environmental restoration and waste management prioritization systems, and the Activity Data Sheets (ADSs) for environmental restoration and waste management. This discussion should help readers understand what the SSP is and how it fits into the environmental restoration and waste management process at INEL. This understanding should provide the reader with a better context for understanding the discussions in the SSP as well as a better feel for how and what to comment on during the public comment period that will be held from the first of September through the end of October 1991

  18. Planning of Agro-Tourism Development, Specific Location in Green Open Space Sarbagita Area, Bali Province

    Science.gov (United States)

    Lanya, I.; Subadiyasa, N.; Sardiana, K.; Ratna Adi, G. P.

    2018-02-01

    Tourism development has a negative impact on agricultural land in Bali, resulted in the transfer of rice field of 800 ha/year. Subak rice field area as a world cultural heritage, requires conservation strategy, increasing economic and environmental value, through integrated agriculture development with tourism. Tourism destination planning in the form of tourist destination (TD) and tourism object (TO) by raising local genius, at specific location, is expected to preserve nature and culture, as well as the economic value of the region. Research Methods: (1) identification of agrarian cultures, (2) field survey, (3) mapping of site specific TD/TO plans, and (4) compile documents of agro-tourism road map based on local genius. Seven subak areas in the green open space area have the potential to develop new TD/TO, namely: (1) Gedon2Subak in Tanah Lot area, is developed for the preservation of agriculture, the implementation of the zoning plan of the sacred, madya and nista areas, (2) the Kerdung and Penatih Subak areas, developed for urban farming in Denpasar City, (3) Cangi south Subak area, built for agro-tourism plasmanutfah banana and Cemagi Let Subak area developed agro-tourism food crops and horticulture, (4) Erjeruk Subak area, developed tourism plasmanutfah coconut.

  19. SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

    Energy Technology Data Exchange (ETDEWEB)

    Olch, A [University of Southern California, Los Angeles, CA (United States)

    2015-06-15

    Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Eleven neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear Corporation has

  20. SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

    International Nuclear Information System (INIS)

    Olch, A

    2015-01-01

    Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Eleven neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear Corporation has

  1. 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

  2. Project W-314 specific test and evaluation plan for AZ tank farm upgrades

    International Nuclear Information System (INIS)

    Hays, W.H.

    1998-01-01

    The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made by the addition of the SN-631 transfer line from the AZ-O1A pit to the AZ-02A pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system's performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation P1 an (TEP). Testing includes Validations and Verifications (e.g., Commercial Grade Item Dedication activities, etc), Factory Tests and Inspections (FTIs), installation tests and inspections, Construction Tests and Inspections (CTIs), Acceptance Test Procedures (ATPs), Pre-Operational Test Procedures (POTPs), and Operational Test Procedures (OTPs). The STEP will be utilized in conjunction with the TEP for verification and validation

  3. Functional anatomy of the prostate: Implications for treatment planning

    International Nuclear Information System (INIS)

    McLaughlin, Patrick W.; Troyer, Sara; Berri, Sally; Narayana, Vrinda; Meirowitz, Amichay; Roberson, Peter L.; Montie, James

    2005-01-01

    Purpose: To summarize the functional anatomy relevant to prostate cancer treatment planning. Methods and Materials: Coronal, axial, and sagittal T2 magnetic resonance imaging (MRI) and MRI angiography were fused by mutual information and registered with computed tomography (CT) scan data sets to improve definition of zonal anatomy of the prostate and critical adjacent structures. Results: The three major prostate zones (inner, outer, and anterior fibromuscular) are visible by T2 MRI imaging. The bladder, bladder neck, and internal (preprostatic) sphincter are a continuous muscular structure and clear definition of the preprostatic sphincter is difficult by MRI. Transition zone hypertrophy may efface the bladder neck and internal sphincter. The external 'lower' sphincter is clearly visible by T2 MRI with wide variations in length. The critical erectile structures are the internal pudendal artery (defined by MRI angiogram or T2 MRI), corpus cavernosum, and neurovascular bundle. The neurovascular bundle is visible along the posterior lateral surface of the prostate on CT and MRI, but its terminal branches (cavernosal nerves) are not visible and must be defined by their relationship to the urethra within the genitourinary diaphragm. Visualization of the ejaculatory ducts within the prostate is possible on sagittal MRI. The anatomy of the prostate-rectum interface is clarified by MRI, as is the potentially important distinction of rectal muscle and rectal mucosa. Conclusion: Improved understanding of functional anatomy and imaging of the prostate and critical adjacent structures will improve prostate radiation therapy by improvement of dose and toxicity correlation, limitation of dose to critical structures, and potential improvement in post therapy quality of life

  4. [Specific treatments of the psychiatric community and thrombogenesis].

    Science.gov (United States)

    Khammassi, N; Chrifi, J; Hamza, M; Cherif, O

    2013-04-01

    The causes of venous thrombosis (DVT) are multifactorial. Psychiatric patients present several etiologic features. Our objective was to determine the role of specific treatments of the psychiatric community on thrombogenesis. retrospective, descriptive and analytical study of 20 cases of DVT in psychiatric patients. We searched MEDLINE (PubMed) between 1959 and 2009. We reviewed article titles and abstracts and full text of selected studies of psychiatric patients with venous thromboembolism (VTE) disease. We identified 31 studies that investigated the association between psychiatric disease and venous thromboembolic events. Our population was young, with an average age of 44.8 years. Lower limb VT is predominant (16 cases). The most common psychiatric disorders are: anxiety-depression (12 cases), unclassifiable psychotic disorders (seven cases) and major depressive disorder (five cases). Their average duration was of 6.4 years. Seventy percent of our patients were taking first generation neuroleptics (NLP), of short half-life (13/14 cases) and at high doses (11/14 patients). Our sample is characterized by the frequency of thrombophilia (45%) and detention in a psychiatric community (35%). Our results are relatively consistent with aggregate data from the literature, underlining a facilitating and pejorative role of the psychiatric community with regard to venous thromboembolic disease. In the psychiatric community, venous thromboembolic disease is conditioned by a combination of several thromboembolism risk factors: linked in part to the psychiatric illness itself; but above all to the specific therapeutic methods in the psychiatric community (antipsychotics, restraint…) which are easily preventable. The relationship between antipsychotic medication and VTE was first suggested about four decades ago, only a few years after the introduction of phenothiazines and reserpine. An association between atypical antipsychotic agents and VTE has been previously suggested

  5. Assessment and treatment of planning skills in adolescents with ADHD

    NARCIS (Netherlands)

    Boyer, B.E.

    2016-01-01

    Planning problems are described to be prominent in the daily lives of adolescents with ADHD (Barkley, 2004) and may cause comorbid conditions and impairments (Safren, 2006). Therefore the central aim of this thesis was to assess planning skills of adolescents with ADHD and to investigate whether

  6. Treatment planning for heavy ion irradiation. Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Jaekel, O. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). FS Radiologische Diagnostik und Therapie; Kraemer, M. [Gesellschaft fuer Schwerionenforschung (GSI), Biophysik, Darmstadt (Germany)

    1997-09-01

    In this contribution we will outline briefly the GSI beam delivery system and the qualitative differences in the methods used for inverse planning arising from it. We will describe the planning package, consisting of VOXELPLAN and TRiP and show some results for first test cases. (orig./MG)

  7. Manpower Planning for Municipal Wastewater Treatment in Texas, LP-8.

    Science.gov (United States)

    Texas State Dept. of Water Resources, Austin.

    This report presents the implementation results of a pilot test of a manpower planning methodology developed by the U.S. Environmental Protection Agency (EPA), Office of Water Programs. Project outputs and projections are described and illustrated in sections of the report dealing with work to be done, organizational staffing plan, transfers and…

  8. Comparison of CT-based 3D treatment planning with simulator planning of pelvic irradiation of primary cervical carcinoma

    International Nuclear Information System (INIS)

    Knocke, T.H.; Pokrajac, B.; Fellner, C.; Poetter, R.

    1999-01-01

    In a prospective study on 20 subsequent patients with primary cervical carcinoma in Stages I to III simulator planning of a 4-field box-technique was performed. After defining the planning target volume (PTV) in the 3D planning system the field configuration of the simulator planning was transmitted. The resulting plan was compared to a second one based on the defined PTV and evaluated regarding a possible geographical miss and encompassment of the PTV by the treated volume (ICRU). Volumes of open and shaped portals were calculated for both techniques. Planning by simulation resulted in 1 geographical miss and in 10 more cases the encompassment of the PTV by the treated volume was inadequate. For a PTV of mean 1 729 cm 3 the mean volume defined by simulation was 3 120 cm 3 for the open portals and 2 702 cm 3 for the shaped portals. The volume reduction by blocks was 13,4% (mean). With CT-based 3D treatment planning the volume of the open portals was 3,3% (mean) enlarged to 3 224 cm 3 . The resulting mean volume of the shaped portals was 2 458 ccm. The reduction compared to the open portals was 23,8% (mean). The treated volumes were 244 cm 3 or 9% (mean) smaller compared to simulator planning. The 'treated volume/planning target volume ratio' was decreased from 1.59 to 1.42. (orig.) [de

  9. A dosimetric comparison of four treatment planning methods for high grade glioma

    Directory of Open Access Journals (Sweden)

    Miller Robert W

    2009-10-01

    Full Text Available Abstract Background High grade gliomas (HGG are typically treated with a combination of surgery, radiotherapy and chemotherapy. Three dimensional (3D conformal radiotherapy treatment planning is still the main stay of treatment for these patients. New treatment planning methods suggest better dose distributions and organ sparing but their clinical benefit is unclear. The purpose of the current study was to compare normal tissue sparing and tumor coverage using four different radiotherapy planning methods in patients with high grade glioma. Methods Three dimensional conformal (3D, sequential boost IMRT, integrated boost (IB IMRT and Tomotherapy (TOMO treatment plans were generated for 20 high grade glioma patients. T1 and T2 MRI abnormalities were used to define GTV and CTV with 2 and 2.5 cm margins to define PTV1 and PTV2 respectively. Results The mean dose to PTV2 but not to PTV1 was less then 95% of the prescribed dose with IB and IMRT plans. The mean doses to the optic chiasm and the ipsilateral globe were highest with 3D plans and least with IB plans. The mean dose to the contralateral globe was highest with TOMO plans. The mean of the integral dose (ID to the brain was least with the IB plan and was lower with IMRT compared to 3D plans. The TOMO plans had the least mean D10 to the normal brain but higher mean D50 and D90 compared to IB and IMRT plans. The mean D10 and D50 but not D90 were significantly lower with the IMRT plans compared to the 3D plans. Conclusion No single treatment planning method was found to be superior to all others and a personalized approach is advised for planning and treating high-grade glioma patients with radiotherapy. Integral dose did not reflect accurately the dose volume histogram (DVH of the normal brain and may not be a good indicator of delayed radiation toxicity.

  10. Methamphetamine treatment outcomes among gay men attending a LGBTI-specific treatment service in Sydney, Australia.

    Directory of Open Access Journals (Sweden)

    Toby Lea

    Full Text Available Gay and bisexual men (GBM report higher rates of methamphetamine use compared to heterosexual men, and thus have a heightened risk of developing problems from their use. We examined treatment outcomes among GBM clients receiving outpatient counseling at a lesbian, gay, bisexual, transgender and intersex (LGBTI-specific, harm reduction treatment service in Sydney, Australia. GBM receiving treatment for methamphetamine use from ACON's Substance Support Service between 2012-15 (n = 101 were interviewed at treatment commencement, and after 4 sessions (n = 60; follow-up 1 and 8 sessions (n = 32; follow-up 2. At each interview, clients completed measures of methamphetamine use and dependence, other substance use, injecting risk practices, psychological distress and quality of life. The median age of participants was 41 years and 56.4% identified as HIV-positive. Participants attended a median of 5 sessions and attended treatment for a median of 112 days. There was a significant reduction in the median days of methamphetamine use in the previous 4 weeks between baseline (4 days, follow-up 1 (2 days and follow-up 2 (2 days; p = .001. There was a significant reduction in the proportion of participants reporting methamphetamine dependence between baseline (92.1%, follow-up 1 (78.3% and follow-up 2 (71.9%, p < .001. There were also significant reductions in psychological distress (p < .001, and significant improvements in quality of life (p < .001. Clients showed reductions in methamphetamine use and improved psychosocial functioning over time, demonstrating the potential effectiveness of a LGBTI-specific treatment service.

  11. 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)

  12. Nevada Test Site site treatment plan. Final annual update. Revision 1

    International Nuclear Information System (INIS)

    1998-04-01

    A Site Treatment Plan (STP) is required for facilities at which the US Department of Energy Nevada Operations Office (DOE/NV) generates or stores mixed waste (MW), defined by the Federal Facility Compliance Act (FFCAct) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act (RCRA) and a radioactive material subject to the Atomic Energy Act. This STP was written to identify specific treatment facilities for treating DOE/NV generated MW and provides proposed implementation schedules. This STP was approved by the Nevada Division of Environmental Protection (NDEP) and provided the basis for the negotiation and issuance of the FFCAct Consent Order (CO) dated March 6, 1996. The FFCAct CO sets forth stringent regulatory requirements to comply with the implementation of the STP

  13. SU-F-T-272: Patient Specific Quality Assurance of Prostate VMAT Plans with Portal Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Darko, J; Osei, E [Grand River Cancer Centre @ Grand River Hospital, Kitchener, ON (Canada); University of Waterloo, Waterloo, ON (Canada); Kiciak, A [University of Waterloo, Waterloo, ON (Canada); Badu, S; Grigorov, G; Fleck, A [Grand River Cancer Centre @ Grand River Hospital, Kitchener, ON (Canada)

    2016-06-15

    Purpose: To evaluate the effectiveness of using the Portal Dosimetry (PD) method for patient specific quality assurance of prostate VMAT plans. Methods: As per institutional protocol all VMAT plans were measured using the Varian Portal Dosimetry (PD) method. A gamma evaluation criterion of 3%-3mm with a minimum area gamma pass rate (gamma <1) of 95% is used clinically for all plans. We retrospectively evaluated the portal dosimetry results for 170 prostate patients treated with VMAT technique. Three sets of criterions were adopted for re-evaluating the measurements; 3%-3mm, 2%-2mm and 1%-1mm. For all criterions two areas, Field+1cm and MLC-CIAO were analysed.To ascertain the effectiveness of the portal dosimetry technique in determining the delivery accuracy of prostate VMAT plans, 10 patients previously measured with portal dosimetry, were randomly selected and their measurements repeated using the ArcCHECK method. The same criterion used in the analysis of PD was used for the ArcCHECK measurements. Results: All patient plans reviewed met the institutional criteria for Area Gamma pass rate. Overall, the gamma pass rate (gamma <1) decreases for 3%-3mm, 2%-2mm and 1%-1mm criterion. For each criterion the pass rate was significantly reduced when the MLC-CIAO was used instead of FIELD+1cm. There was noticeable change in sensitivity for MLC-CIAO with 2%-2mm criteria and much more significant reduction at 1%-1mm. Comparable results were obtained for the ArcCHECK measurements. Although differences were observed between the clockwise verses the counter clockwise plans in both the PD and ArcCHECK measurements, this was not deemed to be statistically significant. Conclusion: This work demonstrates that Portal Dosimetry technique can be effectively used for quality assurance of VMAT plans. Results obtained show similar sensitivity compared to ArcCheck. To reveal certain delivery inaccuracies, the use of a combination of criterions may provide an effective way in improving

  14. Treatment of Solar Generation in Electric Utility Resource Planning

    Energy Technology Data Exchange (ETDEWEB)

    Sterling, J.; McLaren, J.; Taylor, M.; Cory, K.

    2013-10-01

    Today's utility planners have a different market and economic context than their predecessors, including planning for the growth of renewable energy. State and federal support policies, solar photovoltaic (PV) price declines, and the introduction of new business models for solar PV 'ownership' are leading to increasing interest in solar technologies (especially PV); however, solar introduces myriad new variables into the utility resource planning decision. Most, but not all, utility planners have less experience analyzing solar than conventional generation as part of capacity planning, portfolio evaluation, and resource procurement decisions. To begin to build this knowledge, utility staff expressed interest in one effort: utility exchanges regarding data, methods, challenges, and solutions for incorporating solar in the planning process. Through interviews and a questionnaire, this report aims to begin this exchange of information and capture utility-provided information about: 1) how various utilities approach long-range resource planning; 2) methods and tools utilities use to conduct resource planning; and, 3) how solar technologies are considered in the resource planning process.

  15. Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Yang, Yun; Rodrigues, Anna; Yin, Fang-Fang; Jackie Wu, Q.

    2015-01-01

    Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery

  16. Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle{sup 3} scripting and Auto-Planning functions

    Energy Technology Data Exchange (ETDEWEB)

    Speer, Stefan; Weiss, Alexander; Bert, Christoph [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Erlangen (Germany); Klein, Andreas [EKS Engineering GmbH, Fuerth (Germany); Kober, Lukas [Strahlentherapie Tauber-Franken, Bad Mergentheim (Germany); Yohannes, Indra [Rinecker Proton Therapy Center, Munich (Germany)

    2017-08-15

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

  17. Multi-institutional comparison of simulated treatment delivery errors in ssIMRT, manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

    DEFF Research Database (Denmark)

    Pogson, Elise M; Aruguman, Sankar; Hansen, Christian R

    2017-01-01

    PURPOSE: To quantify the impact of simulated errors for nasopharynx radiotherapy across multiple institutions and planning techniques (auto-plan generated Volumetric Modulated Arc Therapy (ap-VMAT), manually planned VMAT (mp-VMAT) and manually planned step and shoot Intensity Modulated Radiation...... Therapy (mp-ssIMRT)). METHODS: Ten patients were retrospectively planned with VMAT according to three institution's protocols. Within one institution two further treatment plans were generated using differing treatment planning techniques. This resulted in mp-ssIMRT, mp-VMAT, and ap-VMAT plans. Introduced...

  18. Treatment planning in dentistry using an electronic health record: implications for undergraduate education

    NARCIS (Netherlands)

    Tokede, O.; Walji, M.; Ramoni, R.; White, J.M.; Schoonheim-Klein, M.; Kimmes, N.S.; Vaderhobli, R.; Stark, P.C.; Patel, V.L.; Kalenderian, E.

    2013-01-01

    Objective Treatment planning, an essential component of clinical practice, has received little attention in the dental literature and there appears to be no consistent format being followed in the teaching and development of treatment plans within dental school curricula. No investigation, to our

  19. Commissioning and acceptance testing of Cadplan plus- a 3D treatment planning system

    International Nuclear Information System (INIS)

    Malhotra, H.K.; Kinhikar, R.K.; Deshpande, D.D.; Dinshaw, K.A.

    2000-01-01

    3D treatment planning systems are finding wide acceptance in the radiotherapy community due to their improved dose calculation accuracy as well as the 3D visualization tools. Cadplan plus, a 3D treatment planning system from Varian, has been commissioned at the Tata Memorial Hospital in accordance to various international guidelines

  20. Smoking-specific communication and children's smoking onset: an extension of the theory of planned behaviour.

    Science.gov (United States)

    Hiemstra, Marieke; Otten, Roy; van Schayck, Onno C P; Engels, Rutger C M E

    2012-01-01

    The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation = 0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.

  1. 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

  2. SU-F-T-298: The Impact of Modeling the Treatment Couch On Patient Specific VMAT QA

    Energy Technology Data Exchange (ETDEWEB)

    Gelover, E; Dalhart, A; Hyer, D [University of Iowa Hospitals & Clinics, Iowa City, IA (United States)

    2016-06-15

    Purpose: The aim of this work is to quantify the impact of modeling the treatment couch on the passing rate of ion chamber measurements during VMAT quality assurance. Methods: For the initial characterization, attenuation and surface dose measurements were performed following the guidelines of TG-176 for the Civco Universal couch top using an Elekta VersaHD accelerator at an energy of 6 MV. A simulation CT was performed to aid in the creation of contours for representing the shape and size of the couch top in the treatment planning system (TPS). A uniform value of density for the couch wall was determined by comparing the ratios of ion chamber measurements made in a 30×30×11 cm3 water phantom with the TPS dose values of a plan with the same geometry. At our institution, patient specific quality assurance is performed using a Sun Nuclear ArcCheck with a multi-plug for chamber measurements, a 0.125cc PTW TN31010 chamber, and a Sun Nuclear 1010 electrometer. Ten VMAT plans were transferred into the phantom geometry created in the TPS with two settings: with and without the couch. The chamber measurements were compared to both treatment plans. Results: A maximum attenuation of 3.6% was observed when the gantry angle was set to 120 and 240 degrees, passing obliquely through the couch. A uniform density of 0.6 g/cm3 for the couch wall was determined in the TPS by comparison with measured data. The VMAT ion chamber measurement/plan ratios systematically improved by 1.79% ±0.53% for all patients when the couch was included in the calculation. Conclusion: The attenuation and surface dose changes produced by the Civco couch can generate observable dose difference in VMAT plans. Including a couch model in the phantom plan used for patient specific VMAT QA can improve the ionization chamber agreement by up to ∼2%.

  3. Comparison of various online IGRT strategies: The benefits of online treatment plan re-optimization

    International Nuclear Information System (INIS)

    Schulze, Derek; Liang, Jian; Yan, Di; Zhang Tiezhi

    2009-01-01

    Purpose: To compare the dosimetric differences of various online IGRT strategies and to predict potential benefits of online re-optimization techniques in prostate cancer radiation treatments. Materials and methods: Nine prostate patients were recruited in this study. Each patient has one treatment planning CT images and 10-treatment day CT images. Five different online IGRT strategies were evaluated which include 3D conformal with bone alignment, 3D conformal re-planning via aperture changes, intensity modulated radiation treatment (IMRT) with bone alignment, IMRT with target alignment and IMRT daily re-optimization. Treatment planning and virtual treatment delivery were performed. The delivered doses were obtained using in-house deformable dose mapping software. The results were analyzed using equivalent uniform dose (EUD). Results: With the same margin, rectum and bladder doses in IMRT plans were about 10% and 5% less than those in CRT plans, respectively. Rectum and bladder doses were reduced as much as 20% if motion margin is reduced by 1 cm. IMRT is more sensitive to organ motion. Large discrepancies of bladder and rectum doses were observed compared to the actual delivered dose with treatment plan predication. The therapeutic ratio can be improved by 14% and 25% for rectum and bladder, respectively, if IMRT online re-planning is employed compared to the IMRT bone alignment approach. The improvement of target alignment approach is similar with 11% and 21% dose reduction to rectum and bladder, respectively. However, underdosing in seminal vesicles was observed on certain patients. Conclusions: Online treatment plan re-optimization may significantly improve therapeutic ratio in prostate cancer treatments mostly due to the reduction of PTV margin. However, for low risk patient with only prostate involved, online target alignment IMRT treatment would achieve similar results as online re-planning. For all IGRT approaches, the delivered organ-at-risk doses may be

  4. Robust Proton Pencil Beam Scanning Treatment Planning for Rectal Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Blanco Kiely, Janid Patricia, E-mail: jkiely@sas.upenn.edu; White, Benjamin M.

    2016-05-01

    Purpose: To investigate, in a treatment plan design and robustness study, whether proton pencil beam scanning (PBS) has the potential to offer advantages, relative to interfraction uncertainties, over photon volumetric modulated arc therapy (VMAT) in a locally advanced rectal cancer patient population. Methods and Materials: Ten patients received a planning CT scan, followed by an average of 4 weekly offline CT verification CT scans, which were rigidly co-registered to the planning CT. Clinical PBS plans were generated on the planning CT, using a single-field uniform-dose technique with single-posterior and parallel-opposed (LAT) fields geometries. The VMAT plans were generated on the planning CT using 2 6-MV, 220° coplanar arcs. Clinical plans were forward-calculated on verification CTs to assess robustness relative to anatomic changes. Setup errors were assessed by forward-calculating clinical plans with a ±5-mm (left–right, anterior–posterior, superior–inferior) isocenter shift on the planning CT. Differences in clinical target volume and organ at risk dose–volume histogram (DHV) indicators between plans were tested for significance using an appropriate Wilcoxon test (P<.05). Results: Dosimetrically, PBS plans were statistically different from VMAT plans, showing greater organ at risk sparing. However, the bladder was statistically identical among LAT and VMAT plans. The clinical target volume coverage was statistically identical among all plans. The robustness test found that all DVH indicators for PBS and VMAT plans were robust, except the LAT's genitalia (V5, V35). The verification CT plans showed that all DVH indicators were robust. Conclusions: Pencil beam scanning plans were found to be as robust as VMAT plans relative to interfractional changes during treatment when posterior beam angles and appropriate range margins are used. Pencil beam scanning dosimetric gains in the bowel (V15, V20) over VMAT suggest that using PBS to treat rectal

  5. Federal Facilities Compliance Act, Draft Site Treatment Plan: Background Volume, Part 2, Volume 1

    International Nuclear Information System (INIS)

    1994-01-01

    This Draft Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed include: purpose and scope of the plan; site history and mission; draft plant organization; waste minimization; waste characterization; preferred option selection process; technology for treating low-level radioactive wastes and TRU wastes; future generation of mixed waste streams; funding; and process for evaluating disposal issues in support of the site treatment plan

  6. Grout Treatment Facility Land Disposal Restriction Management Plan

    International Nuclear Information System (INIS)

    Hendrickson, D.W.

    1991-01-01

    This document establishes management plans directed to result in the land disposal of grouted wastes at the Hanford Grout Facilities in compliance with Federal, State of Washington, and Department of Energy land disposal restrictions. 9 refs., 1 fig

  7. SU-F-T-617: Remotely Pre-Planned Stereotactic Ablative Radiation Therapy: Validation of Treatment Plan Quality

    International Nuclear Information System (INIS)

    Juang, T; Bush, K; Loo, B; Gensheimer, M

    2016-01-01

    Purpose: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors. Methods: Target/normal structures were contoured on dxCT; a plan was created and approved by the physician. Structures were transferred to simCT using deformable image registration and the plan was re-optimized on simCT. Plan quality was evaluated through comparison to gold-standard structures contoured on simCT and a gold-standard plan based on these structures. Workflow-generated plan quality in this study represents a worst-case scenario as these patients were not treated using custom immobilization to match dxCT position as would be done when the workflow is implemented clinically. Results: 5/6 plans created through the pre-planning workflow were clinically acceptable. For all six plans, the gold-standard GTV received full prescription dose, along with median PTV V95%=95.2% and median PTV D95%=95.4%. Median GTV DSC=0.80, indicating high degree of similarity between the deformed and gold-standard GTV contours despite small GTV sizes (mean=3.0cc). One outlier (DSC=0.49) resulted in inadequate PTV coverage (V95%=62.9%) in the workflow plan; in clinical practice, this mismatch between deformed/gold-standard GTV would be revised by the physician after deformable registration. For all patients, normal tissue doses were comparable to the gold-standard plan and well within constraints. Conclusion: Pre-planning SABR cases on diagnostic imaging generated

  8. Three-dimensional patient-specific cardiac model for surgical planning in Nikaidoh procedure.

    Science.gov (United States)

    Valverde, Israel; Gomez, Gorka; Gonzalez, Antonio; Suarez-Mejias, Cristina; Adsuar, Alejandro; Coserria, Jose Felix; Uribe, Sergio; Gomez-Cia, Tomas; Hosseinpour, Amir Reza

    2015-04-01

    To explore the use of three-dimensional patient-specific cardiovascular models using rapid prototyping techniques (fused deposition modelling) to improve surgical planning in patients with complex congenital heart disease. Rapid prototyping techniques are used to print accurate three-dimensional replicas of patients' cardiovascular anatomy based on magnetic resonance images using computer-aided design systems. Models are printed using a translucent polylactic acid polymer. As a proof of concept, a model of the heart of a 1.5-year-old boy with transposition of the great arteries, ventricular septal defect and pulmonary stenosis was constructed to help planning the surgical correction. The cardiac model allowed the surgeon to evaluate the location and dimensions of the ventricular septal defect as well as its relationship with the aorta and pulmonary artery. Cardiovascular models constructed by rapid prototyping techniques are extremely helpful for planning corrective surgery in patients with complex congenital malformations. Therefore they may potentially reduce operative time and morbi-mortality.

  9. 3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

    Science.gov (United States)

    Meess, Karen M.; Izzo, Richard L.; Dryjski, Maciej L.; Curl, Richard E.; Harris, Linda M.; Springer, Michael; Siddiqui, Adnan H.; Rudin, Stephen; Ionita, Ciprian N.

    2017-03-01

    Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training. Using the Vascular Modeling Toolkit (VMTK), 3D Data from a CTA imaging of a patient scheduled for Fenestrated EndoVascular Aortic Repair (FEVAR) was segmented to isolate the aortic lumen, thrombus, and calcifications. A stereolithographic mesh (STL) was generated and then modified in Autodesk MeshMixer for fabrication via a Stratasys Eden 260 printer in a flexible photopolymer to simulate arterial compliance. Fluoroscopic guided simulation of the patient-specific FEVAR procedure was performed by interventionists using all demonstration endografts and accessory devices. Analysis compared treatment strategy between the planned procedure, the simulation procedure, and the patient procedure using a derived scoring scheme. Results: With training on the patient-specific 3D printed AAA phantom, the clinical team optimized their procedural strategy. Anatomical landmarks and all devices were visible under x-ray during the simulation mimicking the clinical environment. The actual patient procedure went without complications. Conclusions: With advances in 3D printing, fabrication of patient specific AAA phantoms is possible. Simulation with 3D printed phantoms shows potential to inform clinical interventional procedures in addition to CTA diagnostic imaging.

  10. The NUKDOS software for treatment planning in molecular radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kletting, Peter; Schimmel, Sebastian [Univ. Ulm (Germany). Klinik fuer Nuklearmedizin; Haenscheid, Heribert; Fernandez, Maria; Lassmann, Michael [Univ. Wuerzburg (Germany). Klinik fuer Nuklearmedizin; Luster, Markus [Univ. Marburg (Germany). Klinik fuer Nuklearmedizin; Nosske, Dietmar [Bundesamt fuer Strahlenschutz, Fachbereich Strahlenschutz und Gesundheit, Oberschleissheim (Germany); Glatting, Gerhard [Heidelberg Univ., Medical Radiation Physics/Radiation Protection, Mannheim (Germany)

    2015-07-01

    The aim of this work was the development of a software tool for treatment planning prior to molecular radiotherapy, which comprises all functionality to objectively determine the activity to administer and the pertaining absorbed doses (including the corresponding error) based on a series of gamma camera images and one SPECT/CT or probe data. NUKDOS was developed in MATLAB. The workflow is based on the MIRD formalism For determination of the tissue or organ pharmacokinetics, gamma camera images as well as probe, urine, serum and blood activity data can be processed. To estimate the time-integrated activity coefficients (TIAC), sums of exponentials are fitted to the time activity data and integrated analytically. To obtain the TIAC on the voxel level, the voxel activity distribution from the quantitative 3D SPECT/CT (or PET/CT) is used for scaling and weighting the TIAC derived from the 2D organ data. The voxel S-values are automatically calculated based on the voxel-size of the image and the therapeutic nuclide ({sup 90}Y, {sup 131}I or {sup 177}Lu). The absorbed dose coefficients are computed by convolution of the voxel TIAC and the voxel S-values. The activity to administer and the pertaining absorbed doses are determined by entering the absorbed dose for the organ at risk. The overall error of the calculated absorbed doses is determined by Gaussian error propagation. NUKDOS was tested for the operation systems Windows {sup registered} 7 (64 Bit) and 8 (64 Bit). The results of each working step were compared to commercially available (SAAMII, OLINDA/EXM) and in-house (UlmDOS) software. The application of the software is demonstrated using examples form peptide receptor radionuclide therapy (PRRT) and from radioiodine therapy of benign thyroid diseases. For the example from PRRT, the calculated activity to administer differed by 4% comparing NUKDOS and the final result using UlmDos, SAAMII and OLINDA/EXM sequentially. The absorbed dose for the spleen and tumour

  11. Adaptive brachytherapy of cervical cancer, comparison of conventional point A and CT based individual treatment planning

    International Nuclear Information System (INIS)

    Wanderaas, Anne D.; Langdal, Ingrid; Danielsen, Signe; Frykholm, Gunilla; Marthinsen, Anne B. L; Sundset, Marit

    2012-01-01

    Background. Locally advanced cervical cancer is commonly treated with external radiation therapy combined with local brachytherapy. The brachytherapy is traditionally given based on standard dose planning with prescription of dose to point A. Dosimetric aspects when changing from former standard treatment to individualized treatment plans based on computed tomography (CT) images are here investigated. Material and methods. Brachytherapy data from 19 patients with a total of 72 individual treatment fractions were retrospectively reviewed. Standard library plans were analyzed with respect to doses to organs at risk (OARs), and the result was compared to corresponding delivered individualized plans. The theoretical potential of further optimization based on prescription to target volumes was investigated. The treatments were performed with a Fletcher applicator. Results. For standard treatment planning, the tolerance dose limits were exceeded in the bladder, rectum and sigmoid in 26%, 4% and 15% of the plans, respectively. This was observed most often for the smallest target volumes. The individualized planning of the delivered treatment gave the possibility of controlling the dose to critical organs to below certain limits. The dose was still prescribed to point A. An increase in target dose coverage was achieved when additional individual optimization was performed, while still keeping the dose to the OARs below predefined limits. Relatively low average target coverage, especially for the largest volumes was however seen. Conclusion. The individualized delivered treatment plans ensured that doses to OARs were within acceptable limits. This was not the case in 42% of the corresponding standard plans. Further optimized treatment plans were found to give an overall better dose coverage. In lack of MR capacity, it may be favorable to use CT for planning due to possible protection of OARs. The CT based target volumes were, however, not equivalent to the volumes described

  12. Mode-Specific Effects among Three Treatments for Depression.

    Science.gov (United States)

    Imber, Stanley D.; And Others

    1990-01-01

    Randomly assigned 250 depressed outpatients to interpersonal psychotherapy, cognitive-behavioral therapy, imipramine plus clinical management, or pill placebo plus clinical management treatments. All treatments demonstrated significant symptom reduction with few differences in general outcomes. None of the therapies produced consistent effects on…

  13. 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.

  14. SU-F-T-128: Dose-Volume Constraints for Particle Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, R; Smith, W; Hendrickson, K; Meyer, J; Cao, N; Lee, E; Gopan, O; Sandison, G; Parvathaneni, U; Laramore, G [University of Washington, Seattle, WA (United States)

    2016-06-15

    Purpose: Determine equivalent Organ at Risk (OAR) tolerance dose (TD) constraints for MV x-rays and particle therapy. Methods: Equivalent TD estimates for MV x-rays are determined from an isoeffect, regression-analysis of published and in-house constraints for various fractionation schedules (n fractions). The analysis yields an estimate of (α/β) for an OAR. To determine equivalent particle therapy constraints, the MV x-ray TD(n) values are divided by the RBE for DSB induction (RBE{sub DSB}) or cell survival (RBE{sub S}). Estimates of (RBE{sub DSB}) are computed using the Monte Carlo Damage Simulation, and estimates of RBES are computed using the Repair-Misrepair-Fixation (RMF) model. A research build of the RayStation™ treatment planning system implementing the above model is used to estimate (RBE{sub DSB}) for OARs of interest in 16 proton therapy patient plans (head and neck, thorax, prostate and brain). Results: The analysis gives an (α/β) estimate of about 20 Gy for the trachea and heart and 2–4 Gy for the esophagus, spine, and brachial plexus. Extrapolation of MV x-ray constraints (n = 1) to fast neutrons using RBE{sub DSB} = 2.7 are in excellent agreement with clinical experience (n = 10 to 20). When conventional (n > 30) x-ray treatments are used as the reference radiation, fast neutron RBE increased to a maximum of 6. For comparison to a constant RBE of 1.1, the RayStation™ analysis gave estimates of proton RBE{sub DSB} from 1.03 to 1.33 for OARs of interest. Conclusion: The presented system of models is a convenient formalism to synthesize from multiple sources of information a set of self-consistent plan constraints for MV x-ray and hadron therapy treatments. Estimates of RBE{sub DSB} from the RayStation™ analysis differ substantially from 1.1 and vary among patients and treatment sites. A treatment planning system that incorporates patient and anatomy-specific corrections in proton RBE would create opportunities to increase the therapeutic

  15. The specifics of marketing in strategic planning of election campaigns in Ukraine

    Directory of Open Access Journals (Sweden)

    O. Y. Shinkarenko

    2015-06-01

    Full Text Available The article considers a number of issues related to common approaches to strategic planning of election campaigns and its specificity in the conditions of modern Ukraine. Examines the role of strategic planning in the process of organizing and conducting election campaigns, various types of strategies used. Provides information on the types of strategies that were used by Ukrainian political parties and blocs in the election period of 2014 to the Verkhovna Rada.In the article the analysis of some (the problem is very wide, to talk about the possibility completely to solve it within a short studies key aspects of strategic planning of election campaigns. And, on the other hand, examples of the use of such approaches in recent election campaigns to be implemented in Ukraine. Strategic planning of election campaigns stands as the most important aspect of their organization, which defines the content of the campaign, we have what you need to send a potential electorate to vote a certain way. The development strategy of the campaign is a necessary stage of its organization, requires the use of experienced creative professionals and a number of methods and technologies designed to achieve the desired candidate or political party participating in the election result. Distinguish the different types and varieties of election campaign strategies, which vary according to the type of elections, the resources, the order of candidates on the configuration of the election campaign, used substantive and technological approaches, as well as the rhythm of the implementation of the election campaign. Determined that in parliamentary elections in 2014, all parties entered the Parliament, including the Opposition bloc, has used various strategies that in some way determined their electoral success.

  16. SU-E-T-473: A Patient-Specific QC Paradigm Based On Trajectory Log Files and DICOM Plan Files

    International Nuclear Information System (INIS)

    DeMarco, J; McCloskey, S; Low, D; Moran, J

    2014-01-01

    Purpose: To evaluate a remote QC tool for monitoring treatment machine parameters and treatment workflow. Methods: The Varian TrueBeamTM linear accelerator is a digital machine that records machine axis parameters and MLC leaf positions as a function of delivered monitor unit or control point. This information is saved to a binary trajectory log file for every treatment or imaging field in the patient treatment session. A MATLAB analysis routine was developed to parse the trajectory log files for a given patient, compare the expected versus actual machine and MLC positions as well as perform a cross-comparison with the DICOM-RT plan file exported from the treatment planning system. The parsing routine sorts the trajectory log files based on the time and date stamp and generates a sequential report file listing treatment parameters and provides a match relative to the DICOM-RT plan file. Results: The trajectory log parsing-routine was compared against a standard record and verify listing for patients undergoing initial IMRT dosimetry verification and weekly and final chart QC. The complete treatment course was independently verified for 10 patients of varying treatment site and a total of 1267 treatment fields were evaluated including pre-treatment imaging fields where applicable. In the context of IMRT plan verification, eight prostate SBRT plans with 4-arcs per plan were evaluated based on expected versus actual machine axis parameters. The average value for the maximum RMS MLC error was 0.067±0.001mm and 0.066±0.002mm for leaf bank A and B respectively. Conclusion: A real-time QC analysis program was tested using trajectory log files and DICOM-RT plan files. The parsing routine is efficient and able to evaluate all relevant machine axis parameters during a patient treatment course including MLC leaf positions and table positions at time of image acquisition and during treatment

  17. BrachyTPS -Interactive point kernel code package for brachytherapy treatment planning of gynaecological cancers

    International Nuclear Information System (INIS)

    Thilagam, L.; Subbaiah, K.V.

    2008-01-01

    Brachytherapy treatment planning systems (TPS) are always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in Intracavitary brachytherapy (ICBT) applicators. Most of the commercially available brachytherapy TPS softwares estimate the absorbed dose at a point, only taking care of the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. So the doses estimated by them are not much accurate under realistic clinical conditions. In this regard, interactive point kernel rode (BrachyTPS) has been developed to perform independent dose calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. As primary input data, the code takes patients' planning data including the source specifications, dwell positions, dwell times and it computes the doses at reference points by dose point kernel formalisms, with multi-layer shield build-up factors accounting for the contributions from scattered radiation. In addition to performing dose distribution calculations, this code package is capable of displaying an isodose distribution curve into the patient anatomy images. The primary aim of this study is to validate the developed point kernel code integrated with treatment planning systems against the other tools which are available in the market. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, Board of Radiation Isotope and Technology (BRIT) made low dose rate (LDR) applicator, Fletcher Green type LDR applicator and Fletcher Williamson high dose rate (HDR) applicator were studied to test the accuracy of the software

  18. Comparison of treatment plans: a retrospective study by the method of radiobiological evaluation

    Science.gov (United States)

    Puzhakkal, Niyas; Kallikuzhiyil Kochunny, Abdullah; Manthala Padannayil, Noufal; Singh, Navin; Elavan Chalil, Jumanath; Kulangarakath Umer, Jamshad

    2016-09-01

    There are many situations in radiotherapy where multiple treatment plans need to be compared for selection of an optimal plan. In this study we performed the radiobiological method of plan evaluation to verify the treatment plan comparison procedure of our clinical practice. We estimated and correlated various radiobiological dose indices with physical dose metrics for a total of 30 patients representing typical cases of head and neck, prostate and brain tumors. Three sets of plans along with a clinically approved plan (final plan) treated by either Intensity Modulated Radiation Therapy (IMRT) or Rapid Arc (RA) techniques were considered. The study yielded improved target coverage for final plans, however, no appreciable differences in doses and the complication probabilities of organs at risk were noticed. Even though all four plans showed adequate dose distributions, from dosimetric point of view, the final plan had more acceptable dose distribution. The estimated biological outcome and dose volume histogram data showed least differences between plans for IMRT when compared to RA. Our retrospective study based on 120 plans, validated the radiobiological method of plan evaluation. The tumor cure or normal tissue complication probabilities were found to be correlated with the corresponding physical dose indices.

  19. Are there national strategies, plans and guidelines for the treatment of hepatitis C in people who inject drugs?

    DEFF Research Database (Denmark)

    Maticic, Mojca; Videcnik Zorman, Jerneja; Gregorcic, Sergeja

    2014-01-01

    BACKGROUND: Hepatitis C virus (HCV) infection represents a major global health problem, which in high-income countries now mostly affects people who inject drugs (PWID). Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID...... have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular....... METHODS: Thirty-three European countries were invited to participate. Data on available national strategies, action plans and guidelines for HCV treatment in general population and in PWID specifically were collected prospectively by means of a structured electronic questionnaire and analyzed accordingly...

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

    Science.gov (United States)

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

    2017-06-01

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

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

    International Nuclear Information System (INIS)

    1995-01-01

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

  2. Improvement of locoregional hyperthermia treatments of oesophageal cancer using treatment planning

    International Nuclear Information System (INIS)

    Kok, H.P.; Haaren Van, P.M.A.; Kamer Van de, J.B.; Zum Voerde Sive Voerding, P.J.; Wiersma, J.; Hulshof, M.C.C.M; Geijsen, E.D.; Crezee, J.

    2005-01-01

    Full text: The thermal dose achieved in the clinic often remains too low due to the incidence of treatment limiting hot spots, which are difficult to avoid intuitively due to the large number of degrees of freedom (amplitudes and phases) of the heating device. To improve hyperthermia treatments of oesophagus carcinoma patients with the 70 MHz AMC-4 waveguide system we performed hyperthermia treatment planning (HTP) with high resolution temperature based optimization. With this optimization we obtain amplitude (A) and phase (p) settings for the antennas for optimal tumor heating (> 43 o C) while preventing hot spots in normal tissue ( o C) and maintaining the spinal cord temperature below 40 o C to prevent neurotoxicity. With the mixed A/P settings the highest absolute ΔT's were achieved, while the ratio was not much different from the other two configurations. This implies that with these settings the same tumor heating can be obtained with less applied power, resulting in more efficient heating. The fact that the combined numerical A/clinical P settings resulted in the highest absolute temperature rises in the oesophagus might be due to the difference in patient positioning between the planning and the actual treatment, since the location of the SAR focus in the tumor is constructed mainly by phase steering. The temperature rise near the spinal cord depends mainly on the power of the top antenna. The correlation coefficient was R=0.37, which was considerably higher than the correlation with the powers or phases of the other antennas. The temperature rise in the oesophagus depends mainly on the power of the top and bottom antenna together. The correlation coefficient was only R=0.12 but this was still more than 2 times higher than the correlation with the power of the left and right antenna. The relation between the temperature rise due to a power pulse of 30 seconds and the achieved steady state temperature was more or less linear, implying a higher T 90 and T 50

  3. Institutional Patient-specific IMRT QA Does Not Predict Unacceptable Plan Delivery

    International Nuclear Information System (INIS)

    Kry, Stephen F.; Molineu, Andrea; Kerns, James R.; Faught, Austin M.; Huang, Jessie Y.; Pulliam, Kiley B.; Tonigan, Jackie; Alvarez, Paola; Stingo, Francesco; Followill, David S.

    2014-01-01

    Purpose: To determine whether in-house patient-specific intensity modulated radiation therapy quality assurance (IMRT QA) results predict Imaging and Radiation Oncology Core (IROC)-Houston phantom results. Methods and Materials: IROC Houston's IMRT head and neck phantoms have been irradiated by numerous institutions as part of clinical trial credentialing. We retrospectively compared these phantom results with those of in-house IMRT QA (following the institution's clinical process) for 855 irradiations performed between 2003 and 2013. The sensitivity and specificity of IMRT QA to detect unacceptable or acceptable plans were determined relative to the IROC Houston phantom results. Additional analyses evaluated specific IMRT QA dosimeters and analysis methods. Results: IMRT QA universally showed poor sensitivity relative to the head and neck phantom, that is, poor ability to predict a failing IROC Houston phantom result. Depending on how the IMRT QA results were interpreted, overall sensitivity ranged from 2% to 18%. For different IMRT QA methods, sensitivity ranged from 3% to 54%. Although the observed sensitivity was particularly poor at clinical thresholds (eg 3% dose difference or 90% of pixels passing gamma), receiver operator characteristic analysis indicated that no threshold showed good sensitivity and specificity for the devices evaluated. Conclusions: IMRT QA is not a reasonable replacement for a credentialing phantom. Moreover, the particularly poor agreement between IMRT QA and the IROC Houston phantoms highlights surprising inconsistency in the QA process

  4. Revealing the Structural Complexity of Component Interactions of Topic-Specific PCK when Planning to Teach

    Science.gov (United States)

    Mavhunga, Elizabeth

    2018-04-01

    Teaching pedagogical content knowledge (PCK) at a topic-specific level requires clarity on the content-specific nature of the components employed, as well as the specific features that bring about the desirable depth in teacher explanations. Such understanding is often hazy; yet, it influences the nature of teacher tasks and learning opportunities afforded to pre-service teachers in a teaching program. The purpose of this study was twofold: firstly, to illuminate the emerging complexity when content-specific components of PCK interact when planning to teach a chemistry topic; and secondly, to identify the kinds of teacher tasks that promote the emergence of such complexity. Data collected were content representations (CoRes) in chemical equilibrium accompanied by expanded lesson outlines from 15 pre-service teachers in their final year of study towards a first degree in teaching (B Ed). The analysis involved extraction of episodes that exhibited component interaction by using a qualitative in-depth analysis method. The results revealed the structure in which the components of PCK in a topic interact among each other to be linear, interwoven, or a combination of the two. The interwoven interactions contained multiple components that connected explanations on different aspects of a concept, all working in a complementary manner. The most sophisticated component interactions emerged from teacher tasks on descriptions of a lesson sequence and a summary of a lesson. Recommendations in this study highlight core practices for making pedagogical transformation of topic content knowledge more accessible.

  5. 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...

  6. Correction factors for ionization chamber dosimetry in CyberKnife: Machine-specific, plan-class, and clinical fields

    International Nuclear Information System (INIS)

    Gago-Arias, Araceli; Antolín, Elena; Fayos-Ferrer, Francisco; Simón, Rocío; González-Castaño, Diego M.; Palmans, Hugo; Sharpe, Peter; Gómez, Faustino; Pardo-Montero, Juan

    2013-01-01

    Purpose: The aim of this work is the application of the formalism for ionization chamber reference dosimetry of small and nonstandard fields [R. Alfonso, P. Andreo, R. Capote, M. S. Huq, W. Kilby, P. Kjäll, T. R. Mackie, H. Palmans, K. Rosser, J. Seuntjens, W. Ullrich, and S. Vatnitsky, “A new formalism for reference dosimetry of small and nonstandard fields,” Med. Phys. 35, 5179–5186 (2008)] to the CyberKnife robotic radiosurgery system. Correction factors for intermediate calibration fields, a machine-specific reference field (msr) and two plan-class specific reference fields (pcsr), have been studied. Furthermore, the applicability of the new formalism to clinical dosimetry has been analyzed through the investigation of two clinical treatments. Methods: PTW31014 and Scanditronix-Wellhofer CC13 ionization chamber measurements were performed for the fields under investigation. Absorbed dose to water was determined using alanine reference dosimetry, and experimental correction factors were calculated from alanine to ionization chamber readings ratios. In addition, correction factors were calculated for the intermediate calibration fields and one of the clinical treatment fields using the Monte Carlo method and these were compared with the experimental values. Results: Overall correction factors deviating from unity by approximately 2% were obtained from both measurements and simulations, with values below and above unity for the studied intermediate calibration fields and clinical fields for the ionization chambers under consideration. Monte Carlo simulations yielded correction factors comparable with those obtained from measurements for the machine-specific reference field, although differences from 1% to 3.3% were observed between measured and calculated correction factors for the composite intermediate calibration fields. Dose distribution inhomogeneities are thought to be responsible for such discrepancies. Conclusions: The differences found between

  7. Comparison of treatments of steep and shoot generated by different inverse planning systems

    International Nuclear Information System (INIS)

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

    2011-01-01

    The problem of IMRT treatments with the technique Steep and Shoot or static is the number of segments and monitor units used in the treatment. These parameters depend largely on the inverse planning system which determines treatment. Are evaluated three commercial planning systems, with each one performing clinical dosimetry for the same series of patients. Dosimetric results are compared, UM calculated and number of segments.

  8. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT

    International Nuclear Information System (INIS)

    Velazquez T, J. J.; Gutierrez M, J. G.; Ortiz A, C. S.; Chagoya G, A.; Gutierrez C, J. G.

    2015-10-01

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  9. 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.)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  11. Dosimetry-based treatment planning for molecular radiotherapy: a summary of the 2017 report from the Internal Dosimetry Task Force

    Directory of Open Access Journals (Sweden)

    Caroline Stokke

    2017-11-01

    Full Text Available Abstract Background The European directive on basic safety standards (Council directive 2013/59 Euratom mandates dosimetry-based treatment planning for radiopharmaceutical therapies. The directive comes into operation February 2018, and the aim of a report produced by the Internal Dosimetry Task Force of the European Association of Nuclear Medicine is to address this aspect of the directive. A summary of the repo