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Sample records for treatment plan background

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

    International Nuclear Information System (INIS)

    1995-01-01

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

  2. Federal Facilities Compliance Act, Draft Site Treatment Plan: Background Volume, Part 2, Volume 1

    International Nuclear Information System (INIS)

    1994-01-01

    This Draft Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed include: purpose and scope of the plan; site history and mission; draft plant organization; waste minimization; waste characterization; preferred option selection process; technology for treating low-level radioactive wastes and TRU wastes; future generation of mixed waste streams; funding; and process for evaluating disposal issues in support of the site treatment plan

  3. Planning, optimisation and evaluation of hyperthermia treatments

    NARCIS (Netherlands)

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

    2017-01-01

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

  4. Employee Ownership Plans. Background Paper No. 34.

    Science.gov (United States)

    Stern, Robert N.

    Employee ownership through employee stock ownership plans (ESOPs) was first mentioned in federal legislation in the Regional Rail Reorganization Act of 1973. Since then, at least 19 pieces of federal legislation have been enacted that deal with employee ownership in some way, including the Employee Retirement Income Security Act (ERISA) and tax…

  5. Computerized radiation treatment planning

    International Nuclear Information System (INIS)

    Laarse, R. van der.

    1981-01-01

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

  6. Background research paper : windpower and renewable energy planning study

    Energy Technology Data Exchange (ETDEWEB)

    Duhamel, R.; Cane, T.; Loft, K. [Jones Consulting Group, Barrie, ON (Canada)

    2007-09-04

    This background paper reviewed wind and renewable energy generation approaches and best practices for the county of Essex in Ontario. The aim of the paper was to provide a foundation for a planning approval framework for the county. No specific provincial guidance is currently offered on how to plan renewable energy facilities. An overview of Essex county provided details of the region's physiography, economy, and general landscape characteristics. Separate details of all townships and municipalities in the county were also included. Renewable energy facilities considered in the study included solar, biomass, wind, geothermal, and hydro technologies. Scale options were considered for wind, solar, and biomass energy facilities. Issues related to wind power and community concerns over visual and noise impacts were reviewed. Opportunities for wind power development in the region were also outlined. Mineral, petroleum and aggregate resources were also reviewed. The report also considered the development of renewable energy resources in relation to environmental impacts on lands as well as cultural heritage landscapes and built heritage resources in the region. It was concluded that the county of Essex possesses a variety of resources that continue to attract the attention of renewable energy facility developers. The background paper will encourage stakeholders to participate in the development of draft policies to respond to emerging land use issues in the county. A literature review of wind turbines and wildlife was provided as an appendix. 51 refs., 11 figs.

  7. Integral multidisciplinary rehabilitation treatment planning

    NARCIS (Netherlands)

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

    2014-01-01

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

  8. Integral multidisciplinary rehabilitation treatment planning

    NARCIS (Netherlands)

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

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

  9. Is pregnancy planning associated with background characteristics and pregnancy-planning behavior?

    DEFF Research Database (Denmark)

    Stern, Jenny; Salih Joelsson, Lana; Tydén, Tanja

    2016-01-01

    -Wallis H and chi-squared tests. Results Three of four pregnancies were very or fairly planned and 12% fairly or very unplanned. Of women with very unplanned pregnancies, 32% had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher......Introduction Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics...... and pregnancy-planning behavior. Material and methods A cross-sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning study. Pregnant women (n = 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal...

  10. Three-dimensional teletherapy treatment planning

    International Nuclear Information System (INIS)

    Panthaleon van Eck, R.B. van.

    1986-01-01

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

  11. Hirsutism in PCOS - low satisfaction of treatment and its background

    DEFF Research Database (Denmark)

    Gade, Melina; Lauszus, Finn

    2014-01-01

    Background: Data are sparse on medical treatment of hirsutism with metformin. The extent of the treatment effects may affect the women’s quality of life, as low self-esteem and higher rates of depression are associated with the severity of the PCOS condition. Aim: Evaluating the self-assessment o......Background: Data are sparse on medical treatment of hirsutism with metformin. The extent of the treatment effects may affect the women’s quality of life, as low self-esteem and higher rates of depression are associated with the severity of the PCOS condition. Aim: Evaluating the self...

  12. Interactively exploring optimized treatment plans.

    Science.gov (United States)

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

    2005-02-01

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

  13. Treatment planning for restorative implantology.

    Science.gov (United States)

    Boyce, Ricardo A; Klemons, Gary

    2015-04-01

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

  14. Backgrounder

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    inequalities, and poverty based on rigorous data collection and analysis. ... at how poor urban planning may be contributing to forced evictions and mass relocations, which in turn can lead to violence in the form of ... communities with similar conditions of social exclusion experience different levels of violence. The study will.

  15. Final Sampling and Analysis Plan for Background Sampling, Fort Sheridan, Illinois

    National Research Council Canada - National Science Library

    1995-01-01

    .... This Background Sampling and Analysis Plan (BSAP) is designed to address this issue through the collection of additional background samples at Fort Sheridan to support the statistical analysis and the Baseline Risk Assessment (BRA...

  16. Concepts of radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Mackie, R.T.

    2000-01-01

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

  17. Automatic planning of head and neck treatment plans

    DEFF Research Database (Denmark)

    Hazell, Irene; Bzdusek, Karl; Kumar, Prashant

    2016-01-01

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

  18. Automatic liver contouring for radiotherapy treatment planning

    Science.gov (United States)

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

    2015-09-01

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

  19. Treatment planning optimization for linear accelerator radiosurgery

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  20. Treatment planning with ion beams

    International Nuclear Information System (INIS)

    Foss, M.H.

    1985-01-01

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

  1. Nuclear power enterprise tax planning strategy in the background of reform

    International Nuclear Information System (INIS)

    Wu Yimin

    2012-01-01

    The success of tax planning can be converted into enterprise's productivity, tax planning strategy can maximize the desired effects and bring out its full play to tax planning. Taking new round of tax reform in 12th five-year-plan and the reformation of professional groups as the background, the author detailedly conceived a frame of corporate tax planning strategy for nuclear power enterprises of China National Nuclear Corporation at the forefront of reformation from an all-round comprehensive view and multi-angle stand. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Farnham, Irene; Marutzky, Sam

    2014-12-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  4. Monte Carlo Treatment Planning for Advanced Radiotherapy

    DEFF Research Database (Denmark)

    Cronholm, Rickard

    This Ph.d. project describes the development of a workflow for Monte Carlo Treatment Planning for clinical radiotherapy plans. The workflow may be utilized to perform an independent dose verification of treatment plans. Modern radiotherapy treatment delivery is often conducted by dynamically...... modulating the intensity of the field during the irradiation. The workflow described has the potential to fully model the dynamic delivery, including gantry rotation during irradiation, of modern radiotherapy. Three corner stones of Monte Carlo Treatment Planning are identified: Building, commissioning...

  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. Recovery post treatment: plans, barriers and motivators

    Directory of Open Access Journals (Sweden)

    Duffy Paul

    2013-01-01

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

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

    International Nuclear Information System (INIS)

    Lawrence, B.

    1999-01-01

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

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

    International Nuclear Information System (INIS)

    Lawrence, B.

    2000-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2000-04-20

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    1999-04-20

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

  11. Motion and operation planning of robotic systems background and practical approaches

    CERN Document Server

    Gomez-Barvo, Fernando

    2015-01-01

    This book addresses the broad multi-disciplinary topic of robotics, and presents the basic techniques for motion and operation planning in robotics systems. Gathering contributions from experts in diverse and wide ranging fields, it offers an overview of the most recent and cutting-edge practical applications of these methodologies. It covers both theoretical and practical approaches, and elucidates the transition from theory to implementation. An extensive analysis is provided, including humanoids, manipulators, aerial robots and ground mobile robots. ‘Motion and Operation Planning of Robotic Systems’ addresses the following topics: *The theoretical background of robotics. *Application of motion planning techniques to manipulators, such as serial and parallel manipulators. *Mobile robots planning, including robotic applications related to aerial robots, large scale robots and traditional wheeled robots. *Motion planning for humanoid robots. An invaluable reference text for graduate students and researche...

  12. Background, Personal, and Environmental Influences on the Career Planning of Adolescent Girls

    Science.gov (United States)

    Novakovic, Alexandra; Fouad, Nadya A.

    2013-01-01

    This study investigated the influence of background variables (age, race/ethnicity, mother's work status outside of the home, and socioeconomic status), personal variables (anticipatory role conflict and academic self-efficacy), and environmental variables (parental attachment and parental support) on aspects of adolescent girls' career planning.…

  13. Implant treatment planning: endodontic considerations.

    Science.gov (United States)

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

    2014-12-01

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

  14. Training Psychotherapists in Hierarchical Treatment Planning

    OpenAIRE

    MAKOVER, RICHARD B.

    1992-01-01

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

  15. Pediatric radiotherapy planning and treatment

    CERN Document Server

    Olch, Arthur J

    2013-01-01

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

  16. When does treatment plan optimization require inverse planning?

    International Nuclear Information System (INIS)

    Sherouse, George W.

    1995-01-01

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

  17. Alzheimer’s Disease: Background, Current and Future Treatments

    OpenAIRE

    Evelyn Chou

    2014-01-01

    Alzheimer’s disease is a currently incurable neurodegenerative disorder, and its treatment has posed a big challenge. Proposed causes of Alzheimer’s disease include the cholinergic, amyloid and tau hypothesis. Current therapeutic treatments have been aimed at dealing with neurotransmitter imbalance. These include cholinesterase inhibitors and N-methyl D-aspartate receptor antagonists. However, current therapeutics have been unable to halt its progression. The future of Alzheimer’s disease tre...

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

    Energy Technology Data Exchange (ETDEWEB)

    D`Amelio, J.

    1994-08-30

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

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

    International Nuclear Information System (INIS)

    D'Amelio, J.

    1994-01-01

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

  20. 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

  1. Pathogenic background for treatment of ascites and the hepatorenal syndrome

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik; Bendtsen, Flemming

    2008-01-01

    Abstract Ascites and hepatorenal syndrome (HRS) are the major and challenging complications of cirrhosis and portal hypertension that significantly affect the course of the disease. Liver insufficiency, portal hypertension, arterial vasodilatation, and systemic cardiovascular dysfunction are major...... pathophysiological hallmarks. Modern treatment of ascites is based on this recognition and includes modest salt restriction and stepwise diuretic therapy with spironolactone and loop diuretics. Tense and refractory ascites should be treated with a large volume paracentesis, followed by volume expansion...... seek to improve liver function, ameliorate arterial hypotension and central hypovolemia, and reduce renal vasoconstriction. Ample treatment of ascites and HRS is important to improve the quality of life and prevent further complications, but since treatment of fluid retention does not significantly...

  2. Emergency Planning for Municipal Wastewater Treatment Facilities.

    Science.gov (United States)

    Lemon, R. A.; And Others

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

  3. [Planning guidelines for prosthodontic treatment].

    Science.gov (United States)

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

    2008-01-01

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

  4. Climate change in Nova Scotia : a background paper to guide Nova Scotia's climate change action plan

    International Nuclear Information System (INIS)

    2007-10-01

    Climate change causes changes in the temperature of the earth, the level of the sea, and the frequency of extreme weather conditions. The province of Nova Scotia recently released an act related to environmental goals and sustainable prosperity. Addressing climate change is a key element in achieving Nova Scotia's sustainable prosperity goals outlined in the act. The Nova Scotia Department of Energy is working towards developing both policy and action, to help meet its target of a 10 per cent reduction in greenhouse gases from 1990 levels by the year 2020. Two major plans are underway, notably a climate change action plan and a renewed energy strategy. This report provided background information on Nova Scotia's climate change action plan. It discussed climate change issues affecting Nova Scotia, air pollutants, energy sources in Nova Scotia, energy consumers in the province, and Nova Scotia's approach to climate change. The report also discussed actions underway and funding sources. It was concluded that in order for the climate change action plan to be successful, Nova Scotians must use energy more efficiently; use renewable energy; use cleaner energy; and plan for change. 13 refs., 2 tabs., 6 figs., 4 appendices

  5. Pathogenic background for treatment of ascites and the hepatorenal syndrome

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik; Bendtsen, Flemming

    2008-01-01

    Abstract Ascites and hepatorenal syndrome (HRS) are the major and challenging complications of cirrhosis and portal hypertension that significantly affect the course of the disease. Liver insufficiency, portal hypertension, arterial vasodilatation, and systemic cardiovascular dysfunction are major...... pathophysiological hallmarks. Modern treatment of ascites is based on this recognition and includes modest salt restriction and stepwise diuretic therapy with spironolactone and loop diuretics. Tense and refractory ascites should be treated with a large volume paracentesis, followed by volume expansion...

  6. Tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1985-10-01

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

  7. Tolerance doses for treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Lyman, J.T.

    1985-10-01

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

  8. Improving treatment plan evaluation with automation

    Science.gov (United States)

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

    2016-01-01

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

  9. Fuzzy logic guided inverse treatment planning

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  10. The evolution of brachytherapy treatment planning

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  12. Radiotherapy treatment planning linear-quadratic radiobiology

    CERN Document Server

    Chapman, J Donald

    2015-01-01

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

  13. Dosimetry treatment planning with uncertainty evaluation

    International Nuclear Information System (INIS)

    Henriquez, Francisco Cutanda; Castrillyn, Silvia Vargas

    2010-01-01

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

  14. Automated radiotherapy treatment plan integrity verification

    International Nuclear Information System (INIS)

    Yang Deshan; Moore, Kevin L.

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Science.gov (United States)

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

    2017-11-22

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

  17. Collision detection and avoidance during treatment planning

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  18. Computer-assisted treatment planning and analysis.

    Science.gov (United States)

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

    2003-01-01

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

  19. Electron Density Calibration for Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  20. Three-dimensional radiation treatment planning

    International Nuclear Information System (INIS)

    Mohan, R.

    1989-01-01

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

  1. Applied Ecosystem Analysis - Background : EDT the Ecosystem Diagnosis and Treatment Method.

    Energy Technology Data Exchange (ETDEWEB)

    Mobrand, Lars E.

    1996-05-01

    This volume consists of eight separate reports. We present them as background to the Ecosystem Diagnosis and Treatment (EDT) methodology. They are a selection from publications, white papers, and presentations prepared over the past two years. Some of the papers are previously published, others are currently being prepared for publication. In the early to mid 1980`s the concern for failure of both natural and hatchery production of Columbia river salmon populations was widespread. The concept of supplementation was proposed as an alternative solution that would integrate artificial propagation with natural production. In response to the growing expectations placed upon the supplementation tool, a project called Regional Assessment of Supplementation Project (RASP) was initiated in 1990. The charge of RASP was to define supplementation and to develop guidelines for when, where and how it would be the appropriate solution to salmon enhancement in the Columbia basin. The RASP developed a definition of supplementation and a set of guidelines for planning salmon enhancement efforts which required consideration of all factors affecting salmon populations, including environmental, genetic, and ecological variables. The results of RASP led to a conclusion that salmon issues needed to be addressed in a manner that was consistent with an ecosystem approach. If the limitations and potentials of supplementation or any other management tool were to be fully understood it would have to be within the context of a broadly integrated approach - thus the Ecosystem Diagnosis and Treatment (EDT) method was born.

  2. Applied Ecosystem Analysis - Background EDT - The Ecosystem Diagnosis and Treatment Method

    International Nuclear Information System (INIS)

    Mobrand, L.E.; Lichatowich, J.A.; Howard, D.A.; Vogel, T.S.

    1996-05-01

    This volume consists of eight separate reports. We present them as background to the Ecosystem Diagnosis and Treatment (EDT) methodology. They are a selection from publications, white papers, and presentations prepared over the past two years. Some of the papers are previously published, others are currently being prepared for publication. In the early to mid 1980's the concern for failure of both natural and hatchery production of Columbia river salmon populations was widespread. The concept of supplementation was proposed as an alternative solution that would integrate artificial propagation with natural production. In response to the growing expectations placed upon the supplementation tool, a project called Regional Assessment of Supplementation Project (RASP) was initiated in 1990. The charge of RASP was to define supplementation and to develop guidelines for when, where and how it would be the appropriate solution to salmon enhancement in the Columbia basin. The RASP developed a definition of supplementation and a set of guidelines for planning salmon enhancement efforts which required consideration of all factors affecting salmon populations, including environmental, genetic, and ecological variables. The results of RASP led to a conclusion that salmon issues needed to be addressed in a manner that was consistent with an ecosystem approach. If the limitations and potentials of supplementation or any other management tool were to be fully understood it would have to be within the context of a broadly integrated approach - thus the Ecosystem Diagnosis and Treatment (EDT) method was born

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-03-22

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

  6. Real-time interactive treatment planning

    International Nuclear Information System (INIS)

    Otto, Karl

    2014-01-01

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

  7. Conventional treatment planning optimization using simulated annealing

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  8. 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

  9. The Effectiveness of Drug Abuse Treatment: Implications for Controlling AIDS/HIV Infection. Background Paper 3.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This background paper examines evidence for the effectiveness of treatment for drug abuse and evaluates the role of drug abuse treatment as a strategy to prevent Human Immunodeficiency Virus (HIV) spread. Because most intravenous (IV) drug users are not in treatment, the study also examines other approaches to HIV prevention. The remainder of the…

  10. Strategic planning of treatment for hyperthyroid disease

    International Nuclear Information System (INIS)

    Hoeffer, R.

    1994-01-01

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

  11. 3-D CT for cardiovascular treatment planning

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  12. Intracavitary radiation treatment planning and dose evaluation

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  13. Treatment Plan Adherence for Your Child With JA

    Science.gov (United States)

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

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

    Science.gov (United States)

    D.L. Peterson; M.C. Johnson

    2007-01-01

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

  15. 49: 3-D treatment planning. 3

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  16. Constrained treatment planning using sequential beam selection

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  17. Novel tracer for radiation treatment planning

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

    Corbet, E; Smales, R

    2012-09-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  1. Hexone Storage and Treatment Facility closure plan

    International Nuclear Information System (INIS)

    1992-11-01

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

  2. Radiation treatment planning using a microcomputer

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  3. 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

  4. 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

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

    International Nuclear Information System (INIS)

    1994-01-01

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

  6. Accuracy requirements in radiotherapy treatment planning

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  7. A treatment planning classification for oligodontia.

    Science.gov (United States)

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

    2010-01-01

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

  8. Volume visualization in radiation treatment planning.

    Science.gov (United States)

    Pelizzari, C A; Chen, G T

    2000-12-01

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

  9. "Planned" Teenage Pregnancy: Perspectives of Young Women from Disadvantaged Backgrounds in England

    Science.gov (United States)

    Coleman, Lester; Cater, Suzanne

    2006-01-01

    The reduction of teenage pregnancy has attracted much interest in research, practice and social policy. Little is known about teenagers who report their pregnancies as "planned." Forty-one in-depth interviews were undertaken, in six different parts of England, among young women who reported their pregnancy as "planned". The…

  10. Radiotherapy Treatment Planning for Testicular Seminoma

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  12. Integration method of 3D MR spectroscopy into treatment planning system for glioblastoma IMRT dose painting with integrated simultaneous boost

    OpenAIRE

    Ken, Sol?akh?na; Vieillevigne, Laure; Franceries, Xavier; Simon, Luc; Supper, Caroline; Lotterie, Jean-Albert; Filleron, Thomas; Lubrano, Vincent; Berry, Isabelle; Cassol, Emmanuelle; Delannes, Martine; Celsis, Pierre; Cohen-Jonathan, Elizabeth Moyal; Laprie, Anne

    2013-01-01

    Abstract Background To integrate 3D MR spectroscopy imaging (MRSI) in the treatment planning system (TPS) for glioblastoma dose painting to guide simultaneous integrated boost (SIB) in intensity-modulated radiation therapy (IMRT). Methods For sixteen glioblastoma patients, we have simulated three types of dosimetry plans, one conventional plan of 60-Gy in 3D conformational radiotherapy (3D-CRT), one 60-Gy plan in IMRT and one 72-Gy plan in SIB-IMRT. All sixteen MRSI metabolic maps were integr...

  13. Project plan for the Background Soil Characterization Project on the Oak Ridge Reservation, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1992-08-01

    The Background Soil characterization Project (BSCP) will provide background concentration levels of selected metals, organic compounds, and radionuclides in soils from uncontaminated on-site areas at the Oak Ridge Reservation (ORR), and off-site in the western part of Roane County and the eastern part of Anderson County. The BSCP will establish a database, recommend how to use the data for contaminated site assessment, and provide estimates of the potential human health and environmental risks associated with the background level concentrations of potentially hazardous constituents

  14. Project plan for the Background Soil Characterization Project on the Oak Ridge Reservation, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    The Background Soil characterization Project (BSCP) will provide background concentration levels of selected metals, organic compounds, and radionuclides in soils from uncontaminated on-site areas at the Oak Ridge Reservation (ORR), and off-site in the western part of Roane County and the eastern part of Anderson County. The BSCP will establish a database, recommend how to use the data for contaminated site assessment, and provide estimates of the potential human health and environmental risks associated with the background level concentrations of potentially hazardous constituents.

  15. A dosimetric comparison of four treatment planning methods for high grade glioma

    Directory of Open Access Journals (Sweden)

    Miller Robert W

    2009-10-01

    Full Text Available Abstract Background High grade gliomas (HGG are typically treated with a combination of surgery, radiotherapy and chemotherapy. Three dimensional (3D conformal radiotherapy treatment planning is still the main stay of treatment for these patients. New treatment planning methods suggest better dose distributions and organ sparing but their clinical benefit is unclear. The purpose of the current study was to compare normal tissue sparing and tumor coverage using four different radiotherapy planning methods in patients with high grade glioma. Methods Three dimensional conformal (3D, sequential boost IMRT, integrated boost (IB IMRT and Tomotherapy (TOMO treatment plans were generated for 20 high grade glioma patients. T1 and T2 MRI abnormalities were used to define GTV and CTV with 2 and 2.5 cm margins to define PTV1 and PTV2 respectively. Results The mean dose to PTV2 but not to PTV1 was less then 95% of the prescribed dose with IB and IMRT plans. The mean doses to the optic chiasm and the ipsilateral globe were highest with 3D plans and least with IB plans. The mean dose to the contralateral globe was highest with TOMO plans. The mean of the integral dose (ID to the brain was least with the IB plan and was lower with IMRT compared to 3D plans. The TOMO plans had the least mean D10 to the normal brain but higher mean D50 and D90 compared to IB and IMRT plans. The mean D10 and D50 but not D90 were significantly lower with the IMRT plans compared to the 3D plans. Conclusion No single treatment planning method was found to be superior to all others and a personalized approach is advised for planning and treating high-grade glioma patients with radiotherapy. Integral dose did not reflect accurately the dose volume histogram (DVH of the normal brain and may not be a good indicator of delayed radiation toxicity.

  16. Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

    Science.gov (United States)

    Shay, Kenneth; Hyduke, Barbara; Burris, James F

    2013-04-01

    The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  17. Optimization of rotational radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Tulovsky, Vladimir; Ringor, Michael; Papiez, Lech

    1995-01-01

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

  18. Inequalities in Access to Treatment and Care for Patients with Dementia and Immigrant Background

    DEFF Research Database (Denmark)

    Stevnsborg, Lea; Jensen-Dahm, Christina; Nielsen, Thomas R

    2016-01-01

    BACKGROUND: Previous studies demonstrated lower quality diagnostic assessment of dementia in immigrant populations, but knowledge about the quality of treatment and care for dementia is still lacking. OBJECTIVE: To conduct a nationwide registry-based study to determine whether inequality exists...... regarding access to anti-dementia treatment and care between immigrant and Danish-born patients with dementia. METHODS: A cross-sectional register-based study was conducted in the entire elderly (60≥years) population with dementia in Denmark in 2012 (n = 34,877). The use of anti-dementia drugs and residency...... measure for adherence). Non-Western immigrants were significantly less likely to live in a nursing home (0.52 [0.41-0.65]). CONCLUSION: This nationwide registry-based study indicated a worrisome difference in access to anti-dementia treatment and care for dementia patients with an immigrant background...

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-10-29

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

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

    International Nuclear Information System (INIS)

    1993-01-01

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

  1. 3-Dimentional radiotherapy versus conventional treatment plans for gastric cancer

    Directory of Open Access Journals (Sweden)

    Aghili M

    2010-11-01

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

  2. 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

  3. Background of Individual Education Plans (IEPs) Policy in Some Countries: A Review

    Science.gov (United States)

    Alkahtani, Mohammed Ali; Kheirallah, Sahar Abdelfattah

    2016-01-01

    This paper seeks to provide a cogent outline of the current policies that six separate countries have on Individual Education Plans (IEPs), identifying the key features in each system. The chosen countries are Australia (Queen Island), Canada (British Columbia), New Zealand, the United Kingdom, the United States of America, and Saudi Arabia. The…

  4. 105: BIODOC - a combined biological treatment planning and treatment organization system

    International Nuclear Information System (INIS)

    Baier, K.

    1987-01-01

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

  5. Project plan for the background soils project for the Paducah Gaseous Diffusion Plant, Paducah, Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The Background Soils Project for the Paducah Gaseous Diffusion Plant (BSPP) will determine the background concentration levels of selected naturally occurring metals, other inorganics, and radionuclides in soils from uncontaminated areas in proximity to the Paducah Gaseous Diffusion Plant (PGDP) in Paducah, Kentucky. The data will be used for comparison with characterization and compliance data for soils, with significant differences being indicative of contamination. All data collected as part of this project will be in addition to other background databases established for the PGDP. The BSPP will address the variability of surface and near-surface concentration levels with respect to (1) soil taxonomical types (series) and (2) soil sampling depths within a specific soil profile. The BSPP will also address the variability of concentration levels in deeper geologic formations by collecting samples of geologic materials. The BSPP will establish a database, with recommendations on how to use the data for contaminated site assessment, and provide data to estimate the potential human and health and ecological risk associated with background level concentrations of potentially hazardous constituents. BSPP data will be used or applied as follows.

  6. Project plan for the background soils project for the Paducah Gaseous Diffusion Plant, Paducah, Kentucky

    International Nuclear Information System (INIS)

    1995-09-01

    The Background Soils Project for the Paducah Gaseous Diffusion Plant (BSPP) will determine the background concentration levels of selected naturally occurring metals, other inorganics, and radionuclides in soils from uncontaminated areas in proximity to the Paducah Gaseous Diffusion Plant (PGDP) in Paducah, Kentucky. The data will be used for comparison with characterization and compliance data for soils, with significant differences being indicative of contamination. All data collected as part of this project will be in addition to other background databases established for the PGDP. The BSPP will address the variability of surface and near-surface concentration levels with respect to (1) soil taxonomical types (series) and (2) soil sampling depths within a specific soil profile. The BSPP will also address the variability of concentration levels in deeper geologic formations by collecting samples of geologic materials. The BSPP will establish a database, with recommendations on how to use the data for contaminated site assessment, and provide data to estimate the potential human and health and ecological risk associated with background level concentrations of potentially hazardous constituents. BSPP data will be used or applied as follows

  7. Adaptive brachytherapy of cervical cancer, comparison of conventional point A and CT based individual treatment planning

    International Nuclear Information System (INIS)

    Wanderaas, Anne D.; Langdal, Ingrid; Danielsen, Signe; Frykholm, Gunilla; Marthinsen, Anne B. L; Sundset, Marit

    2012-01-01

    Background. Locally advanced cervical cancer is commonly treated with external radiation therapy combined with local brachytherapy. The brachytherapy is traditionally given based on standard dose planning with prescription of dose to point A. Dosimetric aspects when changing from former standard treatment to individualized treatment plans based on computed tomography (CT) images are here investigated. Material and methods. Brachytherapy data from 19 patients with a total of 72 individual treatment fractions were retrospectively reviewed. Standard library plans were analyzed with respect to doses to organs at risk (OARs), and the result was compared to corresponding delivered individualized plans. The theoretical potential of further optimization based on prescription to target volumes was investigated. The treatments were performed with a Fletcher applicator. Results. For standard treatment planning, the tolerance dose limits were exceeded in the bladder, rectum and sigmoid in 26%, 4% and 15% of the plans, respectively. This was observed most often for the smallest target volumes. The individualized planning of the delivered treatment gave the possibility of controlling the dose to critical organs to below certain limits. The dose was still prescribed to point A. An increase in target dose coverage was achieved when additional individual optimization was performed, while still keeping the dose to the OARs below predefined limits. Relatively low average target coverage, especially for the largest volumes was however seen. Conclusion. The individualized delivered treatment plans ensured that doses to OARs were within acceptable limits. This was not the case in 42% of the corresponding standard plans. Further optimized treatment plans were found to give an overall better dose coverage. In lack of MR capacity, it may be favorable to use CT for planning due to possible protection of OARs. The CT based target volumes were, however, not equivalent to the volumes described

  8. 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)

  9. Dosimetry audit of radiotherapy treatment planning systems.

    Science.gov (United States)

    Bulski, Wojciech; Chełmiński, Krzysztof; Rostkowska, Joanna

    2015-07-01

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

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

    Science.gov (United States)

    Nicholson, Ken

    2016-01-01

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

  11. Availability and Efficacy of Ballast Water Treatment Technology: Background and Issue Paper

    Science.gov (United States)

    2010-06-01

    Technology, Veolia Water Solutions & Technologies (CleanBallast) System and Greenship Sedinox® Ballast Water Management System. Note that the only...Cape Town - 4 2000+ MEPC 53/2/16 RWO GmbH Marine Water Technology, Veolia Water Solutions & Technologies (CleanBallast!) Filtration...Availability and Efficacy of Ballast Water Treatment Technology: Background and Issue Paper June 2010 Ryan Albert1, Rich

  12. Measles and Rubella Global Strategic Plan 2012-2020 midterm review report: Background and summary.

    Science.gov (United States)

    Orenstein, Walter A; Cairns, Lisa; Hinman, Alan; Nkowane, Benjamin; Olivé, Jean-Marc; Reingold, Arthur L

    2018-01-11

    Measles, a vaccine-preventable illness, is one of the most infectious diseases known to man. In 2015, an estimated 134,200 measles deaths occurred globally. Rubella, also vaccine-preventable, is a concern because infection during pregnancy can result in congenital defects in the baby. More than 100,000 babies with congenital rubella syndrome were estimated to have been born globally in 2010. Eradication of both measles and rubella is considered to be feasible, beneficial, and more cost-effective than high-level control. All six World Health Organization (WHO) regions have measles elimination goals by 2020 and two have rubella elimination goals by that year. However, the World Health Assembly has not endorsed a global eradication goal for either disease. In 2012, the Measles and Rubella Initiative published a Global Measles and Rubella Strategic Plan, 2012-2020, referred to hereafter as the Plan, which aimed to achieve measles and rubella elimination in at least five WHO regions by end-2020 through the implementation of five core strategies, with progress evaluated against 2015 milestones. When, by end-2015, none of these milestones had been met, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) recommended a mid-term review of the Plan to evaluate progress toward goals, assess the quality of strategy implementation, and formulate lessons learned. A five-member team reviewed documents and conducted interviews with stakeholders as the basis for the review's conclusions and recommendations. This team concluded that, although significant progress in measles elimination had been made, progress had slowed. It recommended that countries continue to work toward elimination goals with a focus on strengthening ongoing immunization systems. In addition, it concluded that the strategies articulated in the Plan were sound, however full implementation had been impeded by inadequate country ownership and global political will, reflected in inadequate resources

  13. 2: Local area networks as a multiprocessor treatment planning system

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  14. Nitrate Waste Treatment Sampling and Analysis Plan

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-07-05

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

  15. Accuracy of computerized radiation treatment planning

    International Nuclear Information System (INIS)

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

    1979-01-01

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

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

    Science.gov (United States)

    Tarakji, Bassel

    2014-01-01

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

  17. Savannah River Site Approved Site Treatment Plan, 2001 Annual Update (Volumes I and II)

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2001-04-30

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

  18. Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and Reference Document

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-12-22

    The Compliance Plan Volume provides overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) and contains procedures to establish milestones to be enforced under the Order. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume and is provided for informational purposes only.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-10-26

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

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

    Science.gov (United States)

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

    2011-01-01

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

  4. Volume definition system for treatment planning

    International Nuclear Information System (INIS)

    Alakuijala, Jyrki; Pekkarinen, Ari; Puurunen, Harri

    1997-01-01

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

  5. Development of a pan-Arctic monitoring plan for polar bears: Background paper

    Science.gov (United States)

    Vongraven, Dag; Peacock, Lily

    2011-01-01

    Polar bears (Ursus maritimus), by their very nature, and the extreme, remote environment in which they live, are inherently difficult to study and monitor. Monitoring polar bear populations is both arduous and costly and, to be effective, must be a long-term commitment. There are few jurisdictional governments and management boards with a mandate for polar bear research and management, and many have limited resources. Although population monitoring of polar bears has been a focus to some degree within most jurisdictions around the Arctic, of the 19 subpopulations recognised by the IUCN/Species Survival Commission Polar Bear Specialist Group (PBSG), adequate scientific trend data exist for only three of the subpopulations, fair trend data for five and poor or no trend data for the remaining 11 subpopulations (PBSG 2010a). There are especially critical knowledge gaps for the subpopulations in East Greenland, in the Russian Kara and Laptev seas, and in the Chukchi Sea, which is shared between Russia and the United States. The range covered by these subpopulations represents a third of the total area (approx. 23 million km2) of polar bears’ current range, and more than half if the Arctic Basin is included. If we use popular terms, we know close to nothing about polar bears in this portion of their range.As summer sea-ice extent, and to a lesser degree, spring-time extent, continues to retreat, outpacing model forecasts (Stroeve et al. 2007, Pedersen et al. 2009), polar bears face the challenge of adapting to rapidly changing habitats. There is a need to use current and synthesised information across the Arctic, and to develop new methods that will facilitate monitoring to generate new knowledge at a pan-Arctic scale. The circumpolar dimension can be lost when efforts are channelled into regional monitoring. Developing and implementing a plan that harmonises local, regional and global efforts will increase our power to detect and understand important trends for polar

  6. Manpower Planning for Wastewater Treatment Plants.

    Science.gov (United States)

    Davies, J. Kenneth; And Others

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

  7. A comparison of forward and inverse treatment planning for intensity-modulated radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Baer, Werner; Schwarz, Marco; Alber, Markus; Bos, Luc J.; Mijnheer, Ben J.; Rasch, Coen; Schneider, Christoph; Nuesslin, Fridtjof; Damen, Eugene M.F.

    2003-01-01

    Background and purpose: To compare intensity-modulated treatment plans of patients with head and neck cancer generated by forward and inverse planning. Materials and methods: Ten intensity-modulated treatment plans, planned and treated with a step and shoot technique using a forward planning approach, were retrospectively re-planned with an inverse planning algorithm. For this purpose, two strategies were applied. First, inverse planning was performed with the same beam directions as forward planning. In addition, nine equidistant, coplanar incidences were used. The main objective of the optimisation process was the sparing of the parotid glands beside an adequate treatment of the planning target volume (PTV). Inverse planning was performed both with pencil beam and Monte Carlo dose computation to investigate the influence of dose computation on the result of the optimisation. Results: In most cases, both inverse planning strategies managed to improve the treatment plans distinctly due to a better target coverage, a better sparing of the parotid glands or both. A reduction of the mean dose by 3-11 Gy for at least one of the parotid glands could be achieved for most of the patients. For three patients, inverse planning allowed to spare a parotid gland that had to be sacrificed by forward planning. Inverse planning increased the number of segments compared to forward planning by a factor of about 3; from 9-15 to 27-46. No significant differences for PTV and parotid glands between both inverse planning approaches were found. Also, the use of Monte Carlo instead of pencil beam dose computation did not influence the results significantly. Conclusion: The results demonstrate the potential of inverse planning to improve intensity-modulated treatment plans for head and neck cases compared to forward planning while retaining clinical utility in terms of treatment time and quality assurance

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Automated treatment planning engine for prostate seed implant brachytherapy

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    1999-02-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  12. Exploration of Gamburtsev Subglacial Mountains, East Antarctica: Background and Plans for the Near Future

    Science.gov (United States)

    Talalay, Pavel; Sun, Youhong; Zhao, Yue; Li, Yuansheng; Cao, Pinlu; Xu, Huiwen; Zheng, Zhichuan; Wang, Rusheng; Zhang, Nan; Markov, Alexey; Yu, Dahui; Fan, Xiaopeng; Hu, Zhengyi; Yang, Cheng; Gong, Da; Hong, Jialing; Liu, Chunpeng; Han, Junjie; Yu, Chengfeng; Wang, Lili

    2014-05-01

    drilling of upper permeable snow-firn layer with bottom-air reverse circulation; (2) reaming; (3) casing installation; (4) fluid core drilling of glacial ice with bottom-fluid reverse circulation; (5) bedrock core drilling. All drilling equipment will be installed inside a movable sledge-mounted warm-keeping and wind-protecting drilling shelter that is transported to the chosen site with crawler-tractor. The new approaches of subglacial bedrock drilling technology are connected with utilization of environmental friendly, low-toxic drilling fluids, e.g. low-molecular dimethyl siloxane oils or ester type. They have suitable density-viscosity properties, and can be consider as a viable alternative for drilling in glacial ice and subglacial bedrock. According to approved schedule, the first field tests are planned to carry out just outside Zhongshan Station near Antarctic coast in season 2015-2016. Next season 2016-2017 the movable drilling shelter is planned to be transported to the chosen drilling site in the GSM region, and drilling to the bedrock would be finished during two seasons.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

  17. Troubled social background of male anabolic-androgenic steroid abusers in treatment

    Directory of Open Access Journals (Sweden)

    Skarberg Kurt

    2007-07-01

    Full Text Available Abstract Background The aim of this study was to investigate the social background and current social situation of male abusers of anabolic-androgenic steroids (AAS. Methods We compared thirty-four AAS-abusing patients from an Addiction Centre (AC with two groups, 18 users and 259 non-users of AAS from a public gym in Orebro, Sweden. The study is based on semi-structured interviews and questionnaires. Results Histories of a troubled childhood as well as current social disadvantage were both more frequent among the AAS users. Users also reported poor relationships with their parents and almost half of them had experienced physical or mental abuse. The AC group's experiences from school were mostly negative, and included concentration problems, boredom and learning difficulties. Their current circumstance included abuse of other drugs, battering of spouses and other criminality such as assault, illegal possession of weapons and theft. Conclusion In conclusion, this study shows that abusers of AAS often have a troubled social background. This underlines the importance of making a thorough social assessment as a part of the treatment programme. The results of the study may help in directing appropriate questions relevant to the abuse of AAS.

  18. Planning for the radwaste treatment facility operation

    International Nuclear Information System (INIS)

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

    1985-04-01

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    NARCIS (Netherlands)

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

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

  1. Towards biology-oriented treatment planning in hadrontherapy

    Czech Academy of Sciences Publication Activity Database

    Kundrát, Pavel

    2006-01-01

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

  2. 300 Area waste acid treatment system closure plan. Revision 1

    International Nuclear Information System (INIS)

    1996-03-01

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

  3. The influence of cephalometrics on orthodontic treatment planning

    NARCIS (Netherlands)

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

    2008-01-01

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

  4. 300 Area waste acid treatment system closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  6. Coordination systems for three-dimension radiation treatment planning

    International Nuclear Information System (INIS)

    Yang Dailun; Wu Zhangwen; Luo Zhengming

    2004-01-01

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

  7. 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

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

    Science.gov (United States)

    Aronowitz, Jesse N; Rivard, Mark J

    2014-06-01

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

  9. The relationship between entering medical students' backgrounds and career plans and their rural practice outcomes three decades later.

    Science.gov (United States)

    Rabinowitz, Howard K; Diamond, James J; Markham, Fred W; Santana, Abbie J

    2012-04-01

    Although many studies have investigated predictors of physician practice in rural areas, few have accounted for the importance of physicians' backgrounds. This study analyzed the relationship between the backgrounds and future career plans of entering medical students and their rural practice outcomes. For 1,111 graduates from Jefferson Medical College (JMC, classes of 1978-1982), three factors self-reported at matriculation and previously related to rural practice were obtained from the Jefferson Longitudinal Study of Medical Education: growing up rural, planning rural practice, and planning family medicine. Their 2007 practice location was determined to be in a rural versus nonrural area. Analyses of graduates with various numbers of predictive factors (0-3) and rural practice were performed. Of the 762 JMC graduates (69%) with complete data, 172 (23%) were practicing in rural areas. Of graduates with all three predictors, 45% (45/99) practiced in rural areas compared with 33% (48/145) of those with two predictors, 21% (42/198) with one predictor, and 12% (37/320) of those with none. Of physicians practicing in rural areas in 2007, only 22% had no predictors. Three factors known at the time of medical school matriculation have a powerful relationship with rural practice three decades later. Relatively few students without predictors practice in rural areas, which is particularly significant given subsequent factors known to be related to rural practice--for instance, rural curriculum, residency location, or spouse. These results have major implications for the role of the medical school admissions process in producing rural physicians.

  10. 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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  12. 300 Area waste acid treatment system closure plan

    Energy Technology Data Exchange (ETDEWEB)

    LUKE, S.N.

    1999-05-17

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

  13. 300 Area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    LUKE, S.N.

    1999-01-01

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

  14. 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

  15. Sodium-Bearing Waste Treatment, Applied Technology Plan

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-06-01

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

  16. Troubled social background of male anabolic-androgenic steroid abusers in treatment.

    Science.gov (United States)

    Skarberg, Kurt; Engstrom, Ingemar

    2007-07-05

    The aim of this study was to investigate the social background and current social situation of male abusers of anabolic-androgenic steroids (AAS). We compared thirty-four AAS-abusing patients from an Addiction Centre (AC) with two groups, 18 users and 259 non-users of AAS from a public gym in Orebro, Sweden. The study is based on semi-structured interviews and questionnaires. Histories of a troubled childhood as well as current social disadvantage were both more frequent among the AAS users. Users also reported poor relationships with their parents and almost half of them had experienced physical or mental abuse. The AC group's experiences from school were mostly negative, and included concentration problems, boredom and learning difficulties. Their current circumstance included abuse of other drugs, battering of spouses and other criminality such as assault, illegal possession of weapons and theft. In conclusion, this study shows that abusers of AAS often have a troubled social background. This underlines the importance of making a thorough social assessment as a part of the treatment programme. The results of the study may help in directing appropriate questions relevant to the abuse of AAS.

  17. Materials for Paediatric Dentistry. Part 1: Background to the Treatment of Carious Primary Teeth.

    Science.gov (United States)

    Jenkins, Natalie

    2015-12-01

    Dental caries is a disease that affects many people, including children, and presents numerous challenges to healthcare providers. As clinicians it is important that we consider the advantages and disadvantages of treating carious primary teeth, and make an informed decision about when it is appropriate or not. This paper describes the background to the treatment of carious primary teeth, looking at the differences between primary and permanent teeth, and the relevance of this. It also suggests points to consider when looking at restoration survival studies, as the ability to appraise the literature critically is important for us all in this 'evidence-based' age. CPD/Clinical Relevance: Our early life experiences have the ability to shape our future attitudes and behaviour. Children with carious teeth require careful management so that pain and suffering is minimized, and positive attitudes towards dentistry are fostered.

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

    Science.gov (United States)

    Milgrom, Peter; And Others

    1981-01-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

  20. Periodontal risk assessment, diagnosis and treatment planning.

    Science.gov (United States)

    Pihlstrom, B L

    2001-01-01

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

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

    Science.gov (United States)

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

    2004-07-01

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

  2. Solid Mesh Registration for Radiotherapy Treatment Planning

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Sørensen, Thomas Sangild

    2010-01-01

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

  3. Radiotherapy treatment planning using three dimensional CT images

    International Nuclear Information System (INIS)

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

    1984-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  5. Computerized treatment planning systems for external photon beam radiotherapy

    International Nuclear Information System (INIS)

    Evans, M.D.C.

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  8. 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)

  9. 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

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  11. 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.

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  13. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study

    Science.gov (United States)

    Samieirad, Sahand; Aboutorabzade, Mohammad-Reza; Tohidi, Elahe; Shaban, Baratollah; Khalife, Hussein; Salami, Hamid-Reza

    2017-01-01

    Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma. PMID:28809369

  14. 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.)

  15. 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.)

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Lack of efficacy of psychological and pharmacological treatments of disorders of eating behavior: neurobiological background.

    Science.gov (United States)

    Brambilla, Francesca; Amianto, Federico; Dalle Grave, Riccardo; Fassino, Secondo

    2014-12-24

    Treatments of eating disorders result too often in partial psychological and physical remission, chronicization, dropout, relapse and death, with no fully known explanations for this failure. In order to clarify this problem, we conducted three studies to identify the biochemical background of cognitive-behavioural psychotherapy (CBT), individual psychology brief psychotherapy (IBPP), and psychotherapy-pharmacotherapy with CBT + olanzapine in anorexics (AN) and bulimics (BN) by measuring the levels of plasma homovanillic acid (HVA) for dopamine secretion, plasma 3-methoxy-4-hydroxy-phenylglycol (MHPG) for noradrenalin secretion, and platelet [3H]-Paroxetin-binding Bmax and Kd for serotonin transporter function. The data were then compared with psychopathological and physical alterations. Study 1 investigated the effects of 4 months of CBT on plasma HVA, MHPG and [3H]-Par-binding in 14 AN-restricted, 14 AN-bingeing/purging, and 22 BN inpatients. Study 2 investigated the effects of 4 months of IBPP on plasma HVA in 15 AN and 17 BN outpatients. Study 3 investigated the effect of 3 months of CBT + olanzapine (5 mg/day) in 30 AN outpatients. The data were analyzed using one-way ANOVA for repeated measures for the changes between basal and post-treatment biological and psychological parameters, two-way ANOVA for repeated measures for the differences in the psychobiological data in the 3 groups, Spearman's test for the correlations between basal and final changes in the psychological and biological scores. Study 1 revealed significant amelioration of the psychopathology in the AN and BN patients, no effects on HVA, MHPG or Paroxetin binding Kd, and a significant increase in Par-binding Bmax only in the BN patients. Study 2 revealed a significant effect of IBPP on psychopathology in the AN and BN patients, and a significant increase in HVA only in the BN patients. Study 3 revealed a significant positive effect of CBT + olanzapine therapy on the psychopathology and

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

    Directory of Open Access Journals (Sweden)

    Robine J Rischen

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

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

    Science.gov (United States)

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

    2013-12-21

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

    Rich, Benedict; Goldstein, Gary R

    2002-08-01

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

  3. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1991-12-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  5. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    International Nuclear Information System (INIS)

    1991-12-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

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

    Science.gov (United States)

    Zabalegui, B

    1990-01-01

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

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

    Science.gov (United States)

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

    2018-03-10

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

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

    Directory of Open Access Journals (Sweden)

    Hemalatha Athiyaman

    2014-01-01

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

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

    Science.gov (United States)

    Powell, Billy J.; And Others

    1987-01-01

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

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

    African Journals Online (AJOL)

    2017-09-14

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

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

    DEFF Research Database (Denmark)

    Sjölin, Maria; Edmund, Jens Morgenthaler

    2016-01-01

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

  14. Brachytherapy treatment planning algorithm applied to prostate cancer

    Science.gov (United States)

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

    2000-10-01

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

  15. 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.

  16. Conformal three dimensional radiotherapy treatment planning in Lund

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  17. Conformal three dimensional radiotherapy treatment planning in Lund

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  18. 4D Proton treatment planning strategy for mobile lung tumors

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Enrica Seravalli

    2018-01-01

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

  20. Monte Carlo conformal treatment planning as an independent assessment

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  1. 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

  2. Radiation treatment planning techniques for lymphoma of the stomach

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2018-03-22

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  6. Patients with hip prosthesis: radiotherapy treatment planning considerations

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  7. Current status of quality assurance of treatment planning systems

    International Nuclear Information System (INIS)

    Mijnheer, B.J.

    1997-01-01

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

  8. Experimental background of pain treatment by heat application - rapid heating and cooling in patch clamp experiments

    Czech Academy of Sciences Publication Activity Database

    Dittert, Ivan; Slovák, P.; Jíra, J.

    2005-01-01

    Roč. 8, Suppl.2 (2005), s. 32-32 ISSN 1212-0634. [Česko-Slovenské dialógy o bolesti /7./. 13.10.2005 - 15.10.2005, Bojnice] Institutional research plan: CEZ:AV0Z50110509 Keywords : patch clamp * channels Subject RIV: CF - Physical ; Theoretical Chemistry

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

    Science.gov (United States)

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

    2014-04-01

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

  10. 3D Computer aided treatment planning in endodontics.

    Science.gov (United States)

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

    2016-02-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  12. Technical change to the work plan for the remedial investigation of the Salmon Site, Lamar County, Mississippi: Sampling and analysis plan background soil and groundwater study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    The Salmon Site, formerly known as the Tatum Dome Test Site, is located in south-central Mississippi, southwest of the city of Hattiesburg, in Lamar County. Between 1964 and 1970, two nuclear and two non-nuclear gas explosions were conducted deep underground in the Tatum Salt Dome beneath the site. The tests were performed as part of the former US Atomic Energy Commission`s Vela Uniform Program which was conducted to improve the United States` capability to detect underground nuclear explosions. This document details technical changes to the existing work plan for the remedial investigation of the Salmon Site. A previously conducted Remedial Investigation for the Salmon Site involved the preparation of ecological and human health risk assessments. These risk assessments, which are incorporated into the Remedial Investigation Report, identified several constituents of potential concern (COPC) that could potentially have a negative impact on ecological and human health. These COPC are the primary risk drivers for the Salmon Site; they include arsenic and naturally occurring, gamma-emitting radionuclides. If it can be demonstrated that similar concentrations of these COPCs occur naturally in surrounding areas, they can be removed from consideration in the risk assessments. The purpose of this sampling effort is to collect enough data to prove that the COPCs are naturally occurring and are not a result of the explosives testing activities conducted at the site. This will be accomplished by collecting enough soil samples to have a statistically valid population that can be used to produce defensible comparisons that prove the concentrations identified on site are the same as the background concentrations in surrounding areas.

  13. Antipsychotic drug treatment for patients with schizophrenia: theoretical background, clinical considerations and patients preferences

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Nielsen, Jimmi

    2009-01-01

      The cornerstone in treatment of psychosis is antipsychotic drugs. Treatment options have increased over the years; newer antipsychotic drugs with a proposed efficacy regarding negative and cognitive symptoms, but also a shift in side-effects from neurological side-effects to metabolic side-effe...... treatment. The clinically relevant aspects of antipsychotic drug treatment are reviewed; mechanism of antipsychotic drug action, clinical considerations in treatment, switching antipsychotic drugs, polypharmacy, safety and patient preference.  ......-effects have arisen as the new challenge. The basis of successful pharmacological treatment is a fundamental understanding of the mechanisms of action, the desired effects and side-effects of antipsychotic drugs, a good relationship with the patient and a thorough monitoring of the patient before and during...

  14. Inclusion of geometric uncertainties in treatment plan evaluation

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

    Lawrence, B.; Berry, M.

    1998-03-01

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

  16. The Contribution of Background Variables, Internal and External Resources to Life Satisfaction among Adolescents in Residential Treatment Centers

    Science.gov (United States)

    Lipschitz-Elhawi, Racheli; Itzhaky, Haya; Michal, Hefetz

    2008-01-01

    The article deals with the contribution of background variables (gender, years of residence in a treatment center, and family status), internal resource (self-esteem), and external resources (peer, family and significant other support, sense of belonging to the community) to life satisfaction among adolescents living in residential treatment…

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

    Directory of Open Access Journals (Sweden)

    Rutonjski Laza

    2012-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

    Olch, A.

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

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

    International Nuclear Information System (INIS)

    Matthews, Q; Mestrovic, A; Otto, K

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  3. Incorporating model parameter uncertainty into inverse treatment planning

    International Nuclear Information System (INIS)

    Lian Jun; Xing Lei

    2004-01-01

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

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

    Science.gov (United States)

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

    1998-10-01

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

  5. Treatment planning systems dosimetry auditing project in Portugal.

    Science.gov (United States)

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

    2014-02-01

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

  6. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran

    Science.gov (United States)

    Samieirad, Sahand; Tohidi, Elahe; Shahidi-Payam, Akbar; Abedini, Ali

    2015-01-01

    Background The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). Conclusions Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans. Key words:Epidemiology, treatment, facial injuries, face fractures, maxillofacial trauma, trauma. PMID:26116845

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

    Science.gov (United States)

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

    2017-08-01

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

  8. Patient selection and treatment planning for implant restorations.

    Science.gov (United States)

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

    2014-01-01

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

  9. Development of lingual brachet technique. (Esthetic and hygienic approach to orthodontic treatment) (Part 1) Background and design.

    Science.gov (United States)

    Fujita, K

    1978-04-01

    The present study relates to a development of the new technique and the new appliances, for the treatment of malocclusion and minor tooth movement. The primary purpose of the present study consists in to reduce mental burden of the patients receiving orthodontic treatment and to improve effect of the treatment further by making the appliance invisible when mouth is opened. The second purpose of the study is in orthodontic treatment carried out from lingual side, to control all teeth movement in oral cavity in three dimensions so that the normal occlusion may be operated. The third purpose of the present study is to make the exchange of wire readily when the wire with bigger elasticity is exchanged by turns during the process of the treatment. The background and the design of appliances for the lingual-bracker technique(lingual-bracket mushroom arch wire technique) is found out in this report.

  10. Plutonium Finishing Plan (PFP) Treatment and Storage Unit Interim Status Closure Plan

    International Nuclear Information System (INIS)

    PRIGNANO, A.L.

    2000-01-01

    This document describes the planned activities and performance standards for closing the Plutonium Finishing Plant (PFP) Treatment and Storage Unit. The PFP Treatment and Storage Unit is located within the 234-52 Building in the 200 West Area of the Hanford Facility. Although this document is prepared based upon Title 40 Code of Federal Regulations (CFR), Part 265, Subpart G requirements, closure of the unit will comply with Washington Administrative Code (WAC) 173-303-610 regulations pursuant to Section 5.3 of the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Action Plan (Ecology et al. 1996). Because the PFP Treatment and Storage Unit manages transuranic mixed (TRUM) waste, there are many controls placed on management of the waste. Based on the many controls placed on management of TRUM waste, releases of TRUM waste are not anticipated to occur in the PFP Treatment and Storage Unit. Because the intention is to clean close the PFP Treatment and Storage Unit, postclosure activities are not applicable to this closure plan. To clean close the unit, it will be demonstrated that dangerous waste has not been left onsite at levels above the closure performance standard for removal and decontamination. If it is determined that clean closure is not possible or is environmentally impractical, the closure plan will be modified to address required postclosure activities. The PFP Treatment and Storage Unit will be operated to immobilize and/or repackage plutonium-bearing waste in a glovebox process. The waste to be processed is in a solid physical state (chunks and coarse powder) and will be sealed into and out of the glovebox in closed containers. The containers of immobilized waste will be stored in the glovebox and in additional permitted storage locations at PFP. The waste will be managed to minimize the potential for spills outside the glovebox, and to preclude spills from reaching soil. Containment surfaces will be maintained to ensure

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  13. Final report on the Background Soil Characterization Project at the Oak Ridge Reservation, Oak Ridge, Tennessee. Volume 3: Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Hatmaker, T.L.; Hook, L.A.; Jackson, B.L. [and others

    1993-10-01

    The Background Soil Characterization Project (BSCP) will provide background concentration levels of selected metals, organic compounds, and radionuclides in soils from uncontaminated on-site areas at the Oak Ridge Reservation (ORR), and off-site in the western part of Roane County and the eastern part of Anderson County. The BSCP will establish a database, recommend how to use the data for contaminated site assessment, and provide estimates of the potential human health and environmental risks associated with the background level concentrations of potentially hazardous constituents. ORR background soil characterization data will be used for two purposes. The first application will be in differentiating between naturally occurring constituents and site-related contamination. This is a very important step in a risk assessment because if sufficient background data are not available, no constituent known to be a contaminant can be eliminated from the assessment even if the sampled concentration is measured at a minimum level. The second use of the background data will be in calculating baseline risks against which site-specific contamination risks can be compared.

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

    Energy Technology Data Exchange (ETDEWEB)

    De Wagter, C. [ed.

    1995-12-01

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

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

    International Nuclear Information System (INIS)

    De Wagter, C.

    1995-12-01

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

  16. A review of the aesthetic treatment of abdominal subcutaneous adipose tissue: background, implications, and therapeutic options.

    Science.gov (United States)

    Friedmann, Daniel P

    2015-01-01

    The demand for aesthetic body sculpting procedures has expanded precipitously in recent years. Subcutaneous adipose tissue (SAT) deposits of the central abdomen are especially common areas of concern for both males and females. To review the available literature regarding the underlying pathophysiology of subcutaneous fat accumulation in the abdominal area and available treatment options. A MEDLINE and Google Scholar search was performed accordingly. The preferential accumulation of SAT in the central abdomen is attributable to the reduced lipolytic sensitivity of its adipocytes. A number of therapeutic options are available for the treatment of central abdominal adiposity. Cryolipolysis, high-intensity focused ultrasound, nonthermal ultrasound, radiofrequency, and injection adipolysis lead to adipocyte destruction through multiple different mechanisms. Nonablative modalities such as injection lipolysis mobilize fat stores from viable adipocytes, although its effects may be curtailed in obese patients. Liposuction through tumescent technique, however, mechanically extricates SAT. Although tumescent liposuction remains the gold standard for SAT removal, less invasive ablative and nonablative options for targeting localized deposits of adipose tissue now permeate the aesthetic marketplace. Limited results associated with these modalities mandate multiple sessions or combination treatment paradigms.

  17. 200 Area effluent treatment facility process control plan 98-02

    International Nuclear Information System (INIS)

    Le, E.Q.

    1998-01-01

    This Process Control Plan (PCP) provides a description of the background information, key objectives, and operating criteria defining Effluent Treatment Facility (ETF) Campaign 98-02 as required per HNF-IP-0931 Section 37, Process Control Plans. Campaign 98-62 is expected to process approximately 18 millions gallons of groundwater with an assumption that the UP-1 groundwater pump will be shut down on June 30, 1998. This campaign will resume the UP-1 groundwater treatment operation from Campaign 97-01. The Campaign 97-01 was suspended in November 1997 to allow RCRA waste in LERF Basin 42 to be treated to meet the Land Disposal Restriction Clean Out requirements. The decision to utilize ETF as part of the selected interim remedial action of the 200-UP-1 Operable Unit is documented by the Declaration of the Record of Decision, (Ecology, EPA and DOE 1997). The treatment method was chosen in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), the Hanford Federal Facility Agreement and Consent Order (known as the Tri-Party Agreement or TPA), and to the extent practicable, the National Oil and Hazardous Substances Pollution Contingency Plan (NCP)

  18. 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

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

    International Nuclear Information System (INIS)

    1999-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Thalita Monteiro Obal

    2013-08-01

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

  1. A research-oriented treatment planning program system

    International Nuclear Information System (INIS)

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

    1982-01-01

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

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

    Directory of Open Access Journals (Sweden)

    William B Brinkman

    2011-01-01

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

  3. Differentiated Approach to the Treatment and Secondary Prevention of Asthma on the Background of Persistent Infections in Children

    Directory of Open Access Journals (Sweden)

    O.Ye. Chernyshova

    2016-11-01

    Full Text Available Thе article describes a differentiated approach to the treatment and secondary prevention of asthma occurring on the background of intracellular infections caused by the herpes simplex virus types I and II, cytomegalovirus, Epstein-Barr virus in children. The results confirmed the need for addition to the basic therapy of asthma the etiopathogenetic treatment, in particular, administration of acyclic nucleosides or macrolides depending on diagnosed infection, immunomodulators and alpha-2b-interferon (Laferobion to decrease the severity of disease and to reduce disability.

  4. Design of 4D treatment planning target volumes

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  5. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-13

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

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

    International Nuclear Information System (INIS)

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

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  9. 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

  10. Integrated Waste Treatment Unit GFSI Risk Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    W. A. Owca

    2007-06-21

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

  11. Integrated Waste Treatment Unit GFSI Risk Management Plan

    International Nuclear Information System (INIS)

    W. A. Owca

    2007-01-01

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

  12. Nephrogenic Diabetes Insipidus: Essential Insights into the Molecular Background and Potential Therapies for Treatment

    Science.gov (United States)

    Rittig, Søren

    2013-01-01

    The water channel aquaporin-2 (AQP2), expressed in the kidney collecting ducts, plays a pivotal role in maintaining body water balance. The channel is regulated by the peptide hormone arginine vasopressin (AVP), which exerts its effects through the type 2 vasopressin receptor (AVPR2). Disrupted function or regulation of AQP2 or the AVPR2 results in nephrogenic diabetes insipidus (NDI), a common clinical condition of renal origin characterized by polydipsia and polyuria. Over several years, major research efforts have advanced our understanding of NDI at the genetic, cellular, molecular, and biological levels. NDI is commonly characterized as hereditary (congenital) NDI, arising from genetic mutations in the AVPR2 or AQP2; or acquired NDI, due to for exmple medical treatment or electrolyte disturbances. In this article, we provide a comprehensive overview of the genetic, cell biological, and pathophysiological causes of NDI, with emphasis on the congenital forms and the acquired forms arising from lithium and other drug therapies, acute and chronic renal failure, and disturbed levels of calcium and potassium. Additionally, we provide an overview of the exciting new treatment strategies that have been recently proposed for alleviating the symptoms of some forms of the disease and for bypassing G protein-coupled receptor signaling. PMID:23360744

  13. A comparison of arc-based and static mini-multileaf collimator-based radiosurgery treatment plans

    International Nuclear Information System (INIS)

    Kubo, Hideo Dale; Pappas, Conrad T.E.; Wilder, Richard B.

    1997-01-01

    Background: The purpose of this study is to compare arc-based and mini-multileaf collimator (mMLC)-based radiosurgery treatment plans using isodose distributions and dose-volume histograms. Methods: Of 11 patients who underwent conventional arc-based radiosurgery for intracranial malignancies, four were treated with one isocenter, four were treated with two isocenters and three were treated with three isocenters. The same cases were re-planned using a test version of mMLC-based radiosurgery software for multiple static non-coplanar fields. Results and conclusion: For non-spherical targets, treatment planning is relatively intuitive with mMLC-based radiosurgery, reducing the amount of time required for planning. Moreover, a lower dose of radiation is delivered to normal tissue with mMLC-based radiosurgery than with arc-based radiosurgery, which theoretically should lead to a reduced risk of complications

  14. 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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  16. [Permanent neonatal diabetes with known genetic background: oral drugs in treatment of childhood diabetes].

    Science.gov (United States)

    Gach, Agnieszka; Gadzicka, Anna; Młynarski, Wojciech

    2008-01-01

    Diabetes, which is diagnosed before 6 months of age, is patogenetically different than type 1 diabetes. This kind of diabetes also known as a neonatal diabetes is genetically determined with monogenic mode of inheritance. Most of these patients are carriers of heterozygous mutation in the KCNJ11 or ABCC8 gene. These mutations may activate the Kir6.2/SUR1 potassium channel in the beta cells and disturb insulin secretion, which in consequence leads to diabetes. This patological phenomenon is reversible if sulfonylureas are used as a first line therapy. In the current paper a systematic review of clinical aspects of sulfonylurea treatment in neonatal diabetes has been performed. This gives the further evidence that knowlegde of the patogenesis of neonatal diabetes may be easily transferred to bedside and clinical practice.

  17. The development of mentoring-relationship quality, future-planning style, and career goal setting among adolescents from a disadvantaged background.

    Science.gov (United States)

    Lau, Wendy S Y; Zhou, Xiao-Chun; Lai, Simon M K

    2017-03-01

    Our behaviors are regulated by our perception of the future based on past experiences and knowledge. Children from a disadvantaged background might encounter obstacles more frequently when they plan their future. It is possible that a good relationship with an adult volunteer who provides assistance and guidance in the disadvantaged youth's development may facilitate their future-planning style and career goal setting. The present study investigated the role of a good mentoring relationship in promoting a disadvantaged youth's future-planning style and goal-setting ability. It focused on children from a disadvantaged background who participated in the Child Development Fund (CDF) in Hong Kong. In the study, 187 CDF participants (93 with high mentoring-relationship quality [MRQ] and 94 with low MRQ) and 208 comparison group participants were able to complete all four times of the survey. Repeated-measures analyses of covariance showed that Group main effects were observed for both future-planning style, F(2, 374) = 5.92, p career goal-setting self-efficacy, F(2, 376) = 6.07, p planning style only, F(5.78, 1081.21) = 2.17, p planning style and career goal-setting self-efficacy. Multiple regression analyses revealed that mean MRQ score accounted for 3.9% (p planning style and 4.1% (p career goal-setting self-efficacy, supporting the role of a good mentoring relationship. Mentors have introduced new resources to the disadvantaged youths with high MRQ and have promoted the development of various skills through modeling. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

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

    2016-06-07

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

  20. The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: a systematic review.

    Science.gov (United States)

    Kornet-van der Aa, D A; Altenburg, T M; van Randeraad-van der Zee, C H; Chinapaw, M J M

    2017-05-01

    This review aimed to summarize the evidence on the effectiveness of obesity prevention and treatment programmes for adolescents from socioeconomically disadvantaged backgrounds. A secondary aim was to identify potential successful intervention strategies for this target group. PubMed, EMBASE, PsycINFO and Cochrane Library were searched from January 2000 up to February 2016. Intervention studies targeting adolescents from disadvantaged backgrounds were included, with body mass index as outcome. Secondary outcomes were other adiposity measures, physical activity, diet, sedentary behaviour and screen time. Two independent reviewers extracted data, coded intervention strategies and conducted quality assessments. Fourteen studies were included: nine obesity prevention and five obesity treatment studies. Two preventive and four treatment studies showed significant beneficial effects on body mass index. Five of six studies (four preventive, one treatment studies) measuring dietary behaviour reported significant intervention effects. Evidence on other secondary outcomes was inconclusive. We found no conclusive evidence for which specific intervention strategies were particularly successful in preventing or treating obesity among disadvantaged adolescents. However, the current evidence suggests that involving adolescents in the development and delivering of interventions, the use of experiential activities and involvement of parents seem to be promising strategies. More high quality studies are needed. PROSPERO registration number: CRD42016041612. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

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

    Science.gov (United States)

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

    2009-02-01

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

  2. Modulated electron radiotherapy treatment planning using a photon multileaf collimator for post-mastectomized chest walls

    International Nuclear Information System (INIS)

    Salguero, Francisco Javier; Palma, Bianey; Arrans, Rafael; Rosello, Joan; Leal, Antonio

    2009-01-01

    Background and purpose: To evaluate the feasibility of using a photon MLC (xMLC) for modulated electron radiotherapy treatment (MERT) as an alternative to conventional post-mastectomy chest wall (CW) irradiation. A Monte Carlo (MC) based planning system was developed to overcome the inaccuracy of the 'pencil beam' algorithm. MC techniques are known to accurately calculate the dose distributions of electron beams, allowing the explicit simulation of electron interactions within the MLC. Materials and methods: Four real clinical CW cases were planned using MERT which were compared with the conventional electron treatments based on blocks and by a straightforward approach using the MLC, and not the blocks (as an intermediate step to MERT) to shape the same segments with SSD between 60 and 70 cm depending on PTV size. MC calculations were verified with an array of ionization chambers and radiochromic films in a solid water phantom. Results: Tests based on gamma analysis between MC dose distributions and radiochromic film measurements showed an excellent agreement. Differences in the absolute dose measured with a plane-parallel chamber at a reference point were below 3% for all cases. MERT solution showed a better PTV coverage and a significant reduction of the doses to the organs at risk (OARs). Conclusion: MERT can effectively improve the current electron treatments by obtaining a better PTV coverage and sparing healthy tissues. More directly, block-shaped treatments could be replaced by MLC-shaped non-modulated segments providing similar results.

  3. Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning

    Directory of Open Access Journals (Sweden)

    Greggory J. Schell PhD

    2016-10-01

    Full Text Available Background: Markov decision process (MDP models are powerful tools. They enable the derivation of optimal treatment policies but may incur long computational times and generate decision rules that are challenging to interpret by physicians. Methods: In an effort to improve usability and interpretability, we examined whether Poisson regression can approximate optimal hypertension treatment policies derived by an MDP for maximizing a patient’s expected discounted quality-adjusted life years. Results: We found that our Poisson approximation to the optimal treatment policy matched the optimal policy in 99% of cases. This high accuracy translates to nearly identical health outcomes for patients. Furthermore, the Poisson approximation results in 104 additional quality-adjusted life years per 1000 patients compared to the Seventh Joint National Committee’s treatment guidelines for hypertension. The comparative health performance of the Poisson approximation was robust to the cardiovascular disease risk calculator used and calculator calibration error. Limitations: Our results are based on Markov chain modeling. Conclusions: Poisson model approximation for blood pressure treatment planning has high fidelity to optimal MDP treatment policies, which can improve usability and enhance transparency of more personalized treatment policies.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, Eva E.; Strom, Daniel J.

    2005-08-01

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

  5. Specification and acceptance testing of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    2007-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-04-15

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  8. 3718-F Alkali Metal Treatment and Storage Facility Closure Plan

    International Nuclear Information System (INIS)

    1992-11-01

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

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

    OpenAIRE

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

    1991-01-01

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

  10. Geodesic curve-of-sight formulae for the cosmic microwave background: a unified treatment of redshift, time delay, and lensing

    International Nuclear Information System (INIS)

    Saito, Ryo; Naruko, Atsushi; Hiramatsu, Takashi; Sasaki, Misao

    2014-01-01

    In this paper, we introduce a new approach to a treatment of the gravitational effects (redshift, time delay and lensing) on the observed cosmic microwave background (CMB) anisotropies based on the Boltzmann equation. From the Liouville's theorem in curved spacetime, the intensity of photons is conserved along a photon geodesic when non-gravitational scatterings are absent. Motivated by this fact, we derive a second-order line-of-sight formula by integrating the Boltzmann equation along a perturbed geodesic (curve) instead of a background geodesic (line). In this approach, the separation of the gravitational and intrinsic effects are manifest. This approach can be considered as a generalization of the remapping approach of CMB lensing, where all the gravitational effects can be treated on the same footing

  11. Plans and Progress on Hanford MLLW Treatment and Disposal

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    Science.gov (United States)

    Kasmuri, S.; Pawiro, S. A.

    2017-07-01

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

  13. The 300 area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    Luke, S.N.

    1996-01-01

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

  14. CBCT analysis of three implant cases for treatment planning

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  15. Treatment planning and smile design using composite resin.

    Science.gov (United States)

    Marus, Robert

    2006-05-01

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

  16. Efficient sampling algorithms for Monte Carlo based treatment planning

    International Nuclear Information System (INIS)

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

    1998-01-01

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

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

    International Nuclear Information System (INIS)

    Kapur, A.

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    Chang, J.

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  3. An independent check of treatment plan, prescription and dose calculation as a QA procedure

    International Nuclear Information System (INIS)

    Duggan, Lisa; Kron, Tomas; Howlett, Stephen; Skov, Annette; O'Brien, Peter

    1997-01-01

    In many radiotherapy centres where planning for external beam treatments is performed by radiation therapists, the treatment sheet and its calculations are independently checked by staff from a different educational background, typically a radiotherapy physicist. The benefits of this practice were evaluated in a radiotherapy department with two linear accelerators, one combined superficial-orthovoltage unit and one telecaesium unit. Within the 19 months of the investigation period, 2328 checks were performed on the treatment sheets of 1579 patients. In six cases, errors in excess of 5% were detected, which if uncorrected, could potentially have affected local tumour control or caused normal tissue complications. It was found that an independent check of treatment sheets assists in keeping these errors as low as can be achievable in clinical practice, and suggests that treatment sheet checking and in vivo dosimetry play a complementary role in this aim. Independent treatment sheet checking is an important quality assurance (QA) activity, with additional advantages such as improved communication in the department, education of staff and in vivo dosimetry targeting. Therefore the advantages of the procedure seem to outweigh the additional workload of approximately 0.3 full-time staff per 1000 patients per year

  4. 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

  5. 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

  6. 45 CFR 146.180 - Treatment of non-Federal governmental plans.

    Science.gov (United States)

    2010-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

    Hua, C.

    2015-01-01

    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

  9. 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...

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

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

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

  11. 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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  13. Are there national strategies, plans and guidelines for the treatment of hepatitis C in people who inject drugs?

    DEFF Research Database (Denmark)

    Maticic, Mojca; Videcnik Zorman, Jerneja; Gregorcic, Sergeja

    2014-01-01

    BACKGROUND: Hepatitis C virus (HCV) infection represents a major global health problem, which in high-income countries now mostly affects people who inject drugs (PWID). Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID...... have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular....... METHODS: Thirty-three European countries were invited to participate. Data on available national strategies, action plans and guidelines for HCV treatment in general population and in PWID specifically were collected prospectively by means of a structured electronic questionnaire and analyzed accordingly...

  14. Genotype-based ancestral background consistently predicts efficacy and side effects across treatments in CATIE and STAR*D.

    Directory of Open Access Journals (Sweden)

    Daniel E Adkins

    Full Text Available Only a subset of patients will typically respond to any given prescribed drug. The time it takes clinicians to declare a treatment ineffective leaves the patient in an impaired state and at unnecessary risk for adverse drug effects. Thus, diagnostic tests robustly predicting the most effective and safe medication for each patient prior to starting pharmacotherapy would have tremendous clinical value. In this article, we evaluated the use of genetic markers to estimate ancestry as a predictive component of such diagnostic tests. We first estimated each patient's unique mosaic of ancestral backgrounds using genome-wide SNP data collected in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE (n = 765 and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D (n = 1892. Next, we performed multiple regression analyses to estimate the predictive power of these ancestral dimensions. For 136/89 treatment-outcome combinations tested in CATIE/STAR*D, results indicated 1.67/1.84 times higher median test statistics than expected under the null hypothesis assuming no predictive power (p<0.01, both samples. Thus, ancestry showed robust and pervasive correlations with drug efficacy and side effects in both CATIE and STAR*D. Comparison of the marginal predictive power of MDS ancestral dimensions and self-reported race indicated significant improvements to model fit with the inclusion of MDS dimensions, but mixed evidence for self-reported race. Knowledge of each patient's unique mosaic of ancestral backgrounds provides a potent immediate starting point for developing algorithms identifying the most effective and safe medication for a wide variety of drug-treatment response combinations. As relatively few new psychiatric drugs are currently under development, such personalized medicine offers a promising approach toward optimizing pharmacotherapy for psychiatric conditions.

  15. 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

  16. Automated planning of ablation targets in atrial fibrillation treatment

    Science.gov (United States)

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

    2011-03-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-01-15

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

  19. Stereotactic intensity-modulated radiation therapy (IMRT) and inverse treatment planning for advanced pleural mesothelioma. Feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Muenter, M.W.; Thilmann, C.; Hof, H.; Debus, J. [Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg (Germany); Nill, S.; Hoess, A.; Partridge, M. [Dept. of Medical Physics, German Cancer Research Center (dkfz), Heidelberg (Germany); Haering, P. [Dept. of Central Dosimetry, German Cancer Research Center (dkfz), Heidelberg (Germany); Manegold, C. [Dept. of Medical Oncology/Internal Medicine, Thoraxklinik Heidelberg gGmbH, Heidelberg (Germany); Wannenmacher, M. [Dept. of Clinical Radiology, Univ. of Heidelberg, Heidelberg (Germany)

    2003-08-01

    Background and Purpose: Complex-shaped malignant pleural mesotheliomas (MPMs) with challenging volumes are extremely difficult to treat by conventional radiotherapy due to tolerance doses of the surrounding normal tissue. In a feasibility study, we evaluated if inversely planned stereotactic intensity-modulated radiation therapy (IMRT) could be applied in the treatment of MPM. Patients and Methods: Eight patients with unresectable lesions were treated after failure of chemotherapy. All patients were positioned using noninvasive patient fixation techniques which can be attached to the applied extracranial stereotactic system. Due to craniocaudal extension of the tumor, it was necessary to develop a special software attached to the inverse planning program KonRad, which can connect two inverse treatment plans and consider the applied dose of the first treatment plan in the area of the matchline of the second treatment plan. Results: Except for one patient, in whom radiotherapy was canceled due to abdominal metastasis, treatment could be completed in all patients and was well tolerated. Median survival after diagnosis was 20 months and after IMRT 6.5 months. Therefore, both the 1-year actuarial overall survival from the start of radiotherapy and the 2-year actuarial overall survival since diagnosis were 28%. IMRT did not result in clinically significant acute side effects. By using the described inverse planning software, over- or underdosage in the region of the field matchline could be prevented. Pure treatment time ranged between 10 and 21 min. Conclusion: This study showed that IMRT is feasible in advanced unresectable MPM. The presented possibilities of stereotactic IMRT in the treatment of MPM will justify the evaluation of IMRT in early-stage pleural mesothelioma combined with chemotherapy in a study protocol, in order to improve the outcome of these patients. Furthermore, dose escalation should be possible by using IMRT. (orig.)

  20. The National Library of Medicine's (NLM) Hazardous Substances Data Bank (HSDB): background, recent enhancements and future plans.

    Science.gov (United States)

    Fonger, George Charles; Hakkinen, Pertti; Jordan, Shannon; Publicker, Stephanie

    2014-11-05

    The National Library of Medicine's (NLM) Division of Specialized Information Services (SIS) Toxicology and Environmental Health Information Program is responsible for the management of the online Hazardous Substances Data Bank (HSDB). HSDB, a part of NLM's Toxicology Data Network (TOXNET(®)), is a file of chemical/substance information with one record for each specific chemical or substance, or for a category of chemicals or substances. Like the rest of TOXNET's databases and other resources, HSDB is available online at no cost to global users. HSDB has approximately 5600 chemicals and substances, with a focus on toxicology information and also on human exposure, industrial hygiene, emergency handling procedures, environmental fate, regulatory requirements, and related areas of likely interest to HSDB users. All data are from a core set of books, government documents, technical reports, selected primary journal literature, and other online sources of information, with a goal of linking the HSDB content to as much publicly available information as possible. HSDB's content is peer-reviewed by the Scientific Review Panel, a group of experts in the areas covering the scope of HSDB content. Recent enhancements include the addition of chemical structures to HSDB records, the addition of new subfields such as age groups for human data, more occupational exposure standards, and the addition of information on numerous nanomaterials. Examples of future plans include providing more exposure-related information, e.g., uses of a chemical or substance in consumer products; the addition of information summaries aimed towards consumers and other members of the public wanting to learn about a chemical or substance; more visual content such as diagrams (images) of the pathways of metabolism of a substance; and enhanced search features and navigation. Published by Elsevier Ireland Ltd.

  1. 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.

  2. Integration method of 3D MR spectroscopy into treatment planning system for glioblastoma IMRT dose painting with integrated simultaneous boost

    Directory of Open Access Journals (Sweden)

    Ken Soléakhéna

    2013-01-01

    Full Text Available Abstract Background To integrate 3D MR spectroscopy imaging (MRSI in the treatment planning system (TPS for glioblastoma dose painting to guide simultaneous integrated boost (SIB in intensity-modulated radiation therapy (IMRT. Methods For sixteen glioblastoma patients, we have simulated three types of dosimetry plans, one conventional plan of 60-Gy in 3D conformational radiotherapy (3D-CRT, one 60-Gy plan in IMRT and one 72-Gy plan in SIB-IMRT. All sixteen MRSI metabolic maps were integrated into TPS, using normalization with color-space conversion and threshold-based segmentation. The fusion between the metabolic maps and the planning CT scans were assessed. Dosimetry comparisons were performed between the different plans of 60-Gy 3D-CRT, 60-Gy IMRT and 72-Gy SIB-IMRT, the last plan was targeted on MRSI abnormalities and contrast enhancement (CE. Results Fusion assessment was performed for 160 transformations. It resulted in maximum differences p  Conclusions Delivering standard doses to conventional target and higher doses to new target volumes characterized by MRSI and CE is now possible and does not increase dose to organs at risk. MRSI and CE abnormalities are now integrated for glioblastoma SIB-IMRT, concomitant with temozolomide, in an ongoing multi-institutional phase-III clinical trial. Our method of MR spectroscopy maps integration to TPS is robust and reliable; integration to neuronavigation systems with this method could also improve glioblastoma resection or guide biopsies.

  3. Treatment planning and dosimetry in radiotherapy for glottic cancer

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  4. 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

  5. SNF sludge treatment system preliminary project execution plan

    International Nuclear Information System (INIS)

    Flament, T.A.

    1998-01-01

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

  6. Inverse treatment planning using volume-based objective functions

    Science.gov (United States)

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

    2004-06-01

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

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

    International Nuclear Information System (INIS)

    Niroomand-Rad, A.

    1989-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  9. Principles of treatment planning for compromised first permanent molars in mixed dentition period: A review article

    Directory of Open Access Journals (Sweden)

    Behrad Tanbakuchi

    2017-02-01

    Full Text Available Background and Aims: The first permanent molar is susceptible to caries, endodontic complications and developmental anomalies. Compromised teeth with poor prognosis could cause the clinician to face dilemmas. The aim of this review article was to assess recent guidelines on the treatment planning of compromised first permanent molars in mixed dentition period. Materials and Methods: The design of the study was based on review of literature by searching the MEDLINE, Web of science and Google scholar. Key words (permanent first molar, extraction, treatment plan were used. This search was limited to the English articles published after the year 2000. Conclusion: A number of factors influenced decision-making process regarding compromised first permanent molars including the restorative status of the tooth, dental age of the patient, degree of crowding and occlusal relationships were assessed. The ideal time for removal of these teeth was 8-9 years of age. However, the current evidence for managing compromised first permanent molars demands clinical trials.

  10. A validation of carbon fiber imaging couch top modeling in two radiation therapy treatment planning systems: Philips Pinnacle3 and BrainLAB iPlan RT Dose

    Directory of Open Access Journals (Sweden)

    Njeh Christopher F

    2012-11-01

    Full Text Available Abstract Background Carbon fiber (CF is now the material of choice for radiation therapy couch tops. Initial designs included side metal bars for rigidity; however, with the advent of IGRT, involving on board imaging, new thicker CF couch tops without metal bars have been developed. The new design allows for excellent imaging at the expense of potentially unacceptable dose attenuation and perturbation. Objectives We set out to model the BrainLAB imaging couch top (ICT in Philips Pinnacle3 treatment planning system (TPS, to validate the already modeled ICT in BrainLAB iPlan RT Dose treatment planning system and to compute the magnitude of the loss in skin sparing. Results Using CF density of 0.55 g/cm3 and foam density of 0.03 g/cm3, we demonstrated an excellent agreement between measured dose and Pinnacle3 TPS computed dose using 6 MV beam. The agreement was within 1% for all gantry angle measured except for 120o, which was 1.8%. The measured and iPlan RT Dose TPS computed dose agreed to within 1% for all gantry angles and field sizes measured except for 100o where the agreement was 1.4% for 10 cm × 10 cm field size. Predicted attenuation through the couch by iPlan RT Dose TPS (3.4% - 9.5% and Pinnacle3 TPS (2% - 6.6% were within the same magnitude and similar to previously reported in the literature. Pinnacle3 TPS estimated an 8% to 20% increase in skin dose with increase in field size. With the introduction of the CF couch top, it estimated an increase in skin dose by approximately 46 - 90%. The clinical impact of omitting the couch in treatment planning will be dependent on the beam arrangement, the percentage of the beams intersecting the couch and their angles of incidence. Conclusion We have successfully modeled the ICT in Pinnacle3 TPS and validated the modeled ICT in iPlan RT Dose. It is recommended that the ICT be included in treatment planning for all treatments that involve posteriors beams. There is a significant

  11. 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.

  12. A MULTIDISCIPLINARY APPROACH IN THE TREATMENT OF FRACTURES OF THE PROXIMAL FEMUR ON THE BACKGROUND OF SENILE OSTEOPOROSIS

    Directory of Open Access Journals (Sweden)

    N. V. Zagorodniy

    2016-01-01

    Full Text Available The article presents a review of published data on the problem of osteoporosis in patients older than 75 years who have had fractures of the proximal femur. We used descriptive and analytical methods. Search publications have done in accessible to free search databases. Based on our analysis, it was found: the majority of researchers in Russia and abroad are united in the opinion that this issue requires a multidisciplinary approach; surgical treatment should be initiated as early as possible after the onset of fracture, before the complications from side of the internal organs; patients with fractures on the background of senile osteoporosis should receive drugs that affect to the quantitative and qualitative components of bone.

  13. Functional dyspepsia in adolescents: particulars of its etiology, premorbid background, and a comprehensive treatment approach

    Directory of Open Access Journals (Sweden)

    D. V. Pechkurov

    2017-01-01

    Full Text Available The adolescence is characterized by high rates of gastroenterological morbidity due to physiological characteristics of the body and social and psychological status of the teenager. Dyspepsia takes the leading position in the structure of functional pathology. Studies have shown the role of family, unhealthy habits and addictions in the development of this disorder. One should also bear in mind that the adolescence is characterized by an increase in organic pathology. There is a  close association of the functional dyspepsia and the premorbid background, such as autonomous dysfunction and vertebral abnormalities. The use of cholinolytics, prokinetics, opioid receptor antagonists, antacids and anti-secretory agents seems rational for treatment of dyspepsia. If the above mentioned groups of agents lack efficacy, the second line therapy is proposed, which includes tricyclic antidepressants.

  14. A Study of Department of Defense Drug Abuse Prevention and Control Programs. Volume I. Background.

    Science.gov (United States)

    DRUG ABUSE , *MILITARY PERSONNEL, *MILITARY PLANNING, DEPARTMENT OF DEFENSE, BACKGROUND, SURVEYS, HYPOTHESES, MANAGEMENT, EDUCATION, PREVENTION, CORRECTIONS, IDENTIFICATION, TREATMENT, REHABILITATION, REPORTS, ORGANIZATIONS, COSTS

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

    Boyer, B.E.

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-09-01

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

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

    Science.gov (United States)

    Texas State Dept. of Water Resources, Austin.

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

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

    International Nuclear Information System (INIS)

    Knocke, T.H.; Pokrajac, B.; Fellner, C.; Poetter, R.

    1999-01-01

    In a prospective study on 20 subsequent patients with primary cervical carcinoma in Stages I to III simulator planning of a 4-field box-technique was performed. After defining the planning target volume (PTV) in the 3D planning system the field configuration of the simulator planning was transmitted. The resulting plan was compared to a second one based on the defined PTV and evaluated regarding a possible geographical miss and encompassment of the PTV by the treated volume (ICRU). Volumes of open and shaped portals were calculated for both techniques. Planning by simulation resulted in 1 geographical miss and in 10 more cases the encompassment of the PTV by the treated volume was inadequate. For a PTV of mean 1 729 cm 3 the mean volume defined by simulation was 3 120 cm 3 for the open portals and 2 702 cm 3 for the shaped portals. The volume reduction by blocks was 13,4% (mean). With CT-based 3D treatment planning the volume of the open portals was 3,3% (mean) enlarged to 3 224 cm 3 . The resulting mean volume of the shaped portals was 2 458 ccm. The reduction compared to the open portals was 23,8% (mean). The treated volumes were 244 cm 3 or 9% (mean) smaller compared to simulator planning. The 'treated volume/planning target volume ratio' was decreased from 1.59 to 1.42. (orig.) [de

  2. 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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  4. Treatment of Solar Generation in Electric Utility Resource Planning

    Energy Technology Data Exchange (ETDEWEB)

    Sterling, J.; McLaren, J.; Taylor, M.; Cory, K.

    2013-10-01

    Today's utility planners have a different market and economic context than their predecessors, including planning for the growth of renewable energy. State and federal support policies, solar photovoltaic (PV) price declines, and the introduction of new business models for solar PV 'ownership' are leading to increasing interest in solar technologies (especially PV); however, solar introduces myriad new variables into the utility resource planning decision. Most, but not all, utility planners have less experience analyzing solar than conventional generation as part of capacity planning, portfolio evaluation, and resource procurement decisions. To begin to build this knowledge, utility staff expressed interest in one effort: utility exchanges regarding data, methods, challenges, and solutions for incorporating solar in the planning process. Through interviews and a questionnaire, this report aims to begin this exchange of information and capture utility-provided information about: 1) how various utilities approach long-range resource planning; 2) methods and tools utilities use to conduct resource planning; and, 3) how solar technologies are considered in the resource planning process.

  5. 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...

  6. Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle{sup 3} scripting and Auto-Planning functions

    Energy Technology Data Exchange (ETDEWEB)

    Speer, Stefan; Weiss, Alexander; Bert, Christoph [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Erlangen (Germany); Klein, Andreas [EKS Engineering GmbH, Fuerth (Germany); Kober, Lukas [Strahlentherapie Tauber-Franken, Bad Mergentheim (Germany); Yohannes, Indra [Rinecker Proton Therapy Center, Munich (Germany)

    2017-08-15

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

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

    Directory of Open Access Journals (Sweden)

    Wenz Frederik

    2009-09-01

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

  8. Multi-institutional comparison of simulated treatment delivery errors in ssIMRT, manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

    DEFF Research Database (Denmark)

    Pogson, Elise M; Aruguman, Sankar; Hansen, Christian R

    2017-01-01

    PURPOSE: To quantify the impact of simulated errors for nasopharynx radiotherapy across multiple institutions and planning techniques (auto-plan generated Volumetric Modulated Arc Therapy (ap-VMAT), manually planned VMAT (mp-VMAT) and manually planned step and shoot Intensity Modulated Radiation...... Therapy (mp-ssIMRT)). METHODS: Ten patients were retrospectively planned with VMAT according to three institution's protocols. Within one institution two further treatment plans were generated using differing treatment planning techniques. This resulted in mp-ssIMRT, mp-VMAT, and ap-VMAT plans. Introduced...

  9. Treatment planning in dentistry using an electronic health record: implications for undergraduate education

    NARCIS (Netherlands)

    Tokede, O.; Walji, M.; Ramoni, R.; White, J.M.; Schoonheim-Klein, M.; Kimmes, N.S.; Vaderhobli, R.; Stark, P.C.; Patel, V.L.; Kalenderian, E.

    2013-01-01

    Objective Treatment planning, an essential component of clinical practice, has received little attention in the dental literature and there appears to be no consistent format being followed in the teaching and development of treatment plans within dental school curricula. No investigation, to our

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

    Science.gov (United States)

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

    2013-05-01

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

  11. Commissioning and acceptance testing of Cadplan plus- a 3D treatment planning system

    International Nuclear Information System (INIS)

    Malhotra, H.K.; Kinhikar, R.K.; Deshpande, D.D.; Dinshaw, K.A.

    2000-01-01

    3D treatment planning systems are finding wide acceptance in the radiotherapy community due to their improved dose calculation accuracy as well as the 3D visualization tools. Cadplan plus, a 3D treatment planning system from Varian, has been commissioned at the Tata Memorial Hospital in accordance to various international guidelines

  12. The role of PET/CT in radiation treatment planning for cancer patient treatment

    International Nuclear Information System (INIS)

    2008-10-01

    Positron emission tomography (PET) and, more recently, integrated positron emission tomography/X ray computed tomography (PET/CT) have appeared as significant diagnostic imaging systems in clinical medicine. Accurate recognition of cancers in patients by means of PET scanning with Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) has illustrated a need to determine a mode of therapy to achieve better prognoses. The clinical management of cancer patients has improved dramatically with the introduction of clinical PET. For treatment of cancer patients, on the other hand, radiation therapy (RT) plays an important role as a non-invasive therapy. It is crucial that cancers are encompassed by high dose irradiation, particularly in cases of curative RT. Irradiation should precisely target the entire tumour and aim to minimise the size of microscopic extensions of the cancer, as well as minimize radiation damage to normal tissues. A new imaging technique has therefore been sought to allow precise delineation of the cancer target to be irradiated. Clinical PET, combined with utilization of 18 F-FDG, may have an important role in radiation treatment planning (RTP) in lung cancer. In addition to determining if RT is appropriate and whether therapy will be given with curative or palliative intent, 18 F-FDG-PET is useful for determining therapy ports. It can be used both to limit ports to spare normal tissue and to include additional involved regions. Several studies have shown that PET has an impact on RTP in an important proportion of patients. It is to be hoped that treatment plans that include all the 18 F-FDG-avid lesions or the 18 F-FDG-avid portions of a complex mass will result in more effective local control with less unnecessary tissue being treated. The IAEA has placed emphasis on the issue of application of clinical PET for radiation treatment planning in various cancer patients. Two consultants meetings were held in 2006 and their results are summarized into this IAEA

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  14. Comparison of various online IGRT strategies: The benefits of online treatment plan re-optimization

    International Nuclear Information System (INIS)

    Schulze, Derek; Liang, Jian; Yan, Di; Zhang Tiezhi

    2009-01-01

    Purpose: To compare the dosimetric differences of various online IGRT strategies and to predict potential benefits of online re-optimization techniques in prostate cancer radiation treatments. Materials and methods: Nine prostate patients were recruited in this study. Each patient has one treatment planning CT images and 10-treatment day CT images. Five different online IGRT strategies were evaluated which include 3D conformal with bone alignment, 3D conformal re-planning via aperture changes, intensity modulated radiation treatment (IMRT) with bone alignment, IMRT with target alignment and IMRT daily re-optimization. Treatment planning and virtual treatment delivery were performed. The delivered doses were obtained using in-house deformable dose mapping software. The results were analyzed using equivalent uniform dose (EUD). Results: With the same margin, rectum and bladder doses in IMRT plans were about 10% and 5% less than those in CRT plans, respectively. Rectum and bladder doses were reduced as much as 20% if motion margin is reduced by 1 cm. IMRT is more sensitive to organ motion. Large discrepancies of bladder and rectum doses were observed compared to the actual delivered dose with treatment plan predication. The therapeutic ratio can be improved by 14% and 25% for rectum and bladder, respectively, if IMRT online re-planning is employed compared to the IMRT bone alignment approach. The improvement of target alignment approach is similar with 11% and 21% dose reduction to rectum and bladder, respectively. However, underdosing in seminal vesicles was observed on certain patients. Conclusions: Online treatment plan re-optimization may significantly improve therapeutic ratio in prostate cancer treatments mostly due to the reduction of PTV margin. However, for low risk patient with only prostate involved, online target alignment IMRT treatment would achieve similar results as online re-planning. For all IGRT approaches, the delivered organ-at-risk doses may be

  15. 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

  16. Grout Treatment Facility Land Disposal Restriction Management Plan

    International Nuclear Information System (INIS)

    Hendrickson, D.W.

    1991-01-01

    This document establishes management plans directed to result in the land disposal of grouted wastes at the Hanford Grout Facilities in compliance with Federal, State of Washington, and Department of Energy land disposal restrictions. 9 refs., 1 fig

  17. 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

  18. The NUKDOS software for treatment planning in molecular radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kletting, Peter; Schimmel, Sebastian [Univ. Ulm (Germany). Klinik fuer Nuklearmedizin; Haenscheid, Heribert; Fernandez, Maria; Lassmann, Michael [Univ. Wuerzburg (Germany). Klinik fuer Nuklearmedizin; Luster, Markus [Univ. Marburg (Germany). Klinik fuer Nuklearmedizin; Nosske, Dietmar [Bundesamt fuer Strahlenschutz, Fachbereich Strahlenschutz und Gesundheit, Oberschleissheim (Germany); Glatting, Gerhard [Heidelberg Univ., Medical Radiation Physics/Radiation Protection, Mannheim (Germany)

    2015-07-01

    The aim of this work was the development of a software tool for treatment planning prior to molecular radiotherapy, which comprises all functionality to objectively determine the activity to administer and the pertaining absorbed doses (including the corresponding error) based on a series of gamma camera images and one SPECT/CT or probe data. NUKDOS was developed in MATLAB. The workflow is based on the MIRD formalism For determination of the tissue or organ pharmacokinetics, gamma camera images as well as probe, urine, serum and blood activity data can be processed. To estimate the time-integrated activity coefficients (TIAC), sums of exponentials are fitted to the time activity data and integrated analytically. To obtain the TIAC on the voxel level, the voxel activity distribution from the quantitative 3D SPECT/CT (or PET/CT) is used for scaling and weighting the TIAC derived from the 2D organ data. The voxel S-values are automatically calculated based on the voxel-size of the image and the therapeutic nuclide ({sup 90}Y, {sup 131}I or {sup 177}Lu). The absorbed dose coefficients are computed by convolution of the voxel TIAC and the voxel S-values. The activity to administer and the pertaining absorbed doses are determined by entering the absorbed dose for the organ at risk. The overall error of the calculated absorbed doses is determined by Gaussian error propagation. NUKDOS was tested for the operation systems Windows {sup registered} 7 (64 Bit) and 8 (64 Bit). The results of each working step were compared to commercially available (SAAMII, OLINDA/EXM) and in-house (UlmDOS) software. The application of the software is demonstrated using examples form peptide receptor radionuclide therapy (PRRT) and from radioiodine therapy of benign thyroid diseases. For the example from PRRT, the calculated activity to administer differed by 4% comparing NUKDOS and the final result using UlmDos, SAAMII and OLINDA/EXM sequentially. The absorbed dose for the spleen and tumour

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  1. Dosimetry-based treatment planning for molecular radiotherapy: a summary of the 2017 report from the Internal Dosimetry Task Force

    Directory of Open Access Journals (Sweden)

    Caroline Stokke

    2017-11-01

    Full Text Available Abstract Background The European directive on basic safety standards (Council directive 2013/59 Euratom mandates dosimetry-based treatment planning for radiopharmaceutical therapies. The directive comes into operation February 2018, and the aim of a report produced by the Internal Dosimetry Task Force of the European Association of Nuclear Medicine is to address this aspect of the directive. A summary of the report is presented. Results A brief review of five of the most common therapy procedures is included in the current text, focused on the potential to perform patient-specific dosimetry. In the full report, 11 different therapeutic procedures are included, allowing additional considerations of effectiveness, references to specific literature on quantitative imaging and dosimetry, and existing evidence for absorbed dose-effect correlations for each treatment. Individualized treatment planning with tracer diagnostics and verification of the absorbed doses delivered following therapy is found to be scientifically feasible for almost all procedures investigated, using quantitative imaging and/or external monitoring. Translation of this directive into clinical practice will have significant implications for resource requirements. Conclusions Molecular radiotherapy is undergoing a significant expansion, and the groundwork for dosimetry-based treatment planning is already in place. The mandated individualization is likely to improve the effectiveness of the treatments, although must be adequately resourced.

  2. Clinical evaluation of 3D/3D MRI-CBCT automatching on brain tumors for online patient setup verification - A step towards MRI-based treatment planning

    DEFF Research Database (Denmark)

    Buhl, S.K.; Duun-Christensen, Anne Katrine; Kristensen, B.H.

    2010-01-01

    Background. Magnetic Resonance Imaging (MRI) is often used in modern day radiotherapy (RT) due to superior soft tissue contrast. However, treatment planning based solely on MRI is restricted due to e. g. the limitations of conducting online patient setup verification using MRI as reference. In th...... the absolute difference in couch shift coordinates acquired from MRI-CBCT and CT-CBCT automatching, were...

  3. [Multicenter Prospective Observational Study of Fungal Keratitis--Current Status of Patients' Background, Clinical Findings, Treatment and Prognosis].

    Science.gov (United States)

    Inoue, Yoshitsugu; Ohashi, Yuichi; Suzuki, Takashi; Shimomura, Yoshikazu; Fukuda, Masahiko; Sotozono, Chie; Hatano, Hiroshi; Eguchi, Hiroshi; Araki-Sasaki, Kaoru; Hoshi, Saichi; Sunada, Atsuko; Asari, Seishi; Yaguchi, Takashi; Makimura, Koichi; Yokokura, Shunji; Mochizuki, Kiyofumi; Monden, Yu; Nejima, Ryohei

    2016-01-01

    To investigate the current status of fungal keratitis in Japan. The patients with fungal keratitis were examined at 27 facilities in Japan from November 1st 2011 to October 31st 2013, concerning isolates, patient background, clinical findings, treatment and prognosis. Out of 139 cases, 133 were diagnosed as fungal keratitis, of which fungi were isolated from 72 samples of 71 cases (yeast-like fungi 32 strains and filamentous fungi 40 strains). The corrected visual acuity at the first visit of 88 cases (66.2%) was less than 20/200 and 42 cases (31.6%) were involved with deep stromal lesions, indicating high proportion of severe cases in this study. Three months later, 56 cases (42.1%) were still under treatment, and corrected visual acuity of 57 cases (42.9%) was less than 20/200. In cases with yeast-like fungi, there were significantly more cases with past history of corneal diseases, ocular surgery including keratoplasty, and eye drops' use such as steroids than those with filamentous fungi. On the other hand, there were significantly more cases of filamentous fungi, with trauma on the onset and with intervention of previously attending doctors than those with yeast-like fungi. Logistic regression analyses revealed that contact lens wearing was a significant factor of good prognosis, and yeast-like fungi as one of poor outcome compared with no fungal isolation. Although the choice of antifungal drugs has been increasing, fungal keratitis is still severe, refractory and vision-threatening disease.

  4. Treatment planning comparison of electron arc therapy and photon intensity modulated radiotherapy for Askin's tumor of chest wall

    International Nuclear Information System (INIS)

    Jamema, Swamidas V.; Sharma, Pramod K.; Laskar, Siddhartha; Deshpande, Deepak D.; Shrivastava, Shyam K.

    2007-01-01

    Background and Purpose: A dosimetric study to quantitatively compare radiotherapy treatment plans for Askin's tumor using Electron Arc (EA) vs. photon Intensity Modulated Radiotherapy (IMRT). Materials and methods: Five patients treated with EA were included in this study. Treatment plans were generated for each patient using EA and IMRT. Plans were compared using dose volume histograms (DVH) of the Planning Target Volume (PTV) and Organs at Risk (OAR). Results: IMRT resulted in superior PTV coverage, and homogeneous dose distribution compared to EA. For EA, 92% of the PTV was covered to 85% of the dose compared to IMRT in which 96% was covered to 95% of the dose. V 107 that represents the hot spot within the PTV was more in IMRT compared to EA: 7.4(±2)% vs. 3(±0.5)%, respectively. With PTVs located close to the spinal cord (SC), the dose to SC was more with EA, whereas for PTVs located away from the SC, the dose to SC was more with IMRT. The cardiac dose profile was similar to that of SC. Ipsilateral lung received lower doses with IMRT while contralateral lung received higher dose with IMRT compared to EA. For non-OAR normal tissues, IMRT resulted in large volumes of low dose regions. Conclusions: IMRT resulted in superior PTV coverage and sparing of OAR compared to EA plans. Although IMRT seems to be superior to EA, one needs to keep in mind the volume of low dose regions associated with IMRT, especially while treating young children

  5. Comparison of treatment plans: a retrospective study by the method of radiobiological evaluation

    Science.gov (United States)

    Puzhakkal, Niyas; Kallikuzhiyil Kochunny, Abdullah; Manthala Padannayil, Noufal; Singh, Navin; Elavan Chalil, Jumanath; Kulangarakath Umer, Jamshad

    2016-09-01

    There are many situations in radiotherapy where multiple treatment plans need to be compared for selection of an optimal plan. In this study we performed the radiobiological method of plan evaluation to verify the treatment plan comparison procedure of our clinical practice. We estimated and correlated various radiobiological dose indices with physical dose metrics for a total of 30 patients representing typical cases of head and neck, prostate and brain tumors. Three sets of plans along with a clinically approved plan (final plan) treated by either Intensity Modulated Radiation Therapy (IMRT) or Rapid Arc (RA) techniques were considered. The study yielded improved target coverage for final plans, however, no appreciable differences in doses and the complication probabilities of organs at risk were noticed. Even though all four plans showed adequate dose distributions, from dosimetric point of view, the final plan had more acceptable dose distribution. The estimated biological outcome and dose volume histogram data showed least differences between plans for IMRT when compared to RA. Our retrospective study based on 120 plans, validated the radiobiological method of plan evaluation. The tumor cure or normal tissue complication probabilities were found to be correlated with the corresponding physical dose indices.

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

    Science.gov (United States)

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

    2017-06-01

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

  7. 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

  8. Improvement of locoregional hyperthermia treatments of oesophageal cancer using treatment planning

    International Nuclear Information System (INIS)

    Kok, H.P.; Haaren Van, P.M.A.; Kamer Van de, J.B.; Zum Voerde Sive Voerding, P.J.; Wiersma, J.; Hulshof, M.C.C.M; Geijsen, E.D.; Crezee, J.

    2005-01-01

    Full text: The thermal dose achieved in the clinic often remains too low due to the incidence of treatment limiting hot spots, which are difficult to avoid intuitively due to the large number of degrees of freedom (amplitudes and phases) of the heating device. To improve hyperthermia treatments of oesophagus carcinoma patients with the 70 MHz AMC-4 waveguide system we performed hyperthermia treatment planning (HTP) with high resolution temperature based optimization. With this optimization we obtain amplitude (A) and phase (p) settings for the antennas for optimal tumor heating (> 43 o C) while preventing hot spots in normal tissue ( o C) and maintaining the spinal cord temperature below 40 o C to prevent neurotoxicity. With the mixed A/P settings the highest absolute ΔT's were achieved, while the ratio was not much different from the other two configurations. This implies that with these settings the same tumor heating can be obtained with less applied power, resulting in more efficient heating. The fact that the combined numerical A/clinical P settings resulted in the highest absolute temperature rises in the oesophagus might be due to the difference in patient positioning between the planning and the actual treatment, since the location of the SAR focus in the tumor is constructed mainly by phase steering. The temperature rise near the spinal cord depends mainly on the power of the top antenna. The correlation coefficient was R=0.37, which was considerably higher than the correlation with the powers or phases of the other antennas. The temperature rise in the oesophagus depends mainly on the power of the top and bottom antenna together. The correlation coefficient was only R=0.12 but this was still more than 2 times higher than the correlation with the power of the left and right antenna. The relation between the temperature rise due to a power pulse of 30 seconds and the achieved steady state temperature was more or less linear, implying a higher T 90 and T 50

  9. Comparison of treatments of steep and shoot generated by different inverse planning systems

    International Nuclear Information System (INIS)

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

    2011-01-01

    The problem of IMRT treatments with the technique Steep and Shoot or static is the number of segments and monitor units used in the treatment. These parameters depend largely on the inverse planning system which determines treatment. Are evaluated three commercial planning systems, with each one performing clinical dosimetry for the same series of patients. Dosimetric results are compared, UM calculated and number of segments.

  10. Treatment planning for heavy ion radiotherapy: calculation and optimization of biologically effective dose

    International Nuclear Information System (INIS)

    Kraemer, M.; Scholz, M.

    2000-09-01

    We describe a novel approach to treatment planning for heavy ion radiotherapy based on the local effect model (LEM) which allows to calculate the biologically effective dose not only for the target region but for the entire irradiation volume. LEM is ideally suited to be used as an integral part of treatment planning code systems for active dose shaping devices like the GSI raster scan system. Thus, it has been incorporated into our standard treatment planning system for ion therapy (TRiP). Single intensity modulated fields can be optimized with respect to homogeneous biologically effective dose. The relative biological effectiveness (RBE) is calculated separately for each voxel of the patient CT. Our radiobiologically oriented code system is in use since 1995 for the planning of irradiation experiments with cell cultures and animals such as rats and minipigs. Since 1997 it is in regular and successful use for patient treatment planning. (orig.)

  11. The importance of masticatory functional analysis in the diagnostic finding and treatment planning for prosthodontic rehabilitation

    Directory of Open Access Journals (Sweden)

    Harry Laksono

    2012-06-01

    Full Text Available Background: The masticatory system as a biologic system is subjected to harmful influences of varying severity. Almost half of routine patients requesting prosthodontic treatment indicated at least one sign or symptom of temporomandibular disorders. Analysis of the masticatory system often neglected by dentist. Untreated temporomandibular disorders may significantly implicated in the perpetuation of the disorder and may interfere with routine prosthodontic clinical procedures. It would be resulted unsuccessful long term goal of prosthodontic rehabilitation because of the uncompleted diagnoses and treatment plan. Purpose: The purpose of this case report was to give the information of the importance of masticatory functional analysis in the diagnostic finding for treatment planning in the prosthodontic rehabilitation. Case: A 45 year - old male patient, partial dentate with reduced chewing efficiency, mild pain in right preauricular region in function, left click in opening mouth, severe attrition on all anterior lower teeth with vertical dimension of occlusion decreased due to loss of posterior support. He wanted to make a new denture. Case management: Record and analyze of active and passive mandibular movement, opening pathway, muscle and temporomandibular joints palpation, load testing, and vertical dimension of occlusion with manual functional analysis (MFA, occlusal condition and radiographic examination. Treatment plan was formulated into 3 phases: stabilization of the masticatory system, definitive treatment and periodical control. The result of this treatment excellent for 1 year evaluation after permanent cementation. Conclusion: Masticatory functional analysis is very important and must be done in the diagnosis finding for treatment planning in every case of prosthodontic rehabilitation.Latar belakang: Sistem pengunyahan sebagai sistem biologis sewaktu-waktu dapat terjadi gangguan dengan berbagai derajat keparahan. Hampir setengah dari

  12. Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college students.

    Science.gov (United States)

    Sonneville, K R; Lipson, S K

    2018-03-02

    Eating disorders (EDs) present a significant threat to the health of adolescents and young adults, yet remain under-diagnosed and under-treated at a population-level. EDs have historically been thought to afflict "skinny, white, affluent girls" (the SWAG stereotype). As such, higher-weight individuals, racial/ethnic minorities, those from socioeconomically disadvantaged backgrounds, and males may not recognize their need for treatment, may not be properly screened for EDs, and/or may not be referred to treatment. Using large-scale survey data from the healthy bodies study, we examined variations in prevalence of perceived need for ED treatment, ED diagnosis, past-year ED treatment, and treatment barriers according to weight status, race, socioeconomic background, and sex among undergraduate and graduate students with symptoms of an ED (N = 1,747). Among students with symptoms of an ED, 30.7% perceived a need for treatment, 10.5% had received a diagnosis, and 13.6% had received treatment in the past year. Individual characteristics were highly associated with perceived need, diagnosis, and past-year treatment. Females were more likely than males to perceive a need for treatment (OR = 1.97), to be diagnosed (OR = 4.66), and to be treated (OR = 1.64) for their ED symptoms. Socioeconomic background was associated with perceived need for treatment and past-year treatment, with students from affluent backgrounds having higher odds of perceiving need (OR = 1.52) and of receiving treatment (OR = 1.89) compared with their non-affluent peers. At a population-level, the unmet need for ED treatment disproportionately affects certain groups. Stereotypes about who develops EDs could contribute to disparities in ED treatment and outcomes. © 2018 Wiley Periodicals, Inc.

  13. IMRT treatment planning based on prioritizing prescription goals

    International Nuclear Information System (INIS)

    Wilkens, Jan J; Alaly, James R; Zakarian, Konstantin; Thorstad, Wade L; Deasy, Joseph O

    2007-01-01

    Determining the 'best' optimization parameters in IMRT planning is typically a time-consuming trial-and-error process with no unambiguous termination point. Recently we and others proposed a goal-programming approach which better captures the desired prioritization of dosimetric goals. Here, individual prescription goals are addressed stepwise in their order of priority. In the first step, only the highest order goals are considered (target coverage and dose-limiting normal structures). In subsequent steps, the achievements of the previous steps are turned into hard constraints and lower priority goals are optimized, in turn, subject to higher priority constraints. So-called 'slip' factors were introduced to allow for slight, clinically acceptable violations of the constraints. Focusing on head and neck cases, we present several examples for this planning technique. The main advantages of the new optimization method are (i) its ability to generate plans that meet the clinical goals, as well as possible, without tuning any weighting factors or dose-volume constraints, and (ii) the ability to conveniently include more terms such as fluence map smoothness. Lower level goals can be optimized to the achievable limit without compromising higher order goals. The prioritized prescription-goal planning method allows for a more intuitive and human-time-efficient way of dealing with conflicting goals compared to the conventional trial-and-error method of varying weighting factors and dose-volume constraints

  14. Dose attenuation by a carbon fiber linac couch and modeling with a treatment planning system

    International Nuclear Information System (INIS)

    Sanchez Galiano, P.; Garcia Sancho, J.M.; Crelgo, D.; Pamos, M.; Fernandez, J.; Vivanco, J.

    2010-01-01

    The purpose of this work is to investigate the attenuation caused by a carbon fiber linac treatment couch and the ability of a commercial radiotherapy treatment planning system to simulate it. The attenuation caused by an Exact treatment couch in a Varian Clinac 2100 C/D was characterized in detail. Both 6 MV and 18 MV photon beams were studied. The treatment couch was modeled and incorporated to Elekta XiO treatment planning system. Measured and computed attenuation values were compared. As a result we found that the attenuation caused by this complex treatment couch is strongly dependent on the incidence angle of the beam. The measured attenuation values reach 16% for 6 MV and 10% for 18 MV. The model incorporated to the treatment planning software allows reducing the differences between measured and calculated data below 2.5% and 2.0% for 6 MV and 18 MV respectively. In conclusion, it is strongly recommended accounting for the perturbation caused by this carbon fiber treatment couch when the beam intersects it. The treatment planning system studied can simulate this treatment couch accurately. Clinical implementation of the described method requires a reliable procedure to reproduce the same patient geometry in the treatment delivery and planning. (Author).

  15. What about OMT and nutrition for managing the irritable bowel syndrome? An overview and treatment plan.

    Science.gov (United States)

    Collebrusco, Luca; Lombardini, Rita

    2014-01-01

    A chronic continuous or intermittent gastrointestinal tract dysfunction, the irritable bowel syndrome (IBS), appears to be due to dysregulation of brain-gut-microbiota communication. Furthermore, the "microbiota" greatly impacts the bi-directional brain-gut axis communication. This article describes IBS in relation to similar diseases, presents the background to osteopathy, and proposes osteopathic manipulative treatment (OMT) to manage IBS. In IBS, OMT focuses on the nervous and circulatory systems, spine, viscera, and thoracic and pelvic diaphragms in order to restore homeostatic balance, normalize autonomic activity in the intestine, promote lymphatic flow, and address somatic dysfunction. Lymphatic and venous congestion are treated by the lymphatic pump techniques and stimulation of Chapman׳s reflex points. A simple treatment plan designed to lessen chronic pain and inflammation in IBS is presented based on current evidence-based literature. Since food itself, food allergies, and intolerance could contribute to symptom onset or even cause IBS, this article also provides dietary modifications to consider for patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Novel hyperthermia applicator system allows adaptive treatment planning: Preliminary clinical results in tumour-bearing animals.

    Science.gov (United States)

    Dressel, S; Gosselin, M-C; Capstick, M H; Carrasco, E; Weyland, M S; Scheidegger, S; Neufeld, E; Kuster, N; Bodis, S; Rohrer Bley, C

    2017-09-11

    Hyperthermia (HT) as an adjuvant to radiation therapy (RT) is a multimodality treatment method to enhance therapeutic efficacy in different tumours. High demands are placed on the hardware and treatment planning software to guarantee adequately planned and applied HT treatments. The aim of this prospective study was to determine the effectiveness and safety of the novel HT system in tumour-bearing dogs and cats in terms of local response and toxicity as well as to compare planned with actual achieved data during heating. A novel applicator with a flexible number of elements and integrated closed-loop temperature feedback control system, and a tool for patient-specific treatment planning were used in a combined thermoradiotherapy protocol. Good agreement between predictions from planning and clinical outcome was found in 7 of 8 cases. Effective HT treatments were planned and verified with the novel system and provided improved quality of life in all but 1 patient. This individualized treatment planning and controlled heat exposure allows adaptive, flexible and safe HT treatments in palliatively treated animal patients. © 2017 John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  18. Safety of enfuvirtide in combination with an optimized background of antiretrovirals in treatment-experienced HIV-1-infected adults over 48 weeks

    NARCIS (Netherlands)

    Trottier, Benoit; Walmsley, Sharon; Reynes, Jacques; Piliero, Peter; O'Hearn, Mary; Nelson, Mark; Montaner, Julio; Lazzarin, Adriano; Lalezari, Jacob; Katlama, Christine; Henry, Keith; Cooper, David; Clotet, Bonaventura; Arastéh, Keikawus; Delfraissy, Jean-François; Stellbrink, Hans-Jürgen; Lange, Joep; Kuritzkes, Daniel; Eron, Joseph J.; Cohen, Calvin; Kinchelow, Tosca; Bertasso, Anne; Labriola-Tompkins, Emily; Shikhman, Anna; Atkins, Belinda; Bourdeau, Laurence; Natale, Christopher; Hughes, Fiona; Chung, Jain; Guimaraes, Denise; Drobnes, Claude; Bader-Weder, Silvia; DeMasi, Ralph; Smiley, Lynn; Salgo, Miklos P.

    2005-01-01

    Antiretroviral tolerability is a critical factor contributing to treatment outcome. The T-20 Versus Optimized Background Regimen Only (TORO) studies assessed the safety and efficacy of enfuvirtide in treatment-experienced HIV-1-infected patients. A total of 997 patients were randomized at a 2:1

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

    Science.gov (United States)

    Alexander, Andrew William

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

  20. Automatic treatment planning implementation using a database of previously treated patients

    International Nuclear Information System (INIS)

    Moore, J A; Evans, K; Yang, W; Herman, J; McNutt, T

    2014-01-01

    Purpose: Using a database of prior treated patients, it is possible to predict the dose to critical structures for future patients. Automatic treatment planning speeds the planning process by generating a good initial plan from predicted dose values. Methods: A SQL relational database of previously approved treatment plans is populated via an automated export from Pinnacle 3 . This script outputs dose and machine information and selected Regions of Interests as well as its associated Dose-Volume Histogram (DVH) and Overlap Volume Histograms (OVHs) with respect to the target structures. Toxicity information is exported from Mosaiq and added to the database for each patient. The SQL query is designed to ask the system for the lowest achievable dose for a specified region of interest (ROI) for each patient with a given volume of that ROI being as close or closer to the target than the current patient. Results: The additional time needed to calculate OVHs is approximately 1.5 minutes for a typical patient. Database lookup of planning objectives takes approximately 4 seconds. The combined additional time is less than that of a typical single plan optimization (2.5 mins). Conclusions: An automatic treatment planning interface has been successfully used by dosimetrists to quickly produce a number of SBRT pancreas treatment plans. The database can be used to compare dose to individual structures with the toxicity experienced and predict toxicities before planning for future patients.

  1. Audit of an automated checklist for quality control of radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Breen, Stephen L.; Zhang Beibei

    2010-01-01

    Purpose: To assess the effect of adding an automated checklist to the treatment planning process for head and neck intensity-modulated radiotherapy. Methods: Plans produced within our treatment planning system were evaluated at the planners' discretion with an automated checklist of more than twenty planning parameters. Plans were rated as accepted or rejected for treatment, during regular review by radiation oncologists and physicists as part of our quality control program. The rates of errors and their types were characterised prior to the implementation of the checklist and with the checklist. Results: Without the checklist, 5.9% of plans were rejected; the use of the checklist reduced the rejection rate to 3.1%. The checklist was used for 64.7% of plans. Pareto analysis of the causes of rejection showed that the checklist reduced the number of causes of rejections from twelve to seven. Conclusions: The use of an automated checklist has reduced the need for reworking of treatment plans. With the use of the checklist, most rejections were due to errors in prescription or inadequate dose distributions. Use of the checklist by planners must be increased to maximise improvements in planning efficiency.

  2. Unified dosimetry index (UDI): a figure of merit for ranking treatment plans.

    Science.gov (United States)

    Akpati, Hilary; Kim, ChangSeon; Kim, Bong; Park, Tae; Meek, Allen

    2008-06-23

    We have formulated a unified dosimetry index (UDI) that computes, for any given treatment plan, its deviations in terms of dose coverage, conformity, homogeneity, and dose gradient vis-à-vis an ideal plan (which we define as a dosimetry plan of perfect dose coverage, conformity, homogeneity, and step-wise fall-off to zero dose outside the planning target volume). In order to validate the UDI scoring system, 21 stereotactic cranial radiosurgery cases were evaluated retrospectively. The cases were planned on the BrainSCAN treatment planning system (BrainLAB, Feldkirchen, Germany) using 6 to 8 non-coplanar static beams collimated with the micro multi-leaf collimator (mMLC). We suggest a technique for creating a ranking system that can be utilized for plan evaluation and comparison between multiple plans. Under this system treatment plans are classified as "excellent", "good", "average", or "poor". The proposed ranking system can be utilized as a general guide for generating an optimal dosimetry plan for external beam radiation therapy.

  3. Cerebral cortex dose sparing for glioblastoma patients: IMRT versus robust treatment planning.

    Science.gov (United States)

    Exeli, Ann-Katrin; Kellner, Daniel; Exeli, Lukas; Steininger, Phil; Wolf, Frank; Sedlmayer, Felix; Deutschmann, Heinz

    2018-02-06

    To date, patients with glioblastoma still have a bad median overall survival rate despite radiation dose-escalation and combined modality treatment. Neurocognitive decline is a crucial adverse event which may be linked to high doses to the cortex. In a planning study, we investigated the impact of dose constraints to the cerebral cortex and its relation to the organs at risk for glioblastoma patients. Cortical sparing was implemented into the optimization process for two planning approaches: classical intensity-modulated radiotherapy (IMRT) and robust treatment planning. The plans with and without objectives for cortex sparing where compared based on dose-volume histograms (DVH) data of the main organs at risk. Additionally the cortex volume above a critical threshold of 28.6 Gy was elaborated. Furthermore, IMRT plans were compared with robust treatment plans regarding potential cortex sparing. Cortical dose constraints result in a statistically significant reduced cerebral cortex volume above 28.6 Gy without negative effects to the surrounding organs at risk independently of the optimization technique. For IMRT we found a mean volume reduction of doses beyond the threshold of 19%, and 16% for robust treatment planning, respectively. Robust plans delivered sharper dose gradients around the target volume in an order of 3 - 6%. Aside from that the integration of cortical sparing into the optimization process has the potential to reduce the dose around the target volume (4 - 8%). We were able to show that dose to the cerebral cortex can be significantly reduced both with robust treatment planning and IMRT while maintaining clinically adequate target coverage and without corrupting any organ at risk. Robust treatment plans delivered more conformal plans compared to IMRT and were superior in regards to cortical sparing.

  4. 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.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  6. Delineation of potential hot spots for hyperthermia treatment planning optimisation

    NARCIS (Netherlands)

    Wiersma, J.; van Wieringen, N.; Crezee, H.; van Dijk, J. D. P.

    2007-01-01

    The optimal feed parameters of the generators for a complex-phased hyperthermia array system consisting of 4, 8 or even more applicators cannot be found using only the expertise of the treatment staff or using the limited amount of field and temperature data obtained during treatment. A number of

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

    International Nuclear Information System (INIS)

    Gaddy, Melissa R.; Papp, Dávid

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

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

    Science.gov (United States)

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

    2011-03-01

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

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

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

    International Nuclear Information System (INIS)

    1993-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-12-15

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

  14. Application of Magnetic Resonance Imaging and Three-Dimensional Treatment Planning in the Treatment of Orbital Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Rudoltz, Marc S. [Department of Radiation Oncology And Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, 19107 (United States); Ayyangar, Komanduri [Department of Radiation Therapy, Medical College of Ohio, Toledo, OH43699 (United States); Mohiuddin, Mohammed [Department of Radiation Oncology And Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, 19107 (United States)

    2015-01-15

    Radiotherapy for lymphoma of the orbit must be individualized for each patient and clinical setting. Most techniques focus on optimizing the dose to the tumor while sparing the lens. This study describes a technique utilizing magnetic resonance imaging (MRI) and three dimensional (3D) planning in the treatment of orbital lymphoma. A patient presented with an intermediate grade lymphoma of the right orbit. The prescribed tumor dose was 4050 cGy in 18 fractions. Three D planning was carried out and tumor volumes, retina, and lens were subsequently outlined. Dose calculations including dose volume histograms of the target, retina, and lens were then performed. Part of the retina was outside of the treatment volume while 50% of the retina received 90% or more of the prescribed dose. The patient was clinically NED when last seen 2 years following therapy with no treatment-related morbidity. Patients with lymphomas of the orbit can be optimally treated using MRI based 3D treatment planning.

  15. Application of Magnetic Resonance Imaging and Three-Dimensional Treatment Planning in the Treatment of Orbital Lymphoma

    International Nuclear Information System (INIS)

    Rudoltz, Marc S.; Ayyangar, Komanduri; Mohiuddin, Mohammed

    2015-01-01

    Radiotherapy for lymphoma of the orbit must be individualized for each patient and clinical setting. Most techniques focus on optimizing the dose to the tumor while sparing the lens. This study describes a technique utilizing magnetic resonance imaging (MRI) and three dimensional (3D) planning in the treatment of orbital lymphoma. A patient presented with an intermediate grade lymphoma of the right orbit. The prescribed tumor dose was 4050 cGy in 18 fractions. Three D planning was carried out and tumor volumes, retina, and lens were subsequently outlined. Dose calculations including dose volume histograms of the target, retina, and lens were then performed. Part of the retina was outside of the treatment volume while 50% of the retina received 90% or more of the prescribed dose. The patient was clinically NED when last seen 2 years following therapy with no treatment-related morbidity. Patients with lymphomas of the orbit can be optimally treated using MRI based 3D treatment planning.

  16. Optimization of stereotactic body radiotherapy treatment planning using a multicriteria optimization algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Ghandour, Sarah; Cosinschi, Adrien; Mazouni, Zohra; Pachoud, Marc; Matzinger, Oscar [Riviera-Chablais Hospital, Vevey (Switzerland). Cancer Center, Radiotherapy Dept.

    2016-07-01

    To provide high-quality and efficient dosimetric planning for various types of stereotactic body radiotherapy (SBRT) for tumor treatment using a multicriteria optimization (MCO) technique fine-tuned with direct machine parameter optimization (DMPO). Eighteen patients with lung (n = 11), liver (n = 5) or adrenal cell cancer (n = 2) were treated using SBRT in our clinic between December 2014 and June 2015. Plans were generated using the RayStation trademark Treatment Planning System (TPS) with the VMAT technique. Optimal deliverable SBRT plans were first generated using an MCO algorithm to find a well-balanced tradeoff between tumor control and normal tissue sparing in an efficient treatment planning time. Then, the deliverable plan was post-processed using the MCO solution as the starting point for the DMPO algorithm to improve the dose gradient around the planning target volume (PTV) while maintaining the clinician's priorities. The dosimetric quality of the plans was evaluated using dose-volume histogram (DVH) parameters, which account for target coverage and the sparing of healthy tissue, as well as the CI100 and CI50 conformity indexes. Using a combination of the MCO and DMPO algorithms showed that the treatment plans were clinically optimal and conformed to all organ risk dose volume constraints reported in the literature, with a computation time of approximately one hour. The coverage of the PTV (D99% and D95%) and sparing of organs at risk (OAR) were similar between the MCO and MCO + DMPO plans, with no significant differences (p > 0.05) for all the SBRT plans. The average CI100 and CI50 values using MCO + DMPO were significantly better than those with MCO alone (p < 0.05). The MCO technique allows for convergence on an optimal solution for SBRT within an efficient planning time. The combination of the MCO and DMPO techniques yields a better dose gradient, especially for lung tumors.

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

    International Nuclear Information System (INIS)

    Yang, Mingchao

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  20. WE-AB-201-01: Treatment Planning System Commissioning and QA: Challenges and Opportunities

    International Nuclear Information System (INIS)

    Salomons, G.

    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

  1. WE-AB-201-00: Treatment Planning System Commissioning and QA

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  4. 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

  5. Deliverable navigation for multicriteria IMRT treatment planning by combining shared and individual apertures

    International Nuclear Information System (INIS)

    Fredriksson, Albin; Bokrantz, Rasmus

    2013-01-01

    We consider the problem of deliverable Pareto surface navigation for step-and-shoot intensity-modulated radiation therapy. This problem amounts to calculation of a collection of treatment plans with the property that convex combinations of plans are directly deliverable. Previous methods for deliverable navigation impose restrictions on the number of apertures of the individual plans, or require that all treatment plans have identical apertures. We introduce simultaneous direct step-and-shoot optimization of multiple plans subject to constraints that some of the apertures must be identical across all plans. This method generalizes previous methods for deliverable navigation to allow for treatment plans with some apertures from a collective pool and some apertures that are individual. The method can also be used as a post-processing step to previous methods for deliverable navigation in order to improve upon their plans. By applying the method to subsets of plans in the collection representing the Pareto set, we show how it can enable convergence toward the unrestricted (non-navigable) Pareto set where all apertures are individual. (paper)

  6. 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

  7. Predictors for adherence to action plans for self-treatment of COPD exacerbations

    NARCIS (Netherlands)

    Lenferink, A; van der Palen, J.; Wang, X; van der Valk, P.; Effing, T

    2016-01-01

    Introduction/Aim: A minority of patients with chronic obstructive pulmonary disease (COPD) derives benefit fromself-management interventions that include action plans for self-treatment of COPD exacerbations. The aimof this studywas to identify predictors for adherence to action plans for

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  9. Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

    International Nuclear Information System (INIS)

    Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

    2007-01-01

    Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

  10. 78 FR 65675 - Proposed Collection; 60-Day Comment Request; Multidisciplinary Treatment Planning (MTP) Within...

    Science.gov (United States)

    2013-11-01

    ..., including the validity of the methodology and assumptions used; (3) Ways to enhance the quality, utility..., Division of Cancer Control & Population Sciences, National Cancer Institute, 9609 Medical Center Drive... Program (NCCCP) hospitals define, structure, and implement multidisciplinary treatment planning (MTP...

  11. Neurocognition and quality of life after reinitiating antiretroviral therapy in children randomized to planned treatment interruption

    NARCIS (Netherlands)

    Ananworanich, Jintanat; Melvin, Diane; Amador, Jose T. R.; Childs, Tristan; Medin, Gabriela; Boscolo, Valentina; Compagnucci, Alexandra; Kanjanavanit, Suparat; Montero, Samuel; Gibb, Diana M.; Aboulker, J. -P.; Babiker, A.; Belfrage, E.; Bernardi, S.; Bologna, R.; Burger, D.; Butler, K.; Castelli-Gattinara, G.; Castro, H.; Clayden, P.; Compagnucci, A.; Cressey, T.; Darbyshire, J. H.; Debré, M.; de Groot, R.; della Negra, M.; Di Biagio, A.; de Rossi, A.; Duicelescu, D.; Faye, A.; Giaquinto, C.; Giacomet, V.; Gibb, D. M.; Grosch-Wörner, I.; Hainault, M.; Klein, N.; Lallemant, M.; Levy, J.; Lyall, H.; Marczynska, M.; Marques, L.; Mardarescu, M.; Mellado Peña, M. J.; Nadal, D.; Nastouli, E.; Naver, L.; Niehues, T.; Peckham, C.; Pillay, D.; Popieska, J.; Ramos Amador, J. T.; Rojo Conejo, P.; Rosado, L.; Rosso, R.; Rudin, C.; Scherpbier, H. J.; Sharland, M.; Stevanovic, M.; Thorne, C.; Tovo, P. A.; Tudor-Williams, G.; Turkova, A.; Valerius, N.; Volokha, A.; Walker, A. S.; Welch, S.; Wintergerst, U.; Aboulker, J. P.; Burger, D. M.; Green, H.; Harper, L.; Mofenson, L.; Moye, J.; Saïdi, Y.; Cressey, T. R.; Jacqz-Aigrain, E.; Khoo, S.; Regazzi, M.; Tréluyer, J. M.; Ngo-Giang-Huong, N.; Muñoz Fernandez, M. A.; Hill, C.; Lepage, P.; Pozniak, A.; Vella, S.; Chêne, G.; Vesikari, T.; Hadjou, G.; Léonardo, S.; Riault, Y.; Bleier, J.; Buck, L.; Duong, T.; Farrelly, L.; Forcat, S.; Harrison, L.; Horton, J.; Johnson, D.; Montero, S.; Taylor, C.; Chalermpantmetagul, S.; Peongjakta, R.; Khamjakkaew, W.; Than-in-at, K.; Chailert, S.; Jourdain, G.; Le Coeur, S.; Floret, D.; Costanzo, P.; Le Thi, T. T.; Monpoux, F.; Mellul, S.; Caranta, I.; Boudjoudi, N.; Firtion, G.; Denon, M.; Charlemaine, E.; Picard, F.; Hellier, E.; Heuninck, C.; Damond, F.; Alexandre, G.; Tricoire, J.; Antras, M.; Lachendowier, C.; Nicot, F.; Krivine, A.; Rivaux, D.; Notheis, G.; Strotmann, G.; Schlieben, S.; Rampon, O.; Boscolo, V.; Zanchetta, M.; Ginocchio, F.; Viscoli, C.; Martino, A.; Pontrelli, G.; Baldassar, S.; Concato, C.; Mazza, A.; Rossetti, G.; Dobosz, S.; Oldakowska, A.; Popielska, J.; Kaflik, M.; Stanczak, J.; Stanczack, G.; Dyda, T.; Kruk, M.; González Tomé, M. I.; Delgado García, R.; Fernandez Gonzalez, M. T.; Medin, G.; Mellado Peña, M. José; Martín Fontelos, P.; Garcia Mellado, M. I.; Medina, A. F.; Ascencion, B.; Garcia Bermejo, I.; Navarro Gomez, D. M. L.; Saavedra, J.; Prieto, C.; Jimenez, J. L.; Muñoz-Fernandez, M. A.; Garcia Torre, A.; de José Gómez, M. I.; García Rodriguez, M. C.; Moreno Pérez, D.; Núñez Cuadros, E.; Asensi-Botet, F.; Otero Reigada, C.; Pérez Tamarit, M. D.; Vilalta, R.; Molina Moreno, J. M.; Rainer, Truninger; Schupbach, J.; Rutishauser, M.; Bunupuradah, T.; Butterworth, O.; Phasomsap, C.; Prasitsuebsai, W.; Chuanjaroen, T.; Jupimai, T.; Ubolyam, S.; Phanuphak, P.; Puthanakit, T.; Pancharoen, C.; Mai, Chaing; Kanjanavanit, S.; Namwong, T.; Punsakoon, W.; Payakachat, S.; Chutima, D.; Raksasang, M.; Foster, C.; Hamadache, D.; Campbell, S.; Newbould, C.; Monrose, C.; Abdulla, A.; Walley, A.; Melvin, D.; Patel, D.; Kaye, S.; Seery, P.; Rankin, A.; Wildfire, A.; Novelli, V.; Shingadia, D.; Moshal, K.; Flynn, J.; Clapson, M.; Allen, A.; Spencer, L.; Rackstraw, C.; Ward, B.; Parkes, K.; Depala, M.; Jacobsen, M.; Poulsom, H.; Barkley, L.; Miah, J.; Lurie, P.; Keane, C.; McMaster, P.; Phipps, M.; Orendi, J.; Farmer, C.; Liebeschuetz, S.; Sodeinde, O.; Wong, S.; Bostock, V.; Heath, Y.; Scott, S.; Gandhi, K.; Lewis, P.; Daglish, J.; Miles, K.; Summerhill, L.; Subramaniam, B.; Weiner, L.; Famiglietti, M.; Rana, S.; Yu, P.; Roa, J.; Puga, A.; Haerry, A.

    2016-01-01

    Objective: Understanding the effects of antiretroviral treatment (ART) interruption on neurocognition and quality of life (QoL) are important for managing unplanned interruptions and planned interruptions in HIV cure research. Design: Children previously randomized to continuous (continuous ART, n =

  12. 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.

  13. 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)

  14. Development of a fast optimization preview in radiation treatment planning

    International Nuclear Information System (INIS)

    Hoeffner, J.; Decker, P.; Schmidt, E.L.; Herbig, W.; Rittler, J.; Weiss, P.

    1996-01-01

    Usually, the speed of convergence of some iterative algorithms is restricted to a bounded relaxation parameter. Exploiting the special altering behavior of the weighting factors at each step, many iteration steps are avoided by overrelaxing this relaxation parameter. Therefore, the relaxation parameter is increased as long as the optimization result is improved. This can be performed without loss of accuracy. Our optimization technique is demonstrated by the case of a right lung carcinoma. The solution space for this case is 36 isocentric X-ray beams evenly spaced at 10 . Each beam is restricted to 23 MV X-ray fields with a planning target volume matched by irregular field shapes, similar to that produced by a multileaf collimator. Four organs at risk plus the planning target volume are considered in the optimization process. The convergence behavior of the optimization algorithm is shown by overrelaxing the relaxation parameter in comparison to conventional relaxation parameter control. The new approach offers the ability to get a fast preview of the expected final result. If the clinician is in agreement with the preview, the algorithm is continued and achieves the result proven by the Cimmino optimization algorithm. In the other case, if the clinician doesn't agree with the preview, he will be able to change the optimization parameters (e.g. field entry points) and to restart the algorithm. (orig./MG) [de

  15. Defining bowel dose volume constraints for bladder radiotherapy treatment planning.

    Science.gov (United States)

    McDonald, F; Waters, R; Gulliford, S; Hall, E; James, N; Huddart, R A

    2015-01-01

    Increases to radiotherapy dose are constrained by normal tissue effects. The relationship between bowel dose volume data and late bowel toxicity in patients with muscle-invasive bladder cancer treated with radical radiotherapy was assessed. The bowel was contoured retrospectively on radiotherapy plans of 47 patients recruited to the BC2001 trial (CRUK/01/004). The relationship between bowel volume at various dose levels and prospectively collected late bowel toxicity was explored. Fifteen per cent and 6% of patients experienced grade 1 and grade 2 or more late bowel toxicity, respectively. The mean bowel volume was significantly less at doses ≥50 Gy in those treated with reduced high dose volume radiotherapy compared with standard radiotherapy. The probability of late bowel toxicity increased as bowel volume increased (P ≤ 0.05 for dose levels 30-50 Gy). No grade 2 or more late bowel toxicity was observed in patients with bowel volumes under the thresholds given in the model that predict for 25% probability of late bowel toxicity. There is a dose volume effect for late bowel toxicity in radical bladder radiotherapy. We have modelled the probability of late bowel toxicity from absolute bowel volumes to guide clinicians in assessing radical bladder radiotherapy plans. Thresholds predicting for a 25% probability of late bowel toxicity are proposed as dose volume constraints. Copyright © 2014. Published by Elsevier Ltd.

  16. 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.

  17. Dentists' level of knowledge of the treatment plans for periodontal ligament injuries after dentoalveolar trauma

    OpenAIRE

    Pedrini, Denise [UNESP; Barioni, Sônia Regina Panzarini [UNESP; Poi, Wilson Roberto [UNESP; Marcal Mazza Sundefeld, Maria Lucia [UNESP; Ferreira Tiveron, Adelisa Rodolfo [UNESP

    2011-01-01

    This study investigated the level of knowledge held by dentists about the possible treatment plan procedures for periodontal ligament injuries after dentoalveolar trauma. A 5-item self-applied questionnaire was prepared with questions referring to the professional profile of the interviewees and to the treatment plan they would propose for periodontal ligament injuries secondary to dentoalveolar trauma. The questionnaires were filled out by 693 dentists attending the 23rd Annual Meeting of th...

  18. Five-year experience of the national computerized treatment planning network

    International Nuclear Information System (INIS)

    Varjas, G.; Jozsef, G.; Bozoky, L.; Gyenes, G.

    1984-01-01

    The National Computerized Treatment Planning Network of 7 radiotherapy centres in Hungary connected to a central computer through telephone lines is described. The centralized system has proved to be advantageous because (1) treatment planning and statistical evaluation is done according to the same system in the whole country and (2) there is no need for software or hardware specialists at sub-centres. (U.K.)

  19. Role of Cone Beam Computed Tomography in Diagnosis and Treatment Planning in Dentistry: An Update

    OpenAIRE

    Shukla, Sagrika; Chug, Ashi; Afrashtehfar, Kelvin I.

    2017-01-01

    Accurate diagnosis and treatment planning are the backbone of any medical therapy; for this reason, cone beam computed tomography (CBCT) was introduced and has been widely used. CBCT technology provides a three-dimensional image viewing, enabling exact location and extent of lesions or any anatomical region. For the very same reason, CBCT can not only be used for surgical fields but also for fields such as endodontics, prosthodontics, and orthodontics for appropriate treatment planning and ef...

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

    Science.gov (United States)

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

    2011-12-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  2. Impact of computer-based treatment planning software on clinical judgment of dental students for planning prosthodontic rehabilitation

    Directory of Open Access Journals (Sweden)

    Deshpande S

    2014-08-01

    Full Text Available Saee Deshpande, Jayashree Chahande Department of Prosthodontics, Vidya Shikshan Prasarak Mandal's (VPSM Dental College and Research Centre, Nagpur, Maharashtra, India Purpose: Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students' perceptions about using the program for its intended use. Methods: A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students' perceptions about the program were obtained by a pre-validated feedback questionnaire. Results: The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. Conclusion: CSTP software was well received by the students. There was significant improvement in students' clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students' decision making skills

  3. Impact of computer-based treatment planning software on clinical judgment of dental students for planning prosthodontic rehabilitation.

    Science.gov (United States)

    Deshpande, Saee; Chahande, Jayashree

    2014-01-01

    Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP) software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students' perceptions about using the program for its intended use. A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students' perceptions about the program were obtained by a pre-validated feedback questionnaire. The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. CSTP software was well received by the students. There was significant improvement in students' clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students' decision making skills and confidence.

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

    Science.gov (United States)

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

    2013-11-04

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

  5. Matlab Tools: An Alternative to Planning Systems in Brachytherapy Treatments

    International Nuclear Information System (INIS)

    Herrera, Higmar; Rodriguez, Mercedes; Rodriguez, Miguel

    2006-01-01

    This work proposes the use of the Matlab environment to obtain the treatment dose based on the reported data by Krishnaswamy and Liu et al. The comparison with reported measurements is showed for the Amersham source model. For the 3M source model, measurements with TLDs and a Monte Carlo simulation are compared to the data obtained by Matlab. The difference for the Amersham model is well under the 15% recommended by the IAEA and for the 3M model, although the difference is greater, the results are consistent. The good agreement to the reported data allows the Matlab calculations to be used in daily brachytherapy treatments

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  7. A dose-volume-based tool for evaluating and ranking IMRT treatment plans.

    Science.gov (United States)

    Miften, Moyed M; Das, Shiva K; Su, Min; Marks, Lawrence B

    2004-01-01

    External beam radiotherapy is commonly used for patients with cancer. While tumor shrinkage and palliation are frequently achieved, local control and cure remain elusive for many cancers. With regard to local control, the fundamental problem is that radiotherapy-induced normal tissue injury limits the dose that can be delivered to the tumor. While intensity-modulated radiation therapy (IMRT) allows for the delivery of higher tumor doses and the sparing of proximal critical structures, multiple competing plans can be generated based on dosimetric and/or biological constraints that need to be considered/compared. In this work, an IMRT treatment plan evaluation and ranking tool, based on dosimetric criteria, is presented. The treatment plan with the highest uncomplicated target conformity index (TCI+) is ranked at the top. The TCI+ is a dose-volume-based index that considers both a target conformity index (TCI) and a normal tissue-sparing index (NTSI). TCI+ is designed to assist in the process of judging the merit of a clinical treatment plan. To demonstrate the utility of this tool, several competing lung and prostate IMRT treatment plans are compared. Results show that the plan with the highest TCI+ values accomplished the competing goals of tumor coverage and critical structures sparing best, among rival treatment plans for both treatment sites. The study demonstrates, first, that dose-volume-based indices, which summarize complex dose distributions through a single index, can be used to automatically select the optimal plan among competing plans, and second, that this dose-volume-based index may be appropriate for ranking IMRT dose distributions.

  8. A dose‐volume‐based tool for evaluating and ranking IMRT treatment plans

    Science.gov (United States)

    Miften, Moyed M.; Das, Shiva K.; Su, Min; Marks, Lawrence B.

    2004-01-01

    External beam radiotherapy is commonly used for patients with cancer. While tumor shrinkage and palliation are frequently achieved, local control and cure remain elusive for many cancers. With regard to local control, the fundamental problem is that radiotherapy‐induced normal tissue injury limits the dose that can be delivered to the tumor. While intensity‐modulated radiation therapy (IMRT) allows for the delivery of higher tumor doses and the sparing of proximal critical structures, multiple competing plans can be generated based on dosimetric and/or biological constraints that need to be considered/compared. In this work, an IMRT treatment plan evaluation and ranking tool, based on dosimetric criteria, is presented. The treatment plan with the highest uncomplicated target conformity index (TCI+) is ranked at the top. The TCI+ is a dose‐volume‐based index that considers both a target conformity index (TCI) and a normal tissue‐sparing index (NTSI). TCI+ is designed to assist in the process of judging the merit of a clinical treatment plan. To demonstrate the utility of this tool, several competing lung and prostate IMRT treatment plans are compared. Results show that the plan with the highest TCI+ values accomplished the competing goals of tumor coverage and critical structures sparing best, among rival treatment plans for both treatment sites. The study demonstrates, first, that dose‐volume‐based indices, which summarize complex dose distributions through a single index, can be used to automatically select the optimal plan among competing plans, and second, that this dose‐volume‐based index may be appropriate for ranking IMRT dose distributions. PACS numbers: 87.53.‐j, 87.53.Tf PMID:15738916

  9. 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

  10. 3D Computer aided treatment planning in endodontics

    NARCIS (Netherlands)

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

    Objectives: Obliteration of the root canal system due to accelerated dentinogenesis and dystrophic calcification can challenge the achievement of root canal treatment goals. This paper describes the application of 3D digital mapping technology for predictable navigation of obliterated canal systems

  11. Field Sampling Plan for Closure of the Central Facilities Area Sewage Treatment Plant Lagoon 3 and Land Application Area

    International Nuclear Information System (INIS)

    Lewis, Michael George

    2016-01-01

    This field sampling plan describes sampling of the soil/liner of Lagoon 3 at the Central Facilities Area Sewage Treatment Plant. The lagoon is to be closed, and samples obtained from the soil/liner will provide information to determine if Lagoon 3 and the land application area can be closed in a manner that renders it safe to human health and the environment. Samples collected under this field sampling plan will be compared to Idaho National Laboratory background soil concentrations. If the concentrations of constituents of concern exceed the background level, they will be compared to Comprehensive Environmental Response, Compensation, and Liability Act preliminary remediation goals and Resource Conservation and Recovery Act levels. If the concentrations of constituents of concern are lower than the background levels, Resource Conservation and Recovery Act levels, or the preliminary remediation goals, then Lagoon 3 and the land application area will be closed. If the Resource Conservation and Recovery Act levels and/or the Comprehensive Environmental Response, Compensation, and Liability Act preliminary remediation goals are exceeded, additional sampling and action may be required.

  12. Field Sampling Plan for Closure of the Central Facilities Area Sewage Treatment Plant Lagoon 3 and Land Application Area

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Michael George [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-10-01

    This field sampling plan describes sampling of the soil/liner of Lagoon 3 at the Central Facilities Area Sewage Treatment Plant. The lagoon is to be closed, and samples obtained from the soil/liner will provide information to determine if Lagoon 3 and the land application area can be closed in a manner that renders it safe to human health and the environment. Samples collected under this field sampling plan will be compared to Idaho National Laboratory background soil concentrations. If the concentrations of constituents of concern exceed the background level, they will be compared to Comprehensive Environmental Response, Compensation, and Liability Act preliminary remediation goals and Resource Conservation and Recovery Act levels. If the concentrations of constituents of concern are lower than the background levels, Resource Conservation and Recovery Act levels, or the preliminary remediation goals, then Lagoon 3 and the land application area will be closed. If the Resource Conservation and Recovery Act levels and/or the Comprehensive Environmental Response, Compensation, and Liability Act preliminary remediation goals are exceeded, additional sampling and action may be required.

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

    Science.gov (United States)

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

    2017-12-28

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

  14. Human applications of the INEL patient treatment planning system

    International Nuclear Information System (INIS)

    Wheeler, F.; Wessol, D.; Atkinson, C.; Nigg, D.

    1995-01-01

    During the past few years, murine and large animal research, as well as human studies have provided data to the point where human clinical trials have been initiated at the BMRR using BPA-F for gliomas and at the Massachusetts Institute of Technology Reactor (MITR) using BPA for melanomas of the extremeties. It is expected that glioma trials using BSH will proceed soon at the Petten High Flux Reactor (HFR) in the Netherlands. The first human glioma epithermal boron neutron capture therapy application was performed at the BMRR in the fall of 1994. This was a collaborative effort by BNL, Beth Israel Manhattan hospital, and INEL. The INEL planning system was chosen to perform dose predictions for this application

  15. Hanford Site background: Part 1, Soil background for nonradioactive analytes

    International Nuclear Information System (INIS)

    1993-04-01

    Volume two contains the following appendices: Description of soil sampling sites; sampling narrative; raw data soil background; background data analysis; sitewide background soil sampling plan; and use of soil background data for the detection of contamination at waste management unit on the Hanford Site

  16. The Impact of Colleague Peer Review on the Radiotherapy Treatment Planning Process in the Radical Treatment of Lung Cancer.

    Science.gov (United States)

    Rooney, K P; McAleese, J; Crockett, C; Harney, J; Eakin, R L; Young, V A L; Dunn, M A; Johnston, R E; Hanna, G G

    2015-09-01

    Modern radiotherapy uses techniques to reliably identify tumour and reduce target volume margins. However, this can potentially lead to an increased risk of geographic miss. One source of error is the accuracy of target volume delineation (TVD). Colleague peer review (CPR) of all curative-intent lung cancer plans has been mandatory in our institution since May 2013. At least two clinical oncologists review plans, checking treatment paradigm, TVD, prescription dose tumour and critical organ tolerances. We report the impact of CPR in our institution. Radiotherapy treatment plans of all patients receiving radical radiotherapy were presented at weekly CPR meetings after their target volumes were reviewed and signed off by the treating consultant. All cases and any resultant change to TVD (including organs at risk) or treatment intent were recorded in our prospective CPR database. The impact of CPR over a 13 month period from May 2013 to June 2014 is reported. One hundred and twenty-two patients (63% non-small cell lung carcinoma, 17% small cell lung carcinoma and 20% 'clinical diagnosis') were analysed. On average, 3.2 cases were discussed per meeting (range 1-8). CPR resulted in a change in treatment paradigm in 3% (one patient proceeded to induction chemotherapy, two patients had high-dose palliative radiotherapy). Twenty-one (17%) had a change in TVD and one (1%) patient had a change in dose prescription. In total, 6% of patients had plan adjustment after review of dose volume histogram. The introduction of CPR in our centre has resulted in a change in a component of the treatment plan for 27% of patients receiving curative-intent lung radiotherapy. We recommend CPR as a mandatory quality assurance step in the planning process of all radical lung plans. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. SU-E-T-151: Breathing Synchronized Delivery (BSD) Planning for RapicArc Treatment

    International Nuclear Information System (INIS)

    Lu, W; Chen, M; Jiang, S

    2015-01-01

    Purpose: To propose a workflow for breathing synchronized delivery (BSD) planning for RapicArc treatment. Methods: The workflow includes three stages: screening/simulation, planning, and delivery. In the screening/simulation stage, a 4D CT with the corresponding breathing pattern is acquired for each of the selected patients, who are able to follow their own breathing pattern. In the planning stage, one breathing phase is chosen as the reference, and contours are delineated on the reference image. Deformation maps to other phases are performed along with contour propagation. Based on the control points of the initial 3D plan for the reference phase and the respiration trace, the correlation with respiration phases, the leaf sequence and gantry angles is determined. The beamlet matrices are calculated with the corresponding breathing phase and deformed to the reference phase. Using the 4D dose evaluation tool and the original 3D plan DVHs criteria, the leaf sequence is further optimized to meet the planning objectives and the machine constraints. In the delivery stage, the patients are instructed to follow the programmed breathing patterns of their own, and all other parts are the same as the conventional Rapid-Arc delivery. Results: Our plan analysis is based on comparison of the 3D plan with a static target (SD), 3D plan with motion delivery (MD), and the BSD plan. Cyclic motion of range 0 cm to 3 cm was simulated for phantoms and lung CT. The gain of the BSD plan over MD is significant and concordant for both simulation and lung 4DCT, indicating the benefits of 4D planning. Conclusion: Our study shows that the BSD plan can approach the SD plan quality. However, such BSD scheme relies on the patient being able to follow the same breathing curve that is used in the planning stage during radiation delivery. Funded by Varian Medical Systems

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  20. Treatment planning and dental rehabilitation of periodontally compromised partially edentulous patient: a case report - part II.

    Science.gov (United States)

    Brezavšcek, Miha; Lamott, Ulrich; Att, Wael

    2014-01-01

    When planning a prosthetic rehabilitation of a periodontally compromised case, the clinician is often confronted with difficulties and dilemmas related to selecting the appropriate treatment that would provide long-term successful outcomes in function and esthetics. In such cases, a correct diagnosis and prognosis of the intraoral situation supported by evidence-based dentistry is the basis for the establishment of a proper treatment strategy. In this second part of a two-part treatment planning series, a systematic approach of patient examination and prognosis of each tooth is presented. Furthermore, different removable and fixed treatment possibilities are described and the rationale governing the decision-making process is revealed. The execution of the final treatment plan as specified by the concept of comprehensive dental care is outlined, and the final outcome is discussed according to the literature.

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

    Science.gov (United States)

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

    2018-02-18

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

  2. Background Material

    DEFF Research Database (Denmark)

    Zandersen, Marianne; Hyytiäinen, Kari; Saraiva, Sofia

    This document serves as a background material to the BONUS Pilot Scenario Workshop, which aims to develop harmonised regional storylines of socio-ecological futures in the Baltic Sea region in a collaborative effort together with other BONUS projects and stakeholders.......This document serves as a background material to the BONUS Pilot Scenario Workshop, which aims to develop harmonised regional storylines of socio-ecological futures in the Baltic Sea region in a collaborative effort together with other BONUS projects and stakeholders....

  3. Evaluation of isocenter reproducibility in telemedicine of 3D-radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Hirota, Saeko; Tsujino, Kayoko; Kimura, Kouji; Takada, Yoshiki; Hishikawa, Yoshio; Kono, Michio; Soejima, Toshinori; Kodama, Akihisa

    2000-01-01

    To evaluate the utility in telemedicine of Three-Dimensional Radiotherapy Treatment Planning (tele-3D-RTP) and to examine the accuracy of isocenter reproducibility in its offline trial. CT data of phantoms and patients in the satellite hospital were transferred to our hospital via floppy-disk and 3D-radiotherapy plans were generated by 3D-RTP computer in our hospital. Profile data of CT and treatment beams in the satellite hospital were pre-installed into the computer. Tele-3D-RTPs were performed in 3 phantom plans and 14 clinical plans for 13 patients. Planned isocenters were well reproduced, especially in the immobilized head and neck/brain tumor cases, whose 3D-vector of aberration was 1.96±1.38 (SD) mm. This teletherapy system is well applicable for practical use and can provides cost-reduction through sharing the resources of expensive equipment and radiation oncologists. (author)

  4. Predicting the likelihood of QA failure using treatment plan accuracy metrics

    Science.gov (United States)

    Kairn, T.; Crowe, S. B.; Kenny, J.; Knight, R. T.; Trapp, J. V.

    2014-03-01

    This study used automated data processing techniques to calculate a set of novel treatment plan accuracy metrics, and investigate their usefulness as predictors of quality assurance (QA) success and failure. A small sample of 151 beams from 23 prostate and cranial IMRT treatment plans were used in this study. These plans had been evaluated before treatment using measurements with a diode array system. The TADA software suite was adapted to allow automatic batch calculation of several proposed plan accuracy metrics, including mean field area, small-aperture, off-axis and closed-leaf factors. All of these results were compared to the gamma pass rates from the QA measurements and correlations were investigated. The mean field area factor provided a threshold field size (5 cm2, equivalent to a 2.2 × 2.2 cm2 square field), below which all beams failed the QA tests. The small aperture score provided a useful predictor of plan failure, when averaged over all beams, despite being weakly correlated with gamma pass rates for individual beams. By contrast, the closed leaf and off-axis factors provided information about the geometric arrangement of the beam segments but were not useful for distinguishing between plans that passed and failed QA. This study has provided some simple tests for plan accuracy, which may help minimise time spent on QA assessments of treatments that are unlikely to pass.

  5. 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

  6. MRI-only treatment planning: benefits and challenges

    Science.gov (United States)

    Owrangi, Amir M.; Greer, Peter B.; Glide-Hurst, Carri K.

    2018-03-01

    Over the past decade, the application of magnetic resonance imaging (MRI) has increased, and there is growing evidence to suggest that improvements in the accuracy of target delineation in MRI-guided radiation therapy may improve clinical outcomes in a variety of cancer types. However, some considerations should be recognized including patient motion during image acquisition and geometric accuracy of images. Moreover, MR-compatible immobilization devices need to be used when acquiring images in the treatment position while minimizing patient motion during the scan time. Finally, synthetic CT images (i.e. electron density maps) and digitally reconstructed radiograph images should be generated from MRI images for dose calculation and image guidance prior to treatment. A short review of the concepts and techniques that have been developed for implementation of MRI-only workflows in radiation therapy is provided in this document.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-29

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

  8. A clinical distance measure for evaluating treatment plan quality difference with Pareto fronts in radiotherapy

    Directory of Open Access Journals (Sweden)

    Kristoffer Petersson

    2017-07-01

    Full Text Available We present a clinical distance measure for Pareto front evaluation studies in radiotherapy, which we show strongly correlates (r = 0.74 and 0.90 with clinical plan quality evaluation. For five prostate cases, sub-optimal treatment plans located at a clinical distance value of >0.32 (0.28–0.35 from fronts of Pareto optimal plans, were assessed to be of lower plan quality by our (12 observers (p < .05. In conclusion, the clinical distance measure can be used to determine if the difference between a front and a given plan (or between different fronts corresponds to a clinically significant plan quality difference.

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

    Science.gov (United States)

    Valve, Assi; Keyriläinen, Jani; Kulmala, Jarmo

    2017-12-01

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

    To develop a fully automated procedure for multicriterial volumetric modulated arc therapy (VMAT) treatment planning (autoVMAT) for stage III/IV non-small cell lung cancer (NSCLC) patients treated with curative intent. After configuring the developed autoVMAT system for NSCLC, autoVMAT plans were compared with manually generated clinically delivered intensity-modulated radiotherapy (IMRT) plans for 41 patients. AutoVMAT plans were also compared to manually generated VMAT plans in the absence of time pressure. For 16 patients with reduced planning target volume (PTV) dose prescription in the clinical IMRT plan (to avoid violation of organs at risk tolerances), the potential for dose escalation with autoVMAT was explored. Two physicians evaluated 35/41 autoVMAT plans (85%) as clinically acceptable. Compared to the manually generated IMRT plans, autoVMAT plans showed statistically significant improved PTV coverage (V 95% increased by 1.1% ± 1.1%), higher dose conformity (R 50 reduced by 12.2% ± 12.7%), and reduced mean lung, heart, and esophagus doses (reductions of 0.9 Gy ± 1.0 Gy, 1.5 Gy ± 1.8 Gy, 3.6 Gy ± 2.8 Gy, respectively, all p < 0.001). To render the six remaining autoVMAT plans clinically acceptable, a dosimetrist needed less than 10 min hands-on time for fine-tuning. AutoVMAT plans were also considered equivalent or better than manually optimized VMAT plans. For 6/16 patients, autoVMAT allowed tumor dose escalation of 5-10 Gy. Clinically deliverable, high-quality autoVMAT plans can be generated fully automatically for the vast majority of advanced-stage NSCLC patients. For a subset of patients, autoVMAT allowed for tumor dose escalation. (orig.) [de

  11. Fuels planning: science synthesis and integration; economic uses fact sheet 04: My Fuel Treatment Planner

    Science.gov (United States)

    Rocky Mountain Research Station USDA Forest Service

    2004-01-01

    In the face of rapidly changing public and political attitudes toward fire and fuel planning, one thing remains constant: the fuel planner is ultimately responsible for making decisions on the land. This fact sheet discusses the options for fuel treatments, and the need, development, and use of the MS Excel-based tool, My Fuel Treatment Planner.

  12. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

    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

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

    International Nuclear Information System (INIS)

    Ayyangar, Komanduri M.; Jiang, Steve B.

    1998-01-01

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

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

    Science.gov (United States)

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

    2014-12-07

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

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

    Science.gov (United States)

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

    2014-12-01

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

  17. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Hardev; De La Fuente Herman, Tania; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin [Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104 (United States)

    2012-10-23

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem and ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

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

    CERN Document Server

    Meyer, JL

    2011-01-01

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

  19. Consequences of insufficient treatment planning for flapless implant surgery for a mandibular overdenture: a clinical report.

    Science.gov (United States)

    Bidra, Avinash S

    2011-05-01

    Flapless implant surgery is an emerging modality of treatment in implant dentistry that is known to offer several advantages. However, this procedure is inadvisable for situations where there is an absence of labial/buccal bone, reduced width of alveolar ridge, or a need for alveoloplasty to create prosthetic space. This clinical report describes the biologic and prosthodontic consequences of placing implants through flapless surgery and without preoperative treatment planning. Importance of proper treatment planning and a detailed discussion of prosthetic/restorative space analysis are discussed. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  20. Role of Cone Beam Computed Tomography in Diagnosis and Treatment Planning in Dentistry: An Update.

    Science.gov (United States)

    Shukla, Sagrika; Chug, Ashi; Afrashtehfar, Kelvin I

    2017-11-01

    Accurate diagnosis and treatment planning are the backbone of any medical therapy; for this reason, cone beam computed tomography (CBCT) was introduced and has been widely used. CBCT technology provides a three-dimensional image viewing, enabling exact location and extent of lesions or any anatomical region. For the very same reason, CBCT can not only be used for surgical fields but also for fields such as endodontics, prosthodontics, and orthodontics for appropriate treatment planning and effective dental care. The aim and clinical significance of this review are to update dental clinicians on the CBCT applications in each dental specialty for an appropriate diagnosis and more predictable treatment.

  1. Positron emission tomography in pediatric radiation oncology: integration in the treatment-planning process

    International Nuclear Information System (INIS)

    Krasin, M.J.; Hudson, M.M.; Kaste, S.C.

    2004-01-01

    The application of PET imaging to pediatric radiation oncology allows new approaches to targeting and selection of radiation dose based not only on the size of a tumor, but also on its metabolic activity. In order to integrate PET into treatment planning for radiation oncology, logistical issues regarding patient setup, image fusion, and target selection must be addressed. Through prospective study, the role of PET in pediatric malignancies will be established for diagnosis, treatment, and surveillance. To explore the potential role of PET and its incorporation into treatment planning in pediatric radiation oncology, an example case of pediatric Hodgkin's disease is discussed. (orig.)

  2. Delineation of organs at risk involved in swallowing for radiotherapy treatment planning

    NARCIS (Netherlands)

    Christianen, Miranda E. M. C.; Langendijk, Johannes A.; Westerlaan, Henriette E.; van de Water, Tara A.; Bijl, Hendrik P.

    2011-01-01

    Background and purpose: Radiotherapy, alone or combined with chemotherapy, is a treatment modality used frequently in head and neck cancer. In order to report, compare and interpret the sequelae of radiation treatment adequately, it is important to delineate organs at risk (OARs) according to

  3. Water: from the source to the treatment plan

    Science.gov (United States)

    Baude, I.; Marquet, V.

    2012-04-01

    Isabelle BAUDE isa.baude@free.fr Lycee français de Vienne Liechtensteinstrasse 37AVienna As a physics and chemistry teacher, I have worked on water from the source to the treatment plant with 27 pupils between 14 and 15 years old enrolled in the option "Science and laboratory". The objectives of this option are to interest students in science, to introduce them to practical methods of laboratory analyses, and let them use computer technology. Teaching takes place every two weeks and lasts 1.5 hours. The theme of water is a common project with the biology and geology teacher, Mrs. Virginie Marquet. Lesson 1: Introduction: The water in Vienna The pupils have to consider why the water is so important in Vienna (history, economy etc.) and where tap water comes from. Activities: Brainstorming about where and why we use water every day and why the water is different in Vienna. Lesson 2: Objectives of the session: What are the differences between mineral waters? Activities: Compare water from different origins (France: Evian, Vittel, Contrex. Austria: Vöslauer, Juvina, Gasteiner and tap water from Vienna) by tasting and finding the main ions they contain. Testing ions: Calcium, magnesium, sulphate, chloride, sodium, and potassium Lesson 3: Objectives of the session: Build a hydrometer Activities: Producing a range of calibration solutions, build and calibrate the hydrometer with different salt-water solutions. Measure the density of the Dead Sea's water and other mineral waters. Lesson 4: Objectives of the session: How does a fountain work? Activities: Construction of a fountain as Heron of Alexandria with simple equipment and try to understand the hydrostatic principles. Lesson 5: Objectives of the session: Study of the physical processes of water treatment (decantation, filtration, screening) Activities: Build a natural filter with sand, stone, carbon, and cotton wool. Retrieve the filtered water to test it during lesson 7. Lesson 6: Visit of the biggest treatment

  4. Independent calculation of dose distributions for helical tomotherapy using a conventional treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Klüter, Sebastian, E-mail: sebastian.klueter@med.uni-heidelberg.de; Schubert, Kai; Lissner, Steffen; Sterzing, Florian; Oetzel, Dieter; Debus, Jürgen [Department of Radiation Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany, and Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany, and German Consortium for Translational Cancer Research (DKTK), Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Schlegel, Wolfgang [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Oelfke, Uwe [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany and Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG (United Kingdom); Nill, Simeon [Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London SM2 5NG (United Kingdom)

    2014-08-15

    Purpose: The dosimetric verification of treatment plans in helical tomotherapy usually is carried out via verification measurements. In this study, a method for independent dose calculation of tomotherapy treatment plans is presented, that uses a conventional treatment planning system with a pencil kernel dose calculation algorithm for generation of verification dose distributions based on patient CT data. Methods: A pencil beam algorithm that directly uses measured beam data was configured for dose calculation for a tomotherapy machine. Tomotherapy treatment plans were converted into a format readable by an in-house treatment planning system by assigning each projection to one static treatment field and shifting the calculation isocenter for each field in order to account for the couch movement. The modulation of the fluence for each projection is read out of the delivery sinogram, and with the kernel-based dose calculation, this information can directly be used for dose calculation without the need for decomposition of the sinogram. The sinogram values are only corrected for leaf output and leaf latency. Using the converted treatment plans, dose was recalculated with the independent treatment planning system. Multiple treatment plans ranging from simple static fields to real patient treatment plans were calculated using the new approach and either compared to actual measurements or the 3D dose distribution calculated by the tomotherapy treatment planning system. In addition, dose–volume histograms were calculated for the patient plans. Results: Except for minor deviations at the maximum field size, the pencil beam dose calculation for static beams agreed with measurements in a water tank within 2%/2 mm. A mean deviation to point dose measurements in the cheese phantom of 0.89% ± 0.81% was found for unmodulated helical plans. A mean voxel-based deviation of −0.67% ± 1.11% for all voxels in the respective high dose region (dose values >80%), and a mean local

  5. 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

  6. SU-F-T-99: Data Visualization From a Treatment Planning Tracking System for Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

    Purpose: A treatment planning process tracker database with input forms and a TV-viewable display webpage was developed and implemented in our clinic to collect time data points throughout the process. Tracking plan times is important because it directly affects the patient quality of care. Simply, the longer a patient waits after their initial simulation CT for treatment to begin, the more time the cancer has to progress. The tracker helps to drive workflow through the clinic, while the data collected can be used to understand and manage the process to find and eliminate inefficiencies. Methods: The overall process steps tracked are CT-simulation, mark patient, draw normal contours, draw target volumes, create plan, and review/approve plan. Time stamps for task completion were extracted and used to generate a set of clinic metrics, among which include average time for each step in the process split apart by type of treatment, average time to completion for plans started in a given week, and individual overall completion time per plan. Results: Trends have been tracked for fourteen weeks of clinical data (196 plans). On average, drawing normal contours and target volumes is taking 2–5 times as long as creating the plan itself. This is potentially an issue because it could mean the process is taking too long initially, and it could be forcing the planning step to be done in a short amount of time. We also saw from our graphs that there appears to be no clear trend on the average amount of time per plan week-to-week. Conclusion: A tracker of this type has the potential to provide insight into how time is utilized in our clinic. By equipping our dosimetrists, radiation oncologists, and physicists with individualized metric sets, the tracker can help provide visibility and drive workflow. Funded in part by CPRIT (RP140105).

  7. 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

  8. Application of super-omni wedge concept to conformal radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Dai Jianrong; Fu Weihua; Hu Yimin

    2004-01-01

    Objective: To describe a method which can optimize beam weight, wedge angle, and wedge orientation simultaneously by combining the super-omni wedge (SOW) concept with the function of beam weight optimization provided by a commercial treatment planning system. Methods: A five-step procedure including: Step 1. To set up four 60 degree nominal wedged beams for each beam direction with the wedge orientations of 'LEFT', 'IN', 'RIGHT', 'OUT', respectively; Step 2. To define an optimization request, including an optimization goal and constraints. Authors use CMS Focus treatment planning system which allows us to choose 'maximize target dose' or 'minimize critical structure dose' as the optimization goal, and to set minimum target dose, maximum target dose, and maximum average dose of critical structures as constraints. Then the optimization process was launched as step 3; Step 4. To evaluate the plan using isodose distributions and dose-volume histograms. If acceptable, go to Step 5. Otherwise, go back to Step 2 to modify optimization constraints; and Step 5. Transform the SOW beams into the beams of omni wedge so as to reduce the number of to-be-delivered beams. Results: This procedure was found being able to demonstrate successfully in two clinical cases: an esophageal carcinoma and a brain tumor. Compared with manually designed plan, the optimized plan showed better dose homogeneity in the targets and better sparing of the critical structures. Conclusions: This method described is able to optimize beam weights while working with a treatment planning system. Not only does it improve treatment plans' quality, but also shorten the treatment planning process

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

    International Nuclear Information System (INIS)

    2015-01-01

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

  10. Background radiation

    International Nuclear Information System (INIS)

    Arnott, D.

    1985-01-01

    The effects of background radiation, whether natural or caused by man's activities, are discussed. The known biological effects of radiation in causing cancers or genetic mutations are explained. The statement that there is a threshold below which there is no risk is examined critically. (U.K.)

  11. Poster - 33: Dosimetry Comparison of Prone Breast Forward and Inverse Treatment planning considering daily setup variations

    International Nuclear Information System (INIS)

    Jiang, Runqing; Zhan, Lixin; Osei, Ernest

    2016-01-01

    Introduction: The purpose of this study is to investigate the effects of daily setup variations on prone breast forward field-in-field (FinF) and inverse IMRT treatment planning. Methods: Rando Phantom (Left breast) and Pixy phantom (Right breast) were built and CT scanned in prone position. The treatment planning (TP) is performed in Eclipse TP system. Forward FinF plan and inverse IMRT plan were created to satisfy the CTV coverage and OARs criteria. The daily setup variations were assumed to be 5 mm at left-right, superior-inferior, and anterior-posterior directions. The DVHs of CTV coverage and OARs were compared for both forward FinF plan and inverse IMRT plans due to 5mm setup variation. Results and Discussions: DVHs of CTV coverage had fewer variations for 5m setup variation for forward FinF and inverse IMRT plan for both phantoms. However, for the setup variations in the left-right direction, the DVH of CTV coverage of IMRT plan showed the worst variation due to lateral setup variation for both phantoms. For anterior-posterior variation, the CTV could not get full coverage when the breast chest wall is shallow; however, with the guidance of MV imaging, breast chest wall will be checked during the MV imaging setup. So the setup variations have more effects on inverse IMRT plan, compared to forward FinF plan, especially in the left-right direction. Conclusions: The Forward FinF plan was recommended clinically considering daily setup variation.

  12. Water: from the source to the treatment plan

    Science.gov (United States)

    Marquet, V.; Baude, I.

    2012-04-01

    As a biology and geology teacher, I have worked on water, from the source to the treatment plant, with pupils between 14 and 15 years old. Lesson 1. Introduction, the water in Vienna Aim: The pupils have to consider why the water is so important in Vienna (history, economy etc.) Activities: Brainstorming about