WorldWideScience

Sample records for therapy planning processes

  1. The use of discrete-event simulation modelling to improve radiation therapy planning processes

    International Nuclear Information System (INIS)

    Werker, Greg; Saure, Antoine; French, John; Shechter, Steven

    2009-01-01

    Background and purpose: The planning portion of the radiation therapy treatment process at the British Columbia Cancer Agency is efficient but nevertheless contains room for improvement. The purpose of this study is to show how a discrete-event simulation (DES) model can be used to represent this complex process and to suggest improvements that may reduce the planning time and ultimately reduce overall waiting times. Materials and methods: A simulation model of the radiation therapy (RT) planning process was constructed using the Arena simulation software, representing the complexities of the system. Several types of inputs feed into the model; these inputs come from historical data, a staff survey, and interviews with planners. Results: The simulation model was validated against historical data and then used to test various scenarios to identify and quantify potential improvements to the RT planning process. Conclusions: Simulation modelling is an attractive tool for describing complex systems, and can be used to identify improvements to the processes involved. It is possible to use this technique in the area of radiation therapy planning with the intent of reducing process times and subsequent delays for patient treatment. In this particular system, reducing the variability and length of oncologist-related delays contributes most to improving the planning time.

  2. The use of discrete-event simulation modelling to improve radiation therapy planning processes.

    Science.gov (United States)

    Werker, Greg; Sauré, Antoine; French, John; Shechter, Steven

    2009-07-01

    The planning portion of the radiation therapy treatment process at the British Columbia Cancer Agency is efficient but nevertheless contains room for improvement. The purpose of this study is to show how a discrete-event simulation (DES) model can be used to represent this complex process and to suggest improvements that may reduce the planning time and ultimately reduce overall waiting times. A simulation model of the radiation therapy (RT) planning process was constructed using the Arena simulation software, representing the complexities of the system. Several types of inputs feed into the model; these inputs come from historical data, a staff survey, and interviews with planners. The simulation model was validated against historical data and then used to test various scenarios to identify and quantify potential improvements to the RT planning process. Simulation modelling is an attractive tool for describing complex systems, and can be used to identify improvements to the processes involved. It is possible to use this technique in the area of radiation therapy planning with the intent of reducing process times and subsequent delays for patient treatment. In this particular system, reducing the variability and length of oncologist-related delays contributes most to improving the planning time.

  3. Developing a treatment planning process and software for improved translation of photodynamic therapy

    Science.gov (United States)

    Cassidy, J.; Zheng, Z.; Xu, Y.; Betz, V.; Lilge, L.

    2017-04-01

    Background: The majority of de novo cancers are diagnosed in low and middle-income countries, which often lack the resources to provide adequate therapeutic options. None or minimally invasive therapies such as Photodynamic Therapy (PDT) or photothermal therapies could become part of the overall treatment options in these countries. However, widespread acceptance is hindered by the current empirical training of surgeons in these optical techniques and a lack of easily usable treatment optimizing tools. Methods: Based on image processing programs, ITK-SNAP, and the publicly available FullMonte light propagation software, a work plan is proposed that allows for personalized PDT treatment planning. Starting with, contoured clinical CT or MRI images, the generation of 3D tetrahedral models in silico, execution of the Monte Carlo simulation and presentation of the 3D fluence rate, Φ, [mWcm-2] distribution a treatment plan optimizing photon source placement is developed. Results: Permitting 1-2 days for the installation of the required programs, novices can generate their first fluence, H [Jcm-2] or Φ distribution in a matter of hours. This is reduced to 10th of minutes with some training. Executing the photon simulation calculations is rapid and not the performance limiting process. Largest sources of errors are uncertainties in the contouring and unknown tissue optical properties. Conclusions: The presented FullMonte simulation is the fastest tetrahedral based photon propagation program and provides the basis for PDT treatment planning processes, enabling a faster proliferation of low cost, minimal invasive personalized cancer therapies.

  4. Strategic level proton therapy patient admission planning: a Markov decision process modeling approach.

    Science.gov (United States)

    Gedik, Ridvan; Zhang, Shengfan; Rainwater, Chase

    2017-06-01

    A relatively new consideration in proton therapy planning is the requirement that the mix of patients treated from different categories satisfy desired mix percentages. Deviations from these percentages and their impacts on operational capabilities are of particular interest to healthcare planners. In this study, we investigate intelligent ways of admitting patients to a proton therapy facility that maximize the total expected number of treatment sessions (fractions) delivered to patients in a planning period with stochastic patient arrivals and penalize the deviation from the patient mix restrictions. We propose a Markov Decision Process (MDP) model that provides very useful insights in determining the best patient admission policies in the case of an unexpected opening in the facility (i.e., no-shows, appointment cancellations, etc.). In order to overcome the curse of dimensionality for larger and more realistic instances, we propose an aggregate MDP model that is able to approximate optimal patient admission policies using the worded weight aggregation technique. Our models are applicable to healthcare treatment facilities throughout the United States, but are motivated by collaboration with the University of Florida Proton Therapy Institute (UFPTI).

  5. Full Monte Carlo-Based Biologic Treatment Plan Optimization System for Intensity Modulated Carbon Ion Therapy on Graphics Processing Unit.

    Science.gov (United States)

    Qin, Nan; Shen, Chenyang; Tsai, Min-Yu; Pinto, Marco; Tian, Zhen; Dedes, Georgios; Pompos, Arnold; Jiang, Steve B; Parodi, Katia; Jia, Xun

    2018-01-01

    One of the major benefits of carbon ion therapy is enhanced biological effectiveness at the Bragg peak region. For intensity modulated carbon ion therapy (IMCT), it is desirable to use Monte Carlo (MC) methods to compute the properties of each pencil beam spot for treatment planning, because of their accuracy in modeling physics processes and estimating biological effects. We previously developed goCMC, a graphics processing unit (GPU)-oriented MC engine for carbon ion therapy. The purpose of the present study was to build a biological treatment plan optimization system using goCMC. The repair-misrepair-fixation model was implemented to compute the spatial distribution of linear-quadratic model parameters for each spot. A treatment plan optimization module was developed to minimize the difference between the prescribed and actual biological effect. We used a gradient-based algorithm to solve the optimization problem. The system was embedded in the Varian Eclipse treatment planning system under a client-server architecture to achieve a user-friendly planning environment. We tested the system with a 1-dimensional homogeneous water case and 3 3-dimensional patient cases. Our system generated treatment plans with biological spread-out Bragg peaks covering the targeted regions and sparing critical structures. Using 4 NVidia GTX 1080 GPUs, the total computation time, including spot simulation, optimization, and final dose calculation, was 0.6 hour for the prostate case (8282 spots), 0.2 hour for the pancreas case (3795 spots), and 0.3 hour for the brain case (6724 spots). The computation time was dominated by MC spot simulation. We built a biological treatment plan optimization system for IMCT that performs simulations using a fast MC engine, goCMC. To the best of our knowledge, this is the first time that full MC-based IMCT inverse planning has been achieved in a clinically viable time frame. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Medical nutrition therapy planning

    OpenAIRE

    Torović Ljilja; Grujičić Maja; Pavlović-Trajković Ljiljana; Jovičić Jelena; Novaković Budimka; Balać Dragana

    2010-01-01

    Introduction. Diet has vital, preventive and therapeutic functions. Medical nutrition therapy is a part of the Standardized Nutrition Care Process integrated in health care systems. Material and methods. An overview of the Nutrition Care Process model and the application of nutrition guidelines based on literature, reports, documents and programmes of international health, food and physical activity authorities was done. Results. The Nutrition Care Process model requires registered diet...

  7. Particle therapy planning

    International Nuclear Information System (INIS)

    Zink, S.

    1987-01-01

    The Radiation Research Program (RRP) supports a variety of research through grants and contracts. During the last few years, considerable effort has been devoted to treatment planning evaluation in particle, photon and electron radiotherapy. In 1981, RRP issued a request for proposals (RFP) for the evaluation of treatment planning with particle beam radiotherapy - to include protons, heavy ions and neutrons. Contracts were subsequently awarded to four institutions: Massachusetts General Hospital (MGH), University of Texas and M.D. Anderson Hospital (MDAH), the heavy ion project at Lawrence Berkeley Laboratory (LBL) and University of Pennsylvania (UPa). These contracts reached completion December 31, 1986. The work for the contracts was carried out at the individual institutions and guided through a Working Group made up of the Project Officer and Principal Investigators and primary physicians and physicists at each of the participating institutions. This report summarizes the findings of the Working Group and makes recommendations for further research

  8. Process Management Plans

    Directory of Open Access Journals (Sweden)

    Tomasz Miksa

    2014-07-01

    Full Text Available In the era of research infrastructures and big data, sophisticated data management practices are becoming essential building blocks of successful science. Most practices follow a data-centric approach, which does not take into account the processes that created, analysed and presented the data. This fact limits the possibilities for reliable verification of results. Furthermore, it does not guarantee the reuse of research, which is one of the key aspects of credible data-driven science. For that reason, we propose the introduction of the new concept of Process Management Plans, which focus on the identification, description, sharing and preservation of the entire scientific processes. They enable verification and later reuse of result data and processes of scientific experiments. In this paper we describe the structure and explain the novelty of Process Management Plans by showing in what way they complement existing Data Management Plans. We also highlight key differences, major advantages, as well as references to tools and solutions that can facilitate the introduction of Process Management Plans.

  9. Process planning at Sikorsky

    Science.gov (United States)

    Waldman, H.

    The software program is called Computer Managed Process Planning, (CMPP). This system employs computer technology to speed and simplify process planning of cylindrical parts. It is aimed at the machining of expensive materials requiring tight tolerances and complex manufacturing processes. Thus far, the program has resulted in a 75 percent reduction in manpower and a 70 percent increase in productivity. The software performs four tasks: (1) it manipulates the manufacturing database, accepting input information from a central CAD system or from an interactive display; (2) it finds the dimensioning reference surfaces, clamping surfaces, and locating surfaces for each machining operation; (3) it analyzes dimensions, tolerances, and stock removals in all cuts for each operation to ensure that bluprint specifications can be achieved; and (4) it prints a summary of operations or a routing sheet.

  10. 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

  11. 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.

  12. A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems

    International Nuclear Information System (INIS)

    Bailey, Daniel W; Kumaraswamy, Lalith; Podgorsak, Matthew B

    2010-01-01

    The purpose of this study is to implement an electronic method to perform and analyze intensity-modulated radiation therapy quality assurance (IMRT QA) using an aSi megavoltage electronic portal imaging device in a network comprised of independent treatment planning, record and verify (R&V), and delivery systems. A verification plan was generated in the treatment planning system using the actual treatment plan of a patient. After exporting the treatment fields to the R&V system, the fields were delivered in QA mode with the aSi imager deployed. The resulting dosimetric images are automatically stored in a DICOM-RT format in the delivery system treatment console computer. The relative dose density images are subsequently pushed to the R&V system. The absolute dose images are then transferred electronically from the treatment console computer to the treatment planning system and imported into the verification plan in the dosimetry work space for further analysis. Screen shots of the gamma evaluation and isodose comparison are imported into the R&V system as an electronic file (e.g. PDF) to be reviewed prior to initiation of patient treatment. A relative dose image predicted by the treatment planning system can also be sent to the R&V system to be compared with the relative dose density image measured with the aSi imager. Our department does not have integrated planning, R&V, and delivery systems. In spite of this, we are able to fully implement a paperless and filmless IMRT QA process, allowing subsequent analysis and approval to be more efficient, while the QA document is directly attached to its specific patient chart in the R&V system in electronic form. The calculated and measured relative dose images can be compared electronically within the R&V system to analyze the density differences and ensure proper dose delivery to patients. In the absence of an integrated planning, verifying, and delivery system, we have shown that it is nevertheless possible to develop a

  13. San Diego's Capital Planning Process

    Science.gov (United States)

    Lytton, Michael

    2009-01-01

    This article describes San Diego's capital planning process. As part of its capital planning process, the San Diego Unified School District has developed a systematic analysis of functional quality at each of its school sites. The advantage of this approach is that it seeks to develop and apply quantifiable metrics and standards for the more…

  14. Information management in process planning

    NARCIS (Netherlands)

    Lutters, Diederick; Wijnker, T.C.; Kals, H.J.J.

    1999-01-01

    A recently proposed reference model indicates the use of structured information as the basis for the control of design and manufacturing processes. The model is used as a basis to describe the integration of design and process planning. A differentiation is made between macro- and micro process

  15. Automation of the Marine Corps Planning Process

    Science.gov (United States)

    2014-06-01

    Continuance Model EOU ease of use EPLRS Enhanced Position Location and Reporting System ESGPP ESG Planning Process FA field artillery FRAGO...planning processes like MCPP, MEU/ARG Planning Process (MEU/ARG PP), Army Planning Process (the MDMP) and the ESG Planning Process (ESGPP) (PAE Manual

  16. 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

  17. The Effect of Therapy Oriented CT in Radiation Therapy Planning

    International Nuclear Information System (INIS)

    Kim, Sung Kyu; Shin, Sei One; Kim, Myung Se

    1987-01-01

    The success of radiation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (planning CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients (28%). Treatment planning was changed in 47% of head and neck tumor, 79% of intrathoracic tumor and 63% of abdominal tumor. In breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was 10% in intrathoracic and intra-abdominal tumors but 20% in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation. Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT planning is very helpful in radiotherapy planning

  18. Control engineering for planning drug therapy.

    Science.gov (United States)

    Deutsch, T; Sali, A

    1993-01-01

    An optimal drug input may be defined as producing an ideal therapeutic effect as closely as possible without exceeding predetermined safety limits on any adverse drug effects. The intensity and time patterns of the drug-elicited response are functions of the pharmacodynamic properties of the drug in the patient. Drug input optimisation can be considered as a control problem and the different control engineering techniques may serve to assist in planning/implementing drug dosage regimens. This paper reviews some problems associated with planning optimal drug therapy in different clinical context and illustrates the solution of such problems by clinical examples.

  19. Retail Tactical Planning: An Aligned Process?

    OpenAIRE

    Dreyer , Heidi; Dukovska-Popovska , Iskra; Kiil , Kasper; Kaipia , Riikka

    2016-01-01

    Part 9: Quality in Production Management; International audience; This paper addresses tactical planning in retailing through a case study approach in one grocery retailing company. The issues are how tactical planning is conducted and how the different plans are connected. The study complements earlier retail planning studies by showing the sequence of planning phases and by studying the fragmented plans as a process. The master category planning is important and sets borders for the other p...

  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. OCRWM's evolving strategic planning process and the 1990 plan

    International Nuclear Information System (INIS)

    Sprecher, W.M.; Munro, J.F.; Champagne, D.L.

    1991-01-01

    In 1990, the Secretary of Energy (Secretary Watkins) ordered that all 23 of the Department's major organizations adopt systems of strategic planning. This paper explains the strategic planning process being adopted by one of those organizations, the Office of Civilian Radioactive Waste Management (OCRWM). Secretary Watkins also ordered a much-abbreviated planning cycle for 1990 to produce the first set of plans in September. That first plan for OCRWM is also discussed here

  3. SU-F-P-37: Implementation of An End-To-End QA Test of the Radiation Therapy Imaging, Planning and Delivery Process to Identify and Correct Possible Sources of Deviation

    International Nuclear Information System (INIS)

    Salinas Aranda, F; Suarez, V; Arbiser, S; Sansogne, R

    2016-01-01

    Purpose: To implement an end-to-end QA test of the radiation therapy imaging, planning and delivery process, aimed to assess the dosimetric agreement accuracy between planned and delivered treatment, in order to identify and correct possible sources of deviation. To establish an internal standard for machine commissioning acceptance. Methods: A test involving all steps of the radiation therapy: imaging, planning and delivery process was designed. The test includes analysis of point dose and planar dose distributions agreement between TPS calculated and measured dose. An ad hoc 16 cm diameter PMMA phantom was constructed with one central and four peripheral bores that can accommodate calibrated electron density inserts. Using Varian Eclipse 10.0 and Elekta XiO 4.50 planning systems, IMRT, RapidArc and 3DCRT with hard and dynamic wedges plans were planned on the phantom and tested. An Exradin A1SL chamber is used with a Keithley 35617EBS electrometer for point dose measurements in the phantom. 2D dose distributions were acquired using MapCheck and Varian aS1000 EPID.Gamma analysis was performed for evaluation of 2D dose distribution agreement using MapCheck software and Varian Portal Dosimetry Application.Varian high energy Clinacs Trilogy, 2100C/CD, 2000CR and low energy 6X/EX where tested.TPS-CT# vs. electron density table were checked for CT-scanners used. Results: Calculated point doses were accurate to 0.127% SD: 0.93%, 0.507% SD: 0.82%, 0.246% SD: 1.39% and 0.012% SD: 0.01% for LoX-3DCRT, HiX-3DCRT, IMRT and RapidArc plans respectively. Planar doses pass gamma 3% 3mm in all cases and 2% 2mm for VMAT plans. Conclusion: Implementation of a simple and reliable quality assurance tool was accomplished. The end-to-end proved efficient, showing excellent agreement between planned and delivered dose evidencing strong consistency of the whole process from imaging through planning to delivery. This test can be used as a first step in beam model acceptance for clinical

  4. CAHECA: computer aided hepatocellular carcinoma therapy planning.

    Science.gov (United States)

    Adeshina, A M; Hashim, R; Khalid, N E A

    2014-09-01

    Hepatocellular Carcinoma is the most common type of liver cancer having a strong relation with cirrhosis. Undoubtedly, cirrhosis may be caused by the virus infection of hepatitis B (HBV) and hepatitis C (HBC) or through alchoholism. However, even when cirrhosis has not been developed, patients with hepatitis viral infections are still at the risk of liver cancer. Apparently, among the numerous medical imaging techniques, Computed Tomography (CT) is the best in defining liver tumor borders. Unfortunately, these imaging techniques, including the CT procedures, usually rely on an appended application to reconstruct the generated 2-D slices to 3-D model. This may involve high performance computation, may be time-consuming or costly. Moreover, even with the outstanding performances of CT in defining the liver tumor boundaries, contrast between tumor tissues and the surrounding liver parenchyma is too low in CT slices. With such a close proxity in the tumor and the surrounding liver tissues, accurate characterization of liver tumor is a challenge. Previously, algorithms were developed to reveal abnormalities in brain's MRI datasets and CT abdominal pelvic, however, introducing a framework that could accurately characterize liver tumor and its surrounding tissues in CT datasets would go a long way in contributing to medical diagnosis and therapy planning of Hepatocellular Carcinoma. This paper proposes an Hepatocellular Carcinoma framework by extending the functionalities of SurLens Visualization System with an automatic liver tumor localization technique using Compute Unified Device Architecture (CUDA). The study was evaluated with liver CT datasets from the Imaging Science and Information Systems (ISIS) Center, the Georgetown University Medical Center. Significantly, visualization of liver CT datasets and the localization of the entangled tumor was achieved without prior datasets segmentation. Interestingly, the framework achieved remarkably good processing speed at a

  5. SNF Project Engineering Process Improvement Plan

    International Nuclear Information System (INIS)

    DESAI, S.P.

    2000-01-01

    This plan documents the SNF Project activities and plans to support its engineering process. It describes five SNF Project Engineering initiatives: new engineering procedures, qualification cards process; configuration management, engineering self assessments, and integrated schedule for engineering activities

  6. 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

  7. Radiation therapy plan checks in a paperless clinic.

    Science.gov (United States)

    Siochi, R Alfredo; Pennington, Edward C; Waldron, Timothy J; Bayouth, John E

    2009-01-27

    Traditional quality assurance checks of a patient's radiation therapy plan involve printing out treatment parameters from the treatment planning system and the "record and verify" (R&V) system and visually checking the information for one-to-one correspondence. In a paperless environment, one can automate this process through independent software that can read the treatment planning data directly and compare it against the parameters in the R&V system's database. In addition to verifying the data integrity, it is necessary to check the logical consistency of the data and the accuracy of various calculations. The results are then imported into the patient's electronic medical record. Appropriate workflows must be developed to ensure that no steps of the QA process are missed. This paper describes our electronic QA system (EQS), consisting of in-house software and workflows. The EQS covers 3D conformal and intensity modulated radiation therapy, electrons, stereotactic radiosurgery, total body irradiation, and clinical set ups with and without virtual simulation. The planning systems handled by our EQS are ADAC Pinnacle and Varian FASTPLAN, while the R&V systems are LANTIS and VARIS. The improvement in our plan check process over the paperless system is described in terms of the types of detected errors. The potential problems with the implementation and use of the EQS, as well as workarounds for data that are not easily accessible through electronic means, are described.

  8. 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

  9. Automatic interactive optimization for volumetric modulated arc therapy planning

    International Nuclear Information System (INIS)

    Tol, Jim P; Dahele, Max; Peltola, Jarkko; Nord, Janne; Slotman, Ben J; Verbakel, Wilko FAR

    2015-01-01

    Intensity modulated radiotherapy treatment planning for sites with many different organs-at-risk (OAR) is complex and labor-intensive, making it hard to obtain consistent plan quality. With the aim of addressing this, we developed a program (automatic interactive optimizer, AIO) designed to automate the manual interactive process for the Eclipse treatment planning system. We describe AIO and present initial evaluation data. Our current institutional volumetric modulated arc therapy (RapidArc) planning approach for head and neck tumors places 3-4 adjustable OAR optimization objectives along the dose-volume histogram (DVH) curve that is displayed in the optimization window. AIO scans this window and uses color-coding to differentiate between the DVH-lines, allowing it to automatically adjust the location of the optimization objectives frequently and in a more consistent fashion. We compared RapidArc AIO plans (using 9 optimization objectives per OAR) with the clinical plans of 10 patients, and evaluated optimal AIO settings. AIO consistency was tested by replanning a single patient 5 times. Average V95&V107 of the boost planning target volume (PTV) and V95 of the elective PTV differed by ≤0.5%, while average elective PTV V107 improved by 1.5%. Averaged over all patients, AIO reduced mean doses to individual salivary structures by 0.9-1.6Gy and provided mean dose reductions of 5.6Gy and 3.9Gy to the composite swallowing structures and oral cavity, respectively. Re-running AIO five times, resulted in the aforementioned parameters differing by less than 3%. Using the same planning strategy as manually optimized head and neck plans, AIO can automate the interactive Eclipse treatment planning process and deliver dosimetric improvements over existing clinical plans

  10. 45 CFR 98.14 - Plan process.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Plan process. 98.14 Section 98.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND General Application Procedures § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17...

  11. Prototype demonstration of radiation therapy planning code system

    International Nuclear Information System (INIS)

    Little, R.C.; Adams, K.J.; Estes, G.P.; Hughes, L.S. III; Waters, L.S.

    1996-01-01

    This is the final report of a one-year, Laboratory-Directed Research and Development project at the Los Alamos National Laboratory (LANL). Radiation therapy planning is the process by which a radiation oncologist plans a treatment protocol for a patient preparing to undergo radiation therapy. The objective is to develop a protocol that delivers sufficient radiation dose to the entire tumor volume, while minimizing dose to healthy tissue. Radiation therapy planning, as currently practiced in the field, suffers from inaccuracies made in modeling patient anatomy and radiation transport. This project investigated the ability to automatically model patient-specific, three-dimensional (3-D) geometries in advanced Los Alamos radiation transport codes (such as MCNP), and to efficiently generate accurate radiation dose profiles in these geometries via sophisticated physics modeling. Modem scientific visualization techniques were utilized. The long-term goal is that such a system could be used by a non-expert in a distributed computing environment to help plan the treatment protocol for any candidate radiation source. The improved accuracy offered by such a system promises increased efficacy and reduced costs for this important aspect of health care

  12. Prototype demonstration of radiation therapy planning code system

    Energy Technology Data Exchange (ETDEWEB)

    Little, R.C.; Adams, K.J.; Estes, G.P.; Hughes, L.S. III; Waters, L.S. [and others

    1996-09-01

    This is the final report of a one-year, Laboratory-Directed Research and Development project at the Los Alamos National Laboratory (LANL). Radiation therapy planning is the process by which a radiation oncologist plans a treatment protocol for a patient preparing to undergo radiation therapy. The objective is to develop a protocol that delivers sufficient radiation dose to the entire tumor volume, while minimizing dose to healthy tissue. Radiation therapy planning, as currently practiced in the field, suffers from inaccuracies made in modeling patient anatomy and radiation transport. This project investigated the ability to automatically model patient-specific, three-dimensional (3-D) geometries in advanced Los Alamos radiation transport codes (such as MCNP), and to efficiently generate accurate radiation dose profiles in these geometries via sophisticated physics modeling. Modem scientific visualization techniques were utilized. The long-term goal is that such a system could be used by a non-expert in a distributed computing environment to help plan the treatment protocol for any candidate radiation source. The improved accuracy offered by such a system promises increased efficacy and reduced costs for this important aspect of health care.

  13. The text plan concept: contributions to the writing planning process

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Tinoco Cabral

    2013-12-01

    Full Text Available Students - at different levels, ranging from early grades up to PhD - face problems both on comprehension and text production. This paper focuses on the text plan concept according to the DTA (Discourse Text Analysis approach, i.e., a principle of organization that allows students to put into practice the production intention as well as to arrange text information while producing; being responsible for the text compositional structure (Adam, 2008. The study analyzes the relation between text plan and the writing planning process, in which the first one provides the second with theoretical support. In order to develop such research, the study covers some issues related to the reading skill, analyzes an argumentative text as per its textual plan, and presents some reflections on the writing process, focusing on the relation between textual plan and the writing planning process.

  14. Integration of Climate Data to Planning Process

    OpenAIRE

    BALIK, Hayriye; DUMAN YÜKSEL, Ülkü

    2014-01-01

    Structure and specifications of urban climate is important subjects to consult in the planning and designing process. However, it cannot be involved in the planning process effectively due to lack of knowledge and conscious, lack of communication among planners and climatologists, and lack of proper tools of integration. The purpose of this study was to describe the tools and their utilization that can be used in the process of planning. These tools are determined to be urban climate maps tha...

  15. Technical Project Planning (TPP) Process. Engineer Manual

    National Research Council Canada - National Science Library

    1998-01-01

    This Engineer Manual (EM) describes the Technical Project Planning (TPP) process for identifying project objectives and designing data collection programs at hazardous, toxic, and radioactive waste sites...

  16. Metals and Alloys Material Stabilization Process Plan

    Energy Technology Data Exchange (ETDEWEB)

    RISENMAY, H.R.; BURK, R.A.

    2000-05-18

    This Plan outlines the process for brushing metal and alloys in accordance with the path forward discussed in the Integrated Project Management Plan for the Plutonium Finishing Plant Stabilization and Deactivation Project, HNF-3617, and requirements set forth in the Project Management Plan for Materials Stabilization, HNF-3605. This plan provides the basis for selection of the location to process, the processes involved, equipment to be used, and the characterization of the contents of the can. The scope of the process is from retrieval of metals and alloys from storage to transfer back to storage in a repackaged configuration.

  17. Metals and Alloys Material Stabilization Process Plan

    International Nuclear Information System (INIS)

    RISENMAY, H.R.; BURK, R.A.

    2000-01-01

    This Plan outlines the process for brushing metal and alloys in accordance with the path forward discussed in the Integrated Project Management Plan for the Plutonium Finishing Plant Stabilization and Deactivation Project, HNF-3617, and requirements set forth in the Project Management Plan for Materials Stabilization, HNF-3605. This plan provides the basis for selection of the location to process, the processes involved, equipment to be used, and the characterization of the contents of the can. The scope of the process is from retrieval of metals and alloys from storage to transfer back to storage in a repackaged configuration

  18. Strategic planning processes and hospital financial performance.

    Science.gov (United States)

    Kaissi, Amer A; Begun, James W

    2008-01-01

    Many common management practices in healthcare organizations, including the practice of strategic planning, have not been subject to widespread assessment through empirical research. If management practice is to be evidence-based, evaluations of such common practices need to be undertaken. The purpose of this research is to provide evidence on the extent of strategic planning practices and the association between hospital strategic planning processes and financial performance. In 2006, we surveyed a sample of 138 chief executive officers (CEOs) of hospitals in the state of Texas about strategic planning in their organizations and collected financial information on the hospitals for 2003. Among the sample hospitals, 87 percent reported having a strategic plan, and most reported that they followed a variety of common practices recommended for strategic planning-having a comprehensive plan, involving physicians, involving the board, and implementing the plan. About one-half of the hospitals assigned responsibility for the plan to the CEO. We tested the association between these planning characteristics in 2006 and two measures of financial performance for 2003. Three dimensions of the strategic planning process--having a strategic plan, assigning the CEO responsibility for the plan, and involving the board--are positively associated with earlier financial performance. Further longitudinal studies are needed to evaluate the cause-and-effect relationship between planning and performance.

  19. Hoshin Planning Applies Total Quality Management to the Planning Process.

    Science.gov (United States)

    Heverly, Mary Ann; Parker, Jerome S.

    1993-01-01

    Hoshin, or breakthrough, planning is the Total Quality Management method of integrating strategic planning into the daily work of organizational units. Delaware County (Pennsylvania) Community College's adaptation of the process and its use in daily management are described and presented in the form of a flow chart. (MSE)

  20. Strategy in Generative Planning of Turning Processes

    NARCIS (Netherlands)

    van Houten, Frederikus J.A.M.; Kals, H.J.J.

    1986-01-01

    This paper reports on the process and operations planning system ROUND and the strategies which underlie the decision making processes in the planning of turning operations. At first, an outline is given about the environment for which generative systems like ROUND are being developed. The

  1. Advanced planning for ISS payload ground processing

    Science.gov (United States)

    Page, Kimberly A.

    2000-01-01

    Ground processing at John F. Kennedy Space Center (KSC) is the concluding phase of the payload/flight hardware development process and is the final opportunity to ensure safe and successful recognition of mission objectives. Planning for the ground processing of on-orbit flight hardware elements and payloads for the International Space Station is a responsibility taken seriously at KSC. Realizing that entering into this operational environment can be an enormous undertaking for a payload customer, KSC continually works to improve this process by instituting new/improved services for payload developer/owner, applying state-of-the-art technologies to the advanced planning process, and incorporating lessons learned for payload ground processing planning to ensure complete customer satisfaction. This paper will present an overview of the KSC advanced planning activities for ISS hardware/payload ground processing. It will focus on when and how KSC begins to interact with the payload developer/owner, how that interaction changes (and grows) throughout the planning process, and how KSC ensures that advanced planning is successfully implemented at the launch site. It will also briefly consider the type of advance planning conducted by the launch site that is transparent to the payload user but essential to the successful processing of the payload (i.e. resource allocation, executing documentation, etc.) .

  2. System engineering approach to planning anticancer therapies

    CERN Document Server

    Świerniak, Andrzej; Smieja, Jaroslaw; Puszynski, Krzysztof; Psiuk-Maksymowicz, Krzysztof

    2016-01-01

    This book focuses on the analysis of cancer dynamics and the mathematically based synthesis of anticancer therapy. It summarizes the current state-of-the-art in this field and clarifies common misconceptions about mathematical modeling in cancer. Additionally, it encourages closer cooperation between engineers, physicians and mathematicians by showing the clear benefits of this without stating unrealistic goals. Development of therapy protocols is realized from an engineering point of view, such as the search for a solution to a specific control-optimization problem. Since in the case of cancer patients, consecutive measurements providing information about the current state of the disease are not available, the control laws are derived for an open loop structure. Different forms of therapy are incorporated into the models, from chemotherapy and antiangiogenic therapy to immunotherapy and gene therapy, but the class of models introduced is broad enough to incorporate other forms of therapy as well. The book be...

  3. Malignant pleural mesothelioma segmentation for photodynamic therapy planning.

    Science.gov (United States)

    Brahim, Wael; Mestiri, Makram; Betrouni, Nacim; Hamrouni, Kamel

    2018-04-01

    Medical imaging modalities such as computed tomography (CT) combined with computer-aided diagnostic processing have already become important part of clinical routine specially for pleural diseases. The segmentation of the thoracic cavity represents an extremely important task in medical imaging for different reasons. Multiple features can be extracted by analyzing the thoracic cavity space and these features are signs of pleural diseases including the malignant pleural mesothelioma (MPM) which is the main focus of our research. This paper presents a method that detects the MPM in the thoracic cavity and plans the photodynamic therapy in the preoperative phase. This is achieved by using a texture analysis of the MPM region combined with a thoracic cavity segmentation method. The algorithm to segment the thoracic cavity consists of multiple stages. First, the rib cage structure is segmented using various image processing techniques. We used the segmented rib cage to detect feature points which represent the thoracic cavity boundaries. Next, the proposed method segments the structures of the inner thoracic cage and fits 2D closed curves to the detected pleural cavity features in each slice. The missing bone structures are interpolated using a prior knowledge from manual segmentation performed by an expert. Next, the tumor region is segmented inside the thoracic cavity using a texture analysis approach. Finally, the contact surface between the tumor region and the thoracic cavity curves is reconstructed in order to plan the photodynamic therapy. Using the adjusted output of the thoracic cavity segmentation method and the MPM segmentation method, we evaluated the contact surface generated from these two steps by comparing it to the ground truth. For this evaluation, we used 10 CT scans with pathologically confirmed MPM at stages 1 and 2. We obtained a high similarity rate between the manually planned surface and our proposed method. The average value of Jaccard index

  4. Strategic planning and the budgeting process

    International Nuclear Information System (INIS)

    Craig, J.F.; Probasco, D.R.

    1993-01-01

    As the utility industry continues its transformation to a more competitive environment, companies are coming under ever-increasing pressure to avoid or minimize rate increases, implement new customer and environmental programs, and maintain profitability for shareholders. Two keys to having an effective organization in such an environment are the use of strategic planning and budgetary controls. The authors recently developed and implemented a strategic planning and budgeting process for a client in the Southwest. This paper reviews the highlights of that effort

  5. 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.

  6. SNF project engineering process improvement plan

    International Nuclear Information System (INIS)

    KELMENSON, R.L.

    1999-01-01

    This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project (the Project) to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819 (1819). These requirements are imposed on all engineering activities performed for the Project and apply to all life-cycle stages of the Project's systems, structures and components (SSCs). This Plan describes the steps that will be taken by the Project during the transition period to ensure that new procedures are effectively integrated into the Project's work process as these procedures are issued. The consolidated procedures will be issued and implemented by September 30, 1999

  7. 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

  8. Pancreatic cancer planning: Complex conformal vs modulated therapies

    International Nuclear Information System (INIS)

    Chapman, Katherine L.; Witek, Matthew E.; Chen, Hongyu; Showalter, Timothy N.; Bar-Ad, Voichita; Harrison, Amy S.

    2016-01-01

    To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45 Gy; with tumor/tumor bed boosted to 50.4 Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V 30 , V 35 ), stomach (D 10 %), stomach (V 45 ), mean right kidney dose, and right kidney (V 15 ) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V 35 ), and left kidney (V 15 , V 18 , V 20 ). VMAT plans decreased small bowel (D 10 %, D 15 %), small bowel (V 35 , V 45 ), stomach (D 10 %, D 15 %), stomach (V 35 , V 45 ), mean liver dose, liver (V 35 ), left kidney (V 15 , V 18 , V 20 ), and right kidney (V 18 , V 20 ). VMAT plans significantly decreased small bowel (D 10 %, D 15 %), left kidney (V 20 ), and stomach (V 45 ) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average treatment delivery was within 10 minutes for simple and complex 3DCRT, IMRT, and VMAT treatments. This article

  9. The Strategic Sport Marketing Planning Process

    Directory of Open Access Journals (Sweden)

    Alexandru Lucian Mihai

    2013-05-01

    Full Text Available In many segments of the sport industry, sport marketers are pressured to increase their product sales to generate increased revenues for their organizations. This pressure poses a challenge. Because sport marketers are involved in persuading consumers to buy, they run the risk of exaggerating or misrepresenting their products in an effort to sell them. Today, and in the future, sport marketers should recognize this risk and monitor their marketing strategies to ensure that they communicate honest images and messages about their products that are consistent with the core values of their organizations. A marketing program is not delivered in isolation of the organization-wide planning process. In normal circumstances, the marketing planning process must reflect the overall plans for the organization.

  10. Computed tomography in therapy planning: Abdominal region

    International Nuclear Information System (INIS)

    Munzenrider, J.E.

    1983-01-01

    The radiotherapy community is continuing to appreciate the significant contribution CBT can make to planning abdominal radiotherapy and is also beginning to appreciate the pitfalls and limitations of the technique. Specific attention should continue to focus on patient registration with the scanner and simulator radiographs, patient position during scanning and treatment, and effects of involuntary patient motion, especially breathing, on organ and tumor localization. Effects of patient positional changes and of involuntary motion during treatment on treatment planning and execution should be quantitated, as should effects of inhomogeneities, especially gut air, on abdominal dose distribution. Radiotherapy planned with CBT data can impact significantly on morbidity and mortality associated with abdominal malignancies. Faster scanners (with a scanning time of 9 sec or less) should be employed where possible to obtain maximum diagnostic information. Multiplanar reconstruction and true three-dimensional treatment planning can enhance significantly the value of CBT in treatment planning. Radiotherapists, radiodiagnosticians, radiation physicists, and oncologists must be continue to meet the challenge of realizing the true potential of CBT for the benefit of the cancer patients entrusted to their care

  11. PET/CT in Radiation Therapy Planning

    DEFF Research Database (Denmark)

    Specht, Lena; Berthelsen, Anne Kiil

    2018-01-01

    Radiation therapy (RT) is an important component of the management of lymphoma patients. Most lymphomas are metabolically active and accumulate 18F-fluorodeoxyglucose (FDG). Positron emission tomography with computer tomography (PET/CT) imaging using FDG is used routinely in staging and treatment...

  12. Radiation therapy planning for early-stage Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Maraldo, Maja V; Dabaja, Bouthaina S; Filippi, Andrea R

    2015-01-01

    PURPOSE: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements......, planning parameters, and estimated doses to the critical organs at risk (OARs). METHODS: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30...... axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3...

  13. 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.

  14. SU-E-J-78: Adaptive Planning Workflow in a Pencil Beam Scanning Proton Therapy Center

    International Nuclear Information System (INIS)

    Blakey, M; Price, S; Robison, B; Niek, S; Moe, S; Renegar, J; Mark, A; Spenser, W

    2015-01-01

    Purpose: The susceptibility of proton therapy to changes in patient setup and anatomy necessitates an adaptive planning process. With the right planning tools and clinical workflow, an adaptive plan can be created in a timely manner without adding significant workload to the treatment planning staff. Methods: In our center, a weekly QA CT is performed on most patients to assess setup, anatomy change, and tumor response. The QA CT is fused to the treatment planning CT, the contours are transferred via deformable registration, and the plan dose is recalculated on the QA CT. A physicist assesses the dose distribution, and an adaptive plan is requested based on tumor coverage or OAR dose changes. After the physician confirms or alters the deformed contours, a dosimetrist develops an adaptive plan using our TPS adaptation module. The plan is assessed for robustness and is then reviewed by the physician. Patient QA is performed within three days following the first adapted treatment. Results: Of the patients who received QA CTs, 19% required at least one adaptive plan (18.5% H&N, 18.5% brain, 11.1% breast, 14.8% chestwall, 14.8% lung, 18.5% pelvis and 3.8% abdomen). Of these patients, 14% went on a break, while the remainder was treated with the previous plan during the re-planning process. Adaptive plans were performed based on tumor shrinkage, anatomy change or positioning uncertainties for 37.9%, 44.8%, and 17.3% of the patients, respectively. On average, 3 full days are required between the QA CT and the first adapted plan treatment. Conclusion: Adaptive planning is a crucial component of proton therapy and should be applied to any site when the QA CT shows significant deviation from the plan. With an efficient workflow, an adaptive plan can be applied without delaying patient treatment or burdening the dosimetry and medical physics team

  15. Clinical processes in behavioral couples therapy.

    Science.gov (United States)

    Fischer, Daniel J; Fink, Brandi C

    2014-03-01

    Behavioral couples therapy is a broad term for couples therapies that use behavioral techniques based on principles of operant conditioning, such as reinforcement. Behavioral shaping and rehearsal and acceptance are clinical processes found across contemporary behavioral couples therapies. These clinical processes are useful for assessment and case formulation, as well as teaching couples new methods of conflict resolution. Although these clinical processes assist therapists in achieving efficient and effective therapeutic change with distressed couples by rapidly stemming couples' corrosive affective exchanges, they also address the thoughts, emotions, and issues of trust and intimacy that are important aspects of the human experience in the context of a couple. Vignettes are provided to illustrate the clinical processes described. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  16. Planning guide for radiologic installations. fascicle 1 -- radiation therapy installations

    International Nuclear Information System (INIS)

    Tuddenham, W.J.

    1976-01-01

    Five articles dealing with the development and operation of radiation therapy facilities present recommendations for the design of various types of radiation therapy facilities, including the university center, the free-standing private oncology center, and the community hospital radiation therapy department. Different concepts of department design are represented. In one article, the planning room is conceived to be the central feature of a facility; in another article, radiation therapy is designed around examination rooms. Shielding requirements are also discussed, as are the advantages and space and licensing requirements of various types of equipment. There is a need for planning appropriate computer facilities in conjunction with other equipment plans, and a critique of one radiation therapy unit is provided. The concept of a regional network for the delivery of radiation therapy services is then explored. The volume contains extensive illustrations in the form of floor plans, drawings, figures, and tables. Many of the articles include a bibliography. This is the first in a series of publications on radiation department design which will be useful to architects, engineers, and hospital planners

  17. Renewable Energy Zone (REZ) Transmission Planning Process

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nathan [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-03-08

    A REZ is a geographical area that enables the development of profitable, cost-effective, grid-connected renewable energy (RE). The REZ Transmission Planning Process is a proactive approach to plan, approve, and build transmission infrastructure connecting REZs to the power system which helps to increase the share of solar, wind and other RE resources in the power system while maintaining reliability and economics, and focuses on large-scale wind and solar resources that can be developed in sufficient quantities to warrant transmission system expansion and upgrades.

  18. 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

  19. Treating Social Anxiety in Adolescents: Ten Group Therapy Lesson Plans

    Science.gov (United States)

    Mazur-Elmer, Alison; McBride, Dawn

    2009-01-01

    This project provides a comprehensive overview of the research literature on social anxiety disorder (SAD) in adolescents and concludes by offering a set of 10 group therapy lesson plans for SAD that therapists can use in their practice. The overview includes a description of social anxiety disorder and highlights various theories of anxiety. The…

  20. 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)

  1. Pancreatic cancer planning: Complex conformal vs modulated therapies

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Katherine L. [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Witek, Matthew E. [Department of Radiation Oncology, University of Wisconsin School of Medicine School of Medicine and Public Health, Madison, WI (United States); Chen, Hongyu [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Showalter, Timothy N. [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Bar-Ad, Voichita [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Harrison, Amy S., E-mail: amy.harrison@jefferson.edu [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2016-07-01

    To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45 Gy; with tumor/tumor bed boosted to 50.4 Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V{sub 30}, V{sub 35}), stomach (D{sub 10}%), stomach (V{sub 45}), mean right kidney dose, and right kidney (V{sub 15}) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V{sub 35}), and left kidney (V{sub 15}, V{sub 18}, V{sub 20}). VMAT plans decreased small bowel (D{sub 10}%, D{sub 15}%), small bowel (V{sub 35}, V{sub 45}), stomach (D{sub 10}%, D{sub 15}%), stomach (V{sub 35}, V{sub 45}), mean liver dose, liver (V{sub 35}), left kidney (V{sub 15}, V{sub 18}, V{sub 20}), and right kidney (V{sub 18}, V{sub 20}). VMAT plans significantly decreased small bowel (D{sub 10}%, D{sub 15}%), left kidney (V{sub 20}), and stomach (V{sub 45}) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average

  2. [Mechanized system for planning technological processes].

    Science.gov (United States)

    Pashchenko, V S; Shapiro, A M

    1977-01-01

    A mechanized system for the production processes planning involving the use of an electronic code device for data preparation on a punched tape of the "EPECT-IT" type, at the base of which there are classifiers of standard operations and transitions to individual design members, is considered. A fragment of the classifier and a skeleton diagram of the system are presented. It is pointed out that the use of the system helps improve the quality of the design work, as well as to yield considerable economic advantages. The system is in operation at some enterprises of the medical engineering industry.

  3. Chemical processes in neutron capture therapy

    International Nuclear Information System (INIS)

    Brown, B.J.

    1975-01-01

    Research into the radiation chemical effects of neutron capture therapy are described. In the use of neutron capture therapy for the treatment of brain tumours, compounds containing an activatable nuclide are selectively concentrated within tumour tissue and irradiated with neutrons. Target compounds for use in therapy must accumulate selectively in high concentrations in the tumour and must be non toxic to the patient. The most suitable of these are the boron hydrides. Radiation dosages, resulting from neutron capture in normal tissue constituents are tabulated. As part of the program to study the radiation-induced chemical processes undergone by boron target compounds, the radiolytic degredation of boron hydride and phenyl boric acid system was investigated. No direct dependence between the yield of the transient radiolytic species and the concentration of the B-compound was observed. (author)

  4. Integrative problem-centered metaframeworks therapy II: planning, conversing, and reading feedback.

    Science.gov (United States)

    Pinsof, William; Breunlin, Douglas C; Russell, William P; Lebow, Jay

    2011-09-01

    This is the second of 2 articles presenting Integrative Problem Centered Metaframeworks (IPCM) Therapy, a multisystemic, integrative, empirically informed, and common factor perspective for family, couple, and individual psychotherapy. The first article presented IPCM's foundation concepts and Blueprint for therapy, focusing on the first Blueprint component-Hypothesizing or assessment. This article, focusing on intervention, presents the other 3 Blueprint components-Planning, Conversing, and Feedback. Articulated through the Blueprint, intervention is a clinical experimental process in which therapists formulate hypotheses about the set of constraints (the Web) within a client system that prevents problem resolution, develop a therapeutic Plan based on those hypotheses, implement the Plan through a coconstructed dialogue with the clients, and then evaluate the results. If the intervention is not successful, the results become feedback to modify the Web, revise the Plan, and intervene again. Guided by the therapeutic alliance, this process repeats until the presenting problems resolve. IPCM Planning sequentially integrates the major empirically and yet-to-be empirically validated therapies and organizes their key strategies and techniques as common factors. Conversing and Feedback employ empirical STIC(®) (Systemic Therapy Inventory of Change) data collaboratively with clients to formulate hypotheses and evaluate interventions. This article emphasizes the art and science of IPCM practice. 2011 © FPI, Inc.

  5. LERF Basin 44 Process Test Plan

    International Nuclear Information System (INIS)

    LUECK, K.J.

    1999-01-01

    This document presents a plan to process a portion of the Liquid Effluent Retention Facility (LERF) Basin 44 wastewater through the 200 Area Effluent Treatment Facility (ETF). The objective of this process test is to determine the most effective/efficient method to treat the wastewater currently stored in LERF Basin 44. The process test will determine the operational parameters necessary to comply with facility effluent discharge permit limits (Ecology 1995) and the Environmental Restoration Disposal Facility (ERDF) acceptance criteria (BHI-00139), while achieving ALARA goals and maintaining the integrity of facility equipment. A major focus of the test plan centers on control of contamination due to leaks and/or facility maintenance. As a pre-startup item, all known leaks will be fixed before the start of the test. During the course of the test, a variety of contamination control measures will be evaluated for implementation during the treatment of the remaining Basin 44 inventory. Of special interest will be techniques and tools used to prevent contamination spread during sampling and when opening contaminated facility equipment/piping. At the conclusion of the test, a post ALARA review will be performed to identify lessons learned from the test run which can be applied to the treatment of the remaining Basin 44 inventory. The volume of wastewater to be treated during this test run is 500,000 gallons. This volume limit is necessary to maintain the ETF radiological inventory limits per the approved authorization basis. The duration of the process test is approximately 30 days

  6. Neutron therapy planning: Principles and practice in Edinburgh

    International Nuclear Information System (INIS)

    Duncan, W.; Williams, J.R.; Redpath, A.T.; Arnott, S.J.

    1981-01-01

    The principles of treatment planning using beams of fast neutron irradiation are the same as that involved in X-ray therapy. The optimum treatment technique to be employed and the standard of dose distribution depend on the penetration of the beam, the sophistication of the treatment head and certain clinical constraints. These inter-related factors are briefly discussed. The Edinburgh Cyclotron produces d(15)+Be neutrons and compared to megavoltage X-rays it is necessary to use a greater number of fields, respect greater restraints on planning and, when wedge filters are used, accept relatively higher doses in 'hot spots'. With careful and detailed planning satisfactory dose distributions can be achieved. The procedures followed in clinical planning, field selection and dose computation are described. (orig.)

  7. 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

  8. 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

  9. 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

  10. Essential processes in emotion-focused therapy.

    Science.gov (United States)

    Paivio, Sandra C

    2013-09-01

    Emotion-focused therapy is an evidence-based approach grounded in current experiential therapy theory and research which, in turn, draws on emotion theory and research. Fundamental assumptions are that (1) emotions are associated with a multimodal network of information, (2) accessing emotion in therapy accesses this information, and (3) attention to, and exploration of, subjective internal experience (feelings and meanings) is the primary source of new information used in construction of new meaning. The two primary mechanisms of change are thought to be the therapeutic relationship and emotional processing of problematic material. Emotional change processes include awareness, regulation, reflection, and transformation of emotion. Four intervention principles that are essential to every session are as follows: (1) collaborating on a focus for the session, (2) empathically responding to client struggles and pain, (3) responding to the emergence of adaptive emotion and associated healthy resources, and (4) promoting client experiencing (i.e., attention to, and exploration of, feelings and meanings). These in-session intervention principles are consistent with posited change process. 2013 APA, all rights reserved

  11. 300 Area Process Trenches Postclosure Plan

    International Nuclear Information System (INIS)

    Badden, J.W.

    1998-05-01

    The 300 Area Process Trenches (300 APT) certified closure under a modified closure option and in compliance with Condition II.K.3 oft he Hartford Facility Dangerous Waste Permit (Penit) (Ecology 1994). Modified closure has been determined to be the appropriate closure option for this unit due to groundwater that remains contaminated from past operations at the 300 APT. Corrective actions required for dangerous waste constituents remaining in groundwater will occur pursuant to the 300 APT Resource Conservation and Recovery Act (RCRA) Final Status Facility Ground Water Monitoring Plan, the Hanford Site Wide Dangerous Waste Permit, and in conjunction with the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) remedial actions at the 300-FF-5 Groundwater Operable Unit (OU) pursuant to the Record of Decision (ROD) (EPA 1996). This postclosure plan identifies the modified closure actions required at the unit under postclosure care. It contains a description of the unit, past closure actions, and postclosure care requirements subject to compliance under the Permit (condition II.K.3)

  12. ANALYSIS OF COMPUTER AIDED PROCESS PLANNING TECHNIQUES

    Directory of Open Access Journals (Sweden)

    Salim A. Saleh

    2013-05-01

    Full Text Available Computer Aided Process Planning ( CAPP has been recognized as playing a key role in Computer Integrated Manufacturing ( CIM . It was used as a bridge to link CAD with CAM systems, in order to give the possibility of full integration in agreement with computer engineering to introduce CIM. The benefits of CAPP in the real industrial environment are still to be achieved. Due to different manufacturing applications, many different CAPP systems have been developed. The development of CAPP techniques needs to a summarized classification and a descriptive analysis. This paper presents the most important and famous techniques for the available CAPP systems, which are based on the variant, generative or semi-generative methods, and a descriptive analysis of their application possibilities.

  13. Improving proton therapy accessibility through seamless electronic integration of remote treatment planning sites.

    Science.gov (United States)

    Belard, Arnaud; Dolney, Derek; Zelig, Tochner; McDonough, James; O'Connell, John

    2011-06-01

    Proton radiotherapy is a relatively scarce treatment modality in radiation oncology, with only nine centers currently operating in the United States. Funded by Public Law 107-248, the University of Pennsylvania and the Walter Reed Army Medical Center have developed a remote proton radiation therapy solution with the goals of improving access to proton radiation therapy for Department of Defense (DoD) beneficiaries while minimizing treatment delays and time spent away from home/work (time savings of up to 3 weeks per patient). To meet both Health Insurance Portability and Accountability Act guidelines and the more stringent security restrictions imposed by the DoD, our program developed a hybrid remote proton radiation therapy solution merging a CITRIX server with a JITIC-certified (Joint Interoperability Test Command) desktop videoconferencing unit. This conduit, thoroughly tested over a period of 6 months, integrates both institutions' radiation oncology treatment planning infrastructures into a single entity for DoD patients' treatment planning and delivery. This telemedicine solution enables DoD radiation oncologists and medical physicists the ability to (1) remotely access a proton therapy treatment planning platform, (2) transfer patient plans securely to the University of Pennsylvania patient database, and (3) initiate ad-hoc point-to-point and multipoint videoconferences to dynamically optimize and validate treatment plans. Our robust and secure remote treatment planning solution grants DoD patients not only access to a state-of-the-art treatment modality, but also participation in the treatment planning process by Walter Reed Army Medical Center radiation oncologists and medical physicists. This telemedicine system has the potential to lead to a greater integration of military treatment facilities and/or satellite clinics into regional proton therapy centers.

  14. River Basin Management Plans - Institutional framework and planning process

    DEFF Research Database (Denmark)

    Frederiksen, Pia; Nielsen, Helle Ørsted; Pedersen, Anders Branth

    2011-01-01

    The report it a deliverable to the Waterpraxis project, based on research carried out in WP3. It is based on country reports from analyses of water planning in one river basin district in each of the countries Sweden, Finland, Latvia, Lithuania, Poland, Germany and Denmark, and it compares...... the institutional set-up, the public participation and the potentials and barriers for implementing the water plans....

  15. Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

    International Nuclear Information System (INIS)

    Zheng, Yuanshui; Johnson, Randall; Larson, Gary

    2016-01-01

    Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their

  16. Financially Constrained Transportation Planning and Programming Process

    Science.gov (United States)

    1997-03-01

    This case study report is intended to provide metropolitan planning organizations (MPOs), state departments of transportation and transit agencies with a greater understanding of the important role that financial information plays in the planning and...

  17. 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)

  18. 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

  19. 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.

  20. Computerized System for Safety Verification of External Beam Radiation Therapy Planning.

    Science.gov (United States)

    Holdsworth, Clay; Kukluk, Jacek; Molodowitch, Christina; Czerminska, Maria; Hancox, Cindy; Cormack, Robert A; Beaudette, Kevin; Killoran, Joseph H

    2017-07-01

    To report an assessment of in-house software, Verifier, developed to improve efficacy and efficiency of the radiation therapy (RT) treatment planning process and quality control review (QCR). Radiation therapy plan parameters retrieved from our treatment planning database are used by automated tests to give 75 types of warnings, such as prescription and plan discrepancies. The software is continuously updated on the basis of new issues, ideas, and planning policies. Verifier was retrospectively assessed (2007-2015) by examining impact on treatment plan revisions, frequency of quality improvement incident reports of avoidable RT plan-related safety events, unaddressed issues, and staff efficiency. Plan revisions for specific issues declined dramatically in response to implementation of corresponding Verifier tests. Between 2012 and 2015 our institution's total rate of plan revisions dropped from 18.0% to 11.2%. Between 2008 and 2015 specific tests were added to Verifier while the rate of corresponding avoidable safety events was reduced from 0.34% to 0.00% over the same period. Simulations suggest Verifier saves approximately 2 to 5 minutes per QCR. The decrease in quantifiable metrics of plan revisions and incident reports suggests automatic RT plan-checking software enhances patient safety and clinical efficiency. Although only modest time savings may be gained using Verifier for the QCR itself, the greater impact on efficiency is through avoiding late-stage plan modifications and improving documentation via automation. We encourage other institutions to consider working toward adding similar technologies to enhance their RT quality assurance programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. 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

  2. Plan for advanced microelectronics processing technology application

    Energy Technology Data Exchange (ETDEWEB)

    Goland, A.N.

    1990-10-01

    The ultimate objective of the tasks described in the research agreement was to identify resources primarily, but not exclusively, within New York State that are available for the development of a Center for Advanced Microelectronics Processing (CAMP). Identification of those resources would enable Brookhaven National Laboratory to prepare a program plan for the CAMP. In order to achieve the stated goal, the principal investigators undertook to meet the key personnel in relevant NYS industrial and academic organizations to discuss the potential for economic development that could accompany such a Center and to gauge the extent of participation that could be expected from each interested party. Integrated of these discussions was to be achieved through a workshop convened in the summer of 1990. The culmination of this workshop was to be a report (the final report) outlining a plan for implementing a Center in the state. As events unfolded, it became possible to identify the elements of a major center for x-ray lithography on Lone Island at Brookhaven National Laboratory. The principal investigators were than advised to substitute a working document based upon that concept in place of a report based upon the more general CAMP workshop originally envisioned. Following that suggestion from the New York State Science and Technology Foundation, the principals established a working group consisting of representatives of the Grumman Corporation, Columbia University, the State University of New York at Stony Brook, and Brookhaven National Laboratory. Regular meetings and additional communications between these collaborators have produced a preproposal that constitutes the main body of the final report required by the contract. Other components of this final report include the interim report and a brief description of the activities which followed the establishment of the X-ray Lithography Center working group.

  3. 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.

  4. Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Yujiao [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Zhang, Fan [Occupational and Environmental Safety Office, Duke University Medical Center, Durham, North Carolina (United States); Yoo, David S.; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing, E-mail: jing.cai@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2013-09-01

    Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P{sub NON}) and adaptive plan (P{sub ADP}), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P{sub NON} and P{sub ADP} for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d{sub T-OAR}), initial internal target volume (ITV{sub 1}), ITV change (ΔITV), and effective ITV diameter change (Δd{sub ITV}). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from −59.6% to 13.0%, with a mean (±SD) of −21.0% (±21.4%). On average of all patients, P{sub ADP} resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. Δd{sub ITV}/d{sub T-OAR} was found to correlate with changes in dose to 5 cc (ΔD5cc) of esophagus (r=0.61) and dose to 30 cc (ΔD30cc) of chest wall (r=0.81). Stronger correlations between Δd{sub ITV}/d{sub T-OAR} and ΔD30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment.

  5. [Multicenter trial for sudden hearing loss therapy - planning and concept].

    Science.gov (United States)

    Plontke, S K; Girndt, M; Meisner, C; Probst, R; Oerlecke, I; Richter, M; Steighardt, J; Dreier, G; Weber, A; Baumann, I; Plößl, S; Löhler, J; Laszig, R; Werner, J A; Rahne, T

    2016-04-01

    Systemic steroids are widely used worldwide as a standard of care for primary therapy of idiopathic sudden sensorineural hearing loss (ISSHL). The German ISSHL guideline recommends high-dose steroids for primary therapy of ISSHL, without evidence from randomized controlled trials (RCTs). The rationale for the treatment of ISSHL using high dose steroids is only based on retrospective cohort studies.This article describes the planning and initiation of a multicenter, national, randomized, controlled clinical trial entitled Efficacy and safety of high dose glucocorticosteroid treatment for idiopathic sudden sensorineural hearing loss - a three-armed, randomized, triple-blind, multicenter trial (HODOKORT). This clinical trial aims to compare standard dose with two types of high-dose steroids for primary systemic therapy with respect to their efficacy in improving hearing, and thus communication ability, in patients with idiopathic sudden sensorineural hearing loss.This study is funded by the "Clinical Trials with High Patient Relevance" research program in the health research framework of the German Federal Ministry of Education and Research. It is one of two studies by the German Study Center of Clinical Trials of the German Society of Otorhinolaryngology, Head and Neck Surgery (DSZ-HNO). Planning and initiation was done in cooperation with the DSZ-HNO, the Coordination Center of Clinical Trials of the Martin-Luther-University Halle-Wittenberg, and the Study Center of the University Hospital Freiburg.

  6. OSUL2013: Fostering Organizational Change through a Grassroots Planning Process

    Science.gov (United States)

    Schlosser, Melanie

    2011-01-01

    This paper provides background on planning and organizational culture change in libraries and describes a grassroots planning process taking place at the Ohio State University Libraries. Now in its third phase, the process aims to create a long-term plan for the organization while fostering a more collaborative, innovative culture.

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

    Science.gov (United States)

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

    2017-02-01

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

  8. Incorporating NEPA into IDOT and MPO planning processes.

    Science.gov (United States)

    2014-07-01

    This report summarizes the tasks and findings of the ICT Project R27-132 Incorporating National Environmental : Policy Act (NEPA) into IDOT and Metropolitan Planning Organization (MPO) planning processes, which is aimed : at assisting IDOT in definin...

  9. 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

  10. Vision 20/20: Positron emission tomography in radiation therapy planning, delivery, and monitoring

    International Nuclear Information System (INIS)

    Parodi, Katia

    2015-01-01

    Positron emission tomography (PET) is increasingly considered as an effective imaging method to support several stages of radiation therapy. The combined usage of functional and morphological imaging in state-of-the-art PET/CT scanners is rapidly emerging to support the treatment planning process in terms of improved tumor delineation, and to assess the tumor response in follow-up investigations after or even during the course of fractionated therapy. Moreover, active research is being pursued on new tracers capable of providing different insights into tumor function, in order to identify areas of the planning volume which may require additional dosage for improved probability of tumor control. In this respect, major progresses in the next years will likely concern the development and clinical investigation of novel tracers and image processing techniques for reliable thresholding and segmentation, of treatment planning and beam delivery approaches integrating the PET imaging information, as well as improved multimodal clinical instrumentation such as PET/MR. But especially in the rapidly emerging case of ion beam therapy, the usage of PET is not only limited to the imaging of external tracers injected to the patient. In fact, a minor amount of positron emitters is formed in nuclear fragmentation reactions between the impinging ions and the tissue, bearing useful information for confirmation of the delivered treatment during or after therapeutic irradiation. Different implementations of unconventional PET imaging for therapy monitoring are currently being investigated clinically, and major ongoing research aims at new dedicated detector technologies and at challenging applications such as real-time imaging and time-resolved in vivo verification of motion compensated beam delivery. This paper provides an overview of the different areas of application of PET in radiation oncology and discusses the most promising perspectives in the years to come for radiation therapy

  11. Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Brian J. Isetts

    2012-01-01

    Full Text Available The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS provided in community pharmacies. This was accomplished through a six-step process: (1 application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2 exploratory research, (3 focus group analysis, (4 marketing plan development, (5 marketing plan implementation, and (6 marketing plan evaluation. The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS. Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.   Type: Original Research

  12. An Operational Process for Workforce Planning

    National Research Council Canada - National Science Library

    Emmerichs, Robert

    2004-01-01

    .... This report describes a methodology, developed by RAND at the behest of the Deputy Assistant Secretary of Defense for Civilian Personnel Policy, for conducting workforce planning-a methodology...

  13. Process quality planning of quality function deployment for carrot syrup

    Science.gov (United States)

    Ekawati, Yurida; Noya, Sunday; Widjaja, Filemon

    2017-06-01

    Carrot products are rarely available in the market. Based on previous research that had been done using QFD to generate product design of carrots products, the research to produce the process quality planning had been carried out. The carrot product studied was carrot syrup. The research resulted in a process planning matrix for carrot syrup. The matrix gives information about critical process plan and the priority of the critical process plan. The critical process plan on the production process of carrot syrup consists of carrots sorting, carrots peeling, carrots washing, blanching process, carrots cutting, the making of pureed carrots, filtering carrot juice, the addition of sugar in carrot juice, the addition of food additives in carrot juice, syrup boiling, syrup filtering, syrup filling into the bottle, the bottle closure and cooling. The information will help the design of the production process of carrot syrup.

  14. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a (60)Co Magnetic Resonance Image Guidance Radiation Therapy System

    DEFF Research Database (Denmark)

    Wooten, H Omar; Green, Olga; Yang, Min

    2015-01-01

    PURPOSE: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. METHODS AND MATERIALS...

  15. The systematic review as a research process in music therapy.

    Science.gov (United States)

    Hanson-Abromeit, Deanna; Sena Moore, Kimberly

    2014-01-01

    Music therapists are challenged to present evidence on the efficacy of music therapy treatment and incorporate the best available research evidence to make informed healthcare and treatment decisions. Higher standards of evidence can come from a variety of sources including systematic reviews. To define and describe a range of research review methods using examples from music therapy and related literature, with emphasis on the systematic review. In addition, the authors provide a detailed overview of methodological processes for conducting and reporting systematic reviews in music therapy. The systematic review process is described in five steps. Step 1 identifies the research plan and operationalized research question(s). Step 2 illustrates the identification and organization of the existing literature related to the question(s). Step 3 details coding of data extracted from the literature. Step 4 explains the synthesis of coded findings and analysis to answer the research question(s). Step 5 describes the strength of evidence evaluation and results presentation for practice recommendations. Music therapists are encouraged to develop and conduct systematic reviews. This methodology contributes to review outcome credibility and can determine how information is interpreted and used by clinicians, clients or patients, and policy makers. A systematic review is a methodologically rigorous research method used to organize and evaluate extant literature related to a clinical problem. Systematic reviews can assist music therapists in managing the ever-increasing literature, making well-informed evidence based practice and research decisions, and translating existing music-based and nonmusic based literature to clinical practice and research development. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Adaptive Management Planning Projects as Conflict Resolution Processes

    OpenAIRE

    Greg Walkerden

    2006-01-01

    Adaptive management planning projects use multiparty, multidisciplinary workshops and simulation modeling to facilitate dialogue, negotiation, and planning. However, they have been criticized as a poor medium for conflict resolution. Alternative processes from the conflict resolution tradition, e.g., principled negotiation and sequenced negotiation, address uncertainty and biophysical constraints much less skillfully than does adaptive management. When we evaluate adaptive management planning...

  17. 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

  18. [Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders].

    Science.gov (United States)

    Reher, Cornelia; Metzner, Franka

    2016-12-01

    Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders Due to the Convention on the Rights of the Child and § 6 of the Asylum Seekers' Benefit Act, there are legal and ethical obligations for the care of minor refugees suffering from trauma-related disorders. In Germany, psychotherapeutic care of adolescent refugees is provided by specialized treatment centers and Child and Adolescent psychiatries with specialized consultation-hours for refugees. Treatment of minor refugees is impeded by various legal and organizational barriers. Many therapists have reservations and uncertainties regarding an appropriate therapy for refugees due to a lack of experience. This means that only a fraction of the young refugees with trauma-related disorders find an ambulatory therapist. In a review of international literature, empirical findings on (interpreter-aided) diagnostics and therapy of young refugees were presented. Practical experiences on therapeutic work with traumatized young refugees were summarized in a decision tree for therapy planning in the ambulatory setting. The decision tree was developed to support therapists in private practices by structuring the therapy process.

  19. Kennedy Space Center Orion Processing Team Planning for Ground Operations

    Science.gov (United States)

    Letchworth, Gary; Schlierf, Roland

    2011-01-01

    Topics in this presentation are: Constellation Ares I/Orion/Ground Ops Elements Orion Ground Operations Flow Orion Operations Planning Process and Toolset Overview, including: 1 Orion Concept of Operations by Phase 2 Ops Analysis Capabilities Overview 3 Operations Planning Evolution 4 Functional Flow Block Diagrams 5 Operations Timeline Development 6 Discrete Event Simulation (DES) Modeling 7 Ground Operations Planning Document Database (GOPDb) Using Operations Planning Tools for Operability Improvements includes: 1 Kaizen/Lean Events 2 Mockups 3 Human Factors Analysis

  20. An Approach in Radiation Therapy Treatment Planning: A Fast, GPU-Based Monte Carlo Method.

    Science.gov (United States)

    Karbalaee, Mojtaba; Shahbazi-Gahrouei, Daryoush; Tavakoli, Mohammad B

    2017-01-01

    An accurate and fast radiation dose calculation is essential for successful radiation radiotherapy. The aim of this study was to implement a new graphic processing unit (GPU) based radiation therapy treatment planning for accurate and fast dose calculation in radiotherapy centers. A program was written for parallel running based on GPU. The code validation was performed by EGSnrc/DOSXYZnrc. Moreover, a semi-automatic, rotary, asymmetric phantom was designed and produced using a bone, the lung, and the soft tissue equivalent materials. All measurements were performed using a Mapcheck dosimeter. The accuracy of the code was validated using the experimental data, which was obtained from the anthropomorphic phantom as the gold standard. The findings showed that, compared with those of DOSXYZnrc in the virtual phantom and for most of the voxels (>95%), GPU-based Monte Carlo method in dose calculation may be useful in routine radiation therapy centers as the core and main component of a treatment planning verification system.

  1. Parent Participation in the Transition Planning Process.

    Science.gov (United States)

    deFur, Sharon H.; Todd-Allen, Mary; Getzel, Elizabeth E.

    2001-01-01

    A study involving 28 Virginian parents of adolescents with disabilities found they identified the quality of their relationship with service providers as the key factor affecting their participation in transition planning. A model is presented that illustrates the potential positive or negative cycle that occurs as families and professionals…

  2. Application of influence diagrams to prostate intensity-modulated radiation therapy plan selection

    Science.gov (United States)

    Meyer, Jürgen; Phillips, Mark H.; Cho, Paul S.; Kalet, Ira; Doctor, Jason N.

    2004-05-01

    The purpose is to incorporate clinically relevant factors such as patient-specific and dosimetric information as well as data from clinical trials in the decision-making process for the selection of prostate intensity-modulated radiation therapy (IMRT) plans. The approach is to incorporate the decision theoretic concept of an influence diagram into the solution of the multiobjective optimization inverse planning problem. A set of candidate IMRT plans was obtained by varying the importance factors for the planning target volume (PTV) and the organ-at-risk (OAR) in combination with simulated annealing to explore a large part of the solution space. The Pareto set for the PTV and OAR was analysed to demonstrate how the selection of the weighting factors influenced which part of the solution space was explored. An influence diagram based on a Bayesian network with 18 nodes was designed to model the decision process for plan selection. The model possessed nodes for clinical laboratory results, tumour grading, staging information, patient-specific information, dosimetric information, complications and survival statistics from clinical studies. A utility node was utilized for the decision-making process. The influence diagram successfully ranked the plans based on the available information. Sensitivity analyses were used to judge the reasonableness of the diagram and the results. In conclusion, influence diagrams lend themselves well to modelling the decision processes for IMRT plan selection. They provide an excellent means to incorporate the probabilistic nature of data and beliefs into one model. They also provide a means for introducing evidence-based medicine, in the form of results of clinical trials, into the decision-making process.

  3. 2015 Plan. Project 1: methodology and planning process of the Brazilian electric sector expansion

    International Nuclear Information System (INIS)

    1993-10-01

    The Planning Process of Brazilian Electric Sector Expansion, their normative aspects, instruments, main agents and the planning cycles are described. The methodology of expansion planning is shown, with the interactions of several study areas, electric power market and the used computer models. The forecasts of methodology evolution is also presented. (C.G.C.)

  4. Linking the Teacher Appraisal Process to the School Improvement Plan

    Science.gov (United States)

    Reddekopp, Therese

    2007-01-01

    If a school improvement plan includes input from all stakeholders and focuses on data-driven processes that are linked to teacher appraisal, it can be powerful in leading the school toward the common mission of achieving student success. Linking the school improvement plan to the teacher appraisal process creates a system whereby all individuals…

  5. Organizational factors, planning capacity, and integration challenges constrain provincial planning processes for nutrition in decentralizing Vietnam.

    Science.gov (United States)

    Lapping, Karin; Frongillo, Edward A; Nguyen, Phuong H; Coates, Jennifer; Webb, Patrick; Menon, Purnima

    2014-09-01

    Translating national policies and guidelines into effective action at the subnational level (e.g., province or region) is a prerequisite for ensuring an impact on nutrition. In several countries, including Vietnam, the focus of this paper, this process is affected by the quality of the decentralized process of planning and action. This study examined how provincial planning processes for nutrition occurred in Vietnam during 2009 and 2010. Key goals were to understand variability in processes across provinces, identify factors that influenced the process, and assess the usefulness of the process for individuals involved in planning and action. A qualitative case-study methodology was used. Data were drawn from interviews with 51 government officials in eight provinces. The study found little variability in the planning process among these eight provinces, probably due to a planning process that was predominantly a fiscal exercise within the confines of a largely centralized structure. Respondents were almost unanimous about the main barriers: a top-down approach to planning, limited human capacity for effective planning at subnational levels, and difficulty in integrating actions from multiple sectors. Provincial-level actors were deeply dissatisfied with the nature of their role in the process. Despite the rhetoric to the contrary, too much power is probably still retained at the central level. A strategic multiyear approach is needed to strengthen the provincial planning process and address many of the key barriers identified in this study.

  6. Development of inverse-planning system for neutron capture therapy

    International Nuclear Information System (INIS)

    Kumada, Hiroaki; Yamamoto, Kazuyoshi; Maruo, Takeshi

    2006-01-01

    To lead proper irradiation condition effectively, Japan Atomic Energy Agency (JAEA) is developing an inverse-planning system for neutron capture therapy (NCT-IPS) based on the JAEA computational dosimetry system (JCDS) for BNCT. The leading methodology of an optimum condition in the NCT-IPS has been applied spatial channel theory with adjoint flux solution of Botzman transport. By analyzing the results obtained from the adjoint flux calculations according to the theory, optimum incident point of the beam against the patient can be found, and neutron spectrum of the beam which can generate ideal distribution of neutron flux around tumor region can be determined. The conceptual design of the NCT-IPS was investigated, and prototype of NCT-IPS with JCDS is being developed. (author)

  7. Evaluation on lung cancer patients' adaptive planning of TomoTherapy utilising radiobiological measures and Planned Adaptive module.

    Science.gov (United States)

    Su, Fan-Chi; Shi, Chengyu; Mavroidis, Panayiotis; Rassiah-Szegedi, Prema; Papanikolaou, Niko

    2009-01-01

    Adaptive radiation therapy is a promising concept that allows individualised, dynamic treatment planning based on feedback of measurements. The TomoTherapy Planned Adaptive application, integrated to the helical TomoTherapy planning system, enables calculation of actual dose delivered to the patient for each treatment fraction according to the pretreatment megavoltage computed tomography (MVCT) scan and image registration. As a result, new fractionation treatment plans are available if correction is necessary. In order to evaluate therealclinicaleffect,biologicaldoseis preferred to physical dose. A biological parameter, biologically effective uniform dose ([Formula: see text]), has the advantages of not only reporting delivered dose but also facilitating the analysis of dose-response relations, which link radiation dose to the clinical effect. Therefore, in this study, four lung patients' adaptive plans were evaluated using the [Formula: see text] in addition to physical doses estimated from the TomoTherapy Planned Adaptive module. Higher complication-free tumour control probability (P(+))(of about 8%) was observed in patients treated with larger dose-per-fraction by using the [Formula: see text] in addition to the physical dose. Moreover, a significant increase of 13.2% in the P(+) for the adaptive TomoTherapy plan in one of the lung cancer patients was also observed, which indicates the clinical benefit of adaptive TomoTherapy.

  8. Plutonium Oxide Process Capability Work Plan

    Energy Technology Data Exchange (ETDEWEB)

    Meier, David E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tingey, Joel M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-02-28

    Pacific Northwest National Laboratory (PNNL) has been tasked to develop a Pilot-scale Plutonium-oxide Processing Unit (P3U) providing a flexible capability to produce 200g (Pu basis) samples of plutonium oxide using different chemical processes for use in identifying and validating nuclear forensics signatures associated with plutonium production. Materials produced can also be used as exercise and reference materials.

  9. Clients' Emotional Processing in Psychotherapy: A Comparison between Cognitive-Behavioral and Process-Experiential Therapies

    Science.gov (United States)

    Watson, Jeanne C.; Bedard, Danielle L.

    2006-01-01

    The authors compared clients' emotional processing in good and bad outcome cases in cognitive behavioral therapy (CBT) and process-experiential therapy (PET) and investigated whether clients' emotional processing increases over the course of therapy. Twenty minutes from each of 3 sessions from 40 clients were rated on the Experiencing Scale. A 2 *…

  10. Monte Carlo calculations supporting patient plan verification in proton therapy

    Directory of Open Access Journals (Sweden)

    Thiago Viana Miranda Lima

    2016-03-01

    Full Text Available Patient’s treatment plan verification covers substantial amount of the quality assurance (QA resources, this is especially true for Intensity Modulated Proton Therapy (IMPT. The use of Monte Carlo (MC simulations in supporting QA has been widely discussed and several methods have been proposed. In this paper we studied an alternative approach from the one being currently applied clinically at Centro Nazionale di Adroterapia Oncologica (CNAO. We reanalysed the previously published data (Molinelli et al. 2013, where 9 patient plans were investigated in which the warning QA threshold of 3% mean dose deviation was crossed. The possibility that these differences between measurement and calculated dose were related to dose modelling (Treatment Planning Systems (TPS vs MC, limitations on dose delivery system or detectors mispositioning was originally explored but other factors such as the geometric description of the detectors were not ruled out. For the purpose of this work we compared ionisation-chambers measurements with different MC simulations results. It was also studied some physical effects introduced by this new approach for example inter detector interference and the delta ray thresholds. The simulations accounting for a detailed geometry typically are superior (statistical difference - p-value around 0.01 to most of the MC simulations used at CNAO (only inferior to the shift approach used. No real improvement were observed in reducing the current delta-ray threshold used (100 keV and no significant interference between ion chambers in the phantom were detected (p-value 0.81. In conclusion, it was observed that the detailed geometrical description improves the agreement between measurement and MC calculations in some cases. But in other cases position uncertainty represents the dominant uncertainty. The inter chamber disturbance was not detected for the therapeutic protons energies and the results from the current delta threshold are

  11. Strategic planning processes and financial performance among hospitals in Lebanon.

    Science.gov (United States)

    Saleh, Shadi; Kaissi, Amer; Semaan, Adele; Natafgi, Nabil Maher

    2013-01-01

    Strategic planning has been presented as a valuable management tool. However, evidence of its deployment in healthcare and its effect on organizational performance is limited in low-income and middle-income countries (LMICs). The study aimed to explore the use of strategic planning processes in Lebanese hospitals and to investigate its association with financial performance. The study comprised 79 hospitals and assessed occupancy rate (OR) and revenue-per-bed (RPB) as performance measures. The strategic planning process included six domains: having a plan, plan development, plan implementation, responsibility of planning activities, governing board involvement, and physicians' involvement. Approximately 90% of hospitals have strategic plans that are moderately developed (mean score of 4.9 on a 1-7 scale) and implemented (score of 4.8). In 46% of the hospitals, the CEO has the responsibility for the plan. The level of governing board involvement in the process is moderate to high (score of 5.1), whereas physician involvement is lower (score of 4.1). The OR and RPB amounted to respectively 70% and 59 304 among hospitals with a strategic plan as compared with 62% and 33 564 for those lacking such a plan. No statistical association between having a strategic plan and either of the two measures was detected. However, the findings revealed that among hospitals that had a strategic plan, higher implementation levels were associated with lower OR (p plans allow organizations to better cope with environmental turbulence. Copyright © 2012 John Wiley & Sons, Ltd.

  12. 'Race', disadvantage, and policy processes in British planning

    OpenAIRE

    H Thomas; V Krishnarayan

    1994-01-01

    In this paper some of the mechanisms by which black and ethnic minorities can be put at a particular disadvantage within the planning system in Britain (and how these processes can be challenged) are examined. A number of types of policy processes operating in British planning are identified, and, drawing on a range of secondary and primary data, the influence of black and ethnic minorities within these processes are analysed. The paper is concluded with a review of the possibilities for the ...

  13. 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...

  14. Evidence Considerations for Mobile Devices in the Occupational Therapy Process

    Directory of Open Access Journals (Sweden)

    Kelly Erickson

    2015-04-01

    Full Text Available Mobile app-based device utilization, including smartphones and handheld tablets, suggests a need to evaluate evidence to guide selection and implementation of these devices in the occupational therapy process. The purpose of the research was to explore the current body of evidence in relation to mobile app-based devices and to identify factors in the use of these devices throughout the occupational therapy process. Following review of available occupational therapy profession guidelines, assistive technology literature, and available mobile device research, practitioners using mobile app-based devices in occupational therapy should consider three areas: client needs, practitioner competence, and device factors. The purpose of this guideline is to identify factors in the selection and use of mobile app-based devices throughout the occupational therapy process based on available evidence. Considerations for mobile device implementation during the occupational therapy process is addressed, including evaluating outcomes needs, matching device with the client, and identifying support needs of the client.

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

    Science.gov (United States)

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

    2017-02-01

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

  16. Using gEUD based plan analysis method to evaluate proton vs. photon plans for lung cancer radiation therapy.

    Science.gov (United States)

    Xiao, Zhiyan; Zou, Wei J; Chen, Ting; Yue, Ning J; Jabbour, Salma K; Parikh, Rahul; Zhang, Miao

    2018-03-01

    The goal of this study was to exam the efficacy of current DVH based clinical guidelines draw from photon experience for lung cancer radiation therapy on proton therapy. Comparison proton plans and IMRT plans were generated for 10 lung patients treated in our proton facility. A gEUD based plan evaluation method was developed for plan evaluation. This evaluation method used normal lung gEUD(a) curve in which the model parameter "a" was sampled from the literature reported value. For all patients, the proton plans delivered lower normal lung V 5 Gy with similar V 20 Gy and similar target coverage. Based on current clinical guidelines, proton plans were ranked superior to IMRT plans for all 10 patients. However, the proton and IMRT normal lung gEUD(a) curves crossed for 8 patients within the tested range of "a", which means there was a possibility that proton plan would be worse than IMRT plan for lung sparing. A concept of deficiency index (DI) was introduced to quantify the probability of proton plans doing worse than IMRT plans. By applying threshold on DI, four patients' proton plan was ranked inferior to the IMRT plan. Meanwhile if a threshold to the location of curve crossing was applied, 6 patients' proton plan was ranked inferior to the IMRT plan. The contradictory ranking results between the current clinical guidelines and the gEUD(a) curve analysis demonstrated there is potential pitfalls by applying photon experience directly to the proton world. A comprehensive plan evaluation based on radio-biological models should be carried out to decide if a lung patient would really be benefit from proton therapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  17. Analysing contemporary metropolitan spatial plans in Europe through their institutional context, instrumental content and planning process

    DEFF Research Database (Denmark)

    Elinbaum, Pablo; Galland, Daniel

    2016-01-01

    concerning the institutional context, instrumental content and planning processes associated with four contemporary metropolitan spatial plans in Europe, namely London, Copenhagen, Paris and Barcelona. Through the results of a multiple case study and a subsequent cross comparative analysis, the article......This article sets out to propose and apply a qualitative framework for thinking about how to analyze and compare metropolitan spatial plans in a milieu of divergent spatial planning traditions and discretionary planning practices. In doing so, the article reviews and develops an understanding....... In this sense, the metropolitan scale is treated less explicitly as a planning scale per se; rather, it tends to emerge as a “concealed” scale between municipal and regional scales and also between local and regional knowledge in planning. Moreover, the analysis suggests that while metropolitan plans seem...

  18. Maintenance planning for a deteriorating production process

    International Nuclear Information System (INIS)

    Ahmadi, Reza; Fouladirad, Mitra

    2017-01-01

    We consider a system subject to degradation, more precisely a production process with three quality states evolving according to a homogeneous Markov process. The degradation decreases the income generated by the system. To maintain revenue stream and prevent the loss of revenue, the system is inspected according to a Markov-modulated Poisson process. It is assumed that each inspection at time t incurs a time dependent cost. Each inspection improves the system health and therefore the degradation level jumps to a less deteriorated state. In absence of inspections, the system state is prone to shift to a more deteriorated state with a constant rate. The problem is to determine an optimal operating (stopping) time which truly balances some flow of income and increasing costs due to inspections, and so maximizes the expected gain of the proposed policy. To demonstrate the applicability of the explored approach and its effectiveness, some numerical results are provided. - Highlights: • An integrated model based on a quality state-dependent reward structure is explored. • The model allows the revenue stream responds to variation in the quality state. • The production process is inspected according to a Markovmodulated Poisson process. • Assuming a Markovian structure, we predict the quality state behavior. • We determine an optimal production run length based on a stopping decision rule.

  19. NATO Defence Planning Process. Implications for defence posture

    Directory of Open Access Journals (Sweden)

    Paweł Fleischer

    2015-12-01

    Full Text Available The NATO Defence Planning Process (NDPP is the most important element affecting the Alliance's defence posture. Under the process states commit themselves to provide capabilities and forces required to fulfil NATO missions, defined in the NATO Strategic Concept. The NDPP directly affects national defence plans by harmonizing them with identified security and defence objectives as well by influencing development of the novel national defence capabilities. The emergence of new threats in the NATO environment, demands modifications in the defense planning process and establishing new goals for the Alliance. Enhancement of the NDPP should be priority during the time of unrest.

  20. Classification of risks in the process of financial planning

    Directory of Open Access Journals (Sweden)

    A.V. Overchuk

    2017-12-01

    Full Text Available The essence of the concept «risk» in the process of financial planning is studied. The classification of risks was conducted. The article provides the full enough and detailed system of classification of risks in the process of financial planning. The author researches and provides the factors, which directly influence upon the size of risks, which accompany the process of financial planning. A complete set of isolated independent features was determined for each risk type. It was found out that a part of features depends only on the risk type and the other part is determined by the character of a risky situation. The article substantiates the presence of indeterminacy typical for dynamic and non-stationary environment and the risks of different nature and strength of influence on the efficiency of financial planning, which cause the necessity to develop and implement the effective system of financial planning at an enterprise.

  1. Safeguards planning in a plant design process

    International Nuclear Information System (INIS)

    Heinrich, L.A.

    1977-01-01

    The safeguards efforts for the partitioning fuel cycle are considered. Included in the discussion are the organization of the safeguards study, the development of safeguards criteria, the expression of these criteria as requirements for facility design, and some preliminary details of the implementation of these requirements in facility and process layout

  2. Integrate Evaluation into the Planning Process.

    Science.gov (United States)

    Camp, William

    1985-01-01

    In an attempt to correct for limitations in the Program Evaluation and Review Technique-Critical Path Method (PERT-CPM), the Graphical Evaluation and Review Technique (GERT) has been developed. This management tool allows for evaluation during the facilities' development process. Two figures and two references are provided. (DCS)

  3. A fast - Monte Carlo toolkit on GPU for treatment plan dose recalculation in proton therapy

    Science.gov (United States)

    Senzacqua, M.; Schiavi, A.; Patera, V.; Pioli, S.; Battistoni, G.; Ciocca, M.; Mairani, A.; Magro, G.; Molinelli, S.

    2017-10-01

    In the context of the particle therapy a crucial role is played by Treatment Planning Systems (TPSs), tools aimed to compute and optimize the tratment plan. Nowadays one of the major issues related to the TPS in particle therapy is the large CPU time needed. We developed a software toolkit (FRED) for reducing dose recalculation time by exploiting Graphics Processing Units (GPU) hardware. Thanks to their high parallelization capability, GPUs significantly reduce the computation time, up to factor 100 respect to a standard CPU running software. The transport of proton beams in the patient is accurately described through Monte Carlo methods. Physical processes reproduced are: Multiple Coulomb Scattering, energy straggling and nuclear interactions of protons with the main nuclei composing the biological tissues. FRED toolkit does not rely on the water equivalent translation of tissues, but exploits the Computed Tomography anatomical information by reconstructing and simulating the atomic composition of each crossed tissue. FRED can be used as an efficient tool for dose recalculation, on the day of the treatment. In fact it can provide in about one minute on standard hardware the dose map obtained combining the treatment plan, earlier computed by the TPS, and the current patient anatomic arrangement.

  4. Goal planning: a retrospective audit of rehabilitation process and outcome.

    Science.gov (United States)

    Duff, Jane; Evans, Matthew J; Kennedy, Paul

    2004-05-01

    To consider the effectiveness of a goal planning programme for people with spinal cord injury (SCI) and address some of the current evidence gaps in goal setting. Retrospective audit. Consecutive series of 65 newly injured SCI patients. The Needs Assessment Checklist (NAC) has been specifically developed for the SCI population, and is used to assess patient attainment in core rehabilitation areas. A 'Goal Planning Progress' form was also used to specifically detail the goal planning process. Across the 65 patients, 396 goal planning meetings were held with 6176 goals set in total. Seventy-two per cent of the goals set at the first goal planning meeting were achieved by the second meeting. The rate of achievement at subsequent meetings was 68%. Significant differences in the number of planned rehabilitation days, number of goal planning meetings, and goals set were identified between injury categories. Significant positive correlations were found between the number of goals set and achievement, as measured by the NAC, in certain rehabilitation domains. The findings of this study demonstrate that the Needs Assessment and Goal Planning framework is effective in planning SCI rehabilitation. The capacity of this goal planning system to reflect individual need has also been established. Further systematic analyses of this process could potentially lead to more efficient rehabilitation and the identification of care pathways within clinical areas.

  5. On Intelligent Design and Planning Method of Process Route Based on Gun Breech Machining Process

    Science.gov (United States)

    Hongzhi, Zhao; Jian, Zhang

    2018-03-01

    The paper states an approach of intelligent design and planning of process route based on gun breech machining process, against several problems, such as complex machining process of gun breech, tedious route design and long period of its traditional unmanageable process route. Based on gun breech machining process, intelligent design and planning system of process route are developed by virtue of DEST and VC++. The system includes two functional modules--process route intelligent design and its planning. The process route intelligent design module, through the analysis of gun breech machining process, summarizes breech process knowledge so as to complete the design of knowledge base and inference engine. And then gun breech process route intelligently output. On the basis of intelligent route design module, the final process route is made, edited and managed in the process route planning module.

  6. 44 CFR 78.6 - Flood Mitigation Plan approval process.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Flood Mitigation Plan..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.6 Flood Mitigation Plan approval process. The State POC will forward all Flood...

  7. 49 CFR 1106.4 - The Safety Integration Plan process.

    Science.gov (United States)

    2010-10-01

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

  8. Sampling Plans for Monitoring Quality Control Process at a Plastic ...

    African Journals Online (AJOL)

    While the problem of the company's process control system was being studied, management considered other options that include sampling plans. The sampling plans were evaluated by considering the competing goals of decreasing the shipment of substandard goods, decreasing the percentage of acceptable lot that are ...

  9. Idaho Chemical Processing Plant Site Development Plan

    International Nuclear Information System (INIS)

    Ferguson, F.G.

    1994-02-01

    The Idaho Chemical Processing Plant (ICPP) mission is to receive and store spent nuclear fuels and radioactive wastes for disposition for Department of Energy (DOE) in a cost-effective manner that protects the safety of Idaho National Engineering Laboratory (INEL) employees, the public, and the environment by: Developing advanced technologies to process spent nuclear fuel for permanent offsite disposition and to achieve waste minimization. Receiving and storing Navy and other DOE assigned spent nuclear fuels. Managing all wastes in compliance with applicable laws and regulations. Identifying and conducting site remediation consistent with facility transition activities. Seeking out and implementing private sector technology transfer and cooperative development agreements. Prior to April 1992, the ICPP mission included fuel reprocessing. With the recent phaseout of fuel reprocessing, some parts of the ICPP mission have changed. Others have remained the same or increased in scope

  10. 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

  11. Planning and acceptance testing of MV therapy installations

    International Nuclear Information System (INIS)

    Almond, Peter R.; Horton, John L.

    1995-01-01

    Purpose: This course is designed for practitioners and beginners in brachytherapy. The aim is to review biological principles equipment are aware of all aspects involved. The object is to cover in a broad overview the considerations that go into selecting, installing, testing and accepting megavoltage therapy equipment and to provide a resource for more detailed information. Planning and acceptance testing of a megavoltage therapy installation is a major undertaking for any size group, institution or department. It can take approximately two years from the time a decision is made to get a machine to where the first patient is treated. Because the equipment and site preparation are expensive, and most of the machines are complex and can be supplied by several different manufacturers, it is imperative that a great deal of thought and care go into the decision: the aim being that the specifications of the machine that is installed meet the immediate need of the department and the needs for the projected lifetime of the equipment. A general survey of the types of equipment available will be presented. This will concentrate on general purpose linear accelerators, although Cobalt 60 machines, microtrons and special purpose machines (intra-operative equipment) will also be covered. General descriptions of the machines along with typical specifications will be given. Selecting the best machine to meet specific needs can be quite complex and criteria for making the selection are presented in a series of twelve steps. site selection and room design, including the console area, are also critical. The general principles for shielding calculations will be provided. Critical to any installation is the acceptance testing of the equipment including material and radiation oncology performance tests. These tests will be outlined. A reading list of suitable references describing in detail many of the aspects of this course will be provided

  12. 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

  13. Constellation Mission Operation Working Group: ESMO Maneuver Planning Process Review

    Science.gov (United States)

    Moyer, Eric

    2015-01-01

    The Earth Science Mission Operation (ESMO) Project created an Independent Review Board to review our Conjunction Risk evaluation process and Maneuver Planning Process to identify improvements that safely manages mission conjunction risks, maintains ground track science requirements, and minimizes overall hours expended on High Interest Events (HIE). The Review Board is evaluating the current maneuver process which requires support by multiple groups. In the past year, there have been several changes to the processes although many prior and new concerns exist. This presentation will discuss maneuver process reviews and Board comments, ESMO assessment and path foward, ESMO future plans, recent changes and concerns.

  14. Verification and Planning for Stochastic Processes with Asynchronous Events

    National Research Council Canada - National Science Library

    Younes, Hakan L

    2005-01-01

    .... The most common assumption is that of history-independence: the Markov assumption. In this thesis, the author considers the problems of verification and planning for stochastic processes with asynchronous events, without relying on the Markov assumption...

  15. Cognitive marital therapy : the process of change

    NARCIS (Netherlands)

    Emmelkamp, P.; van Linden van den Heuvell, C.; Sanderman, R.; Scholing, A.

    1988-01-01

    Responds to comments made by N. Epstein and D. H. Baucom (see record 1989-16434-001) concerning the present authors' (see record 1989-16433-001) study of communication skills training and cognitive therapy for distressed couples. The reliable assessment of cognitions in outcome studies is discussed.

  16. New model of enterprises resource planning implementation planning process in manufacturing enterprises

    Directory of Open Access Journals (Sweden)

    Mirjana Misita

    2016-05-01

    Full Text Available This article presents new model of enterprises resource planning implementation planning process in manufacturing enterprises based on assessment of risk sources. This assessment was performed by applying analytic hierarchy process. Analytic hierarchy process method allows variation of relative importance of specific risk sources dependent on the section from which the risk source originates (organizational environment, technical issues, people issues, adoption process management, and external support. Survey was conducted on 85 manufacturing enterprises involved with an enterprises resource planning solution. Ranking of risk sources assessments returns most frequent risks of enterprises resource planning implementation success in manufacturing enterprises, and representative factors were isolated through factor analysis by risk source origin. Finally, results indicate that there are hidden causes of failed implementation, for example, risk source “top management training and education,” from risk origin “adoption process management.”

  17. Beam's-Eye-View Dosimetrics-Guided Inverse Planning for Aperture-Modulated Arc Therapy

    International Nuclear Information System (INIS)

    Ma Yunzhi; Popple, Richard; Suh, Tae-Suk; Xing Lei

    2009-01-01

    Purpose: To use angular beam's-eye-view dosimetrics (BEVD) information to improve the computational efficiency and plan quality of inverse planning of aperture-modulated arc therapy (AMAT). Methods and Materials: In BEVD-guided inverse planning, the angular space spanned by a rotational arc is represented by a large number of fixed-gantry beams with angular spacing of ∼2.5 degrees. Each beam is assigned with an initial aperture shape determined by the beam's-eye-view (BEV) projection of the planning target volume (PTV) and an initial weight. Instead of setting the beam weights arbitrarily, which slows down the subsequent optimization process and may result in a suboptimal solution, a priori knowledge about the quality of the beam directions derived from a BEVD is adopted to initialize the weights. In the BEVD calculation, a higher score is assigned to directions that allow more dose to be delivered to the PTV without exceeding the dose tolerances of the organs at risk (OARs) and vice versa. Simulated annealing is then used to optimize the segment shapes and weights. The BEVD-guided inverse planning is demonstrated by using two clinical cases, and the results are compared with those of a conventional approach without BEVD guidance. Results: An a priori knowledge-guided inverse planning scheme for AMAT is established. The inclusion of BEVD guidance significantly improves the convergence behavior of AMAT inverse planning and results in much better OAR sparing as compared with the conventional approach. Conclusions: BEVD-guidance facilitates AMAT treatment planning and provides a comprehensive tool to maximally use the technical capacity of the new arc therapeutic modality.

  18. Evaluation of participatory planning: Lessons from Hungarian Natura 2000 management planning processes.

    Science.gov (United States)

    Kovács, Eszter; Kelemen, Eszter; Kiss, Gabriella; Kalóczkai, Ágnes; Fabók, Veronika; Mihók, Barbara; Megyesi, Boldizsár; Pataki, György; Bodorkós, Barbara; Balázs, Bálint; Bela, Györgyi; Margóczi, Katalin; Roboz, Ágnes; Molnár, Dániel

    2017-12-15

    Stakeholder participation in nature conservation policies and especially in the management of protected areas has gained importance in the last decades. These changes are underlined by democratic principles and the perceived contribution of stakeholder involvement to the effectiveness of conservation management. Evaluating participatory processes is essential to learn about the past and thus increase the quality of future processes. The evaluation can be useful for the organisations responsible for planning and management, stakeholders and policy makers as well. The present paper shows the results of a systematic evaluation of 25 participatory processes related to the development of management plans for Natura 2000 sites in Hungary between 2007 and 2015. A conceptual framework was developed to evaluate the process and outcome of participatory management planning processes. Criteria were based on the scientific literature on public participation and tailored to conservation-related management planning and stakeholder involvement. Evaluated processes were grouped in three cases based on their time range and financial sources. Overall, the analysed processes scored at a medium level, showing better performance in the process criteria than in the outcome criteria. The best case scored significantly higher in four criteria compared to the other cases: representativeness, resource availability for facilitation, new, creative ideas and impact on the plan. The main factors behind the success were (1) embeddedness of the planning process in a larger project, where the plan was a tool for conservation, (2) carrying out only one process at a time, (3) previous experience of facilitators and planners with participatory planning and (4) the opportunity and capacity to propose a payment scheme as an incentive. But even this case received low scores in some criteria: conflict resolution, early involvement and well defined goals. Based on the results we suggest that more data is

  19. Adaptive Management Planning Projects as Conflict Resolution Processes

    Directory of Open Access Journals (Sweden)

    Greg Walkerden

    2006-06-01

    Full Text Available Adaptive management planning projects use multiparty, multidisciplinary workshops and simulation modeling to facilitate dialogue, negotiation, and planning. However, they have been criticized as a poor medium for conflict resolution. Alternative processes from the conflict resolution tradition, e.g., principled negotiation and sequenced negotiation, address uncertainty and biophysical constraints much less skillfully than does adaptive management. When we evaluate adaptive management planning using conflict resolution practice as a benchmark, we can design better planning procedures. Adaptive management planning procedures emerge that explore system structure, dynamics, and uncertainty, and that also provide a strong negotiation process, grounded in principled exploration of stakeholders' interests and needs. "Crossing" procedures in this manner is a fertile way of developing new forms of professional practice.

  20. Integration of air quality-related planning processes : report

    International Nuclear Information System (INIS)

    2004-05-01

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

  1. Influence of planning time and treatment complexity on radiation therapy errors.

    Science.gov (United States)

    Gensheimer, Michael F; Zeng, Jing; Carlson, Joshua; Spady, Phil; Jordan, Loucille; Kane, Gabrielle; Ford, Eric C

    2016-01-01

    Radiation treatment planning is a complex process with potential for error. We hypothesized that shorter time from simulation to treatment would result in rushed work and higher incidence of errors. We examined treatment planning factors predictive for near-miss events. Treatments delivered from March 2012 through October 2014 were analyzed. Near-miss events were prospectively recorded and coded for severity on a 0 to 4 scale; only grade 3-4 (potentially severe/critical) events were studied in this report. For 4 treatment types (3-dimensional conformal, intensity modulated radiation therapy, stereotactic body radiation therapy [SBRT], neutron), logistic regression was performed to test influence of treatment planning time and clinical variables on near-miss events. There were 2257 treatment courses during the study period, with 322 grade 3-4 near-miss events. SBRT treatments had more frequent events than the other 3 treatment types (18% vs 11%, P = .04). For the 3-dimensional conformal group (1354 treatments), univariate analysis showed several factors predictive of near-miss events: longer time from simulation to first treatment (P = .01), treatment of primary site versus metastasis (P < .001), longer treatment course (P < .001), and pediatric versus adult patient (P = .002). However, on multivariate regression only pediatric versus adult patient remained predictive of events (P = 0.02). For the intensity modulated radiation therapy, SBRT, and neutron groups, time between simulation and first treatment was not found to be predictive of near-miss events on univariate or multivariate regression. When controlling for treatment technique and other clinical factors, there was no relationship between time spent in radiation treatment planning and near-miss events. SBRT and pediatric treatments were more error-prone, indicating that clinical and technical complexity of treatments should be taken into account when targeting safety interventions. Copyright © 2015 American

  2. Building a team through a strategic planning process.

    Science.gov (United States)

    Albert, Debra; Priganc, Dave

    2014-01-01

    Strategic planning is a process often left to senior hospital leadership, with limited input from unit-level, bedside patient care providers. This frequent approach to strategic planning misses the opportunity to engage a wide range of employees, build a shared sense of commitment, produce a collaborative team environment, and to generate greater acceptance of the plan. The Patient Care Services division at the University of Chicago Medicine used a strategic planning process that incorporated 360-degree input from both within the Patient Care Services division and outside of the division. The result is a strategic vision and plan that, shaped by broad-based input from both internal and external constituencies, is strengthened by the team that emerged from the process. Through the process of identifying a common understanding of the group's future direction, a shared purpose was created that transcended traditional professional boundaries and shaped a cohesive team focused on effective and efficient patient care. Now, with a focused strategic plan and a team centered on a shared purpose, the team is beginning to effectively deliver on the plan.

  3. Functional image guided radiation therapy planning in volumetric modulated arc therapy for patients with malignant pleural mesothelioma

    Directory of Open Access Journals (Sweden)

    Yoshiko Doi, MD

    2017-04-01

    Conclusions: Significant reductions in fV5, fV10, fMLD, V5, and MLD were achieved with the functional image guided VMAT plan without negative effects on other factors. LAA-based functional image guided radiation therapy planning in VMAT is a feasible method to spare the functional lung in patients with MPM.

  4. Planning with Shared Vision: A Project Study Examining the Planning Process of School Principals

    Science.gov (United States)

    King, Dennis J.

    2013-01-01

    The process of planning for school principals has become more difficult in recent years because of a shift from simple administrative duties to management duties. Evidence suggests that many school principals lack the resources, training, and guidance to meet and sustain federal planning standards. This problem is important to district…

  5. Interactive Decision-Support Tool for Risk-Based Radiation Therapy Plan Comparison for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Brodin, N. Patrik; Maraldo, Maja V.; Aznar, Marianne C.

    2014-01-01

    PURPOSE: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). METHODS AND MATERIALS...... and a volumetric modulated arc therapy plan for a patient with mediastinal HL. CONCLUSION: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options....

  6. Newly Developed Software Application for Multiple Access Process Planning

    Directory of Open Access Journals (Sweden)

    Katarina Monkova

    2014-11-01

    Full Text Available The purchase of a complex system for computer aided process planning (CAPP can be expensive for little and some middle sized plants, sometimes an inaccessible investment, with a long recoupment period. According to this fact and the author's experience with Eastern European plants, they decided to design a new database application which is suitable for production, stock, and economic data holding as well as processing and exploitation within the manufacturing process. The application can also be used to process a plan according to the selected criteria, for technological documentation and NC program creation. It was based on the theory of a multivariant approach to computer aided plan generation. Its fundamental features, the internal mathematical structure and new code system of processed objects, were prepared by the authors. The verification of the designed information system in real practice has shown that it enables about 30% cost and production time reduction and decreases input material assortment variability.

  7. [Antithrombotic therapy in patients with atrial flutter before planned cardioversion].

    Science.gov (United States)

    М'якінькова, Людмила О; Тесленко, Юрій В; Пустовойт, Ганна Л; Ярмола, Тетяна І; Циганенко, Ірина В

    atrium flutter and fibrillation are the heart rhythm disorders that increase the risk of life-dangerous complications, e.g. cardioembolic stroke, pulmonary embolism. Recommendations for managing patients with atrial fibrillation - atrial flutter, with paroxysm duration over 48 hours, demand anticoagulant therapy. Oral anticoagulants, which are the antagonists of K vitamin (Varpharin) and the new oral anticoagulants (Rivaroxaban), are used during the per-manipulative procedure of patients with atrial flutter before restoring the sinus rhythm with transesophageal cardiac pacing. the present investigation aims to compare efficiency and safety of Varpharin and Rivaaroxaban in treatment patients with atrial flutter before planned cardioversion with transesophageal heart pacing. Varpharin (control group) - in doses equivalent for reaching the target МНВ - or Rivaroxaban (research group), 20 mg., were prescribed to 42 patients with coronary heart disease, concomitant arterial hypertension, and non-valvular paroxysm of atrial flutter with more than 48-hour duration, divided into two groups. There was held the general clinical, echocardioscopy examination. Thrombotic Risk Factor Assessment was made according to the CHA2DS2-VASc scale, Hemorrhagic Risk Factor Assessment was performed according to the HAS-BLED scale, and clinical symptoms assessment was made according to the EHRA scale. The heart rhythm was restored with the transesophageal heart pacing. the per-manipulative procedure of the patients of research group (21 days were suggested according to the guidelines) shortened, unlike the patients of control group (the period of target МНВ selection had made 30,76±0,62days), the reduction of the symptoms severity by EHRA was considered in dynamics. According to the results of transesophageal heart pacing, the heart rhythm of 15 research group patients restored, and 6 research group patients had atrial fibrillation. Among the patients of the control group, 6 had

  8. A systematic process for developing and assessing accident management plans

    International Nuclear Information System (INIS)

    Hanson, D.J.; Blackman, H.S.; Meyer, O.R.; Ward, L.W.

    1991-04-01

    This document describes a four-phase approach for developing criteria recommended for use in assessing the adequacy of nuclear power plant accident management plans. Two phases of the approach have been completed and provide a prototype process that could be used to develop an accident management plan. Based on this process, a preliminary set of assessment criteria are derived. These preliminary criteria will be refined and improved when the remaining steps of the approach are completed, that is, after the prototype process is validated through application. 9 refs., 10 figs., 7 tabs

  9. Information architecture: Standards adoption and retirement process service action plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The purpose of this Service Action Plan is to announce, as well as provide, a high-level outline of a new Departmental process for the adoption and retirement of information technology standards. This process supports the implementation of a Department of Energy (DOE) Information Architecture. This plan was prepared with the Department of Energy information technology standards customers and stakeholders in mind. The process described in this plan will be serviced primarily by staff from the Office of the Deputy Assistant Secretary for Information Management with assistance from designated program and site Information Technology Standards Points of Contact. We welcome any comments regarding this new Departmental process and encourage the proposal of information technology standards for adoption or retirement.

  10. City Labs as Vehicles for Innovation in Urban Planning Processes

    Directory of Open Access Journals (Sweden)

    Christian Scholl

    2016-12-01

    Full Text Available This paper assesses the role of urban experiments for local planning processes through a case-based analysis of the city lab of Maastricht. In conjunction with this, the article offers three contributions, as additional elements. Firstly, the paper develops a set of defining characteristics of city labs as an analytical concept which is relevant for discussions about (collaborative planning. Secondly, it refines the literature on collaborative planning by drawing attention to experimentation and innovation. Thirdly, the paper assesses the potential of city labs to contribute to the innovation of urban governance. The work draws from the literature on experimentation and learning as well as the literature on collaborative urban planning. In the conclusions, we discuss the potential of city labs as vehicles for learning about new urban planning approaches and their limitations as spaces for small-scale experimentation. The paper is based on research for the URB@Exp research project funded by JPI Urban Europe.

  11. Multi-GPU configuration of 4D intensity modulated radiation therapy inverse planning using global optimization

    Science.gov (United States)

    Hagan, Aaron; Sawant, Amit; Folkerts, Michael; Modiri, Arezoo

    2018-01-01

    We report on the design, implementation and characterization of a multi-graphic processing unit (GPU) computational platform for higher-order optimization in radiotherapy treatment planning. In collaboration with a commercial vendor (Varian Medical Systems, Palo Alto, CA), a research prototype GPU-enabled Eclipse (V13.6) workstation was configured. The hardware consisted of dual 8-core Xeon processors, 256 GB RAM and four NVIDIA Tesla K80 general purpose GPUs. We demonstrate the utility of this platform for large radiotherapy optimization problems through the development and characterization of a parallelized particle swarm optimization (PSO) four dimensional (4D) intensity modulated radiation therapy (IMRT) technique. The PSO engine was coupled to the Eclipse treatment planning system via a vendor-provided scripting interface. Specific challenges addressed in this implementation were (i) data management and (ii) non-uniform memory access (NUMA). For the former, we alternated between parameters over which the computation process was parallelized. For the latter, we reduced the amount of data required to be transferred over the NUMA bridge. The datasets examined in this study were approximately 300 GB in size, including 4D computed tomography images, anatomical structure contours and dose deposition matrices. For evaluation, we created a 4D-IMRT treatment plan for one lung cancer patient and analyzed computation speed while varying several parameters (number of respiratory phases, GPUs, PSO particles, and data matrix sizes). The optimized 4D-IMRT plan enhanced sparing of organs at risk by an average reduction of 26% in maximum dose, compared to the clinical optimized IMRT plan, where the internal target volume was used. We validated our computation time analyses in two additional cases. The computation speed in our implementation did not monotonically increase with the number of GPUs. The optimal number of GPUs (five, in our study) is directly related to the

  12. A key to success: optimizing the planning process

    Science.gov (United States)

    Turk, Huseyin; Karakaya, Kamil

    2014-05-01

    By adopting The NATO Strategic Concept Document in 2010, some important changes in the perception of threat and management of crisis were introduced. This new concept, named ''Comprehensive Approach'', includes the precautions of pre-crisis management, applications of crisis-duration management and reconstruction phase of post-intervention management. NATO will be interested in not only the political and military options , but also social, economical and informational aspects of crisis. NATO will take place in all phases of conflict. The conflicts which occur outside the borders of NATO's nations and terrorism are perceived as threat sources for peace and stability. In addition to conventional threats, cyber attacks which threaten network-supported communication systems, preventing applications from accessing to space that will be used in different fields of life. On the other hand, electronic warfare capabilities which can effect us negatively are added to threat list as new threats. In the process in which military is thought as option, a harder planning phase is waiting for NATO's decision makers who struggle for keeping peace and security. Operation planning process which depends on comprehensive approach, contains these steps: Situational awareness of battlefield, evaluation of the military intervention options, orientation, developing an operation plan, reviewing the plan and transition phases.1 To be successful in theater which is always changing with the technological advances, there has to be an accurate and timely planning on the table. So, spending time for planning can be shown as one of the biggest problem. In addition, sustaining situational awareness which is important for the whole operation planning process, technical command and control hitches, human factor, inability to determine the center of gravity of opponent in asymmetrical threat situations can be described as some of the difficulties in operation planning. In this study, a possible air

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

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

  14. The science planning process on the Rosetta mission

    Science.gov (United States)

    Vallat, Claire; Altobelli, Nicolas; Geiger, Bernhard; Grieger, Bjoern; Kueppers, Michael; Muñoz Crego, Claudio; Moissl, Richard; Taylor, Matthew G. G. T.; Alexander, Claudia; Buratti, Bonnie; Choukroun, Mathieu; the RSGS Liaison scientists group

    2017-04-01

    The Rosetta mission arrived at comet 67 P/Churyumov-Gerasimenko in Summer 2014, after more than 10 years in space. All previous mission encounters with a comet have provided a snapshot of the cometary activity at a given heliocentric distance. In contrast, Rosetta has escorted the comet nucleus for an extended period (>2 years) at a large range of cometo-centric and heliocentric distances, which has provided exceptional and unprecedented observing conditions to study, analyse and monitor 67 P during its passage to, through and away from perihelion. One of the biggest challenges of this mission is the development of an observation plan that adequately addresses the mission's science objectives while coping with a largely unknown and continuously evolving environment that constantly modifies the planning constraints. The Rosetta Science Ground Segment (RSGS), in support of the Project Scientist and the Science Working Team, is in charge of translating the high level mission science objectives into a low level pointing and operations plan. We present here the high-level science planning process adopted during the comet escort phase. We describe the main science objectives addressed along the mission lifetime, the different groups involved in the science planning, and the approach followed to translate those requirements into a viable and scientifically valid operations plan. Finally, we describe how the science planning scheme has evolved since arrival at the comet to react to the unexpected environment, largely reducing the planning lead times.

  15. Tracking the Short Term Planning (STP) Development Process

    Science.gov (United States)

    Price, Melanie; Moore, Alexander

    2010-01-01

    Part of the National Aeronautics and Space Administration?s mission is to pioneer the future in space exploration, scientific discovery and aeronautics research is enhanced by discovering new scientific tools to improve life on earth. Sequentially, to successfully explore the unknown, there has to be a planning process that organizes certain events in the right priority. Therefore, the planning support team has to continually improve their processes so the ISS Mission Operations can operate smoothly and effectively. The planning support team consists of people in the Long Range Planning area that develop timelines that includes International Partner?s Preliminary STP inputs all the way through to publishing of the Final STP. Planning is a crucial part of the NASA community when it comes to planning the astronaut?s daily schedule in great detail. The STP Process is in need of improvement, because of the various tasks that are required to be broken down in order to get the overall objective of developing a Final STP done correctly. Then a new project came along in order to store various data in a more efficient database. "The SharePoint site is a Web site that provides a central storage and collaboration space for documents, information, and ideas."

  16. 242-A Campaign 99-1 process control plan

    Energy Technology Data Exchange (ETDEWEB)

    LE, E.Q.

    1999-08-25

    242-A Evaporator 99-1 will process approximately one million gallons of waste from tank 102-AW in June 1999. The process control Plan provides a general description of activities, which will occur during 242-A Evaporator Campaign 99-1 and to document analyses conducted to demonstrate that 102-AW waste is acceptable for processing. Predict is a registered trademark of Risk Decisions England Corporation, United Kingdom.

  17. Conservation Action Planning: Lessons learned from the St. Marys River watershed biodiversity conservation planning process

    Science.gov (United States)

    Patterson, Tamatha A.; Grundel, Ralph

    2014-01-01

    Conservation Action Planning (CAP) is an adaptive management planning process refined by The Nature Conservancy (TNC) and embraced worldwide as the Open Standards for the Practice of Conservation. The CAP process facilitates open, multi-institutional collaboration on a common conservation agenda through organized actions and quantified results. While specifically designed for conservation efforts, the framework is adaptable and flexible to multiple scales and can be used for any collaborative planning effort. The CAP framework addresses inception; design and development of goals, measures, and strategies; and plan implementation and evaluation. The specific components of the CAP include defining the project scope and conservation targets; assessing the ecological viability; ascertaining threats and surrounding situation; identifying opportunities and designing strategies for action; and implementing actions and monitoring results. In 2007, TNC and a multidisciplinary graduate student team from the University of Michigan's School of Natural Resources and Environment initiated a CAP for the St. Marys River, the connecting channel between Lake Superior and Lake Huron, and its local watershed. The students not only gained experience in conservation planning, but also learned lessons that notably benefited the CAP process and were valuable for any successful collaborative effort—a dedicated core team improved product quality, accelerated the timeline, and provided necessary support for ongoing efforts; an academic approach in preparation for engagement in the planning process brought applicable scientific research to the forefront, enhanced workshop facilitation, and improved stakeholder participation; and early and continuous interactions with regional stakeholders improved cooperation and built a supportive network for collaboration.

  18. Process development work plan for waste feed delivery system

    International Nuclear Information System (INIS)

    Papp, I.G.

    1998-01-01

    This work plan defines the process used to develop project definition for Waste Feed Delivery (WFD). Project definition provides the direction for development of definitive design media required for the ultimate implementation of operational processing hardware and software. Outlines for the major deliverables are attached as appendices. The implementation of hardware and software will accommodate requirements for safe retrieval and delivery of waste currently stored in Hanford's underground storage tanks. Operations and maintenance ensure the availability of systems, structures, and components for current and future planned operations within the boundary of the Tank Waste Remediation System (TWRS) authorization basis

  19. Associations between therapy skills and patient experiences of change processes in cognitive behavioral therapy for psychosis.

    Science.gov (United States)

    Wittorf, Andreas; Jakobi-Malterre, Ute E; Beulen, Silke; Bechdolf, Andreas; Müller, Bernhard W; Sartory, Gudrun; Wagner, Michael; Wiedemann, Georg; Wölwer, Wolfgang; Herrlich, Jutta; Klingberg, Stefan

    2013-12-30

    Despite the promising findings in relation to the efficacy of cognitive behavioral therapy for psychosis (CBTp), little attention has been paid to the therapy skills necessary to deliver CBTp and to the influence of such skills on processes underlying therapeutic change. Our study investigated the associations between general and technical therapy skills and patient experiences of change processes in CBTp. The study sample consisted of 79 patients with psychotic disorders who had undergone CBTp. We randomly selected one tape-recorded therapy session from each of the cases. General and technical therapy skills were assessed by the Cognitive Therapy Scale for Psychosis. The Bern Post Session Report for Patients was applied to measure patient experiences of general change processes in the sense of Grawe's psychological therapy. General skills, such as feedback and understanding, explained 23% of the variance of patients' self-esteem experience, but up to 10% of the variance of mastery, clarification, and contentment experiences. The technical skill of guided discovery consistently showed negative associations with patients' alliance, contentment, and control experiences. The study points to the importance of general therapy skills for patient experiences of change processes in CBTp. Some technical skills, however, could detrimentally affect the therapeutic relationship. © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial

    Science.gov (United States)

    Campbell, Melissa; Decker, Kathleen P.; Kruk, Kerry; Deaver, Sarah P.

    2016-01-01

    This randomized controlled trial was designed to determine if art therapy in conjunction with Cognitive Processing Therapy (CPT) was more effective for reducing symptoms of combat posttraumatic stress disorder (PTSD) than CPT alone. Veterans (N = 11) were randomized to receive either individual CPT, or individual CPT in conjunction with individual…

  1. Dose planning and dose delivery in radiation therapy

    International Nuclear Information System (INIS)

    Knoeoes, T.

    1991-01-01

    A method has been developed for calibration of CT-numbers to volumetric electron density distributions using tissue substitutes of known elemental composition and experimentally determined electron density. This information have been used in a dose calculation method based on photon and electron interaction processes. The method utilizes a convolution integral between the photon fluence matrix and dose distribution kernels. Inhomogeneous media are accounted for using the theorems of Fano and O'Connor for scaling dose distribution kernels in proportion to electron density. For clinical application of a calculated dose plan, a method for prediction of accelerator output have been developed. The methods gives the number of monitor units that has to be given to obtain a certain absorbed dose to a point inside an irregular, inhomogeneous object. The method for verification of dose distributions outlined in this study makes it possible to exclude the treatment related variance contributions, making an objective evaluation of dose calculations with experiments feasible. The methods for electron density determination, dose calculation and prediction of accelerator output discussed in this study will all contribute to an increased accuracy in the mean absorbed dose to the target volume. However, a substantial gain in the accuracy for the spatial absorbed dose distribution will also follow, especially using CT for mapping of electron density together with the dose calculation algorithm. (au)

  2. Fish Processed Production Planning Using Integer Stochastic Programming Model

    Science.gov (United States)

    Firmansyah, Mawengkang, Herman

    2011-06-01

    Fish and its processed products are the most affordable source of animal protein in the diet of most people in Indonesia. The goal in production planning is to meet customer demand over a fixed time horizon divided into planning periods by optimizing the trade-off between economic objectives such as production cost and customer satisfaction level. The major decisions are production and inventory levels for each product and the number of workforce in each planning period. In this paper we consider the management of small scale traditional business at North Sumatera Province which performs processing fish into several local seafood products. The inherent uncertainty of data (e.g. demand, fish availability), together with the sequential evolution of data over time leads the production planning problem to a nonlinear mixed-integer stochastic programming model. We use scenario generation based approach and feasible neighborhood search for solving the model. The results which show the amount of each fish processed product and the number of workforce needed in each horizon planning are presented.

  3. Innovation Process Planning Model in the Bpmn Standard

    Directory of Open Access Journals (Sweden)

    Jurczyk-Bunkowska Magdalena

    2013-12-01

    Full Text Available The aim of the article is to show the relations in the innovation process planning model. The relations argued here guarantee the stable and reliable way to achieve the result in the form of an increased competitiveness by a professionally directed development of the company. The manager needs to specify the effect while initiating the realisation of the process, has to be achieved this by the system of indirect goals. The original model proposed here shows the standard of dependence between the plans of the fragments of the innovation process which make up for achieving its final goal. The relation in the present article was shown by using the standard Business Process Model and Notation. This enabled the specification of interrelations between the decision levels at which subsequent fragments of the innovation process are planned. This gives the possibility of a better coordination of the process, reducing the time needed for the achievement of its effect. The model has been compiled on the basis of the practises followed in Polish companies. It is not, however, the reflection of these practises, but rather an idealised standard of proceedings which aims at improving the effectiveness of the management of innovations on the operational level. The model shown could be the basis of the creation of systems supporting the decision making, supporting the knowledge management or those supporting the communication in the innovation processes.

  4. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan.

    Science.gov (United States)

    Christensen, Dale B; Roth, Mary; Trygstad, Troy; Byrd, John

    2007-01-01

    To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees. Before/after design with two control groups. Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005. 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups. Pharmacist-conducted MTM reviews for volunteering patients. Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services). Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service. A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease

  5. Decision Driven Scenario Planning for Process-Level Interventions

    Science.gov (United States)

    Chemarck, Thomas J.; Payne, Tiffani D.

    2005-01-01

    This article builds on previous work that classified types of scenario planning as effective or relevant for particular situations, by adding consideration for levels within the organization. In addition, the argument is built for using a particular form of scenarios to anticipate or explore process level problems and outcomes. The problem of…

  6. Strategic investment of embodied energy during the architectural planning process

    NARCIS (Netherlands)

    Hildebrand, L.

    2014-01-01

    It is an interesting time in the building industry; for more than one decade sustainability is a planning parameter that essentially impacts construction related processes. Reduction of operational energy was initiated after the oil crisis and changed the type of construction by including heat

  7. Process planning for a modular component placement system

    NARCIS (Netherlands)

    Zijm, Willem H.M.; van Harten, Aart

    1993-01-01

    This paper discusses the design of a hierarchically structured process planning system for a printed circuit board assembly line. Basically, the assembly system consists of a series of independently operating placement modules, connected by a carrierless conveyor system. Both the modules and the

  8. City Labs as vehicles for innovation in urban planning processes

    NARCIS (Netherlands)

    Kemp, René; Scholl, Christian

    2016-01-01

    This paper assesses the role of urban experiments for local planning processes through a case-based analysis of the city lab of Maastricht. In conjunction with this, the article offers three contributions, as additional elements. Firstly, the paper develops a set of defining characteristics of city

  9. An assessment of budget planning processes and the impact of ...

    African Journals Online (AJOL)

    The purpose of this study is to investigate budget planning processes and the impact of funds utilization on the management of public secondary schools in Plateau State. One hundred and two principles participated in the study. A survey research designs was adopted. Findings from the data collected revealed that ...

  10. The essence of process-experiential/emotion-focused therapy.

    Science.gov (United States)

    Elliott, Robert; Greenberg, Leslie S

    2007-01-01

    Process-Experiential/Emotion-Focused Therapy (PE-EFT) is an empirically-supported, neo-humanistic approach that integrates and updates person-centered, Gestalt, and existential therapies. In this article, we first present what we see as PE-EFT's five essential features, namely neo-humanistic values, process-experiential emotion theory, person-centered but process-guiding relational stance, therapist exploratory response style, and marker-guided task strategy. Next, we summarize six treatment principles that guide therapists in carrying out this therapy: achieving empathic attunement, fostering an empathic, caring therapeutic bond, facilitating task collaboration, helping the client process experience appropriately to the task, supporting completion of key client tasks, and fostering client development and empowerment. In general, PE-EFT is an approach that seeks to help clients transform contradictions and impasses into wellsprings for growth.

  11. The Importance of Group Process in Gestalt Therapy.

    Science.gov (United States)

    Korb, Margaret Patton; Themis, Sharon

    1980-01-01

    Discusses the Gestalt therapy group process and its roots in theory and therapeutic orientation. Indicates that the process itself, particularly the role of the therapist, is a key factor in the intensity and power of the group experience for the participants. (Author)

  12. 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

  13. Dissociative identity disorder and the process of couple therapy.

    Science.gov (United States)

    Macintosh, Heather B

    2013-01-01

    Couple therapy in the context of dissociative identity disorder (DID) has been neglected as an area of exploration and development in the couple therapy and trauma literature. What little discussion exists focuses primarily on couple therapy as an adjunct to individual therapy rather than as a primary treatment for couple distress and trauma. Couple therapy researchers have begun to develop adaptations to provide effective support to couples dealing with the impact of childhood trauma in their relationships, but little attention has been paid to the specific and complex needs of DID patients in couple therapy (H. B. MacIntosh & S. Johnson, 2008 ). This review and case presentation explores the case of "Lisa," a woman diagnosed with DID, and "Don," her partner, and illustrates the themes of learning to communicate, handling conflicting needs, responding to child alters, and addressing sexuality and education through their therapy process. It is the hope of the author that this discussion will renew interest in the field of couple therapy in the context of DID, with the eventual goal of developing an empirically testable model of treatment for couples.

  14. Local Authorities Participation in the Tourism Planning Process

    Directory of Open Access Journals (Sweden)

    Ali SELCUK CAN

    2014-02-01

    Full Text Available The aim of this article is to explore the weaknesses and strengths of local authorities in terms of their participation in the tourism planning process in Turkey. A two-page questionnaire was applied, along with structured interviews with 71 administrators of metropolitan, provincial, and district authorities, between January 1 and September 31, 2011. The findings of the survey suggest that tourism planning responsibilities should be devolved to local authorities. Local authorities do not extensively participate in tourism planning at present because of inadequate budgeting and tourism allocation facilities, insufficient cooperation among stakeholders, and a domination of central administration traditions. Causes of insufficient participation in tourism planning statistically differ among local authorities, in terms of insufficient realizations of the importance of tourism planning by stakeholders, and public land allocation for the purpose of tourism. On the other hand, there is a statistically significant difference between local authorities that have a tourism master plan and those who do not, in terms of a lack of educational opportunities for planners.

  15. 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.

  16. Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Harding, R., E-mail: ruth.harding2@wales.nhs.uk [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF, United Kingdomand Abertawe Bro Morgannwg University Health Board, Medical Physics and Clinical Engineering, Swansea SA2 8QA (United Kingdom); Trnková, P.; Lomax, A. J. [Paul Scherrer Institute, Centre for Proton Therapy, Villigen 5232 (Switzerland); Weston, S. J.; Lilley, J.; Thompson, C. M.; Cosgrove, V. P. [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF (United Kingdom); Short, S. C. [Leeds Institute of Molecular Medicine, Oncology and Clinical Research, Leeds LS9 7TF, United Kingdomand St James’s Institute of Oncology, Oncology, Leeds LS9 7TF (United Kingdom); Loughrey, C. [St James’s Institute of Oncology, Oncology, Leeds LS9 7TF (United Kingdom); Thwaites, D. I. [St James’s Institute of Oncology, Medical Physics and Engineering, Leeds LS9 7TF, United Kingdomand Institute of Medical Physics, School of Physics, University of Sydney, Sydney NSW 2006 (Australia)

    2014-11-01

    Purpose: Base of skull meningioma can be treated with both intensity modulated radiation therapy (IMRT) and spot scanned proton therapy (PT). One of the main benefits of PT is better sparing of organs at risk, but due to the physical and dosimetric characteristics of protons, spot scanned PT can be more sensitive to the uncertainties encountered in the treatment process compared with photon treatment. Therefore, robustness analysis should be part of a comprehensive comparison between these two treatment methods in order to quantify and understand the sensitivity of the treatment techniques to uncertainties. The aim of this work was to benchmark a spot scanning treatment planning system for planning of base of skull meningioma and to compare the created plans and analyze their robustness to setup errors against the IMRT technique. Methods: Plans were produced for three base of skull meningioma cases: IMRT planned with a commercial TPS [Monaco (Elekta AB, Sweden)]; single field uniform dose (SFUD) spot scanning PT produced with an in-house TPS (PSI-plan); and SFUD spot scanning PT plan created with a commercial TPS [XiO (Elekta AB, Sweden)]. A tool for evaluating robustness to random setup errors was created and, for each plan, both a dosimetric evaluation and a robustness analysis to setup errors were performed. Results: It was possible to create clinically acceptable treatment plans for spot scanning proton therapy of meningioma with a commercially available TPS. However, since each treatment planning system uses different methods, this comparison showed different dosimetric results as well as different sensitivities to setup uncertainties. The results confirmed the necessity of an analysis tool for assessing plan robustness to provide a fair comparison of photon and proton plans. Conclusions: Robustness analysis is a critical part of plan evaluation when comparing IMRT plans with spot scanned proton therapy plans.

  17. Fast planning program for the interstitial and intracavitary 192-Ir afterloading therapy

    International Nuclear Information System (INIS)

    Krieger, H.

    1986-01-01

    A fast on-line planning program is presented running on a mobile computer and serving for the planning of dose distributions in interstitial and intracavitary afterloading therapy. The requirements that have to be fulfilled by such system as well as the execution of the program are described. (orig.) [de

  18. Treatment planning for conformation therapy using a multi-leaf collimator

    International Nuclear Information System (INIS)

    Boesecke, R.; Doll, J.; Bauer, B.; Schlegel, W.; Pastyr, O.; Lorenz, W.J.

    1988-01-01

    In high energy photon therapy an optimum dose distribution is achieved with an irradiation from several directions, thus adapting the field shape to the target volume. Some methods of irradiation planning using these techniques are presented. The result of such a treatment planning is demonstrated. (orig.) [de

  19. Strategic Planning Process and Organizational Structure: Impacts, Confluence and Similarities

    Directory of Open Access Journals (Sweden)

    Dyogo Felype Neis

    2017-01-01

    Full Text Available This article aims to analyze the relationship between the strategic planning process and organizational structure in the reality of a complex organization: the Public Prosecutor’s Office of Santa Catarina (MPSC. The research is set by the single case study research strategy and data were collected through the following instruments: bibliographical research, documentary research, semi-structured interviews and systematic observation. The conclusion indicates that the phases of the strategic planning process influence and are influenced by the elements of the organizational structure and highlights the confluences, the impacts and similarities between the stages of formulation and implementation of the strategic process with the various constituent elements of the organizational structure.

  20. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Willegaignon, J., E-mail: j.willegaignon@gmail.com; Sapienza, M. T.; Coura-Filho, G. B.; Buchpiguel, C. A. [Cancer Institute of São Paulo State (ICESP), Clinical Hospital, School of Medicine, University of São Paulo, São Paulo 01246-000 (Brazil); Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, Sao Paulo 01246-000 (Brazil); Watanabe, T. [Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, São Paulo 01246-000 (Brazil); Traino, A. C. [Unit of Medical Physics, Azienda Ospedaliero-Universitaria Pisana, Pisa 56126 (Italy)

    2014-01-15

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurements were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG and A

  1. Spinal metastases: multimodality imaging in diagnosis and stereotactic body radiation therapy planning.

    Science.gov (United States)

    Jabehdar Maralani, Pejman; Lo, Simon S; Redmond, Kristin; Soliman, Hany; Myrehaug, Sten; Husain, Zain A; Heyn, Chinthaka; Kapadia, Anish; Chan, Aimee; Sahgal, Arjun

    2017-01-01

    Due to increased effectiveness of cancer treatments and increasing survival rates, metastatic disease has become more frequent compared to the past, with the spine being the most common site of bony metastases. Diagnostic imaging is an integral part of screening, diagnosis and follow-up of spinal metastases. In this article, we review the principles of multimodality imaging for tumor detection with respect to their value for diagnosis and stereotactic body radiation therapy planning for spinal metastases. We will also review the current international consensus agreement for stereotactic body radiation therapy planning, and the role of imaging in achieving the best possible treatment plan.

  2. Process evaluation of discharge planning implementation in healthcare using normalization process theory

    OpenAIRE

    Nordmark, Sofi; Zingmark, Karin; Lindberg, Inger

    2016-01-01

    Background Discharge planning is a care process that aims to secure the transfer of care for the patient at transition from home to the hospital and back home. Information exchange and collaboration between care providers are essential, but deficits are common. A wide range of initiatives to improve the discharge planning process have been developed and implemented for the past three decades. However, there are still high rates of reported medical errors and adverse events related to failures...

  3. Review of 3D image data calibration for heterogeneity correction in proton therapy treatment planning

    International Nuclear Information System (INIS)

    Zhu, Jiahua; Penfold, Scott N.

    2016-01-01

    Correct modelling of the interaction parameters of patient tissues is of vital importance in proton therapy treatment planning because of the large dose gradients associated with the Bragg peak. Different 3D imaging techniques yield different information regarding these interaction parameters. Given the rapidly expanding interest in proton therapy, this review is written to make readers aware of the current challenges in accounting for tissue heterogeneities and the imaging systems that are proposed to tackle these challenges. A summary of the interaction parameters of interest in proton therapy and the current and developmental 3D imaging techniques used in proton therapy treatment planning is given. The different methods to translate the imaging data to the interaction parameters of interest are reviewed and a summary of the implementations in several commercial treatment planning systems is presented.

  4. 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

  5. Dyadic Coping in Couple Therapy Process: An Exploratory Study.

    Science.gov (United States)

    Margola, Davide; Donato, Silvia; Accordini, Monica; Emery, Robert E; Snyder, Douglas K

    2017-07-10

    This study aimed at moving beyond previous research on couple therapy efficacy by examining moment-by-moment proximal couple and therapist interactions as well as final treatment outcomes and their reciprocal association. Seven hundred four episodes of dyadic coping within 56 early therapy sessions, taken from 28 married couples in treatment, were intensively analyzed and processed using a mixed-methods software (T-LAB). Results showed that negative dyadic coping was self-perpetuating, and therapists tended to passively observe the negative couple interaction; on the contrary, positive dyadic coping appeared to require a therapist's intervention to be maintained, and successful interventions mainly included information gathering as well as interpreting. Couples who dropped out of treatment were not actively engaged from the outset of therapy, and they used more negative dyadic coping, whereas couples who successfully completed treatment showed more positive dyadic coping very early in therapy. Results highlight the role of therapist action and control as critical to establishing rapport and credibility in couple therapy and suggest that dyadic coping patterns early in therapy may contribute to variable treatment response. © 2017 Family Process Institute.

  6. Intercenter validation of a knowledge based model for automated planning of volumetric modulated arc therapy for prostate cancer. The experience of the German RapidPlan Consortium.

    Directory of Open Access Journals (Sweden)

    Carolin Schubert

    Full Text Available To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy applied to prostate cancer in a multicentric cooperative group. The RapidPlan (RP knowledge-based engine was tested for the planning of Volumetric modulated arc therapy with RapidArc on prostate cancer patients. The study was conducted in the frame of the German RapidPlan Consortium (GRC.43 patients from one institute of the GRC were used to build and train a RP model. This was further shared with all members of the GRC plus an external site from a different country to increase the heterogeneity of the patient's sampling. An in silico multicentric validation of the model was performed at planning level by comparing RP against reference plans optimized according to institutional procedures. A total of 60 patients from 7 institutes were used.On average, the automated RP based plans resulted fully consistent with the manually optimised set with a modest tendency to improvement in the medium-to-high dose region. A per-site stratification allowed to identify different patterns of performance of the model with some organs at risk resulting better spared with the manual or with the automated approach but in all cases the RP data fulfilled the clinical acceptability requirements. Discrepancies in the performance were due to different contouring protocols or to different emphasis put in the optimization of the manual cases.The multicentric validation demonstrated that it was possible to satisfactorily optimize with the knowledge based model patients from all participating centres. In the presence of possibly significant differences in the contouring protocols, the automated plans, though acceptable and fulfilling the benchmark goals, might benefit from further fine tuning of the constraints. The study demonstrates that, at least for the case of prostate cancer patients, it is possibile to share models among different clinical institutes in a cooperative

  7. Art Therapy and Cognitive Processing Therapy for Combat-Related PTSD: A Randomized Controlled Trial

    Science.gov (United States)

    Campbell, Melissa; Decker, Kathleen P.; Kruk, Kerry; Deaver, Sarah P.

    2018-01-01

    This randomized controlled trial was designed to determine if art therapy in conjunction with Cognitive Processing Therapy (CPT) was more effective for reducing symptoms of combat posttraumatic stress disorder (PTSD) than CPT alone. Veterans (N = 11) were randomized to receive either individual CPT, or individual CPT in conjunction with individual art therapy. PTSD Checklist–Military Version and Beck Depression Inventory–II scores improved with treatment in both groups with no significant difference in improvement between the experimental and control groups. Art therapy in conjunction with CPT was found to improve trauma processing and veterans considered it to be an important part of their treatment as it provided healthy distancing, enhanced trauma recall, and increased access to emotions. PMID:29332989

  8. A treatment planning approach to spatially fractionated megavoltage grid therapy for bulky lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Costlow, Heather N. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Zhang, Hualin, E-mail: hzhang@nmh.org [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, Chicago, IL (United States); Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

    2014-10-01

    The purpose of this study was to explore the treatment planning methods of spatially fractionated megavoltage grid therapy for treating bulky lung tumors using multileaf collimator (MLC). A total of 5 patients with lung cancer who had gross tumor volumes ranging from 277 to 635 cm{sup 3} were retrospectively chosen for this study. The tumors were from 6.5 to 9.6 cm at shortest dimension. Several techniques using either electronic compensation or intensity-modulated radiation therapy (IMRT) were used to create a variety of grid therapy plans on the Eclipse treatment planning system. The dose prescription point was calculated to the volume, and a dose of 20 Gy with 6-MV/15-MV beams was used in each plan. The dose-volume histogram (DVH) curves were obtained to evaluate dosimetric characteristics. In addition, DVH curves from a commercially available cerrobend grid collimator were also used for comparison. The linear-quadratic radiobiological response model was used to assess therapeutic ratios (TRs) and equivalent uniform doses (EUD) for all generated plans. A total of 6 different grid therapy plans were created for each patient. Overall, 4 plans had different electronic compensation techniques: Ecomps-Tubes, Ecomps-Circles, Ecomps-Squares, and Ecomps-Weave; the other 2 plans used IMRT and IMRT-Weave techniques. The DVH curves and TRs demonstrated that these MLC-based grid therapy plans can achieve dosimetric properties very similar to those of the cerrobend grid collimator. However, the MLC-based plans have larger EUDs than those with the cerrobend grid collimator. In addition, the field shaping can be performed for targets of any shape in MLC-based plans. Thus, they can deliver a more conformal dose to the targets and spare normal structures better than the cerrobend grid collimator can. The plans generated by the MLC technique demonstrated the advantage over the standard cerrobend grid collimator on accommodating targets and sparing normal structures. Overall, 6

  9. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...... determination of an optimal dwell-time sequence for a train of seeds that deliver ratiation while stepping through the vessel lesion. The results illustrate the advantage of this strategy over the common approach of delivering radiation by positioning a single train of seeds along the whole lesion....

  10. 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

  11. APPLICATION OF EXPERIMENTS PLANNING IN THE MINERAL PROCESSING

    OpenAIRE

    Slavka Pfaff; Branko Salopek

    2004-01-01

    Statistical design of experiments deals with methods of planning the experiment so that appropriate data are collected, which may be analyzed by statistical methods resulting in objective and valid conclusions. These methods extend over two closely related experimental problems: the design of the experiment and the statistical analysis of the data. Moreover, designed experiments maintain a balance between statistical accuracy and the cost of the experimental process. Factorial designs are use...

  12. Monte Carlo based treatment planning systems for Boron Neutron Capture Therapy in Petten, The Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Nievaart, V A; Daquino, G G; Moss, R L [JRC European Commission, PO Box 2, 1755ZG Petten (Netherlands)

    2007-06-15

    Boron Neutron Capture Therapy (BNCT) is a bimodal form of radiotherapy for the treatment of tumour lesions. Since the cancer cells in the treatment volume are targeted with {sup 10}B, a higher dose is given to these cancer cells due to the {sup 10}B(n,{alpha}){sup 7}Li reaction, in comparison with the surrounding healthy cells. In Petten (The Netherlands), at the High Flux Reactor, a specially tailored neutron beam has been designed and installed. Over 30 patients have been treated with BNCT in 2 clinical protocols: a phase I study for the treatment of glioblastoma multiforme and a phase II study on the treatment of malignant melanoma. Furthermore, activities concerning the extra-corporal treatment of metastasis in the liver (from colorectal cancer) are in progress. The irradiation beam at the HFR contains both neutrons and gammas that, together with the complex geometries of both patient and beam set-up, demands for very detailed treatment planning calculations. A well designed Treatment Planning System (TPS) should obey the following general scheme: (1) a pre-processing phase (CT and/or MRI scans to create the geometric solid model, cross-section files for neutrons and/or gammas); (2) calculations (3D radiation transport, estimation of neutron and gamma fluences, macroscopic and microscopic dose); (3) post-processing phase (displaying of the results, iso-doses and -fluences). Treatment planning in BNCT is performed making use of Monte Carlo codes incorporated in a framework, which includes also the pre- and post-processing phases. In particular, the glioblastoma multiforme protocol used BNCT{sub r}tpe, while the melanoma metastases protocol uses NCTPlan. In addition, an ad hoc Positron Emission Tomography (PET) based treatment planning system (BDTPS) has been implemented in order to integrate the real macroscopic boron distribution obtained from PET scanning. BDTPS is patented and uses MCNP as the calculation engine. The precision obtained by the Monte Carlo

  13. Early environmental planning: A process for power line corridor selection

    International Nuclear Information System (INIS)

    Haagenstad, T.; Bare, C.M.

    1998-01-01

    Los Alamos National Laboratory (LANL) conducted an environmental planning study in the fall of 1997 to help determine the best alternative for upgrading the Laboratory's electrical power system. Alternatives considered included an on-site power generation facility and two corridors for a 10-mile-long 115-kV power line. This planning process was conducted prior to the formal National Environmental Policy Act (NEPA) review. The goals were to help select the best proposed action, to recommend modifications and mitigation measures for each alternative for a more environmentally sound project, and to avoid potential delays once the formal Department of Energy review process began. Significant constraints existed from a planning perspective, including operational issues such as existing outdoor high explosives testing areas, as well as environmental issues including threatened and endangered species habitats, multiple archeological sites, contaminated areas, and aesthetics. The study had to be completed within 45 days to meet project schedule needs. The process resulted in a number of important recommendations. While the construction and operation of the on-site power generation facility could have minimal environmental impacts, the need for a new air quality permit would create severe cost and schedule constraints for the project. From an environmental perspective, construction and operation of a power line within either corridor was concluded to be a viable alternative. However, impacts with either corridor would have to be reduced through specific recommended alignment modifications and mitigation measures

  14. Fully Automated Volumetric Modulated Arc Therapy Plan Generation for Prostate Cancer Patients

    International Nuclear Information System (INIS)

    Voet, Peter W.J.; Dirkx, Maarten L.P.; Breedveld, Sebastiaan; Al-Mamgani, Abrahim; Incrocci, Luca; Heijmen, Ben J.M.

    2014-01-01

    Purpose: To develop and evaluate fully automated volumetric modulated arc therapy (VMAT) treatment planning for prostate cancer patients, avoiding manual trial-and-error tweaking of plan parameters by dosimetrists. Methods and Materials: A system was developed for fully automated generation of VMAT plans with our commercial clinical treatment planning system (TPS), linked to the in-house developed Erasmus-iCycle multicriterial optimizer for preoptimization. For 30 randomly selected patients, automatically generated VMAT plans (VMAT auto ) were compared with VMAT plans generated manually by 1 expert dosimetrist in the absence of time pressure (VMAT man ). For all treatment plans, planning target volume (PTV) coverage and sparing of organs-at-risk were quantified. Results: All generated plans were clinically acceptable and had similar PTV coverage (V 95%  > 99%). For VMAT auto and VMAT man plans, the organ-at-risk sparing was similar as well, although only the former plans were generated without any planning workload. Conclusions: Fully automated generation of high-quality VMAT plans for prostate cancer patients is feasible and has recently been implemented in our clinic

  15. Participative Facility Planning for Obstetrical and Neonatal Care Processes: Beginning of Life Process

    Directory of Open Access Journals (Sweden)

    Jori Reijula

    2016-01-01

    Full Text Available Introduction. Old hospitals may promote inefficient patient care processes and safety. A new, functionally planned hospital presents a chance to create an environment that supports streamlined, patient-centered healthcare processes and adapts to users’ needs. This study depicts the phases of a facility planning project for pregnant women and newborn care processes (beginning of life process at Turku University Hospital. Materials and Methods. Project design reports and meeting documents were utilized to assess the beginning of life process as well as the work processes of the Women’s and Children’s Hospital. Results. The main elements of the facility design (FD project included rigorous preparation for the FD phase, functional planning throughout the FD process, and setting key values: (1 family-centered care, (2 Lean thinking and Lean tools as the framework for the FD process, (3 safety, and (4 cooperation. Conclusions. A well-prepared FD project with sufficient insight into functional planning, Lean thinking, and user-centricity seemed to facilitate the actual FD process. Although challenges occurred, the key values were not forgone and were successfully incorporated into the new hospital building.

  16. The Impact of Process Observers on Interpersonal Group Therapy

    Science.gov (United States)

    Hogan, Christopher; Harris, Rafael S.; Cassidy, Jennie M.

    2006-01-01

    The impact of including process observers (all master's-level trainees) and their notes on the outcome of interpersonal group therapy at a university counseling center was investigated. For a total of four groups, one method per group of delivering the notes to the participants was designated and assessed for perceived differences. A self-report…

  17. A detailed evaluation of TomoDirect 3DCRT planning for whole-breast radiation therapy

    International Nuclear Information System (INIS)

    Fields, Emma C.; Rabinovitch, Rachel; Ryan, Nicole E.; Miften, Moyed; Westerly, David C.

    2013-01-01

    The goal of this work was to develop planning strategies for whole-breast radiotherapy (WBRT) using TomoDirect three-dimensional conformal radiation therapy (TD-3DCRT) and to compare TD-3DCRT with conventional 3DCRT and TD intensity-modulated radiation therapy (TD-IMRT) to evaluate differences in WBRT plan quality. Computed tomography (CT) images of 10 women were used to generate 150 WBRT plans, varying in target structures, field width (FW), pitch, and number of beams. Effects on target and external maximum doses (EMD), organ-at-risk (OAR) doses, and treatment time were assessed for each parameter to establish an optimal planning technique. Using this technique, TD-3DCRT plans were generated and compared with TD-IMRT and standard 3DCRT plans. FW 5.0 cm with pitch = 0.250 cm significantly decreased EMD without increasing lung V20 Gy. Increasing number of beams from 2 to 6 and using an additional breast planning structure decreased EMD though increased lung V20 Gy. Changes in pitch had minimal effect on plan metrics. TD-3DCRT plans were subsequently generated using FW 5.0 cm, pitch = 0.250 cm, and 2 beams, with additional beams or planning structures added to decrease EMD when necessary. TD-3DCRT and TD-IMRT significantly decreased target maximum dose compared to standard 3DCRT. FW 5.0 cm with 2 to 6 beams or novel planning structures or both allow for TD-3DCRT WBRT plans with excellent target coverage and OAR doses. TD-3DCRT plans are comparable to plans generated using TD-IMRT and provide an alternative to conventional 3DCRT for WBRT

  18. North Dakota Metropolitan Planning Organization's peer exchange on introducing performance management into the MPO planning process : A TPCB Exchange

    Science.gov (United States)

    2013-06-19

    This report highlights key recommendations and noteworthy practices identified at the peer exchange on Introducing Performance Management into the Metropolitan Planning Organization (MPO) Planning Process held on June, 19, 2013 in Bismarck, Nor...

  19. Connected vehicle impacts on transportation planning technical memorandum #2 : connected vehicle planning processes and products and stakeholder roles and responsibilities.

    Science.gov (United States)

    2015-01-01

    The objective of this project, Connected Vehicle Impacts on Transportation Planning, is to comprehensively assess how connected vehicles should : be considered across the range of transportation planning processes and products developed by Stat...

  20. 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.

  1. 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

  2. Facility Effluent Monitoring Plan for the 325 Radiochemical Processing Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Shields, K.D.; Ballinger, M.Y.

    1999-04-02

    This Facility Effluent Monitoring Plan (FEMP) has been prepared for the 325 Building Radiochemical Processing Laboratory (RPL) at the Pacific Northwest National Laboratory (PNNL) to meet the requirements in DOE Order 5400.1, ''General Environmental Protection Programs.'' This FEMP has been prepared for the RPL primarily because it has a ''major'' (potential to emit >0.1 mrem/yr) emission point for radionuclide air emissions according to the annual National Emission Standards for Hazardous Air Pollutants (NESHAP) assessment performed. This section summarizes the airborne and liquid effluents and the inventory based NESHAP assessment for the facility. The complete monitoring plan includes characterization of effluent streams, monitoring/sampling design criteria, a description of the monitoring systems and sample analysis, and quality assurance requirements. The RPL at PNNL houses radiochemistry research, radioanalytical service, radiochemical process development, and hazardous and radioactive mixed waste treatment activities. The laboratories and specialized facilities enable work ranging from that with nonradioactive materials to work with picogram to kilogram quantities of fissionable materials and up to megacurie quantities of other radionuclides. The special facilities within the building include two shielded hot-cell areas that provide for process development or analytical chemistry work with highly radioactive materials and a waste treatment facility for processing hazardous, mixed radioactive, low-level radioactive, and transuranic wastes generated by PNNL activities.

  3. Clinical treatment planning for subjects undergoing boron neutron capture therapy at Harvard-MIT

    International Nuclear Information System (INIS)

    Zamenhof, R.G.; Palmer, M.R.; Buse, P.M.

    2001-01-01

    Treatment planning is a crucial component of the Harvard-MIT boron neutron capture therapy (BNCT) clinical trials. Treatment planning can be divided into five stages: (1) pre-planning, based on CT and MRI scans obtained when the subject arrives at the hospital and on assumed boron-10 distribution parameters; (2) subject set-up, or simulation, in the MITR-II medical therapy room to determine the boundary conditions for possible set-up configurations; (3) re-planning, following the subject simulation; (4) final localization of the subject in the medical therapy room for BNCT; and (5) final post facto recalculation of the doses delivered based on firm knowledge of the blood boron-10 concentration profiles and the neutron flux histories from precise online monitoring. The computer-assisted treatment planning is done using a specially written BNCT treatment planning code called MacNCTPLAN. The code uses the Los Alamos National Laboratory's Monte Carlo n-particle radiation transport code MCNPv.4b as the dose calculation engine and advanced anatomical model simulation based on an automatic evaluation of CT scan data. Results are displayed as isodose contours and dose-volume histograms, the latter correlated precisely with corresponding anatomical CT or MRI image planes. Examples of typical treatment planning scenarios will be presented. (author)

  4. Distributed approximation of Pareto surfaces in multicriteria radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Bokrantz, Rasmus

    2013-01-01

    We consider multicriteria radiation therapy treatment planning by navigation over the Pareto surface, implemented by interpolation between discrete treatment plans. Current state of the art for calculation of a discrete representation of the Pareto surface is to sandwich this set between inner and outer approximations that are updated one point at a time. In this paper, we generalize this sequential method to an algorithm that permits parallelization. The principle of the generalization is to apply the sequential method to an approximation of an inexpensive model of the Pareto surface. The information gathered from the model is sub-sequently used for the calculation of points from the exact Pareto surface, which are processed in parallel. The model is constructed according to the current inner and outer approximations, and given a shape that is difficult to approximate, in order to avoid that parts of the Pareto surface are incorrectly disregarded. Approximations of comparable quality to those generated by the sequential method are demonstrated when the degree of parallelization is up to twice the number of dimensions of the objective space. For practical applications, the number of dimensions is typically at least five, so that a speed-up of one order of magnitude is obtained. (paper)

  5. Distributed approximation of Pareto surfaces in multicriteria radiation therapy treatment planning.

    Science.gov (United States)

    Bokrantz, Rasmus

    2013-06-07

    We consider multicriteria radiation therapy treatment planning by navigation over the Pareto surface, implemented by interpolation between discrete treatment plans. Current state of the art for calculation of a discrete representation of the Pareto surface is to sandwich this set between inner and outer approximations that are updated one point at a time. In this paper, we generalize this sequential method to an algorithm that permits parallelization. The principle of the generalization is to apply the sequential method to an approximation of an inexpensive model of the Pareto surface. The information gathered from the model is sub-sequently used for the calculation of points from the exact Pareto surface, which are processed in parallel. The model is constructed according to the current inner and outer approximations, and given a shape that is difficult to approximate, in order to avoid that parts of the Pareto surface are incorrectly disregarded. Approximations of comparable quality to those generated by the sequential method are demonstrated when the degree of parallelization is up to twice the number of dimensions of the objective space. For practical applications, the number of dimensions is typically at least five, so that a speed-up of one order of magnitude is obtained.

  6. Forward-planned intensity modulated radiation therapy using a cobalt source: A dosimetric study in breast cancer

    Directory of Open Access Journals (Sweden)

    Savino Cilla

    2013-01-01

    Full Text Available This analysis evaluates the feasibility and dosimetric results of a simplified intensity-modulated radiotherapy (IMRT treatment using a cobalt-therapy unit for post-operative breast cancer. Fourteen patients were included. Three plans per patient were produced by a cobalt-60 source: A standard plan with two wedged tangential beams, a standard tangential plan optimized without the use of wedges and a plan based on the forward-planned "field-in-field" IMRT technique (Co-FinF where the dose on each of the two tangential beams was split into two different segments and the two segments weight was determined with an iterative process. For comparison purposes, a 6-MV photon standard wedged tangential treatment plan was generated. D mean , D 98% , D 2% , V 95% , V 107%, homogeneity, and conformity indices were chosen as parameters for comparison. Co-FinF technique improved the planning target volume dose homogeneity compared to other cobalt-based techniques and reduced maximum doses (D 2% and high-dose volume (V 110% . Moreover, it showed a better lung and heart dose sparing with respect to the standard approach. The higher dose homogeneity may encourage the adoption of accelerated-hypofractionated treatments also with the cobalt sources. This approach can promote the spread of breast conservative treatment in developing countries.

  7. A Guide in the Process of Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: Formulation

    Directory of Open Access Journals (Sweden)

    Nergis LAPSEKİLİ

    2012-03-01

    Full Text Available Introduction: The implementation of effective treatment depends on thorough understanding of disorder and its presentation. Treatment strategies must depend on the individual formulation of the patient. In this paper an Obsessive Compulsive Disorder(OCD patient treated with Cognitive Behavioral Therapy (CBT methods is presented. It is discussed that in the therapy, formulation is an ongoing dynamic process and necessarily required for the effectiveness of therapy. Case: Y.B. was 32 years old, single male patient graduated from university. He applied because of his obsessions and compulsions. He was diagnosed OCD after the psychiatric evaluation according to Diagnostic and Statistical Manual of Mental Disorders-IV(DSM-IV. In treatment following strategies were applied: 1 Cognitive restructuring of the thoughtaction- fusion, anxiety intolerance, overestimated threat appraisals, 2 exposure and response prevention techniques aimed to test if catastrophic expectations would occur. Discussion: When planning CBT for the treatment of OCD, the first and most important step is a good formulation created with the data obtained from a good evaluation process. Treatment planning in our case was planned on using cognitive restructing techniques for thought-action-fusion, anxiety intolerance and overestimated threat appraisals but the formulation was completed in the course of treatment when the patient could talk about his early experiences. As a result, the formulation is a roadmap that should be taken into consideration at every stage of therapy. Its presence is essential to reach the correct destination and it is a dynamic process needed to be updated according to the information from the patient

  8. Groundwater monitoring plan for the 300 Area process trenches

    International Nuclear Information System (INIS)

    Lindberg, J.W.; Chou, C.J.; Johnson, V.G.

    1995-01-01

    This document describes the groundwater monitoring program for the Hanford Site 300 Area Process Trenches (300 APT). The 300 APT are a Resource Conservation and Recovery Act of 1976 (RCRA) regulated unit. The 300 APT are included in the Dangerous Waste Portion of the Resource Conservation and Recovery Act Permit for the Treatment, Storage, and Disposal of Dangerous Waste, Permit No. WA890008967, and are subject to final-status requirements for groundwater monitoring. This document describes a compliance monitoring program for groundwater in the uppermost aquifer system at the 300 APT. This plan describes the 300 APT monitoring network, constituent list, sampling schedule, statistical methods, and sampling and analysis protocols that will be employed for the 300 APT. This plan will be used to meet groundwater monitoring requirements from the time the 300 APT becomes part of the Permit and through the postclosure care period until certification of final closure

  9. Putting ecology in environmental remediation: The strategic planning process

    International Nuclear Information System (INIS)

    Kapustka, L.A.; Williams, B.A.

    1991-01-01

    Traditional ecological studies have been conducted on many sites impacted by hazardous wastes. Yet in many cases, the information obtained has had limited value in the selection of remediation options. This paper discusses the importance of developing an ecological risk-based strategic plan to fulfill the scientific and social needs demanded in the remediation and restoration of hazardous waste sites. Ecological issues need to be considered seriously at the earliest phases of the scoping process. The decisions regarding selection of assessment endpoints and data quality objectives must be incorporated from the start to insure that cost-efficient and useful measurements are used. It is too late to develop effective ecological studies after the engineering decisions have been made. Strategic planning that integrates ecological concerns will minimize the frustration and the cost associated with clean up of hazardous waste sites and maximize the likelihood of successful site restoration

  10. Groundwater monitoring plan for the 300 Area process trenches

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, J.W.; Chou, C.J.; Johnson, V.G.

    1995-05-23

    This document describes the groundwater monitoring program for the Hanford Site 300 Area Process Trenches (300 APT). The 300 APT are a Resource Conservation and Recovery Act of 1976 (RCRA) regulated unit. The 300 APT are included in the Dangerous Waste Portion of the Resource Conservation and Recovery Act Permit for the Treatment, Storage, and Disposal of Dangerous Waste, Permit No. WA890008967, and are subject to final-status requirements for groundwater monitoring. This document describes a compliance monitoring program for groundwater in the uppermost aquifer system at the 300 APT. This plan describes the 300 APT monitoring network, constituent list, sampling schedule, statistical methods, and sampling and analysis protocols that will be employed for the 300 APT. This plan will be used to meet groundwater monitoring requirements from the time the 300 APT becomes part of the Permit and through the postclosure care period until certification of final closure.

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

    CERN Document Server

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

    2013-01-01

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

  12. nestor Guideline for Preservation Planning – a Process Model

    Directory of Open Access Journals (Sweden)

    Sabine Schrimpf

    2014-02-01

    Full Text Available The nestor guideline for preservation planning is the latest in a series of nestor publications. nestor is the German competence network for digital preservation and it offers all interested parties from the private and public domains the possibility to participate in working groups. The guideline for preservation planning is the result of such a working group, which discussed the conceptual and practical issues of implementing the OAIS Functional Entity “Preservation Planning”.The guideline describes a process model and offers some guidance on potential implementations. It integrates and builds on recognized community concepts like Significant Properties, the OAIS Designated Community, the National Archives of Australia’s Performance Model, the PREMIS concept of Intellectual Entities and Representations, and the PLANET’s approach to preservation planning. Furthermore, it introduces the concepts “intended use” (Nutzungsziele, “information type” (Informationstyp and “preservation group” (Erhaltungsgruppe. The purpose of these new categories is that information objects shall be grouped by information type (e.g., audio, video, text… and intended use (e.g., reading for pleasure, search for specific information… to preservation groups for automatic processing. Significant properties can then be derived for whole preservation groups. The file format alone is considered as not completely sufficient for such categorisation. Some exemplary implementation solutions of the new concepts are presented in an annex.The guideline takes into account that resources for preservation planning and preservation actions are limited and has therefore adopted 4 premises: adequacy, financial viability, automation, and authenticity of archived objects. Its pragmatic approach becomes apparent in the definition and explanation of these dimensions. The guideline is written from the point of view of representatives of memory institutions, i

  13. Image-assisted knowledge discovery and decision support in radiation therapy planning.

    Science.gov (United States)

    Liu, Brent J; Law, Maria Y Y; Documet, Jorge; Gertych, Arkadiusz

    2007-01-01

    The need for quantified knowledge and decision-support tools to handle complex radiation therapy (RT) imaging and informatics data is becoming steadily apparent. Lessons can be learned from current CAD applications in radiology. This paper proposes a methodology to develop this quantified knowledge and decision-support tools to facilitate RT treatment planning. The methodology is applied to cancer patient cases treated by intensity modulated radiation therapy (IMRT). The use of the "inverse treatment planning" and imaging intensive nature of IMRT allows for the development of such image-assisted tools for supporting decision-making thus providing better workflow efficiency and more precise dose predictions.

  14. Interobserver variability in radiation therapy plan output: Results of a single-institution study.

    Science.gov (United States)

    Berry, Sean L; Boczkowski, Amanda; Ma, Rongtao; Mechalakos, James; Hunt, Margie

    We investigated the sources of variability in radiation therapy treatment plan output between planners within a single institution. Forty treatment planners across 5 campuses of an institution created a plan on the same thoracic esophagus patient computed tomography scan and structure set. Plans were scored and ranked based on the planner's adherence to an ordered list of target dose coverage and normal tissue evaluation criteria. A runs test was used to identify whether any of the studied planner qualities influenced the ranking. Spearman rank correlation was used to investigate whether plan score correlated with years of experience or planned monitor units. The distribution of scores, ranging from 80.24 to 135.89, was negatively skewed (mean, 128.7; median, 131.5). No statistically significant relationship between plan score and campus (P = .193), job title (P = .174), previous outside experience (P = .611), or number of gantry angles (P = .156) was discovered. No statistical correlation between plan score and monitor unit or years of experience was found. Despite clear and established critical organ dose criteria and well-documented planning guidelines, planning variation still occurs, even among members of the same institution. Because plan consistency does not seem to significantly correlate with experience, career path, or campus, investigation into alternate methods beyond additional education and training to reduce this variation, such as knowledge-based planning or advanced optimization techniques, is necessary. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  15. How wilderness therapy works: an examination of the wilderness therapy process to treat adolescents with behavioral problems and addictions

    Science.gov (United States)

    Keith C. Russell; John C. Hendee; Dianne Phillips-Miller

    2000-01-01

    This paper summarizes findings from a detailed study of the processes employed by four leading wilderness therapy programs focusing on how wilderness therapy works, the kinds of behavioral problems to which it is commonly applied, expected outcomes and the role of wilderness in the intervention and treatment process (Russell, 1999). Wilderness therapy is an emerging...

  16. Adaptive planning using megavoltage fan-beam CT for radiation therapy with testicular shielding

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, Poonam [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); School of Advance Sciences, Vellore Institue of Technology University, Vellore, Tamil Nadu (India); Kozak, Kevin [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Tolakanahalli, Ranjini [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Ramasubramanian, V. [School of Advance Sciences, Vellore Institue of Technology University, Vellore, Tamil Nadu (India); Paliwal, Bhudatt R. [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin, Riverview Cancer Centre, Wisconsin Rapids, WI (United States); Welsh, James S. [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); Department of Medical Physics, University of Wisconsin, Madison, Madison, WI (United States); Rong, Yi, E-mail: rong@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin, Madison, Madison, WI (United States); University of Wisconsin, Riverview Cancer Centre, Wisconsin Rapids, WI (United States)

    2012-07-01

    This study highlights the use of adaptive planning to accommodate testicular shielding in helical tomotherapy for malignancies of the proximal thigh. Two cases of young men with large soft tissue sarcomas of the proximal thigh are presented. After multidisciplinary evaluation, preoperative radiation therapy was recommended. Both patients were referred for sperm banking and lead shields were used to minimize testicular dose during radiation therapy. To minimize imaging artifacts, kilovoltage CT (kVCT) treatment planning was conducted without shielding. Generous hypothetical contours were generated on each 'planning scan' to estimate the location of the lead shield and generate a directionally blocked helical tomotherapy plan. To ensure the accuracy of each plan, megavoltage fan-beam CT (MVCT) scans were obtained at the first treatment and adaptive planning was performed to account for lead shield placement. Two important regions of interest in these cases were femurs and femoral heads. During adaptive planning for the first patient, it was observed that the virtual lead shield contour on kVCT planning images was significantly larger than the actual lead shield used for treatment. However, for the second patient, it was noted that the size of the virtual lead shield contoured on the kVCT image was significantly smaller than the actual shield size. Thus, new adaptive plans based on MVCT images were generated and used for treatment. The planning target volume was underdosed up to 2% and had higher maximum doses without adaptive planning. In conclusion, the treatment of the upper thigh, particularly in young men, presents several clinical challenges, including preservation of gonadal function. In such circumstances, adaptive planning using MVCT can ensure accurate dose delivery even in the presence of high-density testicular shields.

  17. Nano-scale processes behind ion-beam cancer therapy

    Science.gov (United States)

    Surdutovich, Eugene; Garcia, Gustavo; Mason, Nigel; Solov'yov, Andrey V.

    2016-04-01

    This topical issue collates a series of papers based on new data reported at the third Nano-IBCT Conference of the COST Action MP1002: Nanoscale Insights into Ion Beam Cancer Therapy, held in Boppard, Germany, from October 27th to October 31st, 2014. The Nano-IBCT COST Action was launched in December 2010 and brought together more than 300 experts from different disciplines (physics, chemistry, biology) with specialists in radiation damage of biological matter from hadron-therapy centres, and medical institutions. This meeting followed the first and the second conferences of the Action held in October 2011 in Caen, France and in May 2013 in Sopot, Poland respectively. This conference series provided a focus for the European research community and has highlighted the pioneering research into the fundamental processes underpinning ion beam cancer therapy. Contribution to the Topical Issue "COST Action Nano-IBCT: Nano-scale Processes Behind Ion-Beam Cancer Therapy", edited by Andrey V. Solov'yov, Nigel Mason, Gustavo Garcia and Eugene Surdutovich.

  18. Improved Beam Angle Arrangement in Intensity Modulated Proton Therapy Treatment Planning for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Cao, Wenhua; Lim, Gino J.; Li, Yupeng; Zhu, X. Ronald; Zhang, Xiaodong

    2015-01-01

    Purpose: This study investigates potential gains of an improved beam angle arrangement compared to a conventional fixed gantry setup in intensity modulated proton therapy (IMPT) treatment for localized prostate cancer patients based on a proof of principle study. Materials and Methods: Three patients with localized prostate cancer retrospectively selected from our institution were studied. For each patient, IMPT plans were designed using two, three and four beam angles, respectively, obtained from a beam angle optimization algorithm. Those plans were then compared with ones using two lateral parallel-opposed beams according to the conventional planning protocol for localized prostate cancer adopted at our institution. Results: IMPT plans with two optimized angles achieved significant improvements in rectum sparing and moderate improvements in bladder sparing against those with two lateral angles. Plans with three optimized angles further improved rectum sparing significantly over those two-angle plans, whereas four-angle plans found no advantage over three-angle plans. A possible three-beam class solution for localized prostate patients was suggested and demonstrated with preserved dosimetric benefits because individually optimized three-angle solutions were found sharing a very similar pattern. Conclusions: This study has demonstrated the potential of using an improved beam angle arrangement to better exploit the theoretical dosimetric benefits of proton therapy and provided insights of selecting quality beam angles for localized prostate cancer treatment

  19. Considerations in setting up and planning a graft processing facility.

    Science.gov (United States)

    Koh, Mickey B C

    2017-12-01

    The graft processing facility forms one of the core components of a clinical haematopoietic stem cell transplant program. The quality of a graft is instrumental in leading to consistent and reproducible outcomes of engraftment and other parameters. As such, meticulous planning and consideration is required and will include core elements including physical design and clinical correlates. The successful running of such a facility depends on an overarching quality program and adherence to local and international regulatory guidelines. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Bartzsch, Stefan

    2014-11-05

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

  1. Computed tomography in planning radiation therapy for nasopharyngeal cancer

    International Nuclear Information System (INIS)

    Trinci, M.; Raffetto, N.; Trinci, C.; Marini, M.

    1991-01-01

    The authors compare the results obtained by CT with clinics and conventional radiography in the staging of nasopharyngeal tumors. The accurate evaluation of tumor size, localization, and spread, helps optimize treatment planning and fit radiation boosts on small fields. Twenty-six patients underwent clinical examination, radiography of the skull and neck, lateral stratigraphy of epipharinx, and CT of head and neck. We compared the results obtained in the study of: nasopharyngeal walls, parapharyngeal space, paranasal sinuses, nasal cavity, bone erosion of the base of the skull, and continuous invasion without bone erosions. Our results point to conventional radiology as the examination of choice for the study of upper nasopharyngeal wall, while CT allows a better evaluation of the lateral wall, and is clearly superior in demonstrating parapharyngeal space, contiguous intracranial invasion, and neck nodes involvement

  2. SU-D-BRD-05: Online Framework for Plan Tracking and Automatic Checks in Radiation Therapy

    International Nuclear Information System (INIS)

    Zaks, D; Fletcher, R; Salamon, S; Kim, G; Ning, T; Cornell, M; Pawlicki, T; Cervino, L

    2015-01-01

    Purpose: To develop an online framework that tracks a patient’s plan from initial simulation to treatment and that helps automate elements of the physics plan checks usually performed in the record and verify (RV) system and treatment planning system. Methods: We have developed PlanTracker, an online plan tracking system that automatically imports new patients tasks and follows it through treatment planning, physics checks, therapy check, and chart rounds. A survey was designed to collect information about the amount of time spent by medical physicists in non-physics related tasks. We then assessed these non-physics tasks for automation. Using these surveys, we directed our PlanTracker software development towards the automation of intra-plan physics review. We then conducted a systematic evaluation of PlanTracker’s accuracy by generating test plans in the RV system software designed to mimic real plans, in order to test its efficacy in catching errors both real and theoretical. Results: PlanTracker has proven to be an effective improvement to the clinical workflow in a radiotherapy clinic. We present data indicating that roughly 1/3 of the physics plan check can be automated, and the workflow optimized, and show the functionality of PlanTracker. When the full system is in clinical use we will present data on improvement of time use in comparison to survey data prior to PlanTracker implementation. Conclusion: We have developed a framework for plan tracking and automatic checks in radiation therapy. We anticipate using PlanTracker as a basis for further development in clinical/research software. We hope that by eliminating the most simple and time consuming checks, medical physicists may be able to spend their time on plan quality and other physics tasks rather than in arithmetic and logic checks. We see this development as part of a broader initiative to advance the clinical/research informatics infrastructure surrounding the radiotherapy clinic. This research

  3. Interactive Decision-Support Tool for Risk-Based Radiation Therapy Plan Comparison for Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Brodin, N. Patrik [Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, New York, New York (United States); Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Aznar, Marianne C. [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Niels Bohr Institute, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Vogelius, Ivan R. [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Petersen, Peter M. [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Department of Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Department of Hematology, Rigshospitalet, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Bentzen, Søren M. [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Department of Human Oncology, University of Wisconsin Medical School, Madison, Wisconsin (United States); Specht, Lena [Department of Radiation Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Department of Oncology, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark); Department of Hematology, Rigshospitalet, Faculty of Sciences, University of Copenhagen, Copenhagen (Denmark)

    2014-02-01

    Purpose: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). Methods and Materials: A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose–response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A “relevance score” was assigned to each data source, reflecting how relevant the input data are to current RT for HL. Results: The tool is applied to visualize the local steepness of dose–response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL. Conclusion: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.

  4. Linking human and natural systems in the planning process

    Science.gov (United States)

    Susan I. Stewart; Miranda H. Mockrin; Roger B. Hammer

    2012-01-01

    Planning links human and natural systems in the urban-rural interface by engaging people in consideration of the future of natural resources. We review evolving ideas about what planning entails, who it involves, and what its outcomes should be. Sense of place, collaboration, emergent planning, and other new developments in planning are discussed. Smaller plans,...

  5. An Exploration of Strategic Planning Perspectives and Processes within Community Colleges Identified as Being Distinctive in Their Strategic Planning Practices

    Science.gov (United States)

    Augustyniak, Lisa J.

    2015-01-01

    Community college leaders face unprecedented change, and some have begun reexamining their institutional strategic planning processes. Yet, studies in higher education strategic planning spend little time examining how community colleges formulate their strategic plans. This mixed-method qualitative study used an expert sampling method to identify…

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  7. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  8. Endodontic or dental implant therapy: the factors affecting treatment planning.

    Science.gov (United States)

    Torabinejad, Mahmoud; Goodacre, Charles J

    2006-07-01

    Clinicians are confronted with difficult choices regarding whether a tooth with pulpal and/or periapical disease should be saved through endodontic treatment or be extracted and replaced with an implant. The authors examined publications (research, literature reviews and systematic reviews) related to the factors affecting decision making for patients who have oral diseases or traumatic injuries. The factors to be considered included patient-related issues (systemic and oral health, as well as comfort and treatment perceptions), tooth- and periodontium-related factors (pulpal and periodontal conditions, color characteristics of the teeth, quantity and quality of bone, and soft-tissue anatomy) and treatment-related factors (the potential for procedural complications, required adjunctive procedures and treatment outcomes). On the basis of survival rates, it appears that more than 95 percent of dental implants and teeth that have undergone endodontic treatment remain functional over time. Clinicians need to consider carefully several factors before choosing whether to perform endodontic therapy or extract a tooth and place an implant. The result should be high levels of comfort, function, longevity and esthetics for patients.

  9. 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

  10. Spine stereotactic body radiation therapy plans: Achieving dose coverage, conformity, and dose falloff

    International Nuclear Information System (INIS)

    Hong, Linda X.; Shankar, Viswanathan; Shen, Jin; Kuo, Hsiang-Chi; Mynampati, Dinesh; Yaparpalvi, Ravindra; Goddard, Lee; Basavatia, Amar; Fox, Jana; Garg, Madhur; Kalnicki, Shalom; Tomé, Wolfgang A.

    2015-01-01

    We report our experience of establishing planning objectives to achieve dose coverage, conformity, and dose falloff for spine stereotactic body radiation therapy (SBRT) plans. Patients with spine lesions were treated using SBRT in our institution since September 2009. Since September 2011, we established the following planning objectives for our SBRT spine plans in addition to the cord dose constraints: (1) dose coverage—prescription dose (PD) to cover at least 95% planning target volume (PTV) and 90% PD to cover at least 99% PTV; (2) conformity index (CI)—ratio of prescription isodose volume (PIV) to the PTV < 1.2; (3) dose falloff—ratio of 50% PIV to the PTV (R 50% ); (4) and maximum dose in percentage of PD at 2 cm from PTV in any direction (D 2cm ) to follow Radiation Therapy Oncology Group (RTOG) 0915. We have retrospectively reviewed 66 separate spine lesions treated between September 2009 and December 2012 (31 treated before September 2011 [group 1] and 35 treated after [group 2]). The χ 2 test was used to examine the difference in parameters between groups. The PTV V 100% PD ≥ 95% objective was met in 29.0% of group 1 vs 91.4% of group 2 (p < 0.01) plans. The PTV V 90% PD ≥ 99% objective was met in 38.7% of group 1 vs 88.6% of group 2 (p < 0.01) plans. Overall, 4 plans in group 1 had CI > 1.2 vs none in group 2 (p = 0.04). For D 2cm , 48.3% plans yielded a minor violation of the objectives and 16.1% a major violation for group 1, whereas 17.1% exhibited a minor violation and 2.9% a major violation for group 2 (p < 0.01). Spine SBRT plans can be improved on dose coverage, conformity, and dose falloff employing a combination of RTOG spine and lung SBRT protocol planning objectives

  11. Treatment planning and sequence for implant therapy in a young adult with generalized aggressive periodontitis.

    Science.gov (United States)

    Bidra, Avinash S; Shaqman, Murad

    2012-08-01

    Treatment planning for full-mouth rehabilitation in patients with generalized aggressive periodontitis often requires a staged approach. Few articles have addressed treatment planning and sequencing issues in this patient population. This report describes the multidisciplinary management of a young adult by a combination of periodontal and implant therapy and rehabilitation with fixed prostheses. At a 2-year follow-up, the patient's periodontal health and peri-implant conditions were stable. Prosthodontic rationale and treatment planning concepts in a patient with multiple challenges are discussed.

  12. A new approach to integrate GPU-based Monte Carlo simulation into inverse treatment plan optimization for proton therapy.

    Science.gov (United States)

    Li, Yongbao; Tian, Zhen; Song, Ting; Wu, Zhaoxia; Liu, Yaqiang; Jiang, Steve; Jia, Xun

    2017-01-07

    Monte Carlo (MC)-based spot dose calculation is highly desired for inverse treatment planning in proton therapy because of its accuracy. Recent studies on biological optimization have also indicated the use of MC methods to compute relevant quantities of interest, e.g. linear energy transfer. Although GPU-based MC engines have been developed to address inverse optimization problems, their efficiency still needs to be improved. Also, the use of a large number of GPUs in MC calculation is not favorable for clinical applications. The previously proposed adaptive particle sampling (APS) method can improve the efficiency of MC-based inverse optimization by using the computationally expensive MC simulation more effectively. This method is more efficient than the conventional approach that performs spot dose calculation and optimization in two sequential steps. In this paper, we propose a computational library to perform MC-based spot dose calculation on GPU with the APS scheme. The implemented APS method performs a non-uniform sampling of the particles from pencil beam spots during the optimization process, favoring those from the high intensity spots. The library also conducts two computationally intensive matrix-vector operations frequently used when solving an optimization problem. This library design allows a streamlined integration of the MC-based spot dose calculation into an existing proton therapy inverse planning process. We tested the developed library in a typical inverse optimization system with four patient cases. The library achieved the targeted functions by supporting inverse planning in various proton therapy schemes, e.g. single field uniform dose, 3D intensity modulated proton therapy, and distal edge tracking. The efficiency was 41.6  ±  15.3% higher than the use of a GPU-based MC package in a conventional calculation scheme. The total computation time ranged between 2 and 50 min on a single GPU card depending on the problem size.

  13. Planning and implementing an implanted fiducial programme for prostate cancer radiation therapy

    International Nuclear Information System (INIS)

    Thompson, A.; Owen, R.; Laferlita, M.; Fox, C.; Foroudi, F.; Tai, K. H.; Styles, C.

    2008-01-01

    Full text: Using implanted gold seeds as fiducial markers to verify the position of the prostate in radiation therapy is well accepted and is becoming the standard of practice and requirement for international multicentre trials. In 2006 the decision was made at the Peter MacCallum Caner Centre (Peter Mac) to plan for and implement this process as standard clinical practice for radical dose prostate treatments (74-78 Gy). Before this, programme verification of field placement for prostate cancer radiation treatment was routinely carried out using regular off-line electronic portal imaging with matching of bony anatomy. A small multidisciplinary team investigated and assisted in the implementation of this new practice across the Peter Mac sites at East Melbourne and our three satellite centres. Issues considered included seed size, number and position in the prostate, implant equipment, imaging equipment and procedure and consent and information forms. The use of a custom made fiducial pack, comprehensive patient information and a daily on-line imaging process was implemented. The experience of the first 28 patients at Peter Mac from January 2007 to May 2007 inclusive is reported on.

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

    Science.gov (United States)

    Sengbusch, Evan R.

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

  15. Deformable registration of the planning image (kVCT) and the daily images (MVCT) for adaptive radiation therapy

    International Nuclear Information System (INIS)

    Lu Weiguo; Olivera, Gustavo H; Chen, Quan; Ruchala, Kenneth J; Haimerl, Jason; Meeks, Sanford L; Langen, Katja M; Kupelian, Patrick A

    2006-01-01

    The incorporation of daily images into the radiotherapy process leads to adaptive radiation therapy (ART), in which the treatment is evaluated periodically and the plan is adaptively modified for the remaining course of radiotherapy. Deformable registration between the planning image and the daily images is a key component of ART. In this paper, we report our researches on deformable registration between the planning kVCT and the daily MVCT image sets. The method is based on a fast intensity-based free-form deformable registration technique. Considering the noise and contrast resolution differences between the kVCT and the MVCT, an 'edge-preserving smoothing' is applied to the MVCT image prior to the deformable registration process. We retrospectively studied daily MVCT images from commercial TomoTherapy machines from different clinical centers. The data set includes five head-neck cases, one pelvis case, two lung cases and one prostate case. Each case has one kVCT image and 20-40 MVCT images. We registered the MVCT images with their corresponding kVCT image. The similarity measures and visual inspections of contour matches by physicians validated this technique. The applications of deformable registration in ART, including 'deformable dose accumulation', 'automatic re-contouring' and 'tumour growth/regression evaluation' throughout the course of radiotherapy are also studied

  16. 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.

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

    International Nuclear Information System (INIS)

    Addison, S.J.

    1984-01-01

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

  18. TU-F-CAMPUS-J-04: Evaluation of Metal Artifact Reduction Technique for the Radiation Therapy Planning

    International Nuclear Information System (INIS)

    Jeong, K; Kuo, H; Ritter, J; Shen, J; Basavatia, A; Yaparpalvi, R; Kalnicki, S; Tome, W

    2015-01-01

    Purpose: To evaluate the feasibility of using a metal artifact reduction technique in depleting metal artifact and its application in improving dose calculation in External Radiation Therapy Planning. Methods: CIRS electron density phantom was scanned with and without steel drill bits placed in some plug holes. Meta artifact reduction software with Metal Deletion Technique (MDT) was used to remove metal artifacts for scanned image with metal. Hounsfield units of electron density plugs from artifact free reference image and MDT processed images were compared. To test the dose calculation improvement after the MDT processed images, clinically approved head and neck plan with manual dental artifact correction was tested. Patient images were exported and processed with MDT and plan was recalculated with new MDT image without manual correction. Dose profiles near the metal artifacts were compared. Results: The MDT used in this study effectively reduced the metal artifact caused by beam hardening and scatter. The windmill around the metal drill was greatly improved with smooth rounded view. Difference of the mean HU in each density plug between reference and MDT images were less than 10 HU in most of the plugs. Dose difference between original plan and MDT images were minimal. Conclusion: Most metal artifact reduction methods were developed for diagnostic improvement purpose. Hence Hounsfield unit accuracy was not rigorously tested before. In our test, MDT effectively eliminated metal artifacts with good HU reproduciblity. However, it can introduce new mild artifacts so the MDT images should be checked with original images

  19. Short report on the evaluation of a graphical user interface for radiation therapy planning systems

    International Nuclear Information System (INIS)

    Martin, M.B.

    1993-01-01

    Since their introduction graphical user interfaces for computing applications have generally appealed more to users than command-line or menu interfaces. Benefits from using a graphical interface include ease-of-use, ease-of-under-standing and increased productivity. For a radiation therapy planning application, an additional potential benefit is that the user regards the planning activity as a closer simulation of the real world situation. A prototype radiation therapy planning system incorporating a graphical user interface was developed on an Apple Macintosh microcomputer. Its graphic interface was then evaluated by twenty-six participants. The results showed markedly that the features associated with a graphic user interface were preferred. 6 refs., 3 figs., 1 tab

  20. 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

  1. Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans.

    Science.gov (United States)

    Robles-Bykbaev, Vladimir; López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

    2016-07-01

    Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs' work and leads to more accurate, consistent, and complete therapy plans for their patients. We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency

  2. High resolution X-ray fluorescence imaging for a microbeam radiation therapy treatment planning system

    Science.gov (United States)

    Chtcheprov, Pavel; Inscoe, Christina; Burk, Laurel; Ger, Rachel; Yuan, Hong; Lu, Jianping; Chang, Sha; Zhou, Otto

    2014-03-01

    Microbeam radiation therapy (MRT) uses an array of high-dose, narrow (~100 μm) beams separated by a fraction of a millimeter to treat various radio-resistant, deep-seated tumors. MRT has been shown to spare normal tissue up to 1000 Gy of entrance dose while still being highly tumoricidal. Current methods of tumor localization for our MRT treatments require MRI and X-ray imaging with subject motion and image registration that contribute to the measurement error. The purpose of this study is to develop a novel form of imaging to quickly and accurately assist in high resolution target positioning for MRT treatments using X-ray fluorescence (XRF). The key to this method is using the microbeam to both treat and image. High Z contrast media is injected into the phantom or blood pool of the subject prior to imaging. Using a collimated spectrum analyzer, the region of interest is scanned through the MRT beam and the fluorescence signal is recorded for each slice. The signal can be processed to show vascular differences in the tissue and isolate tumor regions. Using the radiation therapy source as the imaging source, repositioning and registration errors are eliminated. A phantom study showed that a spatial resolution of a fraction of microbeam width can be achieved by precision translation of the mouse stage. Preliminary results from an animal study showed accurate iodine profusion, confirmed by CT. The proposed image guidance method, using XRF to locate and ablate tumors, can be used as a fast and accurate MRT treatment planning system.

  3. Planning of process of physical education of students.

    Directory of Open Access Journals (Sweden)

    Pylypey L.P.

    2012-09-01

    Full Text Available Going is considered near the personality oriented system professionally-applied physical training of students. In an experiment 500 students of 1-3 courses took part in age from 17 to 23 years. In research of motivation to employments 52 students took part 3 courses. The results of cross-correlation analysis of computer-integrated indexes of level of physical training are resulted. Aims, functions of structure, typology and principles of physical education, are certain. Progress of professional training trends are exposed. The organizational and methodical aspects of construction of the system of physical education are recommended. Directions of planning of educational process are offered on physical education on the basis of professionally-applied physical training of students. Attention is accented on the necessity of exposure of terms for realization of creative capabilities of teacher, leaders and students.

  4. PERSPECTIVES ON INTEROPERABILITY INTEGRATION WITHIN NATO DEFENSE PLANNING PROCESS

    Directory of Open Access Journals (Sweden)

    Florian CIOCAN

    2011-01-01

    Full Text Available Interoperability is not a new area of effort at NATO level. In fact, interoperability and more specifi cally standardization, has been a key element of the Alliance’s approach to fi elding forces for decades. But as the security and operational environment has been in a continuous change, the need to face the new threats and the current involvement in challenging operations in Afghanistan and elsewhere alongside with the necessity to interoperate at lower and lower levels of command with an increasing number of nations, including non-NATO ISAF partners, NGOs, and other organizations, have made the task even more challenging. In this respect Interoperability Integration within NATO Defense Planning Process will facilitate the timely identifi cation, development and delivery of required forces and capabilities that are interoperable and adequately prepared, equipped, trained and supported to undertake the Alliance’s full spectrum of missions.

  5. Stakeholder relationships in the festival and event planning process

    DEFF Research Database (Denmark)

    Michelsen la Cour, Annette

    -friendly workplace while simultaneously strengthening the networks between the civic society and the city. Some of the local sports associations took advantage of the festival’s need for volunteers to recruit and strengthen the ties with potential, “sleeping” volunteers before and during the festival. In doing so......, they came out of the festival with strengthened networks, while others saw the festival as an opportunity to train their collaborative skills of managing an event. The outcome of the collaboration during the planning process was a successful rebranding of the festival and the city strengthening both...... the civic stakeholders and the municipal stakeholders and leaving the community of Esbjerg with improved event management skills....

  6. Study on Process Planning System for Holonic Manufacturing

    Science.gov (United States)

    Rais, Suyoto; Sugimura, Nobuhiro; Kokubun, Atsushi

    New architectures of manufacturing systems have been proposed aiming at realizing more flexible control structures of manufacturing systems which can cope with dynamic changes in volume and variety of products. They are so called as holonic manufacturing systems, autonomous distributed manufacturing systems, random manufacturing systems and biological manufacturing systems. The objective of the present research is to develop an integrated process planning and scheduling system which is applicable to the holonic manufacturing systems. In the previous paper, procedures were proposed to recognize the machining features from the product model. A systematic method is proposed, in this paper, to select suitable machining sequences and sequences of machining equipment, by applying the genetic algorithm (GA) and the dynamic programming (DP) methods.

  7. DOE's planning process for mixed low-level waste disposal

    International Nuclear Information System (INIS)

    Case, J.T.; Letourneau, M.J.; Chu, M.S.Y.

    1995-01-01

    A disposal planning process was established by the Department of Energy (DOE) Mixed Low-Level Waste (MLLW) Disposal Workgroup. The process, jointly developed with the States, includes three steps: site-screening, site-evaluation, and configuration study. As a result of the screening process, 28 sites have been eliminated from further consideration for MLLW disposal and 4 sites have been assigned a lower priority for evaluation. Currently 16 sites are being evaluated by the DOE for their potential strengths and weaknesses as MLLW disposal sites. The results of the evaluation will provide a general idea of the technical capability of the 16 disposal sites; the results can also be used to identify which treated MLLW streams can be disposed on-site and which should be disposed of off-site. The information will then serve as the basis for a disposal configuration study, which includes analysis of both technical as well as non-technical issues, that will lead to the ultimate decision on MLLW disposal site locations

  8. City and Energy Infrastructures between Economic Processes and Urban Planning

    Directory of Open Access Journals (Sweden)

    Giuseppe Mazzeo

    2013-11-01

    Full Text Available The paper deals with the issues related to the relationship between city, energy, economic factors and city planning. These issues are analyzed from a theoretical point of view and are placed in a logical path based on three assumptions. The first considers the city as an intelligent system constantly evolving. The second considers the city as a system where economic processes come out at their highest level affecting other aspects of social and urban structure. The third considers the planning as the weak link in the process of urban development, one of the most exposed to economic and social pressures.Energy production has experienced a great progress since steam and electricity were discovered. Each stage of this evolution has affected city and territory introducing significant physical signs, changing the ways of carrying out functions and creating new needs and new activities. The energy revolution, based on sustainable sources and on skillful management of the networks, will strongly affect the city and the way of organizing the activities, their location, dimension, and the shape of the spaces.The paper explores some of the issues related to the relationship between urban system and energy.The first section analyzes the meaning of the intelligent city as an entity that is constantly changing and constantly adapting. The second section analyzes the role of the energy systems in the evolution of the activities and of the city’s image. The last section investigates the role of the economic factors in the evolution of the shape and meaning of city, pointing out that the way towards smart and green urban systems will largely depend on their economic advantage. 

  9. USGCRP's Sustained Assessment Process: Progress to date and future plans

    Science.gov (United States)

    DeAngelo, B. J.; Reidmiller, D.; Lipschultz, F.; Cloyd, E. T.

    2016-12-01

    One of the four main objectives of the U.S. Global Change Research Program's (USGCRP's) Strategic Plan is to "Conduct Sustained Assessments", which seeks to build a process that synthesizes and advances the state of scientific knowledge on global change, develops future scenarios and potential impacts, and evaluates how effectively science is being and can be used to inform and support the Nation's response to climate change. To do so, USGCRP strives to establish a standing capacity to conduct national climate assessments with sectoral and regional information to evaluate climate risks and opportunities, and to inform decision-making, especially with regard to resiliency planning and adaptation measures. Building on the success of the 3rd National Climate Assessment (NCA) (2014), we discuss the range of USGCRP activities that embody the sustained assessment concept. Special reports, such as the recent Climate and Human Health Assessment and upcoming Climate Science Special Report, fill gaps in our understanding and provide crucial building blocks for next NCA report (NCA4). To facilitate the use of consistent assumptions across NCA4, new scenario products for climate, population, and land use will be made available through initiatives such as NOAA's Climate Resilience Toolkit. NCA4 will be informed by user engagement to advance the customization of knowledge. The report will strive to advance our ability to quantify various risks, monetize certain impacts, and communicate the benefits (i.e., avoided impacts) of various mitigation pathways. NCAnet (a national network of climate-interested stakeholders) continues to grow and foster collaborations across levels of governance and within civil society. Finally, USGCRP continues to actively engage with other assessment processes, at international, state, city, and tribal levels, to exchange ideas and to facilitate the potential for "linked" assessments across spatial scales.

  10. Allogeneic cell therapy bioprocess economics and optimization: downstream processing decisions.

    Science.gov (United States)

    Hassan, Sally; Simaria, Ana S; Varadaraju, Hemanthram; Gupta, Siddharth; Warren, Kim; Farid, Suzanne S

    2015-01-01

    To develop a decisional tool to identify the most cost effective process flowsheets for allogeneic cell therapies across a range of production scales. A bioprocess economics and optimization tool was built to assess competing cell expansion and downstream processing (DSP) technologies. Tangential flow filtration was generally more cost-effective for the lower cells/lot achieved in planar technologies and fluidized bed centrifugation became the only feasible option for handling large bioreactor outputs. DSP bottlenecks were observed at large commercial lot sizes requiring multiple large bioreactors. The DSP contribution to the cost of goods/dose ranged between 20-55%, and 50-80% for planar and bioreactor flowsheets, respectively. This analysis can facilitate early decision-making during process development.

  11. 15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

    Science.gov (United States)

    2010-01-01

    ... additionally planned production, processing, or consumption of Schedule 2 chemicals. 713.4 Section 713.4..., processing, or consumption of Schedule 2 chemicals. (a) Declaration requirements for additionally planned activities. (1) You must declare additionally planned production, processing, or consumption of Schedule 2...

  12. A Collaborative, Ongoing University Strategic Planning Framework: Process, Landmines, and Lessons

    Science.gov (United States)

    Hill, Susan E. Kogler; Thomas, Edward G.; Keller, Lawrence F.

    2009-01-01

    This article examines the strategic planning process at Cleveland State University, a large metropolitan state university in Ohio. A faculty-administrative team used a communicative planning approach to develop a collaborative, ongoing, bottom-up, transparent strategic planning process. This team then spearheaded the process through plan…

  13. Current concepts in F18 FDG PET/CT-based Radiation Therapy planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Percy eLee

    2012-07-01

    Full Text Available Radiation therapy is an important component of cancer therapy for early stage as well as locally advanced lung cancer. The use of F18 FDG PET/CT has come to the forefront of lung cancer staging and overall treatment decision-making. FDG PET/CT parameters such as standard uptake value and metabolic tumor volume provide important prognostic and predictive information in lung cancer. Importantly, FDG PET/CT for radiation planning has added biological information in defining the gross tumor volume as well as involved nodal disease. For example, accurate target delineation between tumor and atelectasis is facilitated by utilizing PET and CT imaging. Furthermore, there has been meaningful progress in incorporating metabolic information from FDG PET/CT imaging in radiation treatment planning strategies such as radiation dose escalation based on standard uptake value thresholds as well as using respiratory gated PET and CT planning for improved target delineation of moving targets. In addition, PET/CT based follow-up after radiation therapy has provided the possibility of early detection of local as well as distant recurrences after treatment. More research is needed to incorporate other biomarkers such as proliferative and hypoxia biomarkers in PET as well as integrating metabolic information in adaptive, patient-centered, tailored radiation therapy.

  14. The design of system for operative planning of blast furnace production process

    Directory of Open Access Journals (Sweden)

    Malindžák Dušan

    1996-12-01

    Full Text Available A system for operative planning of blast furnace production process is described in the paper. The suggested system is based on the use of a new hierarchy of operative plans, consisting of one-month plan, (7+3 days plan, and 24-hour plan. The system allows smoothing of production process at the blast furnace plant, and at the same time satisfies all requirements of the steel plant regarding to the amount of pig iron.

  15. SU-E-T-56: Brain Metastasis Treatment Plans for Contrast-Enhanced Synchrotron Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Rhone-Alpes (France); Tessier, A [Centre Hospitalier Universitaire, La Tronche, Rhone-Alpes (France); Vautrin, M; Benkebil, M [DOSIsoft, Cachan, Ile de France (France); Sihanath, R [Centre Hospitalier Universitaire, La Tronche, Rhone- Alpes (France)

    2014-06-01

    Purpose: Iodine-enhanced radiotherapy is an innovative treatment combining the selective accumulation of an iodinated contrast agent in brain tumors with irradiations using monochromatic medium energy x-rays. The aim of this study is to compare dynamic stereotactic arc-therapy and iodineenhanced SSRT. Methods: Five patients bearing brain metastasis received a standard helical 3D-scan without iodine. A second scan was acquired 13 min after an 80 g iodine infusion. Two SSRT treatment plans (with/without iodine) were performed for each patient using a dedicated Monte Carlo (MC) treatment planning system (TPS) based on the ISOgray TPS. Ten coplanar beams (6×6 cm2, shaped with collimator) were simulated. MC statistical error objective was less than 5% in the 50% isodose. The dynamic arc-therapy plan was achieved on the Iplan Brainlab TPS. The treatment plan validation criteria were fixed such that 100% of the prescribed dose is delivered at the beam isocentre and the 70% isodose contains the whole target volume. The comparison elements were the 70% isodose volume, the average and maximum doses delivered to organs at risk (OAR): brainstem, optical nerves, chiasma, eyes, skull bone and healthy brain parenchyma. Results: The stereotactic dynamic arc-therapy remains the best technique in terms of dose conformation. Iodine-enhanced SSRT presents similar performances to dynamic arc-therapy with increased brainstem and brain parenchyma sparing. One disadvantage of SSRT is the high dose to the skull bone. Iodine accumulation in metastasis may increase the dose by 20–30%, allowing a normal tissue sparing effect at constant prescribed dose. Treatment without any iodine enhancement (medium-energy stereotactic radiotherapy) is not relevant with degraded HDVs (brain, parenchyma and skull bone) comparing to stereotactic dynamic arc-therapy. Conclusion: Iodine-enhanced SSRT exhibits a good potential for brain metastasis treatment regarding the dose distribution and OAR criteria.

  16. Cystic Echinococcal Liver Disease: New Insights into an Old Disease and an Algorithm for Therapy Planning

    International Nuclear Information System (INIS)

    Rozanes, Izzet; Gueven, Koray; Acunas, Buelent; Emre, Ali

    2007-01-01

    Human cystic echinococcosis (CE) continues to be a major health problem in developing countries. A review of current literature discloses four alternatives for the management of active CE, consisting of surgery, percutaneous treatment (PT), chemotherapy, and follow-up without intervention, but no clear guidelines for directing patients to the different management options. Palliation of symptoms or prevention of complications is the main rationale for the treatment of CE. Surgery has long been considered as the gold standard treatment. However, a meta-analysis comparing the clinical outcomes of patients treated with PT with those of a control group treated with surgery found PT to be more effective, safer, and cheaper. Medical therapy is considered to be ineffective when the criterion of success is defined as the disappearance of the lesion. However, medical therapy seems to be effective when the goal of therapy is defined as the prevention of complications in asymptomatic patients. We propose an algorithm for therapy planning in CE where the first line of therapy for patients with active lesions is PT. Patients with lesions unsuitable for PT are directed to surgery if they are symptomatic, have complicated lesions or have lesions that are prone to rupture. Asymptomatic patients with uncomplicated lesions are directed to medical therapy. Medical therapy failures are redirected to surgery

  17. Integrating climate change into the transportation planning process : final report

    Science.gov (United States)

    2008-07-01

    The objective of this study is to advance the practice and application of transportation planning among state, regional, and local transportation planning agencies to successfully meet growing concerns about the relationship between transportation an...

  18. 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

  19. RADPLANET—A New Integrated Radiation Therapy Planning Facility Structured as a Local Area Computer Network

    OpenAIRE

    Neilsen, Ivan R.; Slater, James M.

    1982-01-01

    RADPLANET is an integrated information management and computing resource structured as a packet broadcast local area network for the Radiation Oncology Service. Computed tomography as input to the radiation treatment planning and delivery process is central to the RADPLANET system design. The initial network implementation plan has therefore been extended to include resources for the CT scanner service within its structure.

  20. Strategic Planning and the Marketing Process: Library Applications.

    Science.gov (United States)

    Wood, Elizabeth J.

    1983-01-01

    Illustrates how basic principles of marketing and strategic market planning can be applied to libraries and discusses some concepts of strategic planning (organization mission, objectives and goals, growth strategy, program portfolio plan) and marketing (opportunity analysis, target market selection, marketing mix strategy, marketing systems…

  1. Risk-maps informing land-use planning processes

    Energy Technology Data Exchange (ETDEWEB)

    Basta, Claudia [DIRC Sustainable Urban Areas, Section of Material Science and Sustainable Construction, Delft University of Technology, Stevinweg 1, 2600 GA, Delft (Netherlands)]. E-mail: c.basta@citg.tudelft.nl; Neuvel, Jeroen M.M. [Land Use Planning, Wageningen University, Droevendaalsesteeg 3, Postbus 47, 6700 AA Wageningen (Netherlands)]. E-mail: jeroen.neuvel@wur.nl; Zlatanova, Sisi [Section GISt, OTB Research Institute for Housing, Urban and Mobility Studies, Delft University of Technology, Jaffalaan 9, P.O. Box 5030, 2600 GA, Delft (Netherlands)]. E-mail: s.zlatanova@otb.tudelft.nl; Ale, Ben [Safety Science Group, TBM Faculty, Delft University of Technology, Jaffalaan 5, 2600 GA, Delft (Netherlands)

    2007-06-25

    The definition of safety distances as required by Art 12 of the Seveso II Directive on dangerous substances (96/82/EC) is necessary to minimize the consequences of potential major accidents. As they affect the land-use destinations of involved areas, safety distances can be considered as risk tolerability criteria with a territorial reflection. Recent studies explored the suitability of using Geographical Information System technologies to support their elaboration and visual rendering. In particular, the elaboration of GIS 'risk-maps' has been recognized as functional to two objectives: connecting spatial planners and safety experts during decision making processes and communicating risk to non-experts audiences. In order to elaborate on these findings and to verify their reflection on European practices, the article presents the result of a comparative study between the United Kingdom and the Netherlands recent developments. Their land-use planning practices for areas falling under Seveso II requirements are explored. The role of GIS risk-maps within decisional processes is analyzed and the reflection on the transparency and accessibility of risk-information is commented. Recommendations for further developments are given.

  2. 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

  3. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    DEFF Research Database (Denmark)

    Kornerup, Josefine S.; Brodin, N. P.; Bjork-Eriksson, T.

    2015-01-01

    scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP......) and estimated risk of secondary cancer (SC). RESULTS: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target...... volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. CONCLUSION: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing...

  4. Plan for advanced microelectronics processing technology application. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Goland, A.N.

    1990-10-01

    The ultimate objective of the tasks described in the research agreement was to identify resources primarily, but not exclusively, within New York State that are available for the development of a Center for Advanced Microelectronics Processing (CAMP). Identification of those resources would enable Brookhaven National Laboratory to prepare a program plan for the CAMP. In order to achieve the stated goal, the principal investigators undertook to meet the key personnel in relevant NYS industrial and academic organizations to discuss the potential for economic development that could accompany such a Center and to gauge the extent of participation that could be expected from each interested party. Integrated of these discussions was to be achieved through a workshop convened in the summer of 1990. The culmination of this workshop was to be a report (the final report) outlining a plan for implementing a Center in the state. As events unfolded, it became possible to identify the elements of a major center for x-ray lithography on Lone Island at Brookhaven National Laboratory. The principal investigators were than advised to substitute a working document based upon that concept in place of a report based upon the more general CAMP workshop originally envisioned. Following that suggestion from the New York State Science and Technology Foundation, the principals established a working group consisting of representatives of the Grumman Corporation, Columbia University, the State University of New York at Stony Brook, and Brookhaven National Laboratory. Regular meetings and additional communications between these collaborators have produced a preproposal that constitutes the main body of the final report required by the contract. Other components of this final report include the interim report and a brief description of the activities which followed the establishment of the X-ray Lithography Center working group.

  5. Effect of objective function on multi-objective inverse planning of radiation therapy

    International Nuclear Information System (INIS)

    Li Guoli; Wu Yican; Song Gang; Wang Shifang

    2006-01-01

    There are two kinds of objective functions in radiotherapy inverse planning: dose distribution-based and Dose-Volume Histogram (DVH)-based functions. The treatment planning in our days is still a trial and error process because the multi-objective problem is solved by transforming it into a single objective problem using a specific set of weights for each object. This work investigates the problem of objective function setting based on Pareto multi-optimization theory, and compares the effect on multi-objective inverse planning of those two kinds of objective functions including calculation time, converge speed, etc. The basis of objective function setting on inverse planning is discussed. (authors)

  6. Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hae Youn; Seok, Jin Yong; Hong, Joo Wan; Chang, Nam Jun; Choi, Byeong Don; Park, Jin Hong [Dept. of Radiation Oncology, Seoul National University Bundang Hospital, Sangnam (Korea, Republic of)

    2015-06-15

    The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and R{sub 50%} was calculated to assess low dose spillage as per treatment plan. D{sub 50%} of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and R{sub 50%} on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum D{sub 50%} was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest

  7. Feasibility of dual-energy computed tomography in radiation therapy planning

    Science.gov (United States)

    Sheen, Heesoon; Shin, Han-Back; Cho, Sungkoo; Cho, Junsang; Han, Youngyih

    2017-12-01

    In this study, the noise level, effective atomic number ( Z eff), accuracy of the computed tomography (CT) number, and the CT number to the relative electron density EDconversion curve were estimated for virtual monochromatic energy and polychromatic energy. These values were compared to the theoretically predicted values to investigate the feasibility of the use of dual-energy CT in routine radiation therapy planning. The accuracies of the parameters were within the range of acceptability. These results can serve as a stepping stone toward the routine use of dual-energy CT in radiotherapy planning.

  8. Interfractional Displacement Analysis of the Spinal Cord for 21 Head & Neck Cases in Radiation Therapy Planning

    Science.gov (United States)

    Stoll, Armin; Giske, Kristina; Stoiber, Eva; Bendl, Rolf

    A monomodal slice-based displacement analysis of the spinal cord for three-dimensional computer tomography imaging in radiation therapy planning is presented. In total, 21 head and neck cases with tumor indications close to the spinal cord are studied and evaluated. Two-dimensional cross-correlation is applied to propagate manually segmented contours of the spinal cord from a high-resolution planning CT to subsequently acquired control CTs. The method and the fully automatic implementation turned out to be reliable and robust. A very few manual corrections on the resulting contours remained necessary in single transversal slices.

  9. A fast optimization algorithm for multicriteria intensity modulated proton therapy planning

    International Nuclear Information System (INIS)

    Chen Wei; Craft, David; Madden, Thomas M.; Zhang, Kewu; Kooy, Hanne M.; Herman, Gabor T.

    2010-01-01

    Purpose: To describe a fast projection algorithm for optimizing intensity modulated proton therapy (IMPT) plans and to describe and demonstrate the use of this algorithm in multicriteria IMPT planning. Methods: The authors develop a projection-based solver for a class of convex optimization problems and apply it to IMPT treatment planning. The speed of the solver permits its use in multicriteria optimization, where several optimizations are performed which span the space of possible treatment plans. The authors describe a plan database generation procedure which is customized to the requirements of the solver. The optimality precision of the solver can be specified by the user. Results: The authors apply the algorithm to three clinical cases: A pancreas case, an esophagus case, and a tumor along the rib cage case. Detailed analysis of the pancreas case shows that the algorithm is orders of magnitude faster than industry-standard general purpose algorithms (MOSEK's interior point optimizer, primal simplex optimizer, and dual simplex optimizer). Additionally, the projection solver has almost no memory overhead. Conclusions: The speed and guaranteed accuracy of the algorithm make it suitable for use in multicriteria treatment planning, which requires the computation of several diverse treatment plans. Additionally, given the low memory overhead of the algorithm, the method can be extended to include multiple geometric instances and proton range possibilities, for robust optimization.

  10. LOCATE: an application of computed tomography in radiation therapy treatment planning with emphasis on tumor localization

    International Nuclear Information System (INIS)

    Griffin, B.R.; Shuman, W.P.; Luk, K.H.; Tong, D.

    1984-01-01

    Computed tomography can provide precise information for radiation therapy treatment planning. However, inaccuracies in radiation field design may occur when the radiation oncologist attempts to tranfer information about tumor location from the transverse plane of the CT scan to the longitudinal plane of the simulation film. This report describes a new computer program, LOCATE, which addresses this problem. The program uses operator generated information from the cross sectional CT images to draw an outline of tumor on AP and lateral longitudinal scanned projection radiographs. The resultant images are useful because they are in the same plane as radiographs obtained on a therapy simulator. The impact of LOCATE on radiation treatment planning for 26 patients is discussed along with several cases in which LOCATE was particularly helpful

  11. Interactive contour delineation and refinement in treatment planning of image-guided radiation therapy.

    Science.gov (United States)

    Zhou, Wu; Xie, Yaoqin

    2014-01-06

    The accurate contour delineation of the target and/or organs at risk (OAR) is essential in treatment planning for image-guided radiation therapy (IGRT). Although many automatic contour delineation approaches have been proposed, few of them can fulfill the necessities of applications in terms of accuracy and efficiency. Moreover, clinicians would like to analyze the characteristics of regions of interests (ROI) and adjust contours manually during IGRT. Interactive tool for contour delineation is necessary in such cases. In this work, a novel approach of curve fitting for interactive contour delineation is proposed. It allows users to quickly improve contours by a simple mouse click. Initially, a region which contains interesting object is selected in the image, then the program can automatically select important control points from the region boundary, and the method of Hermite cubic curves is used to fit the control points. Hence, the optimized curve can be revised by moving its control points interactively. Meanwhile, several curve fitting methods are presented for the comparison. Finally, in order to improve the accuracy of contour delineation, the process of the curve refinement based on the maximum gradient magnitude is proposed. All the points on the curve are revised automatically towards the positions with maximum gradient magnitude. Experimental results show that Hermite cubic curves and the curve refinement based on the maximum gradient magnitude possess superior performance on the proposed platform in terms of accuracy, robustness, and time calculation. Experimental results of real medical images demonstrate the efficiency, accuracy, and robustness of the proposed process in clinical applications.

  12. Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

    International Nuclear Information System (INIS)

    Marnitz, S.; Hinkelbein, W.; Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H.; Bendl, R.; Lemke, A.J.; Bechrakis, N.E.; Foerster, M.H.

    2006-01-01

    Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

  13. Proton therapy of uveal melanomas. Intercomparison of MRI-based and conventional treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, S.; Hinkelbein, W. [Dept. of Radiooncology, Charite Univ. Medicine, Berlin (Germany); Cordini, D.; Heufelder, J.; Simiantonakis, I.; Kluge, H. [Eye Tumor Therapy, Hahn-Meitner Inst., Berlin (Germany); Bendl, R. [Dept. of Medical Physics, German Cancer Research Center (DKFZ), Heidelberg (Germany); Lemke, A.J. [Dept. of Diagnostic Radiology, Charite Univ. Medicine, Berlin (Germany); Bechrakis, N.E.; Foerster, M.H. [Dept. of Ophthalmology, Charite Univ. Medicine, Berlin (Germany)

    2006-07-15

    Background and purpose: proton therapy for uveal melanoma provides high-conformal dose application to the target volume and, thus, an optimal saving of the organs at risk nearby. Treatment planning is done with the model-based treatment-planning system eyeplan. Tumor reconstruction is based only on a fundus composite, which often leads to an overestimation of the clinical target volume (CTV). The purpose was to exploit MRI on trial in a proton therapy-planning system by using the novel image-based treatment-planning system octopus. Patients and methods: ten patients with uveal melanomas received both a high-resolution planning CT and MRI of the eye. MR examinations were made with an eye coil. Eyeplan requires eye geometry data for modeling, and tantalum marker clips for submillimeter positioning and additional information from ultrasound and 3-D imaging. By contrast, octopus provides the full integration of 3-D imaging (e.g., CT, MRI). CTVs were delineated in each slice. For all patients, CTVs (eyeplan vs. octopus) were compared intraindividually. Results: octopus planning led to a mean reduction of the target volume by a factor of 1.7 (T1-weighted [T1w]) and 2.2 (T2w) without compromising safety. The corresponding field size could be scaled down on average by a factor of 1.2 (T1w) and 1.4 (T2w), respectively. Conclusion: compared with the conventional eyeplan, MRI-based treatment planning of ocular tumors with octopus could be a powerful tool for reducing the CTV and, consequently, the treatment volume and the field size. This might be translated into a better patient compliance during treatment and a decreased late toxicity. (orig.)

  14. A tool for preparation of voxel phantoms. Potentialities for planning of neutron capture therapy

    International Nuclear Information System (INIS)

    Borisov, Nikolay; Khokhlov, Vyacheslav; Kulakov, Viktor; Sheino, Igor; Carlan, L. de; Franck, Didier

    2006-01-01

    The tremendous development of voxel phantom techniques for computations in nuclear medicine and hygiene during the past decade led to the creation of special software packages designed for automatic preparation of voxel phantoms for subsequent radiation transport calculations. The package OEDIPE, which facilitates the MCNP (X) calculations, was originally designed for internal irradiation dosimetry. However, its flexibility and universality makes it attractive for radiation therapy planning, too. (author)

  15. The effect of educational group therapy plan on self–esteem rate in adolescent girls

    Directory of Open Access Journals (Sweden)

    Roya Turkashvand

    2011-07-01

    Full Text Available Background: Adolescence is a period of major changes in various aspects of physical, mental and social caracters they may get. There are new requirements for the changes have been occurred. Attention to these needs, in turn, are faster and better compatibility and increase self-esteem. Self-esteem is the basic factor of personality development in adolescents. Therefore, the aim of this study was to evaluate the effect of educational group therapy on self-esteem of adolescent girls.Materials and Method: This is a quasi- experimental study. Seventy-one adolescent girls of 13-15 years old were selected cluster-randomly from guidance school and divided in two groups of experimental and control (35 cases, 36 controls. Self-esteem of adolescents in two groups measured using Pop test. Then the educational group therapy plan was utilized based on promotion of adolescent’s self- esteem at 10 sessions for case group. Self-esteem rate was measured just after the performance of planned session and were analyzed with SPSS-14 software.Results: The results of the study indicated that performing educational group therapy session can increase the mean self-esteem score for case group (84.74 comparing to control group (74.05. Independent t-test shows significant difference between self-esteem score in case and control groups.Conclusion: According to our results the authors suggest that using educational group therapy plan is an effective approach in increasing self-esteem in adolescent girls and may improve mental health. Therefore, we suggest this plan for increasing self-esteem of adolescents in the schools

  16. Introduction to Strategic Planning in Student Affairs: A Model for Process and Elements of a Plan

    Science.gov (United States)

    Ellis, Shannon E.

    2010-01-01

    Planning from a strategic perspective has been a mainstay of organizational management for decades. Founded in the private sector, strategic planning is now embraced by the nonprofit world as a catalyst for sound resource allocation, transformative decision making, and motivating staff. Student affairs professionals who think, plan, and act…

  17. [Music therapy and neuropsychology: a proposal to music therapy based on the cognitive processing of music].

    Science.gov (United States)

    Satoh, Masayuki; Takeda, Katsuhiko; Kuzuhara, Shigeki

    2007-11-01

    In the last decade, a considerable number of studies have been made on the cognitive processing of music. A patient with pure amusia due to the infarction of anterior portion of bilateral temporal lobes revealed the disturbance of the discrimination of chords. Using positron emission tomography, these regions were activated when musically naive normal subjects listened to the harmony compared to the rhythm of identical music. So, we concluded that anterior temporal portion might participate in the recognition of chords. Several articles reported that the musician's brain was different from nonmusicians' functionally and anatomically. This difference was considered to be caused by the musical training for a long time. Recent studies clarified that the reorganization might occur by musical training for a few months. Melodic intonation therapy (MIT) is a method aimed to improve speech output of aphasic patients, using short melodic phrase with a word. The literatures of mental processing of music suggested that right hemisphere might participate in the expression of music, namely singing and playing instrumentals. So, it was supposed that MIT utilized the compensational function of right hemisphere for damaged left hemisphere. We also reported that mental singing improved the gait disturbance of patients with Parkinson's disease. Music therapy is changing from a social science model based on the individual experiences to a neuroscience-guided model based on brain function and cognitive processing of the perception and expression of music.

  18. Process Control Plan for 242-A Evaporator Campaign January 2001

    International Nuclear Information System (INIS)

    LE, E.Q.

    2001-01-01

    Wastewater stored in 104-AW that was generated during the terminal cleanout of the PUREX facility is the primary feed to be processed during the 242-A Evaporator Campaign 01-01, Approximately 801,600 gallons of 104-AW waste was transferred to feed tank 102-AW at the end of January 2001, in preparation for the campaign. The total feed volume that will be processed during Campaign 01-01 is 8 15,200 gallons, which includes the waste from 104-AW and residual waste from the previous evaporator campaign, 00-01, Additional feed will be generated during the pre-campaign cold run and processed during campaign 01-01. Based on characterization data from 104-AW feed waste 'and the evaluation of waste processability presented in Section 5 of this PCP, Campaign 01-01 does not pose any unacceptable risks to the facility, safety, environmental, human health offsite, or onsite personnel. Evaporator Campaign 01-01 is essential in supporting the River Protection Project (RPP) to maintaining its critical mission schedule and regulator commitments for tank waste systems. Several of RPP critical activities requiring completion of Campaign 01-01 by April 1, 2001 are highlighted below. Availability of DST space: Additional tank space that will be made available by this campaign is needed to support the continued interim stabilization of Single-Shell Tanks (SSTs). This additional space will also be used to move waste among Double-Shell Tanks (DSTs) to support the demonstrations of SST waste retrieval. DST life extension: An electrical outage in the AW Tank Farm is scheduled to begin following completion of the Campaign 01-01. This outage is a critical step in identifying and completing life extension upgrades to the DST systems. DST upgrades: Project W-314 plans significant upgrades to the AW Tank Farm to retrieve and supply waste feed to the Waste Treatment (Vitrification) Plant using a system that complies with current environmental requirements. These upgrades will commence on

  19. Resource recovery planning: an overview of the implementation process. [Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Resource recovery increasingly is becoming a major concern of city officials. Cities that undertake effective resource-recovery programs can benefit in two ways. First, the volume of solid waste can be significantly reduced, thus prolonging the life of existing landfill sites. Second, resource recovery can produce revenues that will offset, at least in part, refuse collection and disposal costs. However, no city should undertake resource-recovery activities with the expectation that a profit will be made. Third, there is an increasing appreciation of the fact that the nation's resources are finite. City officials may begin considering resource recovery in anticipation that the recycling of consumed materials may become national policy. Successful implementation and management of resource-recovery facilities is a difficult and complex venture for city officials. This report outlines the critical components of the implementation process. The guide covers the issues of mixed waste recovery: large-scale, capital-investment projects that require precision planning and analysis of the financial, technical, and administrative considerations.

  20. 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.

  1. 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

  2. A case study of the South Puget Intertribal Planning Agency's comprehensive cancer control planning and community mobilization process.

    Science.gov (United States)

    Nass, Carrie; Simmons, John; Bowen, Deborah; Guthrie, Teresa

    2008-04-01

    The high rates of cancer among American Indians and Alaska Natives are of growing concern. In response to high cancer rates, national, state, and tribal organizations have worked to assess knowledge, attitudes, beliefs, and screening practices related to cancer in American Indian and Alaska Native communities and to increase awareness and use of cancer screening. The National Comprehensive Cancer Control Program (NCCCP) of the Centers for Disease Control and Prevention is one such effort. NCCCP's comprehensive cancer control (CCC) planning process provides a new approach to planning and implementing cancer control programs. The CCC process and components for American Indians and Alaska Natives are not yet fully understood because this is a fairly new approach for these communities. Therefore, the purpose of our case study was to describe the CCC process and its outcomes and successes as applied to these communities and to identify key components and lessons learned from the South Puget Intertribal Planning Agency's (SPIPA's) CCC planning and community mobilization process. We used interviews, document reviews, and observations to collect data on SPIPA's CCC planning and community mobilization process. We identified the key components of SPIPA's CCC as funding and hiring key staff, partnering with outside organizations, developing a project management plan and a core planning team, creating community cancer orientations, conducting community cancer surveys, developing a community advisory committee, ongoing training and engaging of the community advisory committee, and supporting the leadership of the communities involved. The CCC planning process is a practicable model, even for groups with little experience or few resources. The principles identified in this case study can be applied to the cancer control planning process for other tribes.

  3. Radiation therapy planning with photons and protons for early and advanced breast cancer: an overview

    Directory of Open Access Journals (Sweden)

    Lomax Antony J

    2006-07-01

    Full Text Available Abstract Postoperative radiation therapy substantially decreases local relapse and moderately reduces breast cancer mortality, but can be associated with increased late mortality due to cardiovascular morbidity and secondary malignancies. Sophistication of breast irradiation techniques, including conformal radiotherapy and intensity modulated radiation therapy, has been shown to markedly reduce cardiac and lung irradiation. The delivery of more conformal treatment can also be achieved with particle beam therapy using protons. Protons have superior dose distributional qualities compared to photons, as dose deposition occurs in a modulated narrow zone, called the Bragg peak. As a result, further dose optimization in breast cancer treatment can be reasonably expected with protons. In this review, we outline the potential indications and benefits of breast cancer radiotherapy with protons. Comparative planning studies and preliminary clinical data are detailed and future developments are considered.

  4. Volumetric-modulated arc therapy in postprostatectomy radiotherapy patients: A planning comparison study

    International Nuclear Information System (INIS)

    Forde, Elizabeth; Kneebone, Andrew; Bromley, Regina; Guo, Linxin; Hunt, Peter; Eade, Thomas

    2013-01-01

    The purpose of this study was to compare postprostatectomy planning for volumetric-modulated arc therapy (VMAT) with both single arc (SA) and double arcs (DA) against dynamic sliding window intensity-modulated radiotherapy (IMRT). Ten cases were planned with IMRT, SA VMAT, and DA VMAT. All cases were planned to achieve a minimum dose of 68 Gy to 95% of the planning target volume (PTV) and goals to limit rectal volume >40 Gy to 35% and >65 Gy to 17%, and bladder volumes >40 Gy to 50% and >65 Gy to 25%. Plans were averaged across the 10 patients and compared for mean dose, conformity, homogeneity, rectal and bladder doses, and monitor units. The mean dose to the clinical target volume and PTV was significantly higher (p<0.05) for SA compared with DA or IMRT. The homogeneity index was not significantly different: SA = 0.09; DA = 0.08; and IMRT = 0.07. The rectal V40 was lowest for the DA plan. The rectal V20 was significantly lower (p<0.05) for both the VMAT plans compared with IMRT. There were no significant differences for bladder V40 or rectal and bladder V65. The IMRT plans required 1400 MU compared with 745 for DA and 708 for SA. This study shows that for equivalent dose coverage, SA and DA VMAT plans result in higher mean doses to the clinical target volume and PTV. This greater dose heterogeneity is balanced by improved low-range rectal doses and halving of the monitor units

  5. Volumetric-modulated arc therapy in postprostatectomy radiotherapy patients: A planning comparison study

    Energy Technology Data Exchange (ETDEWEB)

    Forde, Elizabeth, E-mail: eforde@tcd.ie [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Kneebone, Andrew [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Northern Clinical School, University of Sydney, New South Wales (Australia); Bromley, Regina [Institute of Medical Physics, School of Physics, University of Sydney, New South Wales (Australia); Guo, Linxin; Hunt, Peter [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Eade, Thomas [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Northern Clinical School, University of Sydney, New South Wales (Australia)

    2013-10-01

    The purpose of this study was to compare postprostatectomy planning for volumetric-modulated arc therapy (VMAT) with both single arc (SA) and double arcs (DA) against dynamic sliding window intensity-modulated radiotherapy (IMRT). Ten cases were planned with IMRT, SA VMAT, and DA VMAT. All cases were planned to achieve a minimum dose of 68 Gy to 95% of the planning target volume (PTV) and goals to limit rectal volume >40 Gy to 35% and >65 Gy to 17%, and bladder volumes >40 Gy to 50% and >65 Gy to 25%. Plans were averaged across the 10 patients and compared for mean dose, conformity, homogeneity, rectal and bladder doses, and monitor units. The mean dose to the clinical target volume and PTV was significantly higher (p<0.05) for SA compared with DA or IMRT. The homogeneity index was not significantly different: SA = 0.09; DA = 0.08; and IMRT = 0.07. The rectal V40 was lowest for the DA plan. The rectal V20 was significantly lower (p<0.05) for both the VMAT plans compared with IMRT. There were no significant differences for bladder V40 or rectal and bladder V65. The IMRT plans required 1400 MU compared with 745 for DA and 708 for SA. This study shows that for equivalent dose coverage, SA and DA VMAT plans result in higher mean doses to the clinical target volume and PTV. This greater dose heterogeneity is balanced by improved low-range rectal doses and halving of the monitor units.

  6. Open low-field magnetic resonance imaging in radiation therapy treatment planning.

    Science.gov (United States)

    Krempien, Robert C; Schubert, Kai; Zierhut, Dietmar; Steckner, Michael C; Treiber, Martina; Harms, Wolfgang; Mende, Ulrich; Latz, Detlev; Wannenmacher, Michael; Wenz, Frederik

    2002-08-01

    To evaluate the possibilities of an open low-field magnetic resonance imaging (MRI) scanner in external beam radiotherapy treatment (RT) planning. A custom-made flat tabletop was constructed for the open MR, which was compatible with standard therapy positioning devices. To assess and correct image distortion in low-field MRI, a custom-made phantom was constructed and a software algorithm was developed. A total of 243 patients (43 patients with non-small-cell lung cancer, 155 patients with prostate cancer, and 45 patients with brain tumors) received low-field MR imaging in addition to computed tomographic (CT) planning imaging between January 1998 and September 2001 before the start of the irradiation. Open low-field MRI provided adequate images for RT planning in nearly 95% of the examined patients. The mean and the maximal distortions 15 cm around the isocenter were reduced from 2.5 mm to 0.9 mm and from 6.1 mm to 2.1 mm respectively. The MRI-assisted planning led to better discrimination of tumor extent in two-thirds of the patients and to an optimization in lung cancer RT planning in one-third of the patients. In prostate cancer planning, low-field MRI resulted in significant reduction (40%) of organ volume and clinical target volume (CTV) compared with CT and to a reduction of the mean percentage of rectal dose of 15%. In brain tumors, low-field MR image quality was superior compared with CT in 39/45 patients for planning purposes. The data presented here show that low-field MRI is feasible in RT treatment planning when image correction regarding system-induced distortions is performed and by selecting MR imaging protocol parameters with the emphasis on adequate images for RT planning.

  7. Institutional Assessment, Planning, and Institutional Change: An Integrated Institutional Assessment and Strategic Planning Process for Community Colleges.

    Science.gov (United States)

    Leas, David; Lillibridge, Fred

    In 1992, Alamogordo Branch Community College (ABCC), a branch campus of New Mexico State University, developed and implemented the Institutional Assessment and Strategic Planning (IASP) process, an integrated process designed to assess both student academic achievement and institutional effectiveness. Each year, the IASP process begins when…

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  9. An evaluation of Mexican transportation planning, finance, implementation, and construction processes.

    Science.gov (United States)

    2009-10-01

    This research examined the legal, financial, institutional and policy processes that Mexico uses to plan, finance, : construct, and implement its transportation network. It documents through twelve case studies the state of the : practice in planning...

  10. The relationship of title VI requirements to Florida's transportation planning process.

    Science.gov (United States)

    2011-10-01

    The Florida Department of Transportation (FDOT) and metropolitan planning organizations (MPO) in Florida are : required to address Title VI and environmental justice (EJ) in the transportation planning process. This study : reviews those practices an...

  11. 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

  12. The Budget Connection: The Last Step in the Planning Process.

    Science.gov (United States)

    Barker, Thomas S.

    1997-01-01

    In order to succeed, a college or university must link its mission and plans to the budget. The statement of cash flow is a useful tool to establish this connection and adjust expenditures when necessary. Financial Accounting Standards Board formats help in preparing statements for planning purposes. An example of cash flow statement use for…

  13. A model for the distribution channels planning process

    NARCIS (Netherlands)

    Neves, M.F.; Zuurbier, P.; Campomar, M.C.

    2001-01-01

    Research of existing literature reveals some models (sequence of steps) for companies that want to plan distribution channels. None of these models uses strong contributions from transaction cost economics, bringing a possibility to elaborate on a "distribution channels planning model", with these

  14. SU-F-T-427: Utilization and Evaluation of Diagnostic CT Imaging with MAR Technique for Radiation Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Xu, M; Foster, R; Parks, H; Pankuch, M

    2016-01-01

    Purpose: The objective was to utilize and evaluate diagnostic CT-MAR technique for radiation therapy treatment planning. Methods: A Toshiba-diagnostic-CT acquisition with SEMAR(Single-energy-MAR)-algorism was performed to make the metal-artifact-reduction (MAR) for patient treatment planning. CT-imaging datasets with and without SEMAR were taken on a Catphan-phantom. Two sets of CT-numbers were calibrated with the relative electron densities (RED). A tissue characterization phantom with Gammex various simulating material rods was used to establish the relationship between known REDs and corresponding CT-numbers. A GE-CT-sim acquisition was taken on the Catphan for comparison. A patient with bilateral hip arthroplasty was scanned in the radiotherapy CT-sim and the diagnostic SEMAR-CT on a flat panel. The derived SEMAR images were used as a primary CT dataset to create contours for the target, critical-structures, and for planning. A deformable registration was performed with VelocityAI to track voxel changes between SEMAR and CT-sim images. The SEMAR-CT images with minimal artifacts and high quality of geometrical and spatial integrity were employed for a treatment plan. Treatment-plans were evaluated based on deformable registration of SEMAR-CT and CT-sim dataset with assigned CT-numbers in the metal artifact regions in Eclipse v11 TPS. Results: The RED and CT-number relationships were consistent for the datasets in CT-sim and CT’s with and without SEMAR. SEMAR datasets with high image quality were used for PTV and organ delineation in the treatment planning process. For dose distribution to the PTV through the DVH analysis, the plan using CT-sim with the assigned CT-number showed a good agreement to those on deformable CT-SEMAR. Conclusion: A diagnostic-CT with MAR-algorithm can be utilized for radiotherapy treatment planning with CT-number calibrated to the RED. Treatment planning comparison and DVH shows a good agreement in the PTV and critical organs between

  15. Monte Carlo fluence simulation for prospective evaluation of interstitial photodynamic therapy treatment plans

    Science.gov (United States)

    Cassidy, Jeffrey; Betz, Vaughn; Lilge, Lothar

    2015-03-01

    Photodynamic therapy (PDT) delivers a localized cytotoxic dose that is a function of tissue oxygen availability, photosensitive drug concentration, and light fluence. Providing safe and effective PDT requires an understanding of all three elements and the physiological response to the radicals generated. Interstitial PDT (IPDT) for solid tumours poses particular challenges due to complex organ geometries and the associated limitations for diffusion theory based fluence rate prediction, in addition to restricted access for light delivery and dose monitoring. As a first step towards enabling a complete prospective IPDT treatment-planning platform, we demonstrate use of our previously developed FullMonte tetrahedral Monte Carlo simulation engine for modeling of the interstitial fluence field due to intravesicular insertion of brief light sources. The goal is to enable a complete treatment planning and monitoring work flow analogous to that used in ionizing radiation therapy, including plan evaluation through dose-volume histograms and algorithmic treatment plan optimization. FullMonte is to our knowledge the fastest open-source tetrahedral MC light propagation software. Using custom hardware acceleration, we achieve 4x faster computing with 67x better power efficiency for limited-size meshes compared to the software. Ongoing work will improve the performance advantage to 16x with unlimited mesh size, enabling algorithmic plan optimization in reasonable time. Using FullMonte, we demonstrate significant new plan-evaluation capabilities including fluence field visualization, generation of organ dose-volume histograms, and rendering of isofluence surfaces for a representative bladder cancer mesh from a real patient. We also discuss the advantages of MC simulations for dose-volume histogram generation and the need for online personalized fluence-rate monitoring.

  16. 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

  17. Predicting adherence to combination antiretroviral therapy for HIV in Tanzania: A test of an extended theory of planned behaviour model.

    Science.gov (United States)

    Banas, Kasia; Lyimo, Ramsey A; Hospers, Harm J; van der Ven, Andre; de Bruin, Marijn

    2017-10-01

    Combination antiretroviral therapy (cART) for HIV is widely available in sub-Saharan Africa. Adherence is crucial to successful treatment. This study aimed to apply an extended theory of planned behaviour (TPB) model to predict objectively measured adherence to cART in Tanzania. Prospective observational study (n = 158) where patients completed questionnaires on demographics (Month 0), socio-cognitive variables including intentions (Month 1), and action planning and self-regulatory processes hypothesised to mediate the intention-behaviour relationship (Month 3), to predict adherence (Month 5). Taking adherence was measured objectively using the Medication Events Monitoring System (MEMS) caps. Model tests were conducted using regression and bootstrap mediation analyses. Perceived behavioural control (PBC) was positively (β = .767, p < .001, R 2  = 57.5%) associated with adherence intentions. Intentions only exercised an indirect effect on adherence (B = 1.29 [0.297-3.15]) through self-regulatory processes (B = 1.10 [0.131-2.87]). Self-regulatory processes (β = .234, p = .010, R 2  = 14.7%) predicted better adherence. This observational study using an objective behavioural measure, identified PBC as the main driver of adherence intentions. The effect of intentions on adherence was only indirect through self-regulatory processes, which were the main predictor of objectively assessed adherence.

  18. Fast shading correction for cone beam CT in radiation therapy via sparse sampling on planning CT.

    Science.gov (United States)

    Shi, Linxi; Tsui, Tiffany; Wei, Jikun; Zhu, Lei

    2017-05-01

    The image quality of cone beam computed tomography (CBCT) is limited by severe shading artifacts, hindering its quantitative applications in radiation therapy. In this work, we propose an image-domain shading correction method using planning CT (pCT) as prior information which is highly adaptive to clinical environment. We propose to perform shading correction via sparse sampling on pCT. The method starts with a coarse mapping between the first-pass CBCT images obtained from the Varian TrueBeam system and the pCT. The scatter correction method embedded in the Varian commercial software removes some image errors but the CBCT images still contain severe shading artifacts. The difference images between the mapped pCT and the CBCT are considered as shading errors, but only sparse shading samples are selected for correction using empirical constraints to avoid carrying over false information from pCT. A Fourier-Transform-based technique, referred to as local filtration, is proposed to efficiently process the sparse data for effective shading correction. The performance of the proposed method is evaluated on one anthropomorphic pelvis phantom and 17 patients, who were scheduled for radiation therapy. (The codes of the proposed method and sample data can be downloaded from https://sites.google.com/view/linxicbct) RESULTS: The proposed shading correction substantially improves the CBCT image quality on both the phantom and the patients to a level close to that of the pCT images. On the phantom, the spatial nonuniformity (SNU) difference between CBCT and pCT is reduced from 74 to 1 HU. The root of mean square difference of SNU between CBCT and pCT is reduced from 83 to 10 HU on the pelvis patients, and from 101 to 12 HU on the thorax patients. The robustness of the proposed shading correction is fully investigated with simulated registration errors between CBCT and pCT on the phantom and mis-registration on patients. The sparse sampling scheme of our method successfully

  19. Robust plan optimization for electromagnetic transponder guided hypo-fractionated prostate treatment using volumetric modulated arc therapy

    Science.gov (United States)

    Zhang, Pengpeng; Hunt, Margie; Happersett, Laura; Yang, Jie; Zelefsky, Michael; Mageras, Gig

    2013-11-01

    To develop an optimization algorithm for volumetric modulated arc therapy which incorporates an electromagnetic tracking (EMT) guided gating strategy and is robust to residual intra-fractional motion uncertainties. In a computer simulation, intra-fractional motion traces from prior treatments with EMT were converted to a probability distribution function (PDF), truncated using a patient specific action volume that encloses allowed deviations from the planned position, and renormalized to yield a new PDF with EMT-gated interventions. In lieu of a conventional planning target volume (PTV), multiple instances of clinical target volume (CTV) and organs at risk (OARs) were replicated and displaced to extreme positions inside the action volume representing possible delivery scenarios. When optimizing the volumetric modulated arc therapy plan, doses to the CTV and OARs were calculated as a sum of doses to the replicas weighted by the PDF to account for motion. A treatment plan meeting the clinical constraints was produced and compared to the counterpart conventional margin (PTV) plan. EMT traces from a separate testing database served to simulate motion during gated delivery. Dosimetric end points extracted from dose accumulations for each motion trace were utilized to evaluate potential clinical benefit. Five prostate cases from a hypofractionated protocol (42.5 Gy in 5 fractions) were retrospectively investigated. The patient specific gating window resulted in tight anterior and inferior action levels (∼1 mm) to protect rectal wall and bladder wall, and resulted in an average of four beam interruptions per fraction in the simulation. The robust-optimized plans achieved the same average CTV D95 coverage of 40.5 Gy as the PTV-optimized plans, but with reduced patient-averaged rectum wall D1cc by 2.2 Gy (range 0.7 to 4.7 Gy) and bladder wall mean dose by 2.9 Gy (range 2.0 to 3.4 Gy). Integration of an intra-fractional motion management strategy into the robust

  20. APPLICATION OF EXPERIMENTS PLANNING IN THE MINERAL PROCESSING

    Directory of Open Access Journals (Sweden)

    Slavka Pfaff

    2004-12-01

    Full Text Available Statistical design of experiments deals with methods of planning the experiment so that appropriate data are collected, which may be analyzed by statistical methods resulting in objective and valid conclusions. These methods extend over two closely related experimental problems: the design of the experiment and the statistical analysis of the data. Moreover, designed experiments maintain a balance between statistical accuracy and the cost of the experimental process. Factorial designs are used in experiments involving several factors where it is necessary to study the joint effects of these factors on a dependent variable i.e. response. In case of k factors, each at only two levels, the full 2k factorial design in which the response is tested in all possible combinations of settings is widely used. If the response is investigated with more than two different values of each factor then, in addition to the effect estimates of factors and their interactions, the curvilinear regression equation of the relationship between response and factors can be obtained. In case of two factors such equation represents a surface in three-dimensional space, so designs for fitting the response surface are often called response surface designs. One of them is the central composite design. The paper presents the full 24 factorial design and the central composite design and their analysis exemplified by the results of investigation about how the four factors (pressure, humidity, temperature and granulation of the coal affect the water absorption. The methods of analysis and the way of drawing conclusions have been outlined (the paper is published in Croatian.

  1. The vital issues process: Strategic planning for a changing world

    Energy Technology Data Exchange (ETDEWEB)

    Engi, D.; Glicken, J.

    1995-05-01

    The Vital Issues process (VIp) is a strategic planning tool initially developed by Sandia National Laboratories (SNL) for the Office of Foreign Intelligence (OFI)* of the US Department of Energy (DOE). It was further developed and refined through its application to a variety of strategic purposes for a range of public and semipublic organizations. The VIp provides a structured mechanism for assisting organizations in accomplishing specified objectives by identifying and prioritizing a portfolio of strategic issues, programmatic areas, or responses to a specified problem. It employs day-long panel meetings in a specified format to elicit a broad range of perspectives on a particular issue in a nonconfrontational manner and to facilitate the interaction and synthesis of diverse viewpoints on a specific topic. The VIp is unique in its incorporation of two primary approaches in each panel session: a qualitative or transactional segment, which entails the synthesis of the alternatives through negotiations or discussion, and a quantitative or net benefit maximization segment, an analytical approach, which involves prioritization of the alternatives using pairwise comparisons. This combination of facilitated group discussion and quantitative ranking provides input to strategic management decisions in the form of stakeholder-defined and -prioritized items as well as information on potential barriers to the implementation of policies and programs. This is the final volume in the series Identifying Vital Issues: New Intelligence Strategies for a New World, a three-volume set that gives an accounting of the VIp as implemented for OFI. This volume provides an in-depth description of the methodology used in the VIp.

  2. Renewable Energy Zone (REZ) Transmission Planning Process: A Guidebook for Practitioners

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nathan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Flores-Espino, Francisco [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hurlbut, David J. [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-05

    Achieving clean energy goals may require new investments in transmission, especially if planners anticipate economic growth and increased demand for electricity. The renewable energy zone (REZ) transmission planning process can help policymakers ensure their infrastructure investments achieve national goals in the most economical manner. Policymakers, planners, and system operators around the world have used variations of the REZ process to chart the expansion of their transmission networks and overcome the barriers of traditional transmission planning. This guidebook seeks to help power system planners, key decision makers, and stakeholders understand and use the REZ transmission planning process to integrate transmission expansion planning and renewable energy generation planning.

  3. Consideration of the 15 Factors in the Metropolitan Planning Process

    Science.gov (United States)

    1995-01-01

    This synthesis will be of immediate interest to land luse and transportation : planning officials, with special interest to state, regional, and local planners : and administrators who must repond to the requirements of the Intermodal Surface : Trans...

  4. Wilmington Area Planning Council, New Castle County, Delaware and Cecil County, Maryland : a performance-based approach to integrating congestion management into the metropolitan planning process

    Science.gov (United States)

    2009-04-01

    The Wilmington Area Planning Council takes an objectives-driven, performance-based approach to its metropolitan transportation planning, including paying special attention to integrating its Congestion Management Process into its planning efforts. Th...

  5. Application of ConceptDraw Office for planning, documenting, monitoring of operating processes

    International Nuclear Information System (INIS)

    Bocharnikov, O.P.; Savenko, S.V.; Nikiforov, N.S.

    2011-01-01

    ConceptDraw Office allows effectively deciding the following tasks: to carry out planning, designing, control of implementation of production processes; to prepare working documents (engineering diagrams, process flor diagrams, evacuation and emergency plans; to create dashboards with information for organization management; to distribute the organization resources with the purpose of increase of efficiency and safety of operating processes.

  6. Occupational therapy discharge planning for older adults: A protocol for a randomised trial and economic evaluation

    Science.gov (United States)

    2012-01-01

    Background Decreased functional ability is common in older adults after hospitalisation. Lower levels of functional ability increase the risk of hospital readmission and nursing care facility admission. Discharge planning across the hospital and community interface is suggested to increase functional ability and decrease hospital length of stay and hospital readmission. However evidence is limited and the benefits of occupational therapists providing this service has not been investigated. This randomised trial will investigate the clinical effectiveness of a discharge planning program in reducing functional difficulties of older adults post-discharge. This trial will also examine the cost of the intervention and cost effectiveness when compared to in-hospital discharge planning. Methods/design 400 participants admitted to participating hospitals will be recruited. Participants will be 70 years of age and over, have no significant cognitive impairment and be independently mobile at discharge. This study protocol was approved by the ethics committee of Ryde Rehabilitation Human Research Ethics Committee, Western Sydney Local Health District (Westmead Campus) Human Research Ethics Committee, Alfred Health Human Research ethics committee for the randomised trial and NSW Population and Health Service Human Research Ethics Committee for data linkage. Participants will provide informed written consent. Participants will be randomly allocated to the intervention or control group. The intervention group will receive discharge planning therapies primarily within their home environment while the control group will receive an in-hospital consultation, both provided by trained occupational therapists. Primary outcome measures will be the Nottingham Extended Activities of Daily Living Scale (NEADL) and the Late Life Disability Index (LLDI) which will measure functional independence, and participation and limitation in daily life activities. Discussion This trial will

  7. The Process of Educational Planning: PROJECT DESIGN. Interagency Planning for Urban Educational Needs, Number 31.

    Science.gov (United States)

    Eastmond, Jefferson N.

    This planning overview is part of phase two of PROJECT DESIGN, an ESEA Title III project administered by the Fresno City Unified School District. Developing a long-range interagency master plan for Fresno involves three separate but interrelated activities. The first branch of activity consists of conducting a needs assessment (EA 002 822 thru EA…

  8. A multileaf collimator phantom for the quality assurance of radiation therapy planning systems and CT simulators

    International Nuclear Information System (INIS)

    McNiven, Andrea; Kron, Tomas; Van Dyk, Jake

    2004-01-01

    Purpose: The evolution of three-dimensional conformal radiation treatment has led to the use of multileaf collimators (MLCs) in intensity-modulated radiation therapy (IMRT) and other treatment techniques to increase the conformity of the dose distribution. A new quality assurance (QA) phantom has been designed to check the handling of MLC settings in treatment planning and delivery. Methods and materials: The phantom consists of a Perspex block with stepped edges that can be rotated in all planes. The design allows for the assessment of several MLC and micro-MLC types from various manufacturers, and is therefore applicable to most radiation therapy institutions employing MLCs. The phantom is computed tomography (CT) scanned as is a patient, and QA assessments can be made of field edge display for a variety of shapes and orientations on both radiation treatment planning systems (RTPS) and computed tomography simulators. Results: The dimensions of the phantom were verified to be physically correct within an uncertainty range of 0-0.7 mm. Errors in leaf position larger than 1 mm were easily identified by multiple observers. Conclusions: The MLC geometry phantom is a useful tool in the QA of radiation therapy with application to RTPS, CT simulators, and virtual simulation packages with MLC display capabilities

  9. Intensity-modulated radiation therapy to bilateral lower limb extremities concurrently: a planning case study

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, Emma, E-mail: emmafitz1390@gmail.com; Miles, Wesley; Fenton, Paul; Frantzis, Jim [Radiation Oncology, Epworth HealthCare, Victoria (Australia)

    2014-09-15

    Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues. The patient was prescribed a dose of 60 Gy to the planning target volume (PTV) with 1.0 cm bolus over the ventral surface of each limb. The beam arrangement consisted of six treatment fields that avoided entry and exit through the contralateral limb. The treatment plans met the International Commission on Radiation Units and Measurements (ICRU) guidelines and produced highly conformal dosimetric results. Skin toxicity was measured against the National Cancer Institute: Common Terminology Criteria for Adverse Events (NCI: CTCAE) version 3. A well-tolerated treatment was delivered with excellent results given the initial extent of the disease. This case study has demonstrated the feasibility and effectiveness of IMRT for skin cancers as an alternative to surgery and traditional superficial radiation therapy, utilising a complex PTV of the extremities for patients with similar presentations.

  10. Intensity-modulated radiation therapy to bilateral lower limb extremities concurrently: a planning case study

    International Nuclear Information System (INIS)

    Fitzgerald, Emma; Miles, Wesley; Fenton, Paul; Frantzis, Jim

    2014-01-01

    Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues. The patient was prescribed a dose of 60 Gy to the planning target volume (PTV) with 1.0 cm bolus over the ventral surface of each limb. The beam arrangement consisted of six treatment fields that avoided entry and exit through the contralateral limb. The treatment plans met the International Commission on Radiation Units and Measurements (ICRU) guidelines and produced highly conformal dosimetric results. Skin toxicity was measured against the National Cancer Institute: Common Terminology Criteria for Adverse Events (NCI: CTCAE) version 3. A well-tolerated treatment was delivered with excellent results given the initial extent of the disease. This case study has demonstrated the feasibility and effectiveness of IMRT for skin cancers as an alternative to surgery and traditional superficial radiation therapy, utilising a complex PTV of the extremities for patients with similar presentations

  11. Spent Nuclear Fuel (SNF) Process Validation Technical Support Plan

    Energy Technology Data Exchange (ETDEWEB)

    SEXTON, R.A.

    2000-03-13

    The purpose of Process Validation is to confirm that nominal process operations are consistent with the expected process envelope. The Process Validation activities described in this document are not part of the safety basis, but are expected to demonstrate that the process operates well within the safety basis. Some adjustments to the process may be made as a result of information gathered in Process Validation.

  12. Spent Nuclear Fuel (SNF) Process Validation Technical Support Plan

    International Nuclear Information System (INIS)

    SEXTON, R.A.

    2000-01-01

    The purpose of Process Validation is to confirm that nominal process operations are consistent with the expected process envelope. The Process Validation activities described in this document are not part of the safety basis, but are expected to demonstrate that the process operates well within the safety basis. Some adjustments to the process may be made as a result of information gathered in Process Validation

  13. Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

    Directory of Open Access Journals (Sweden)

    Coffey Mary

    2009-02-01

    Full Text Available Abstract Intensity Modulated Radiation Therapy (IMRT is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC shapes in the sequencing step. One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality. The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one. Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct

  14. Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes

    Energy Technology Data Exchange (ETDEWEB)

    Kranen, Simon van; Hamming-Vrieze, Olga; Wolf, Annelisa; Damen, Eugène [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Herk, Marcel van [Christie Hospital and University of Manchester, Manchester (United Kingdom); Sonke, Jan-Jakob, E-mail: j.sonke@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2016-11-01

    Purpose: We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials: For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results: Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (D{sub mean}) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10%), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, D{sub mean}) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to <2 Gy of initially planned. Conclusions: Volumetric modulated arc therapy head and neck cancer treatment plans with 5-mm margins are robust for anatomy changes and show a modest

  15. Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

    International Nuclear Information System (INIS)

    Broderick, Maria; Leech, Michelle; Coffey, Mary

    2009-01-01

    Intensity Modulated Radiation Therapy (IMRT) is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC) shapes in the sequencing step. One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU) required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality. The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one. Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct Aperture optimization

  16. Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes

    International Nuclear Information System (INIS)

    Kranen, Simon van; Hamming-Vrieze, Olga; Wolf, Annelisa; Damen, Eugène; Herk, Marcel van; Sonke, Jan-Jakob

    2016-01-01

    Purpose: We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials: For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results: Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (D mean ) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10%), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, D mean ) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to <2 Gy of initially planned. Conclusions: Volumetric modulated arc therapy head and neck cancer treatment plans with 5-mm margins are robust for anatomy changes and show a modest increase in OAR

  17. A system for continual quality improvement of normal tissue delineation for radiation therapy treatment planning.

    Science.gov (United States)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman; Roeske, John C

    2012-08-01

    To implement the "plan-do-check-act" (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ("gold" contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose assessment in radiotherapy treatment planning and delivery. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. A critical evaluation of worst case optimization methods for robust intensity-modulated proton therapy planning.

    Science.gov (United States)

    Fredriksson, Albin; Bokrantz, Rasmus

    2014-08-01

    To critically evaluate and compare three worst case optimization methods that have been previously employed to generate intensity-modulated proton therapy treatment plans that are robust against systematic errors. The goal of the evaluation is to identify circumstances when the methods behave differently and to describe the mechanism behind the differences when they occur. The worst case methods optimize plans to perform as well as possible under the worst case scenario that can physically occur (composite worst case), the combination of the worst case scenarios for each objective constituent considered independently (objectivewise worst case), and the combination of the worst case scenarios for each voxel considered independently (voxelwise worst case). These three methods were assessed with respect to treatment planning for prostate under systematic setup uncertainty. An equivalence with probabilistic optimization was used to identify the scenarios that determine the outcome of the optimization. If the conflict between target coverage and normal tissue sparing is small and no dose-volume histogram (DVH) constraints are present, then all three methods yield robust plans. Otherwise, they all have their shortcomings: Composite worst case led to unnecessarily low plan quality in boundary scenarios that were less difficult than the worst case ones. Objectivewise worst case generally led to nonrobust plans. Voxelwise worst case led to overly conservative plans with respect to DVH constraints, which resulted in excessive dose to normal tissue, and less sharp dose fall-off than the other two methods. The three worst case methods have clearly different behaviors. These behaviors can be understood from which scenarios that are active in the optimization. No particular method is superior to the others under all circumstances: composite worst case is suitable if the conflicts are not very severe or there are DVH constraints whereas voxelwise worst case is advantageous if

  19. A critical evaluation of worst case optimization methods for robust intensity-modulated proton therapy planning

    International Nuclear Information System (INIS)

    Fredriksson, Albin; Bokrantz, Rasmus

    2014-01-01

    Purpose: To critically evaluate and compare three worst case optimization methods that have been previously employed to generate intensity-modulated proton therapy treatment plans that are robust against systematic errors. The goal of the evaluation is to identify circumstances when the methods behave differently and to describe the mechanism behind the differences when they occur. Methods: The worst case methods optimize plans to perform as well as possible under the worst case scenario that can physically occur (composite worst case), the combination of the worst case scenarios for each objective constituent considered independently (objectivewise worst case), and the combination of the worst case scenarios for each voxel considered independently (voxelwise worst case). These three methods were assessed with respect to treatment planning for prostate under systematic setup uncertainty. An equivalence with probabilistic optimization was used to identify the scenarios that determine the outcome of the optimization. Results: If the conflict between target coverage and normal tissue sparing is small and no dose-volume histogram (DVH) constraints are present, then all three methods yield robust plans. Otherwise, they all have their shortcomings: Composite worst case led to unnecessarily low plan quality in boundary scenarios that were less difficult than the worst case ones. Objectivewise worst case generally led to nonrobust plans. Voxelwise worst case led to overly conservative plans with respect to DVH constraints, which resulted in excessive dose to normal tissue, and less sharp dose fall-off than the other two methods. Conclusions: The three worst case methods have clearly different behaviors. These behaviors can be understood from which scenarios that are active in the optimization. No particular method is superior to the others under all circumstances: composite worst case is suitable if the conflicts are not very severe or there are DVH constraints whereas

  20. Strategic investment of embodied energy during the architectural planning process

    Directory of Open Access Journals (Sweden)

    Linda Hildebrand

    2014-05-01

    Full Text Available Background and motivation Building industry impacts natural cycles and has potential for optimization. While impairment on nature reached a new dimension already some three centuries ago the building industry started to realize the dependency in the second half of the 20th century. With LCA method all life cycle phases can be monitored and the environmental impact of each can be quantified. The energy consuming and emission generating components in the building context can be distinguished in the groups transport, operation and material. An architect deals with the operational energy and the building substance. With nearly zero (not renewable energy for operation an ecological building is defined by the building substance. Evaluation of the building substance While the building structure accounts for the highest share of embodied energy and GWP, the facade offers high potential for optimisation. This potential is even higher when considering a long (50-100 years usage life span; the building structure remains while the (non load-bearing facade is object to exchange cycles. Findings and their integration into the architectural planning process The city is a depot for resources and we (it involves a variety of professions need to learn how to organize it. Modularity, light construction, the use of renewable materials and mono materials are also interesting fields which are looked at from a different point of view. They are relevant for all building elements. Although they are not initially invented to reduce the ecological impact of the built environment, they show potential to do so. The facade is the essential parameter for the resource-efficiency of a building as it is exchanged and binds relevant amounts of material. Impact can be made within this element due to its high variation in construction and materialization. The material cycles need to become smaller and the gaps – landfill or downcycling need to be closed. The use of resources will

  1. 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

  2. Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

    International Nuclear Information System (INIS)

    Quan, Enzhuo M.; Chang, Joe Y.; Liao Zhongxing; Xia Tingyi; Yuan Zhiyong; Liu Hui; Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe; Zhang Xiaodong

    2012-01-01

    Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

  3. Performance of a Knowledge-Based Model for Optimization of Volumetric Modulated Arc Therapy Plans for Single and Bilateral Breast Irradiation.

    Directory of Open Access Journals (Sweden)

    Antonella Fogliata

    Full Text Available To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy, VMAT, applied to whole breast irradiation.A set of 150 VMAT dose plans with simultaneous integrated boost were selected to train a model for the prediction of dose-volume constraints. The dosimetric validation was done on different groups of patients from three institutes for single (50 cases and bilateral breast (20 cases.Quantitative improvements were observed between the model-based and the reference plans, particularly for heart dose. Of 460 analysed dose-volume objectives, 13% of the clinical plans failed to meet the constraints while the respective model-based plans succeeded. Only in 5 cases did the reference plans pass while the respective model-based failed the criteria. For the bilateral breast analysis, the model-based plans resulted in superior or equivalent dose distributions to the reference plans in 96% of the cases.Plans optimised using a knowledge-based model to determine the dose-volume constraints showed dosimetric improvements when compared to earlier approved clinical plans. The model was applicable to patients from different centres for both single and bilateral breast irradiation. The data suggests that the dose-volume constraint optimisation can be effectively automated with the new engine and could encourage its application to clinical practice.

  4. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    Science.gov (United States)

    Brodin, N P; Björk-Eriksson, T; Birk Christensen, C; Kiil-Berthelsen, A; Aznar, M C; Hollensen, C; Markova, E; Munck af Rosenschöld, P

    2015-01-01

    Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT. PMID:25494657

  5. ‘Strategic navigation’ in collaborative innovation planning processes

    DEFF Research Database (Denmark)

    Hansen, Jesper Rohr

    2013-01-01

    actors needs to collaborate in order to pool resources and come up with innovative solutions. This paper argues that collaborative innovation leadership as a research field struggles with the same dilemma between control and self-organization as contemporary planning theory. The theoretical discussion......Today’s planning dilemmas for the urban fringe in western cities can be perceived of as a struggle between self-organization and control. This is pertinent in times of austerity. Public planning authorities are dependent on cross-sector collaboration in order to enhance the urban development...... leads to the formulation of an analytical model that can be used in future studies of leadership emergence in the urban fringe....

  6. Finite Progressive Planning for the Assembly Process in Footwear

    Science.gov (United States)

    Reyes, John; Aldás, Darwin; Salazar, Edisson; Armendáriz, Evelyn; Álvarez, Kevin; Núñez, José; García, Mario

    2017-06-01

    The scheduling of the operations of a manufacturing system is recognized for its efficiency in establishing a characteristic rate of production based on the forecasting of the ending date of an order. However, progressive planning focused on the footwear industries has not been studied in detail, since it is limited by the use of machines and supply according to the demand of the production line, whose development is based on just in time. The study proposes a finite progressive planning model in the area of footwear assembly that begins with analysis of the demand and identification of manufacturing constraints in order to establish an optimal ordering sequence. The results show manufacturing requirements through production orders that automatically determine production shifts per order, through experimentation of scenarios, the 25% increase in productivity indicators and a 31% improvement in efficiency are established. This improvement represents higher benefits for the industrial sector when establishing planning in the workplace.

  7. Planning, execution and monitoring of physical rehabilitation therapies with a robotic architecture.

    Science.gov (United States)

    González, José Carlos; Pulido, José Carlos; Fernández, Fernando; Suárez-Mejías, Cristina

    2015-01-01

    Traditional methods of rehabilitation require continuous attention of therapists during the therapy sessions. This is a hard and expensive task in terms of time and effort. In many cases, the therapeutic objectives cannot be achieved due to the overwork or the difficulty for therapists to plan accurate sessions according to the medical criteria. For this purpose, a wide range of studies is opened in order to research new ways of rehabilitation, as in the field of social robotics. This work presents the current state of the THERAPIST project. Our main goal is to develop a cognitive architecture which provides a robot with enough autonomy to carry out an upper-limb rehabilitation therapy for patients with physical impairments, such as Cerebral Palsy and Obstetric Brachial Plexus Palsy.

  8. Computational Modeling of Medical Images of Brain Tumor Patients for Optimized Radiation Therapy Planning

    DEFF Research Database (Denmark)

    Agn, Mikael

    In brain tumor radiation therapy, the aim is to maximize the delivered radiation dose to the targeted tumor and at the same time minimize the dose to sensitive healthy structures – so-called organs-at-risk (OARs). When planning a radiation therapy session, the tumor and the OARs therefore need......, a need for automated methods that can segment both brain tumors and OARs. However, there is a noticeable lack in the literature of methods that simultaneously segment both types of structures. To automatically segment medical images of brain tumor patients is difficult because brain tumors vary greatly...... in size, shape, appearance and location within the brain. Furthermore, healthy structures surrounding a tumor are pushed and deformed by the so-called mass effect of the tumor. Moreover, medical imaging techniques often result in imaging artifacts and varying intensity across imaging centers. The goal...

  9. User requirements on CT-based computed dose planning systems in radiation therapy

    International Nuclear Information System (INIS)

    Dahlin, H.

    1983-01-01

    The expanding use of computers in radiation therapy procedures, especially the rapidly increasing use of digital CT-information, necessitates the coordination of the different systems in order to facilitate their developments. In order to define necessary demands for tomorrow a Nordic cooperation was initiated in 1981 by NORDFORSK (Nordic co-operative organisation for applied research), and a group of physicians and physicists having their daily work in this field of medicine and physics was invited to produce a report on 'User requirements on CT-based computed dose planning systems in radiation therapy'. The work has been done within the frame of NORDFORSK's activities and has been independent of the existing commissions and associations in the radiology field, but it has taken into consideration recommendations that have been given by or are being produced by other organizations. (Auth.)

  10. 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

  11. 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...

  12. Statistical process control analysis for patient quality assurance of intensity modulated radiation therapy

    Science.gov (United States)

    Lee, Rena; Kim, Kyubo; Cho, Samju; Lim, Sangwook; Lee, Suk; Shim, Jang Bo; Huh, Hyun Do; Lee, Sang Hoon; Ahn, Sohyun

    2017-11-01

    This study applied statistical process control to set and verify the quality assurances (QA) tolerance standard for our hospital's characteristics with the criteria standards that are applied to all the treatment sites with this analysis. Gamma test factor of delivery quality assurances (DQA) was based on 3%/3 mm. Head and neck, breast, prostate cases of intensity modulated radiation therapy (IMRT) or volumetric arc radiation therapy (VMAT) were selected for the analysis of the QA treatment sites. The numbers of data used in the analysis were 73 and 68 for head and neck patients. Prostate and breast were 49 and 152 by MapCHECK and ArcCHECK respectively. C p value of head and neck and prostate QA were above 1.0, C pml is 1.53 and 1.71 respectively, which is close to the target value of 100%. C pml value of breast (IMRT) was 1.67, data values are close to the target value of 95%. But value of was 0.90, which means that the data values are widely distributed. C p and C pml of breast VMAT QA were respectively 1.07 and 2.10. This suggests that the VMAT QA has better process capability than the IMRT QA. Consequently, we should pay more attention to planning and QA before treatment for breast Radiotherapy.

  13. Reoptimization of Intensity Modulated Proton Therapy Plans Based on Linear Energy Transfer

    Energy Technology Data Exchange (ETDEWEB)

    Unkelbach, Jan, E-mail: junkelbach@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Botas, Pablo [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Faculty of Physics, Ruprecht-Karls-Universität Heidelberg, Heidelberg (Germany); Giantsoudi, Drosoula; Gorissen, Bram L.; Paganetti, Harald [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-12-01

    Purpose: We describe a treatment plan optimization method for intensity modulated proton therapy (IMPT) that avoids high values of linear energy transfer (LET) in critical structures located within or near the target volume while limiting degradation of the best possible physical dose distribution. Methods and Materials: To allow fast optimization based on dose and LET, a GPU-based Monte Carlo code was extended to provide dose-averaged LET in addition to dose for all pencil beams. After optimizing an initial IMPT plan based on physical dose, a prioritized optimization scheme is used to modify the LET distribution while constraining the physical dose objectives to values close to the initial plan. The LET optimization step is performed based on objective functions evaluated for the product of LET and physical dose (LET×D). To first approximation, LET×D represents a measure of the additional biological dose that is caused by high LET. Results: The method is effective for treatments where serial critical structures with maximum dose constraints are located within or near the target. We report on 5 patients with intracranial tumors (high-grade meningiomas, base-of-skull chordomas, ependymomas) in whom the target volume overlaps with the brainstem and optic structures. In all cases, high LET×D in critical structures could be avoided while minimally compromising physical dose planning objectives. Conclusion: LET-based reoptimization of IMPT plans represents a pragmatic approach to bridge the gap between purely physical dose-based and relative biological effectiveness (RBE)-based planning. The method makes IMPT treatments safer by mitigating a potentially increased risk of side effects resulting from elevated RBE of proton beams near the end of range.

  14. A class solution for volumetric-modulated arc therapy planning in postprostatectomy radiotherapy

    International Nuclear Information System (INIS)

    Forde, Elizabeth; Bromley, Regina; Kneebone, Andrew; Eade, Thomas

    2014-01-01

    This study is aimed to test a postprostatectomy volumetric-modulated arc therapy (VMAT) planning class solution. The solution applies to both the progressive resolution optimizer algorithm version 2 (PRO 2) and the algorithm version 3 (PRO 3), addressing the effect of an upgraded algorithm. A total of 10 radical postprostatectomy patients received 68 Gy to 95% of the planning target volume (PTV), which was planned using VMAT. Each case followed a set of planning instructions; including contouring, field setup, and predetermined optimization parameters. Each case was run through both algorithms only once, with no user interaction. Results were averaged and compared against Radiation Therapy Oncology Group (RTOG) 0534 end points. In addition, the clinical target volume (CTV) D 100 , PTV D 99 , and PTV mean doses were recorded, along with conformity indices (CIs) (95% and 98%) and the homogeneity index. All cases satisfied PTV D 95 of 68 Gy and a maximum dose < 74.8 Gy. The average result for the PTV D 99 was 64.1 Gy for PRO 2 and 62.1 Gy for PRO 3. The average PTV mean dose for PRO 2 was 71.4 Gy and 71.5 Gy for PRO 3. The CTV D 100 average dose was 67.7 and 68.0 Gy for PRO 2 and PRO 3, respectively. The mean homogeneity index for both algorithms was 0.08. The average 95% CI was 1.17 for PRO 2 and 1.19 for PRO 3. For 98%, the average results were 1.08 and 1.12 for PRO 2 and PRO 3, respectively. All cases for each algorithm met the RTOG organs at risk dose constraints. A successful class solution has been established for prostate bed VMAT radiotherapy regardless of the algorithm used

  15. A class solution for volumetric-modulated arc therapy planning in postprostatectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Forde, Elizabeth, E-mail: eforde@tcd.ie [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Bromley, Regina [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Institute of Medical Physics, School of Physics, University of Sydney, New South Wales (Australia); Kneebone, Andrew; Eade, Thomas [Radiation Oncology Department, Northern Sydney Cancer Centre, St Leonards, New South Wales (Australia); Northern Clinical School, University of Sydney, New South Wales (Australia)

    2014-10-01

    This study is aimed to test a postprostatectomy volumetric-modulated arc therapy (VMAT) planning class solution. The solution applies to both the progressive resolution optimizer algorithm version 2 (PRO 2) and the algorithm version 3 (PRO 3), addressing the effect of an upgraded algorithm. A total of 10 radical postprostatectomy patients received 68 Gy to 95% of the planning target volume (PTV), which was planned using VMAT. Each case followed a set of planning instructions; including contouring, field setup, and predetermined optimization parameters. Each case was run through both algorithms only once, with no user interaction. Results were averaged and compared against Radiation Therapy Oncology Group (RTOG) 0534 end points. In addition, the clinical target volume (CTV) D{sub 100}, PTV D{sub 99}, and PTV mean doses were recorded, along with conformity indices (CIs) (95% and 98%) and the homogeneity index. All cases satisfied PTV D{sub 95} of 68 Gy and a maximum dose < 74.8 Gy. The average result for the PTV D{sub 99} was 64.1 Gy for PRO 2 and 62.1 Gy for PRO 3. The average PTV mean dose for PRO 2 was 71.4 Gy and 71.5 Gy for PRO 3. The CTV D{sub 100} average dose was 67.7 and 68.0 Gy for PRO 2 and PRO 3, respectively. The mean homogeneity index for both algorithms was 0.08. The average 95% CI was 1.17 for PRO 2 and 1.19 for PRO 3. For 98%, the average results were 1.08 and 1.12 for PRO 2 and PRO 3, respectively. All cases for each algorithm met the RTOG organs at risk dose constraints. A successful class solution has been established for prostate bed VMAT radiotherapy regardless of the algorithm used.

  16. 75 FR 66319 - State Systems Advance Planning Document (APD) Process

    Science.gov (United States)

    2010-10-28

    ... program and information technology managers, and welfare researchers. The working seminar met eight times.... This final rule reduces the submission requirements for lower-risk information technology (IT) projects... submitted by States, counties, and territories for approval of their Information Technology plans and...

  17. An Ensemble Approach to Knowledge-Based Intensity-Modulated Radiation Therapy Planning

    Directory of Open Access Journals (Sweden)

    Jiahan Zhang

    2018-03-01

    Full Text Available Knowledge-based planning (KBP utilizes experienced planners’ knowledge embedded in prior plans to estimate optimal achievable dose volume histogram (DVH of new cases. In the regression-based KBP framework, previously planned patients’ anatomical features and DVHs are extracted, and prior knowledge is summarized as the regression coefficients that transform features to organ-at-risk DVH predictions. In our study, we find that in different settings, different regression methods work better. To improve the robustness of KBP models, we propose an ensemble method that combines the strengths of various linear regression models, including stepwise, lasso, elastic net, and ridge regression. In the ensemble approach, we first obtain individual model prediction metadata using in-training-set leave-one-out cross validation. A constrained optimization is subsequently performed to decide individual model weights. The metadata is also used to filter out impactful training set outliers. We evaluate our method on a fresh set of retrospectively retrieved anonymized prostate intensity-modulated radiation therapy (IMRT cases and head and neck IMRT cases. The proposed approach is more robust against small training set size, wrongly labeled cases, and dosimetric inferior plans, compared with other individual models. In summary, we believe the improved robustness makes the proposed method more suitable for clinical settings than individual models.

  18. Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma.

    Science.gov (United States)

    Ulger, Sukran; Cetin, Eren; Catli, Serap; Sarac, Hilal; Kilic, Diclehan; Bora, Huseyin

    2017-06-01

    To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma. Twenty-four radiation therapy plannings were evaluated and compared with dosimetric outcomes of conformal radiation therapy and intensity-modulated radiation therapy. Hemithoracal radiation therapy was performed on 12 patients with a fraction of 1.8 Gy to a total dose of 50.4 Gy. All organs at risk were contoured. Radiotherapy plannings were differed according to the technique; conformal radiation therapy was planned with conventionally combined photon-electron fields, and intensity-modulated radiation therapy was planned with 7 to 9 radiation beam angles optimized in inverse planning. Strict dose-volume constraints were applied. Intensity-modulated radiation therapy was statistically superior in target coverage and dose homogeneity (intensity-modulated radiation therapy-planning target volume 95 mean 100%; 3-dimensional conformal radiation therapy-planning target volume 95 mean 71.29%, P = .0001; intensity-modulated radiation therapy-planning target volume 105 mean 11.14%; 3-dimensional conformal radiation therapy-planning target volume 105 mean 35.69%, P = .001). The dosimetric results of the remaining lung was below the limitations on intensity-modulated radiation therapy planning data (intensity-modulated radiation therapy-lung mean dose mean 7.5 [range: 5.6%-8.5%]; intensity-modulated radiation therapy-lung V5 mean 55.55% [range: 47%-59.9%]; intensity-modulated radiation therapy-lung V20 mean 4.5% [range: 0.5%-9.5%]; intensity-modulated radiation therapy-lung V13 mean 13.43% [range: 4.2%-22.9%]). With a complex and large target volume of malignant pleural mesothelioma, intensity-modulated radiation therapy has the ability to deliver efficient tumoricidal radiation dose within the safe dose limits of the remaining lung tissue.

  19. Comparison of organ-at-risk sparing and plan robustness for spot-scanning proton therapy and volumetric modulated arc photon therapy in head-and-neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Barten, Danique L. J., E-mail: d.barten@vumc.nl; Tol, Jim P.; Dahele, Max; Slotman, Ben J.; Verbakel, Wilko F. A. R. [Department of Radiotherapy, VU University Medical Center, De Boelelaan 1118, Amsterdam 1081 HV (Netherlands)

    2015-11-15

    Purpose: Proton radiotherapy for head-and-neck cancer (HNC) aims to improve organ-at-risk (OAR) sparing over photon radiotherapy. However, it may be less robust for setup and range uncertainties. The authors investigated OAR sparing and plan robustness for spot-scanning proton planning techniques and compared these with volumetric modulated arc therapy (VMAT) photon plans. Methods: Ten HNC patients were replanned using two arc VMAT (RapidArc) and spot-scanning proton techniques. OARs to be spared included the contra- and ipsilateral parotid and submandibular glands and individual swallowing muscles. Proton plans were made using Multifield Optimization (MFO, using three, five, and seven fields) and Single-field Optimization (SFO, using three fields). OAR sparing was evaluated using mean dose to composite salivary glands (Comp{sub Sal}) and composite swallowing muscles (Comp{sub Swal}). Plan robustness was determined for setup and range uncertainties (±3 mm for setup, ±3% HU) evaluating V95% and V107% for clinical target volumes. Results: Averaged over all patients Comp{sub Sal}/Comp{sub Swal} mean doses were lower for the three-field MFO plans (14.6/16.4 Gy) compared to the three-field SFO plans (20.0/23.7 Gy) and VMAT plans (23.0/25.3 Gy). Using more than three fields resulted in differences in OAR sparing of less than 1.5 Gy between plans. SFO plans were significantly more robust than MFO plans. VMAT plans were the most robust. Conclusions: MFO plans had improved OAR sparing but were less robust than SFO and VMAT plans, while SFO plans were more robust than MFO plans but resulted in less OAR sparing. Robustness of the MFO plans did not increase with more fields.

  20. Applying lean principles to continuous renal replacement therapy processes.

    Science.gov (United States)

    Benfield, C Brett; Brummond, Philip; Lucarotti, Andrew; Villarreal, Maria; Goodwin, Adam; Wonnacott, Rob; Talley, Cheryl; Heung, Michael

    2015-02-01

    The application of lean principles to continuous renal replacement therapy (CRRT) processes in an academic medical center is described. A manual audit over six consecutive weeks revealed that 133 5-L bags of CRRT solution were discarded after being dispensed from pharmacy but before clinical use. Lean principles were used to examine the workflow for CRRT preparation and develop and implement an intervention. An educational program was developed to encourage and enhance direct communication between nursing and pharmacy about changes in a patient's condition or CRRT order. It was through this education program that the reordering workflow shifted from nurses to pharmacy technicians. The primary outcome was the number of CRRT solution bags delivered in the preintervention and postintervention periods. Nurses and pharmacy technicians were surveyed to determine their satisfaction with the workflow change. After implementation of lean principles, the mean number of CRRT solution bags dispensed per day of CRRT decreased substantially. Respondents' overall satisfaction with the CRRT solution preparation process increased during the postintervention period, and the satisfaction scores for each individual component of the workflow after implementation of lean principles. The decreased solution waste resulted in projected annual cost savings exceeding $70,000 in product alone. The use of lean principles to identify medication waste in the CRRT workflow and implementation of an intervention to shift the workload from intensive care unit nurses to pharmacy technicians led to reduced CRRT solution waste, improved efficiency of CRRT workflow, and increased satisfaction among staff. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  1. Distinguishing between taskwork and teamwork planning in teams: relations with coordination and interpersonal processes.

    Science.gov (United States)

    Fisher, David M

    2014-05-01

    Planning in teams represents a critical process that lays the groundwork for effective team functioning. The current investigation examined whether emergent team planning can be meaningfully characterized in terms of a distinction between planning that focuses on taskwork and planning that focuses on teamwork. In Study 1, items written to reflect commonly identified indicators of team planning were subjected to an exploratory factor analysis. In Study 2, slightly modified items were provided to a separate sample, and a confirmatory factor analysis was conducted. In Study 3, the relationships between the different forms of planning and other team processes (i.e., coordination, interpersonal processes) were examined in order to determine whether there are unique relationships for task-focused and team-focused planning. Results from the first 2 studies provided support for a 2-factor structure of team planning, whereas Study 3 found independent relationships for taskwork and teamwork planning with subsequent team processes. Both forms of planning also exhibited indirect relationships with team performance via the mediating role of subsequent team processes. (c) 2014 APA, all rights reserved.

  2. Increasing the Usability of Cognitive Processing Therapy for Survivors of Child Sexual Abuse

    Science.gov (United States)

    House, Amy S.

    2006-01-01

    There is an ongoing need for empirically based treatments for child sexual abuse (CSA) that are time-efficient and cost-effective. This article describes a modification of cognitive processing therapy for child sexual abuse (CPT-SA) that increases the therapy's usability by reducing the number of individual therapy sessions required. The…

  3. Feasibility of Proton Beam Therapy for Ocular Melanoma Using a Novel 3D Treatment Planning Technique

    International Nuclear Information System (INIS)

    Hartsell, William F.; Kapur, Rashmi; Hartsell, Siobhan O'Connor; Sweeney, Patrick; Lopes, Caitlin; Duggal, Amanda; Cohen, Jack; Chang, John; Polasani, Rajeev S.; Dunn, Megan; Pankuch, Mark

    2016-01-01

    Purpose: We evaluated sparing of normal structures using 3-dimensional (3D) treatment planning for proton therapy of ocular melanomas. Methods and Materials: We evaluated 26 consecutive patients with choroidal melanomas on a prospective registry. Ophthalmologic work-up included fundoscopic photographs, fluorescein angiography, ultrasonographic evaluation of tumor dimensions, and magnetic resonance imaging of orbits. Three tantalum clips were placed as fiducial markers to confirm eye position for treatment. Macula, fovea, optic disc, optic nerve, ciliary body, lacrimal gland, lens, and gross tumor volume were contoured on treatment planning compute tomography scans. 3D treatment planning was performed using noncoplanar field arrangements. Patients were typically treated with 3 fields, with at least 95% of planning target volume receiving 50 GyRBE in 5 fractions. Results: Tumor stage was T1a in 10 patients, T2a in 10 patients, T2b in 1 patient, T3a in 2 patients, T3b in 1 patient, and T4a in 2 patients. Acute toxicity was mild. All patients completed treatment as planned. Mean optic nerve dose was 10.1 Gy relative biological effectiveness (RBE). Ciliary body doses were higher for nasal (mean: 11.4 GyRBE) than temporal tumors (5.8 GyRBE). Median follow-up was 31 months (range: 18-40 months). Six patients developed changes which required intraocular bevacizumab or corticosteroid therapy, but only 1 patient developed neovascular glaucoma. Five patients have since died: 1 from metastatic disease and 4 from other causes. Two patients have since required enucleation: 1 due to tumor and 1 due to neovascular glaucoma. Conclusions: 3D treatment planning can be used to obtain appropriate coverage of choroidal melanomas. This technique is feasible with relatively low doses to anterior structures, and appears to have acceptable rates of local control with low risk of enucleation. Further evaluation and follow-up is needed to determine optimal dose-volume relationships for

  4. Feasibility of Proton Beam Therapy for Ocular Melanoma Using a Novel 3D Treatment Planning Technique

    Energy Technology Data Exchange (ETDEWEB)

    Hartsell, William F., E-mail: whartsell@chicagocancer.org [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Kapur, Rashmi [Retina Consultants, Des Plaines, Illinois (United States); Hartsell, Siobhan O' Connor; Sweeney, Patrick [Northwestern Medicine Chicago Proton Center, Warrenville, Illinois (United States); Lopes, Caitlin [Rush Medical College, Chicago, Illinois (United States); Duggal, Amanda [Northwestern Medicine Chicago Proton Center, Warrenville, Illinois (United States); Cohen, Jack [Department of Ophthalmology, Rush University, Chicago, Illinois (United States); Chang, John [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Polasani, Rajeev S. [Northwestern Medicine Central DuPage Hospital, Winfield, Illinois (United States); Dunn, Megan [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States); Pankuch, Mark [Northwestern Medicine Chicago Proton Center, Proton Collaborative Group, Warrenville, Illinois (United States)

    2016-05-01

    Purpose: We evaluated sparing of normal structures using 3-dimensional (3D) treatment planning for proton therapy of ocular melanomas. Methods and Materials: We evaluated 26 consecutive patients with choroidal melanomas on a prospective registry. Ophthalmologic work-up included fundoscopic photographs, fluorescein angiography, ultrasonographic evaluation of tumor dimensions, and magnetic resonance imaging of orbits. Three tantalum clips were placed as fiducial markers to confirm eye position for treatment. Macula, fovea, optic disc, optic nerve, ciliary body, lacrimal gland, lens, and gross tumor volume were contoured on treatment planning compute tomography scans. 3D treatment planning was performed using noncoplanar field arrangements. Patients were typically treated with 3 fields, with at least 95% of planning target volume receiving 50 GyRBE in 5 fractions. Results: Tumor stage was T1a in 10 patients, T2a in 10 patients, T2b in 1 patient, T3a in 2 patients, T3b in 1 patient, and T4a in 2 patients. Acute toxicity was mild. All patients completed treatment as planned. Mean optic nerve dose was 10.1 Gy relative biological effectiveness (RBE). Ciliary body doses were higher for nasal (mean: 11.4 GyRBE) than temporal tumors (5.8 GyRBE). Median follow-up was 31 months (range: 18-40 months). Six patients developed changes which required intraocular bevacizumab or corticosteroid therapy, but only 1 patient developed neovascular glaucoma. Five patients have since died: 1 from metastatic disease and 4 from other causes. Two patients have since required enucleation: 1 due to tumor and 1 due to neovascular glaucoma. Conclusions: 3D treatment planning can be used to obtain appropriate coverage of choroidal melanomas. This technique is feasible with relatively low doses to anterior structures, and appears to have acceptable rates of local control with low risk of enucleation. Further evaluation and follow-up is needed to determine optimal dose-volume relationships for

  5. A methodology integrating Petri nets and knowledge-based systems to support process family planning

    NARCIS (Netherlands)

    Zhang, Linda L.; Xu, Qianli; Helo, Petri

    2012-01-01

    Planning production processes for product families have been well recognised as an effective means of achieving successful product family development. However, most existing approaches do not lend themselves to planning production processes with focus on the optimality of the cohort of a product

  6. An expert system for process planning of sheet metal parts produced

    Indian Academy of Sciences (India)

    Process planning of sheet metal part is an important activity in the design of compound die. Traditional methods of carrying out this task are manual, tedious, time-consuming, error-prone and experiencebased. This paper describes the research work involved in the development of an expert system for process planning of ...

  7. The Development and Implementation of a Minority Recruitment Plan: Process, Strategy and Results.

    Science.gov (United States)

    Oliver, John; Brown, Lester B.

    1988-01-01

    The planning process and results of a three-year minority student recruitment process in a school of social work are described, including effective tasks and strategies. The recruitment and retention effort consisted of six phases: gauging the environment, preinitiation, program planning and development, implementation, evaluation, and…

  8. An expert system for process planning of sheet metal parts produced ...

    Indian Academy of Sciences (India)

    Process planning of sheet metal part is an important activity in the design of compound die. Traditional methods of carrying out this task are manual, tedious, time-consuming, error-prone and experiencebased. This paper describes the research work involved in the development of an expert system for process planning of ...

  9. 25 CFR 1200.15 - What is the approval process for management plans?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false What is the approval process for management plans? 1200... INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT Withdrawing Tribal Funds From Trust § 1200.15 What is the approval process for management plans? The Secretary will approve or disapprove each...

  10. An expert system for process planning of sheet metal parts produced ...

    Indian Academy of Sciences (India)

    Sachin Salunkhe

    AutoLISP language and user interface is created using visual basic (VB). The system is capable to automate various activities of process planning including blank modeling, ... edge-based process planning system to support auto panel die development and design automation. A computerized. *For correspondence. 901.

  11. The integration of process planning and shop floor scheduling in small batch part manufacturing

    NARCIS (Netherlands)

    Zijm, Willem H.M.; Kals, H.J.J.

    1995-01-01

    In this paper we explore possibilities to cut manufacturing leadtimes and to improve delivery performance in a small batch part manufacturing shop by integrating process planning and shop floor scheduling. Using a set of initial process plans (one for each order in the shop), we exploit a resource

  12. 40 CFR 130.5 - Continuing planning process.

    Science.gov (United States)

    2010-07-01

    ... disposition of all residual waste from any water treatment processing. (8) The process for developing an... Section 130.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER... the Act. Each State is responsible for managing its water quality program to implement the processes...

  13. 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

  14. Influence of the demand information quality on planning process accuracy in supply chain. Case studies

    Directory of Open Access Journals (Sweden)

    Natalia Szozda

    2013-06-01

    Full Text Available Background: Identification and analysis of factors that affect the accuracy of demand planning process across the supply chain is one of the most important problems which influence the effectiveness of its material and information flows. Material and methods: On the basis of demand planning process investigation authors define the main elements affecting the right supply chain performance level and investigate the possible connections between demand information quality and demand planning process accuracy. Later, an overview of some recent developments in the analyzed research area is provided. Results: Based on the literature review, there is described the defined factors impact on the accuracy of demand plan in each echelon for case companies. There are considered three cases. The examples illustrate supply chains of different manufacturing companies. The focus is placed on demand planning across the supply chains. The issue of determining the accuracy of future sales plans in each echelon of supply chains and factors affecting it are raised. Taking into account the case companies demand planning process analyses, there are defined possible quality measures, that are possible to be used when forecasting the customer demand. Conclusions: One of the most important and difficult planning area in the companies is becoming planning demand. Errors in planning are reflected not just in the business resource planning but also in the entire supply chain. Presented cases show that many factors affect the proper demand planning process in the supply chain, like e.g.  information technologies, lead-time, or number of supplied materials. As it can be seen from the case studies, the model of collecting information from the market plays an important role in the demand planning process.

  15. Using discrete-event simulation in strategic capacity planning for an outpatient physical therapy service.

    Science.gov (United States)

    Rau, Chi-Lun; Tsai, Pei-Fang Jennifer; Liang, Sheau-Farn Max; Tan, Jhih-Cian; Syu, Hong-Cheng; Jheng, Yue-Ling; Ciou, Ting-Syuan; Jaw, Fu-Shan

    2013-12-01

    This study uses a simulation model as a tool for strategic capacity planning for an outpatient physical therapy clinic in Taipei, Taiwan. The clinic provides a wide range of physical treatments, with 6 full-time therapists in each session. We constructed a discrete-event simulation model to study the dynamics of patient mixes with realistic treatment plans, and to estimate the practical capacity of the physical therapy room. The changes in time-related and space-related performance measurements were used to evaluate the impact of various strategies on the capacity of the clinic. The simulation results confirmed that the clinic is extremely patient-oriented, with a bottleneck occurring at the traction units for Intermittent Pelvic Traction (IPT), with usage at 58.9 %. Sensitivity analysis showed that attending to more patients would significantly increase the number of patients staying for overtime sessions. We found that pooling the therapists produced beneficial results. The average waiting time per patient could be reduced by 45 % when we pooled 2 therapists. We found that treating up to 12 new patients per session had no significantly negative impact on returning patients. Moreover, we found that the average waiting time for new patients decreased if they were given priority over returning patients when called by the therapists.

  16. A unifying probabilistic Bayesian approach to derive electron density from MRI for radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Gudur, Madhu Sudhan Reddy; Hara, Wendy; Le, Quynh-Thu; Wang, Lei; Xing, Lei; Li, Ruijiang

    2014-01-01

    MRI significantly improves the accuracy and reliability of target delineation in radiation therapy for certain tumors due to its superior soft tissue contrast compared to CT. A treatment planning process with MRI as the sole imaging modality will eliminate systematic CT/MRI co-registration errors, reduce cost and radiation exposure, and simplify clinical workflow. However, MRI lacks the key electron density information necessary for accurate dose calculation and generating reference images for patient setup. The purpose of this work is to develop a unifying method to derive electron density from standard T1-weighted MRI. We propose to combine both intensity and geometry information into a unifying probabilistic Bayesian framework for electron density mapping. For each voxel, we compute two conditional probability density functions (PDFs) of electron density given its: (1) T1-weighted MRI intensity, and (2) geometry in a reference anatomy, obtained by deformable image registration between the MRI of the atlas and test patient. The two conditional PDFs containing intensity and geometry information are combined into a unifying posterior PDF, whose mean value corresponds to the optimal electron density value under the mean-square error criterion. We evaluated the algorithm’s accuracy of electron density mapping and its ability to detect bone in the head for eight patients, using an additional patient as the atlas or template. Mean absolute HU error between the estimated and true CT, as well as receiver operating characteristics for bone detection (HU > 200) were calculated. The performance was compared with a global intensity approach based on T1 and no density correction (set whole head to water). The proposed technique significantly reduced the errors in electron density estimation, with a mean absolute HU error of 126, compared with 139 for deformable registration (p = 2  ×  10 −4 ), 283 for the intensity approach (p = 2  ×  10 −6 ) and 282

  17. A unifying probabilistic Bayesian approach to derive electron density from MRI for radiation therapy treatment planning

    Science.gov (United States)

    Sudhan Reddy Gudur, Madhu; Hara, Wendy; Le, Quynh-Thu; Wang, Lei; Xing, Lei; Li, Ruijiang

    2014-11-01

    MRI significantly improves the accuracy and reliability of target delineation in radiation therapy for certain tumors due to its superior soft tissue contrast compared to CT. A treatment planning process with MRI as the sole imaging modality will eliminate systematic CT/MRI co-registration errors, reduce cost and radiation exposure, and simplify clinical workflow. However, MRI lacks the key electron density information necessary for accurate dose calculation and generating reference images for patient setup. The purpose of this work is to develop a unifying method to derive electron density from standard T1-weighted MRI. We propose to combine both intensity and geometry information into a unifying probabilistic Bayesian framework for electron density mapping. For each voxel, we compute two conditional probability density functions (PDFs) of electron density given its: (1) T1-weighted MRI intensity, and (2) geometry in a reference anatomy, obtained by deformable image registration between the MRI of the atlas and test patient. The two conditional PDFs containing intensity and geometry information are combined into a unifying posterior PDF, whose mean value corresponds to the optimal electron density value under the mean-square error criterion. We evaluated the algorithm’s accuracy of electron density mapping and its ability to detect bone in the head for eight patients, using an additional patient as the atlas or template. Mean absolute HU error between the estimated and true CT, as well as receiver operating characteristics for bone detection (HU > 200) were calculated. The performance was compared with a global intensity approach based on T1 and no density correction (set whole head to water). The proposed technique significantly reduced the errors in electron density estimation, with a mean absolute HU error of 126, compared with 139 for deformable registration (p = 2  ×  10-4), 283 for the intensity approach (p = 2  ×  10-6) and 282 without density

  18. Dosimetric Changes Resulting From Patient Rotational Setup Errors in Proton Therapy Prostate Plans

    International Nuclear Information System (INIS)

    Sejpal, Samir V.; Amos, Richard A.; Bluett, Jaques B.; Levy, Lawrence B.; Kudchadker, Rajat J.; Johnson, Jennifer; Choi, Seungtaek; Lee, Andrew K.

    2009-01-01

    Purpose: To evaluate the dose changes to the target and critical structures from rotational setup errors in prostate cancer patients treated with proton therapy. Methods and Materials: A total of 70 plans were analyzed for 10 patients treated with parallel-opposed proton beams to a dose of 7,600 60 Co-cGy-equivalent (CcGE) in 200 CcGE fractions to the clinical target volume (i.e., prostate and proximal seminal vesicles). Rotational setup errors of +3 o , -3 deg., +5 deg., and -5 deg. (to simulate pelvic tilt) were generated by adjusting the gantry. Horizontal couch shifts of +3 deg. and -3 deg. (to simulate longitudinal setup variability) were also generated. Verification plans were recomputed, keeping the same treatment parameters as the control. Results: All changes shown are for 38 fractions. The mean clinical target volume dose was 7,780 CcGE. The mean change in the clinical target volume dose in the worse case scenario for all shifts was 2 CcGE (absolute range in worst case scenario, 7,729-7,848 CcGE). The mean changes in the critical organ dose in the worst case scenario was 6 CcGE (bladder), 18 CcGE (rectum), 36 CcGE (anterior rectal wall), and 141 CcGE (femoral heads) for all plans. In general, the percentage of change in the worse case scenario for all shifts to the critical structures was <5%. Deviations in the absolute percentage of volume of organ receiving 45 and 70 Gy for the bladder and rectum were <2% for all plans. Conclusion: Patient rotational movements of 3 deg. and 5 deg. and horizontal couch shifts of 3 deg. in prostate proton planning did not confer clinically significant dose changes to the target volumes or critical structures.

  19. Is it possible for knowledge-based planning to improve intensity modulated radiation therapy plan quality for planners with different planning experiences in left-sided breast cancer patients?

    Science.gov (United States)

    Wang, Juanqi; Hu, Weigang; Yang, Zhaozhi; Chen, Xiaohui; Wu, Zhiqiang; Yu, Xiaoli; Guo, Xiaomao; Lu, Saiquan; Li, Kaixuan; Yu, Gongyi

    2017-05-22

    Knowledge-based planning (KBP) is a promising technique that can improve plan quality and increase planning efficiency. However, no attempts have been made to extend the domain of KBP for planners with different planning experiences so far. The purpose of this study was to quantify the potential gains for planners with different planning experiences after implementing KBP in intensity modulated radiation therapy (IMRT) plans for left-sided breast cancer patients. The model libraries were populated with 80 expert clinical plans from treated patients who previously received left-sided breast-conserving surgery and IMRT with simultaneously integrated boost. The libraries were created on the RapidPlan TM . 6 planners with different planning experiences (2 beginner planners, 2 junior planners and 2 senior planners) generated manual and KBP optimized plans for additional 10 patients, similar to those included in the model libraries. The plan qualities were compared between manual and KBP plans. All plans were capable of achieving the prescription requirement. There were almost no statistically significant differences in terms of the planning target volume (PTV) coverage and dose conformality. It was demonstrated that the doses for most of organs-at-risk (OARs) were on average lower or equal in KBP plans compared to manual plans except for the senior planners, where the very small differences were not statistically significant. KBP data showed a systematic trend to have superior dose sparing at most parameters for the heart and ipsilateral lung. The observed decrease in the doses to these OARs could be achieved, particularly for the beginner and junior planners. Many differences were statistically significant. It is feasible to generate acceptable IMRT plans after implementing KBP for left-sided breast cancer. KBP helps to effectively improve the quality of IMRT plans against the benchmark of manual plans for less experienced planners without any manual intervention. KBP

  20. The effectiveness of pretreatment physics plan review for detecting errors in radiation therapy.

    Science.gov (United States)

    Gopan, Olga; Zeng, Jing; Novak, Avrey; Nyflot, Matthew; Ford, Eric

    2016-09-01

    detected at the review. Of the 81 events from the SAFRON database, 66/81 (81%) were potentially detectable by the pretreatment physics plan review. From the institutional database, three specific physics checks were particularly effective at detecting events (combined effectiveness of 38%): verifying the isocenter (39/180), verifying DRRs (17/180), and verifying that the plan matched the prescription (12/180). The most effective checks from the SAFRON database were verifying that the plan matched the prescription (13/66) and verifying the field parameters in the record and verify system against those in the plan (23/66). Software-based plan checking systems, if available, would have potential effectiveness of 29% and 64% at detecting events from the institutional and SAFRON databases, respectively. Pretreatment physics plan review is a key safety measure and can detect a high percentage of errors. However, the majority of errors that potentially could have been detected were not detected in this study, indicating the need to improve the pretreatment physics plan review performance. Suggestions for improvement include the automation of specific physics checks performed during the pretreatment physics plan review and the standardization of the review process.

  1. The effectiveness of pretreatment physics plan review for detecting errors in radiation therapy

    International Nuclear Information System (INIS)

    Gopan, Olga; Zeng, Jing; Novak, Avrey; Nyflot, Matthew; Ford, Eric

    2016-01-01

    , only 38% (47/125) were actually detected at the review. Of the 81 events from the SAFRON database, 66/81 (81%) were potentially detectable by the pretreatment physics plan review. From the institutional database, three specific physics checks were particularly effective at detecting events (combined effectiveness of 38%): verifying the isocenter (39/180), verifying DRRs (17/180), and verifying that the plan matched the prescription (12/180). The most effective checks from the SAFRON database were verifying that the plan matched the prescription (13/66) and verifying the field parameters in the record and verify system against those in the plan (23/66). Software-based plan checking systems, if available, would have potential effectiveness of 29% and 64% at detecting events from the institutional and SAFRON databases, respectively. Conclusions: Pretreatment physics plan review is a key safety measure and can detect a high percentage of errors. However, the majority of errors that potentially could have been detected were not detected in this study, indicating the need to improve the pretreatment physics plan review performance. Suggestions for improvement include the automation of specific physics checks performed during the pretreatment physics plan review and the standardization of the review process.

  2. Total variation superiorization in dual-energy CT reconstruction for proton therapy treatment planning

    Science.gov (United States)

    Zhu, Jiahua; Penfold, Scott

    2017-04-01

    Proton therapy is a precise form of radiotherapy in which the range of an energetic beam of protons within a patient must be accurately known. The current approach based on single-energy computed tomography (SECT) can lead to uncertainties in the proton range of approximately 3%. This range of uncertainty may lead to under-dosing of the tumour or over-dosing of healthy tissues. Dual-energy CT (DECT) theoretically has the potential to reduce these range uncertainties by quantifying electron density and the effective atomic number. In practice, however, DECT images reconstructed with filtered backprojection (FBP) tend to suffer from high levels of noise. The objective of the current work was to examine the effect of total variation superiorization (TVS) on proton therapy planning accuracy when compared with FBP. A virtual CT scanner was created with the Monte Carlo toolkit Geant4. Tomographic images were reconstructed with FBP and TVS combined with diagonally relaxed orthogonal projections (TVS-DROP). A total variation minimization (TVM) filter was also applied to the image reconstructed with FBP (FBP-TVM). Quantitative accuracy and variance of proton relative stopping power (RSP) derived from each image set was assessed. Mean RSPs were comparable with each image; however, the standard deviation of pixel values with TVS-DROP was reduced by a factor of 0.44 compared with the FBP image and a factor of 0.66 when compared with the FBP-TVM image. Proton doses calculated with the TVS-DROP image set were also better able to predict a reference dose distribution when compared with the FBP and FBP-TVM image sets. The study demonstrated the potential advantages of TVS-DROP as an image reconstruction method for DECT applied to proton therapy treatment planning.

  3. Photon and proton therapy planning comparison for malignant glioma based on CT, FDG-PET, DTI-MRI and fiber tracking

    DEFF Research Database (Denmark)

    Munck af Rosenschöld, Per; Engelholm, Silke; Ohlhues, Lars

    2011-01-01

    The purpose of this study was to compare treatment plans generated using fixed beam Intensity Modulated photon Radiation Therapy (IMRT), inversely optimized arc therapy (RapidArc(R), RA) with spot-scanned Intensity Modulated Proton Therapy (IMPT) for high-grade glioma patients. Plans were compared...

  4. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman; Roeske, John C.

    2012-01-01

    Purpose: To implement the “plan-do-check-act” (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues (“gold” contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes ≥8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose assessment in

  5. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States); Roeske, John C., E-mail: jroeske@lumc.edu [Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois (United States)

    2012-08-01

    Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose

  6. 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.

  7. Achieving performance breakthroughs in an HMO business process through quality planning.

    Science.gov (United States)

    Hanan, K B

    1993-01-01

    Kaiser Permanente's Georgia Region commissioned a quality planning team to design a new process to improve payments to its suppliers and vendors. The result of the team's effort was a 73 percent reduction in cycle time. This team's experiences point to the advantages of process redesign as a quality planning model, as well as some general guidelines for its most effective use in teams. If quality planning project teams are carefully configured, sufficiently expert in the existing process, and properly supported by management, organizations can achieve potentially dramatic improvements in process performance using this approach.

  8. Development of the computer-aided process planning (CAPP system for polymer injection molds manufacturing

    Directory of Open Access Journals (Sweden)

    J. Tepić

    2011-10-01

    Full Text Available Beginning of production and selling of polymer products largely depends on mold manufacturing. The costs of mold manufacturing have significant share in the final price of a product. The best way to improve and rationalize polymer injection molds production process is by doing mold design automation and manufacturing process planning automation. This paper reviews development of a dedicated process planning system for manufacturing of the mold for injection molding, which integrates computer-aided design (CAD, computer-aided process planning (CAPP and computer-aided manufacturing (CAM technologies.

  9. Value of CT scanning in radiation therapy treatment planning: a prospective study

    International Nuclear Information System (INIS)

    Goitein, M.; Wittenberg, J.; Mendiondo, M.; Doucette, J.; Friedberg, C.; Ferrucci, J.; Gunderson, L.; Linggood, R.; Shipley, W.U.; Fineberg, H.V.

    1979-01-01

    We report the results of a prospective study in which we assessed the value of computed tomography (CT) scanning in planning radiation therapy for 77 patients. First, conventional studies were performed, treatment fields were designed and simulated and, where appropriate, computer generated treatment plans drawn up. Then a CT scan was performed to delineate the location of the tumor and adjacent uninvolved tissues. The treatment goals and plans were reevaluated and changed when necessary. Forty of the 77 patients (52%) had their treatment changed as a result of the CT scan. Of these, four (5%) had a change of treatment modality. Thirty-two patients (42%) had changes in the radiotherapy technique because of inadequate tumor coverage (in 24 patients (31%) part of the tumor was outside one or more of the fields and in the other 8 patients (10%) the tumor coverage was marginal). Field changes resulting only from considerations of normal tissue coverage were made for 4 of these patients (5%). In total, normal tissue coverage was affected in 36 patients (47%). When the significance of these changes was evaluated, CT scanning was judged to be of major value for 28 of the 77 patients (36%) and of minor value in a further 12 patients

  10. Automation of the solution type of intensity modulated radiation therapy with direct planning neoplastic breast lesions

    International Nuclear Information System (INIS)

    Fuente Rosales, Liset De La; Larrinaga Cortina, Eduardo Francisco

    2009-01-01

    Breast cancer ranks first among the lesions malignancies involving the Cuban women and the second in mortality only surpassed by lung injury. The breast-conserving surgery is becoming less appeal, with an increase in the choice of radiotherapy to the breast operated, and the surgical bed. Intensity Modulated Radiation Therapy, IMRT has demonstrated better results in the dose distribution for irradiation dimensional treatment breast shaping, 3DCRT. We developed a MATLAB application to obtain the solution type to direct planning IMRT for breast neoplasm. The technique was implemented in the Planning System Treatment Plus Theraplan v3.8 and Precise1 ELEKTA linear accelerator. Static segments are constructed for each portal of incidence and Excel files are exported as the positions of the blades. The technique was validated with a patient, which he performed a radiographic study of computerized axial tomography planning purposes. The standard solution built is consistent with those reported internationally and consists of a segment type and at least two segments of type B. The assignment of the relative weights of the segments is done manually by trial and error procedure, with the general rule of 90% by weight assigned to segment A and the remaining 10% divided equally between B-type segments IMRT breast obtained in a dose 17% homogeneity better than 3DCRT and reduced the average dose in the lung ipsilateral 15%. (author)

  11. The planning flexibility bottleneck in food processing industries

    NARCIS (Netherlands)

    van Wezel, W.M.C.; van Donk, D.P.; Gaalman, G.J.C.

    Production planners in food processing industries must continuously balance efficient production with flexible performance. On the basis of case studies, we state that flexibility is not only restrained by hard-wired production process characteristics, but also by organizational procedures in the

  12. The asphalt paving process: Plans for action research

    NARCIS (Netherlands)

    Miller, Seirgei Rosario; ter Huerne, Henderikus L.; Doree, Andries G.; Atkin, Brian; Borgbrant, Jan

    2007-01-01

    Recent significant changes in public sector procurement in the Netherlands are forcing road construction companies to professionalize one of their primary processes: on-site asphalt paving. This paper describes an initiative aimed at improving quality in the process. A literature review confirmed

  13. sampling plans for monitoring quality control process at a plastic

    African Journals Online (AJOL)

    Dr Obe

    control techniques. Quality control techniques are a means of seeing that quality standards are maintained. A more specific definition of quality control, simply state by juran. 5. , is that it is “the ... but acceptance sampling is a common tool in practice. .... are useful for process monitoring and process capability analysis. Also ...

  14. Density overwrites of internal tumor volumes in intensity modulated proton therapy plans for mobile lung tumors

    Science.gov (United States)

    Botas, Pablo; Grassberger, Clemens; Sharp, Gregory; Paganetti, Harald

    2018-02-01

    The purpose of this study was to investigate internal tumor volume density overwrite strategies to minimize intensity modulated proton therapy (IMPT) plan degradation of mobile lung tumors. Four planning paradigms were compared for nine lung cancer patients. Internal gross tumor volume (IGTV) and internal clinical target volume (ICTV) structures were defined encompassing their respective volumes in every 4DCT phase. The paradigms use different planning CT (pCT) created from the average intensity projection (AIP) of the 4DCT, overwriting the density within the IGTV to account for movement. The density overwrites were: (a) constant filling with 100 HU (C100) or (b) 50 HU (C50), (c) maximum intensity projection (MIP) across phases, and (d) water equivalent path length (WEPL) consideration from beam’s-eye-view. Plans were created optimizing dose-influence matrices calculated with fast GPU Monte Carlo (MC) simulations in each pCT. Plans were evaluated with MC on the 4DCTs using a model of the beam delivery time structure. Dose accumulation was performed using deformable image registration. Interplay effect was addressed applying 10 times rescanning. Significantly less DVH metrics degradation occurred when using MIP and WEPL approaches. Target coverage (D99≥slant 70 Gy(RBE)) was fulfilled in most cases with MIP and WEPL (D{{99}WEPL}=69.2+/- 4.0 Gy (RBE)), keeping dose heterogeneity low (D5-D{{95}WEPL}=3.9+/- 2.0 Gy(RBE)). The mean lung dose was kept lowest by the WEPL strategy, as well as the maximum dose to organs at risk (OARs). The impact on dose levels in the heart, spinal cord and esophagus were patient specific. Overall, the WEPL strategy gives the best performance and should be preferred when using a 3D static geometry for lung cancer IMPT treatment planning. Newly available fast MC methods make it possible to handle long simulations based on 4D data sets to perform studies with high accuracy and efficiency, even prior to individual treatment planning.

  15. COLLABORATIVE AND PARTICIPATORY PLANNING PROCESSES AND METHODS FOR LOCAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Mauricio Hernandez Bonilla

    2009-11-01

    Full Text Available In 2006, The University of Veracruz (UV, the State Government of Veracruz and the United Nations Program for Human Settlements (UN/Habitat signed an agreement to promote the urban and territorial development of the Veracruz State. This event is the result of The University of Veracruz’s policies on the production of knowledge for the improvement of social and economic conditions in Veracruz through the involvement of the University organization in the real problems of different groups within society. Under this agreement, the University has made a commitment to promote sustainable development in the main regions of Veracruz, firstly through the implementation of strategic regional planning using inclusive and participatory methods; and secondly, through the strengthening of state and local authorities’ capacities for the development and implementation of urban and regional policies that have an effective and integral impact on the social, environmental and economic dimensions of cities. The purpose of this paper is to present the participatory exercises conducted by the multidisciplinary academic group of The University of Veracruz, under UN/Habitat-UVVeracruz State Government agreement following the UN methodology to promote Local Economic and Territorial Development. This paper explains these participatory planning experiences, methods and the results in the context of the central urban region of Veracruz State (made up of 15 municipalities.

  16. Application of the Process Scoring System to waking, dream and therapy reports.

    Science.gov (United States)

    Corriere, R; Hart, J; Karle, W; Switzer, A; Woldenberg, L

    1978-07-01

    Extended the Process Scoring System, originally developed for measuring dream dynamics and content, to waking and therapy experiences and applied it in a study of 5 new and 5 experienced Ss in an intensive outpatient psychotherapy. Two areas were examined: First, differences on process and content variables related to length of time in therapy and, second, the parallel relationship in these variables between waking, dream, and therapy experiences. The Process Scoring System proved useful in measuring these variables in all three types of experiences. The results indicated significant differences between the new and experienced patients and measurable interaction between the waking, dream, and therapy areas.

  17. NEW APPROACH TO TERRITORIAL PLANNING IN UKRAINE TAKING INTO ACCOUNT PROCESSE OF DECENTRALIZATIONAND AUSTRIAS EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Dorosh A.M

    2016-08-01

    and goals of development without a clear spatial reference (so-called vision of future is developed. Based on this concept a plan for targeted purposes is developed.It clearly defines the boundaries of land parcelswith appropriate purpose. The next step is to make a plan of development for areas that are designated for residential, public or industrial building.This plan put restrictions and requirements for newbuildings,namely for their superficiality, compactness, density and possible use. Like the planning hierarchy, there is also a hierarchy of planning and cartographic materials of all planning levels. During the process of comparing the approaches to spatial planning in Austria and spatial planning in Ukraine was found that the spatial planning system of Ukraine requires conceptual changes. Therefore, it is proposed to upgrade the system of spatial planning to a hierarchical system, to refuse from separation of urbanplanning and spatial planning and land management and to update the tolls of this process at the local level (at the level of local communities. It is proposed instead of the Master Plan of settlement, which in the present conditions of land relations reforming is not able to ensure the effective planning processes to implement a plan for target purposes and restrictions for the entire community and to develop on this basis detailed plans for areas designated for built up. This approach will provide a unified system of spatial planning for the successful development of both urban and rural communities.

  18. WE-AB-201-03: TPS Commissioning and QA: Incorporating the Entire Planning Process

    International Nuclear Information System (INIS)

    Mutic, S.

    2015-01-01

    Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in terms of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar

  19. [Multimodal pain therapy - implementation of process management - an attempt to consider management approaches].

    Science.gov (United States)

    Dunkel, Marion; Kramp, Melanie

    2012-07-01

    The combination of medical and economical proceedings allows new perspectives in the illustration of medical workflows. Considering structural and developmental aspects multimodal therapy programs show similarities with typical subjects of economic process systems. By pointing out the strategic appearance of the multimodal pain therapy concept multimodal approaches can be described to some extent by using management approaches. E. g., an economic process landscape can be used to represent procedures of a multimodal pain therapy program. © Georg Thieme Verlag Stuttgart · New York.

  20. 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

  1. Spot-scanning beam proton therapy vs intensity-modulated radiation therapy for ipsilateral head and neck malignancies: A treatment planning comparison

    International Nuclear Information System (INIS)

    Kandula, Shravan; Zhu, Xiaorong; Garden, Adam S.; Gillin, Michael; Rosenthal, David I.; Ang, Kie-Kian; Mohan, Radhe; Amin, Mayankkumar V.; Garcia, John A.; Wu, Richard; Sahoo, Narayan; Frank, Steven J.

    2013-01-01

    Radiation therapy for head and neck malignancies can have side effects that impede quality of life. Theoretically, proton therapy can reduce treatment-related morbidity by minimizing the dose to critical normal tissues. We evaluated the feasibility of spot-scanning proton therapy for head and neck malignancies and compared dosimetry between those plans and intensity-modulated radiation therapy (IMRT) plans. Plans from 5 patients who had undergone IMRT for primary tumors of the head and neck were used for planning proton therapy. Both sets of plans were prepared using computed tomography (CT) scans with the goals of achieving 100% of the prescribed dose to the clinical target volume (CTV) and 95% to the planning TV (PTV) while maximizing conformity to the PTV. Dose-volume histograms were generated and compared, as were conformity indexes (CIs) to the PTVs and mean doses to the organs at risk (OARs). Both modalities in all cases achieved 100% of the dose to the CTV and 95% to the PTV. Mean PTV CIs were comparable (0.371 IMRT, 0.374 protons, p = 0.953). Mean doses were significantly lower in the proton plans to the contralateral submandibular (638.7 cGy IMRT, 4.3 cGy protons, p = 0.002) and parotid (533.3 cGy IMRT, 48.5 cGy protons, p = 0.003) glands; oral cavity (1760.4 cGy IMRT, 458.9 cGy protons, p = 0.003); spinal cord (2112.4 cGy IMRT, 249.2 cGy protons, p = 0.002); and brainstem (1553.52 cGy IMRT, 166.2 cGy protons, p = 0.005). Proton plans also produced lower maximum doses to the spinal cord (3692.1 cGy IMRT, 2014.8 cGy protons, p = 0.034) and brainstem (3412.1 cGy IMRT, 1387.6 cGy protons, p = 0.005). Normal tissue V 10 , V 30 , and V 50 values were also significantly lower in the proton plans. We conclude that spot-scanning proton therapy can significantly reduce the integral dose to head and neck critical structures. Prospective studies are underway to determine if this reduced dose translates to improved quality of life

  2. Spot-scanning beam proton therapy vs intensity-modulated radiation therapy for ipsilateral head and neck malignancies: A treatment planning comparison

    Energy Technology Data Exchange (ETDEWEB)

    Kandula, Shravan [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Zhu, Xiaorong [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Garden, Adam S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Gillin, Michael [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I.; Ang, Kie-Kian [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Amin, Mayankkumar V.; Garcia, John A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Wu, Richard; Sahoo, Narayan [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Frank, Steven J., E-mail: sjfrank@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2013-01-01

    Radiation therapy for head and neck malignancies can have side effects that impede quality of life. Theoretically, proton therapy can reduce treatment-related morbidity by minimizing the dose to critical normal tissues. We evaluated the feasibility of spot-scanning proton therapy for head and neck malignancies and compared dosimetry between those plans and intensity-modulated radiation therapy (IMRT) plans. Plans from 5 patients who had undergone IMRT for primary tumors of the head and neck were used for planning proton therapy. Both sets of plans were prepared using computed tomography (CT) scans with the goals of achieving 100% of the prescribed dose to the clinical target volume (CTV) and 95% to the planning TV (PTV) while maximizing conformity to the PTV. Dose-volume histograms were generated and compared, as were conformity indexes (CIs) to the PTVs and mean doses to the organs at risk (OARs). Both modalities in all cases achieved 100% of the dose to the CTV and 95% to the PTV. Mean PTV CIs were comparable (0.371 IMRT, 0.374 protons, p = 0.953). Mean doses were significantly lower in the proton plans to the contralateral submandibular (638.7 cGy IMRT, 4.3 cGy protons, p = 0.002) and parotid (533.3 cGy IMRT, 48.5 cGy protons, p = 0.003) glands; oral cavity (1760.4 cGy IMRT, 458.9 cGy protons, p = 0.003); spinal cord (2112.4 cGy IMRT, 249.2 cGy protons, p = 0.002); and brainstem (1553.52 cGy IMRT, 166.2 cGy protons, p = 0.005). Proton plans also produced lower maximum doses to the spinal cord (3692.1 cGy IMRT, 2014.8 cGy protons, p = 0.034) and brainstem (3412.1 cGy IMRT, 1387.6 cGy protons, p = 0.005). Normal tissue V{sub 10}, V{sub 30}, and V{sub 50} values were also significantly lower in the proton plans. We conclude that spot-scanning proton therapy can significantly reduce the integral dose to head and neck critical structures. Prospective studies are underway to determine if this reduced dose translates to improved quality of life.

  3. A novel conformity index for intensity modulated radiation therapy plan evaluation.

    Science.gov (United States)

    Cheung, Fion W K; Law, Maria Y Y

    2012-09-01

    Intensity modulated radiation therapy (IMRT) has gained popularity in the treatment of cancers. Manual evaluation of IMRT plans for head-and-neck cancers has been especially challenging necessitating efficient and objective assessment tools. In this work, the authors address this issue by developing a personalized conformity index (CI) for comparison of IMRT plans for head-and-neck cancers and evaluating its plan quality discerning power in comparison with other widely used CIs. A two-dimensional CI with dose and distance incorporated (CI(DD)) was developed using the MATLAB program language, to quantify the planning target volume (PTV) coverage. Valuable information contained in the digital imaging and communication in medicine (DICOM) RT objects were harvested for computation of each of the CI(DD) components. Apart from the dose penalty factor, a distance-based exponential function was employed by varying the penalty weight associated with the location of cold spots within the PTV. With the goal of deriving a customized penalty factor, the distances between individual pixel and its nearest PTV boundary was found. Using the exponential function, the impact of distance penalty was substantially larger for cold spots closer to the PTV centroid but petered out quickly wherever they were situated in the vicinity of PTV border. In order to evaluate the CI(DD) scoring system, three CT image data sets of nasopharyngeal carcinoma (NPC) patients were collected. Ten IMRT plans with degrading qualities were generated from each dataset and were ranked based on CI(DD) and other existing indices. The coefficient of variance was calculated for each dataset to compare the degree of variation. The CI(DD) scoring system that considered spatial importance of each voxel within the PTV was successfully developed. The results demonstrated that the CI(DD) including four discrete factors could provide accurate rankings of plan quality by examining the relative importance of each cold spot

  4. Adlerian "Encouragement" and the Therapeutic Process of Solution-Focused Brief Therapy.

    Science.gov (United States)

    Watts, Richard E.; Pietrzak, Dale

    2000-01-01

    Discusses the overlooked similarities between the therapeutic process of solution-focused brief therapy (SFBT) and the Adlerian process of therapeutic encouragement. SFBT and Adlerian therapy share common perspectives, albeit using different nomenclature, on maladjustment, the client-counselor relationship, and methods of facilitating change.…

  5. Development of the computer-aided process planning (CAPP) system for polymer injection molds manufacturing

    OpenAIRE

    J. Tepić; V. Todić; D. Lukić; M. Milošević; S. Borojević

    2011-01-01

    Beginning of production and selling of polymer products largely depends on mold manufacturing. The costs of mold manufacturing have significant share in the final price of a product. The best way to improve and rationalize polymer injection molds production process is by doing mold design automation and manufacturing process planning automation. This paper reviews development of a dedicated process planning system for manufacturing of the mold for injection molding, which integrates computer-...

  6. Integrated skin flash planning technique for intensity-modulated radiation therapy for vulvar cancer prevents marginal misses and improves superficial dose coverage.

    Science.gov (United States)

    Dyer, Brandon A; Jenshus, Abriel; Mayadev, Jyoti S

    2018-02-28

    Radiation therapy (RT) plays a definitive role in locally advanced vulvar cancer, and in the adjuvant setting with high risk postoperative features after wide local excision. There is significant morbidity associated with traditional, large RT fields using 2D or 3D techniques, and the use of intensity-modulated radiation therapy (IMRT) in vulvar cancer is increasing. However, there remains a paucity of technical information regarding the prevention of a marginal miss during the treatment planning process. The use of an integrated skin flash (ISF) during RT planning can be used to account for anatomic variation, and intra- and interfraction motion seen during treatment. Herein we present the case of a patient with a T1aN0M0, Stage IA vulva cancer to illustrate the progressive vulvar swelling and lymph edema seen during treatment and retrospectively evaluate the dosimetric effects of using an ISF RT plan vs standard RT planning techniques. Standard planning techniques to treat vulvar cancer patients with IMRT do not sufficiently account for the change in patient anatomy and can lead to a marginal miss. ISF is an RT planning technique that can decrease the risk of a marginal miss and the technique is easily implemented during the planning stages of RT treatment. Furthermore, use of an ISF technique can improve vulvar clinical target volume coverage and plan homogeneity. Based on our experience, and this study, a 2-cm ISF is suggested to account for variations in daily clinical setup and changes in patient anatomy during treatment. Published by Elsevier Inc.

  7. Land processes distributed active archive center product lifecycle plan

    Science.gov (United States)

    Daucsavage, John C.; Bennett, Stacie D.

    2014-01-01

    The U.S. Geological Survey (USGS) Earth Resources Observation and Science (EROS) Center and the National Aeronautics and Space Administration (NASA) Earth Science Data System Program worked together to establish, develop, and operate the Land Processes (LP) Distributed Active Archive Center (DAAC) to provide stewardship for NASA’s land processes science data. These data are critical science assets that serve the land processes science community with potential value beyond any immediate research use, and therefore need to be accounted for and properly managed throughout their lifecycle. A fundamental LP DAAC objective is to enable permanent preservation of these data and information products. The LP DAAC accomplishes this by bridging data producers and permanent archival resources while providing intermediate archive services for data and information products.

  8. Comparison of volumetric modulated arc therapy and intensity modulated radiation therapy for whole brain hippocampal sparing treatment plans based on radiobiological modeling

    Directory of Open Access Journals (Sweden)

    Ethan Kendall

    2018-01-01

    Full Text Available Introduction: In this article, we report the results of our investigation on comparison of radiobiological aspects of treatment plans with linear accelerator-based intensity-modulated radiation therapy and volumetric-modulated arc therapy for patients having hippocampal avoidance whole-brain radiation therapy. Materials and Methods: In this retrospective study using the dose-volume histogram, we calculated and compared biophysical indices of equivalent uniform dose, tumor control probability, and normal tissue complication probability (NTCP for 15 whole-brain radiotherapy patients. Results and Discussions: Dose-response models for tumors and critical structures were separated into two groups: mechanistic and empirical. Mechanistic models formulate mathematically with describable relationships while empirical models fit data through empirical observations to appropriately determine parameters giving results agreeable to those given by mechanistic models. Conclusions: Techniques applied in this manuscript could be applied to any other organs or types of cancer to evaluate treatment plans based on radiobiological modeling.

  9. The impact of curricula and lesson planning in the teaching process

    Directory of Open Access Journals (Sweden)

    Majlinda Lika

    2017-03-01

    Full Text Available Lesson planning is at the core of teaching. It allows teachers to create an orientation path in the process of teaching, taking into consideration, many elements such as, students’ styles of learning, previous knowledge, types of intelligences, interests etc. Effective curricula plans are characterized by principles of coherence, flexibility, integration of knowledge etc. Effective lesson plans strongly rely on previous information gathered through different forms of assessment, and provide inclusive opportunities for every student. This paper will show how planning affects teaching and the quality of learning. First, a review of the literature will represent the importance of flexible planning and incorporation of differentiated elements of planning that ensure inclusive opportunities of learning for all students. Second, there will be a detailed analysis of findings taken by 25 full school inspections practices on the field of “lesson planning”. This part of the study will specify the planning difficulties the teachers face and how this affects the process of teaching and learning. Third, benefits of lesson plans that rely on good assessment practices and integrate differentiated instruction according to students' needs will be discussed as ways of helping teachers adjust lesson plans to overcome their planning difficulties. Findings indicate that teachers design lesson plans that do not rely on good assessment practices. Lesson plans are not flexible enough to respond and satisfy the needs of all categories of students, impacting that way the quality of instruction and learning. The paper will serve teachers to review their planning approaches and integrate elements of differentiated instruction as an organic part of the process, responding to traits and uniqueness students represent.

  10. Critical path method as the criterion for optimization of business planning process

    OpenAIRE

    Butsenko Elena V.

    2016-01-01

    In today's economy the task of improving business planning is considered a necessary component of any enterprise management process and is precisely the solution drawn from that task which determines the financial policy and economic structure. The development of technologies based on the optimization of business planning is a very urgent scientific challenge. In this paper we propose to use the methods of network planning and management as a tool for economic and mathematical modeling to...

  11. The Effect of a New Therapy for Children with Tics Targeting Underlying Cognitive, Behavioral, and Physiological Processes.

    Science.gov (United States)

    Leclerc, Julie B; O'Connor, Kieron P; J-Nolin, Gabrielle; Valois, Philippe; Lavoie, Marc E

    2016-01-01

    Tourette disorder (TD) is characterized by motor and vocal tics, and children with TD tend to present a lower quality of life than neurotypical children. This study applied a manualized treatment for childhood tics disorder, Facotik, to a consecutive case series of children aged 8-12 years. The Facotik therapy was adapted from the adult cognitive and psychophysiological program validated on a range of subtypes of tics. This approach aims to modify the cognitive-behavioral and physiological processes against which the tic occurs, rather than only addressing the tic behavior. The Facotik therapy lasted 12-14 weeks. Each week 90-min session contained 20 min of parental training. The therapy for children followed 10 stages including: awareness training; improving motor control; modifying style of planning; cognitive and behavioral restructuring; and relapse prevention. Thirteen children were recruited as consecutive referrals from the general population, and seven cases completed therapy and posttreatment measures. Overall results showed a significant decrease in symptom severity as measured by the YGTSS and the TSGS. However, there was a discrepancy between parent and child rating, with some children perceiving an increase in tics, possibly due to improvement of awareness along therapy. They were also individual changes on adaptive aspects of behavior as measured with the BASC-2, and there was variability among children. All children maintained or improved self-esteem posttreatment. The results confirm the conclusion of a previous pilot study, which contributed to the adaptation of the adult therapy. In summary, the Facotik therapy reduced tics in children. These results underline that addressing processes underlying tics may complement approaches that target tics specifically.

  12. The effect of a new therapy for children with tics targeting underlying cognitive, behavioral and physiological processes

    Directory of Open Access Journals (Sweden)

    Julie B. Leclerc

    2016-08-01

    Full Text Available Tourette disorder (TD is characterized by motor and vocal tics and children with TD tend to present a lower quality of life than neurotypical children. This study applied a manualized treatment for childhood tics disorder Facotik to a consecutive case series of children aged 8-12 years. The Facotik therapy was adapted from the adult Cognitive and Psychophysiological program validated on a range of subtypes of tics. This approach aims to modify the cognitive-behavioral and physiological processes against which the tic occurs rather than only addressing the tic behavior. The Facotik therapy lasted 12-14 weeks. Each week 90-minute session contained 20 minutes of parental training. The therapy for children followed 10 stages including: awareness training; improving motor control; modifying style of planning; cognitive and behavioral restructuring; and relapse prevention. Thirteen children were recruited as consecutive referrals from the general population and seven cases completed therapy and post-treatment measures. Overall results showed a significant decrease in symptom severity as measured by the YGTSS and the TSGS. However, there was a discrepancy between parent and child rating, with some children perceiving an increase in tics, possibly due to improvement of awareness along therapy. They were also individual changes on adaptive aspects of behavior as measured with the BASC-2, and there was variability among children. All children maintained or improved self-esteem post treatment. The results confirm the conclusion of a previous pilot study which contributed to the adaptation of the adult therapy. In summary, the Facotik therapy reduced tics in children. These results underline that addressing processes underlying tics may complement approaches which target tics specifically.

  13. Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

    Science.gov (United States)

    Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

    2016-07-01

    Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

  14. Benefits to blood banks of a sales and operations planning process.

    Science.gov (United States)

    Keal, Donald A; Hebert, Phil

    2010-12-01

    A formal sales and operations planning (S&OP) process is a decision making and communication process that balances supply and demand while integrating all business operational components with customer-focused business plans that links high level strategic plans to day-to-day operations. Furthermore, S&OP can assist in managing change across the organization as it provides the opportunity to be proactive in the face of problems and opportunities while establishing a plan for everyone to follow. Some of the key outcomes from a robust S&OP process in blood banking would include: higher customer satisfaction (donors and health care providers), balanced inventory across product lines and customers, more stable production rates and higher productivity, more cooperation across the entire operation, and timely updates to the business plan resulting in better forecasting and fewer surprises that negatively impact the bottom line. © 2010 American Association of Blood Banks.

  15. Inverse planning for x-ray rotation therapy: a general solution of the inverse problem

    International Nuclear Information System (INIS)

    Oelfke, U.; Bortfeld, T.

    1999-01-01

    Rotation therapy with photons is currently under investigation for the delivery of intensity modulated radiotherapy (IMRT). An analytical approach for inverse treatment planning of this radiotherapy technique is described. The inverse problem for the delivery of arbitrary 2D dose profiles is first formulated and then solved analytically. In contrast to previously applied strategies for solving the inverse problem, it is shown that the most general solution for the fluence profiles consists of two independent solutions of different parity. A first analytical expression for both fluence profiles is derived. The mathematical derivation includes two different strategies, an elementary expansion of fluence and dose into polynomials and a more practical approach in terms of Fourier transforms. The obtained results are discussed in the context of previous work on this problem. (author)

  16. A whole body atlas for segmentation and delineation of organs for radiation therapy planning

    International Nuclear Information System (INIS)

    Qatarneh, S.M.; Crafoord, J.; Kramer, E.L.; Maguire, G.Q.; Brahme, A.; Noz, M.E.; Hyoedynmaa, S.

    2001-01-01

    A semi-automatic procedure for delineation of organs to be used as the basis of a whole body atlas database for radiation therapy planning was developed. The Visible Human Male Computed Tomography (CT)-data set was used as a 'standard man' reference. The organ of interest was outlined manually and then transformed by a polynomial warping algorithm onto a clinical patient CT. This provided an initial contour, which was then adjusted and refined by the semi-automatic active contour model to find the final organ outline. The liver was used as a test organ for evaluating the performance of the procedure. Liver outlines obtained by the segmentation algorithm on six patients were compared to those manually drawn by a radiologist. The combination of warping and semi-automatic active contour model generally provided satisfactory segmentation results, but the procedure has to be extended to three dimensions

  17. Fast cine-magnetic resonance imaging point tracking for prostate cancer radiation therapy planning

    International Nuclear Information System (INIS)

    Dowling, J; Chandra, S; Dang, K; Fox, Chris D; Gill, Suki; Kron, T; Pham, D; Foroudi, F

    2014-01-01

    The analysis of intra-fraction organ motion is important for improving the precision of radiation therapy treatment delivery. One method to quantify this motion is for one or more observers to manually identify anatomic points of interest (POIs) on each slice of a cine-MRI sequence. However this is labour intensive and inter- and intra- observer variation can introduce uncertainty. In this paper a fast method for non-rigid registration based point tracking in cine-MRI sagittal and coronal series is described which identifies POIs in 0.98 seconds per sagittal slice and 1.35 seconds per coronal slice. The manual and automatic points were highly correlated (r>0.99, p<0.001) for all organs and the difference generally less than 1mm. For prostate planning peristalsis and rectal gas can result in unpredictable out of plane motion, suggesting the results may require manual verification.

  18. SU-E-T-357: Semi-Automated Knowledge-Based Radiation Therapy (KBRT) Planning for Head-And-Neck Cancer (HNC): Can KBRT Plans Achieve Better Results Than Manual Planning?

    Energy Technology Data Exchange (ETDEWEB)

    Lutzky, C; Grzetic, S; Lo, J; Das, S [Duke University Medical Center, Durham, NC (United States)

    2014-06-01

    Purpose: Knowledge Based Radiation Therapy Treatment (KBRT) planning can be used to semi-automatically generate IMRT plans for new patients using constraints derived from previously manually-planned, geometrically similar patients. We investigate whether KBRT plans can achieve greater dose sparing than manual plans using optimized, organspecific constraint weighting factors. Methods: KBRT planning of HNC radiotherapy cases geometrically matched each new (query) case to one of the 105 clinically approved plans in our database. The dose distribution of the planned match was morphed to fit the querys geometry. Dose-volume constraints extracted from the morphed dose distribution were used to run the IMRT optimization with no user input. In the first version, all constraints were multiplied by a weighting factor of 0.7. The weighting factors were then systematically optimized (in order of OARs with increasing separation from the target) to maximize sparing to each OAR without compromising other OARs. The optimized, second version plans were compared against the first version plans and the clinically approved plans for 45 unilateral/bilateral target cases using the dose metrics: mean, median and maximum (brainstem and cord) doses. Results: Compared to the first version, the second version significantly reduced mean/median contralateral parotid doses (>2Gy) for bilateral cases. Other changes between the two versions were not clinically meaningful. Compared to the original clinical plans, both bilateral and unilateral plans in the second version had lower average dose metrics for 5 of the 6 OARs. Compared to the original plans, the second version achieved dose sparing that was at least as good for all OARs and better for the ipsilateral parotid (bilateral) and oral cavity (bilateral/unilateral). Differences in planning target volume coverage metrics were not clinically significant. Conclusion: HNC-KBRT planning generated IMRT plans with at least equivalent dose sparing to

  19. SU-E-T-357: Semi-Automated Knowledge-Based Radiation Therapy (KBRT) Planning for Head-And-Neck Cancer (HNC): Can KBRT Plans Achieve Better Results Than Manual Planning?

    International Nuclear Information System (INIS)

    Lutzky, C; Grzetic, S; Lo, J; Das, S

    2014-01-01

    Purpose: Knowledge Based Radiation Therapy Treatment (KBRT) planning can be used to semi-automatically generate IMRT plans for new patients using constraints derived from previously manually-planned, geometrically similar patients. We investigate whether KBRT plans can achieve greater dose sparing than manual plans using optimized, organspecific constraint weighting factors. Methods: KBRT planning of HNC radiotherapy cases geometrically matched each new (query) case to one of the 105 clinically approved plans in our database. The dose distribution of the planned match was morphed to fit the querys geometry. Dose-volume constraints extracted from the morphed dose distribution were used to run the IMRT optimization with no user input. In the first version, all constraints were multiplied by a weighting factor of 0.7. The weighting factors were then systematically optimized (in order of OARs with increasing separation from the target) to maximize sparing to each OAR without compromising other OARs. The optimized, second version plans were compared against the first version plans and the clinically approved plans for 45 unilateral/bilateral target cases using the dose metrics: mean, median and maximum (brainstem and cord) doses. Results: Compared to the first version, the second version significantly reduced mean/median contralateral parotid doses (>2Gy) for bilateral cases. Other changes between the two versions were not clinically meaningful. Compared to the original clinical plans, both bilateral and unilateral plans in the second version had lower average dose metrics for 5 of the 6 OARs. Compared to the original plans, the second version achieved dose sparing that was at least as good for all OARs and better for the ipsilateral parotid (bilateral) and oral cavity (bilateral/unilateral). Differences in planning target volume coverage metrics were not clinically significant. Conclusion: HNC-KBRT planning generated IMRT plans with at least equivalent dose sparing to

  20. Dosimetric Comparison of Real-Time MRI-Guided Tri-Cobalt-60 Versus Linear Accelerator-Based Stereotactic Body Radiation Therapy Lung Cancer Plans.

    Science.gov (United States)

    Wojcieszynski, Andrzej P; Hill, Patrick M; Rosenberg, Stephen A; Hullett, Craig R; Labby, Zacariah E; Paliwal, Bhudatt; Geurts, Mark W; Bayliss, R Adam; Bayouth, John E; Harari, Paul M; Bassetti, Michael F; Baschnagel, Andrew M

    2017-06-01

    Magnetic resonance imaging-guided radiation therapy has entered clinical practice at several major treatment centers. Treatment of early-stage non-small cell lung cancer with stereotactic body radiation therapy is one potential application of this modality, as some form of respiratory motion management is important to address. We hypothesize that magnetic resonance imaging-guided tri-cobalt-60 radiation therapy can be used to generate clinically acceptable stereotactic body radiation therapy treatment plans. Here, we report on a dosimetric comparison between magnetic resonance imaging-guided radiation therapy plans and internal target volume-based plans utilizing volumetric-modulated arc therapy. Ten patients with early-stage non-small cell lung cancer who underwent radiation therapy planning and treatment were studied. Following 4-dimensional computed tomography, patient images were used to generate clinically deliverable plans. For volumetric-modulated arc therapy plans, the planning tumor volume was defined as an internal target volume + 0.5 cm. For magnetic resonance imaging-guided plans, a single mid-inspiratory cycle was used to define a gross tumor volume, then expanded 0.3 cm to the planning tumor volume. Treatment plan parameters were compared. Planning tumor volumes trended larger for volumetric-modulated arc therapy-based plans, with a mean planning tumor volume of 47.4 mL versus 24.8 mL for magnetic resonance imaging-guided plans ( P = .08). Clinically acceptable plans were achievable via both methods, with bilateral lung V20, 3.9% versus 4.8% ( P = .62). The volume of chest wall receiving greater than 30 Gy was also similar, 22.1 versus 19.8 mL ( P = .78), as were all other parameters commonly used for lung stereotactic body radiation therapy. The ratio of the 50% isodose volume to planning tumor volume was lower in volumetric-modulated arc therapy plans, 4.19 versus 10.0 ( P guided tri-cobalt-60 radiation therapy is capable of delivering lung high

  1. sampling plans for monitoring quality control process at a plastic

    African Journals Online (AJOL)

    Dr Obe

    managing these -activities in an intercultural environment will be of increasing importance. These intercultural activities not only are helping to reduce differences in technological and industrial process, but also are leading to adoption of new managerial concepts and .techniques among Societies around the world. 3.

  2. SU-F-T-446: Improving Craniospinal Irradiation Technique Using Volumetric Modulated Arc Therapy (VMAT) Planning and Its Dosimetric Verification

    Energy Technology Data Exchange (ETDEWEB)

    Yang, X; Tejani, M; Jiang, X; Elder, E; Dhabaan, A [Emory University, Atlanta, GA (United States)

    2016-06-15

    Purpose: The purpose of this study is to investigate a volumetric modulated arc therapy (VMAT) treatment planning technique for supine craniospinal irradiation (CSI). Evaluate the suitability of VMAT for CSI with dosimetric measurements and compare it to 3D conformal planning using specific plan metrics such as dose conformity, homogeneity, and dose of organs at risk (OAR). Methods: Ten CSI patients treated with conventional 3D technique were re-planned with VMAT. The PTV was contoured to include the whole contents of the brain and spinal canal with a uniform margin of 5 mm. VMAT plans were generated with two partial arcs covering the brain, two partial arcs for the superior portion of the spinal cord and two partial arcs covering the remaining inferior portion of the spinal cord. Conformity index (CI), heterogeneity indexes (HI) and max and mean doses of OAR were compared to 3D plans. VMAT plans were delivered onto an anthropomorphic phantom loaded with Gafchromic films and OSLDs placed at specific positions to evaluate the plan dose at the junctions and as well as the plan dose distributions. Results: This VMAT technique was validated with a clinical study of 10 patients. The average CI was 1.03±0.02 for VMAT plans and 1.96±0.32 for conformal plans. And the average HI was 1.15±0.01 for VMAT plans and 1.51±0.21 for conformal plans. The mean and max doses to the all OARs for VMAT plans were significantly lower than conformal plans. The measured dose in phantom for VAMT plans was comparable to the calculated dose in Eclipse and the doses at junctions were verified. Conclusion: VMAT CSI was able to achieve better dose conformity and heterogeneity as well as significantly reducing the dose to Heart, esophagus and larynx. VMAT CSI appears to be a dosimterically advantageous, faster delivery, has better reproducibility CSI treatment.

  3. Monte Carlo evaluation of a photon pencil kernel algorithm applied to fast neutron therapy treatment planning

    Science.gov (United States)

    Söderberg, Jonas; Alm Carlsson, Gudrun; Ahnesjö, Anders

    2003-10-01

    When dedicated software is lacking, treatment planning for fast neutron therapy is sometimes performed using dose calculation algorithms designed for photon beam therapy. In this work Monte Carlo derived neutron pencil kernels in water were parametrized using the photon dose algorithm implemented in the Nucletron TMS (treatment management system) treatment planning system. A rectangular fast-neutron fluence spectrum with energies 0-40 MeV (resembling a polyethylene filtered p(41)+ Be spectrum) was used. Central axis depth doses and lateral dose distributions were calculated and compared with the corresponding dose distributions from Monte Carlo calculations for homogeneous water and heterogeneous slab phantoms. All absorbed doses were normalized to the reference dose at 10 cm depth for a field of radius 5.6 cm in a 30 × 40 × 20 cm3 water test phantom. Agreement to within 7% was found in both the lateral and the depth dose distributions. The deviations could be explained as due to differences in size between the test phantom and that used in deriving the pencil kernel (radius 200 cm, thickness 50 cm). In the heterogeneous phantom, the TMS, with a directly applied neutron pencil kernel, and Monte Carlo calculated absorbed doses agree approximately for muscle but show large deviations for media such as adipose or bone. For the latter media, agreement was substantially improved by correcting the absorbed doses calculated in TMS with the neutron kerma factor ratio and the stopping power ratio between tissue and water. The multipurpose Monte Carlo code FLUKA was used both in calculating the pencil kernel and in direct calculations of absorbed dose in the phantom.

  4. Fast voxel and polygon ray-tracing algorithms in intensity modulated radiation therapy treatment planning

    International Nuclear Information System (INIS)

    Fox, Christopher; Romeijn, H. Edwin; Dempsey, James F.

    2006-01-01

    We present work on combining three algorithms to improve ray-tracing efficiency in radiation therapy dose computation. The three algorithms include: An improved point-in-polygon algorithm, incremental voxel ray tracing algorithm, and stereographic projection of beamlets for voxel truncation. The point-in-polygon and incremental voxel ray-tracing algorithms have been used in computer graphics and nuclear medicine applications while the stereographic projection algorithm was developed by our group. These algorithms demonstrate significant improvements over the current standard algorithms in peer reviewed literature, i.e., the polygon and voxel ray-tracing algorithms of Siddon for voxel classification (point-in-polygon testing) and dose computation, respectively, and radius testing for voxel truncation. The presented polygon ray-tracing technique was tested on 10 intensity modulated radiation therapy (IMRT) treatment planning cases that required the classification of between 0.58 and 2.0 million voxels on a 2.5 mm isotropic dose grid into 1-4 targets and 5-14 structures represented as extruded polygons (a.k.a. Siddon prisms). Incremental voxel ray tracing and voxel truncation employing virtual stereographic projection was tested on the same IMRT treatment planning cases where voxel dose was required for 230-2400 beamlets using a finite-size pencil-beam algorithm. Between a 100 and 360 fold cpu time improvement over Siddon's method was observed for the polygon ray-tracing algorithm to perform classification of voxels for target and structure membership. Between a 2.6 and 3.1 fold reduction in cpu time over current algorithms was found for the implementation of incremental ray tracing. Additionally, voxel truncation via stereographic projection was observed to be 11-25 times faster than the radial-testing beamlet extent approach and was further improved 1.7-2.0 fold through point-classification using the method of translation over the cross product technique

  5. Complementary Therapies – a spiritual resource in recovery-processes?

    DEFF Research Database (Denmark)

    Lunde, Anita; Dürr, Dorte Wiwe; Johannessen, Helle

    Background: Studies show that spirituality is an important issue for alternative and complementary practitioners and their treatment practice. In social psychiatry in Denmark, several residential homes have implemented various therapies such as massage and ear acupuncture, which along with other ...... and health as well as for the ethics of providing complementary treatment practice in social psychiatry....

  6. Photoinduced transfer processes in complex carrier systems for photodynamic therapy

    OpenAIRE

    Regehly, Martin

    2008-01-01

    Der Gegenstand der vorliegenden Arbeit ist die photophysikalische Untersuchung von drei unterschiedlichen Photosensibilisator-Transportsystemen hinsichtlich ihrer Eignung für die photodynamische Therapie. In Fulleren-Pyropheophorbid-a-Konjugaten (P6, FHP6, FP6) finden nach Lichtabsorption effiziente Energietransferprozesse sowie exzitonische Wechselwirkungen unter den Pyropheophorbid a Chromophoren statt. Exzitonische Interaktionen limitieren das Potential der Komplexe zytotoxischen Singulett...

  7. Perceptions of the Purpose and Value of the School Improvement Plan Process

    Science.gov (United States)

    Dunaway, David M.; Kim, Do-Hong; Szad, Elizabeth R.

    2012-01-01

    The purpose of this research was to determine how teachers and administrators in a successful North Carolina district perceived the purpose and value of a school improvement plan (SIP) and the planning process. The SIP is the accepted best practice for school-wide improvement, and the perceptions of the purpose and value of the process…

  8. How Innovation Theory Can Contribute to the Military Operations Planning Process

    DEFF Research Database (Denmark)

    Heltberg, Anna Therese; Dahl, Kåre

    The research study considers how the application of innovation theory might contribute to military staff work planning processes and bring new perspectives to operational models of analysis such as NATO’s Comprehensive Operations Planning Directive (COPD) and the Danish Field Manual III....

  9. Optimization-based decision support systems for planning problems in processing industries

    NARCIS (Netherlands)

    Claassen, G.D.H.

    2014-01-01

    Summary Optimization-based decision support systems for planning problems in processing industries Nowadays, efficient planning of material flows within and between supply chains is of vital importance and has become one of the most challenging problems for decision support in practice. The

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

    Science.gov (United States)

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

    2010-01-01

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

  11. Optimization-based decision support systems for planning problems in processing industries

    NARCIS (Netherlands)

    Claassen, G.D.H.

    2014-01-01

    Summary

    Optimization-based decision support systems for planning problems in processing industries

    Nowadays, efficient planning of material flows within and between supply chains is of vital importance and has become one of the most challenging problems for decision support in

  12. Automatic image processing solutions for MRI-guided minimally invasive intervention planning

    NARCIS (Netherlands)

    Noorda, YH

    2016-01-01

    In this thesis, automatic image processing methods are discussed for the purpose of improving treatment planning of MRI-guided minimally invasive interventions. Specifically, the following topics are addressed: rib detection in MRI, liver motion modeling in MRI and MR-CT registration of planning

  13. Strategic Planning Process Exercise: A Semester-Long Experiential Approach to Engage Students

    Science.gov (United States)

    Singh, Jitendra

    2018-01-01

    Strategic planning provides a sense of direction and can have a significant impact on the future of an organization. Students wanting to serve in leadership positions need to demonstrate a firm understanding of the concepts necessary to work on this complex process. Careful planning also ensures students' survival in a competitive business…

  14. Superintendents' Perceptions of the School Improvement Planning Process in the Southeastern USA

    Science.gov (United States)

    Dunaway, David M.; Bird, James J.; Wang, Chuang; Hancock, Dawson

    2014-01-01

    The purpose of this study of school improvement planning in the southeastern USA was to establish the current view of the process through the eyes of the district superintendents. The answers to the questions were consistently mixed. Generally, the presence of school improvement planning is prevalent in the large majority of districts. However,…

  15. Basic processes in nuclear forensics and analytical plan

    International Nuclear Information System (INIS)

    Venugopal, V.

    2016-01-01

    Nuclear forensics is the analysis of nuclear materials recovered from either the capture of unused materials, or from the radioactive debris following a nuclear explosion and can contribute significantly to the identification of the sources of the materials and the industrial processes used to obtain them. In the case of an explosion, nuclear forensics can also reconstruct key features of the nuclear device. Nuclear forensic analysis works best in conjunction with other law enforcement, radiological protection dosimetry, traditional forensics, and intelligence work to provide the basis for attributing the materials and/or nuclear device to its originators. Nuclear forensics is a piece of the overall attribution process, not a stand-alone activity

  16. Process and assembly plans for low cost commercial fuselage structure

    Science.gov (United States)

    Willden, Kurtis; Metschan, Stephen; Starkey, Val

    1991-01-01

    Cost and weight reduction for a composite structure is a result of selecting design concepts that can be built using efficient low cost manufacturing and assembly processes. Since design and manufacturing are inherently cost dependent, concurrent engineering in the form of a Design-Build Team (DBT) is essential for low cost designs. Detailed cost analysis from DBT designs and hardware verification must be performed to identify the cost drivers and relationships between design and manufacturing processes. Results from the global evaluation are used to quantitatively rank design, identify cost centers for higher ranking design concepts, define and prioritize a list of technical/economic issues and barriers, and identify parameters that control concept response. These results are then used for final design optimization.

  17. Job training planning and design for process plant operators

    International Nuclear Information System (INIS)

    Wirstad, J.

    1983-01-01

    A method is presented by which process plant operators for nuclear power plants are trained in Sweden. It works by a top-down method of systems analysis which can be integrated into the analysis, specification, and design of the process automation system. The training methods can also be adapted to existing automation systems and operating schedules. The author's method is based on the principle that training programs should be based on job requirements, e.g. operator tasks in common, less frequent, and rare operating conditions. Procedures have been tested for the following steps: Job analysis, analysis of knowledge and experience required, analysis of operator training requirements, set-up and organisation of the training programme, achievement control, evaluation of the training programme. (orig./HP) [de

  18. Job training planning and design for process plant operators

    Energy Technology Data Exchange (ETDEWEB)

    Wirstad, J.

    1983-01-01

    A method is presented by which process plant operators for nuclear power plants are trained in Sweden. It works by a top-down method of systems analysis which can be integrated into the analysis, specification, and design of the process automation system. The training methods can also be adapted to existing automation systems and operating schedules. The author's method is based on the principle that training programs should be based on job requirements, e.g. operator tasks in common, less frequent, and rare operating conditions. Procedures have been tested for the following steps: Job analysis, analysis of knowledge and experience required, analysis of operator training requirements, set-up and organisation of the training programme, achievement control, evaluation of the training programme.

  19. The Islamic State Battle Plan: Press Release Natural Language Processing

    Science.gov (United States)

    2016-06-01

    we apply Natural Language Processing (NLP) tools to a unique database constructed from approximately 3,000 English translated press releases...in the English language . It denies any bias introduced by limiting sources to English language media reports. IBC critics claim that its body counts...added benefit to the understanding of the text. There are variations of stopwords for each language . The System for the Mechanical Analysis and

  20. Investigating benefits realisation process for enterprise resource planning systems

    OpenAIRE

    Badewi, Amgad

    2016-01-01

    This research aims to investigate the benefit realisation process for ERP systems so as to develop a benefit realization road map whereby organisations can realize the maximum potential of their ERP systems. This research covers two areas: mechanism of implementation and the destination to change (i.e. road map). It has been found that project management and benefits management approaches are necessary for recouping benefits from investing in Information Technologies (IT) pr...

  1. Development process for integrated water resources management plan under a bottom-up participation perspective

    Directory of Open Access Journals (Sweden)

    Kittiwet Kuntiyawichai

    2014-06-01

    Full Text Available This article presents the development process for the integrated water resources management and development plan of Maha Sarakham Province by considering the priority and urgency of water problem issues. Gathering feedback from stakeholders and prioritizing water management and development projects are also taken into consideration. In view of integrated plans, the project is classified into short-, medium- and long-term plans with the project duration of 2 years, 3 years and 5 years, respectively. In this case, the plans can be categorized into proposed provincial and local plans. Firstly, the comprehensive provincial plans can be divided into 2 groups, i.e. district plans with the total number of 532 plans, which comprise of 505 projects for coping with drought and 27 projects for flood mitigation, and provincial plans from 13 agencies with the amount of 513 projects, which include 396 projects and 117 projects for dealing with drought and flood, respectively. Secondly, there are 4,099 of local plans to be put in place, in which 3,973 projects and 126 projects are proposed to handle drought and flood problems, respectively. From the analysis, it is found that if all planned drought relief projects are implemented, the water demand for domestic and agricultural needs could be covered by 96% and 51%, respectively. In case of the entire proposed flood alleviation projects are executed, 29% of the total flood prone areas can be effectively protected.

  2. Assessment of Uncertainties in Treatment Planning for Scanned Ion Beam Therapy of Moving Tumors

    International Nuclear Information System (INIS)

    Hild, Sebastian; Durante, Marco; Bert, Christoph

    2013-01-01

    Purpose: To provide methods for quantification of uncertainties in 4-dimensional (4D) treatment during treatment planning. Methods and Materials: Uncertainty information was generated by multiple 4D treatment simulations with varying parameters. Sampled data were analyzed using uncertainty visualization methods that have been added to common treatment plan evaluation methods (eg, dose-volume histogram and dose distribution analysis). To illustrate the potential of the introduced methods, uncertainty analysis was completed for a single lung cancer case using 3 motion mitigation techniques: gating, slice-by-slice rescanning, and breath-controlled rescanning. Results: By repeating 4D dose calculations with varying parameters, we were able to show local uncertainties in dose distributions and to evaluate the stability of treatment setups. The new methods were found suitable for uncertainty evaluation in 4D treatment planning of moving tumors. Calculation time of the uncertainty base data was time consuming but contrivable overnight. Conclusions: Uncertainty analysis and visualization for 4D treatment planning provide an important tool in the decision process for an optimal treatment approach.

  3. Treatment planning using tailored and standard cylindrical light diffusers for photodynamic therapy of the prostate

    International Nuclear Information System (INIS)

    Rendon, Augusto; Lilge, Lothar; Beck, J Christopher

    2008-01-01

    Interstitial photodynamic therapy (PDT) has seen a rebirth, partially prompted by the development of photosensitizers with longer absorption wavelengths that enable the treatment of larger tissue volumes. Here, we study whether using diffusers with customizable longitudinal emission profiles, rather than conventional ones with flat emission profiles, improves our ability to conform the light dose to the prostate. We present a modified Cimmino linear feasibility algorithm to solve the treatment planning problem, which improves upon previous algorithms by (1) correctly minimizing the cost function that penalizes deviations from the prescribed light dose, and (2) regularizing the inverse problem. Based on this algorithm, treatment plans were obtained under a variety of light delivery scenarios using 5-15 standard or tailored diffusers. The sensitivity of the resulting light dose distributions to uncertainties in the optical properties, and the placement of diffusers was also studied. We find that tailored diffusers only marginally outperform conventional ones in terms of prostate coverage and rectal sparing. Furthermore, it is shown that small perturbations in optical properties can lead to large changes in the light dose distribution, but that those changes can be largely corrected with a simple light dose re-normalization. Finally, we find that prostate coverage is only minimally affected by small changes in diffuser placement. Our results suggest that prostate PDT is not likely to benefit from the use of tailored diffusers. Other locations with more complex geometries might see a better improvement

  4. Comparative accuracy of different techniques in planning radiation therapy of breast cancer

    International Nuclear Information System (INIS)

    Bignardi, M.; Frata, P.; Barbera, F.; Moretti, R.

    1991-01-01

    The authors report the results of the analysis of several factors contributing to the accuracy of treatment planning in the radiation therapy of breast cancer. Different techniques (non-radiological vs CT-based) were used for the acquisition of patients' data; different methods (manual vs computerized) were employed for dose calculation. As for geometric parameters describing the external outline and target volume, mean differences were lower than 4%. Switching from a completely manual method to a CT-based one with computerized calculation, a 3.56% mean decrease in the value of reference isodose (p<0.01) was observed, togheter with a 3.87% mean increase in the estimated inhomogeneity (p<0.001). The non-CT-based outline of target volume exhibited geographic missing of inner portions of the target in 8/16 patients. Our results demonstarte that treatment planning procedures can be a significant source of clinically relevant inaccuracy, which may affect treatment outcome and tumor control

  5. Managing the construction bidding process : a move to simpler construction plan sets

    Science.gov (United States)

    2001-01-31

    This project was conducted to determine whether construction plan sets could be significantly simplified to speed the process of moving projects to construction. The work steps included a literature review, a telephone survey of highway agencies in s...

  6. Proceedings - Limits of Acceptable Change and related planning processes: Progress and future directions

    Science.gov (United States)

    Stephen F. McCool; David N. Cole

    1997-01-01

    Experience with Limits of Acceptable Change (LAC) and related planning processes has accumulated since the mid-1980's. These processes were developoed as a means of dealing with recreation carrying capacity issues in wilderness and National Parks. These processes clearly also have application outside of protected areas and to issues other than recreation...

  7. Analytic network process (ANP approach for product mix planning in railway industry

    Directory of Open Access Journals (Sweden)

    Hadi Pazoki Toroudi

    2016-08-01

    Full Text Available Given the competitive environment in the global market in recent years, organizations need to plan for increased profitability and optimize their performance. Planning for an appropriate product mix plays essential role for the success of most production units. This paper applies analytical network process (ANP approach for product mix planning for a part supplier in Iran. The proposed method uses four criteria including cost of production, sales figures, supply of raw materials and quality of products. In addition, the study proposes different set of products as alternatives for production planning. The preliminary results have indicated that that the proposed study of this paper could increase productivity, significantly.

  8. Radiotherapy, hadron therapy and the treatment planning for heavy ion and proton irradiation

    International Nuclear Information System (INIS)

    Boriano, A.; Bourhaleb, F.; Donetti, M.; Marchetto, F.; Sanz Freire, C.J.; Peroni, C.; Cirio, R.; Derkaoui, J.

    2001-01-01

    The aim of conformal radiation therapy is to deliver the dose as high and as uniform as possible to diseased tissue sparing all the other parts, without causing unwanted and unnecessary side effects for the patient. Difficulties to achieve this goal start with the determination of the three dimensional volumes of interest and end up in realizing a three-dimensional uniform and maximal as possible, the dose distribution. The technique of intensity-modulated radiotherapy (IMRT) as form of conformation in radiation therapy is a real revolution. One of the newest attempts in this field, which reaches to have a great success, is the use of multi-leaf collimators (MLC). It is not the unique new technique. In fact the use of therapeutic ions, especially carbon ions and protons is the technology of the actual future which is really the challenge in conformation of dose to targets, thanks to energy deposition characteristics of hadronic beams. An appropriate treatment planning system is strictly necessary to take full advantage of the novel technique. We have developed, for this purpose, an analytical code in C++ language, running on Unix platform. The package presented, is a special code system dedicated to the planning of radiotherapy with energetic ions. ANCOD is an analytical code using the voxels-scan technique as an active method for irradiating the patients. It is based on an iterative algorithm to determine the best fluencies to realize the optimal dose distribution, delivering a maximum of dose on the target volume and a minimum of dose distribution all around, especially on organs at risk. As input, the code use experimental data of linear energy-loss of a particular set of initial kinetic energies, and as a clinical data a complete set of CT images with contours of volumes of interest. Inverse planning techniques are implemented in order to obtain the initial energies needed for each beam to have a uniform target dose distribution. The package can determine the

  9. Influence of the demand information quality on planning process accuracy in supply chain. Case studies

    OpenAIRE

    Natalia Szozda; Sylwia Werbińska-Wojciechowska

    2013-01-01

    Background: Identification and analysis of factors that affect the accuracy of demand planning process across the supply chain is one of the most important problems which influence the effectiveness of its material and information flows. Material and methods: On the basis of demand planning process investigation authors define the main elements affecting the right supply chain performance level and investigate the possible connections between demand information quality and demand plannin...

  10. Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs.

    Science.gov (United States)

    Rutt, Benjamin T; Oehlert, Mary E; Krieshok, Thomas S; Lichtenberg, James W

    2018-04-01

    Objective This study evaluated the effectiveness of cognitive processing therapy and prolonged exposure in conditions reflective of current clinical practice within the Veterans Health Administration. Method This study involved a retrospective review of 2030 charts. A total of 750 veterans from 10 U.S. states who received cognitive processing therapy or prolonged exposure in individual psychotherapy were included in the study (participants in cognitive processing therapy, N = 376; participants in prolonged exposure, N = 374). The main dependent variable was self-reported posttraumatic stress disorder symptoms as measured by total scores on the Posttraumatic Stress Disorder Checklist. The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and determine the relationship between patient-level variables and total Posttraumatic Stress Disorder Checklist scores during treatment. Results Cognitive processing therapy and prolonged exposure were equally effective at reducing total Posttraumatic Stress Disorder Checklist scores. Veterans who completed therapy reported significantly larger reductions in the Posttraumatic Stress Disorder Checklist than patients who did not complete therapy. There were no significant differences in the improvement of posttraumatic stress disorder symptoms with respect to age and three racial/ethnic groups (Caucasian, African American, and Hispanic). Conclusions Cognitive processing therapy and prolonged exposure were shown to be effective in conditions highly reflective of clinical practice and with a highly diverse sample of veterans. Challenges related to dropout from trauma focused therapy should continue to be researched.

  11. Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

    Science.gov (United States)

    Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

    2014-09-28

    Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

  12. Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction

    Science.gov (United States)

    Giantsoudi, Drosoula; De Man, Bruno; Verburg, Joost; Trofimov, Alexei; Jin, Yannan; Wang, Ge; Gjesteby, Lars; Paganetti, Harald

    2017-04-01

    A significant and increasing number of patients receiving radiation therapy present with metal objects close to, or even within, the treatment area, resulting in artifacts in computed tomography (CT) imaging, which is the most commonly used imaging method for treatment planning in radiation therapy. In the presence of metal implants, such as dental fillings in treatment of head-and-neck tumors, spinal stabilization implants in spinal or paraspinal treatment or hip replacements in prostate cancer treatments, the extreme photon absorption by the metal object leads to prominent image artifacts. Although current CT scanners include a series of correction steps for beam hardening, scattered radiation and noisy measurements, when metal implants exist within or close to the treatment area, these corrections do not suffice. CT metal artifacts affect negatively the treatment planning of radiation therapy either by causing difficulties to delineate the target volume or by reducing the dose calculation accuracy. Various metal artifact reduction (MAR) methods have been explored in terms of improvement of organ delineation and dose calculation in radiation therapy treatment planning, depending on the type of radiation treatment and location of the metal implant and treatment site. Including a brief description of the available CT MAR methods that have been applied in radiation therapy, this article attempts to provide a comprehensive review on the dosimetric effect of the presence of CT metal artifacts in treatment planning, as reported in the literature, and the potential improvement suggested by different MAR approaches. The impact of artifacts on the treatment planning and delivery accuracy is discussed in the context of different modalities, such as photon external beam, brachytherapy and particle therapy, as well as by type and location of metal implants.

  13. 3D displays and user interface design for a radiation therapy treatment planning CAD tool

    International Nuclear Information System (INIS)

    Mosher, C.E. Jr.; Sherouse, G.W.; Chaney, E.L.; Rosenman, J.G.

    1988-01-01

    The long term goal of the project described in this paper is to improve local tumor control through the use of computer-aided treatment design methods that can result in selection of better treatment plans compared with conventional planning methods. To this end, a CAD tool for the design of radiation treatment beams is described. Crucial to the effectiveness of this tool are high quality 3D display techniques. The authors found that 2D and 3D display methods dramatically improve the comprehension of the complex spatial relationships between patient anatomy, radiation beams, and dose distributions. In order to take full advantage of these displays, an intuitive and highly interactive user interface was created. If the system is to be used by physicians unfamiliar with computer systems, it is essential that a user interface is incorporated that allows the user to navigate through each step of the design process in a manner similar to what they are used to

  14. 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

  15. Incorporating gender, equity, and human rights into the action planning process: moving from rhetoric to action

    Directory of Open Access Journals (Sweden)

    Sanjeev Sridharan

    2016-09-01

    Full Text Available Background: Mainstreaming of gender, equity, and human rights (GER is an important focus of the World Health Organization (WHO and other UN organizations. This paper explores the role of action plans in mainstreaming GER. This paper is informed by a theory-driven evaluation lens. Design: A theory of change framework explored the following seven dimensions of how action plans can implement mainstreaming of GER: awareness of the foundations of GER; understanding of context; planning to impact GER; implementation for GER; monitoring, evaluation, and learning; planning for sustainability; agenda setting and buy-in. The seven dimensions were used to analyze the action plans. Reviewers also explored innovations within each of the action plans for the seven dimensions. Results: GER mainstreaming is more prominent in the foundation, background, and planning components of the plan but becomes less so along the theory of change including implementation; monitoring and evaluation; sustainability; and agenda setting and buy-in. Conclusions: Our analysis demonstrates that much more can be done to incorporate GER considerations into the action planning process. Nine specific recommendations are identified for WHO and other organizations. A theory-driven approach as described in the paper is potentially helpful for developing clarity by which action plans can help with mainstreaming GER considerations.

  16. Incorporating gender, equity, and human rights into the action planning process: moving from rhetoric to action.

    Science.gov (United States)

    Sridharan, Sanjeev; Maplazi, Joanna; Shirodkar, Apurva; Richardson, Emma; Nakaima, April

    2016-01-01

    Mainstreaming of gender, equity, and human rights (GER) is an important focus of the World Health Organization (WHO) and other UN organizations. This paper explores the role of action plans in mainstreaming GER. This paper is informed by a theory-driven evaluation lens. A theory of change framework explored the following seven dimensions of how action plans can implement mainstreaming of GER: awareness of the foundations of GER; understanding of context; planning to impact GER; implementation for GER; monitoring, evaluation, and learning; planning for sustainability; agenda setting and buy-in. The seven dimensions were used to analyze the action plans. Reviewers also explored innovations within each of the action plans for the seven dimensions. GER mainstreaming is more prominent in the foundation, background, and planning components of the plan but becomes less so along the theory of change including implementation; monitoring and evaluation; sustainability; and agenda setting and buy-in. Our analysis demonstrates that much more can be done to incorporate GER considerations into the action planning process. Nine specific recommendations are identified for WHO and other organizations. A theory-driven approach as described in the paper is potentially helpful for developing clarity by which action plans can help with mainstreaming GER considerations.

  17. A new Monte Carlo-based treatment plan optimization approach for intensity modulated radiation therapy.

    Science.gov (United States)

    Li, Yongbao; Tian, Zhen; Shi, Feng; Song, Ting; Wu, Zhaoxia; Liu, Yaqiang; Jiang, Steve; Jia, Xun

    2015-04-07

    Intensity-modulated radiation treatment (IMRT) plan optimization needs beamlet dose distributions. Pencil-beam or superposition/convolution type algorithms are typically used because of their high computational speed. However, inaccurate beamlet dose distributions may mislead the optimization process and hinder the resulting plan quality. To solve this problem, the Monte Carlo (MC) simulation method has been used to compute all beamlet doses prior to the optimization step. The conventional approach samples the same number of particles from each beamlet. Yet this is not the optimal use of MC in this problem. In fact, there are beamlets that have very small intensities after solving the plan optimization problem. For those beamlets, it may be possible to use fewer particles in dose calculations to increase efficiency. Based on this idea, we have developed a new MC-based IMRT plan optimization framework that iteratively performs MC dose calculation and plan optimization. At each dose calculation step, the particle numbers for beamlets were adjusted based on the beamlet intensities obtained through solving the plan optimization problem in the last iteration step. We modified a GPU-based MC dose engine to allow simultaneous computations of a large number of beamlet doses. To test the accuracy of our modified dose engine, we compared the dose from a broad beam and the summed beamlet doses in this beam in an inhomogeneous phantom. Agreement within 1% for the maximum difference and 0.55% for the average difference was observed. We then validated the proposed MC-based optimization schemes in one lung IMRT case. It was found that the conventional scheme required 10(6) particles from each beamlet to achieve an optimization result that was 3% difference in fluence map and 1% difference in dose from the ground truth. In contrast, the proposed scheme achieved the same level of accuracy with on average 1.2 × 10(5) particles per beamlet. Correspondingly, the computation

  18. 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

  19. 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

  20. Predictors of response to CBT and IPT for depression; the contribution of therapy process.

    Science.gov (United States)

    Carter, Janet D; Crowe, Marie T; Jordan, Jennifer; McIntosh, Virginia V W; Frampton, Christopher; Joyce, Peter R

    2015-11-01

    Little is known about the factors that contribute to a positive psychotherapy outcome. There is still considerable debate as to whether specific factors (e.g. severity of symptoms, comorbidity) or nonspecific factors (e.g. alliance, therapy process) are most important in influencing outcome. This study examined the additional contribution that therapeutic process and alliance made to previously identified specific predictors of response to CBT and IPT for depression over the course of therapy. The previously identified specific factors were belief that childhood reasons caused the depression, recurrent depression, perceptions about how logical therapy was and comorbid personality disorder symptoms. One hundred and sixty five adult outpatients with major depression were treated for depression in a randomised clinical trial examining predictors of response to Cognitive Behavior Therapy and Interpersonal Psychotherapy. All therapy sessions were audiorecorded to enable objective ratings of therapeutic process and alliance. Process factors - patient psychic distress, patient participation and patient alliance had the strongest associations with outcome. The early and middle stage of therapy process did not account for any additional variance other than that previously identified by the patient predictors, however, at the end stage of therapy process contributed a further 14%. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Analysis of Participatory Processes in the Formulation of Spatial Plan for Nature Park Medvednica

    Directory of Open Access Journals (Sweden)

    Nataša Lovrić

    2011-12-01

    Full Text Available Background and Purpose: This research aims to assess the stakeholders influence on spatial planning of Nature Park Medvednica, a mountainous protected area adjacent to Zagreb, the capital city of Croatia, which tries to hold on to the pressure of the urbanization. Because of the inexistence of spatial plan which is required with the Croatian laws, its area was significantly decreased in 2009. This kind of research has not been done yet for NP Medvednica, and it will provide a contribution to the process of developing a spatial Plan for NP Medvednica. Material and Methods: The study was conducted in the framework of stakeholder analysis, for which a series of in-depth interviews with - stakeholders were performed, and documents concerning the spatial plan were analysed. The data gained was processed in MAXQDA software for qualitative analysis. Results and Conclusion: The gathered data explains which are the disadvantages of the tree processes of the formulation of the spatial plan and is giving a possible theoretical explanation or a model which can be implied in any decision making process involving stakeholders in natural resources management in within a given political and cultural context. Description of the past and current spatial planning situation of the NP Medvednica was specified and issues and stakeholders concerning the creation of the spatial plan where identified. The key conflict areas that affect the formulation of spatial plan were detected and examined. The level of participation of stakeholders in the context of fulfilment of their own interests was assessed as well as the influence on participation processes of different stakeholder groups on the formulation of the spatial plan. In order to have proper citizens and stakeholders participation some changes in the legislation should take place.

  2. Attachment-based family therapy and emotion-focused therapy for unresolved anger: The role of productive emotional processing.

    Science.gov (United States)

    Diamond, Gary M; Shahar, Ben; Sabo, Daphna; Tsvieli, Noa

    2016-03-01

    A growing body of research suggests that emotional processing is a central and common change mechanism across various types of therapies (Diener & Hilsenroth, 2009; Foa, Huppert, & Cahill, 2006; Greenberg, 2011). This study examined whether 10 weeks of attachment-based family therapy (ABFT), characterized by the use of in-session young adult-parent dialogues, were more effective than 10 weeks of individual emotion-focused therapy (EFT), characterized by the use of imaginal dialogues, in terms of facilitating productive emotional processing among a sample of 32 young adults presenting with unresolved anger toward a parent. This study also examined whether greater amounts of productive emotional processing predicted more favorable treatment outcomes. In contrast to our expectations, we found significantly more productive emotional processing in individual EFT than in conjoint ABFT. Results also showed that while both treatments led to significant and equivalent decreases in unresolved anger, state anger, attachment anxiety, and psychological symptoms, only ABFT was associated with decreases in attachment avoidance. Although amount of emotional processing did not explain the unique decrease in attachment avoidance in ABFT, greater amounts of productive emotional processing predicted greater decreases in psychological symptoms (but not other outcome measures) across both treatments. (c) 2016 APA, all rights reserved).

  3. Rolling Stock Planning at DSB S-tog - Processes, Cost Structures and Requirements

    DEFF Research Database (Denmark)

    Thorlacius, Per

    A central issue for operators of suburban passenger train transport systems is providing sufficient number of seats for the passengers while at the same time minimising operating costs. The process of providing this is called rolling stock planning. This technical report documents the terminology......, the processes, the cost structures and the requirements for rolling stock planning at DSB S-tog, the suburban passenger train operator of the City of Copenhagen. The focus of the technical report is directed at practical train operator oriented issues. The technical report is thought to serve as a basis...... for investigating better methods to perform the rolling stock planning (to be the topic of later papers). This technical report is produced as a part of the current industrial Ph. D. project to improve the rolling stock planning process of DSB S-tog....

  4. Process and Outcome Evaluation of an Art Therapy Program for People Living with HIV/AIDS

    Science.gov (United States)

    Feldman, Matthew B.; Betts, Donna J.; Blausey, Daniel

    2014-01-01

    Program evaluation offers an opportunity for improving the implementation and impact of art therapy. This article describes a process and outcomes evaluation of an art therapy program within the mental health services unit of a community-based organization for people living with HIV/AIDS. The aims were to assess utilization patterns and program…

  5. Building bridges to observational perspectives: a grounded theory of therapy processes in psychosis.

    Science.gov (United States)

    Dilks, Sarah; Tasker, Fiona; Wren, Bernadette

    2008-06-01

    This study set out to explore therapy processes in psychosis with an initial focus on reflexivity and how this might be expressed in therapy conversations. Leiman's (2000) definition of reflexivity was used as a starting-point for an exploratory investigation of the use of language as reflective activity. Grounded theory was chosen as an appropriate methodology to distil an explanatory account across the qualitative data collected. Six psychologist-client pairs supplied three tapes of therapy sessions spread out across the course of therapy. Each participant was separately interviewed on two occasions to ascertain their views of therapy and of the emerging grounded theory. A grounded theory was developed conceptualizing the processes and activities in psychological therapy in psychosis. Building bridges to observational perspectives summarizes the core process in psychological therapy in psychosis. Therapy in psychosis is understood as intimately linking the social and internal world in a dialogical process aimed at enhancing the client's functioning in the social world rather than at specifically developing the private mental experience of reflexivity or mentalizing.

  6. An Extended Genetic Algorithm for Distributed Integration of Fuzzy Process Planning and Scheduling

    Directory of Open Access Journals (Sweden)

    Shuai Zhang

    2016-01-01

    Full Text Available The distributed integration of process planning and scheduling (DIPPS aims to simultaneously arrange the two most important manufacturing stages, process planning and scheduling, in a distributed manufacturing environment. Meanwhile, considering its advantage corresponding to actual situation, the triangle fuzzy number (TFN is adopted in DIPPS to represent the machine processing and transportation time. In order to solve this problem and obtain the optimal or near-optimal solution, an extended genetic algorithm (EGA with innovative three-class encoding method, improved crossover, and mutation strategies is proposed. Furthermore, a local enhancement strategy featuring machine replacement and order exchange is also added to strengthen the local search capability on the basic process of genetic algorithm. Through the verification of experiment, EGA achieves satisfactory results all in a very short period of time and demonstrates its powerful performance in dealing with the distributed integration of fuzzy process planning and scheduling (DIFPPS.

  7. Model Development and Process Analysis for Lean Cellular Design Planning in Aerospace Assembly and Manufacturing

    Science.gov (United States)

    Hilburn, Monty D.

    Successful lean manufacturing and cellular manufacturing execution relies upon a foundation of leadership commitment and strategic planning built upon solid data and robust analysis. The problem for this study was to create and employ a simple lean transformation planning model and review process that could be used to identify functional support staff resources required to plan and execute lean manufacturing cells within aerospace assembly and manufacturing sites. The lean planning model was developed using available literature for lean manufacturing kaizen best practices and validated through a Delphi panel of lean experts. The resulting model and a standardized review process were used to assess the state of lean transformation planning at five sites of an international aerospace manufacturing and assembly company. The results of the three day, on-site review were compared with baseline plans collected from each of the five sites to determine if there analyzed, with focus on three critical areas of lean planning: the number and type of manufacturing cells identified, the number, type, and duration of planned lean and continuous kaizen events, and the quantity and type of functional staffing resources planned to support the kaizen schedule. Summarized data of the baseline and on-site reviews was analyzed with descriptive statistics. ANOVAs and paired-t tests at 95% significance level were conducted on the means of data sets to determine if null hypotheses related to cell, kaizen event, and support resources could be rejected. The results of the research found significant differences between lean transformation plans developed by site leadership and plans developed utilizing the structured, on-site review process and lean transformation planning model. The null hypothesis that there was no difference between the means of pre-review and on-site cell counts was rejected, as was the null hypothesis that there was no significant difference in kaizen event plans. These

  8. Targeting epigenetic processes in photodynamic therapy-induced anticancer immunity

    Directory of Open Access Journals (Sweden)

    Malgorzata eWachowska

    2015-07-01

    Full Text Available Photodynamic therapy (PDT of cancer is an approved therapeutic procedure that generates oxidative stress leading to cell death of tumour and stromal cells. Cell death resulting from oxidative damage to intracellular components leads to the release of damage-associated molecular patterns (DAMPs that trigger robust inflammatory response and creates local conditions for effective sampling of tumour-associated antigens (TAA by antigen presenting cells. The latter can trigger development of TAA-specific adaptive immune response. However, due to a number of mechanisms, including epigenetic regulation of TAA expression, tumour cells evade immune recognition. Therefore, numerous approaches are being developed to combine PDT with immunotherapies to allow development of systemic immunity. In this review we describe immunoregulatory mechanisms of epigenetic treatments that were shown to restore the expression of epigenetically silenced or down-regulated major histocompatibility complex (MHC molecules as well as TAA. We also discuss the results of our recent studies showing that epigenetic treatments based on administration of methyltransferase inhibitors in combination with photodynamic therapy can release effective mechanisms leading to development of antitumour immunity and potentiated antitumour effects.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

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

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

    International Nuclear Information System (INIS)

    1998-05-01

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

  11. Usefulness of radiation treatment planning allpied respiration factor for streotatic body radiation therapy in the lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Pil; Kim, Tae Hyung; So, Woon Young; Back, Geum Mun [Dept. of Medical Health Science, Graduate School, Kangwon National University, Chuncheon (Korea, Republic of)

    2016-12-15

    We are evaluated the usefulness of radiation treatment planning applied respiration factor for stereotactic body radiation therapy in the lung cancer. Four dimensional computed tomography images were obtained in 10 patients with lung cancer. The radiation treatment plans were established total lung volume according to respiration images (new method) and conventional method. We was analyzed in the lung volume, radiation absorbed dose of lung and main organs (ribs, tracheobronchus, esophagus, spinal cord) around the tumor, respectively. We were confirmed that lung volume and radiation absorbed dose of lung and main organs around the tumor deference according to applied respiration. In conclusion, radiation treatment planning applied respiration factor seems to be useful for stereotactic body radiation therapy in the lung cancer.

  12. Treatment planning and dose analysis for interstitial photodynamic therapy of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, Sean R H; Gertner, Mark R; Bogaards, Arjen; Sherar, Michael D; Wilson, Brian C [Division of Biophysics and Bioimaging, Ontario Cancer Institute, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada); Weersink, Robert A; Giewercer, David [Laboratory for Applied Biophysics, Ontario Cancer Institute, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada); Haider, Masoom A [Joint Department of Medical Imaging, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada); Scherz, Avigdor [Department of Plant Science, Weizmann Institute of Science, PO Box 26, Rehovot 76100 (Israel); Elhilali, Mostafa [Department of Surgery, McGill University, 3655 Promenade Sir William Osler, Montreal, Quebec H3G 1Y6 (Canada); Chin, Joseph L [Department of Oncology, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, Ontario N6A 5W9 (Canada); Trachtenberg, John [Department of Urology, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada)], E-mail: wilson@uhnres.utoronto.ca

    2009-04-21

    With the development of new photosensitizers that are activated by light at longer wavelengths, interstitial photodynamic therapy (PDT) is emerging as a feasible alternative for the treatment of larger volumes of tissue. Described here is the application of PDT treatment planning software developed by our group to ensure complete coverage of larger, geometrically complex target volumes such as the prostate. In a phase II clinical trial of TOOKAD vascular targeted photodynamic therapy (VTP) for prostate cancer in patients who failed prior radiotherapy, the software was used to generate patient-specific treatment prescriptions for the number of treatment fibres, their lengths, their positions and the energy each delivered. The core of the software is a finite element solution to the light diffusion equation. Validation against in vivo light measurements indicated that the software could predict the location of an iso-fluence contour to within approximately {+-}2 mm. The same software was used to reconstruct the treatments that were actually delivered, thereby providing an analysis of the threshold light dose required for TOOKAD-VTP of the post-irradiated prostate. The threshold light dose for VTP-induced prostate damage, as measured one week post-treatment using contrast-enhanced MRI, was found to be highly heterogeneous, both within and between patients. The minimum light dose received by 90% of the prostate, D{sub 90}, was determined from each patient's dose-volume histogram and compared to six-month sextant biopsy results. No patient with a D{sub 90} less than 23 J cm{sup -2} had complete biopsy response, while 8/13 (62%) of patients with a D{sub 90} greater than 23 J cm{sup -2} had negative biopsies at six months. The doses received by the urethra and the rectal wall were also investigated.

  13. Treatment planning and dose analysis for interstitial photodynamic therapy of prostate cancer.

    Science.gov (United States)

    Davidson, Sean R H; Weersink, Robert A; Haider, Masoom A; Gertner, Mark R; Bogaards, Arjen; Giewercer, David; Scherz, Avigdor; Sherar, Michael D; Elhilali, Mostafa; Chin, Joseph L; Trachtenberg, John; Wilson, Brian C

    2009-04-21

    With the development of new photosensitizers that are activated by light at longer wavelengths, interstitial photodynamic therapy (PDT) is emerging as a feasible alternative for the treatment of larger volumes of tissue. Described here is the application of PDT treatment planning software developed by our group to ensure complete coverage of larger, geometrically complex target volumes such as the prostate. In a phase II clinical trial of TOOKAD vascular targeted photodynamic therapy (VTP) for prostate cancer in patients who failed prior radiotherapy, the software was used to generate patient-specific treatment prescriptions for the number of treatment fibres, their lengths, their positions and the energy each delivered. The core of the software is a finite element solution to the light diffusion equation. Validation against in vivo light measurements indicated that the software could predict the location of an iso-fluence contour to within approximately +/-2 mm. The same software was used to reconstruct the treatments that were actually delivered, thereby providing an analysis of the threshold light dose required for TOOKAD-VTP of the post-irradiated prostate. The threshold light dose for VTP-induced prostate damage, as measured one week post-treatment using contrast-enhanced MRI, was found to be highly heterogeneous, both within and between patients. The minimum light dose received by 90% of the prostate, D(90), was determined from each patient's dose-volume histogram and compared to six-month sextant biopsy results. No patient with a D(90) less than 23 J cm(-2) had complete biopsy response, while 8/13 (62%) of patients with a D(90) greater than 23 J cm(-2) had negative biopsies at six months. The doses received by the urethra and the rectal wall were also investigated.

  14. Process planning optimization on turning machine tool using a hybrid genetic algorithm with local search approach

    Directory of Open Access Journals (Sweden)

    Yuliang Su

    2015-04-01

    Full Text Available A turning machine tool is a kind of new type of machine tool that is equipped with more than one spindle and turret. The distinctive simultaneous and parallel processing abilities of turning machine tool increase the complexity of process planning. The operations would not only be sequenced and satisfy precedence constraints, but also should be scheduled with multiple objectives such as minimizing machining cost, maximizing utilization of turning machine tool, and so on. To solve this problem, a hybrid genetic algorithm was proposed to generate optimal process plans based on a mixed 0-1 integer programming model. An operation precedence graph is used to represent precedence constraints and help generate a feasible initial population of hybrid genetic algorithm. Encoding strategy based on data structure was developed to represent process plans digitally in order to form the solution space. In addition, a local search approach for optimizing the assignments of available turrets would be added to incorporate scheduling with process planning. A real-world case is used to prove that the proposed approach could avoid infeasible solutions and effectively generate a global optimal process plan.

  15. Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

    Science.gov (United States)

    Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

    2013-10-01

    The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

  16. Dosimetric verification of a dedicated 3D treatment planning system for episcleral plaque therapy

    International Nuclear Information System (INIS)

    Knutsen, Stig; Hafslund, Rune; Monge, Odd R.; Valen, Harald; Muren, Ludvig Paul; Rekstad, Bernt Louni; Krohn, Joergen; Dahl, Olav

    2001-01-01

    Purpose: Episcleral plaque therapy (EPT) is applied in the management of some malignant ocular tumors. A customized configuration of typically 4 to 20 radioactive seeds is fixed in a gold plaque, and the plaque is sutured to the scleral surface corresponding to the basis of the intraocular tumor, allowing for a localized radiation dose delivery to the tumor. Minimum target doses as high as 100 Gy are directed at malignant tumor sites close to critical normal tissues (e.g., optic disc and macula). Precise dosimetry is therefore fundamental for judging both the risk for normal tissue toxicity and tumor dose prescription. This paper describes the dosimetric verification of a commercially available dedicated treatment planning system (TPS) for EPT when realistic multiple-seed configurations are applied. Materials and Methods: The TPS Bebig Plaque Simulator is used to plan EPT at our institution. Relative dose distributions in a water phantom, including central axis depth dose and off-axis dose profiles for three different plaques, the University of Southern California (USC) No. 9 and the Collaborative Ocular Melanoma Study (COMS) 12-mm and 20-mm plaques, were measured with a diode detector. Each plaque was arranged with realistic multiple 125 I seed configurations. The measured dose distributions were compared to the corresponding dose profiles calculated with the TPS. All measurements were corrected for the angular sensitivity variation of the diode. Results: Single-seed dose distributions measured with our dosimetry setup agreed with previously published data within 3%. For the three multiple-seed plaque configurations, the measured and calculated dose distributions were in good agreement. For the central axis depth doses, the agreement was within 4%, whereas deviations up to 11% were observed in single points far off-axis. Conclusions: The Bebig Plaque Simulator is a reliable TPS for calculating relative dose distributions around realistic multiple 125 I seed

  17. MRI-alone radiation therapy planning for prostate cancer: Automatic fiducial marker detection

    International Nuclear Information System (INIS)

    Ghose, Soumya; Mitra, Jhimli; Rivest-Hénault, David; Fazlollahi, Amir; Fripp, Jurgen; Dowling, Jason A.; Stanwell, Peter; Pichler, Peter; Sun, Jidi; Greer, Peter B.

    2016-01-01

    Purpose: The feasibility of radiation therapy treatment planning using substitute computed tomography (sCT) generated from magnetic resonance images (MRIs) has been demonstrated by a number of research groups. One challenge with an MRI-alone workflow is the accurate identification of intraprostatic gold fiducial markers, which are frequently used for prostate localization prior to each dose delivery fraction. This paper investigates a template-matching approach for the detection of these seeds in MRI. Methods: Two different gradient echo T1 and T2* weighted MRI sequences were acquired from fifteen prostate cancer patients and evaluated for seed detection. For training, seed templates from manual contours were selected in a spectral clustering manifold learning framework. This aids in clustering “similar” gold fiducial markers together. The marker with the minimum distance to a cluster centroid was selected as the representative template of that cluster during training. During testing, Gaussian mixture modeling followed by a Markovian model was used in automatic detection of the probable candidates. The probable candidates were rigidly registered to the templates identified from spectral clustering, and a similarity metric is computed for ranking and detection. Results: A fiducial detection accuracy of 95% was obtained compared to manual observations. Expert radiation therapist observers were able to correctly identify all three implanted seeds on 11 of the 15 scans (the proposed method correctly identified all seeds on 10 of the 15). Conclusions: An novel automatic framework for gold fiducial marker detection in MRI is proposed and evaluated with detection accuracies comparable to manual detection. When radiation therapists are unable to determine the seed location in MRI, they refer back to the planning CT (only available in the existing clinical framework); similarly, an automatic quality control is built into the automatic software to ensure that all gold

  18. MRI-alone radiation therapy planning for prostate cancer: Automatic fiducial marker detection

    Energy Technology Data Exchange (ETDEWEB)

    Ghose, Soumya, E-mail: soumya.ghose@case.edu; Mitra, Jhimli [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 and CSIRO Health and Biosecurity, The Australian e-Health & Research Centre, Herston, QLD 4029 (Australia); Rivest-Hénault, David; Fazlollahi, Amir; Fripp, Jurgen; Dowling, Jason A. [CSIRO Health and Biosecurity, The Australian e-Health & Research Centre, Herston, QLD 4029 (Australia); Stanwell, Peter [School of health sciences, The University of Newcastle, Newcastle, NSW 2308 (Australia); Pichler, Peter [Department of Radiation Oncology, Cavalry Mater Newcastle Hospital, Newcastle, NSW 2298 (Australia); Sun, Jidi; Greer, Peter B. [School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW 2308, Australia and Department of Radiation Oncology, Cavalry Mater Newcastle Hospital, Newcastle, NSW 2298 (Australia)

    2016-05-15

    Purpose: The feasibility of radiation therapy treatment planning using substitute computed tomography (sCT) generated from magnetic resonance images (MRIs) has been demonstrated by a number of research groups. One challenge with an MRI-alone workflow is the accurate identification of intraprostatic gold fiducial markers, which are frequently used for prostate localization prior to each dose delivery fraction. This paper investigates a template-matching approach for the detection of these seeds in MRI. Methods: Two different gradient echo T1 and T2* weighted MRI sequences were acquired from fifteen prostate cancer patients and evaluated for seed detection. For training, seed templates from manual contours were selected in a spectral clustering manifold learning framework. This aids in clustering “similar” gold fiducial markers together. The marker with the minimum distance to a cluster centroid was selected as the representative template of that cluster during training. During testing, Gaussian mixture modeling followed by a Markovian model was used in automatic detection of the probable candidates. The probable candidates were rigidly registered to the templates identified from spectral clustering, and a similarity metric is computed for ranking and detection. Results: A fiducial detection accuracy of 95% was obtained compared to manual observations. Expert radiation therapist observers were able to correctly identify all three implanted seeds on 11 of the 15 scans (the proposed method correctly identified all seeds on 10 of the 15). Conclusions: An novel automatic framework for gold fiducial marker detection in MRI is proposed and evaluated with detection accuracies comparable to manual detection. When radiation therapists are unable to determine the seed location in MRI, they refer back to the planning CT (only available in the existing clinical framework); similarly, an automatic quality control is built into the automatic software to ensure that all gold

  19. Comparison of Planning Quality and Efficiency Between Conventional and Knowledge-based Algorithms in Nasopharyngeal Cancer Patients Using Intensity Modulated Radiation Therapy.

    Science.gov (United States)

    Chang, Amy T Y; Hung, Albert W M; Cheung, Fion W K; Lee, Michael C H; Chan, Oscar S H; Philips, Helen; Cheng, Yung-Tang; Ng, Wai-Tong

    2016-07-01

    Intensity modulated radiation therapy (IMRT) is widely used to achieve a highly conformal dose and improve treatment outcome. However, plan quality and planning time are institute and planner dependent, and no standardized tool exists to recognize an optimal plan. RapidPlan, a knowledge-based algorithm, can generate constraints to assist optimization and produce high-quality IMRT plans. This report evaluated the quality and efficiency of using RapidPlan in nasopharyngeal carcinoma (NPC) IMRT planning. RapidPlan was configured using 79 radical IMRT plans for NPC; 20 consecutive NPC patients indicated for radical radiation therapy between October 2014 and May 2015 were then recruited to assess its performance. The ability of RapidPlan to produce acceptable plans was evaluated. For plans that could not achieve clinical acceptance, manual touch-up was performed. The IMRT plans produced without RapidPlan (manual plans) and with RapidPlan (RP-2 plans, including those with manual touch-up) were compared in terms of dosimetric quality and planning efficiency. RapidPlan by itself could produce clinically acceptable plans for 9 of the 20 patients; manual touch-up increased the number of acceptable plans (RP-2 plans) to 19. The target dose coverage and conformity were very similar. No difference was found in the maximum dose to the brainstem and optic chiasm. RP-2 plans delivered a higher maximum dose to the spinal cord (46.4 Gy vs 43.9 Gy, P=.002) but a lower dose to the parotid (mean dose to right parotid, 37.3 Gy vs 45.4 Gy; left, 34.4 Gy vs 43.1 Gy; Pmanual plans (64 minutes vs 295 minutes, P<.001). This study shows that RapidPlan can significantly improve planning efficiency and produce quality IMRT plans for NPC patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Evaluation of the capacity development of actors within participatory planning process

    Directory of Open Access Journals (Sweden)

    Čolić Ratka

    2014-01-01

    Full Text Available This paper focuses on measuring the capacity development within the participatory planning process of formulation of development strategy. It starts with the discussion of how individual, collaborative and governance capacities became a part of collaborative and consensus planning, and continues with proposing the mixed method approach. Quantitative methods have been used to measure the level of satisfaction/dissatisfaction that participatory approach had on the actors. Evaluation has shown significant increase in actors’ capacities during the planning process. Qualitative methods aim to reach understanding of the actors’ perception of the results of the participatory planning process they were engaged in. Local actors recognized results as the following: opportunity for gaining a new knowledge, understanding of problems, importance of information and cooperation exchange, recognition of ‘others’, capability for evaluation of plans, understanding of different roles and responsibilities, importance of team work and bundling of knowledge from different sources in problem solving, and collective action and interaction. Thus, the participatory planning holds potential as a continual process of developing the capacities of actors.

  1. Computer aided process planning at the Oak Ridge Y-12 plant: a pilot project

    International Nuclear Information System (INIS)

    Hewgley, R.E. Jr.; Prewett, H.P. Jr.

    1979-01-01

    In 1976, a formal needs analysis was conducted in one of the Fabrication Division Shops of all activities from the receipt of an order through final machining. The results indicated deficiencies in process planning activities involving special production work. A pilot program was organized to investigate the benefits of emerging CAM technology and application of GT concepts for machining operations at the Y-12 Plant. The objective of the CAPP Project was to provide computer-assisted process planning for special production machining in th shop. The CAPP team was charged with the specific goal of demonstrating computer-aided process planning within a four-year term. The CAPP charter included a plan with intermediate measurable milestones for achieving its mission. In three years, the CAPP project demonstrated benefits to process planning. A capability to retrieve historical records for similar parts, to review accurately the status of all staff assignments, and to generate detailed machining procedures definitely can impact the way in which a machine shop prepared for new orders. The real payoff is in the hardcopy output (N/C programs, studies, sequence plans, and procedures). 4 figures,

  2. Global Production Planning Process considering the Supply Risk of Overseas Manufacturing Sites

    Directory of Open Access Journals (Sweden)

    Hosang Jung

    2015-01-01

    Full Text Available Although global manufacturers can produce most of their final products in local plants, they need to source components or parts from desirable overseas manufacturing partners at low cost in order to fulfill customer orders. In this global manufacturing environment, capacity information for planning is usually imprecise owing to the various risks of overseas plants (e.g., foreign governments’ policies and labor stability. It is therefore not easy for decision-makers to generate a global production plan showing the production amounts at local plants and overseas manufacturing facilities operated by manufacturing partners. In this paper, we present a new global production planning process considering the supply risk of overseas manufacturing sites. First, local experts estimate the supply capacity of an overseas plant using their judgment to determine when the risk could occur and how large the risk impact would be. Next, we run a global production planning model with the estimated supply capacities. The proposed process systematically adopts the qualitative judgments of local experts in the global production planning process and thus can provide companies with a realistic global production plan. We demonstrate the applicability of the proposed process with a real world case.

  3. Interpersonal processes affecting early alliance formation in experiential therapy for depression.

    Science.gov (United States)

    Wong, Karen; Pos, Alberta E

    2014-01-01

    This study examined the effects of in-session interpersonal process and pre-therapy interpersonal problems on session-one alliance formation for 32 clients who received short-term experiential therapy for depression. Interpersonal behavior measured by the Structural Analysis of Social Behavior, as well as clients' pre-therapy reports of interpersonal problems significantly related to session-one alliance scores. Greater client disclosure independently predicted a stronger session-one bond with the therapist. Both greater client disclosure (positively) and pre-therapy Social Inhibition (negatively) independently predicted early goal agreement. Findings suggest that client disclosure is a marker of early engagement in experiential therapy, as well as support this model's mandate to form interpersonally safe therapeutic environments from the first moments of therapy.

  4. Combined Log Inventory and Process Simulation Models for the Planning and Control of Sawmill Operations

    Science.gov (United States)

    Guillermo A. Mendoza; Roger J. Meimban; Philip A. Araman; William G. Luppold

    1991-01-01

    A log inventory model and a real-time hardwood process simulation model were developed and combined into an integrated production planning and control system for hardwood sawmills. The log inventory model was designed to monitor and periodically update the status of the logs in the log yard. The process simulation model was designed to estimate various sawmill...

  5. An Exploratory Study of Planning, Attention, Simultaneous, and Successive Cognitive Processes.

    Science.gov (United States)

    Naglieri, Jack A.; And Others

    1989-01-01

    Examined factorial validity of tasks designed to measure cognitive processing in each of Luria's three functional units. Fourth and fifth graders (N=112) were administered nine experimental tasks chosen or developed according to theoretical components of planning, attention, simultaneous, and successive processes. Obtained general support for…

  6. Practice comparisons between accelerated resolution therapy, eye movement desensitization and reprocessing and cognitive processing therapy with case examples.

    Science.gov (United States)

    Hernandez, Diego F; Waits, Wendi; Calvio, Lisseth; Byrne, Mary

    2016-12-01

    Recent outcomes for Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy indicate that as many as 60-72% of patients retain their PTSD diagnosis after treatment with CPT or PE. One emerging therapy with the potential to augment existing trauma focused therapies is Accelerated Resolution Therapy (ART). ART is currently being used along with evidence based approaches at Fort Belvoir Community Hospital and by report has been both positive for clients as well as less taxing on professionals trained in ART. The following is an in-practice theoretical comparison of CPT, EMDR and ART with case examples from Fort Belvoir Community Hospital. While all three approaches share common elements and interventions, ART distinguishes itself through emphasis on the rescripting of traumatic events and the brevity of the intervention. While these case reports are not part of a formal study, they suggest that ART has the potential to augment and enhance the current delivery methods of mental health care in military environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Radiation Therapy Planning for Early-Stage Hodgkin Lymphoma: Experience of the International Lymphoma Radiation Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Maraldo, Maja V., E-mail: dra.maraldo@gmail.com [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Dabaja, Bouthaina S. [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Filippi, Andrea R. [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Illidge, Tim [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Tsang, Richard [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Petersen, Peter M.; Schut, Deborah A. [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark); Garcia, John [Department of Radiation Oncology, MD Anderson Cancer Center, Texas (United States); Headley, Jayne [Department of Oncology, Christie Hospital, Manchester (United Kingdom); Parent, Amy; Guibord, Benoit [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ragona, Riccardo [Department of Oncology, University of Torino School of Medicine, Torino (Italy); Specht, Lena [Departments of Clinical Oncology and Hematology, Rigshospitalet, University of Copenhagen (Denmark)

    2015-05-01

    Purpose: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs). Methods: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013. Results: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient. Conclusions: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs.

  8. [Collage therapy and an analysis of production process in collage work].

    Science.gov (United States)

    Sato, S

    1998-10-01

    An application of collage as an art form has been made in clinical psychology, and has been established as collage therapy. This paper attempted to answer the following questions: What kind of behavior people show during production of collage work; how the production behavior differs from person to person; what causes the behavior differences. The framework of creative problem solving and behavior analysis technique with VTR were used, and behavior characteristics of mentally retarded subjects (N = 20) were compared with non-retarded adults (N = 20). Results revealed three behavior patterns: Whole linear type ([SEAF]n), partially repeated linear type ([SE]n and [AF]m), and circuit type ([SEA]n and [AF]m) from the analysis of transition probability of four fundamental action elements (search [S], extraction [E], arrangement [A] and fixation [F]) of collage work production. The difference in the production process of each subject may be attributed to the difference in proportions of the three behavior patterns. The proportion difference in turn appeared to reflect that on the global-local dimension in the work production plan.

  9. Decontamination and decommissioning plan for processing contaminated NaK at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    LaRue, D.M.; Dolenc, M.R.

    1986-09-01

    This decontamination and decommissioning (D&D) plan describes the work elements and project management plan for processing four containers of contaminated sodium/potassium (NaK) and returning the Army Reentry Vehicle Facility Site (ARVFS) to a reusable condition. The document reflects the management plan for this project before finalizing the conceptual design and preliminary prototype tests of the reaction kinetics. As a result, the safety, environmental, and accident analyses are addressed as preliminary assessments before completion at a later date. ARVFS contains an earth-covered bunker, a cylindrical test pit and metal shed, and a cable trench connecting the two items. The bunker currently stores the four containers of NaK from the meltdown of the EBR-1 Mark II core. The D&D project addressed in this plan involves processing the contaminated NaK and returning the ARVFS to potential reuse after cleanup.

  10. Decontamination and decommissioning plan for processing contaminated NaK at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    LaRue, D.M.; Dolenc, M.R.

    1986-09-01

    This decontamination and decommissioning (D D) plan describes the work elements and project management plan for processing four containers of contaminated sodium/potassium (NaK) and returning the Army Reentry Vehicle Facility Site (ARVFS) to a reusable condition. The document reflects the management plan for this project before finalizing the conceptual design and preliminary prototype tests of the reaction kinetics. As a result, the safety, environmental, and accident analyses are addressed as preliminary assessments before completion at a later date. ARVFS contains an earth-covered bunker, a cylindrical test pit and metal shed, and a cable trench connecting the two items. The bunker currently stores the four containers of NaK from the meltdown of the EBR-1 Mark II core. The D D project addressed in this plan involves processing the contaminated NaK and returning the ARVFS to potential reuse after cleanup.