Science.gov

Sample records for 5-mm planning target

  1. Is smaller better? Comparison of 3-mm and 5-mm leaf size for stereotactic radiosurgery: A dosimetric study

    SciTech Connect

    Chern, Shyh-shi . E-mail: Richard.Chern@hci.utah.edu; Leavitt, Dennis D.; Jensen, Randy L.; Shrieve, Dennis C.

    2006-11-15

    Purpose: To perform a dosimetric comparison of a minimal 3-mm leaf width multileaf collimator (MLC) and a minimal 5-mm MLC in dynamic conformal arc stereotactic radiosurgery for treatment of intracranial lesions. Methods and Materials: The treatment plans of 23 patients previously treated for intracranial lesions in our institution were redone using the BrainSCAN, version 5.3, stereotactic radiosurgery treatment planning system (BrainLAB). For each case, two dynamic conformal arc plans were generated: one using a minimal 3-mm micro-MLC (BrainLAB, Novalis) and one using a minimal 5-mm MLC (Varian Millennium). All arc parameters were the same in each of the two plans, except for the collimator angle settings. The collimator angle settings were optimized for each arc in each plan. A peritumoral rind structure (1 cm) was created to evaluate normal tissue sparing immediately adjacent to the target volume. Conformity indexes (CIs) were calculated for each plan. The dependence of normal tissue sparing and target conformity on target volume (TV) was determined. Results: The TV was 0.14-36.32 cm{sup 3} (median, 5.90). The CI was 1.22-2.60 (median, 1.51) for the 3-mm micro-MLC and 1.23-2.69 (median, 1.60) for the 5-mm MLC. Despite this small difference, it was a statistically significant increase (p < 0.0001) for the 5-mm MLC compared with the 3-mm micro-MLC. Improved normal tissue sparing was demonstrated using the 3-mm micro-MLC compared with the 5-mm MLC by examining the peritumoral rind volumes (PRVs) receiving 50% (PRV{sub 5}), 80% (PRV{sub 8}), and 90% (PRV{sub 9}) of the prescription dose. The reduction in the PRV{sub 5}, PRV{sub 8}, and PRV{sub 9} for the 3-mm micro-MLC compared with the 5-mm MLC was 13.5%, 12.9%, and 11.5%, respectively. The CI decreased with a larger TV, as did the difference in the CIs between the 3-mm micro-MLC and 5-mm MLC. A reduction in the PRV increased with larger TVs. Conclusion: The 3-mm micro-MLC provided better target conformity and

  2. Planning Targets for Phase II Watershed Implementation Plans

    EPA Pesticide Factsheets

    On August 1, 2011, EPA provided planning targets for nitrogen, phosphorus and sediment for the Phase II Watershed Implementation Plans (WIPs) of the Chesapeake Bay TMDL. This page provides the letters containing those planning targets.

  3. [Clinical to planning target volume margins in prostate cancer radiotherapy].

    PubMed

    Ramiandrisoa, F; Duvergé, L; Castelli, J; Nguyen, T D; Servagi-Vernat, S; de Crevoisier, R

    2016-10-01

    The knowledge of inter- and intrafraction motion and deformations of the intrapelvic target volumes (prostate, seminal vesicles, prostatectomy bed and lymph nodes) as well as the main organs at risk (bladder and rectum) allow to define rational clinical to planning target volume margins, depending on the different radiotherapy techniques and their uncertainties. In case of image-guided radiotherapy, prostate margins and seminal vesicles margins can be between 5 and 10mm. The margins around the prostatectomy bed vary from 10 to 15mm and those around the lymph node clinical target volume between 7 and 10mm. Stereotactic body radiotherapy allows lower margins, which are 3 to 5mm around the prostate. Image-guided and stereotactic body radiotherapy with adequate margins allow finally moderate or extreme hypofractionation.

  4. 40 CFR 35.9020 - Planning targets.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Planning targets. 35.9020 Section 35... STATE AND LOCAL ASSISTANCE Financial Assistance for the National Estuary Program § 35.9020 Planning targets. The EPA Assistant Administrator for Water develops planning targets each year to help...

  5. NOTE: Elongated beamlets: a simple technique for segment and MU reduction for sMLC IMRT delivery on accelerators utilizing 5 mm leaf widths

    NASA Astrophysics Data System (ADS)

    Price, R. A., Jr.; Paskalev, K.; McNeeley, S.; Ma, C.-M.

    2005-10-01

    The focus of this work is to demonstrate the effects of using an elongated beamlet to achieve similar dose conformity as achieved with a square beamlet while reducing the number of segments and subsequent MU required. A series of 10 patients were planned for IMRT delivery to the prostate using minimum beamlet sizes of 5 × 5 mm2 (default scheme), 10 × 5 mm2 with the short axis parallel to the prostate rectum interface (scheme 1), and 10 × 5 mm2 with the short axis perpendicular to the prostate rectum interface (scheme 2). All other parameters between plans were left unchanged. Plans were appropriately normalized and evaluated for R65, R40, conformity index, total number of segments and MU. All plans were generated using the Corvus inverse planning system. The average number of segments in this study decreased by approximately 49% for both schemes 1 and 2. The subsequent number of MU required decreased by approximately 34.6%. The resultant modified modulation scaling factor (MSFmod) decreased by approximately 34.3%. Additionally, we found that each isodose distribution using scheme 2 would still meet our clinical acceptance criteria with no visible degradation in the dose distribution as compared with the default scheme. In conclusion, we have demonstrated that it is possible to achieve similar results as those obtained using a 5 × 5 mm2 beamlet with respect to target coverage and critical structure sparing by using strategically oriented elongated beamlets. This technique directly translates to a decreased MSFmod allowing for decreased leakage dose to the patient, a decreased risk of exceeding secondary shielding limits in pre-existing vaults, and shorter treatment times.

  6. Project Plan Remote Target Fabrication Refurbishment Project

    SciTech Connect

    Bell, Gary L; Taylor, Robin D

    2009-08-01

    In early FY2009, the DOE Office of Science - Nuclear Physics Program reinstated a program for continued production of {sup 252}Cf and other transcurium isotopes at the Radiochemical Engineering Development Center (REDC) at Oak Ridge National Laboratory (ORNL). The FY2009 major elements of the workscope are as follows: (1) Recovery and processing of seven transuranium element targets undergoing irradiation at the High Flux Isotope Reactor (HFIR) at ORNL; (2) Development of a plan to manufacture new targets for irradiation beginning in early- to mid-FY10 to supply irradiated targets for processing Campaign 75 (TRU75); and (3) Refurbishment of the target manufacturing equipment to allow new target manufacture in early FY10 The {sup 252}Cf product from processing Campaign 74 (recently processed and currently shipping to customers) is expected to supply the domestic demands for a period of approximately two years. Therefore it is essential that new targets be introduced for irradiation by the second quarter of FY10 (HFIR cycle 427) to maintain supply of {sup 252}Cf; the average irradiation period is {approx}10 HFIR cycles, requiring about 1.5 calendar years. The strategy for continued production of {sup 252}Cf depends upon repairing and refurbishing the existing pellet and target fabrication equipment for one additional target production campaign. This equipment dates from the mid-1960s to the late 1980s, and during the last target fabrication campaign in 2005- 2006, a number of component failures and operations difficulties were encountered. It is expected that following the target fabrication and acceptance testing of the targets that will supply material for processing Campaign 75 a comprehensive upgrade and replacement of the remote hot-cell equipment will be required prior to subsequent campaigns. Such a major refit could start in early FY 2011 and would take about 2 years to complete. Scope and cost estimates for the repairs described herein were developed, and

  7. Video-Assisted Thoracoscopic Surgery for Correction of Adolescent Idiopatic Scoliosis: Comparison of 4.5 mm versus 5.5 mm Rod Constructs

    PubMed Central

    Kim, Hak Sun; Park, Jin Oh; Nanda, Ankur; Kho, Phillip Anthony; Kim, Jin Young; Lee, Hwan Mo; Moon, Seong Hwan; Ha, Jung Won; Ahn, Eun Kyoung; Shin, Dong Eun; Kim, Sung Jun

    2010-01-01

    Purpose The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS). Materials and Methods Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis. Results The major curve was corrected from 49.8° and 47.2° pre-operatively to 24.5° and 18.8° at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group. Conclusion Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction. PMID:20635452

  8. 12 CFR 952.4 - Targeted Community Lending Plan

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Targeted Community Lending Plan 952.4 Section... SHEET ITEMS COMMUNITY INVESTMENT CASH ADVANCE PROGRAMS § 952.4 Targeted Community Lending Plan Each Bank shall develop and adopt an annual Targeted Community Lending Plan pursuant to § 944.6 of this chapter....

  9. Surgical Management of Tibial Plateau Fractures With 3.5 mm Simple Plates

    PubMed Central

    Bagherifard, Abolfazl; Jabalameli, Mahmoud; Hadi, Hosseinali; Rahbar, Mohammad; Minator Sajjadi, Mohammadreza; Jahansouz, Ali; Karimi Heris, Hossein

    2016-01-01

    Background Tibial plateau fractures can be successfully fixed utilizing 3.5 mm locking plates. However, there are some disadvantages to using these plates. Objectives In the current prospective study, we investigated the outcome of treating different types of tibial plateau fractures with 3.5 mm simple plates which, to our knowledge, has not been evaluated in previous studies. Materials and Methods Between 2011 and 2013, 32 patients aged 40 ± 0.2 years underwent open reduction and internal fixation for tibial plateau fractures with 3.5 mm simple plates. The patients were followed for 16.14 ± 2.1 months. At each patient’s final visit, the articular surface depression, medial proximal tibial angle, and slope angle were measured and compared with measurements taken early after the operation. The functional outcomes were measured with the WOMAC and Lysholm knee scores. Results The mean union time was 13 ± 1.2 weeks. The mean knee range of motion was 116.8° ± 3.3°. The mean WOMAC and Lysholm scores were 83.5 ± 1.8 and 76.8 ± 1.6, respectively. On the early postoperative and final X-rays, 87.5% and 84% of patients, respectively, had acceptable reduction. Medial proximal tibial and slope angles did not change significantly by the last visit. No patient was found to have complications related to the type of plate. Conclusions In this case series study, the fixation of different types of tibial plateau fractures with 3.5 mm simple non-locking and non-precontoured plates was associated with acceptable clinical, functional, and radiographic outcomes. Based on the advantages and costs of these plates, the authors recommend using 3.5 mm simple plates for different types of tibial plateau fractures. PMID:27626010

  10. Preliminary Analysis of a 27.5 mm Period Undulator for the MBA Lattice

    SciTech Connect

    Abliz, M.; Grimmer, J.

    2016-07-27

    The magnetic design of a 27.5 mm period undulator was performed for the APS MBA Lattice. One purpose of the magnetic design was to decrease the magnetic force in order to operate the undulator successfully at a smaller gap compared to the existing 27 mm undulator at the APS. As a result, the magnetic force is decreased by about 18% at a gap of 11 mm and the total volume of the magnet and the pole is decreased by approximately 22% with the new model. The calculated effective field with the new model was 172 G higher than the existing 27-mm period undulator with a gap of 11 mm. The calculated field roll-off with the new optimized model is within the requirements of the MBA, in the range of ± 5 mm.

  11. LIFE Target Fabrication Research Plan Sept 2008

    SciTech Connect

    Miles, R; Biener, J; Kucheyev, S; Montesanti, R; Satcher, J; Spadaccini, C; Rose, K; Wang, M; Hamza, A; Alexander, N; Brown, L; Hund, J; Petzoldt, R; Sweet, W; Goodin, D

    2008-11-10

    The target-system for the baseline LIFE fast-ignition target was analyzed to establish a preliminary estimate for the costs and complexities involved in demonstrating the technologies needed to build a prototype LIFE plant. The baseline fast-ignition target upon which this analysis was developed is shown in Figure 1.0-1 below. The LIFE target-system incorporates requirements for low-cost, high throughput manufacture, high-speed, high accuracy injection of the target into the chamber, production of sufficient energy from implosion and recovery and recycle of the imploded target material residue. None of these functions has been demonstrated to date. Existing target fabrication techniques which lead to current 'hot spot' target costs of {approx}$100,000 per target and at a production rate of 2/day are unacceptable for the LIFE program. Fabrication techniques normally used for low-cost, low accuracy consumer products such as toys must be adapted to the high-accuracy LIFE target. This will be challenge. A research program resulting is the demonstration of the target-cycle technologies needed for a prototype LIFE reactor is expected to cost {approx}$51M over the course of 5 years. The effort will result in targets which will cost an estimated $0.23/target at a rep-rate of 20 Hz or about 1.73M targets/day.

  12. Results of Endovascular Coil Embolization Treatment for Small (≤ 5 mm) Unruptured Intracranial Aneurysms

    PubMed Central

    Lee, Siwoo; Lee, Yong-Woo; Kim, Hyo-Joon; Kweon, Chang-young

    2016-01-01

    Objective Researchers and clinicians have been unable to fully elucidate the natural course of and proper treatment for unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm, particularly with regard to whether close observation or surgery is more appropriate. In this retrospective study, we evaluated the safety and efficacy of endovascular coil embolization of small (≤ 5 mm) asymptomatic UIAs by analyzing outcomes and complications associated with the procedure. Materials and Methods We analyzed data from 150 patients with small asymptomatic UIAs (≤ 5 mm) treated with coil embolization between January 2011 and December 2015. Three-dimensional angiography was used to measure aneurysm size. We evaluated procedure-related morbidity and mortality, immediate post-operative angiographic results, brain computed thomography follow-up results on post-operative day one, and clinical progress. Results UIAs occurred primarily in the anterior circulation area (142 cases, 94.67%), though eight patients exhibited UIAs of the posterior circulation. Following coil embolization, aneurysms with complete occlusion were observed in 137 cases (91.3%). Partial occlusion occurred in five cases (3.33%), while the procedure had failed in eight cases (5.33%). Procedure-related morbidity and mortality were five cases (3.33%) and zero cases, respectively. Conclusion The endovascular treatment of small asymptomatic UIAs is associated with good short-term outcomes without permanent neurologic complications as well as low overall complication and morbidity rates. Thus, the procedure should be considered for patients with smaller asymptomatic UIAs. PMID:27847766

  13. Succession Planning and Targeted Leadership Development

    ERIC Educational Resources Information Center

    Wallin, Desna; Cameron, Don W.; Sharples, Kent

    2005-01-01

    A growing number of colleges and boards of trustees are looking to the future by embracing succession planning as the key to assuring college sustainability in an environment that requires global thinking, strategic planning and political savvy. Once confined to the corporate world or to family businesses, and limited to the CEO, succession…

  14. 40 CFR 35.9020 - Planning targets.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... STATE AND LOCAL ASSISTANCE Financial Assistance for the National Estuary Program § 35.9020 Planning... expenditures by each estuary program and are directly related to the activities that are to be carried out...

  15. 40 CFR 35.9020 - Planning targets.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... STATE AND LOCAL ASSISTANCE Financial Assistance for the National Estuary Program § 35.9020 Planning... expenditures by each estuary program and are directly related to the activities that are to be carried out...

  16. 40 CFR 35.9020 - Planning targets.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... STATE AND LOCAL ASSISTANCE Financial Assistance for the National Estuary Program § 35.9020 Planning... expenditures by each estuary program and are directly related to the activities that are to be carried out...

  17. 40 CFR 35.9020 - Planning targets.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... STATE AND LOCAL ASSISTANCE Financial Assistance for the National Estuary Program § 35.9020 Planning... expenditures by each estuary program and are directly related to the activities that are to be carried out...

  18. Low-Friction Minilaparoscopy Outperforms Regular 5-mm and 3-mm Instruments for Precise Tasks

    PubMed Central

    Firme, Wood A.; Lima, Diego L.; de Paula Lopes, Vladmir Goldstein; Montandon, Isabelle D.; Filho, Flavio Santos; Shadduck, Phillip P.

    2015-01-01

    Background and Objectives: Therapeutic laparoscopy was incorporated into surgical practice more than 25 y ago. Several modifications have since been developed to further minimize surgical trauma and improve results. Minilaparoscopy, performed with 2- to 3-mm instruments was introduced in the mid 1990s but failed to attain mainstream use, mostly because of the limitations of the early devices. Buoyed by a renewed interest, new generations of mini instruments are being developed with improved functionality and durability. This study is an objective evaluation of a new set of mini instruments with a novel low-friction design. Method: Twenty-two medical students and 22 surgical residents served as study participants. Three designs of laparoscopic instruments were evaluated: conventional 5 mm, traditional 3 mm, and low-friction 3 mm. The instruments were evaluated with a standard surgical simulator, emulating 4 exercises of various complexities, testing grasping, precise 2-handed movements, and suturing. The metric measured was time to task completion, with 5 replicates for every combination of instrument–exercise–participant. Results: For all 4 tasks, the instrument design that performed the best was the same in both the medical student and surgical resident groups. For the gross-grasping task, the 5-mm conventional instruments performed best, followed by the low-friction mini instruments. For the 3 more complex and precise tasks, the low-friction mini instruments outperformed both of the other instrument designs. Conclusion: In standard surgical simulator exercises, low-friction minilaparoscopic instruments outperformed both conventional 3- and 5-mm laparoscopic instruments for precise tasks. PMID:26390530

  19. Video-assisted thoracoscopic thymectomy using 5-mm ports and carbon dioxide insufflation

    PubMed Central

    2016-01-01

    The continuous development and refinement of minimally invasive approaches to thymectomy over the last two decades has potential benefits for patients in terms of better cosmesis, less postoperative pain, shorter length of stay, earlier return to daily activities, less bleeding and fewer complications overall with similar outcomes regarding survival, recurrence of thymoma and complete remission (CR) for myasthenia gravis patients. A variety of different approaches have been described previously. This is a detailed description of video-assisted thoracoscopic thymectomy using three 5 mm ports, carbon dioxide (CO2) insufflation and bipolar electrocoagulation (LigaSure). PMID:26904432

  20. The Intrinsic Shape of Sagittarius A* at 3.5 mm Wavelength

    NASA Astrophysics Data System (ADS)

    Ortiz-León, Gisela N.; Johnson, Michael D.; Doeleman, Sheperd S.; Blackburn, Lindy; Fish, Vincent L.; Loinard, Laurent; Reid, Mark J.; Castillo, Edgar; Chael, Andrew A.; Hernández-Gómez, Antonio; Hughes, David H.; León-Tavares, Jonathan; Lu, Ru-Sen; Montaña, Alfredo; Narayanan, Gopal; Rosenfeld, Katherine; Sánchez, David; Schloerb, F. Peter; Shen, Zhi-qiang; Shiokawa, Hotaka; SooHoo, Jason; Vertatschitsch, Laura

    2016-06-01

    The radio emission from Sgr A{}\\ast is thought to be powered by accretion onto a supermassive black hole of ˜ 4× {10}6 {M}⊙ at the Galactic Center. At millimeter wavelengths, Very Long Baseline Interferometry (VLBI) observations can directly resolve the bright innermost accretion region of Sgr A{}\\ast . Motivated by the addition of many sensitive long baselines in the north-south direction, we developed a full VLBI capability at the Large Millimeter Telescope Alfonso Serrano (LMT). We successfully detected Sgr A{}\\ast at 3.5 mm with an array consisting of six Very Long Baseline Array telescopes and the LMT. We model the source as an elliptical Gaussian brightness distribution and estimate the scattered size and orientation of the source from closure amplitude and self-calibration analysis, obtaining consistent results between methods and epochs. We then use the known scattering kernel to determine the intrinsic two-dimensional source size at 3.5 mm: (147+/- 7 μ {{as}})× (120+/- 12 μ {{as}}), at position angle 88^\\circ +/- 7^\\circ east of north. Finally, we detect non-zero closure phases on some baseline triangles, but we show that these are consistent with being introduced by refractive scattering in the interstellar medium and do not require intrinsic source asymmetry to explain.

  1. Three-degree-of-freedom ultrasonic motor using a 5-mm-diameter piezoelectric ceramic tube.

    PubMed

    Mingsen Guo; Junhui Hu; Hua Zhu; Chunsheng Zhao; Shuxiang Dong

    2013-07-01

    A small three-degree-of-freedom ultrasonic motor has been developed using a simple piezoelectric lead zirconate titanate (PZT)-tube stator (OD 5 mm, ID 3 mm, length 15 mm). The stator drives a ball-rotor into rotational motion around one of three orthogonal (x-, y-, and z-) axes by combing the first longitudinal and second bending vibration modes. A motor prototype was fabricated and characterized; its performance was superior to those of previous motors made with a PZT ceramic/metal composite stator of comparable size. The method for further improving the performance was discussed. The motor can be further miniaturized and it has potential to be applied to medical microrobots, endoscopes or micro laparoscopic devices, and cell manipulation devices.

  2. A 2.5-mm diameter probe for photoacoustic and ultrasonic endoscopy

    PubMed Central

    Yang, Joon-Mo; Chen, Ruimin; Favazza, Christopher; Yao, Junjie; Li, Chiye; Hu, Zhilin; Zhou, Qifa; Shung, K. Kirk; Wang, Lihong V.

    2012-01-01

    We have created a 2.5-mm outer diameter integrated photo-acoustic and ultrasonic mini-probe which can be inserted into a standard video endoscope’s instrument channel. A small-diameter focused ultrasonic transducer made of PMN-PT provides adequate signal sensitivity, and enables miniaturization of the probe. Additionally, this new endoscopic probe utilizes the same scanning mirror and micromotor-based built-in actuator described in our previous reports; however, the length of the rigid distal section of the new probe has been further reduced to ~35 mm. This paper describes the technical details of the mini-probe and presents experimental results that both quantify the imaging performance and demonstrate its in vivo imaging capability, which suggests that it could work as a mini-probe for certain clinical applications. PMID:23188360

  3. Novel Port Placement and 5-mm Instrumentation for Robotic-Assisted Hysterectomy

    PubMed Central

    Katz, Adi; Dun, Erica C.; Kho, Kimberly A.; Wieser, Friedrich A.

    2014-01-01

    Background and Objectives: The value of robotic surgery for gynecologic procedures has been critically evaluated over the past few years. Its drawbacks have been noted as larger port size, location of port placement, limited instrumentation, and cost. In this study, we describe a novel technique for robotic-assisted laparoscopic hysterectomy (RALH) with 3 important improvements: (1) more aesthetic triangular laparoscopic port configuration, (2) use of 5-mm robotic cannulas and instruments, and (3) improved access around the robotic arms for the bedside assistant with the use of pediatric-length laparoscopic instruments. Methods: We reviewed a series of 44 women who underwent a novel RALH technique and concomitant procedures for benign hysterectomy between January 2008 and September 2011. Results: The novel RALH technique and concomitant procedures were completed in all of the cases without conversion to larger ports, laparotomy, or video-assisted laparoscopy. Mean age was 49.9 years (SD 8.8, range 33–70), mean body mass index was 26.1 (SD 5.1, range 18.9–40.3), mean uterine weight was 168.2 g (SD 212.7, range 60–1405), mean estimated blood loss was 69.7 mL (SD 146.9, range 20–1000), and median length of stay was <1 day (SD 0.6, range 0–2.5). There were no major and 3 minor peri- and postoperative complications, including 2 urinary tract infections and 1 case of intravenous site thrombophlebitis. Mean follow-up time was 40.0 months (SD 13.6, range 15–59). Conclusion: Use of the triangular gynecology laparoscopic port placement and 5-mm robotic instruments for RALH is safe and feasible and does not impede the surgeon's ability to perform the procedures or affect patient outcomes. PMID:24960478

  4. Combined Recipe for Clinical Target Volume and Planning Target Volume Margins

    SciTech Connect

    Stroom, Joep; Gilhuijs, Kenneth; Vieira, Sandra; Chen, Wei; Salguero, Javier; Moser, Elizabeth; Sonke, Jan-Jakob

    2014-03-01

    Purpose: To develop a combined recipe for clinical target volume (CTV) and planning target volume (PTV) margins. Methods and Materials: A widely accepted PTV margin recipe is M{sub geo} = aΣ{sub geo} + bσ{sub geo}, with Σ{sub geo} and σ{sub geo} standard deviations (SDs) representing systematic and random geometric uncertainties, respectively. On the basis of histopathology data of breast and lung tumors, we suggest describing the distribution of microscopic islets around the gross tumor volume (GTV) by a half-Gaussian with SD Σ{sub micro}, yielding as possible CTV margin recipe: M{sub micro} = ƒ(N{sub i}) × Σ{sub micro}, with N{sub i} the average number of microscopic islets per patient. To determine ƒ(N{sub i}), a computer model was developed that simulated radiation therapy of a spherical GTV with isotropic distribution of microscopic disease in a large group of virtual patients. The minimal margin that yielded D{sub min} <95% in maximally 10% of patients was calculated for various Σ{sub micro} and N{sub i}. Because Σ{sub micro} is independent of Σ{sub geo}, we propose they should be added quadratically, yielding for a combined GTV-to-PTV margin recipe: M{sub GTV-PTV} = √([aΣ{sub geo}]{sup 2} + [ƒ(N{sub i})Σ{sub micro}]{sup 2}) + bσ{sub geo}. This was validated by the computer model through numerous simultaneous simulations of microscopic and geometric uncertainties. Results: The margin factor ƒ(N{sub i}) in a relevant range of Σ{sub micro} and N{sub i} can be given by: ƒ(N{sub i}) = 1.4 + 0.8log(N{sub i}). Filling in the other factors found in our simulations (a = 2.1 and b = 0.8) yields for the combined recipe: M{sub GTV-PTV} = √((2.1Σ{sub geo}){sup 2} + ([1.4 + 0.8log(N{sub i})] × Σ{sub micro}){sup 2}) + 0.8σ{sub geo}. The average margin difference between the simultaneous simulations and the above recipe was 0.2 ± 0.8 mm (1 SD). Calculating M{sub geo} and M{sub micro} separately and adding them linearly overestimated PTVs by on

  5. Men targeted for family planning in Zambia.

    PubMed

    Chirambo, K

    1992-08-01

    80% of women using contraception in Zambia use oral contraceptives (OCs), yet they often complain about side effects. 66% of people polled at family planning (FP) clinics prefer OCs and 30% chose condoms. Nevertheless only 10% of the 60% of married couples familiar with FP use contraception. This contributes to Zambia having 1 of the highest annual population growth rates in the world (3.4%). The Planned Parenthood Association of Zambia (PPAZ) thinks that if males become more knowledgeable about FP, the population growth would slow down. At least 60% of men in Zambia approve of their wives using FP, yet they are slow to use male contraception. They say condoms reduce sensation and wives often consider condoms a nuisance. The AIDS epidemic forces men to rethink their views toward condom use, however. Those 30% of men who do use condoms are more likely to use them with their girlfriends or women with whom they are unfamiliar. So they are not using them for FP purposes. Men fear vasectomy because they perceive it to cause impotence. Considerable education to counter this myth is needed to increase the number of vasectomies. Besides some men prefer their wives be sterilized rather than themselves because if the men lose all their children they can have other children with other wives. PPAZ aims programs at men in order to expand their participation and nurture their influence in FP matters. It has a male counseling program serving rural villages along the railroad lines which begin in the northern copper belt and end in urban areas in the south to promote birth spacing. It is working with companies to include FP services in their clinics so men can learn more about FP. FP specialists in Zambia foresee an increase in male support of FP as they realize the difficulty of supporting large families during the economic crises.

  6. Planning paths to multiple targets: memory involvement and planning heuristics in spatial problem solving.

    PubMed

    Wiener, J M; Ehbauer, N N; Mallot, H A

    2009-09-01

    For large numbers of targets, path planning is a complex and computationally expensive task. Humans, however, usually solve such tasks quickly and efficiently. We present experiments studying human path planning performance and the cognitive processes and heuristics involved. Twenty-five places were arranged on a regular grid in a large room. Participants were repeatedly asked to solve traveling salesman problems (TSP), i.e., to find the shortest closed loop connecting a start location with multiple target locations. In Experiment 1, we tested whether humans employed the nearest neighbor (NN) strategy when solving the TSP. Results showed that subjects outperform the NN-strategy, suggesting that it is not sufficient to explain human route planning behavior. As a second possible strategy we tested a hierarchical planning heuristic in Experiment 2, demonstrating that participants first plan a coarse route on the region level that is refined during navigation. To test for the relevance of spatial working memory (SWM) and spatial long-term memory (LTM) for planning performance and the planning heuristics applied, we varied the memory demands between conditions in Experiment 2. In one condition the target locations were directly marked, such that no memory was required; a second condition required participants to memorize the target locations during path planning (SWM); in a third condition, additionally, the locations of targets had to retrieved from LTM (SWM and LTM). Results showed that navigation performance decreased with increasing memory demands while the dependence on the hierarchical planning heuristic increased.

  7. A 3.5 mm POLARIMETRIC SURVEY OF RADIO-LOUD ACTIVE GALACTIC NUCLEI

    SciTech Connect

    Agudo, I.; Thum, C.; Wiesemeyer, H.; Krichbaum, T. P. E-mail: thum@iram.f E-mail: tkrichbaum@mpifr-bonn.mpg.d

    2010-07-15

    We present the results from the first large (>100 sources) 3.5 mm polarimetric survey of radio-loud active galactic nuclei (AGNs). This wavelength is favorable within the radio-millimeter range for measuring the intrinsic linearly polarized emission from AGNs, since in general it is only marginally affected by Faraday rotation of the electric vector position angle and depolarization. The I, Q, U, and V Stokes parameter observations were performed with the XPOL polarimeter at the IRAM 30 m Telescope on different observing epochs from 2005 July (when most of the measurements were made) to 2009 October. Our sample consists of 145 flat-radio-spectrum AGNs with declination >-30{sup 0} (J2000.0) and flux density {approx}>1 Jy at {approx}86 GHz, as measured at the IRAM 30 m Telescope from 1978 to 1994. This constraint on the radio spectrum causes our sample to be dominated by blazars, which allows us to conduct new statistical studies on this class of high-luminosity, relativistically beamed emitters. We detect linear and circular polarization (above minimum 3{sigma} levels of {approx}1.5% and {approx}0.3%) for 76% and 6% of the sample, respectively. We find a clear excess in degree of linear polarization detected at 86 GHz with regard to that at 15 GHz by a factor of {approx}2. Over our entire source sample, the luminosity of the jets is anticorrelated with the degree of linear polarization. Consistent with previous findings claiming larger Doppler factors for brighter {gamma}-ray blazars, quasars listed in our sample, and in the Fermi Large Area Telescope Bright Source Catalog (LBAS), show larger luminosities than non-LBAS ones, but our data do not allow us to confirm the same for BL Lac objects. We do not find a clear relation between the linear polarization angle and the jet structural position angle for any source class in our sample. We interpret this as the consequence of a markedly non-axisymmetric character of the 3 mm emitting region in the jets. We find that

  8. A 5-mm piezo-scanning fiber device for high speed ultrafast laser microsurgery

    PubMed Central

    Ferhanoglu, Onur; Yildirim, Murat; Subramanian, Kaushik; Ben-Yakar, Adela

    2014-01-01

    Towards developing precise microsurgery tools for the clinic, we previously developed image-guided miniaturized devices using low repetition rate amplified ultrafast lasers for surgery. To improve the speed of tissue removal while reducing device diameter, here we present a new 5-mm diameter device that delivers high-repetition rate laser pulses for high speed ultrafast laser microsurgery. The device consists of an air-core photonic bandgap fiber (PBF) for the delivery of high energy pulses, a piezoelectric tube actuator for fiber scanning, and two aspheric lenses for focusing the light. Its inline optical architecture provides easy alignment and substantial size reduction to 5 mm diameter as compared to our previous MEMS-scanning devices while realizing improved intensity squared (two-photon) lateral and axial resolutions of 1.16 μm and 11.46 μm, respectively. Our study also sheds light on the maximum pulse energies that can be delivered through the air-core PBF and identifies cladding damage at the input facet of the fiber as the limiting factor. We have achieved a maximum energy delivery larger than 700 nJ at 92% coupling efficiency. An in depth analysis reveals how this value is greatly affected by possible slight misalignments of the beam during coupling and the measured small beam pointing fluctuations. In the absence of these imperfections, self-phase modulation becomes the limiting factor for the maximum energy delivery, setting the theoretical upper bound to near 2 μJ for a 1-m long, 7-μm, air-core PBF. Finally, the use of a 300 kHz repetition rate fiber laser enabled rapid ablation of 150 µm x 150 µm area within only 50 ms. Such ablation speeds can now allow the surgeons to translate the surgery device as fast as ~4 mm/s to continuously remove a thin layer of a 150 µm wide tissue. Thanks to a high optical transmission efficiency of the in-line optical architecture of the device and improved resolution, we could successfully perform ablation of

  9. In vitro biomechanical comparison of six different fixation methods following 5-mm sagittal split advancement osteotomies.

    PubMed

    Oguz, Y; Watanabe, E R; Reis, J M; Spin-Neto, R; Gabrielli, M A; Pereira-Filho, V A

    2015-08-01

    The sagittal split ramus osteotomy (SSRO) is a surgical technique used widely to treat many congenital and acquired mandibular discrepancies. Stabilization of the osteotomy site and the potential for skeletal relapse after the procedure are still major problems. The aim of this study was to compare the mechanical stability of six methods of rigid fixation in SSRO using a biomechanical test model. Sixty polyurethane replicas of human hemimandibles were divided into six groups. In group I, the osteotomies were fixed with two four-hole titanium miniplates; in group II, with one four-hole miniplate; in group III, with one four-hole miniplate+a bicortical screw; in group IV, with a grid miniplate; in group V, with a four-hole locking miniplate; and in group VI, with a six-hole miniplate. A linear load in the premolar region was applied to the hemimandibles. The resistance forces (N) needed to displace the distal segment by 1, 3, and 5mm were recorded and the data transmitted from the load cell to a computer. One-way analysis of variance with Tukey's post hoc test was performed to compare the means between groups. For the three displacement conditions, there was a strong tendency for the 2.0-mm plate+screw and the grid plate to have higher values.

  10. Morphological evaluation of eccentric sets guide-plates of dcp-l 4.5 mm

    PubMed Central

    Borges, José Humberto de Souza; da Silva Filho, Antonio Lisboa; Pereira Neto, Francisco; Daher, Walter Rodrigo; de Mesquita, Alessandro Queiroz; Freitas, Anderson

    2012-01-01

    Objective To carry out isolated and comparative evaluations of the measurements of the set eccentric guide plates used in 4.5mm surgical implants, and to determine the effect of these measurements on compression strength. Methods Four eccentric guides, four large dynamic compression plates (L-DCP) from four local manufacturers, and a Vonder® 200 mm caliper brand were used. Five standard parameter measurements were created for the set eccentric guide-plate, which were identified as A to E. Four sets were made, using materials of the same factory, and identified as groups I to IV. The analyses were performed by measuring all the parameters from a ventral view of the plate, with the eccentric guide placed in the plate hole. Results Groups I and II showed the same values for all the parameters. All the groups showed the same measurements for E = 8.15 e B = 3.60. Group III: A = 8.10mm, C = 3.25mm, D = 1.25mm. Group IV: A = 7.00mm, C = 3.10mm, D = 0.30mm. Maximum compression force was (F Max.): Group I 80.58 N, Group. II: F Max. 81.63 N, Group. III: F Max. 36.32N, Group. IV: F Max. 37.52N Conclusion The measurements evaluated show a lack of standardization in the manufacture of orthopedic instruments and its effects on the values for compression strength. Level of Evidence: Level III, analytical study. PMID:24453573

  11. Planning Target Margin Calculations for Prostate Radiotherapy Based on Intrafraction and Interfraction Motion Using Four Localization Methods

    SciTech Connect

    Beltran, Chris Herman, Michael G.; Davis, Brian J.

    2008-01-01

    Purpose: To determine planning target volume (PTV) margins for prostate radiotherapy based on the internal margin (IM) (intrafractional motion) and the setup margin (SM) (interfractional motion) for four daily localization methods: skin marks (tattoo), pelvic bony anatomy (bone), intraprostatic gold seeds using a 5-mm action threshold, and using no threshold. Methods and Materials: Forty prostate cancer patients were treated with external radiotherapy according to an online localization protocol using four intraprostatic gold seeds and electronic portal images (EPIs). Daily localization and treatment EPIs were obtained. These data allowed inter- and intrafractional analysis of prostate motion. The SM for the four daily localization methods and the IM were determined. Results: A total of 1532 fractions were analyzed. Tattoo localization requires a SM of 6.8 mm left-right (LR), 7.2 mm inferior-superior (IS), and 9.8 mm anterior-posterior (AP). Bone localization requires 3.1, 8.9, and 10.7 mm, respectively. The 5-mm threshold localization requires 4.0, 3.9, and 3.7 mm. No threshold localization requires 3.4, 3.2, and 3.2 mm. The intrafractional prostate motion requires an IM of 2.4 mm LR, 3.4 mm IS and AP. The PTV margin using the 5-mm threshold, including interobserver uncertainty, IM, and SM, is 4.8 mm LR, 5.4 mm IS, and 5.2 mm AP. Conclusions: Localization based on EPI with implanted gold seeds allows a large PTV margin reduction when compared with tattoo localization. Except for the LR direction, bony anatomy localization does not decrease the margins compared with tattoo localization. Intrafractional prostate motion is a limiting factor on margin reduction.

  12. Targeting Low Career Confidence Using the Career Planning Confidence Scale

    ERIC Educational Resources Information Center

    McAuliffe, Garrett; Jurgens, Jill C.; Pickering, Worth; Calliotte, James; Macera, Anthony; Zerwas, Steven

    2006-01-01

    The authors describe the development and validation of a test of career planning confidence that makes possible the targeting of specific problem issues in employment counseling. The scale, developed using a rational process and the authors' experience with clients, was tested for criterion-related validity against 2 other measures. The scale…

  13. Target allocation and prioritized motion planning for MIRADAS probe arms

    NASA Astrophysics Data System (ADS)

    Sabater, Josep; Riera-Ledesma, Jorge; Torres, Santiago; Garzón, Francisco; Torra, Jordi; Gómez, José M.

    2016-07-01

    The Mid-resolution InfRAreD Astronomical Spectrograph (MIRADAS) is a near-infrared multi-object echelle spectrograph for the 10.4-meter Gran Telescopio Canarias. The instrument has 12 pickoff mirror optics on cryogenic probe arms, enabling it to concurrently observe up to 12 user-defined objects located in its field-of-view. In this paper, a method to compute collision-free trajectories for the arms of MIRADAS is presented. We propose a sequential approach that has two stages: target to arm assignment and motion planning. For the former, we present a model based on linear programming that allocates targets according to their associated priorities. The model is constrained by two matrices specifying the targets' reachability and the incompatibilities among each pair of feasible target-arm pairs. This model has been implemented and experiments show that it is able to determine assignments in less than a second. Regarding the second step, we present a prioritized approach which uses sampled-based roadmaps containing a variety of paths. The motions along a given path are coordinated with the help of a depth-first search algorithm. Paths are sequentially explored according to how promising they are and those not leading to a solution are skipped. This motion planning approach has been implemented considering real probe arm geometries and joint velocities. Experimental results show that the method achieves good performance in scenarios presenting two different types of conflicts.

  14. SU-E-J-88: Margin Reduction of Level II/III Planning Target Volume for Image-Guided Simultaneous Integrated Boost Head-And-Neck Treatment

    SciTech Connect

    Can, S; Neylon, J; Qi, S; Santhanam, A; Low, D

    2014-06-01

    Purpose: To investigate the feasibility of improved normal tissue sparing for head-and-neck (H'N) image-guided radiotherapy (IGRT) by employing tighter CTV-to-PTV margins for target level II/III though a GPU-based deformable image registration and dose accumulation framework. Methods: Ten H'N simultaneous integrated boost cases treated on TomoTherapy were retrospectively analyzed. Weekly kVCT scans in addition to daily MVCT scans were acquired for each patient. Reduced margin plans were generated with 0- mm margin for level II and III PTV (while 3-5 mm margin for PTV1) and compared with the standard margin plan using 3-5mm margin to all CTV1-3 (reference plan). An in-house developed GPU-based 3D image deformation tool was used to register and deform the weekly KVCTs with the planning CT and determine the delivered mean/minimum/maximum dose, dose volume histograms (DVHs), etc. Results: Compared with the reference plans, the averaged cord maximum, the right and left parotid doses reduced by 22.7 %, 16.5 %, and 9 % respectively in the reduced margin plans. The V95 for PTV2 and PTV3 were found within 2 and 5% between the reference and tighter margin plans. For the reduced margin plans, the averaged cumulative mean doses were consistent with the planned dose for PTV1, PTV2 and PTV3 within 1.5%, 1.7% and 1.4%. Similar dose variations of the delivered dose were seen for the reference and tighter margin plans. The delivered maximum and mean doses for the cord were 3.55 % and 2.37% higher than the planned doses; a 5 % higher cumulative mean dose for the parotids was also observed for the delivered dose than the planned doses in both plans. Conclusion: By imposing tighter CTV-to-PTV margins for level II and III targets for H'N irradiation, acceptable cumulative doses were achievable when coupled with weekly kVCT guidance while improving normal structure sparing.

  15. A method to individualize adaptive planning target volumes for deformable targets

    NASA Astrophysics Data System (ADS)

    Wright, Pauliina; Redpath, Anthony Thomas; Høyer, Morten; Muren, Ludvig Paul

    2009-12-01

    We have investigated a method to individualize the planning target volume (PTV) for deformable targets in radiotherapy by combining a computer tomography (CT) scan with multiple cone beam (CB)CT scans. All combinations of the CT and up to five initial CBCTs were considered. To exclude translational motion, the clinical target volumes (CTVs) in the CBCTs were matched to the CTV in the CT. PTVs investigated were the unions, the intersections and all other structures defined by a volume with a constant CTV location frequency. The method was investigated for three bladder cancer patients with a CT and 20-27 CBCTs. Reliable alternatives to a standard PTV required use of at least four scans for planning. The CTV unions of four or five scans gave similar results when considering the fraction of individual repeat scan CTVs they volumetrically covered to at least 99%. For patient 1, 64% of the repeat scan CTVs were covered by these unions and for patient 2, 86% were covered. Further, the PTVs defined by the volume occupied by the CTV in all except one of the four or five planning scans seemed clinically feasible. On average, 52% of the repeat CBCT CTVs for patient 1 and 64% for patient 2 were covered to minimum 99% of their total volume. For patient 3, the method failed due to poor volume control of the bladder. The suggested PTVs could, with considerably improved conformity, complement the standard PTV.

  16. Final work plan for targeted sampling at Webber, Kansas.

    SciTech Connect

    LaFreniere, L. M.; Environmental Science Division

    2006-05-01

    This Work Plan outlines the scope of work for targeted sampling at Webber, Kansas (Figure 1.1). This activity is being conducted at the request of the Kansas Department of Health and Environment (KDHE), in accordance with Section V of the Intergovernmental Agreement between the KDHE and the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA). Data obtained in this sampling event will be used to (1) evaluate the current status of previously detected contamination at Webber and (2) determine whether the site requires further action. This work is being performed on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. Argonne is a nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy (DOE). The CCC/USDA has entered into an interagency agreement with DOE, under which Argonne provides technical assistance to the CCC/USDA with environmental site characterization and remediation at its former grain storage facilities. Argonne has issued a Master Work Plan (Argonne 2002) that describes the general scope of and guidance for all investigations at former CCC/USDA facilities in Kansas. The Master Work Plan, approved by the KDHE, contains the materials common to investigations at all locations in Kansas. This document should be consulted for complete details of the technical activities proposed at the former CCC/USDA facility in Webber.

  17. Evaluation of the Planning Target Volume in the Treatment of Head and Neck Cancer With Intensity-Modulated Radiotherapy: What Is the Appropriate Expansion Margin in the Setting of Daily Image Guidance?

    SciTech Connect

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Donald, Paul J.; Perks, Julian; Purdy, James A.

    2011-11-15

    Purpose: To compare patterns of disease failure among patients treated with intensity-modulated radiotherapy (IMRT) in conjunction with daily image-guided radiotherapy (IGRT) for head and neck cancer, according to the margins used to expand the clinical target volume (CTV) to create a planning target volume (PTV). Methods and Materials: Two-hundred and twenty-five patients were treated with IMRT for squamous cell carcinoma of the head and neck. Daily IGRT scans were acquired using either kilovoltage or megavoltage volumetric imaging prior to each delivered fraction. The first 95 patients were treated with IMRT with 5-mm CTV-to-PTV margins. The subsequent 130 patients were treated using 3-mm PTV expansion margins. Results: Two-year estimates of overall survival, local-regional control, and distant metastasis-free survival were 76%, 78%, and 81%, respectively. There were no differences with respect to any of these endpoints among patients treated with 5-mm and 3-mm PTV expansion margins (p > 0.05, all). The 2-year local-regional control rate for patients treated with IMRT with 5-mm and 3-mm PTV margins was 78% and 78%, respectively (p = 0.96). Spatial evaluation revealed no differences in the incidences of marginal failures among those treated with 5-mm and 3-mm PTV margins. Conclusions: The use of 3-mm PTV expansion margins appears adequate and did not increase local-regional failures among patients treated with IMRT for head and neck cancer. These data demonstrate the safety of PTV reduction of less than 5 mm and support current protocols recommending this approach in the setting of daily IGRT.

  18. Automated planning of ablation targets in atrial fibrillation treatment

    NASA Astrophysics Data System (ADS)

    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.

  19. Strategic targeting of advance care planning interventions: the Goldilocks phenomenon.

    PubMed

    Billings, J Andrew; Bernacki, Rachelle

    2014-04-01

    Strategically selecting patients for discussions and documentation about limiting life-sustaining treatments-choosing the right time along the end-of-life trajectory for such an intervention and identifying patients at high risk of facing end-of-life decisions-can have a profound impact on the value of advance care planning (ACP) efforts. Timing is important because the completion of an advance directive (AD) too far from or too close to the time of death can lead to end-of-life decisions that do not optimally reflect the patient's values, goals, and preferences: a poorly chosen target patient population that is unlikely to need an AD in the near future may lead to patients making unrealistic, hypothetical choices, while assessing preferences in the emergency department or hospital in the face of a calamity is notoriously inadequate. Because much of the currently studied ACP efforts have led to a disappointingly small proportion of patients eventually benefitting from an AD, careful targeting of the intervention should also improve the efficacy of such projects. A key to optimal timing and strategic selection of target patients for an ACP program is prognostication, and we briefly highlight prognostication tools and studies that may point us toward high-value AD interventions.

  20. Optimized Planning Target Volume for Intact Cervical Cancer

    SciTech Connect

    Khan, Alvin; Jensen, Lindsay G.; Sun Shuai; Song, William Y.; Yashar, Catheryn M.; Mundt, Arno J.; Zhang Fuquan; Jiang, Steve B.; Mell, Loren K.

    2012-08-01

    Purpose: To model interfraction clinical target volume (CTV) variation in patients with intact cervical cancer and design a planning target volume (PTV) that minimizes normal tissue dose while maximizing CTV coverage. Methods and Materials: We analyzed 50 patients undergoing external-beam radiotherapy for intact cervical cancer using daily online cone-beam computed tomography (CBCT). The CBCTs (n = 972) for each patient were rigidly registered to the planning CT. The CTV was delineated on the planning CT (CTV{sub 0}) and the set of CBCTs ({l_brace}CTV{sub 1}-CTV{sub 25}{r_brace}). Manual (n = 98) and automated (n = 668) landmarks were placed over the surface of CTV{sub 0} with reference to defined anatomic structures. Normal vectors were extended from each landmark, and the minimum length required for a given probability of encompassing CTV{sub 1}-CTV{sub 25} was computed. The resulting expansions were used to generate an optimized PTV. Results: The mean (SD; range) normal vector length to ensure 95% coverage was 4.3 mm (2.7 mm; 1-16 mm). The uniform expansion required to ensure 95% probability of CTV coverage was 13 mm. An anisotropic margin of 20 mm anteriorly and posteriorly and 10 mm superiorly, inferiorly, and laterally also would have ensured a 95% probability of CTV coverage. The volume of the 95% optimized PTV (1470 cm{sup 3}) was significantly lower than both the anisotropic PTV (2220 cm{sup 3}) and the uniformly expanded PTV (2110 cm{sup 3}) (p < 0.001). For a 95% probability of CTV coverage, normal lengths of 1-3 mm were found along the superior and lateral regions of CTV{sub 0}, 5-10 mm along the interfaces of CTV{sub 0} with the bladder and rectum, and 10-14 mm along the anterior surface of CTV{sub 0} at the level of the uterus. Conclusion: Optimizing PTV definition according to surface landmarking resulted in a high probability of CTV coverage with reduced PTV volumes. Our results provide data justifying planning margins to use in practice and

  1. [Intubation of a patient with rheumatoid arthritis with a 7.5-mm-ID armored endotracheal tube using a laryngeal mask airway].

    PubMed

    Mashio, H; Kojima, T; Goda, Y; Kawahigashi, H; Ito, Y; Kato, M

    1997-12-01

    A 71-year-old male patient with rheumatoid arthritis was scheduled for posterior fusion of the cervical spine. He showed limited cervical movement and atrophic mandible. Tracheal intubation was difficult in his last anesthetic management for the same surgery. This time, we planned a special procedure for predicted difficult tracheal intubation. After induction of general anesthesia, a size-4 laryngeal mask airway was inserted. Next, a flexible fiberscope sheathed with a 6.0-mm-ID cuffed endotracheal tube was inserted through a laryngeal mask airway into the trachea, and the fiberscope was withdrawn. Then, an endotracheal tube changer was inserted through the endotracheal tube. The laryngeal mask airway and the endotracheal tube were withdrawn simultaneously leaving the tube changer. Finally, a 7.5-mm-ID armored endotracheal tube was inserted through the tube changer. The procedure applied in this case is a safe and reliable intubating method in patients with difficult tracheal intubation.

  2. Texas Quality Workforce Planning: 1993 Key Industries and Targeted Occupations for Texas' 24 Quality Work Force Planning Regions.

    ERIC Educational Resources Information Center

    Texas State Dept. of Commerce, Austin.

    In 1993, Texas' 24 quality work force planning committees used a state-developed targeted occupations planning methodology to identify key industries and targeted occupations with the greatest potential for job openings in their respective regions. Between 11 and 20 key industries (13.5 on average) were identified for each region. The following 10…

  3. Dosimetric evaluation of planning target volume margin reduction for prostate cancer via image-guided intensity-modulated radiation therapy

    NASA Astrophysics Data System (ADS)

    Hwang, Taejin; Kang, Sei-Kwon; Cheong, Kwang-Ho; Park, Soah; Yoon, Jai-Woong; Han, Taejin; Kim, Haeyoung; Lee, Meyeon; Kim, Kyoung-Joo; Bae, Hoonsik; Suh, Tae-Suk

    2015-07-01

    The aim of this study was to quantitatively estimate the dosimetric benefits of the image-guided radiation therapy (IGRT) system for the prostate intensity-modulated radiation therapy (IMRT) delivery. The cases of eleven patients who underwent IMRT for prostate cancer without a prostatectomy at our institution between October 2012 and April 2014 were retrospectively analyzed. For every patient, clinical target volume (CTV) to planning target volume (PTV) margins were uniformly used: 3 mm, 5 mm, 7 mm, 10 mm, 12 mm, and 15 mm. For each margin size, the IMRT plans were independently optimized by one medical physicist using Pinnalce3 (ver. 8.0.d, Philips Medical System, Madison, WI) in order to maintain the plan quality. The maximum geometrical margin (MGM) for every CT image set, defined as the smallest margin encompassing the rectum at least at one slice, was between 13 mm and 26 mm. The percentage rectum overlapping PTV (%V ROV ), the rectal normal tissue complication probability (NTCP) and the mean rectal dose (%RD mean ) increased in proportion to the increase of PTV margin. However the bladder NTCP remained around zero to some extent regardless of the increase of PTV margin while the percentage bladder overlapping PTV (%V BOV ) and the mean bladder dose (%BD mean ) increased in proportion to the increase of PTV margin. Without relatively large rectum or small bladder, the increase observed for rectal NTCP, %RDmean and %BD mean per 1-mm PTV margin size were 1.84%, 2.44% and 2.90%, respectively. Unlike the behavior of the rectum or the bladder, the maximum dose on each femoral head had little effect on PTV margin. This quantitative study of the PTV margin reduction supported that IG-IMRT has enhanced the clinical effects over prostate cancer with the reduction of normal organ complications under the similar level of PTV control.

  4. Automated Target Planning for FUSE Using the SOVA Algorithm

    NASA Technical Reports Server (NTRS)

    Heatwole, Scott; Lanzi, R. James; Civeit, Thomas; Calvani, Humberto; Kruk, Jeffrey W.; Suchkov, Anatoly

    2007-01-01

    IRUs and four reaction wheels. Over time through various failures, the satellite has been left with one reaction wheel on the vehicle skew axis and two gyros. To remain operational, a control scheme has been implemented using the magnetic torque rods and the remaining momentum wheel.[2] As a consequence, there are attitude regions where there is insufficient torque authority to overcome environmental disturbances (e.g. gravity gradient torques). The situation is further complicated by the fact that these attitude regions shift inertially with time as the spacecraft moves through earth s magnetic field during the course of its orbit. Under these conditions, the burden of planning targets and target-to-target slew maneuvers has increased significantly since the beginning of the mission.[3] Individual targets must be selected so that the magnetic field remains roughly aligned with the skew wheel axis to provide enough control authority to the other two orthogonal axes. If the field moves too far away from the skew axis, the lack of control authority allows environmental torques to pull the satellite away from the target and can potentially cause it to tumble. Slew maneuver planning must factor the stability of targets at the beginning and end, and the torque authority at all points along the slew. Due to the time varying magnetic field geometry relative to any two inertial targets, small modifications in slew maneuver timing can make large differences in the achievability of a maneuver.

  5. Autonomous underwater vehicle adaptive path planning for target classification

    NASA Astrophysics Data System (ADS)

    Edwards, Joseph R.; Schmidt, Henrik

    2002-11-01

    Autonomous underwater vehicles (AUVs) are being rapidly developed to carry sensors into the sea in ways that have previously not been possible. The full use of the vehicles, however, is still not near realization due to lack of the true vehicle autonomy that is promised in the label (AUV). AUVs today primarily attempt to follow as closely as possible a preplanned trajectory. The key to increasing the autonomy of the AUV is to provide the vehicle with a means to make decisions based on its sensor receptions. The current work examines the use of active sonar returns from mine-like objects (MLOs) as a basis for sensor-based adaptive path planning, where the path planning objective is to discriminate between real mines and rocks. Once a target is detected in the mine hunting phase, the mine classification phase is initialized with a derivative cost function to emphasize signal differences and enhance classification capability. The AUV moves adaptively to minimize the cost function. The algorithm is verified using at-sea data derived from the joint MIT/SACLANTCEN GOATS experiments and advanced acoustic simulation using SEALAB. The mission oriented operating system (MOOS) real-time simulator is then used to test the onboard implementation of the algorithm.

  6. Final work plan for targeted investigation at Hilton, Kansas.

    SciTech Connect

    LaFreniere, L. M.; Environmental Science Division

    2007-08-28

    This Work Plan outlines the scope of a targeted investigation to update the status of carbon tetrachloride contamination in groundwater associated with grain storage operations at Hilton, Kansas. The Commodity Credit Corporation (CCC), an agency of the U.S. Department of Agriculture (USDA), operated a grain storage facility in Hilton during the 1950s and 1960s. At the time of the CCC/USDA operation in Hilton, grain storage facilities (CCC/USDA and private) were located along the both sides of the former Union Pacific railroad tracks (Figure 1.1). The main grain storage structures were on or near the railroad right-of-way. The proposed targeted investigation, to be conducted by Argonne National Laboratory on the behalf of CCC/USDA, will supplement Argonne's Phase I and Phase II investigations in 1996-1997. The earlier investigations erroneously focused on an area east of the railroad property where the CCC/USDA did not operate, specifically on a private grain storage facility. In addition, the investigation was limited in scope, because access to railroad property was denied (Argonne 1997a,b). The hydrogeologic system at Hilton is potentially complex.

  7. Assessment of digital panoramic radiography's diagnostic value in angular bony lesions with 5 mm or deeper pocket depth in mandibular molars

    PubMed Central

    Saberi, Bardia Vadiati; Nemati, Somayeh; Malekzadeh, Meisam; Javanmard, Afrooz

    2017-01-01

    Background: Assessment of alveolar bone level in periodontitis is very important in determining prognosis and treatment plan. Panoramic radiography is a diagnostic tool used to screen patients. The aim of the present study was to assess the diagnostic value of digital panoramic radiography in angular bony defects with 5 mm or deeper pocket depth in mandibular molars. Materials and Methods: In this cross-sectional study, ninety angular bony defects in mandibular molars teeth with 5 mm or deeper pocket depth were selected in sixty patients with the diagnosis of chronic periodontitis. Before surgery, bone probing was performed. During the surgery, the vertical distance from cementoenamel junction to the most apical part of bony defect was measured using a Williams probe and this measurements were employed as gold standard. This distance was measured on the panoramic radiographs by a Digital Calliper and Digital Ruler. All data were compare dusing independent samples t-test and Pearson's correlation coefficient. Results: No significant difference was found between the results of bone probing and intra-surgical measurements (P = 0.377). The mean defect depth determined by Digital Caliper and Digital Ruler on panoramic radiographs was significantly less than surgical measurements (P < 0.001). The correlation between bone probing and surgical measurements in determining the defect depth was strong (r = 0.98, P < 0.001). Radiographic measurements made by Digital Ruler (r = 0.86), comparing to Digital Caliper (r = 0.79), showed a higher degree of correlation with surgical measurements. Conclusion: Based on this study, bone probing is a reliable method in vertical alveolar bone defect measurements. While the information obtained from digital panoramic radiographs should be used with caution and the ability of digital panoramic radiography in the determination of defect depth is limited. PMID:28348615

  8. Maximizing Strike Planning Efficiency for a Given Class of Targets

    DTIC Science & Technology

    2010-03-01

    at the same time. In general, the aircraft attack target groups and the target groups contain several single targets. In this research, it is assumed...that every strike package attacks a 4 single target in a target group and returns to base. Therefore, aircraft do not carry different types of weapons...However, different strike packages from different bases can be assigned to a target group containing several single targets where each strike package may

  9. Washout/rainout contribution in wet deposition estimated by 0.5 mm precipitation sampling/analysis

    NASA Astrophysics Data System (ADS)

    Aikawa, Masahide; Hiraki, Takatoshi

    A precipitation dataset collected on a 0.5 mm precipitation basis was studied. The parameters analyzed in this study were the pH (i.e., H + concentration), electric conductivity (EC), and SO42- and NO3- concentrations. The NO3- concentration clearly decayed with an increase of the precipitation amount, while a larger variation was observed in the SO42- concentration even when the precipitation amount increased. Assuming that the decaying NO3- concentration (0.70 μg ml -1) was the result of the rainout process, the estimates were: annual total deposition, 3252 mg m -2 yr -1; rainout process, 1092 mg m -2 yr -1; and rainout/total, 34%. The estimates for SO42- were: annual total deposition, 4687 mg m -2 yr -1; rainout process, 2096 mg m -2 yr -1; and rainout/total, 45%.

  10. Lambmeat colour values (HunterLab CIE and reflectance) are influenced by aperture size (5 mm v. 25 mm).

    PubMed

    Holman, Benjamin W B; Ponnampalam, Eric N; van de Ven, Remy J; Kerr, Matthew G; Hopkins, David L

    2015-02-01

    The effect of aperture size on the assessment of lamb meat colour values (L*, a*, b* and R630/580)was investigated. Two experiments using 2 HunterLab MiniScan colorimeters (large [25 mm] and small [5 mm] apertures) were conducted: 1) coloured tiles were measured and 2) unaged lamb (n = 65) m. longissimus lumborum (LL) and m. semimembranosus (SM) muscles were measured over 2.5 d under simulated retail display. For Experiment three, 2 different colorimeters were used on lamb (n = 36) LL aged for 6 weeks before measurement over 4 don simulated retail display. Coloured tile a* and b* values were unaffected by aperture size, but L* values and the R630/580 ratio were influenced by aperture size. The effect of aperture size on lamb meat colour measurements varied with display time and muscle type. The large aperture size generally provided the highest colorimetric values, and is recommended for measuring lamb meat colour.

  11. Restoration planning to guide Aichi targets in a megadiverse country.

    PubMed

    Tobón, Wolke; Urquiza-Haas, Tania; Koleff, Patricia; Schröter, Matthias; Ortega-Álvarez, Rubén; Campo, Julio; Lindig Cisneros, Roberto; Sarukhán, José; Bonn, Aletta

    2017-02-24

    Ecological restoration has become an important conservation strategy to safeguard biodiversity and ecosystems services. To restore 15% of degraded ecosystems as stipulated by the CBD Aichi target 15, we developed a prioritization framework to identify potential priority sites for restoration in a megadiverse country. Based on a restoration planning approach and involving stakeholders and experts throughout the process, we used the most current data on biological and environmental information in Mexico to assess areas of biological importance and restoration feasibility at national scale. We integrated criteria reflecting these two components using a spatial multi-criteria evaluation and generated eleven different scenarios to test the effect of integrating the components with distinct weights. The identified priority scenario represents a clear spatial guide where restoration could potentially enhance the persistence of species of conservation concern and vulnerable ecosystems while maximizing the likelihood of restoration success. This spatial prioritization is a first step to inform policy makers and restoration planners where to focus efforts towards local and large scale restoration programs, which should further incorporate social and monetary cost-benefit considerations. This article is protected by copyright. All rights reserved.

  12. Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography

    SciTech Connect

    Takahashi, Wataru; Yamashita, Hideomi; Kida, Satoshi; Masutani, Yoshitaka; Sakumi, Akira; Ohtomo, Kuni; Nakagawa, Keiichi; Haga, Akihiro

    2013-07-01

    Purpose: To evaluate setup error and tumor motion during beam delivery by using 4-dimensional cone beam computed tomography (4D CBCT) and to assess the adequacy of the planning target volume (PTV) margin for lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). Methods and Materials: Fifteen lung cancer patients treated by single-arc VMAT-SBRT were selected in this analysis. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on maximum inspiration and maximum expiration CT datasets from 4D CT respiratory sorting and merged into internal target volumes (ITVs). The PTV margin was isotropically taken as 5 mm. Registration was automatically performed using “pre-3D” CBCT. Treatment was performed with a D95 prescription of 50 Gy delivered in 4 fractions. The 4D tumor locations during beam delivery were determined using in-treatment 4D CBCT images acquired in each fraction. Then, the discrepancy between the actual tumor location and the ITV was evaluated in the lateral, vertical, and longitudinal directions. Results: Overall, 55 4D CBCT sets during VMAT-SBRT were successfully obtained. The amplitude of tumor motion was less than 10 mm in all directions. The average displacements between ITV and actual tumor location during treatment were 0.41 ± 0.93 mm, 0.15 ± 0.58 mm, and 0.60 ± 0.99 mm for the craniocaudal, left-right, and anteroposterior directions, respectively. The discrepancy in each phase did not exceed 5 mm in any direction. Conclusions: With in-treatment 4D CBCT, we confirmed the required PTV margins when the registration for moving target was performed using pre-3D CBCT. In-treatment 4D CBCT is a direct method for quantitatively assessing the intrafractional location of a moving target.

  13. Monte Carlo Simulations for Dosimetry in Prostate Radiotherapy with Different Intravesical Volumes and Planning Target Volume Margins

    PubMed Central

    Lv, Wei; Yu, Dong; He, Hengda; Liu, Qian

    2016-01-01

    In prostate radiotherapy, the influence of bladder volume variation on the dose absorbed by the target volume and organs at risk is significant and difficult to predict. In addition, the resolution of a typical medical image is insufficient for visualizing the bladder wall, which makes it more difficult to precisely evaluate the dose to the bladder wall. This simulation study aimed to quantitatively investigate the relationship between the dose received by organs at risk and the intravesical volume in prostate radiotherapy. The high-resolution Visible Chinese Human phantom and the finite element method were used to construct 10 pelvic models with specific intravesical volumes ranging from 100 ml to 700 ml to represent bladders of patients with different bladder filling capacities during radiotherapy. This series of models was utilized in six-field coplanar 3D conformal radiotherapy simulations with different planning target volume (PTV) margins. Each organ’s absorbed dose was calculated using the Monte Carlo method. The obtained bladder wall displacements during bladder filling were consistent with reported clinical measurements. The radiotherapy simulation revealed a linear relationship between the dose to non-targeted organs and the intravesical volume and indicated that a 10-mm PTV margin for a large bladder and a 5-mm PTV margin for a small bladder reduce the effective dose to the bladder wall to similar degrees. However, larger bladders were associated with evident protection of the intestines. Detailed dosimetry results can be used by radiation oncologists to create more accurate, individual water preload protocols according to the patient’s anatomy and bladder capacity. PMID:27441944

  14. Assessment of Planning Target Volume Margins for Intensity-Modulated Radiotherapy of the Prostate Gland: Role of Daily Inter- and Intrafraction Motion

    SciTech Connect

    Tanyi, James A.; He, Tongming; Summers, Paige A.; Mburu, Ruth G.; Kato, Catherine M.; Rhodes, Stephen M.; Hung, Arthur Y.; Fuss, Martin

    2010-12-01

    Purpose: To determine planning target volume margins for prostate intensity-modulated radiotherapy based on inter- and intrafraction motion using four daily localization techniques: three-point skin mark alignment, volumetric imaging with bony landmark registration, volumetric imaging with implanted fiducial marker registration, and implanted electromagnetic transponders (beacons) detection. Methods and Materials: Fourteen patients who underwent definitive intensity-modulated radiotherapy for prostate cancer formed the basis of this study. Each patient was implanted with three electromagnetic transponders and underwent a course of 39 treatment fractions. Daily localization was based on three-point skin mark alignment followed by transponder detection and patient repositioning. Transponder positioning was verified by volumetric imaging with cone-beam computed tomography of the pelvis. Relative motion between the prostate gland and bony anatomy was quantified by offline analyses of daily cone-beam computed tomography. Intratreatment organ motion was monitored continuously by the Calypso (registered) System for quantification of intrafraction setup error. Results: As expected, setup error (that is, inter- plus intrafraction motion, unless otherwise stated) was largest with skin mark alignment, requiring margins of 7.5 mm, 11.4 mm, and 16.3 mm, in the lateral (LR), longitudinal (SI), and vertical (AP) directions, respectively. Margin requirements accounting for intrafraction motion were smallest for transponder detection localization techniques, requiring margins of 1.4 mm (LR), 2.6 mm (SI), and 2.3 mm (AP). Bony anatomy alignment required 2.1 mm (LR), 9.4 mm (SI), and 10.5 mm (AP), whereas image-guided marker alignment required 2.8 mm (LR), 3.7 mm (SI), and 3.2 mm (AP). No marker migration was observed in the cohort. Conclusion: Clinically feasible, rapid, and reliable tools such as the electromagnetic transponder detection system for pretreatment target localization

  15. Development of a ¹³C-optimized 1.5-mm high temperature superconducting NMR probe.

    PubMed

    Ramaswamy, Vijaykumar; Hooker, Jerris W; Withers, Richard S; Nast, Robert E; Brey, William W; Edison, Arthur S

    2013-10-01

    We report a 1.5-mm NMR probe based on high temperature superconductors operating at 14.1T optimized for (13)C detection. The probe has a total sample volume of about 35 microliters (μL) with an active volume of 20 μL and provides exceptional mass sensitivity for (13)C detection. The probe also has excellent (1)H sensitivity and employs a (2)H lock; (15)N irradiation capability can be added in the future. The coils are cooled to about 20K using a standard Agilent cryogenic refrigeration system, and the sample temperature is regulated near room temperature. The coil design considerations are discussed in detail. This probe is ideal for directly detected (13)C NMR experiments for natural products chemistry and metabolomics applications, for which 35 μL is an optimal sample volume. The outstanding (13)C sensitivity of this probe allowed us to directly determine the (13)C connectivity on 1.1mg of natural abundance histidine using an INADEQUATE experiment. We demonstrated the utility of this probe for (13)C-based metabolomics using a synthetic mixture of common natural abundance metabolites whose concentrations ranged from 1 to 5mM (40-200 nmol).

  16. Experimental Evaluation of the Impact of Different Head-and-Neck Intensity-Modulated Radiation Therapy Planning Techniques on Doses to the Skin and Shallow Targets

    SciTech Connect

    Court, Laurence E. Tishler, Roy B.

    2007-10-01

    Purpose: To investigate experimentally the impact of different head-and-neck intensity-modulated radiation therapy (IMRT) planning techniques on doses to the skin and shallow targets. Methods and Materials: A semicylindrical phantom was constructed with micro-MOSFET dosimeters (Thomson-Nielson, Ottawa, Ontario, Canada) at 0-, 3-, 6-, 9-, and 12-mm depths. The planning target volume (PTV) was pulled back 0, 3, or 5 mm from the body contour. The IMRT plans were created to maximize PTV coverage, with one of the following strategies: (a) aim for a maximum 110% hotspot, with 115% allowed; (b) aims for a maximum 105% hotspot; (c) aims for a maximum 105% hotspot and 50% of skin to get a maximum 70% of the prescribed dose; and (d) aim for 99% of the PTV volume to receive 90-93% of prescribed dose, with a maximum 105% hotspot, and with the dose to the skin structure minimized. Doses delivered using a linear accelerator were measured. Setup uncertainty was simulated by intentionally shifting the phantom in a range of {+-}8 mm, and calculating the delivered dose for a range of systematic and random uncertainties. Results: From lowest to highest skin dose, the planning strategies were in the order of c, d, b, and a, but c showed a tendency to underdose tissues at depth. Delivered doses varied by 10-20%, depending on planning strategy. For typical setup uncertainties, cumulative dose reduction to a point 6 mm deep was <4%. Conclusions: It is useful to use skin as a sensitive structure, but a minimum dose constraint must be used for the PTV if unwanted reductions in dose to nodes near the body surface are to be avoided. Setup uncertainties are unlikely to give excessive reductions in cumulative dose.

  17. Using “Functional” Target Coordinates of the Subthalamic Nucleus to Assess the Indirect and Direct Methods of the Preoperative Planning: Do the Anatomical and Functional Targets Coincide?

    PubMed Central

    Rabie, Ahmed; Verhagen Metman, Leo; Slavin, Konstantin V.

    2016-01-01

    Objective: To answer the question of whether the anatomical center of the subthalamic nucleus (STN), as calculated indirectly from stereotactic atlases or by direct visualization on magnetic resonance imaging (MRI), corresponds to the best functional target. Since the neighboring red nucleus (RN) is well visualized on MRI, we studied the relationships of the final target to its different borders. Methods: We analyzed the data of 23 PD patients (46 targets) who underwent bilateral frame-based STN deep brain stimulation (DBS) procedure with microelectrode recording guidance. We calculated coordinates of the active contact on DBS electrode on postoperative MRI, which we referred to as the final “functional/optimal” target. The coordinates calculated by the atlas-based “indirect” and “direct” methods, as well as the coordinates of the different RN borders were compared to these final coordinates. Results: The mean ± SD of the final target coordinates was 11.7 ± 1.5 mm lateral (X), 2.4 ± 1.5 mm posterior (Y), and 6.1 ± 1.7 mm inferior to the mid-commissural point (Z). No significant differences were found between the “indirect” X, Z coordinates and those of the final targets. The “indirect” Y coordinate was significantly posterior to Y of the final target, with mean difference of 0.6 mm (p = 0.014). No significant differences were found between the “direct” X, Y, and Z coordinates and those of the final targets. Conclusions: The functional STN target is located in direct proximity to its anatomical center. During preoperative targeting, we recommend using the “direct” method, and taking into consideration the relationships of the final target to the mid-commissural point (MCP) and the different RN borders. PMID:28009826

  18. Plan demographics, participants' saving behavior, and target-date fund investments.

    PubMed

    Park, Youngkyun

    2009-05-01

    This analysis explores (1) whether plan demographic characteristics would affect individual participant contribution rates and target-date fund investments and (2) equity glide paths for participants in relation to plan demographics by considering target replacement income and its success rate. PLAN DEMOGRAPHIC CHARACTERISTICS IN PARTICIPANT CONTRIBUTION RATES: This study finds empirical evidence that 401(k) plan participants' contribution rates differ by plan demographics based on participants' income and/or tenure. In particular, participants in 401(k) plans dominated by those with low income and short tenure tend to contribute less than those in plans dominated by participants with high income and long tenure. Future research will explore how participant contribution behavior may also be influenced by incentives provided by employers through matching formulae. PLAN DEMOGRAPHIC CHARACTERISTICS IN TARGET-DATE FUND INVESTMENTS: The study also finds empirical evidence that participants' investments in target-date funds with different equity allocations differ by plan demographics based on participants' income and/or tenure. In particular, target-date fund users with 90 percent or more of their account balances in target-date funds who are in 401(k) plans dominated by low-income and short-tenure participants tend to hold target-date funds with lower equity allocations, compared with their counterparts in plans dominated by high-income and long-tenure participants. Future research will focus on the extent to which these characteristics might influence the selection of target-date funds by plan sponsors. EQUITY GLIDE PATHS: Several stylized equity glide paths as well as alternative asset allocations are compared for participants at various starting ages to demonstrate the interaction between plan demographics and equity glide paths/asset allocations in terms of success rates in meeting various replacement income targets. The equity glide path/asset allocation providing

  19. Listening to Local Voices? International Targets and Decentralised Education Planning in Nepal

    ERIC Educational Resources Information Center

    Caddell, M.

    2005-01-01

    This article draws on a case study of district educational planning in Nepal to explore how education for all priorities and targets impact on educational practice at the sub-national level. It raises questions about the extent of local ownership of education and development targets and highlights the micro-politics of data collection exercises.…

  20. Differential Evolution Optimization for Targeting Spacecraft Maneuver Plans

    NASA Technical Reports Server (NTRS)

    Mattern, Daniel

    2016-01-01

    Previous analysis identified specific orbital parameters as being safer for conjunction avoidance for the TDRS fleet. With TDRS-9 being considered an at-risk spacecraft, a potential conjunction concern was raised should TDRS-9 fail while at a longitude of 12W. This document summarizes the analysis performed to identify if these specific orbital parameters could be targeted using the remaining drift-termination maneuvers for the relocation of TDRS-9 from 41W longitude to 12W longitude.

  1. A memory-based model for planning target reach postures in the presence of obstructions.

    PubMed

    Park, W; Singh, D; Martin, B J

    2006-12-15

    Existing posture prediction and motion simulation models generally lack the capability of simulating human obstruction avoidance during target reach. This compromises the utility of digital human models for ergonomics, as many design problems involve interactions between humans and obstructions. To address this problem, this paper presents a novel memory-based posture planning (MBPP) model, which plans reach postures that avoid obstructions. In this model, the task space is partitioned into small regions called cells. For a given human figure, each cell is linked to a memory that stores various alternative postures for reaching the cell. When a posture planning problem is given in terms of a target and an obstruction configuration, the model examines postures belonging to the relevant cell, selects collision-free ones and modifies them to exactly meet the hand target acquisition constraint. Simulation results showed that the MBPP model is capable of rapidly and robustly planning reach postures for various scenarios.

  2. [Definition of accurate planning target volume margins for esophageal cancer radiotherapy].

    PubMed

    Lesueur, P; Servagi-Vernat, S

    2016-10-01

    More than 4000 cases of esophagus neoplasms are diagnosed every year in France. Radiotherapy, which can be delivered in preoperative or exclusive with a concomitant chemotherapy, plays a central role in treatment of esophagus cancer. Even if efficacy of radiotherapy no longer has to be proved, the prognosis of esophagus cancer remains unfortunately poor with a high recurrence rate. Toxicity of esophageal radiotherapy is correlated with the irradiation volume, and limits dose escalation and local control. Esophagus is a deep thoracic organ, which undergoes cardiac and respiratory motion, making the radiotherapy delivery more difficult and increasing the planning target volume margins. Definition of accurate planning target volume margins, taking into account the esophagus' intrafraction motion and set up margins is very important to be sure to cover the clinical target volume and restrains acute and late radiotoxicity. In this article, based on a review of the literature, we propose planning target volume margins adapted to esophageal radiotherapy.

  3. Dosimetric effects of rotational output variation and x-ray target degradation on helical tomotherapy plans.

    PubMed

    Staton, Robert J; Langen, Katja M; Kupelian, Patrick A; Meeks, Sanford L

    2009-07-01

    In this study, two potential sources of IMRT delivery error have been identified for helical tomotherapy delivery using the HiART system (TomoTherapy, Inc., Madison, WI): Rotational output variation and target degradation. The HiArt system is known to have output variation, typically about +/- 2%, due to the absence of a dose servo system. On the HiArt system, x-ray target replacement is required approximately every 10-12 months due to target degradation. Near the end of target life, the target thins and causes a decrease in the beam energy and a softening of the beam profile at the lateral edges of the beam. The purpose of this study is to evaluate the dosimetric effects of rotational output variation and target degradation by modeling their effects and incorporating them into recalculated treatment plans for three clinical scenarios: Head and neck, partial breast, and prostate. Models were created to emulate both potential sources of error. For output variation, a model was created using a sine function to match the amplitude (+/- 2%), frequency, and phase of the measured rotational output variation data. A second model with a hypothetical variation of +/- 7% was also created to represent the largest variation that could exist without violating the allowable dose window in the delivery system. A measured beam profile near the end of target life was used to create a modified beam profile model for the target degradation. These models were then incorporated into the treatment plan by modifying the leaf opening times in the delivery sinogram. A new beam model was also created to mimic the change in beam energy seen near the end of target life. The plans were then calculated using a research version of the PLANNED ADAPTIVE treatment planning software from TomoTherapy, Inc. Three plans were evaluated in this study: Head and neck, partial breast, and prostate. The D50 of organs at risk, the D95 for planning target volumes (PTVs), and the local dose difference were used

  4. Use of target-date funds in 401(k) plans, 2007.

    PubMed

    Copeland, Craig

    2009-03-01

    WHAT THEY ARE: Target-date funds (also called "life-cycle" funds) are a type of mutual fund that automatically rebalances its asset allocation following a predetermined pattern over time. They typically rebalance to more conservative and income-producing assets as the participant's target date of retirement approaches. WHY THEY'RE IMPORTANT AND GROWING: Of the 401(k) plan participants in the EBRI/ICI 401(k) database who were found to be in plans that offeredtarget-date funds, 37 percent had at least some fraction of their account in target-date funds in 2007. Target-date funds held about 7 percent of total assets in 401(k) plans and the use of these funds is expected to increase in the future. The Pension Protection Act of 2006 made it easier for plan sponsors to automatically enroll new workers in a 401(k) plan, and target-date funds were one of the types of approved funds specified for a "default" investment if the participant does not elect a choice. BRI/ICI 401(K) DATABASE: This study uses the unique richness of the data in the EBRI/ICI Participant-Directed Retirement Plan Data Collection Project, which has almost 22 million participants, to examine the choices and characteristics of participants whose plans offer target-date funds. EFFECT OF AGE, SALARY, JOB TENURE, AND ACCOUNT BALANCE: Younger workers are significantly more likely to invest in target-date funds than are older workers: Almost 44 percent of participants under age 30 had assets in a target-date fund, compared with 27 percent of those 60 or older. Target-date funds appeal to those with lower incomes, little time on the job, and with few assets. On average, target-date fund investors are about 2.5 years younger than those who do not invest in target-date funds, have about 3.5 years less tenure, make about $11,000 less in salary, have $25,000 less in their account, and are in smaller plans. EFFECT OF AUTOMATIC ENROLLMENT: While the EBRI/ICI database does not contain specific information on whether

  5. Embodied Moving-Target Seeking with Prediction and Planning

    NASA Astrophysics Data System (ADS)

    Oses, Noelia; Hoffmann, Matej; Koene, Randal A.

    We present a bio-inspired control method for moving-target seeking with a mobile robot, which resembles a predator-prey scenario. The motor repertoire of a simulated Khepera robot was restricted to a discrete number of 'gaits'. After an exploration phase, the robot automatically synthesizes a model of its motor repertoire, acquiring a forward model. Two additional components were introduced for the task of catching a prey robot. First, an inverse model to the forward model, which is used to determine the action (gait) needed to reach a desired location. Second, while hunting the prey, a model of the prey's behavior is learned online by the hunter robot. All the models are learned ab initio, without assumptions, work in egocentric coordinates, and are probabilistic in nature. Our architecture can be applied to robots with any physical constraints (or embodiment), such as legged robots.

  6. Final work plan for targeted investigation at Inman, Kansas.

    SciTech Connect

    LaFreniere, L. M.; Environmental Science Division

    2007-11-05

    In 1997, low levels of carbon tetrachloride (below the maximum contaminant level [MCL] of 5 {micro}g/L) were detected in groundwater at Inman, Kansas, by the Kansas Department of Health and Environment (KDHE). The 1997 KDHE sampling was conducted under the U.S. Department of Agriculture (USDA) private well sampling program. The Commodity Credit Corporation (CCC), a USDA agency, operated a grain storage facility in Inman from 1954 to 1965. Carbon tetrachloride is the contaminant of primary concern at sites associated with former CCC/USDA grain storage operations. Inman is located in southwest McPherson County, approximately 10 mi southwest of the city of McPherson (Figure 1.1). To determine whether the former CCC/USDA facility at Inman is a potential contaminant source and its possible relationship to the contamination in groundwater, the CCC/USDA has agreed to conduct an investigation at Inman, in accordance with the Intergovernmental Agreement between the KDHE and the Farm Service Agency of the USDA. For this work plan, Argonne compiled historical data related to the previous investigations and grain storage operations at Inman. Through a review of documents acquired from all available sources, other potential contaminant source areas (in addition to the former CCC/USDA facility) have been identified as (1) the commercial grain storage structures northwest of Inman, along the railroad right-of-way, and (2) small former private grain storage facilities west of Main Street and near the former CCC/USDA facility at the southern edge of Inman (Figure 1.2). Previous investigations and the potential source areas are discussed in Section 2.

  7. Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam

    PubMed Central

    Harris, Jody; Nguyen, Phuong H.; To, Quyen; Frongillo, Edward A.; Menon, Purnima

    2016-01-01

    Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009–2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. PMID:27198978

  8. A method for deriving a 4D-interpolated balanced planning target for mobile tumor radiotherapy

    SciTech Connect

    Roland, Teboh; Hales, Russell; McNutt, Todd; Wong, John; Simari, Patricio; Tryggestad, Erik

    2012-01-15

    Purpose: Tumor control and normal tissue toxicity are strongly correlated to the tumor and normal tissue volumes receiving high prescribed dose levels in the course of radiotherapy. Planning target definition is, therefore, crucial to ensure favorable clinical outcomes. This is especially important for stereotactic body radiation therapy of lung cancers, characterized by high fractional doses and steep dose gradients. The shift in recent years from population-based to patient-specific treatment margins, as facilitated by the emergence of 4D medical imaging capabilities, is a major improvement. The commonly used motion-encompassing, or internal-target volume (ITV), target definition approach provides a high likelihood of coverage for the mobile tumor but inevitably exposes healthy tissue to high prescribed dose levels. The goal of this work was to generate an interpolated balanced planning target that takes into account both tumor coverage and normal tissue sparing from high prescribed dose levels, thereby improving on the ITV approach. Methods: For each 4DCT dataset, 4D deformable image registration was used to derive two bounding targets, namely, a 4D-intersection and a 4D-composite target which minimized normal tissue exposure to high prescribed dose levels and maximized tumor coverage, respectively. Through definition of an ''effective overlap volume histogram'' the authors derived an ''interpolated balanced planning target'' intended to balance normal tissue sparing from prescribed doses with tumor coverage. To demonstrate the dosimetric efficacy of the interpolated balanced planning target, the authors performed 4D treatment planning based on deformable image registration of 4D-CT data for five previously treated lung cancer patients. Two 4D plans were generated per patient, one based on the interpolated balanced planning target and the other based on the conventional ITV target. Plans were compared for tumor coverage and the degree of normal tissue sparing

  9. Family planning education: working with target groups in the South Pacific.

    PubMed

    Winn, M

    1992-07-01

    Family planning education programs are commonly designed by expert educators who are far removed, in location and experience, from their target audiences. Educators operate on the premise that their job is simply to develop strategies to successfully transfer their knowledge to the target audience. Judgements are often colored by a determination not to offend local sensibilities, which can lead educators to uncritically adopt the local wisdom about what is and is not culturally acceptable. A proper exploration of sexuality is absent from most family planning programs. Usual features of expert-designed family planning programs are an admonishment about people having too many children (the stick), a clear rationale for having fewer children (the carrot), the provision of detailed contraceptive information (the means), and the encouragement of individuals to exercise some personal control over their fertility (the ends). This standard model, although widely used throughout the Pacific, was not adopted by the Family Planning Federation of Australia in its regional family planning education work. The Federation, in conjunction with the independent Family Planning Association in the South Pacific, has taken a more participatory, learner-focused approach that values the contribution of the audience in all phases of the program. There is a huge need to target men, particularly young, unmarried men. The Federation found that not only did Pacific men want to view and discuss the women's documentary video Taboo Talk about family planning issues, they wanted their own men's version. The Federation soon discovered that attempts to meet the requests can easily flounder on the issue of language. The Federation has worked with the target audience to develop a lexicon of acceptable words for reproductive health education.

  10. Lymphatic atlas-based target volume definition for intensity-modulated radiation therapy planning

    NASA Astrophysics Data System (ADS)

    Qatarneh, S. M.; Kiricuta, I. C.; Brahme, A.; Noz, M. E.; Ferreira, B.; Kim, W. C.; Lind, B. K.

    2007-10-01

    Despite the improvements in current imaging modalities such as CT and MRI, the detection of normal or malignant lymph nodes remains a challenge due to the large variability in lymph node characteristics and the variation in imaging quality and the limited imaging resolution. A computerized lymph node atlas could be the ideal tool for target volume definition based on the distribution of normal lymph nodes surrounding the verified malignant nodes to improve the accuracy of intensity-modulated radiation therapy planning. The standard lymph node topography in the newly constructed 3D lymph node atlas offers a detailed topographical distribution of discrete nodal locations in relation to surrounding organs at risk. In the present paper, the recently developed lymph node atlas is used for selection and delineation of target volumes in the head and neck, thorax and pelvic region. Image registration techniques were implemented to integrate the topography of the lymph node atlas into the patient's data set. By combining the knowledge-based lymph node distribution with the patient's data set, more detailed definitions of the target volumes were obtained to facilitate biologically based treatment plan optimization. The response values of the biologically optimized treatment plans were used to derive the probability of tumor control and the probability of complications in organs at risk. The treatment outcome of the lung reference plan showed a lower probability of recurrence in comparison to planning without the lymph node atlas. The lymph node atlas can improve and standardize the target volume definition by including more accurate anatomical knowledge for target volume definition and biologically optimized radiation therapy planning.

  11. UAVs Task and Motion Planning in the Presence of Obstacles and Prioritized Targets.

    PubMed

    Gottlieb, Yoav; Shima, Tal

    2015-11-24

    The intertwined task assignment and motion planning problem of assigning a team of fixed-winged unmanned aerial vehicles to a set of prioritized targets in an environment with obstacles is addressed. It is assumed that the targets' locations and initial priorities are determined using a network of unattended ground sensors used to detect potential threats at restricted zones. The targets are characterized by a time-varying level of importance, and timing constraints must be fulfilled before a vehicle is allowed to visit a specific target. It is assumed that the vehicles are carrying body-fixed sensors and, thus, are required to approach a designated target while flying straight and level. The fixed-winged aerial vehicles are modeled as Dubins vehicles, i.e., having a constant speed and a minimum turning radius constraint. The investigated integrated problem of task assignment and motion planning is posed in the form of a decision tree, and two search algorithms are proposed: an exhaustive algorithm that improves over run time and provides the minimum cost solution, encoded in the tree, and a greedy algorithm that provides a quick feasible solution. To satisfy the target's visitation timing constraint, a path elongation motion planning algorithm amidst obstacles is provided. Using simulations, the performance of the algorithms is compared, evaluated and exemplified.

  12. Experimental characterization and system simulations of depth of interaction PET detectors using 0.5 mm and 0.7 mm LSO arrays.

    PubMed

    James, Sara St; Yang, Yongfeng; Wu, Yibao; Farrell, Richard; Dokhale, Purushottam; Shah, Kanai S; Cherry, Simon R

    2009-07-21

    Small animal PET scanners may be improved by increasing the sensitivity, improving the spatial resolution and improving the uniformity of the spatial resolution across the field of view. This may be achieved by using PET detectors based on crystal elements that are thin in the axial and transaxial directions and long in the radial direction, and by employing depth of interaction (DOI) encoding to minimize the parallax error. With DOI detectors, the diameter of the ring of the PET scanner may also be decreased. This minimizes the number of detectors required to achieve the same solid angle coverage as a scanner with a larger ring diameter and minimizes errors due to non-collinearity of the annihilation photons. In this study, we characterize prototype PET detectors that are finely pixelated with individual LSO crystal element sizes of 0.5 mm x 0.5 mm x 20 mm and 0.7 mm x 0.7 mm x 20 mm, read out at both ends by position sensitive avalanche photodiodes (PSAPDs). Both a specular reflector and a diffuse reflector were evaluated. The detectors were characterized based on the ability to clearly resolve the individual crystal elements, the DOI resolution and the energy resolution. Our results indicate that a scanner based on any of the four detector designs would offer improved spatial resolution and more uniform spatial resolution compared to present day small animal PET scanners. The greatest improvements to spatial resolution will be achieved when the detectors employing the 0.5 mm x 0.5 mm x 20 mm crystals are used. Monte Carlo simulations were performed to demonstrate that 2 mm DOI resolution is adequate to ensure uniform spatial resolution for a small animal PET scanner geometry using these detectors. The sensitivity of such a scanner was also simulated using Monte Carlo simulations and was shown to be greater than 10% for a four ring scanner with an inner diameter of 6 cm, employing 20 detectors per scanner ring.

  13. Experimental characterization and system simulations of depth of interaction PET detectors using 0.5 mm and 0.7 mm LSO arrays

    NASA Astrophysics Data System (ADS)

    James, Sara St; Yang, Yongfeng; Wu, Yibao; Farrell, Richard; Dokhale, Purushottam; Shah, Kanai S.; Cherry, Simon R.

    2009-07-01

    Small animal PET scanners may be improved by increasing the sensitivity, improving the spatial resolution and improving the uniformity of the spatial resolution across the field of view. This may be achieved by using PET detectors based on crystal elements that are thin in the axial and transaxial directions and long in the radial direction, and by employing depth of interaction (DOI) encoding to minimize the parallax error. With DOI detectors, the diameter of the ring of the PET scanner may also be decreased. This minimizes the number of detectors required to achieve the same solid angle coverage as a scanner with a larger ring diameter and minimizes errors due to non-collinearity of the annihilation photons. In this study, we characterize prototype PET detectors that are finely pixelated with individual LSO crystal element sizes of 0.5 mm × 0.5 mm × 20 mm and 0.7 mm × 0.7 mm × 20 mm, read out at both ends by position sensitive avalanche photodiodes (PSAPDs). Both a specular reflector and a diffuse reflector were evaluated. The detectors were characterized based on the ability to clearly resolve the individual crystal elements, the DOI resolution and the energy resolution. Our results indicate that a scanner based on any of the four detector designs would offer improved spatial resolution and more uniform spatial resolution compared to present day small animal PET scanners. The greatest improvements to spatial resolution will be achieved when the detectors employing the 0.5 mm × 0.5 mm × 20 mm crystals are used. Monte Carlo simulations were performed to demonstrate that 2 mm DOI resolution is adequate to ensure uniform spatial resolution for a small animal PET scanner geometry using these detectors. The sensitivity of such a scanner was also simulated using Monte Carlo simulations and was shown to be greater than 10% for a four ring scanner with an inner diameter of 6 cm, employing 20 detectors per scanner ring.

  14. Target Allocation Methodology for China's Provinces: Energy Intensity in the 12th FIve-Year Plan

    SciTech Connect

    Ohshita, Stephanie; Price, Lynn

    2011-03-21

    Experience with China's 20% energy intensity improvement target during the 11th Five-Year Plan (FYP) (2006-2010) has shown the challenges of rapidly setting targets and implementing measures to meet them. For the 12th FYP (2011-2015), there is an urgent need for a more scientific methodology to allocate targets among the provinces and to track physical and economic indicators of energy and carbon saving progress. This report provides a sectoral methodology for allocating a national energy intensity target - expressed as percent change in energy per unit gross domestic product (GDP) - among China's provinces in the 12th FYP. Drawing on international experience - especially the European Union (EU) Triptych approach for allocating Kyoto carbon targets among EU member states - the methodology here makes important modifications to the EU approach to address an energy intensity rather than a CO{sub 2} emissions target, and for the wider variation in provincial energy and economic structure in China. The methodology combines top-down national target projections and bottom-up provincial and sectoral projections of energy and GDP to determine target allocation of energy intensity targets. Total primary energy consumption is separated into three end-use sectors - industrial, residential, and other energy. Sectoral indicators are used to differentiate the potential for energy saving among the provinces. This sectoral methodology is utilized to allocate provincial-level targets for a national target of 20% energy intensity improvement during the 12th FYP; the official target is determined by the National Development and Reform Commission. Energy and GDP projections used in the allocations were compared with other models, and several allocation scenarios were run to test sensitivity. The resulting allocations for the 12th FYP offer insight on past performance and offer somewhat different distributions of provincial targets compared to the 11th FYP. Recommendations for reporting

  15. Absorption of Iontophoresis-Driven 2% Lidocaine With Epinephrine in the Tissues at 5 mm Below the Surface of the Skin

    PubMed Central

    Draper, David O.; Coglianese, Mark; Castel, Chris

    2011-01-01

    Context: In a recent study, we were unable to measure lidocaine in the human calf at a 5-mm depth via iontophoresis. We surmised that this might be due to a lack of epinephrine in the compound. Because epinephrine is a vasoconstrictor, it might allow the drug to pass beyond the capillaries and be delivered to the deeper tissues. Objective: To determine if iontophoresis could deliver lidocaine with epinephrine 5 mm under the surface of human skin, as measured by microdialysis. Design: Descriptive laboratory study. Setting: Therapeutic modalities research laboratory. Patients or Other Participants: Ten volunteers (5 males, 5 females; age, 15–28 years) with less than 5 mm of adipose tissue in the area we measured and with no allergies to lidocaine participated. The measurement area had been free of any injury, swelling, or infection for at least 3 months before the study. Intervention(s): We inserted a microdialysis probe 0.5 cm under the skin of the right lower leg. Next, microdialysis was performed through this area for 60 minutes, which allowed local skin blood flow to return to baseline. We then performed iontophoresis at 40 mA/min using 2 mL of 2% lidocaine. Iontophoresis was performed over this area for 10.5 minutes to collect the lidocaine samples. After this stage, the electrode was left in place for another 50 minutes for a total of 60 minutes. Main Outcome Measure(s): The samples of the drug were analyzed via reverse-phase high-performance liquid chromatography (RP-HPLC) in the chemistry department. Results: The RP-HPLC analysis confirmed the presence of lidocaine in all 10 participants. The mean concentration of lidocaine detected at the 5-mm depth was calculated as 3.63 mg/mL (greater than 18% of delivered concentration). Conclusions: We found that 2% lidocaine can be delivered up to 5 mm below the surface of the skin when the drug compound contains epinephrine and when passive delivery occurs for at least 50 minutes after the active delivery has

  16. SU-E-T-513: Investigating Dose of Internal Target Volume After Correcting for Tissue Heterogeneity in SBRT Lung Plans with Homogeneity Calculation

    SciTech Connect

    Qi, P; Zhuang, T; Magnelli, A; Djemil, T; Shang, Q; Balik, S; Andrews, M; Stephans, K; Videtic, G; Xia, P

    2015-06-15

    Purpose It was recommended to use the prescription of 54 Gy/3 with heterogeneity corrections for previously established dose scheme of 60 Gy/3 with homogeneity calculation. This study is to investigate dose coverage for the internal target volume (ITV) with and without heterogeneity correction. Methods Thirty patients who received stereotactic body radiotherapy (SBRT) to a dose of 60 Gy in 3 fractions with homogeneous planning for early stage non-small-cell lung cancer (NSCLC) were selected. ITV was created either from 4DCT scans or a fusion of multi-phase respiratory scans. Planning target volume (PTV) was a 5 mm expansion of the ITV. For this study, we recalculated homogeneous clinical plans using heterogeneity corrections with monitor units set as clinically delivered. All plans were calculated with 3 mm dose grids and collapsed cone convolution algorithm. To account for uncertainties from tumor delineation and image-guided radiotherapy, a structure ITV2mm was created by expanding ITV with 2 mm margins. Dose coverage to the PTV, ITV and ITV2mm were compared with a student paired t-test. Results With heterogeneity corrections, the PTV V60Gy decreased by 10.1% ± 18.4% (p<0.01) while the maximum dose to the PTV increased by 3.7 ± 4.3% (p<0.01). With and without corrections, D99% was 65.8 ± 4.0 Gy and 66.7 ± 4.8 Gy (p=0.15) for the ITV, and 63.9 ± 3.4 Gy and 62.9 ± 4.6 Gy for the ITV2mm (p=0.22), respectively. The mean dose to the ITV and ITV2mm increased 3.6% ± 4.7% (p<0.01) and 2.3% ± 5.2% (p=0.01) with heterogeneity corrections. Conclusion After heterogeneity correction, the peripheral coverage of the PTV decreased to approximately 54 Gy, but D99% of the ITV and ITV2mm was unchanged and the mean dose to the ITV and ITV2mm was increased. Clinical implication of these results requires more investigation.

  17. Pulp stone--an endodontic challenge: successful retrieval of exceptionally long pulp stones measuring 14 and 9.5 mm from the palatal roots of maxillary molars.

    PubMed

    Nanjannawar, Girish S; Vagarali, Hemanth; Nanjannawar, Lalita G; Prathasarathy, Bharath; Patil, Anand; Bhandi, Shilpa

    2012-09-01

    Pulp stones are nodular, calcified masses commonly appearing in the coronal pulp and occasionally extending in radicular pulp. Retrieval of pulp stones remains a challenge for the endodontist as complete cleaning and shaping of root canal system is the bases for successful endodontic therapy. The aim of this case report is to show the retrieval of long pulp stones measuring 14 and 9.5 mm by utilizing synergistic effect of ultrasonics and sodium hypochlorite from the palatal roots of maxillary molars. Such case has not been reported in the literature so far.

  18. Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

    SciTech Connect

    Ipsen, S.; Blanck, O.; Rades, D.; Oborn, B.; Bode, F.; Liney, G.; Hunold, P.; Schweikard, A.; Keall, P. J.

    2014-12-15

    Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefits of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the

  19. Crestal bone changes on platform-switched implants and adjacent teeth when the tooth-implant distance is less than 1.5 mm.

    PubMed

    Vela, Xavier; Méndez, Víctor; Rodríguez, Xavier; Segalá, Maribel; Tarnow, Dennis P

    2012-04-01

    Because of the peri-implant bone resorption that occurs when a non-platform switched implant is exposed to the oral environment, it has been recommended to maintain 1.5 mm between the tooth and implant to preserve the bone adjacent to the teeth. Several studies have documented that platform-switched implants have less peri-implant bone resorption than matched implants. This retrospective radiographic analysis studied 70 platform-switched implants placed less than 1.5 mm from an adjacent tooth and with prostheses loaded for a minimum of 6 months. The mean distance between the implant and tooth was 0.99 mm (range, 0.20 to 1.49 mm); the mean horizontal and vertical bone resorption was 0.36 and 0.43 mm, respectively. The mean bone peak reduction was 0.37 mm. The results confirm that the use of platform-switched implants reduces bone resorption after two-piece implants have been uncovered and that it is possible to place this type of implant 1 mm from teeth while maintaining the bone level adjacent to them (the bone peak).

  20. [Margin determination from clinical to planning target volume for lung cancer treated with conformal or intensity-modulated irradiation].

    PubMed

    Berthelot, K; Thureau, S; Giraud, P

    2016-10-01

    Technological progress in radiotherapy enables more precision for treatment planning and delivery. The margin determination between the clinical target volume and the planning target volumes stem from the estimation of geometric uncertainties of the tumour localization into the radiation beam. The inner motion complexity of lung tumours has led to the use of 4D computed tomography and nurtures specific dosimetric concerns. Few strategies consisting in integrating tumour motion allow margin reduction regarding inner movements. The patient immobilization and onboard imagery improvement decrease the setup uncertainties. Each step between the initial planning imagery and treatment delivery has to be analysed as systematic or random errors to calculate the optimal planning margin.

  1. Monte Carlo treatment planning for molecular targeted radiotherapy within the MINERVA system.

    PubMed

    Lehmann, Joerg; Hartmann Siantar, Christine; Wessol, Daniel E; Wemple, Charles A; Nigg, David; Cogliati, Josh; Daly, Tom; Descalle, Marie-Anne; Flickinger, Terry; Pletcher, David; Denardo, Gerald

    2005-03-07

    The aim of this project is to extend accurate and patient-specific treatment planning to new treatment modalities, such as molecular targeted radiation therapy, incorporating previously crafted and proven Monte Carlo and deterministic computation methods. A flexible software environment is being created that allows planning radiation treatment for these new modalities and combining different forms of radiation treatment with consideration of biological effects. The system uses common input interfaces, medical image sets for definition of patient geometry and dose reporting protocols. Previously, the Idaho National Engineering and Environmental Laboratory (INEEL), Montana State University (MSU) and Lawrence Livermore National Laboratory (LLNL) had accrued experience in the development and application of Monte Carlo based, three-dimensional, computational dosimetry and treatment planning tools for radiotherapy in several specialized areas. In particular, INEEL and MSU have developed computational dosimetry systems for neutron radiotherapy and neutron capture therapy, while LLNL has developed the PEREGRINE computational system for external beam photon-electron therapy. Building on that experience, the INEEL and MSU are developing the MINERVA (modality inclusive environment for radiotherapeutic variable analysis) software system as a general framework for computational dosimetry and treatment planning for a variety of emerging forms of radiotherapy. In collaboration with this development, LLNL has extended its PEREGRINE code to accommodate internal sources for molecular targeted radiotherapy (MTR), and has interfaced it with the plugin architecture of MINERVA. Results from the extended PEREGRINE code have been compared to published data from other codes, and found to be in general agreement (EGS4-2%, MCNP-10%) (Descalle et al 2003 Cancer Biother. Radiopharm. 18 71-9). The code is currently being benchmarked against experimental data. The interpatient variability of the

  2. Monte Carlo treatment planning for molecular targeted radiotherapy within the MINERVA system

    NASA Astrophysics Data System (ADS)

    Lehmann, Joerg; Hartmann Siantar, Christine; Wessol, Daniel E.; Wemple, Charles A.; Nigg, David; Cogliati, Josh; Daly, Tom; Descalle, Marie-Anne; Flickinger, Terry; Pletcher, David; DeNardo, Gerald

    2005-03-01

    The aim of this project is to extend accurate and patient-specific treatment planning to new treatment modalities, such as molecular targeted radiation therapy, incorporating previously crafted and proven Monte Carlo and deterministic computation methods. A flexible software environment is being created that allows planning radiation treatment for these new modalities and combining different forms of radiation treatment with consideration of biological effects. The system uses common input interfaces, medical image sets for definition of patient geometry and dose reporting protocols. Previously, the Idaho National Engineering and Environmental Laboratory (INEEL), Montana State University (MSU) and Lawrence Livermore National Laboratory (LLNL) had accrued experience in the development and application of Monte Carlo based, three-dimensional, computational dosimetry and treatment planning tools for radiotherapy in several specialized areas. In particular, INEEL and MSU have developed computational dosimetry systems for neutron radiotherapy and neutron capture therapy, while LLNL has developed the PEREGRINE computational system for external beam photon-electron therapy. Building on that experience, the INEEL and MSU are developing the MINERVA (modality inclusive environment for radiotherapeutic variable analysis) software system as a general framework for computational dosimetry and treatment planning for a variety of emerging forms of radiotherapy. In collaboration with this development, LLNL has extended its PEREGRINE code to accommodate internal sources for molecular targeted radiotherapy (MTR), and has interfaced it with the plugin architecture of MINERVA. Results from the extended PEREGRINE code have been compared to published data from other codes, and found to be in general agreement (EGS4—2%, MCNP—10%) (Descalle et al 2003 Cancer Biother. Radiopharm. 18 71-9). The code is currently being benchmarked against experimental data. The interpatient variability of

  3. Monte Carlo Treatment Planning for Molecular Targeted Radiotherapy within the MINERVA System

    SciTech Connect

    Lehmann, J; Siantar, C H; Wessol, D E; Wemple, C A; Nigg, D; Cogliati, J; Daly, T; Descalle, M; Flickinger, T; Pletcher, D; DeNardo, G

    2004-09-22

    The aim of this project is to extend accurate and patient-specific treatment planning to new treatment modalities, such as molecular targeted radiation therapy, incorporating previously crafted and proven Monte Carlo and deterministic computation methods. A flexible software environment is being created that allows planning radiation treatment for these new modalities and combining different forms of radiation treatment with consideration of biological effects. The system uses common input interfaces, medical image sets for definition of patient geometry, and dose reporting protocols. Previously, the Idaho National Engineering and Environmental Laboratory (INEEL), Montana State University (MSU), and Lawrence Livermore National Laboratory (LLNL) had accrued experience in the development and application of Monte Carlo-based, three-dimensional, computational dosimetry and treatment planning tools for radiotherapy in several specialized areas. In particular, INEEL and MSU have developed computational dosimetry systems for neutron radiotherapy and neutron capture therapy, while LLNL has developed the PEREGRINE computational system for external beam photon-electron therapy. Building on that experience, the INEEL and MSU are developing the MINERVA (Modality Inclusive Environment for Radiotherapeutic Variable Analysis) software system as a general framework for computational dosimetry and treatment planning for a variety of emerging forms of radiotherapy. In collaboration with this development, LLNL has extended its PEREGRINE code to accommodate internal sources for molecular targeted radiotherapy (MTR), and has interfaced it with the plug-in architecture of MINERVA. Results from the extended PEREGRINE code have been compared to published data from other codes, and found to be in general agreement (EGS4 - 2%, MCNP - 10%)(Descalle et al. 2003). The code is currently being benchmarked against experimental data. The interpatient variability of the drug pharmacokinetics in MTR

  4. PLANS FOR WARM DENSE MATTER EXPERIMENTS AND IFE TARGET EXPERIMENTS ON NDCX-II

    SciTech Connect

    Waldron, W.L.; Barnard, J.J.; Bieniosek, F.M.; Friedman, A.; Henestroza, E.; Leitner, M.; Logan, B.G.; Ni, P.A.; Roy, P.K.; Seidl, P.A.; Sharp, W.M.

    2008-09-22

    The Heavy Ion Fusion Science Virtual National Laboratory (HIFS-VNL) is currently developing design concepts for NDCX-II, the second phase of the Neutralized Drift Compression Experiment, which will use ion beams to explore Warm Dense Matter (WDM) and Inertial Fusion Energy (IFE) target hydrodynamics. The ion induction accelerator will consist of a new short pulse injector and induction cells from the decommissioned Advanced Test Accelerator (ATA) at Lawrence Livermore National Laboratory (LLNL). To fit within an existing building and to meet the energy and temporal requirements of various target experiments, an aggressive beam compression and acceleration schedule is planned. WDM physics and ion-driven direct drive hydrodynamics will initially be explored with 30 nC of lithium ions in experiments involving ion deposition, ablation, acceleration and stability of planar targets. Other ion sources which may deliver higher charge per bunch will be explored. A test stand has been built at Lawrence Berkeley National Laboratory (LBNL) to test refurbished ATA induction cells and pulsed power hardware for voltage holding and ability to produce various compression and acceleration waveforms. Another test stand is being used to develop and characterize lithium-doped aluminosilicate ion sources. The first experiments will include heating metallic targets to 10,000 K and hydrodynamics studies with cryogenic hydrogen targets.

  5. The role of PET in target localization for radiotherapy treatment planning.

    PubMed

    Rembielak, Agata; Price, Pat

    2008-02-01

    Positron emission tomography (PET) is currently accepted as an important tool in oncology, mostly for diagnosis, staging and restaging purposes. It provides a new type of information in radiotherapy, functional rather than anatomical. PET imaging can also be used for target volume definition in radiotherapy treatment planning. The need for very precise target volume delineation has arisen with the increasing use of sophisticated three-dimensional conformal radiotherapy techniques and intensity modulated radiation therapy. It is expected that better delineation of the target volume may lead to a significant reduction in the irradiated volume, thus lowering the risk of treatment complications (smaller safety margins). Better tumour visualisation also allows a higher dose of radiation to be applied to the tumour, which may lead to better tumour control. The aim of this article is to review the possible use of PET imaging in the radiotherapy of various cancers. We focus mainly on non-small cell lung cancer, lymphoma and oesophageal cancer, but also include current opinion on the use of PET-based planning in other tumours including brain, uterine cervix, rectum and prostate.

  6. Data fusion for planning target volume and isodose prediction in prostate brachytherapy

    NASA Astrophysics Data System (ADS)

    Nouranian, Saman; Ramezani, Mahdi; Mahdavi, S. Sara; Spadinger, Ingrid; Morris, William J.; Salcudean, Septimiu E.; Abolmaesumi, Purang

    2015-03-01

    In low-dose prostate brachytherapy treatment, a large number of radioactive seeds is implanted in and adjacent to the prostate gland. Planning of this treatment involves the determination of a Planning Target Volume (PTV), followed by defining the optimal number of seeds, needles and their coordinates for implantation. The two major planning tasks, i.e. PTV determination and seed definition, are associated with inter- and intra-expert variability. Moreover, since these two steps are performed in sequence, the variability is accumulated in the overall treatment plan. In this paper, we introduce a model based on a data fusion technique that enables joint determination of PTV and the minimum Prescribed Isodose (mPD) map. The model captures the correlation between different information modalities consisting of transrectal ultrasound (TRUS) volumes, PTV and isodose contours. We take advantage of joint Independent Component Analysis (jICA) as a linear decomposition technique to obtain a set of joint components that optimally describe such correlation. We perform a component stability analysis to generate a model with stable parameters that predicts the PTV and isodose contours solely based on a new patient TRUS volume. We propose a framework for both modeling and prediction processes and evaluate it on a dataset of 60 brachytherapy treatment records. We show PTV prediction error of 10:02+/-4:5% and the V100 isodose overlap of 97+/-3:55% with respect to the clinical gold standard.

  7. SU-E-T-428: Dosimetric Impact of Multileaf Collimator Leaf Width On Single and multiple Isocenter Stereotactic IMRT Treatment Plans for multiple Brain Tumors

    SciTech Connect

    Giem, J; Algan, O; Ahmad, S; Ali, I; Young, J; Hossain, S

    2014-06-01

    Purpose: To assess the impacts that multileaf collimator (MLC) leaf width has on the dose conformity and normal brain tissue doses of single and multiple isocenter stereotactic IMRT (SRT) plans for multiple intracranial tumors. Methods: Fourteen patients with 2–3 targets were studied retrospectively. Patients treated with multiple isocenter treatment plans using 9 to 12 non-coplanar beams per lesion underwent repeat planning using single isocenter and 10 to 12 non-coplanar beams with 2.5mm, 3mm and 5mm MLC leaf widths. Brainlab iPlan treatment planning system for delivery with the 2.5mm MLC served as reference. Identical contour sets and dose-volume constraints were applied. The prescribed dose to each target was 25 Gy to be delivered over 5 fractions with a minimum of 99% dose to cover ≥ 95% of the target volume. Results: The lesions and normal brains ranged in size from 0.11 to 51.67cc (median, 2.75cc) and 1090 to 1641cc (median, 1401cc), respectively. The Paddick conformity index for single and multiple isocenter (2.5mm vs. 3mm and 5mm MLCs) was (0.79±0.08 vs. 0.79±0.07 and 0.77±0.08) and (0.79±0.09 vs. 0.77±0.09 and 0.76±0.08), respectively. The average normal brain volumes receiving 15 Gy for single and multiple isocenter (2.5mm vs. 3mm and 5mm MLCs) were (3.65% vs. 3.95% and 4.09%) and (2.89% vs. 2.91% and 2.92%), respectively. Conclusion: The average dose conformity observed for the different leaf width for single and multiple isocenter plans were similar, throughout. However, the average normal brain volumes receiving 2.5 to 15 Gy were consistently lower for the 2.5mm MLC leaf width, especially for single isocenter plans. The clinical consequences of these integral normal brain tissue doses are still unknown, but employing the use of the 2.5mm MLC option is desirable at sparing normal brain tissue for both single and multiple isocenter cases.

  8. Planning an effective anti-smoking mass media campaign targeting adolescents.

    PubMed

    Pechmann, C; Reibling, E T

    2000-05-01

    This article addresses the following issues: Can an anti-smoking campaign that depends largely on mass media vehicles effectively reduce adolescent tobacco use? Why is an integrated campaign recommended and what are the steps in designing such a campaign? How should the campaign be evaluated? Specific topics include recommended campaign expenditures, target audience identification, selection of persuasive message content, executional (stylistic) considerations, media buying decisions, the use of focus group research and advertising copy-testing research, and outcome evaluations. It is concluded that comprehensive strategic planning and extensive research at all phases of the campaign are essential to success.

  9. Repeated 1-cm Resolution Topographic and 2.5-mm Resolution Photomosiac Surveys of Benthic Communities and Fine Scale Bedforms in Monterey Canyon

    NASA Astrophysics Data System (ADS)

    Caress, D. W.; Hobson, B.; Thomas, H. J.; Henthorn, R.; Martin, E. J.; Bird, L.; Risi, M.; Troni, G.; Paull, C. K.; Rock, S.; Padial, J. A.; Hammond, M. M.

    2014-12-01

    The Monterey Bay Aquarium Research Institute has developed a low altitude, ROV-based seafloor mapping system that combines lidar laser ranging, multibeam sonar, and stereo photographic imagery. When operated at a 3-m altitude, this system maps seafloor topography with a 1-cm lateral resolution and simultaneously collects 2.5-mm resolution color photography. We have twice mapped an 80-m by 80-m area of a chemosynthetic clam community located at 2850-m depth in the Monterey Canyon axis. Both the topography and the photomosaics resolve changes in the clam community over a six-month interval. Many individual animals have moved, and tracks of those animals are visible in the lidar topography. No other changes in the seafloor at this site can be discerned. We have also performed single surveys of bedforms and scours at both 1850-m and 2850-m depths in Monterey Canyon. The highest resolution bathymetry data are collected using a 3DatDepth SL1 lidar laser scanner. This system has a 30° field of view and ranges continuously, achieving a 1 cm sounding spacing at a 3 m altitude and 0.3 m/s speed. Bathymetry data are also collected using a 400-kHz Reson 7125 multibeam sonar. This configuration produces 512 beams across a 135° wide swath; each beam has a 0.5° acrosstrack by 1.0° alongtrack angular width. At a 3-m altitude, the nadir beams have a 2.5 cm acrosstrack and 5 cm alongtrack footprint. Dual Prosilica GX1920 2.4 Mpixel color cameras provide color stereo photography of the seafloor. Illumination is provided by dual xenon strobes. The camera housings have been fitted with corrective optics achieving a 90° field of view with less than 1% distortion. At a 3-m altitude the raw image pixels have a 2.5 mm resolution. Position and attitude data are provided by a Kearfott SeaDevil Inertial Navigation System (INS) integrated with a 300 kHz Teledyne RD Instruments Doppler velocity log (DVL). A separate Paroscientific pressure sensor is mounted adjacent to the INS. The INS

  10. Are two retrograde 3.5 mm screws superior to one 7.3 mm screw for anterior pelvic ring fixation in bones with low bone mineral density?

    PubMed Central

    Zderic, I.; Grechenig, S.; Richards, R. G.; Schmitz, P.; Gueorguiev, B.

    2017-01-01

    Objectives Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible. The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws. Materials and Methods A total of 12 human cadaveric hemipelvises were analysed in a matched pair study design. Bone mineral density of the specimens was 68 mgHA/cm3 (standard deviation (sd) 52). The anterior pelvic ring fracture was fixed with either one 7.3 mm cannulated screw (Group 1) or two 3.5 mm pelvic cortex screws (Group 2). Progressively increasing cyclic axial loading was applied through the acetabulum. Relative movements in terms of interfragmentary displacement and gap angle at the fracture site were evaluated by means of optical movement tracking. The Wilcoxon signed-rank test was applied to identify significant differences between the groups Results Initial axial construct stiffness was not significantly different between the groups (p = 0.463). Interfragmentary displacement and gap angle at the fracture site were also not statistically significantly different between the groups throughout the evaluated cycles (p ⩾ 0.249). Similarly, cycles to failure were not statistically different between Group 1 (8438, sd 6968) and Group 2 (10 213, sd 10 334), p = 0.379. Failure mode in both groups was characterised by screw cutting through the cancellous bone. Conclusion From a biomechanical point of view, pubic ramus stabilisation with either one large or two small fragment screw osteosynthesis is comparable in osteoporotic bone. However, the two-screw fixation technique is less demanding as the smaller screws deflect at the cortical margins. Cite this article: Y. P. Acklin, I. Zderic, S. Grechenig, R. G. Richards, P

  11. Femtosecond laser written 16.5 mm long glass-waveguide amplifier and laser with 5.2 dB cm-1 internal gain at 1534 nm

    NASA Astrophysics Data System (ADS)

    Hoyo, J.; Berdejo, V.; Toney Fernandez, T.; Ferrer, A.; Ruiz, A.; Valles, J. A.; Rebolledo, M. A.; Ortega-Feliu, I.; Solis, J.

    2013-10-01

    A 16.5 mm long, heavily doped erbium-ytterbium phosphate glass-waveguide amplifier was fabricated by the femtosecond laser (fs-laser) inscription technique. The femtosecond laser inscription of waveguides was carried out at 500 kHz repetition rate using a 0.68 NA aspheric lens. The energy deposition profile in the dielectric material was initially simulated using a generalized adaptive fast-Fourier evolver (GAFFE) algorithm. The size and shape of the guiding structures were carefully controlled by the slit shaping technique to reduce the coupling losses, with achievable values down to less than 0.1 dB. Rigorous simulations of the response of the active waveguides were carried out to optimize their performance as optical amplifiers. A maximum of 8.6 dB internal gain at 1534 nm was obtained upon bidirectional laser pumping at 976 nm, leading to a gain per unit length of 5.2 dB cm-1. Laser action was also achieved for both ring and linear cavity configurations.

  12. Targeting climate diversity in conservation planning to build resilience to climate change

    USGS Publications Warehouse

    Heller, Nicole E.; Kreitler, Jason R.; Ackerly, David; Weiss, Stuart; Recinos, Amanda; Branciforte, Ryan; Flint, Lorraine E.; Flint, Alan L.; Micheli, Elisabeth

    2015-01-01

    Climate change is raising challenging concerns for systematic conservation planning. Are methods based on the current spatial patterns of biodiversity effective given long-term climate change? Some conservation scientists argue that planning should focus on protecting the abiotic diversity in the landscape, which drives patterns of biological diversity, rather than focusing on the distribution of focal species, which shift in response to climate change. Climate is one important abiotic driver of biodiversity patterns, as different climates host different biological communities and genetic pools. We propose conservation networks that capture the full range of climatic diversity in a region will improve the resilience of biotic communities to climate change compared to networks that do not. In this study we used historical and future hydro-climate projections from the high resolution Basin Characterization Model to explore the utility of directly targeting climatic diversity in planning. Using the spatial planning tool, Marxan, we designed conservation networks to capture the diversity of climate types, at the regional and sub-regional scale, and compared them to networks we designed to capture the diversity of vegetation types. By focusing on the Conservation Lands Network (CLN) of the San Francisco Bay Area as a real-world case study, we compared the potential resilience of networks by examining two factors: the range of climate space captured, and climatic stability to 18 future climates, reflecting different emission scenarios and global climate models. We found that the climate-based network planned at the sub-regional scale captured a greater range of climate space and showed higher climatic stability than the vegetation and regional based-networks. At the same time, differences among network scenarios are small relative to the variance in climate stability across global climate models. Across different projected futures, topographically heterogeneous areas

  13. Radiotherapy planning for glioblastoma based on a tumor growth model: improving target volume delineation

    NASA Astrophysics Data System (ADS)

    Unkelbach, Jan; Menze, Bjoern H.; Konukoglu, Ender; Dittmann, Florian; Le, Matthieu; Ayache, Nicholas; Shih, Helen A.

    2014-02-01

    Glioblastoma differ from many other tumors in the sense that they grow infiltratively into the brain tissue instead of forming a solid tumor mass with a defined boundary. Only the part of the tumor with high tumor cell density can be localized through imaging directly. In contrast, brain tissue infiltrated by tumor cells at low density appears normal on current imaging modalities. In current clinical practice, a uniform margin, typically two centimeters, is applied to account for microscopic spread of disease that is not directly assessable through imaging. The current treatment planning procedure can potentially be improved by accounting for the anisotropy of tumor growth, which arises from different factors: anatomical barriers such as the falx cerebri represent boundaries for migrating tumor cells. In addition, tumor cells primarily spread in white matter and infiltrate gray matter at lower rate. We investigate the use of a phenomenological tumor growth model for treatment planning. The model is based on the Fisher-Kolmogorov equation, which formalizes these growth characteristics and estimates the spatial distribution of tumor cells in normal appearing regions of the brain. The target volume for radiotherapy planning can be defined as an isoline of the simulated tumor cell density. This paper analyzes the model with respect to implications for target volume definition and identifies its most critical components. A retrospective study involving ten glioblastoma patients treated at our institution has been performed. To illustrate the main findings of the study, a detailed case study is presented for a glioblastoma located close to the falx. In this situation, the falx represents a boundary for migrating tumor cells, whereas the corpus callosum provides a route for the tumor to spread to the contralateral hemisphere. We further discuss the sensitivity of the model with respect to the input parameters. Correct segmentation of the brain appears to be the most

  14. SUPERCONDUCTING LINAC UPGRADE PLAN FOR THE SECOND TARGET STATION PROJECT AT SNS

    SciTech Connect

    Kim, Sang-Ho; Doleans, Marc; Galambos, John D; Howell, Matthew P; Mammosser, John

    2015-01-01

    The beam power of the Linac for the Second Target Station (STS) at the Spallation Neutron Source (SNS) will be doubled to 2.8 MW. For the energy upgrade, seven additional cryomodules will be installed in the reserved space at the end of the linac tunnel to produce linac output energy of 1.3 GeV. The cryomodules for STS will have the same physical length but will incorporate some design changes based on the lessons learned from operational experience over the last 10 years and from the high beta spare cryomodule developed in house. The average macro-pulse beam current for the STS will be 38 mA which is about a 40 % increase from the present beam current for 1.4 MW operation. Plans for the new cryomodules and for the existing cryomodules to support higher beam current for the STS are presented in this paper.

  15. 3D Ultrasound Can Contribute to Planning CT to Define the Target for Partial Breast Radiotherapy

    SciTech Connect

    Berrang, Tanya S.; Truong, Pauline T. Popescu, Carmen; Drever, Laura; Kader, Hosam A.; Hilts, Michelle L.; Mitchell, Tracy; Soh, S.Y.; Sands, Letricia; Silver, Stuart; Olivotto, Ivo A.

    2009-02-01

    Purpose: The role of three-dimensional breast ultrasound (3D US) in planning partial breast radiotherapy (PBRT) is unknown. This study evaluated the accuracy of coregistration of 3D US to planning computerized tomography (CT) images, the seroma contouring consistency of radiation oncologists using the two imaging modalities and the clinical situations in which US was associated with improved contouring consistency compared to CT. Materials and Methods: Twenty consecutive women with early-stage breast cancer were enrolled prospectively after breast-conserving surgery. Subjects underwent 3D US at CT simulation for adjuvant RT. Three radiation oncologists independently contoured the seroma on separate CT and 3D US image sets. Seroma clarity, seroma volumes, and interobserver contouring consistency were compared between the imaging modalities. Associations between clinical characteristics and seroma clarity were examined using Pearson correlation statistics. Results: 3D US and CT coregistration was accurate to within 2 mm or less in 19/20 (95%) cases. CT seroma clarity was reduced with dense breast parenchyma (p = 0.035), small seroma volume (p < 0.001), and small volume of excised breast tissue (p = 0.01). US seroma clarity was not affected by these factors (p = NS). US was associated with improved interobserver consistency compared with CT in 8/20 (40%) cases. Of these 8 cases, 7 had low CT seroma clarity scores and 4 had heterogeneously to extremely dense breast parenchyma. Conclusion: 3D US can be a useful adjunct to CT in planning PBRT. Radiation oncologists were able to use US images to contour the seroma target, with improved interobserver consistency compared with CT in cases with dense breast parenchyma and poor CT seroma clarity.

  16. Does 11.5 mm guided single port surgery has clinical advantage than multi-port thoracoscopic surgery in spontaneous pneumothorax?

    PubMed Central

    Jeon, Hyun Woo

    2016-01-01

    Background Video-assisted thoracoscopic surgery (VATS) has been widely used for spontaneous pneumothorax (SP). In recent years, thoracic surgeons have attempted single incision or single port surgery with the development of surgical technology and skills. Theoretically, single port surgery is expected to provide benefits such as less pain and early recovery. The purpose of this study was to determine the benefits of single port surgery in SP. Methods The 107 patients with SP who underwent surgery, between July 2013 and May 2015, were reviewed retrospectively. The patients with secondary pneumothorax, who underwent open procedures and lacking of medical records were excluded. Visual analog scale (VAS), paresthesia and clinical outcomes were reviewed in 86 patients (46 patients: three-port, 40 patients: 11.5 mm guided single-port). Results The mean age was 23.4 years in three-port and 22.4 in single-port (P=0.247). The height and body weight were not significantly difference between two groups. The mean operation time was 39 minutes (mins) in the three-port and 37.3 mins in the single port without statistical difference (P=0.204). The pain score in the single port surgery was significantly lower after postoperative day (POD) 1 (P=0.028). However chest tube duration time was significantly shorter in the single port group (P<0.001). After exclusion of the patients with chest tube removal within postoperative 1 day, the pain score was not significantly different at the POD 1 between two groups (P=0.176). The pain score between two groups were not different at 1 week after discharge. Conclusions The pain score reduction was found 1 day after operation in the single port group. However, the chest tube duration time was significantly shorter in the single port group and the pain score was not different at 1 week after discharge. Considering young age in primary SP, the benefit of single port surgery in SP was minimal. PMID:27867569

  17. SU-E-T-333: Dosimetric Impact of Rotational Error On the Target Coverage in IMPT Lung Cancer Plans

    SciTech Connect

    Rana, S; Zheng, Y

    2015-06-15

    Purpose: The main purpose of this study was to investigate the impact of rotational (yaw, roll, and pitch) error on the planning target volume (PTV) coverage in lung cancer plans generated by intensity modulated proton therapy (IMPT). Methods: In this retrospective study, computed tomography (CT) dataset of previously treated lung case was used. IMPT plan were generated on the original CT dataset using left-lateral (LL) and posterior-anterior (PA) beams for a total dose of 74 Gy[RBE] with 2 Gy[RBE] per fraction. In order to investigate the dosimetric impact of rotational error, 12 new CT datasets were generated by re-sampling the original CT dataset for rotational (roll, yaw, and pitch) angles ranged from −5° to +5°, with an increment of 2.5°. A total of 12 new IMPT plans were generated based on the re-sampled CT datasets using beam parameters identical to the ones in the original IMPT plan. All treatment plans were generated in XiO treatment planning system. The PTV coverage (i.e., dose received by 95% of the PTV volume, D95) in new IMPT plans were then compared with the PTV coverage in the original IMPT plan. Results: Rotational errors caused the reduction in the PTV coverage in all 12 new IMPT plans when compared to the original IMPT lung plan. Specifically, the PTV coverage was reduced by 4.94% to 50.51% for yaw, by 4.04% to 23.74% for roll, and by 5.21% to 46.88% for pitch errors. Conclusion: Unacceptable dosimetric results were observed in new IMPT plans as the PTV coverage was reduced by up to 26.87% and 50.51% for rotational error of 2.5° and 5°, respectively. Further investigation is underway in evaluating the PTV coverage loss in the IMPT lung cancer plans for smaller rotational angle change.

  18. A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture

    PubMed Central

    Aquilina, Peter; Parr, William C.H.; Chamoli, Uphar; Wroe, Stephen; Clausen, Philip

    2014-01-01

    The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases. PMID:25136411

  19. Demographic evaluation of progress and target of national family planning programme of India.

    PubMed

    Chaudhuri, S K

    1982-04-01

    The number of couples effectively protected is a good index to measure the effect of India's family planning program. The methodology, which is complicated, takes into account the following factors: cumulative effect of sterilization and IUD and current number of conventional contraceptives and oral contraceptive (OC) users; annual attrition rate for sterilization and IUD due to aging, mortality, and removal/expulsion of IUD; latest age distribution of acceptors; latest joint survival ratios of husbands and wives in different age groups; and use-effectiveness of different methods. The number of couples effectively protected increased gradually from 10.6 in 1970-71 to 23.9 in 1976-77. An upward trend appeared evident in 1980-81. The most effective means of effective couple protection was provided by sterilization (20.1%) out of a total 22.5%. The trend for the last 4 years favors tubal ligations, 73.7% of total sterilizations in India in 1979-80. Of the conventional contraceptives, condoms were preferred to OCs in the government family planning centers. The popularity of the IUD was low. Number of births averted is another good index of measurement of the effect of the family planning program. This complicated index considers the following facts: latest age distribution of acceptors; IUD retention rates; and joint survivance ratios of husbands and wives in different age groups. The number of births averted was actually less in 1978-79 and 1979-80 in contrast to 1976-77. It is estimated that over 4 million illegal abortions take place annually in India. The number of medical terminations was as follows: 1975-76, 214,197; 1976-77, 278,870; 1977-78, 241,724; 1978-79, 305,804; and 1979-80, 306,878. It is most difficult at any 1 time to estimate the effect of a motivational campaign. A significant effect of such a campaign is reflected in the lowering of average age and average number of living children of sterilization acceptors. Gross reproduction rate has been lowered

  20. Carcinoma ex-pleomorphic adenoma of the salivary glands has a high risk of progression when the tumor invades more than 2.5 mm beyond the capsule of the residual pleomorphic adenoma.

    PubMed

    Rito, Miguel; Fonseca, Isabel

    2016-03-01

    Carcinoma ex-pleomorphic adenoma (CPA) is subclassified based on the extent of penetration of the malignant component beyond the fibrous capsule of the pre-existing pleomorphic adenoma (PA). These subclasses are considered to be prognostically significant since the non-invasive/minimally invasive groups have an excellent outcome. Nevertheless, there is no consensus as to the cutoff value to distinguish between minimal and wide invasion, even though the 2005 WHO classification defines 1.5 mm as cutoff. The objective of this study is to evaluate a consecutive series of CPA, in order to establish what the effect is of the extent of extra-capsular invasion on prognosis. Fifty-eight cases of CPA were reviewed to obtain demographic and pathological information. Extent of invasion was measured. Eleven cases were non-invasive, 9 had ≤1.5 mm invasion, and for the remainder, the depth of invasion ranged between 2.5 and >10 mm. Distant metastases or death did not occur in the first two groups. In the group with ≥2.5 mm invasion, 15 patients had progressive disease and 9 of them died. The minimum extent of invasion associated with tumor progression and death was 2.5 mm. Two histologically non-invasive carcinomas had regional lymph node metastasis. CPA with ≤1.5 mm depth of invasion has good prognosis. Nevertheless, the lymph node metastases found in two cases of this group question the concept that intracapsular/minimally invasive CPA has a prognosis similar to that of PA. The minimum extent of invasion associated with death was 2.5 mm, which is at variance with findings in other recent series. Thirteen cases with depth of invasion exceeding 2.5 mm did well, confirming that additional factors should be considered in the clinical management of these patients.

  1. The performance of the progressive resolution optimizer (PRO) for RapidArc planning in targets with low-density media.

    PubMed

    Kan, Monica W K; Leung, Lucullus H T; Yu, Peter K N

    2013-11-04

    A new version of progressive resolution optimizer (PRO) with an option of air cavity correction has been implemented for RapidArc volumetric-modulated arc therapy (RA). The purpose of this study was to compare the performance of this new PRO with the use of air cavity correction option (PRO10_air) against the one without the use of the air cavity correction option (PRO10_no-air) for RapidArc planning in targets with low-density media of different sizes and complexities. The performance of PRO10_no-air and PRO10_air was initially compared using single-arc plans created for four different simple heterogeneous phantoms with virtual targets and organs at risk. Multiple-arc planning of 12 real patients having nasopharyngeal carcinomas (NPC) and ten patients having non-small cell lung cancer (NSCLC) were then performed using the above two options for further comparison. Dose calculations were performed using both the Acuros XB (AXB) algorithm with the dose to medium option and the analytical anisotropic algorithm (AAA). The effect of using intermediate dose option after the first optimization cycle in PRO10_air and PRO10_no-air was also investigated and compared. Plans were evaluated and compared using target dose coverage, critical organ sparing, conformity index, and dose homogeneity index. For NSCLC cases or cases for which large volumes of low-density media were present in or adjacent to the target volume, the use of the air cavity correction option in PRO10 was shown to be beneficial. For NPC cases or cases for which small volumes of both low- and high-density media existed in the target volume, the use of air cavity correction in PRO10 did not improve the plan quality. Based on the AXB dose calculation results, the use of PRO10_air could produce up to 18% less coverage to the bony structures of the planning target volumes for NPC cases. When the intermediate dose option in PRO10 was used, there was negligible difference observed in plan quality between

  2. Defining the Clinical Target Volume for Bladder Cancer Radiotherapy Treatment Planning

    SciTech Connect

    Jenkins, Peter; Anjarwalla, Salim; Gilbert, Hugh; Kinder, Richard

    2009-12-01

    Purpose: There are currently no data for the expansion margin required to define the clinical target volume (CTV) around bladder tumors. This information is particularly relevant when perivesical soft tissue changes are seen on the planning scan. While this appearance may reflect extravesical extension (EVE), it may also be an artifact of previous transurethral resection (TUR). Methods and Materials: Eighty patients with muscle-invasive bladder cancer who had undergone radical cystectomy were studied. All patients underwent preoperative TUR and staging computed tomography (CT) scans. The presence and extent of tumor growth beyond the outer bladder wall was measured radiologically and histopathologically. Results: Forty one (51%) patients had histologically confirmed tumor extension into perivesical fat. The median and mean extensions beyond the outer bladder wall were 1.7 and 3.1 mm, respectively. Thirty five (44%) patients had EVE, as seen on CT scans. The sensitivity and specificity of CT scans for EVE were 56% and 79%, respectively. False-positive results were infrequent and not affected by either the timing or the amount of tissue resected at TUR. CT scans consistently tended to overestimate the extent of EVE. Tumor size and the presence of either lymphovascular invasion or squamoid differentiation predict a greater extent of EVE. Conclusions: In patients with radiological evidence of extravesical disease, the CTV should comprise the outer bladder wall plus a 10-mm margin. In patients with no evidence of extravesical disease on CT scans, the CTV should be restricted to the outer bladder wall plus a 6-mm margin. These recommendations would encompass microscopic disease extension in 90% of cases.

  3. Targeting "Plan Colombia": A Critical Analysis of Ideological and Political Visual Narratives by the Beehive Collective and the Drug Enforcement Administration Museum

    ERIC Educational Resources Information Center

    Erler, Carolyn

    2008-01-01

    This article compares the Beehive Collective's "Plan Colombia" to a museum exhibition representing the official U.S. position on Plan Colombia. Through a dialectical (Kellner & Share, 2007; Greene, 1988) reading of "Plan Colombia" and "Target America," I examine how each uses visual narrative to promote a…

  4. Threshold segmentation for PET target volume delineation in radiation treatment planning: the role of target-to-background ratio and target size.

    PubMed

    Brambilla, M; Matheoud, R; Secco, C; Loi, G; Krengli, M; Inglese, E

    2008-04-01

    A multivariable approach was adopted to study the dependence of the percentage threshold [TH(%)] used to define the boundaries of 18F-FDG positive tissue on emission scan duration (ESD) and activity at the start of acquisition (Aacq) for different target sizes and target-to-background (T/B) ratios. An anthropomorphic model, at least for counting rate characteristics, was used to study this dependence in conditions resembling the ones that can be encountered in the clinical studies. An annular ring of water bags of 3 cm thickness was fitted over an International Electro-technical Commission (IEC) phantom in order to obtain counting rates similar to those found in average patients. The scatter fraction of the modified IEC phantom was similar to the mean scatter fraction measured on patients, with a similar scanner. A supplemental set of microhollow spheres was positioned inside the phantom. The NEMA NU 2-2001 scatter phantom was positioned at the end of the IEC phantom to approximate the clinical situation of having activity that extends beyond the scanner field of view. The phantoms were filled with a solution of water and 18F (12 kBq/mL) and the spheres with various T/B ratios of 22.5, 10.3, and 3.6. Sequential imaging was performed to acquire PET images with varying background activity concentrations of about 12, 9, 6.4, 5.3, and 3.1 kBq/mL. The ESD was set to 60, 120, 180, and 240 s/bed. Data were fitted using two distinct multiple linear regression models for sphere ID < or = 10 mm and sphere ID > 10 mm. The fittings of both models were good with an R2 of 0.86 in both cases. Neither ESD nor Aacq resulted as significant predictors of the TH(%). For sphere ID < or =10 mm the target size was the most significant predictor of the TH(%), followed by the T/B ratio, while for sphere ID > 10 mm the explanatory power of the target size and T/B ratio were reversed, the T/B ratio being now the most important predictor of the TH(%). Both the target size and T/B ratio play a

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

    SciTech Connect

    Willegaignon, J. Sapienza, M. T.; Coura-Filho, G. B.; Buchpiguel, C. A.; Watanabe, T.; Traino, A. C.

    2014-01-15

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

  6. Dosimetric impact of multileaf collimator leaf width according to sophisticated grade of technique in the IMRT and VMAT planning for pituitary adenoma lesion

    PubMed Central

    Chae, Soo-Min; Lee, Ki Woong; Son, Seok Hyun

    2016-01-01

    We analyzed the difference in the dosimetric effect between 5-mm and 2.5-mm multileaf collimator (MLC) leaf width according to the sophisticated grades of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT). Nineteen patients with pituitary adenomas were selected for this study. The treatment plans were performed according to the size of the MLC (5-mm and 2.5-mm MLC), the type of technique (IMRT and VMAT), and the sophisticated grades of each technique (5-field, 9-field, 13-field, 17-field technique in IMRT and 1-arc and 2-arc techniques in VMAT). The downsizing effects of MLC leaf width were analyzed using target volume coverage (TVC), conformity index (CI), dose gradient index (GI), and normal tissue difference 70% isodose line and 50% isodose line. Upon replacing the 5-mm MLC with the 2.5-mm MLC, TVC and CI improved by 1.30% and 1.36%, respectively, in total plans. The TVC and CI improved by 1.68% and 1.67% in IMRT, respectively, and by 0.54% and 0.72% in VMAT, respectively. TVC improved by 2.53%, 1.82%, 1.34%, and 0.94%, and CI also improved by 2.70%, 1.81%, 1.24%, and 0.94%, in 5-field, 9-field, 13-field, and 17-field IMRT, respectively. TVC improved by 0.66% and 0.43%, and CI also improved by 0.93%, and 0.52% in 1-arc and 2-arc VMAT, respectively. Regarding the target coverage, there were dosimetric benefits of a smaller MLC leaf width. However, the downsizing effect of the MLC leaf width decreased with the use of a more precise RT technique and a more sophisticated grade of the same technique. PMID:27806336

  7. Impact of 18FDG-PET/CT on biological target volume (BTV) definition for treatment planning for non-small cell lung cancer patients

    NASA Astrophysics Data System (ADS)

    Devic, Slobodan; Tomic, Nada; Faria, Sergio; Dean, Geoffrey; Lisbona, Robert; Parker, William; Kaufman, Chris; Podgorsak, Ervin B.

    2007-02-01

    This work represents our effort to test feasibility of FDG-based PET/CT on target volume delineation in radiotherapy treatment planning of NSCLC patients. Different methods have been developed to enable more precise target outlining using PET: Qualitative Visual Method, CTV=2.5 SUV units, linear SUV threshold function method, and CTV=40% Iso of Maximum Uptake Value. We are proposing reconstruction of three biological target volumes: necrotic BTV (same as PTV created by radiation oncologist using CT data), proliferating BTV (based on PET signal to background ratio 1:3) and hypoxic BTV (based on PET signal to background ratio of 1:19). Two IMRT plans were created and compared to the conventional treatment plan: "conservative" IMRT plan delivers 52.5 Gy to the necrotic BTV and 65 Gy to the hypoxic BTV; "radical" IMRT plan delivers 30 Gy to necrotic BTV, 52.5 Gy to proliferating BTV and 65 Gy to hypoxic BTV. Use of BTVs in IMRT plans is attractive because it increases dose to targets considered to need higher doses. It reduces considerably dose to heart and spinal cord, organs considered to limit dose escalation approaches in NSCLC treatment. "Conservative" IMRT approach can be understood as a PET/CT-based concomitant boost to the tumor expressing the highest FDG uptake. "Radical" plan implies deviation from the traditional uniform dose target coverage approach, with the intention of achieving better surrounding tissue sparing and ultimately allowing for dose escalation protocols relying on biologically based treatment planning.

  8. Clinical Evaluation of Stereotactic Target Localization Using 3-Tesla MRI for Radiosurgery Planning

    SciTech Connect

    MacFadden, Derek; Zhang Beibei; Brock, Kristy K.; Hodaie, Mojgan; Laperriere, Normand; Schwartz, Michael; Tsao, May; Stainsby, Jeffrey; Lockwood, Gina; Mikulis, David; Menard, Cynthia

    2010-04-15

    Purpose: Increasing the magnetic resonance imaging (MRI) field strength can improve image resolution and quality, but concerns remain regarding the influence on geometric fidelity. The objectives of the present study were to spatially investigate the effect of 3-Tesla (3T) MRI on clinical target localization for stereotactic radiosurgery. Methods and Materials: A total of 39 patients were enrolled in a research ethics board-approved prospective clinical trial. Imaging (1.5T and 3T MRI and computed tomography) was performed after stereotactic frame placement. Stereotactic target localization at 1.5T vs. 3T was retrospectively analyzed in a representative cohort of patients with tumor (n = 4) and functional (n = 5) radiosurgical targets. The spatial congruency of the tumor gross target volumes was determined by the mean discrepancy between the average gross target volume surfaces at 1.5T and 3T. Reproducibility was assessed by the displacement from an averaged surface and volume congruency. Spatial congruency and the reproducibility of functional radiosurgical targets was determined by comparing the mean and standard deviation of the isocenter coordinates. Results: Overall, the mean absolute discrepancy across all patients was 0.67 mm (95% confidence interval, 0.51-0.83), significantly <1 mm (p < .010). No differences were found in the overall interuser target volume congruence (mean, 84% for 1.5T vs. 84% for 3T, p > .4), and the gross target volume surface mean displacements were similar within and between users. The overall average isocenter coordinate discrepancy for the functional targets at 1.5T and 3T was 0.33 mm (95% confidence interval, 0.20-0.48), with no patient-specific differences between the mean values (p >.2) or standard deviations (p >.1). Conclusion: Our results have provided clinically relevant evidence supporting the spatial validity of 3T MRI for use in stereotactic radiosurgery under the imaging conditions used.

  9. [Terrorists' target World Cup 2006: disaster medicine on the sidelines?! Aspects of hospital disaster planning].

    PubMed

    Weidringer, J W; Ansorg, J; Ulrich, B C; Polonius, M-J; Domres, B D

    2004-09-01

    Focussing on possible mass casualty situations during events such as the soccer world championship in 2006, the Professional Board of Surgeons in Germany and the German Society for Surgery canvassed surgeons-in-chief in the last quarter of 2003 concerning disaster plans for hospitals. The rate of returned questionnaires amounted to 26% covering the following areas of interest: plans-ready to use, known by the employees as well as by the rescue coordination center, performance of exercises, and concepts on decontamination and detoxification. Based on past numbers of casualties during soccer disasters, an excursus into details also includes a description of an approach to reduce the danger of bottleneck effects at doors. A preliminary concept based on the upcoming system for funding hospitals in Germany and including new partnerships is outlined, succeeded by some hopefully helpful hints for a web-based hospital disaster plan.

  10. Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

    PubMed Central

    Urabe, Yoji; Kitagawa, Toshiro; Utsunomiya, Hiroto; Tsushima, Hiroshi; Tatsugami, Fuminari; Awai, Kazuo; Kihara, Yasuki

    2016-01-01

    Aims: In a new-generation computed tomography (CT) scanner, coronary artery calcium (CAC) scores were measured using 3.0-mm slice reconstruction images originally acquired with 0.5 mm thickness scans in a single beat. This study investigated the usefulness of thin-slice (0.5 mm) reconstruction for identifying small calcifications in coronary arteries and evaluated the association with coronary plaques and stenosis compared to conventional 3.0-mm reconstruction images. Methods: We evaluated 132 patients with zero CAC scores in conventional 3.0-mm Agatston method using a 320-slice CT. Then, 0.5-mm slice reconstruction was performed to identify small calcifications. The presence of stenosis and coronary plaques was assessed using coronary CT angiography. Results: In total, 22 small calcifications were identified in 18 patients. There were 28 (21%) patients with any (≥ 25%) stenosis (34 lesions). Forty-seven coronary plaques were found in 33 patients (25%), including 7 calcified plaques in 7 patients (5%), 34 noncalcified plaques in 27 patients (20%), and 6 partially calcified plaques in 5 patients (4%). Patients with small calcifications had a significantly higher prevalence of noncalcified or partially calcified plaques (83% vs 14%; p < 0.001) and obstructive stenosis (33% vs 5.2%; p < 0.001) compared to those without small calcifications. The addition of small calcifications to the coronary risk factors when diagnosing stenosis significantly improved the diagnostic value. Conclusion: Small calcifications detected by thin-slice 0.5-mm reconstruction are useful for distinguishing coronary atherosclerotic lesions in patients with zero CAC scores from conventional CT reconstruction. PMID:27397477

  11. Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

    SciTech Connect

    Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

    2009-05-01

    Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

  12. Impact of [{sup 11}C]Methionine Positron Emission Tomography for Target Definition of Glioblastoma Multiforme in Radiation Therapy Planning

    SciTech Connect

    Matsuo, Masayuki; Miwa, Kazuhiro; Tanaka, Osamu; Shinoda, Jun; Nishibori, Hironori; Tsuge, Yusuke; Yano, Hirohito; Iwama, Toru; Hayashi, Shinya; Hoshi, Hiroaki; Yamada, Jitsuhiro; Kanematsu, Masayuki; Aoyama, Hidefumi

    2012-01-01

    Purpose: The purpose of this work was to define the optimal margins for gadolinium-enhanced T{sub 1}-weighted magnetic resonance imaging (Gd-MRI) and T{sub 2}-weighted MRI (T{sub 2}-MRI) for delineating target volumes in planning radiation therapy for postoperative patients with newly diagnosed glioblastoma multiforme (GBM) by comparison to carbon-11-labeled methionine positron emission tomography ([{sup 11}C]MET-PET) findings. Methods and Materials: Computed tomography (CT), MRI, and [{sup 11}C]MET-PET were separately performed for radiation therapy planning for 32 patients newly diagnosed with GBM within 2 weeks after undergoing surgery. The extent of Gd-MRI (Gd-enhanced clinical target volume [CTV-Gd]) uptake and that of T{sub 2}-MRI of the CTV (CTV-T{sub 2}) were compared with the extent of [{sup 11}C]MET-PET (CTV--[{sup 11}C]MET-PET) uptake by using CT--MRI or CT--[{sup 11}C]MET-PET fusion imaging. We defined CTV-Gd (x mm) and CTV-T{sub 2} (x mm) as the x-mm margins (where x = 0, 2, 5, 10, and 20 mm) outside the CTV-Gd and the CTV-T{sub 2}, respectively. We evaluated the relationship between CTV-Gd (x mm) and CTV-- [{sup 11}C]MET-PET and the relationship between CTV-T{sub 2} (x mm) and CTV-- [{sup 11}C]MET-PET. Results: The sensitivity of CTV-Gd (20 mm) (86.4%) was significantly higher than that of the other CTV-Gd. The sensitivity of CTV-T{sub 2} (20 mm) (96.4%) was significantly higher than that of the other CTV-T{sub 2} (x = 0, 2, 5, 10 mm). The highest sensitivity and lowest specificity was found with CTV-T{sub 2} (x = 20 mm). Conclusions: It is necessary to use a margin of at least 2 cm for CTV-T{sub 2} for the initial target planning of radiation therapy. However, there is a limit to this setting in defining the optimal margin for Gd-MRI and T{sub 2}-MRI for the precise delineation of target volumes in radiation therapy planning for postoperative patients with GBM.

  13. Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation

    SciTech Connect

    Ohtakara, Kazuhiro; Hoshi, Hiroaki

    2015-10-01

    This study was conducted to ascertain whether homogeneous target dose planning is suitable for stereotactic body radiotherapy (SBRT) of peripheral lung cancer under appropriate breath-holding. For 20 peripheral lung tumors, paired dynamic conformal arc plans were generated by only adjusting the leaf margin to the planning target volume (PTV) edge for fulfilling the conditions such that the prescription isodose surface (IDS) encompassing exactly 95% of the PTV (PTV D{sub 95}) corresponds to 95% and 80% IDS, normalized to 100% at the PTV isocenter under a pencil beam (PB) algorithm with radiologic path length correction. These plans were recalculated using the x-ray voxel Monte Carlo (XVMC) algorithm under otherwise identical conditions, and then compared. Lesions abutting the parietal pleura or not were defined as edge or island tumors, respectively, and the influences of the target volume and its location relative to the chest wall on the target dose were examined. The median (range) leaf margin required for the 95% and 80% plans was 3.9 mm (1.3 to 5.0) and −1.2 mm (−1.8 to 0.1), respectively. Notably, the latter was significantly correlated negatively with PTV. In the 80% plans, the PTV D{sub 95} was slightly higher under XVMC, whereas the PTV D{sub 98} was significantly lower, irrespective of the dose calculation algorithm used. Other PTV and all gross tumor volume doses were significantly higher, while the lung doses outside the PTV were slightly lower. The target doses increased as a function of PTV and were significantly lower for island tumors than for edge tumors. In conclusion, inhomogeneous target dose planning using smaller leaf margin for a larger tumor volume was deemed suitable in ensuring more sufficient target dose while slightly reducing lung dose. In addition, more inhomogeneous target dose planning using <80% IDS (e.g., 70%) for PTV covering would be preferable for island tumors.

  14. Targeting MRS-Defined Dominant Intraprostatic Lesions with Inverse-Planned High Dose Rate Brachytherapy

    DTIC Science & Technology

    2011-06-01

    requirements depending on rectal and bladder doses. The class solution in inverse planned HDR prostate brachythe - rapy for dose escalation of a DIL...High-dose-rate brachyther- apy without external beam irradiation for locally advanced prostate cancer. Radiother Oncol 2006; 80: 62-68. 7. Galalae RM... prostate brachytherapy for dose escalation of DIL defined by combined MRI/MRSI. Radiother Oncol 2008; 88: 148-155. 16. Pouliot J, Kim Y, Lessard E et al

  15. Development of whole-building energy design targets for commercial buildings: Phase 1, Planning: Volume 2, Technical report

    SciTech Connect

    Crawley, D.B.; Briggs, R.S.; Jones, J.W.; Seaton, W.W.; Kaufman, J.E.; Deringer, J.J.; Kennett, E.W.

    1987-08-01

    This is the second volume of the Phase 1 report and discusses the 10 tasks performed in Phase 1. The objective of this research is to develop a methodology for setting energy design targets to provide voluntary guidelines for the buildings industry. The whole-building energy targets project is being conducted at the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE) to encourage the construction of energy-efficient buildings by informing designers and owners about cost-effective goals for energy use in new commercial buildings. The outcome of this research will be a flexible methodology for setting such targets. The tasks are listed and discussed in this report as follows: Task 1 - Develop Detailed Project Goals and Objectives; Task 2 - Establish Buildings-Industry Liaison; Task 3 - Develop Approaches to the Energy Targets Model, Building Operations, and Climate; Task 4 - Develop an Approach for Treating Economic Considerations; Task 5 - Develop an Approach for Treating Energy Sources; Task 6 - Collect Energy-Use Data; Task 7 - Survey Energy Expert Opinion; Task 8 - Evaluation Procedure Specification and Integration; Task 9 - Phase 1 Report Development; and Task 10 - Phase 1 Review Planning.

  16. Sparing Healthy Tissue and Increasing Tumor Dose Using Bayesian Modeling of Geometric Uncertainties for Planning Target Volume Personalization

    SciTech Connect

    Herschtal, Alan; Te Marvelde, Luc; Mengersen, Kerrie; Foroudi, Farshad; Eade, Thomas; Pham, Daniel; Caine, Hannah; Kron, Tomas

    2015-06-01

    Objective: To develop a mathematical tool that can update a patient's planning target volume (PTV) partway through a course of radiation therapy to more precisely target the tumor for the remainder of treatment and reduce dose to surrounding healthy tissue. Methods and Materials: Daily on-board imaging was used to collect large datasets of displacements for patients undergoing external beam radiation therapy for solid tumors. Bayesian statistical modeling of these geometric uncertainties was used to optimally trade off between displacement data collected from previously treated patients and the progressively accumulating data from a patient currently partway through treatment, to optimally predict future displacements for that patient. These predictions were used to update the PTV position and margin width for the remainder of treatment, such that the clinical target volume (CTV) was more precisely targeted. Results: Software simulation of dose to CTV and normal tissue for 2 real prostate displacement datasets consisting of 146 and 290 patients treated with a minimum of 30 fractions each showed that re-evaluating the PTV position and margin width after 8 treatment fractions reduced healthy tissue dose by 19% and 17%, respectively, while maintaining CTV dose. Conclusion: Incorporating patient-specific displacement patterns from early in a course of treatment allows PTV adaptation for the remainder of treatment. This substantially reduces the dose to healthy tissues and thus can reduce radiation therapy–induced toxicities, improving patient outcomes.

  17. The effect of image-guided radiation therapy on the margin between the clinical target volume and planning target volume in lung cancer

    SciTech Connect

    Liang, Jun; Li, Minghui; Zhang, Tao; Han, Wei; Chen, Dongfu; Hui, Zhouguang; Lv, Jima; Zhang, Zhong; Zhang, Yin; Zhang, Liansheng; Zheng, Rong; Dai, Jianrong; Wang, Luhua

    2014-02-15

    Introduction: This study aimed to evaluate the effect of image-guided radiation therapy (IGRT) on the margin between the clinical target volume (CTV) and planning target volume (PTV) in lung cancer. Methods: The CTV and PTV margin were determined in three dimensions by four radiation oncologists using a standard method in 10 lung cancer patients, and compared to consensus values. Transfer error was measured using a rigid phantom containing gold markers. Systematic error and random error set up errors were calculated in three dimensions from pre-treatment and post-treatment cone beam CT scans. Finally, the margin between the CTV and PTV was corrected for set up error and calculated. Results: The margins between the CTV and PTV with IGRT (and without IGRT) were 0.88 cm (0.96 cm), 0.99 cm (1.08 cm) and 1.28 cm (1.82 cm) in the anterior and posterior (AP), left and right (LR) and superior and inferior (SI) directions, respectively. Images from two other patients verified the validity of the corrected margin. The target delineation errors of the radiation oncologists are considered to be the largest compared with the set up errors. The application of IGRT reduced the set up errors and the margins between CTV and PTV. Conclusions: The delineation errors of radiation oncologists are the most important factor to consider for the margin between CTV and PTV for lung cancer. IGRT can reduce the margins by reducing the set up errors, especially in the SI direction. Further research is required to assess whether the reduction in the margin is solely based on set up errors.

  18. The optimization of intensity modulated radiotherapy in cases where the planning target volume extends into the build-up region.

    PubMed

    Nguyen, T B; Hoole, A C F; Burnet, N G; Thomas, S J

    2009-04-21

    A common clinical problem in IMRT, especially when treating head and neck cases, is that the clinical target volume (CTV) stops short of the skin surface, whilst the margin for geometric uncertainties may take the planning target volume (PTV) to the skin surface or beyond. In these cases, optimization leads to over-dosing of the skin, unless the planner resorts to procedural tricks to avoid this, such as the use of pretend bolus or reduction of the PTV followed by adding 'flash' after optimization. This paper describes a method of avoiding the need for these tricks by using a multiple-isocentre CTV-based objective function. This enables plans to be produced that will give good coverage of the CTV for all the geometrical uncertainties that would have been covered by the PTV without causing the problem of over-dosing the skin. Eight isocentre shifts, equally distributed on the surface of a sphere with a radius equal to the CTV-PTV margin, are shown to be adequate for the optimization process. The resulting fluence maps are much simpler than those resulting from PTV optimization and will therefore be simpler to deliver. The method also permits better sparing of organs at risk such as the spinal cord.

  19. The optimization of intensity modulated radiotherapy in cases where the planning target volume extends into the build-up region

    NASA Astrophysics Data System (ADS)

    Nguyen, T. B.; Hoole, A. C. F.; Burnet, N. G.; Thomas, S. J.

    2009-04-01

    A common clinical problem in IMRT, especially when treating head and neck cases, is that the clinical target volume (CTV) stops short of the skin surface, whilst the margin for geometric uncertainties may take the planning target volume (PTV) to the skin surface or beyond. In these cases, optimization leads to over-dosing of the skin, unless the planner resorts to procedural tricks to avoid this, such as the use of pretend bolus or reduction of the PTV followed by adding 'flash' after optimization. This paper describes a method of avoiding the need for these tricks by using a multiple-isocentre CTV-based objective function. This enables plans to be produced that will give good coverage of the CTV for all the geometrical uncertainties that would have been covered by the PTV without causing the problem of over-dosing the skin. Eight isocentre shifts, equally distributed on the surface of a sphere with a radius equal to the CTV-PTV margin, are shown to be adequate for the optimization process. The resulting fluence maps are much simpler than those resulting from PTV optimization and will therefore be simpler to deliver. The method also permits better sparing of organs at risk such as the spinal cord.

  20. Accuracy in parameter estimation for targeted effects in structural equation modeling: sample size planning for narrow confidence intervals.

    PubMed

    Lai, Keke; Kelley, Ken

    2011-06-01

    In addition to evaluating a structural equation model (SEM) as a whole, often the model parameters are of interest and confidence intervals for those parameters are formed. Given a model with a good overall fit, it is entirely possible for the targeted effects of interest to have very wide confidence intervals, thus giving little information about the magnitude of the population targeted effects. With the goal of obtaining sufficiently narrow confidence intervals for the model parameters of interest, sample size planning methods for SEM are developed from the accuracy in parameter estimation approach. One method plans for the sample size so that the expected confidence interval width is sufficiently narrow. An extended procedure ensures that the obtained confidence interval will be no wider than desired, with some specified degree of assurance. A Monte Carlo simulation study was conducted that verified the effectiveness of the procedures in realistic situations. The methods developed have been implemented in the MBESS package in R so that they can be easily applied by researchers.

  1. Nanoparticle-enabled, image-guided treatment planning of target specific RNAi therapeutics in an orthotopic prostate cancer model.

    PubMed

    Lin, Qiaoya; Jin, Cheng S; Huang, Huang; Ding, Lili; Zhang, Zhihong; Chen, Juan; Zheng, Gang

    2014-08-13

    The abilities to deliver siRNA to its intended action site and assess the delivery efficiency are challenges for current RNAi therapy, where effective siRNA delivery will join force with patient genetic profiling to achieve optimal treatment outcome. Imaging could become a critical enabler to maximize RNAi efficacy in the context of tracking siRNA delivery, rational dosimetry and treatment planning. Several imaging modalities have been used to visualize nanoparticle-based siRNA delivery but rarely did they guide treatment planning. We report a multimodal theranostic lipid-nanoparticle, HPPS(NIR)-chol-siRNA, which has a near-infrared (NIR) fluorescent core, enveloped by phospholipid monolayer, intercalated with siRNA payloads, and constrained by apoA-I mimetic peptides to give ultra-small particle size (<30 nm). Using fluorescence imaging, we demonstrated its cytosolic delivery capability for both NIR-core and dye-labeled siRNAs and its structural integrity in mice through intravenous administration, validating the usefulness of NIR-core as imaging surrogate for non-labeled therapeutic siRNAs. Next, we validated the targeting specificity of HPPS(NIR)-chol-siRNA to orthotopic tumor using sequential four-steps (in vivo, in situ, ex vivo and frozen-tissue) fluorescence imaging. The image co-registration of computed tomography and fluorescence molecular tomography enabled non-invasive assessment and treatment planning of siRNA delivery into the orthotopic tumor, achieving efficacious RNAi therapy.

  2. Comparison of internal target volumes defined on 3-dimensional, 4-dimensonal, and cone-beam CT images of non-small-cell lung cancer

    PubMed Central

    Li, Fengxiang; Li, Jianbin; Ma, Zhifang; Zhang, Yingjie; Xing, Jun; Qi, Huanpeng; Shang, Dongping

    2016-01-01

    Purpose The purpose of this study was to compare the positional and volumetric differences of internal target volumes defined on three-dimensional computed tomography (3DCT), four-dimensional CT (4DCT), and cone-beam CT (CBCT) images of non-small-cell lung cancer (NSCLC). Materials and methods Thirty-one patients with NSCLC sequentially underwent 3DCT and 4DCT simulation scans of the thorax during free breathing. The first CBCT was performed and registered to the planning CT using the bony anatomy registration during radiotherapy. The gross tumor volumes were contoured on the basis of 3DCT, maximum intensity projection (MIP) of 4DCT, and CBCT. CTV3D (clinical target volume), internal target volumes, ITVMIP and ITVCBCT, were defined with a 7 mm margin accounting for microscopic disease. ITV10 mm and ITV5 mm were defined on the basis of CTV3D: ITV10 mm with a 5 mm margin in left–right (LR), anterior–posterior (AP) directions and 10 mm in cranial–caudal (CC) direction; ITV5 mm with an isotropic internal margin (IM) of 5 mm. The differences in the position, size, Dice’s similarity coefficient (DSC) and inclusion relation of different volumes were evaluated. Results The median size ratios of ITV10 mm, ITV5 mm, and ITVMIP to ITVCBCT were 2.33, 1.88, and 1.03, respectively, for tumors in the upper lobe and 2.13, 1.76, and 1.1, respectively, for tumors in the middle-lower lobe. The median DSCs of ITV10 mm, ITV5 mm, ITVMIP, and ITVCBCT were 0.6, 0.66, and 0.83 for all patients. The median percentages of ITVCBCT not included in ITV10 mm, ITV5 mm, and ITVMIP were 0.1%, 1.63%, and 15.21%, respectively, while the median percentages of ITV10 mm, ITV5 mm, and ITVMIP not included in ITVCBCT were 57.08%, 48.89%, and 20.04%, respectively. Conclusion The use of the individual ITV derived from 4DCT merely based on bony registration in radiotherapy may result in a target miss. The ITVs derived from 3DCT with isotropic margins have a good coverage of the ITV from CBCT, but the

  3. [Update of planning tables of cholesterol-lowering therapy orientated to achieve LDL therapeutic targets].

    PubMed

    Masana, Luis; Plana, Núria

    2015-01-01

    This is the third update of a planning-table for use in cholesterol-lowering therapy, so as to obtain LDLc objectives. This is an easy to use laptop tool to help choose the best statin or combination therapy (statin plus ezetimibe) depending on the current LDL concentration of the patient, and the LDLc objective to achieve. It is based on a colour code that indicates the drugs that are efficient enough to help patients to achieve their LDL goal. Along with the table, recommendations are given for the best strategy in order to implement the optimal therapy in a maximum of two clinical encounters.

  4. Developing a Campaign Plan to Target Centers of Gravity Within Economic Systems

    DTIC Science & Technology

    1995-05-01

    virus into an active, destructive mode. The latest generation of logic bombs incorporate the use of artificial intelligence (AI) to selectively...TARGETING COMMUNICATIONS AND DATA NETWORKS TO INFLUENCE TRADE 50 Intelligence Gathering Activities 50 Determining the Desired Effect 54 Selection of the...communications protocol or address system, allowing various subnets to exist on a LAN.20 A bridge can be thought of as an " intelligent " router which traffics

  5. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 408: Bomblet Target Area, Tonopah Test Range, Nevada

    SciTech Connect

    NSTec Environmental Management

    2006-10-01

    This Streamlined Approach for Environmental Restoration Plan provides the details for the closure of Corrective Action Unit (CAU) 408, Bomblet Target Area. CAU 408 is located at the Tonopah Test Range and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order of 1996. One Corrective Action Site (CAS) is included in CAU 408: {lg_bullet} CAS TA-55-002-TAB2, Bomblet Target Areas Based on historical documentation, personnel interviews, process knowledge, site visits, aerial photography, multispectral data, preliminary geophysical surveys, and the results of data quality objectives process (Section 3.0), clean closure will be implemented for CAU 408. CAU 408 closure activities will consist of identification and clearance of bomblet target areas, identification and removal of depleted uranium (DU) fragments on South Antelope Lake, and collection of verification samples. Any soil containing contaminants at concentrations above the action levels will be excavated and transported to an appropriate disposal facility. Based on existing information, contaminants of potential concern at CAU 408 include explosives. In addition, at South Antelope Lake, bomblets containing DU were tested. None of these contaminants is expected to be present in the soil at concentrations above the action levels; however, this will be determined by radiological surveys and verification sample results. The corrective action investigation and closure activities have been planned to include data collection and hold points throughout the process. Hold points are designed to allow decision makers to review the existing data and decide which of the available options are most suitable. Hold points include the review of radiological, geophysical, and analytical data and field observations.

  6. Final work plan : targeted groundwater sampling and monitoring well installation for potential site reclassification at Barnes, Kansas.

    SciTech Connect

    LaFreniere, L. M.

    2006-07-11

    This ''Work Plan'' outlines the scope of work for a targeted groundwater sampling investigation and monitoring well installation at Barnes, Kansas. This activity is being conducted at the request of the Kansas Department of Health and Environment (KDHE), in accordance with the intergovernmental agreement between the KDHE and the Commodity Credit Corporation (CCC), an agency of the U.S. Department of Agriculture (USDA). Data resulting from the proposed work will be used to determine the hydraulic gradient near the former CCC/USDA facility, delineate the downgradient carbon tetrachloride plume, and determine additional monitoring requirements at Barnes. The overall goal is to establish criteria for monitoring leading to potential site reclassification. The proposed work will be performed on behalf of the CCC/USDA by the Environmental Science Division of Argonne National Laboratory. Argonne is a nonprofit, multidisciplinary research center operated by the University of Chicago for the U.S. Department of Energy (DOE). The Farm Service Agency of the USDA has entered into an interagency agreement with DOE, under which Argonne provides technical assistance with environmental site characterization and remediation at former CCC/USDA grain storage facilities. Argonne issued a ''Master Work Plan'' (Argonne 2002) to provide general guidance for all investigations at former CCC/USDA facilities in Kansas. The ''Master Work Plan'', approved by the KDHE, contains the materials common to investigations at all locations in Kansas. This document must be consulted for the complete details of plans for this work associated with the former CCC/USDA facility at Barnes.

  7. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers’ Program Planning Toolkit (DMPPT) 2.0

    PubMed Central

    Kripke, Katharine; Opuni, Marjorie; Schnure, Melissa; Sgaier, Sema; Castor, Delivette; Reed, Jason; Stover, John

    2016-01-01

    Background Despite considerable efforts to scale up voluntary medical male circumcision (VMMC) for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President’s Plan for AIDS Relief (PEPFAR) supported the development and application of a model to inform national planning in five countries from 2013–2014. Methods and Findings The Decision Makers’ Program Planning Toolkit (DMPPT) 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15–34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20–29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10–19 in Uganda, 15–24 in Malawi and South Africa, 10–24 in Tanzania, and 15–29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15–34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds. Conclusions The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly. PMID:27410966

  8. MO-C-17A-06: Online Adaptive Re-Planning to Account for Independent Motions Between Multiple Targets During Radiotherapy of Lung Cancer

    SciTech Connect

    Liu, F; Tai, A; Ahunbay, E; Gore, E; Johnstone, C; Li, X

    2014-06-15

    Purpose: To quantify interfractional independent motions between multiple targets in radiotherapy (RT) of lung cancer, and to study the dosimetric benefits of an online adaptive replanning method to account for these variations. Methods: Ninety five diagnostic-quality daily CTs acquired for 9 lung cancer patients treated with IGRT using an in-room CT (CTVision, Siemens) were analyzed. On each daily CT set, contours of the targets (GTV, CTV, or involved nodes) and organs at risk were generated by populating the planning contours using an auto-segmentation tool (ABAS, Elekta) with manual editing. For each patient, an IMRT plan was generated based on the planning CT with a prescription dose of 60 Gy in 2Gy fractions. Three plans were generated and compared for each daily CT set: an IGRT (repositioning) plan by copying the original plan with the required shifts, an online adaptive plan by rapidly modifying the aperture shapes and segment weights of the original plan to conform to the daily anatomy, and a new fully re-optimized plan based on the daily CT using a planning system (Panther, Prowess). Results: The daily deviations of the distance between centers of masses of the targets from the plans varied daily from -10 to 8 mm with an average −0.9±4.1 mm (one standard deviation). The average CTV V100 are 99.0±0.7%, 97.9±2.8%, 99.0±0.6%, and 99.1±0.6%, and the lung V20 Gy 928±332 cc, 944±315 cc, 917±300 cc, and 891±295 cc for the original, repositioning, adaptive, and re-optimized plans, respectively. Wilcoxon signed-rank tests show that the adaptive plans are statistically significantly better than the repositioning plans and comparable with the reoptimized plans. Conclusion: There exist unpredictable, interfractional, relative volume changes and independent motions between multiple targets during lung cancer RT which cannot be accounted for by the current IGRT repositioning but can be corrected by the online adaptive replanning method.

  9. PACE-90 water and solute transport calculations for 0.01, 0.1, and 0. 5 mm/yr infiltration into Yucca Mountain; Yucca Mountain Site Characterization Project

    SciTech Connect

    Dykhuizen, R.C.; Eaton, R.R.; Hopkins, P.L.; Martinez, M.J.

    1991-12-01

    Numerical results are presented for the Performance Assessment Calculational Exercise (PACE-90). One- and two-dimensional water and solute transport are presented for steady infiltration into Yucca Mountain. Evenly distributed infiltration rates of 0.01, 0.1, and 0.5 mm/yr were considered. The calculations of solute transport show that significant amounts of radionuclides can reach the water table over 100,000 yr at the 0.5 mm/yr rate. For time periods less than 10,000 yr or infiltrations less than 0.1 mm/yr very little solute reaches the water table. The numerical simulations clearly demonstrate that multi-dimensional effects can result in significant decreases in the travel time of solute through the modeled domain. Dual continuum effects are shown to be negligible for the low steady state fluxes considered. However, material heterogeneities may cause local amplification of the flux level in multi-dimensional flows. These higher flux levels may then require modeling of a dual continuum porous medium.

  10. Optimal and safe treatment of spider leg veins measuring less than 1.5 mm on skin type IV patients, using repeated low-fluence Nd:YAG laser pulses after polidocanol injection.

    PubMed

    Moreno-Moraga, Javier; Hernández, Esteban; Royo, Josefina; Alcolea, Justo; Isarría, M Jose; Pascu, Mihail Lucian; Smarandache, Adriana; Trelles, Mario

    2013-05-01

    Treatment of micro-veins of less than 1.5 mm with laser and with chemical sclerosis is technically challenging because of their difficulty to remedy. Laser treatment is even more difficult when dark phototypes are involved.Three groups of 30 patients each, skin type IV, and vessels measuring less than 1.5 mm in diameter, were enrolled for two treatment sessions 8 weeks apart: group A, polidocanol (POL) micro-foam injection; group B, Nd:YAG laser alone; and group C, laser after POL injection. Repeated 8-Hz low-fluence pulses, moving the hand piece over a 3-cm vein segment with an average of five laser passes maximum and with a total time irradiation of 1 s were used. Sixteen weeks after the second treatment, statistically, degree of clearance after examining photographs and patients satisfaction index, plotted on a visual analogue scale and comparing results of all three groups, results were significantly better for group C (p<0.0001). No significant differences in complications were noticed between the three groups. Efficacy of combining POL and laser proved safe and satisfactory in 96 % of patients using low-fluence laser pulses with a total cumulative energy in the 3 cm venous segment, lower than that of conventional treatment. Very few and transient complications were observed. POL foam injection followed by laser pulses is safe and efficient for vein treatment in dark-skinned patients.

  11. Sci—Fri AM: Mountain — 06: Optimizing planning target volume in lung radiotherapy using deformable registration

    SciTech Connect

    Hoang, P; Wierzbicki, M

    2014-08-15

    A four dimensional computed tomography (4DCT) image is acquired for all radically treated, lung cancer patients to define the internal target volume (ITV), which encompasses tumour motion due to breathing and subclinical disease. Patient set-up error and anatomical motion that is not due to breathing is addressed through an additional 1 cm margin around the ITV to obtain the planning target volume (PTV). The objective of this retrospective study is to find the minimum PTV margin that provides an acceptable probability of delivering the prescribed dose to the ITV. Acquisition of a kV cone beam computed tomography (CBCT) image at each fraction was used to shift the treatment couch to accurately align the spinal cord and carina. Our method utilized deformable image registration to automatically position the planning ITV on each CBCT. We evaluated the percentage of the ITV surface that fell within various PTVs for 79 fractions across 18 patients. Treatment success was defined as a situation where at least 99% of the ITV is covered by the PTV. Overall, this is to be achieved in at least 90% of the treatment fractions. The current approach with a 1cm PTV margin was successful ∼96% of the time. This analysis revealed that the current margin can be reduced to 0.8cm isotropic or 0.6×0.6×1 cm{sup 3} non-isotropic, which were successful 92 and 91 percent of the time respectively. Moreover, we have shown that these margins maintain accuracy, despite intrafractional variation, and maximize CBCT image guidance capabilities.

  12. Ground-based LiDAR integration with avalanche control operations: target planning and assessment of control effectiveness

    NASA Astrophysics Data System (ADS)

    Deems, J. S.; LeWinter, A.; Gadomski, P. J.; Finnegan, D. C.

    2015-12-01

    The varying distribution of snow depth in avalanche starting zones exerts a strong influence on avalanche potential and character. Extreme depth changes over short distances are common, especially in wind-affected, above-treeline environments. Snow depth also affects the ease of avalanche triggering. Experience shows that avalanche reduction efforts are often more successful when targeting shallow trigger point areas near deeper slabs with explosives or ski cutting. We are exploring the use of high resolution snow depth and depth change maps from differential LiDAR scans to quantify loading patterns for use in both pre-control planning and in post-control assessment. We present results from our ongoing work at the Arapahoe Basin and Aspen Highlands ski areas in Colorado, USA, and from a new collaboration with the Colorado Department of Transportation. At Arapahoe Basin we have tested rapid snow depth product generation for use in planning placement of explosives for artificial avalanche triggering. At Aspen Highlands we have explored measurement of minimum disturbance depth from bootpacking. In a new application, we are assessing avalanche hazard reduction with new Gazex exploder arrays on Loveland and Berthoud Passes.

  13. Epithermal Neutron Observations and Lunar South Pole Targeting for LCROSS Impact Planning using the Lunar Reconnaissance Orbiter (LRO), Lunar Exploring Neutron Detector (LEND)

    NASA Technical Reports Server (NTRS)

    McClanahan, T. P.; Mitrofanov, I.; Boynton, W. V.; Chin, G.; Colaprete, A.; Evans, L. G.; Garvin, J.; Harshman, K.; Litvak, R.; Malakhov, A.; Milikh, G. M.; Nandikotkur, G.; Sagdeev, R.; Sanin, A. B.; Smith, D. E.; Starr, R. D.; Trombka, J.

    2009-01-01

    LCROSS impact targeting and planning efforts included quantifying South Polar epithermal neutron flux depressions in early LEND mapped results to maximize the expected plume Hydrogen (H) yield. Epithermal neutron surface fluxes are a key geochemical indicator of surface Hydrogen (H) concentration inferred to be elevated in polar permanent shadow regions (PSR). LCROSS impact target regions were delineated as (PSR) using illumination modeling of polar topography. To quantify targets potential yield for LCROSS, LEND epithermal neutron flux observations were integrated over LCROSS targets of interest and compared to background observations. Discussion will define methods review impact prior estimates and contrast post impact results.

  14. Sci—Thur PM: Planning and Delivery — 04: Respiratory margin derivation and verification in partial breast irradiation

    SciTech Connect

    Quirk, S; Conroy, L; Smith, WL

    2014-08-15

    Partial breast irradiation (PBI) following breast-conserving surgery is emerging as an effective means to achieve local control and reduce irradiated breast volume. Patients are planned on a static CT image; however, treatment is delivered while the patient is free-breathing. Respiratory motion can degrade plan quality by reducing target coverage and/or dose homogeneity. A variety of methods can be used to determine the required margin for respiratory motion in PBI. We derive geometric and dosimetric respiratory 1D margin. We also verify the adequacy of the typical 5 mm respiratory margin in 3D by evaluating plan quality for increasing respiratory amplitudes (2–20 mm). Ten PBI plans were used for dosimetric evaluation. A database of volunteer respiratory data, with similar characteristics to breast cancer patients, was used for this study. We derived a geometric 95%-margin of 3 mm from the population respiratory data. We derived a dosimetric 95%-margin of 2 mm by convolving 1D dose profiles with respiratory probability density functions. The 5 mm respiratory margin is possibly too large when 1D coverage is assessed and could lead to unnecessary normal tissue irradiation. Assessing margins only for coverage may be insufficient; 3D dosimetric assessment revealed degradation in dose homogeneity is the limiting factor, not target coverage. Hotspots increased even for the smallest respiratory amplitudes, while target coverage only degraded at amplitudes greater than 10 mm. The 5 mm respiratory margin is adequate for coverage, but due to plan quality degradation, respiratory management is recommended for patients with respiratory amplitudes greater than 10 mm.

  15. Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    PubMed

    Lin, Liyong; Kang, Minglei; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-11-08

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4D CT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4D CT phases, using ± 3% uncertainty in stopping power and ± 3 mm uncertainty in patient setup in each direction, were used to create 8 × 12 × 10 = 960 PBS plans for the evaluation of 10 patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus, and heart doses were decreased from 37.1 Gy, 71.7 Gy, and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy, and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04, and 72.1 Gy with PBS. All differences are statistically significant, with p-values <0.05, with the exception of the heart V45 (p = 0.146). PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential.

  16. Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    PubMed

    Lin, Liyong; Kang, Minglei; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-11-01

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4D CT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4D CT phases, using ±3% uncertainty in stopping power and ±3 mm uncertainty in patient setup in each direction, were used to create 8×12×10=960 PBS plans for the evaluation of 10 patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus, and heart doses were decreased from 37.1 Gy, 71.7 Gy, and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy, and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04, and 72.1 Gy with PBS. All differences are statistically significant, with p-values <0.05, with the exception of the heart V45 (p=0.146). PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential. PACS number: 87.55.D.

  17. Distance-to-Agreement Investigation of Tomotherapy's Bony Anatomy-Based Autoregistration and Planning Target Volume Contour-Based Optimization

    SciTech Connect

    Suh, Steve; Schultheiss, Timothy E.

    2013-03-01

    Purpose: To compare Tomotherapy's megavoltage computed tomography bony anatomy autoregistration with the best achievable registration, assuming no deformation and perfect knowledge of planning target volume (PTV) location. Methods and Materials: Distance-to-agreement (DTA) of the PTV was determined by applying a rigid-body shift to the PTV region of interest of the prostate from its reference position, assuming no deformations. Planning target volume region of interest of the prostate was extracted from the patient archives. The reference position was set by the 6 degrees of freedom (dof)—x, y, z, roll, pitch, and yaw—optimization results from the previous study at this institution. The DTA and the compensating parameters were calculated by the shift of the PTV from the reference 6-dof to the 4-dof—x, y, z, and roll—optimization. In this study, the effectiveness of Tomotherapy's 4-dof bony anatomy–based autoregistration was compared with the idealized 4-dof PTV contour-based optimization. Results: The maximum DTA (maxDTA) of the bony anatomy-based autoregistration was 3.2 ± 1.9 mm, with the maximum value of 8.0 mm. The maxDTA of the contour-based optimization was 1.8 ± 1.3 mm, with the maximum value of 5.7 mm. Comparison of Pearson correlation of the compensating parameters between the 2 4-dof optimization algorithms shows that there is a small but statistically significant correlation in y and z (0.236 and 0.300, respectively), whereas there is very weak correlation in x and roll (0.062 and 0.025, respectively). Conclusions: We find that there is an average improvement of approximately 1 mm in terms of maxDTA on the PTV going from 4-dof bony anatomy-based autoregistration to the 4-dof contour-based optimization. Pearson correlation analysis of the 2 4-dof optimizations suggests that uncertainties due to deformation and inadequate resolution account for much of the compensating parameters, but pitch variation also makes a statistically significant

  18. Dosimetric Comparison of 3-Dimensional Planning Techniques Using an Intravaginal Multichannel Balloon Applicator for High-Dose-Rate Gynecologic Brachytherapy

    SciTech Connect

    Park, Sang-June Chung, Melody; Demanes, D. Jeffrey; Banerjee, Robyn; Steinberg, Michael; Kamrava, Mitchell

    2013-11-15

    Purpose: To study the dosimetric differences of various channel combinations of the Capri vaginal applicator. Methods and Materials: The Capri consists of a single central channel (R1), an inner array of 6 channels (R2), and an outer array of 6 channels (R3). Three-dimensional plans were simulated for 6 channel arrangements (R1, R2, R12, R13, R23, and R123). Treatment plans were optimized to the applicator surface or 5-mm depth while minimizing dose to organs at risk (OARs: bladder, rectum, sigmoid, and urethra). The clinical target volume (CTV) was defined as a 5-mm circumferential shell extending 4 cm in length around the applicator. Clinical target volume coverage (D{sub mean}, D{sub 90}, V{sub 100}, and V{sub 150}) and OAR doses (D{sub 0.1} {sub cm{sup 3}}, D{sub 1} {sub cm{sup 3}}, D{sub 2} {sub cm{sup 3}}, and D{sub mean}) were compared. A comparison between the Capri (R123) and a conventional single-channel applicator was also done. Statistical significance (P value <.05) was evaluated with a 2-tailed t test. Results: When prescribing to 5-mm depth, CTV coverage using all 13 channels (R123) versus a single channel (R1) was similar; however, when prescribing to the surface there were differences (P<.0001) in all CTV metrics except for the V{sub 150}. The R1 plans had higher doses to all OARs compared with R123 plans (P<.007). Doses to OARs were not significantly different between R23 and R123 plans (P=.05-.95), and CTV coverage differences were on the order of 1%. Capri R123 plans provided slightly lower CTV D{sub 90} and D{sub mean} but equivalent OAR doses with smaller standard deviations compared with conventional cylinder plans for both prescriptions. Conclusions: The Capri multichannel applicator provides equivalent target coverage at 5-mm depth, with significantly reduced dose to OARs relative to using a single channel. Optimal plans can be achieved using R12 (lowest V{sub 150}) or R123 or R23 (lowest OAR doses)

  19. The effect of the target-organ geometric complexity on the choice of delivery between RapidArc and sliding-window IMRT for nasopharyngeal carcinoma

    SciTech Connect

    Kan, Monica W.K.; Leung, Lucullus H.T.; Yu, Peter K.N.

    2013-10-01

    We attempted to assess the effect of target-organ geometric complexity on the plan quality of sliding-window intensity-modulated radiotherapy (IMRT), double-arc (RA2), and triple-arc (RA3) RapidArc volumetric-modulated arc radiotherapy for nasopharyngeal carcinoma (NPC). Plans for 9-field sliding-window IMRT, RA2, and RA3 were optimized for 36 patients with NPC ranging from T1 to T4 tumors. Initially the patients were divided into 2 groups, with group A representing the most simple early stage (T1 and T2) cases, whereas group B represented the more complex advanced cases (T3 and T4). Evaluation was performed based on target conformity, target dose homogeneity, organ-sparing capability, and delivery efficiency. Based on the plan quality results, a subgroup of advanced cases, group B2, representing the most demanding task was distinguished and reported separately from the rest of the group B cases, B1. Detailed analysis was performed on the anatomic features for each group of cases, so that planners can easily identify the differences between B1 and B2. For the group A cases, RA3 plans were superior to the IMRT plans in terms of organ sparing, whereas target conformity and dose homogeneity were similar. For the group B1 cases, the RA3 plans produced almost equivalent plan quality as the IMRT plans. For the group B2 cases, for most of which large target volumes were adjacent to (5 mm or less) and wrapping around the brain stem, RA2 and RA3 were inferior to the IMRT regarding both target dose homogeneity and conformity. RA2 plans were slightly inferior to IMRT and RA3 plans for most cases. The plan comparison results depend on the target to brain stem distances and the target sizes. The plan quality results together with the anatomic information may allow the evaluation of the 3 treatment options before actual planning.

  20. Importance of protocol target definition on the ability to spare normal tissue: An IMRT and 3D-CRT planning comparison for intraorbital tumors

    SciTech Connect

    Hein, Patrick A.; Gladstone, David J.; Bellerive, Marc R.; Hug, Eugen B. . E-mail: Eugen.B.Hug@hitchcock.org

    2005-08-01

    Purpose: We selected five intraorbital tumor sites that are frequently found in clinical practice in children diagnosed with orbital rhabdomyosarcoma and performed three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated photon radiotherapy (IMRT) planning. Results of target coverage and doses to critical structures were compared. The goal of this study was to evaluate and to document realistic expectations as to organ-sparing capabilities of modern radiation therapy planning technologies with a focus on lens-sparing irradiation. Furthermore, we investigated potential added benefits of IMRT compared with 3D-CRT and the influence of protocol volume criteria definitions on the ability to obtain normal tissue dose sparing using the orbit as an example of a complex anatomic site. Methods and Materials: The five intraorbital tumor sites were placed retrobulbar, temporal, nasal, in the upper inner and upper outer quadrant, the latter two more complex in shape. Gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) were defined in image-fused computed tomography and magnetic resonance data sets. 3D-CRT and IMRT photon plans, using equal beam angles and collimation for direct comparison, were designed to 45 Gy prescription dose according to Intergroup Rhabdomyosarcoma Study Group-D9602 (IRSG-D9602) protocol (Intergroup Rhabdomyosarcoma Study V [IRS-V] protocol) for Stage I, Clinical Group 3 orbital rhabdomyosarcoma. To compare the impact of changed target definitions in IMRT planning, additional IMRT plans were generated using modified volume and dose coverage criteria. The minimum dose constraint (95%) of the PTV was substituted by a required minimum volume coverage (95%) with the prescribed dose. Dose-volume histograms (DVHs) were obtained, including target volumes, lens, optic nerves, optic chiasm, lacrimal gland, bony orbit, pituitary gland, frontal and temporal lobes. Results: Protocol target volume coverage criteria

  1. A method to obtain correct standard uptake values in Pinnacle treatment planning system for target volume delineation

    PubMed Central

    Salehzahi, Farshid; Tse, Jason; Lee, Jonathan; Selvaraj, Jothybasu

    2016-01-01

    Standardized uptake value (SUV) is an advanced tool for quantitative tumor identification and metabolic target volume delineation (TVD) in diagnostic and therapeutic settings. It is thus important to establish a quality assured process to maintain the traceability of data correctly by positron emission tomography (PET) systems. Patient administration of 18fluoro-deoxy-glucose is increasingly delivered by automated infusion systems (AISs). Whenever AIS is used, its accuracy and traceability measurement need verification. In addition, it was observed that the unreproducible SUV displayed in PET and the treatment planning system (TPS) may cause grave concerns for radiation oncologists for TVD. This concern may complicate the correlation of TVD on PET and TPS and their clinical reporting. The SUV traceability was established from the PET system to AIS. Its accuracy was verified by cross-referencing to the reference dose calibrator traceable to a primary standard. The SUV values were converted in TPS using the in-house “clinical tool” to be identical as in PET, to allow radiation oncologists to use SUV confidently. The outcome of this study enables the clinical groups to rely on the correct SUV values displayed on the TPS and to improve the quality of care for patients in clinical procedures. PMID:28144116

  2. Towards sustainable settlement growth: A new multi-criteria assessment for implementing environmental targets into strategic urban planning

    SciTech Connect

    Schetke, Sophie; Haase, Dagmar; Koetter, Theo

    2012-01-15

    For nearly one decade, the German political and research-agenda has been to a large extent determined by the ongoing question of how to limit the expansion of settlement areas around cities in order to preserve natural resources, make settlement growth more sustainable and to strengthen the re-use of existing inner-urban areas (see a.o. Koetter et al. 2009a, 2010; Schetke et al. 2009, 2010b). What is already under discussion within the international literature are the recommendations of the German Council for Sustainability to quantitatively reduce the daily greenfield consumption from the current rate of over 100 ha per day to a rate of 30 ha per day in 2020 and to bring urban infill development up to a ratio of 3:1 with greenfield development (German Council for Sustainability, 2004).). This paper addresses the added value beyond those abstract political targets and presents an innovative, multi-criteria assessment (MCA) of greenfield and infill sites to evaluate their sustainability and resource efficiency. MCA development and its incorporation into a Decision Support System (DSS) were accomplished by utilising a stakeholder-driven approach. The resulting tool can be applied in preparing and revising land-use plans. The paper presents the concept and the development process of the MCA-DSS. Test runs with planners prove that the evaluation of potential housing sites using individually weighted environmental indicators helps to identify those strategies of housing development that accord most closely with sustainability goals. The tests further show that the development of greenfield sites generally exhibits less sustainability than that of infill sites. - Highlights: Black-Right-Pointing-Pointer This paper presents an innovative, multi-criteria assessment (MCA) of greenfield and infill sites. Black-Right-Pointing-Pointer The MCA evaluates sustainability and resource efficiency of potential housing sites in a stakeholder-driven approach. Black

  3. SU-E-T-504: Usefulness of CT-MR Fusion in Radiotherapy Planning for Prostate Cancer Patient with Bilateral Hip Replacements

    SciTech Connect

    He, R.; Giri, Shankar; Kumar, P.; Hu, Y.; Suggs, J.; Yang, C.

    2014-06-01

    Purpose: Target localization of prostate for Intensity Modulated Radiation Therapy (IMRT) in patients with bilateral hip replacements is difficult due to artifacts in Computed Tomography (CT) images generated from the prostheses high Z materials. In this study, Magnetic Resonance (MR) images fused with CT images are tested as a solution. Methods: CT images of 2.5 mm slice thickness were acquired on a GE Lightspeed scanner with a flat-topped couch for a prostate cancer patient with bilateral hip replacements. T2 weighted images of 5 mm separation were acquired on a MR Scanner. After the MR-CT registration on a radiotherapy treatment planning system (Eclipse, Varian), the target volumes were defined by the radiation oncologists on MR images and then transferred to CT images for planning and dose calculation. The CT Hounsfield Units (HU) was reassigned to zero (as water) for artifacts. The Varian flat panel treatment couch was modeled for dose calculation accuracy with heterogeneity correction. A Volume Matrix Arc Therapy (VMAT) and a seven-field IMRT plans were generated, each avoiding any beam transversing the prostheses; the two plans were compared. The superior VMAT plan was used for treating the patient. In-vivo dosimetry was performed using MOSFET (Best Canada) placed in a surgical tube inserted into the patient rectum during therapy. The measured dose was compared with planned dose for MOSFET location. Results: The registration of MR-CT images and the agreement of target volumes were confirmed by three physicians. VMAT plan was deemed superior to IMRT based on dose to critical nearby structures and overall conformality of target dosing. In-vivo measured dose compared with calculated dose was -4.5% which was likely due to attenuation of the surgical tube surrounding MOSFET. Conclusion: When artifacts are present on planning CT due to bilateral hip prostheses, MR-CT image fusion is a feasible solution for target delineation.

  4. Defining the Optimal Planning Target Volume in Image-Guided Stereotactic Radiosurgery of Brain Metastases: Results of a Randomized Trial

    SciTech Connect

    Kirkpatrick, John P.; Wang, Zhiheng; Sampson, John H.; McSherry, Frances; Herndon, James E.; Allen, Karen J.; Duffy, Eileen; Hoang, Jenny K.; Chang, Zheng; Yoo, David S.; Kelsey, Chris R.; Yin, Fang-Fang

    2015-01-01

    Purpose: To identify an optimal margin about the gross target volume (GTV) for stereotactic radiosurgery (SRS) of brain metastases, minimizing toxicity and local recurrence. Methods and Materials: Adult patients with 1 to 3 brain metastases less than 4 cm in greatest dimension, no previous brain radiation therapy, and Karnofsky performance status (KPS) above 70 were eligible for this institutional review board–approved trial. Individual lesions were randomized to 1- or 3- mm uniform expansion of the GTV defined on contrast-enhanced magnetic resonance imaging (MRI). The resulting planning target volume (PTV) was treated to 24, 18, or 15 Gy marginal dose for maximum PTV diameters less than 2, 2 to 2.9, and 3 to 3.9 cm, respectively, using a linear accelerator–based image-guided system. The primary endpoint was local recurrence (LR). Secondary endpoints included neurocognition Mini-Mental State Examination, Trail Making Test Parts A and B, quality of life (Functional Assessment of Cancer Therapy-Brain), radionecrosis (RN), need for salvage radiation therapy, distant failure (DF) in the brain, and overall survival (OS). Results: Between February 2010 and November 2012, 49 patients with 80 brain metastases were treated. The median age was 61 years, the median KPS was 90, and the predominant histologies were non–small cell lung cancer (25 patients) and melanoma (8). Fifty-five, 19, and 6 lesions were treated to 24, 18, and 15 Gy, respectively. The PTV/GTV ratio, volume receiving 12 Gy or more, and minimum dose to PTV were significantly higher in the 3-mm group (all P<.01), and GTV was similar (P=.76). At a median follow-up time of 32.2 months, 11 patients were alive, with median OS 10.6 months. LR was observed in only 3 lesions (2 in the 1 mm group, P=.51), with 6.7% LR 12 months after SRS. Biopsy-proven RN alone was observed in 6 lesions (5 in the 3-mm group, P=.10). The 12-month DF rate was 45.7%. Three months after SRS, no significant change in

  5. Determination of Internal Target Volume for Radiation Treatment Planning of Esophageal Cancer by Using 4-Dimensional Computed Tomography (4DCT)

    SciTech Connect

    Chen, Xiaojian; Lu, Haijun; Tai, An; Johnstone, Candice; Gore, Elizabeth; Li, X. Allen

    2014-09-01

    Purpose: To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). Methods and Materials: 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV{sub M}IP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2 plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). Results: For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV{sub M}IP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. Conclusions: The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers.

  6. Poster — Thur Eve — 64: Preliminary investigation of arc configurations for optimal sparing of normal tissue in hypofractionated stereotactic radiotherapy (HF-SRT) of multiple brain metastases using a 5mm interdigitating micro-multileaf collimator

    SciTech Connect

    Leavens, C; Wronski, M; Lee, YK; Ruschin, M; Soliman, H; Sahgal, A

    2014-08-15

    Purpose: To evaluate normal tissue sparing in intra-cranial HF-SRT, comparing various arc configurations with the Synergy Beam Modulator (SynBM) and Agility linacs, the latter incorporating leaf interdigitation and backup jaws. Methods: Five patients with multiple brain metastases (BMs), (5 BMs (n=2), 3 BMs (n=3)) treated with HF-SRT using 25 Gy (n=2) or 30 Gy (n=3) in 5 fractions, were investigated. Clinical treatment plans used the SynBM. Each patient was retrospectively re-planned on Agility, employing three planning strategies: (A) one isocenter and dedicated arc for each BM; (B) a single isocenter, centrally placed with respect to BMs; (C) the isocenter and arc configuration used in the SynBM plan, where closely spaced (<5cm) BMs used a dedicated isocenter and arcs. Agility plans were normalized for PTV coverage and heterogeneity. Results and Conclusion: Strategy A obtained the greatest improvements over the SynBM plan, where the maximum OAR dose, and mean dose to normal brain (averaged for all patients) were reduced by 55cGy and 25cGy, respectively. Strategy B was limited by having a single isocenter, hence less jaw shielding and increased MLC leakage. The maximum OAR dose was reduced by 13cGy, however mean dose to normal brain increased by 84cGy. Strategy C reduced the maximum OAR dose and mean dose to normal brain by 32cGy and 9cGy, respectively. The results from this study indicate that, for intra-cranial HF-SRT of multiple BMs, Agility plans are equal or better than SynBM plans. Further planning is needed to investigate dose sparing using Strategy A and the SynBM.

  7. Comparative evaluation of target volumes defined by deformable and rigid registration of diagnostic PET/CT to planning CT in primary esophageal cancer

    PubMed Central

    Guo, Yanluan; Li, Jianbin; Zhang, Peng; Shao, Qian; Xu, Min; Li, Yankang

    2017-01-01

    Abstract Background: To evaluate the geometrical differences of target volumes propagated by deformable image registration (DIR) and rigid image registration (RIR) to assist target volume delineation between diagnostic Positron emission tomography/computed tomography (PET/CT) and planning CT for primary esophageal cancer (EC). Methods: Twenty-five patients with EC sequentially underwent a diagnostic 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan and planning CT simulation. Only 19 patients with maximum standardized uptake value (SUVmax) ≥ 2.0 of the primary volume were available. Gross tumor volumes (GTVs) were delineated using CT and PET display settings. The PET/CT images were then registered with planning CT using MIM software. Subsequently, the PET and CT contours were propagated by RIR and DIR to planning CT. The properties of these volumes were compared. Results: When GTVCT delineated on CT of PET/CT after both RIR and DIR was compared with GTV contoured on planning CT, significant improvements using DIR were observed in the volume, displacements of the center of mass (COM) in the 3-dimensional (3D) direction, and Dice similarity coefficient (DSC) (P = 0.003; 0.006; 0.014). Although similar improvements were not observed for the same comparison using DIR for propagated PET contours from diagnostic PET/CT to planning CT (P > 0.05), for DSC and displacements of COM in the 3D direction of PET contours, the DIR resulted in the improved volume of a large percentage of patients (73.7%; 68.45%; 63.2%) compared with RIR. For diagnostic CT-based contours or PET contours at SUV2.5 propagated by DIR with planning CT, the DSC and displacements of COM in 3D directions in the distal segment were significantly improved compared to the upper and middle segments (P > 0.05). Conclusion: We observed a trend that deformable registration might improve the overlap for gross target volumes from diagnostic PET/CT to planning CT. The distal EC might benefit more from DIR

  8. Optimization of helical tomotherapy treatment plans for prostate cancer

    NASA Astrophysics Data System (ADS)

    Grigorov, G.; Kron, T.; Wong, E.; Chen, J.; Sollazzo, J.; Rodrigues, G.

    2003-07-01

    Helical tomotherapy (HT) is a novel treatment approach where the ring gantry irradiation geometry of a helical CT scanner is combined with an intensity-modulated megavoltage x-ray fan beam. An inverse treatment planning system (TomoTherapy Inc., Madison) was used to optimize the treatment plans for ten randomly selected prostate patients. Five different sets of margins (2, 5, 7.5 and 10 mm uniform 3D margins and a non-uniform margin of 5 to 10 mm) were employed for the prostate (GTV2) and seminal vesicles (GTV1). The dose distribution was evaluated in targets, rectum, bladder and femoral heads. HT plans are characterized by a rapid dose fall off around the target in all directions resulting in low doses (less than 30% of the dose at ICRU reference point) to the femurs in all cases. Up to a margin of 5 mm for target structures, it was always possible to satisfy the requirements for dose delivery set by RTOG protocol P-0126. Using a 'class solution', HT plans require minimal operator interaction and result in excellent sparing of normal structures in prostate radiotherapy.

  9. Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation

    NASA Astrophysics Data System (ADS)

    Magro, G.; Molinelli, S.; Mairani, A.; Mirandola, A.; Panizza, D.; Russo, S.; Ferrari, A.; Valvo, F.; Fossati, P.; Ciocca, M.

    2015-09-01

    This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5-30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo® TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus® chamber. An EBT3® film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size ratio. The accuracy of the TPS was proved to be clinically acceptable in all cases but very small and shallow volumes. In this contest, the use of MC to validate TPS results proved to be a reliable procedure for pre-treatment plan verification.

  10. MO-A-BRD-08: Radiosurgery Beyond Cancer: Real-Time Target Localization and Treatment Planning for Cardiac Radiosurgery Under MRI Guidance

    SciTech Connect

    Ipsen, S; Blanck, O; Oborn, B; Bode, F; Liney, G; Keall, P

    2014-06-15

    Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting >2.5M Americans and >4.5M Europeans. AF is usually treated with minimally-invasive, time consuming catheter ablation techniques. Radiosurgery of the pulmonary veins (PV) has been proposed for AF treatment, however is challenging due to the complex respiratory and cardiac motion patterns. We hypothesize that an MRI-linac could solve the difficult real-time targeting and adaptation problem. In this study we quantified target motion ranges on cardiac MRI and analyzed the dosimetric benefits of margin reduction assuming real-time MRI tracking was applied. Methods: For the motion study, four human subjects underwent real-time cardiac MRI under free breathing. The target motion on coronal and axial cine planes was analyzed using a template matching algorithm. For the planning study, an ablation line at each PV antrum was defined as target on an AF patient scheduled for catheter ablation. Various safety margins ranging from 0mm (perfect tracking) to 8mm (untracked motion) were added to the target defining the PTV. 30Gy single fraction IMRT plans were then generated. Finally, the influence of a 1T magnetic field on treatment beam delivery was calculated using the Geant4 Monte Carlo algorithm to simulate the dosimetric impact of MRI guidance. Results: The motion study showed the mean respiratory motion of the target area on MRI was 8.4mm (SI), 1.7mm (AP) and 0.3mm (LR). Cardiac motion was small (<2mm). The planning study showed that with increasing safety margins to encompass untracked motion, dose tolerances for OARs such as the esophagus and airways were exceeded by >100%. The magnetic field had little impact on the dose distribution. Conclusion: Our results indicate that real-time MRI tracking of the PVs seems feasible. Accurate image guidance for high-dose AF radiosurgery is essential since safety margins covering untracked target motion will result in unacceptable treatment plans.

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

    SciTech Connect

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

    2014-06-01

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

  12. Planning Evaluation of C-Arm Cone Beam CT Angiography for Target Delineation in Stereotactic Radiation Surgery of Brain Arteriovenous Malformations

    SciTech Connect

    Kang, Jun; Huang, Judy; Gailloud, Philippe; Rigamonti, Daniele; Lim, Michael; Bernard, Vincent; Ehtiati, Tina; Ford, Eric C.

    2014-10-01

    Purpose: Stereotactic radiation surgery (SRS) is one of the therapeutic modalities currently available to treat cerebral arteriovenous malformations (AVM). Conventionally, magnetic resonance imaging (MRI) and MR angiography (MRA) and digital subtraction angiography (DSA) are used in combination to identify the target volume for SRS treatment. The purpose of this study was to evaluate the use of C-arm cone beam computed tomography (CBCT) in the treatment planning of SRS for cerebral AVMs. Methods and Materials: Sixteen consecutive patients treated for brain AVMs at our institution were included in this retrospective study. Prior to treatment, all patients underwent MRA, DSA, and C-arm CBCT. All images were coregistered using the GammaPlan planning system. AVM regions were delineated independently by 2 physicians using either C-arm CBCT or MRA, resulting in 2 volumes: a CBCT volume (VCBCT) and an MRA volume (V{sub MRA}). SRS plans were generated based on the delineated regions. Results: The average volume of treatment targets delineated using C-arm CBCT and MRA were similar, 6.40 cm{sup 3} and 6.98 cm{sup 3}, respectively (P=.82). However, significant regions of nonoverlap existed. On average, the overlap of the MRA with the C-arm CBCT was only 52.8% of the total volume. In most cases, radiation plans based on V{sub MRA} did not provide adequate dose to the region identified on C-arm CBCT; the mean minimum dose to V{sub CBCT} was 29.5%, whereas the intended goal was 45% (P<.001). The mean volume of normal brain receiving 12 Gy or more in C-arm CBCT-based plans was not greater than in the MRA-based plans. Conclusions: Use of C-arm CBCT images significantly alters the delineated regions of AVMs for SRS planning, compared to that of MRA/MRI images. CT-based planning can be accomplished without increasing the dose to normal brain and may represent a more accurate definition of the nidus, increasing the chances for successful obliteration.

  13. A Treatment Planning Study of Stereotactic Body Radiotherapy for Atrial Fibrillation

    PubMed Central

    Kotecha, Rupesh; Sharma, Naveen; Andrews, Martin; Stephans, Kevin L; Oberti, Carlos; Lin, Sara; Wazni, Oussama; Tchou, Patrick; Saliba, Walid I; Suh, John

    2016-01-01

    Purpose: To explore the feasibility of using stereotactic body radiotherapy (SBRT) to irradiate the antra of the four pulmonary veins while protecting nearby critical organs, such as the esophagus. Materials and Methods: Twenty patients who underwent radiofrequency catheter ablation for atrial fibrillation were selected. For each patient, the antra of the four pulmonary veins were identified as the target volumes on a pre-catheterization contrast or non-contrast CT scan. On each CT scan, the esophagus, trachea, heart, and total lung were delineated and the esophagus was identified as the critical organ. For each patient, three treatment plans were designed with 0, 2, and 5 mm planning margins around the targets while avoiding overlap with a planning organ at risk volume (PRV) generated by a 2 mm expansion of the esophagus. Using three non-coplanar volumetric modulated arcs (VMAT), 60 plans were created to deliver a prescription dose of 50 Gy in five fractions, following the SBRT dose regimen for central lung tumors. With greater than 97% of the planning target volumes (PTV) receiving the prescription doses, we examined dosimetry to 0.03 cc and 5 cc of the esophagus PRV volume as well as other contoured structures. Results: The average PTV-0 mm, PTV-2 mm, and PTV-5 mm volumes were 3.05 ± 1.90 cc, 14.70 ± 5.00 cc, and 40.85 ± 10.20 cc, respectively. With three non-coplanar VMAT arcs, the average conformality indices (ratio of prescription isodose volume to the PTV volume) for the PTV-0 mm, PTV-2 mm and PTV-5 mm were 4.81 ± 2.0, 1.71 ± 0.19, and 1.23 ± 0.08, respectively. Assuming patients were treated under breath-hold with 2 mm planning margins to account for cardiac motion, all plans met esophageal PRV maximum dose limits < 50 Gy to 0.03 cc and 16 plans (80%) met < 27.5 Gy to 5 cc of the esophageal PRVs. For PTV-5 mm plans, 18 plans met the maximum dose limit < 50 Gy to 0.03 cc and only two plans met the maximum dose limit < 27.5 Gy to 5 cc of the

  14. Streamlined Approach for Environmental Restoration (SAFER) Plan for Corrective Action Unit 408: Bomblet Target Area Tonopah Test Range (TTR), Nevada, Revision 1

    SciTech Connect

    Mark Krauss

    2010-03-01

    This Streamlined Approach for Environmental Restoration Plan addresses the actions needed to achieve closure of Corrective Action Unit (CAU) 408, Bomblet Target Area (TTR). Corrective Action Unit 408 is located at the Tonopah Test Range and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order. Corrective Action Unit 408 comprises Corrective Action Site TA-55-002-TAB2, Bomblet Target Areas. Clean closure of CAU 408 will be accomplished by removal of munitions and explosives of concern within seven target areas and potential disposal pits. The target areas were used to perform submunitions related tests for the U.S. Department of Energy (DOE). The scope of CAU 408 is limited to submunitions released from DOE activities. However, it is recognized that the presence of other types of unexploded ordnance and munitions may be present within the target areas due to the activities of other government organizations. The CAU 408 closure activities consist of: • Clearing bomblet target areas within the study area. • Identifying and remediating disposal pits. • Collecting verification samples. • Performing radiological screening of soil. • Removing soil containing contaminants at concentrations above the action levels. Based on existing information, contaminants of potential concern at CAU 408 include unexploded submunitions, explosives, Resource Conservation Recovery Act metals, and depleted uranium. Contaminants are not expected to be present in the soil at concentrations above the action levels; however, this will be determined by radiological surveys and verification sample results.

  15. [Impact of planning CT slice thickness on the accuracy of automatic target registration using the on-board cone-beam CT].

    PubMed

    Inoue, Hiroyuki; Tanooka, Masao; Doi, Hiroshi; Miura, Hideharu; Nakagawa, Hideo; Sakai, Toshiyuki; Oda, Masahiko; Yasumasa, Katsumi; Sakamoto, Kiyoshi; Kamikonya, Norihiko; Hirota, Shozo

    2011-01-01

    We have evaluated relationship between planning CT slice thickness and the accuracy of automatic target registration using cone-beam CT (CBCT). Planning CT images were acquired with reconstructed slice thickness of 1, 2, 3, 5, and 10mm for three different phantoms: Penta-Guide phantom, acrylic ball phantom, and pelvic phantom. After correctly placing the phantom at the isocenter using an in-room laser, we purposely displaced it by moving the treatment couch and then obtained CBCT images. Registration between the planning CT and the CBCT was performed using automatic target registration software, and the registration errors were recorded for each planning CT data set with different slice thickness. The respective average and standard deviation of errors for 10 mm slice thickness CT in the lateral, longitudinal, and vertical directions (n=15 data sets) were: 0.7 +/- 0.2mm, 0.8 +/- 0.2mm, and 0.2 +/- 0.2mm for the Penta-Guide phantom; 0.5 +/- 0.4 mm, 0.6 +/- 0.3 mm, and 0.4 +/- 0.3 mm for the acrylic ball phantom; and 0.6 +/- 0.2 mm, 0.9 +/- 0.2 mm, and 0.2 +/- 0.2 mm for the pelvic phantom. We found that the mean registration errors were always less than 1 mm regardless of the slice thickness tested. The results suggest that there is no obvious correlation between the planning CT slice thickness and the registration errors.

  16. SU-E-T-425: Spherical Dose Distributions for Radiosurgery Using a Standardized MLC Plan

    SciTech Connect

    Popple, R; Brezovich, I; Wu, X; Fiveash, J

    2014-06-01

    Purpose: To investigate a standardized MLC treatment plan to generate small spherical dose distributions. Methods: The static virtual cone plan comprised six table positions with clockwise and counterclockwise arcs having collimator angles 45 and 135 degrees, respectively, at each position. The central two leaves of a 2.5 mm leaf width MLC were set to a constant gap. Control points were weighted proportional to the sine of the gantry angle. Plans were created for the 10 MV flattening-filter-free beam of a TrueBeam STx (Varian Medical Systems) with gaps of 1, 1.5, 2, and 3 mm and were delivered to a phantom containing radiochromic film. Dose was calculated using the Eclipse AAA (Varian Medical Systems). A dynamic plan in which the table and gantry moved simultaneously with 1.5 mm gap was also created and delivered using the TrueBeam developer mode. Results: The full-width-half-max (FWHM) varied with leaf gap, ranging from 5.2 to 6.2 mm. Calculated FWHM was smaller than measured by 0.7 mm for the 1 mm gap and ≤ 0.4 mm for the larger gaps. The measured-to-calculated dose ratio was 0.93, 0.96, 1.01, and 0.99 for 1 mm, 1.5 mm, 2 mm, and 3 mm gaps, respectively. The dynamic results were the same as the static. The position deviations between the phantom target position and the center of the dose distribution were < 0.4 mm. Conclusion: The virtual cone can deliver spherical dose distributions suitable for radio surgery of small targets such as the trigeminal nerve. The Eclipse AAA accurately calculates the expected dose, particularly for leaf gap ≥ 1.5 mm. The measured dose distribution is slightly larger than the calculation, which is likely due to systematic leaf position error, isocenter variation due to gantry sag and table eccentricity, and inaccuracy in MLC leaf end modeling.

  17. Audio-Visual Biofeedback Does Not Improve the Reliability of Target Delineation Using Maximum Intensity Projection in 4-Dimensional Computed Tomography Radiation Therapy Planning

    SciTech Connect

    Lu, Wei; Neuner, Geoffrey A.; George, Rohini; Wang, Zhendong; Sasor, Sarah; Huang, Xuan; Regine, William F.; Feigenberg, Steven J.; D'Souza, Warren D.

    2014-01-01

    Purpose: To investigate whether coaching patients' breathing would improve the match between ITV{sub MIP} (internal target volume generated by contouring in the maximum intensity projection scan) and ITV{sub 10} (generated by combining the gross tumor volumes contoured in 10 phases of a 4-dimensional CT [4DCT] scan). Methods and Materials: Eight patients with a thoracic tumor and 5 patients with an abdominal tumor were included in an institutional review board-approved prospective study. Patients underwent 3 4DCT scans with: (1) free breathing (FB); (2) coaching using audio-visual (AV) biofeedback via the Real-Time Position Management system; and (3) coaching via a spirometer system (Active Breathing Coordinator or ABC). One physician contoured all scans to generate the ITV{sub 10} and ITV{sub MIP}. The match between ITV{sub MIP} and ITV{sub 10} was quantitatively assessed with volume ratio, centroid distance, root mean squared distance, and overlap/Dice coefficient. We investigated whether coaching (AV or ABC) or uniform expansions (1, 2, 3, or 5 mm) of ITV{sub MIP} improved the match. Results: Although both AV and ABC coaching techniques improved frequency reproducibility and ABC improved displacement regularity, neither improved the match between ITV{sub MIP} and ITV{sub 10} over FB. On average, ITV{sub MIP} underestimated ITV{sub 10} by 19%, 19%, and 21%, with centroid distance of 1.9, 2.3, and 1.7 mm and Dice coefficient of 0.87, 0.86, and 0.88 for FB, AV, and ABC, respectively. Separate analyses indicated a better match for lung cancers or tumors not adjacent to high-intensity tissues. Uniform expansions of ITV{sub MIP} did not correct for the mismatch between ITV{sub MIP} and ITV{sub 10}. Conclusions: In this pilot study, audio-visual biofeedback did not improve the match between ITV{sub MIP} and ITV{sub 10}. In general, ITV{sub MIP} should be limited to lung cancers, and modification of ITV{sub MIP} in each phase of the 4DCT data set is recommended.

  18. Identifying the 'if' for 'if-then' plans: combining implementation intentions with cue-monitoring targeting unhealthy snacking behaviour.

    PubMed

    Verhoeven, Aukje A C; Adriaanse, Marieke A; de Vet, Emely; Fennis, Bob M; de Ridder, Denise T D

    2014-01-01

    Implementation intentions aimed at changing unwanted habits require the identification of personally relevant cues triggering the habitual response in order to be effective. To facilitate successful implementation intention formation, in the present study, planning was combined with cue-monitoring, a novel way to gain insight into triggers for unhealthy snacking. It was tested whether keeping a cue-monitoring diary and tailoring implementation intentions accordingly improves plan effectiveness. A 2 Monitoring (cue-monitoring, control) × 2 Planning (implementation intention, goal intention) between subjects design was adopted. Participants (N = 161) monitored their unhealthy snacking behaviour for a week using either a cue-monitoring or a control diary. Participants then formulated a goal intention or an implementation intention tailored to their personal cue. Snacking frequency and caloric intake from unhealthy snacks were examined using a seven-day snack diary. The results did not indicate an interaction but yielded a main effect of Monitoring. Cue-monitoring either or not combined with implementation intentions reduced unhealthy snacking behaviour compared with control. Findings emphasise the effectiveness of cue-monitoring, suggesting that on the short term, cue-monitoring suffices to decrease unhealthy snacking, without additional benefit from planning. Future research should examine whether supplementing cue-monitoring with implementation intentions is required to establish long-term behaviour change maintenance.

  19. Feasibility and robustness of dose painting by numbers in proton therapy with contour-driven plan optimization

    SciTech Connect

    Barragán, A. M. Differding, S.; Lee, J. A.; Sterpin, E.; Janssens, G.

    2015-04-15

    Purpose: To prove the ability of protons to reproduce a dose gradient that matches a dose painting by numbers (DPBN) prescription in the presence of setup and range errors, by using contours and structure-based optimization in a commercial treatment planning system. Methods: For two patients with head and neck cancer, voxel-by-voxel prescription to the target volume (GTV{sub PET}) was calculated from {sup 18}FDG-PET images and approximated with several discrete prescription subcontours. Treatments were planned with proton pencil beam scanning. In order to determine the optimal plan parameters to approach the DPBN prescription, the effects of the scanning pattern, number of fields, number of subcontours, and use of range shifter were separately tested on each patient. Different constant scanning grids (i.e., spot spacing = Δx = Δy = 3.5, 4, and 5 mm) and uniform energy layer separation [4 and 5 mm WED (water equivalent distance)] were analyzed versus a dynamic and automatic selection of the spots grid. The number of subcontours was increased from 3 to 11 while the number of beams was set to 3, 5, or 7. Conventional PTV-based and robust clinical target volumes (CTV)-based optimization strategies were considered and their robustness against range and setup errors assessed. Because of the nonuniform prescription, ensuring robustness for coverage of GTV{sub PET} inevitably leads to overdosing, which was compared for both optimization schemes. Results: The optimal number of subcontours ranged from 5 to 7 for both patients. All considered scanning grids achieved accurate dose painting (1% average difference between the prescribed and planned doses). PTV-based plans led to nonrobust target coverage while robust-optimized plans improved it considerably (differences between worst-case CTV dose and the clinical constraint was up to 3 Gy for PTV-based plans and did not exceed 1 Gy for robust CTV-based plans). Also, only 15% of the points in the GTV{sub PET} (worst case) were

  20. SU-E-T-01: (In)dependence of Plan Quality On Treatment Modalities and Target-To-Critical Structure Geometry for Brain Tumor

    SciTech Connect

    Ruan, D; Shao, W; Low, D; Kupelian, P; Qi, S X

    2015-06-15

    Purpose: To evaluate and test the hypothesis that plan quality may be systematically affected by treatment delivery techniques and target-tocritical structure geometric relationship in radiotherapy for brain tumor. Methods: Thirty-four consecutive brain tumor patients treated between 2011–2014 were analyzed. Among this cohort, 10 were planned with 3DCRT, 11 with RadipArc, and 13 with helical IMRT on TomoTherapy. The selected dosimetric endpoints (i.e., PTV V100, maximum brainstem/chiasm/ optic nerve doses) were considered as a vector in a highdimensional space. A Pareto analysis was performed to identify the subset of Pareto-efficient plans.The geometric relationships, specifically the overlapping volume and centroid-of-mass distance between each critical structure to the PTV were extracted as potential geometric features. The classification-tree analyses were repeated using these geometric features with and without the treatment modality as an additional categorical predictor. In both scenarios, the dominant features to prognosticate the Pareto membership were identified and the tree structures to provide optimal inference were recorded. The classification performance was further analyzed to determine the role of treatment modality in affecting plan quality. Results: Seven Pareto-efficient plans were identified based on dosimetric endpoints (3 from 3DCRT, 3 from RapicArc, 1 from Tomo), which implies that the evaluated treatment modality may have a minor influence on plan quality. Classification trees with/without the treatment modality as a predictor both achieved accuracy of 88.2%: with 100% sensitivity and 87.1% specificity for the former, and 66.7% sensitivity and 96.0% specificity for the latter. The coincidence of accuracy from both analyses further indicates no-to-weak dependence of plan quality on treatment modality. Both analyses have identified the brainstem to PTV distance as the primary predictive feature for Pareto-efficiency. Conclusion: Pareto

  1. The Coordination of Program Planning and Evaluation Systems for Occupational Education. Volume 2: A Targeting System for Occupational Education.

    ERIC Educational Resources Information Center

    Riverside Research Inst., New York, NY.

    The second volume of the final report deals with the targeting system--one of a hierarchy of systems required to support the effective delivery of superior occupational education. It determines that program objectives match student training in occupations, that the best choice of occupations in which to train students has been made, and that the…

  2. Accuracy in Parameter Estimation for Targeted Effects in Structural Equation Modeling: Sample Size Planning for Narrow Confidence Intervals

    ERIC Educational Resources Information Center

    Lai, Keke; Kelley, Ken

    2011-01-01

    In addition to evaluating a structural equation model (SEM) as a whole, often the model parameters are of interest and confidence intervals for those parameters are formed. Given a model with a good overall fit, it is entirely possible for the targeted effects of interest to have very wide confidence intervals, thus giving little information about…

  3. Quantification of Trade-Off Between Parotid Gland Sparing and Planning Target Volume Underdosages in Clinically Node-Negative Head-and-Neck Intensity-Modulated Radiotherapy

    SciTech Connect

    Kruijf, Wilhelmus de . E-mail: kruijf.de.w@bvi.nl; Heijmen, Ben; Levendag, Peter C.

    2007-05-01

    Purpose: To quantify the trade-off between parotid gland sparing and planning target volume (PTV) underdosages for head-and-neck intensity-modulated radiotherapy. Methods and Materials: A planning study was performed for 4 patients with either soft palate or tonsil tumors treated with external radiotherapy up to 46 Gy. The trade-off between underdosages in the PTV and sparing of the parotid glands was investigated by systematically varying the optimization objectives for the inverse planning. A new way of presenting dose-volume information allows easy detection of small PTV subvolumes with underdosages that cannot be assessed in conventional cumulative dose-volume histograms. A simple radiobiological model to estimate the control probability for an electively irradiated neck level was developed. Results: The average dose to the parotid glands can decrease by >10 Gy by allowing the PTV to be underdosed in such a way that the radiobiological model predicts a decrease in subclinical disease control probability of (typically) 1% to a few percent. Conclusion: The trade-off between parotid gland sparing and underdosages in the PTV has been quantified by the use of an alternative method to present dose-volume information and by the use of a radiobiological model to predict subclinical disease control probability.

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

    SciTech Connect

    Bazalova-Carter, Magdalena; Qu, Bradley; Palma, Bianey; Jensen, Christopher; Maxim, Peter G. E-mail: BWLoo@Stanford.edu; Loo, Billy W. E-mail: BWLoo@Stanford.edu; Hårdemark, Björn; Hynning, Elin

    2015-05-15

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

  5. A New Brain Positron Emission Tomography Scanner With Semiconductor Detectors for Target Volume Delineation and Radiotherapy Treatment Planning in Patients With Nasopharyngeal Carcinoma

    SciTech Connect

    Katoh, Norio; Yasuda, Koichi; Shiga, Tohru; Hasegawa, Masakazu; Onimaru, Rikiya; Shimizu, Shinichi; Bengua, Gerard; Ishikawa, Masayori; Tamaki, Nagara; Shirato, Hiroki

    2012-03-15

    Purpose: We compared two treatment planning methods for stereotactic boost for treating nasopharyngeal carcinoma (NPC): the use of conventional whole-body bismuth germanate (BGO) scintillator positron emission tomography (PET{sub CONV}WB) versus the new brain (BR) PET system using semiconductor detectors (PET{sub NEW}BR). Methods and Materials: Twelve patients with NPC were enrolled in this study. [{sup 18}F]Fluorodeoxyglucose-PET images were acquired using both the PET{sub NEW}BR and the PET{sub CONV}WB system on the same day. Computed tomography (CT) and two PET data sets were transferred to a treatment planning system, and the PET{sub CONV}WB and PET{sub NEW}BR images were coregistered with the same set of CT images. Window width and level values for all PET images were fixed at 3000 and 300, respectively. The gross tumor volume (GTV) was visually delineated on PET images by using either PET{sub CONV}WB (GTV{sub CONV}) images or PET{sub NEW}BR (GTV{sub NEW}) images. Assuming a stereotactic radiotherapy boost of 7 ports, the prescribed dose delivered to 95% of the planning target volume (PTV) was set to 2000 cGy in 4 fractions. Results: The average absolute volume ({+-}standard deviation [SD]) of GTV{sub NEW} was 15.7 ml ({+-}9.9) ml, and that of GTV{sub CONV} was 34.0 ({+-}20.5) ml. The average GTV{sub NEW} was significantly smaller than that of GTV{sub CONV} (p = 0.0006). There was no statistically significant difference between the maximum dose (p = 0.0585) and the mean dose (p = 0.2748) of PTV. The radiotherapy treatment plan based on the new gross tumor volume (PLAN{sub NEW}) significantly reduced maximum doses to the cerebrum and cerebellum (p = 0.0418) and to brain stem (p = 0.0041). Conclusion: Results of the present study suggest that the new brain PET system using semiconductor detectors can provide more accurate tumor delineation than the conventional whole-body BGO PET system and may be an important tool for functional and molecular radiotherapy

  6. Improving superficial target delineation in radiation therapy with endoscopic tracking and registration

    SciTech Connect

    Weersink, R. A.; Qiu, J.; Hope, A. J.; Daly, M. J.; Cho, B. C. J.; DaCosta, R. S.; Sharpe, M. B.; Breen, S. L.; Chan, H.; Jaffray, D. A.

    2011-12-15

    Purpose: Target delineation within volumetric imaging is a critical step in the planning process of intensity modulated radiation therapy. In endoluminal cancers, endoscopy often reveals superficial areas of visible disease beyond what is seen on volumetric imaging. Quantitatively relating these findings to the volumetric imaging is prone to human error during the recall and contouring of the target. We have developed a method to improve target delineation in the radiation therapy planning process by quantitatively registering endoscopic findings contours traced on endoscopic images to volumetric imaging. Methods: Using electromagnetic sensors embedded in an endoscope, 2D endoscopic images were registered to computed tomography (CT) volumetric images by tracking the position and orientation of the endoscope relative to a CT image set. Regions-of-interest (ROI) in the 2D endoscopic view were delineated. A mesh created within the boundary of the ROI was projected onto the 3D image data, registering the ROI with the volumetric image. This 3D ROI was exported to clinical radiation treatment planning software. The precision and accuracy of the procedure was tested on two solid phantoms with superficial markings visible on both endoscopy and CT images. The first phantom was T-shaped tube with X-marks etched on the interior. The second phantom was an anatomically correct skull phantom with a phantom superficial lesion placed on the pharyngeal surface. Markings were contoured on the endoscope images and compared with contours delineated in the treatment planning system based on the CT images. Clinical feasibility was tested on three patients with early stage glottic cancer. Image-based rendering using manually identified landmarks was used to improve the registration. Results: Using the T-shaped phantom with X-markings, the 2D to 3D registration accuracy was 1.5-3.5 mm, depending on the endoscope position relative to the markings. Intraobserver standard variation was 0.5

  7. Using the theory of planned behaviour and prototype willingness model to target binge drinking in female undergraduate university students.

    PubMed

    Todd, Jemma; Mullan, Barbara

    2011-10-01

    The current study investigated whether binge drinking in female undergraduates could be reduced by the mere measurement effect (MME), and by altering binge drinker prototypes from the prototype willingness model (PWM). Whether willingness added to the theory of planned behaviour (TPB) was also explored. Female undergraduates aged 17-25 (N=122) were randomly allocated to a prototype manipulation, mere measurement, or control group, and completed two online questionnaires separated by 14-21 days. Controlling for past behaviour, MME group consumed less alcohol than the control group, and this effect was more extreme for those who previously consumed more alcohol. However, the prototype manipulation had no effect. The TPB variables were predictive of intentions and behaviour, but willingness was not. Despite limitations, the MME could be utilised to reduce binge drinking in female undergraduates. The TPB appears to model binge drinking in female undergraduates better than the PWM, implying that binge drinking can be a reasoned behaviour.

  8. Enabling implementation of the Global Vaccine Action Plan: developing investment cases to achieve targets for measles and rubella prevention.

    PubMed

    Thompson, Kimberly M; Strebel, Peter M; Dabbagh, Alya; Cherian, Thomas; Cochi, Stephen L

    2013-04-18

    Global prevention and control of infectious diseases requires significant investment of financial and human resources and well-functioning leadership and management structures. The reality of competing demands for limited resources leads to trade-offs and questions about the relative value of specific investments. Developing investment cases can help to provide stakeholders with information about the benefits, costs, and risks associated with available options, including examination of social, political, governance, and ethical issues. We describe the process of developing investment cases for globally coordinated management of action plans for measles and rubella as tools for enabling the implementation of the Global Vaccine Action Plan (GVAP). We focus on considerations related to the timing of efforts to achieve measles and rubella goals independently and within the context of ongoing polio eradication efforts, other immunization priorities, and other efforts to control communicable diseases or child survival initiatives. Our analysis suggests that the interactions between the availability and sustainability of financial support, sufficient supplies of vaccines, capacity of vaccine delivery systems, and commitments at all levels will impact the feasibility and timing of achieving national, regional, and global goals. The timing of investments and achievements will determine the net financial and health benefits obtained. The methodology, framing, and assumptions used to characterize net benefits and uncertainties in the investment cases will impact estimates and perceptions about the value of prevention achieved overall by the GVAP. We suggest that appropriately valuing the benefits of investments of measles and rubella prevention will require the use of integrated dynamic disease, economic, risk, and decision analytic models in combination with consideration of qualitative factors, and that synthesizing information in the form of investment cases may help

  9. TU-EF-304-02: 4D Optimized Treatment Planning for Actively Scanned Proton Therapy Delivered to Moving Target Volume

    SciTech Connect

    Bernatowicz, K; Zhang, Y; Weber, D; Lomax, A

    2015-06-15

    Purpose: To develop a 4D treatment optimization approach for Pencil Beam Scanned (PBS) proton therapy that includes breathing variability. Method: PBS proton therapy delivers a pattern of proton pencil beams (PBs), distributed to cover the target volume and optimized such as to achieve a homogenous dose distribution across the target. In this work, this optimization step has been enhanced to include advanced 4D dose calculations of liver tumors based on motion extracted from either 4D-CT (representing a single and averaged respiratory cycle) or 4D-CT(MRI) (including breathing variability). The 4D dose calculation is performed per PB on deforming dose grid, and according to the timestamp of each PB, a displacement due to patient’s motion and a change in radiological depth.Three different treatment fields have been optimized in 3D on the end-exhale phase of a 4D-CT liver data set (3D-opt) and then in 4D using the motion extracted from either 4D-CT or 4D-CT(MRI) using deformable image registration. All plans were calculated directly on the PTV without the use of an ITV. The delivery characteristics of the PSI Gantry 2 have been assumed for all calculations. Results: Dose inhomogeneities (D5-D95) in the CTV for the 3D optimized plans recalculated under conditions of variable motion were increased by on average 19.8% compared to the static case. These differences could be reduced by 4D-CT based 4D optimization to 10.5% and by 4D-CT(MRI) based optimization to only 2.3% of the static value. Liver V25 increased by less than 1% using 4D optimization. Conclusion: 4D optimized PBS treatment plans taking into account breathing variability provide for significantly improved robustness against motion and motion variability than those based on 4D-CT alone, and may negate the need of motion specific target expansions. Swiss National Fund Grant (320030-1493942-1)

  10. Validation of 3DVH estimated DVH metrics for prostate VMAT plans

    NASA Astrophysics Data System (ADS)

    Arumugam, Sankar; Xing, Aitang; Young, Tony; Thwaites, David; Holloway, Lois

    2015-01-01

    The accuracy of 3DVH (Sun Nuclear Corporation, USA) reported DVH metrics for target volumes and Organs at Risk (OARs) for two Prostate Volumetric Modulated Arc Therapy (VMAT) plans was studied. The accuracy of 3DVH estimated DVH metrics in the presence of Multi Leaf Collimator (MLC) systematic errors was also tested with error introduced plans calculated in Pinnacle. The results of the study show that the DVH metrics estimated by 3DVH for error-free plans agree with the TPS calculation within 3%. The D95 to PTV was shown to be sensitive in detecting studied MLC errors. However the accuracy of 3DVH estimated DVH metrics for Target Volumes and OARs in the presence of MLC errors for VMAT prostate plans has limitations with this small data set. Although for most situations values matched within 3% for small MLC errors, there was up to a 9.8% difference between the TPS and 3DVH in the presence of a simulated 5mm MLC positioning error. Further study with more plans including other treatment sites is required to fully assess the performance of 3DVH in detecting potential clinical delivery errors.

  11. Sci—Sat AM: Stereo — 06: Dosimetric Comparison of 3D Conformai, Flattened and Flattening Filter-Free TrueBeam RapidArc Planning for Lung SBRT

    SciTech Connect

    Jiang, Runqing; Zhan, Lixin; Osei, Ernest

    2014-08-15

    The major advantages of the VMAT SBRT plans compared to the conventional 3D conformai plan include faster delivery and improved target dose conformity. This study quantifies the dosimetric differences among 3D conformai plan; flattened beam and flattening filter-free (FFF) beam RapidArc Plans for lung SBRT. Five early stage lung cancer patients with various tumor positions and sizes previously treated with 3D non-coplanar SBRT were randomly selected. 4DCT was used for each patient to determine the internal target volume. Abdominal compression was applied to minimize respiratory motion for SBRT patients. For treatment planning, a 5 mm margin was given to the ITV to generate a planning target volume. The prescription dose was 48 Gy in 4 fractions and normalized to 95% of the PTV. Organs at risk (OAR) included spinal cord, esophagus, heart, trachea, bilateral lung, and great vessels. Optimization constraints were set to meet the criteria of the RTOG-0915 protocol. All VMAT plans were optimized with the RapidArc technique using two full arcs in Eclipse treatment planning system. The RapidArc SBRT plans with flattened 6MV beam and 6MV FFF beam were generated and dosimetric results were compared with the previous treated 3D non-coplanar plans. RapidArc plans demonstrated better conformity to target, sharper dose fall-off in normal tissues and lower dose to normal lung and other OARs than the 3D conformai plans. RapidArc SBRT for FFF beam showed comparable target conformity, adequate tumor dose, and clinically acceptable DVHs of OARs to flattened beams and significantly reduced treatment delivery time.

  12. Biopsy validation of 18F-DOPA PET and biodistribution in gliomas for neurosurgical planning and radiotherapy target delineation: results of a prospective pilot study

    PubMed Central

    Pafundi, Deanna H.; Laack, Nadia N.; Youland, Ryan S.; Parney, Ian F.; Lowe, Val J.; Giannini, Caterina; Kemp, Brad J.; Grams, Michael P.; Morris, Jonathan M.; Hoover, Jason M.; Hu, Leland S.; Sarkaria, Jann N.; Brinkmann, Debra H.

    2013-01-01

    Background Delineation of glioma extent for surgical or radiotherapy planning is routinely based on MRI. There is increasing awareness that contrast enhancement on T1-weighted images (T1-CE) may not reflect the entire extent of disease. The amino acid tracer 18F-DOPA (3,4-dihydroxy-6-[18F] fluoro-l-phenylalanine) has a high tumor-to-background signal and high sensitivity for glioma imaging. This study compares 18F-DOPA PET against conventional MRI for neurosurgical biopsy targeting, resection planning, and radiotherapy target volume delineation. Methods Conventional MR and 18F-DOPA PET/CT images were acquired in 10 patients with suspected malignant brain tumors. One to 3 biopsy locations per patient were chosen in regions of concordant and discordant 18F-DOPA uptake and MR contrast enhancement. Histopathology was reviewed on 23 biopsies. 18F-DOPA PET was quantified using standardized uptake values (SUV) and tumor-to-normal hemispheric tissue (T/N) ratios. Results Pathologic review confirmed glioma in 22 of 23 biopsy specimens. Thirteen of 16 high-grade biopsy specimens were obtained from regions of elevated 18F-DOPA uptake, while T1-CE was present in only 6 of those 16 samples. Optimal 18F-DOPA PET thresholds corresponding to high-grade disease based on histopathology were calculated as T/N > 2.0. In every patient, 18F-DOPA uptake regions with T/N > 2.0 extended beyond T1-CE up to a maximum of 3.5 cm. SUV was found to correlate with grade and cellularity. Conclusions 18F-DOPA PET SUVmax may more accurately identify regions of higher-grade/higher-density disease in patients with astrocytomas and will have utility in guiding stereotactic biopsy selection. Using SUV-based thresholds to define high-grade portions of disease may be valuable in delineating radiotherapy boost volumes. PMID:23460322

  13. Progress of health plans toward meeting the million hearts clinical target for high blood pressure control - United States, 2010-2012.

    PubMed

    Patel, Milesh M; Datu, Bennett; Roman, Dan; Barton, Mary B; Ritchey, Matthew D; Wall, Hilary K; Loustalot, Fleetwood

    2014-02-14

    High blood pressure is a major cardiovascular disease risk factor and contributed to >362,895 deaths in the United States during 2010. Approximately 67 million persons in the United States have high blood pressure, and only half of those have their condition under control. An estimated 46,000 deaths could be avoided annually if 70% of patients with high blood pressure were treated according to published guidelines. To assess blood pressure control among persons with health insurance, CDC and the National Committee for Quality Assurance (NCQA) examined data in the 2010-2012 Healthcare Effectiveness Data and Information Set (HEDIS). In 2012, approximately 113 million adults aged 18-85 years were covered by health plans measured by HEDIS. The HEDIS controlling blood pressure (CBP) performance measure is the proportion of enrollees with a diagnosis of high blood pressure confirmed in their medical record whose blood pressure is controlled. Overall, only 64% of enrollees with diagnosed high blood pressure in HEDIS-reporting plans had documentation that their blood pressure was controlled. Although these findings signal that additional work is needed to meet the 70% target, modest improvements since 2010, coupled with focused efforts, might make it achievable.

  14. Poster — Thur Eve — 66: Robustness Assessment of a Novel IMRT Planning Method for Lung Radiotherapy

    SciTech Connect

    Ahanj, M.; Bissonnette, J.-P.; Heath, E.; McCann, C.

    2014-08-15

    Conventional radiotherapy treatment planning for lung cancer accounts for tumour motion by increasing the beam apertures. We recently developed an IMRT planning strategy which uses reduced beam apertures in combination with an edge enhancing boost of 110% of the prescription dose to the volume that corresponds to the portion of the CTV that moves outside of the reduced beam. Previous results showed that this approach ensures target coverage while reducing lung dose. In the current study, we evaluate the robustness of this boost volume approach to changes in respiratory motion, including amplitude and phase weight variations. ITV and boost volume plans were generated for 5 NSCLC patients with respiratory motion amplitudes ranging from 1 to 2 cm. A standard 5mm PTV margin was used for all plans. The ORBIT treatment planning tool was used to plan and accumulate dose over 10 respiratory phases defined by the 4DCT datasets. For the phase weight variation study, dose was accumulated for three scenarios: equally-weighted-phases, higher weight assigned to exhale phases and higher weight assigned to inhale phases. For the amplitude variation study, a numerical phantom was used to generate 4DCT datasets corresponding to 7 mm, 10 mm and 14 mm motion amplitudes. Preliminary results found that delivered plans for all phase weight scenarios were clinically acceptable. When normalized to mean lung dose, the boost volume plan delivered 5% more dose to the CTV which indicates the potential for dose escalation using this approach.

  15. Work plan : targeted investigation to assess current conditions associated with the carbon tetrachloride plume downgradient from the former CCC/USDA facility at Milford, Nebraska.

    SciTech Connect

    LaFreniere, L. M.; Environmental Science Division

    2008-07-09

    The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) formerly operated a grain storage facility at Milford, Nebraska. In May 2008, the CCC/USDA directed the Environmental Science Division of Argonne National Laboratory, as its technical consultant, to develop a work plan for a targeted investigation at the Milford site. The purpose of the targeted investigation is to assess the current extent and configuration of the carbon tetrachloride plume downgradient from the former CCC/USDA facility and proximal to the banks of the Big Blue River, which borders the area of concern to the east, southeast, and northeast. In 1995, carbon tetrachloride contamination was detected by the Nebraska Department of Health and Human Services in a private drinking water well and a livestock well 1.25 mi south of Milford (Figure 1.1). The Trojan drinking water well is located directly downgradient (approximately 300 ft east) of the former CCC/USDA facility. Low levels of carbon tetrachloride contamination were also found in the Troyer livestock well, approximately 1,200 ft north of the former CCC/USDA facility.

  16. SU-E-T-300: Spatial Variations of Multiple Off-Axial Targets for a Single Isocenter SRS Treatment Plan in ExacTrac 6D Robotic Couch System

    SciTech Connect

    Kim, S; Tseng, T

    2014-06-01

    Purpose: To evaluate the spatial variations of multiple off-axial targets for a single isocenter stereotactic radiosurgery (SRS) treatment plan in ExacTrac 6D robotic couch system (BrainLab AG). Methods: Five metallic ball bearing (BB) markers were placed sparsely in 3D off-axial locations (non-coplanar) inside a skull phantom as the representatives of multiple targets mimicking multiple brain metastases. The locations of the BB markers were carefully chosen to minimize overlapping of each other in a port imaging detector plane. The skull phantom was immobilized by a frameless mask and CT scanned with a BrainLab Head and Neck Localizer using a GE Optima MDCT scanner. The CT images were exported to iPlan software (BrainLab AG) and a multiple target PTV was drawn by combining all the contours of the BBs. The margin of the MLC opening was selected as 3 mm expansion outward. Two coplanar arc beams were placed to generate a single isocenter SRS plan to treat the PTV. The arc beams were delivered using Novalis Tx system with portal imaging acquisition mode per 10% temporal resolution. The locations of the BBs were visualized and analyzed with respect to the MLC aperture in the treatment plan similar to the Winston-Lutz test. Results: All the BBs were clearly identified inside the MLC openings. The positional errors for the BBs were overall less than 1 mm along the rotational path of the two arcs. Conclusion: This study verified that the spatial deviations of multiple off-axial targets for a single isocenter SRS treatment plan is within sub-millimeter range in ExacTrac 6D robotic couch system. Accompanied with the Winston-Lutz test, this test will quality-assure the spatial accuracies of the isocenter as well as the positions of multiple off-axial targets for the SRS treatment using a single isocenter multiple target treatment plan.

  17. Skin-Sparing Radiation Using Intensity-Modulated Radiotherapy After Conservative Surgery in Early-Stage Breast Cancer: A Planning Study

    SciTech Connect

    Saibishkumar, Elantholi P.; MacKenzie, Marc A.; Severin, Diane; Mihai, Alina; Hanson, John M.Sc.; Daly, Helene; Fallone, Gino; Parliament, Matthew B.; Abdulkarim, Bassam S.

    2008-02-01

    Purpose: To evaluate the feasibility of skin-sparing by configuring it as an organ-at-risk (OAR) while delivering whole-breast intensity-modulated radiotherapy (IMRT) in early breast cancer. Methods and Materials: Archival computed tomography scan images of 14 left-sided early-breast tumor patients who had undergone lumpectomy were selected for this study. Skin was contoured as a 4- to 5-mm strip extending from the patient outline to anterior margin of the breast planning target volume (PTV). Two IMRT plans were generated by the helical tomotherapy approach to deliver 50 Gy in 25 fractions to the breast alone: one with skin dose constraints (skin-sparing plan) and the other without (non-skin-sparing plan). Comparison of the plans was done using a two-sided paired Student t test. Results: The mean skin dose and volume of skin receiving 50 Gy were significantly less with the skin-sparing plan compared with non-skin-sparing plan (42.3 Gy vs. 47.7 Gy and 12.2% vs. 57.8% respectively; p < 0.001). The reduction in skin dose was confirmed by TLD measurements in anthropomorphic phantom using the same plans. Dose-volume analyses for other OARs were similar in both plans. Conclusions: By configuring the skin as an OAR, it is possible to achieve skin dose reduction while delivering whole-breast IMRT without compromising dose profiles to PTV and OARs.

  18. SU-E-T-147: Beam Specific Planning Target Volumes Incorporating 4DCT for Pencil Beam Scanning Proton Therapy of Thoracic Tumors

    SciTech Connect

    Lin, L; Kang, M; Huang, S; McDonough, J; Solberg, T; Simone, C; Mayer, R; Thomas, A

    2015-06-15

    Purpose: The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties and patient setup variations. Methods: Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4DCT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4DCT phases, using ±3% uncertainty in stopping power, and ±3 mm uncertainty in patient setup in each direction were used to create 8*12*10=960 PBS plans for the evaluation of ten patients. Plans were normalized to provide identical coverage between DS and PBS. Results: The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus and heart dose were decreased from 37.1 Gy, 71.7 Gy and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04 and 72.1 Gy with PBS. All differences are statistically significant, with p values <0.05, with the exception of the heart V45 (p= 0.146). Conclusion: PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential This work was supported by the US Army Medical Research and Materiel Command under Contract Agreement No. DAMD17-W81XWH-07-2-0121 and W81XWH-09-2-0174.

  19. Coregistration of Prechemotherapy PET-CT for Planning Pediatric Hodgkin's Disease Radiotherapy Significantly Diminishes Interobserver Variability of Clinical Target Volume Definition

    SciTech Connect

    Metwally, Hussein; Courbon, Frederic; David, Isabelle; Filleron, Thomas; Blouet, Aurelien; Rives, Michel; Izar, Francoise; Zerdoud, Slimane; Plat, Genevieve; Vial, Julie; Robert, Alain; Laprie, Anne

    2011-07-01

    Purpose: To assess the interobserver variability in clinical target volume (CTV) definitions when using registered {sup 18}F-labeled deoxyglucose positron emission tomography (FDG-PET-CT) versus side-by-side image sets in pediatric Hodgkin's disease (HD). Methods and Materials: Prechemotherapy FDG-PET-CT scans performed in the treatment position were acquired from 20 children (median age, 14 years old) with HD (stages 2A to 4B) and registered with postchemotherapy planning CT scans. The patients had a median age of 14 years and stages of disease ranging between 2A and 4B. Image sets were coregistered using a semiautomatic coregistration system. The biological target volume was defined on all the coregistered images as a guide to defining the initial site of involvement and to avoid false-positive or negative results. Five radiation oncologists independently defined the CTV for all 20 patients: once using separate FDG-PET-CT images as a guide (not registered) to define CTVa and once using the registered FDG-PET-CT data to define CTVb. The total volumes were compared, as well as their coefficients of variation (COV). To assess the interobserver variability, the percentages of intersection between contours drawn by all observers for each patient were calculated for CTVa and for CTVb. Results: The registration of a prechemotherapy FDG-PET-CT scan caused a change in the CTV for all patients. Comparing CTVa with CTVb showed that the mean CTVb increased in 14 patients (range, 0.61%-101.96%) and decreased in 6 patients (range, 2.97%-37.26%). The COV for CTVb significantly decreased for each patient; the mean COVs for CTVa and CTVb were 45% (21%-65%) and 32% (13%-57%), respectively (p = 0.0004). The percentage of intersection among all CTVbs for the five observers increased significantly by 89.77% (1.99%-256.41%) compared to that of CTVa (p = 0.0001). Conclusions: High observer variability can occur during CT-based definition of CTVs for children diagnosed with HD

  20. [The practical theory of occupational health planning: Part One--The theoretical background of the target population setting and needs assessment procedures (OPST research report 2)].

    PubMed

    Jahng, D J; Hashimoto, H; Furuki, K

    1996-09-01

    The OPSS is an 8 stage program which was developed as a practical tool for occupational health services planning. This paper examines the theoretical aspects of the first two stages. The OPSS is a planning tool with a theoretical grounding in OHP (The practical theory of Occupational Health Planning). The target population setting has two functions. The first is to establish the physician's first-hypothesis to design a program. The other is deciding the group which has an occupational health problem in a company. The Needs Assessment helps to clarify the physician's hypothesis, which may be weak due to the limited knowledge of various demands of the employees and senior management. On the other hand, the risks and needs vary according to what kind of expert looks at a situation. To date, occupational physicians have been limited to their medical background in determining only risks and needs. However, understanding the various stakeholders in a particular environment means that any project will be more relevant to all concerned. Another limitation of the occupational physicians hypothesis can be the lack of objective data to support it. This makes it difficult to persuade senior management to sign on to a program. The Needs Assessment procedure with OHQ steps is useful in a number of ways. The Observation step allows for finding risks and needs from various situations in the company from the occupational physician's viewpoint (prehypothesis setting). Hearing is for understanding the subject's demands and finding common themes in the company (final hypothesis setting). Finally, the questionnaire step is for providing objectivity of these common themes and quantitative data for the next Priority Setting procedure. The BITOP (Budget, Information, Time, Order, key Person) has been proposed as a way to diagnose the structural and functional aspects of an organization's procedures. Budget tracks the financial flow through the organization, while Information identifies

  1. Impact of treatment planning target volumen (PTV) size on radiation induced diarrhoea following selenium supplementation in gynecologic radiation oncology - a subgroup analysis of a multicenter, phase III trial

    PubMed Central

    2013-01-01

    Background In a previous analysis (Int J Radiat Oncol Biol Phys 70:828-835,2010), we assessed whether an adjuvant supplementation with selenium (Se) improves Se status and reduces the radiation-induced side-effects of patients treated by adjuvant radiotherapy (RT) for cervical and uterine cancer. Now, a potential relation between the planning target volume (PTV) of the RT and the Se effect concerning radiation induced diarrhoea was evaluated in detail. Methods Whole blood Se concentrations had been measured in patients with cervical (n=11) and uterine cancer (n=70) after surgical treatment, during, and at the end of RT. Patients with initial Se concentrations of less than 84 μg/l were categorized as Se-deficient and randomized before RT to receive Se (as sodium selenite) per os on the days of RT, or to receive no supplement during RT. Diarrhoea was graded according to the Common Toxicity Criteria system (CTC, Version 2a). The evaluation of the PTV of the RT was ascertained with the help of a specialised computer-assisted treatment planning software used for radiation planning procedure. Results A total of 81 patients had been randomized for the initial supplementation study, 39 of which received Se [selenium group, SeG] and 42 serving as controls [control group, CG]. Mean Se levels did not differ between SeG and CG upon study initiation, but were significantly higher in the SeG compared to the CG at the end of RT. The actuarial incidence of at least CTC 2 radiation induced diarrhoea in the SeG was 20.5% compared to 44.5% in the CG (p=0.04). The median PTV in both groups was 1302 ml (916–4608). With a PTV of <= 1302 ml (n=41) the actuarial incidence of at least CTC 2 diarrhoea in the SeG was 22.3% (4 of 18 patients) compared to 34.8% (8 of 23 patients) in the CG (p=0.50). In patients with a PTV of > 1302 ml (n=40) the actuarial incidence of at least CTC 2 diarrhoea in the SeG was 19.1% (4 of 21 patients) versus 52.6% (10 of 19 patients) in the CG (p=0

  2. SU-E-J-76: Incorporation of Ultrasound Elastography in Target Volume Delineation for Partial Breast Radiotherapy Planning: A Comparative Study

    SciTech Connect

    Juneja, P; Harris, E; Bamber, J

    2014-06-01

    Purpose: There is substantial observer variability in the delineation of target volumes for post-surgical partial breast radiotherapy because the tumour bed has poor x-ray contrast. This variability may result in substantial variations in planned dose distribution. Ultrasound elastography (USE) has an ability to detect mechanical discontinuities and therefore, the potential to image the scar and distortion in breast tissue architecture. The goal of this study was to compare USE techniques: strain elastography (SE), shear wave elastography (SWE) and acoustic radiation force impulse (ARFI) imaging using phantoms that simulate features of the tumour bed, for the purpose of incorporating USE in breast radiotherapy planning. Methods: Three gelatine-based phantoms (10% w/v) containing: a stiff inclusion (gelatine 16% w/v) with adhered boundaries, a stiff inclusion (gelatine 16% w/v) with mobile boundaries and fluid cavity inclusion (to mimic seroma), were constructed and used to investigate the USE techniques. The accuracy of the elastography techniques was quantified by comparing the imaged inclusion with the modelled ground-truth using the Dice similarity coefficient (DSC). For two regions of interest (ROI), the DSC measures their spatial overlap. Ground-truth ROIs were modelled using geometrical measurements from B-mode images. Results: The phantoms simulating stiff scar tissue with adhered and mobile boundaries and seroma were successfully developed and imaged using SE and SWE. The edges of the stiff inclusions were more clearly visible in SE than in SWE. Subsequently, for all these phantoms the measured DSCs were found to be higher for SE (DSCs: 0.91–0.97) than SWE (DSCs: 0.68–0.79) with an average relative difference of 23%. In the case of seroma phantom, DSC values for SE and SWE were similar. Conclusion: This study presents a first attempt to identify the most suitable elastography technique for use in breast radiotherapy planning. Further analysis will

  3. How China achieved its 11th Five-Year Plan emissions reduction target: A structural decomposition analysis of industrial SO2 and chemical oxygen demand.

    PubMed

    Liu, Qiaoling; Wang, Qi

    2017-01-01

    To curb the increasing pollutant emissions that have accompanied rapid economic growth, China implemented a mandatory emissions control system since the 11th Five-Year Plan (FYP) period, and the emission reduction targets have been met and even exceeded. This article explores how China achieved its emissions reduction targets by systematically identifying the main emission reduction pathways, including both the environmental and economic factors, and evaluates the contribution of each factor using structure decomposition analysis. A study of the two key controlled pollutants, industrial sulfur dioxide (SO2) and chemical oxygen demand (COD), during the 11th FYP period showed that (i) changes in the end-of-pipe treatment and pollutant generation coefficient were the dominant contributors to emissions reduction. The power and metal smelting sectors played important roles in SO2 abatement, while the paper products and food products sectors were important in COD reduction; (ii) changes to the input coefficient increased overall emissions although there was a decrease in SO2 emissions in 2007-2010 mainly due to input structure improvements in the construction sector; (iii) the trade effect largely offset the domestic emission reduction effects, although the trade effect declined during the study period; (iv) domestic demand was the main factor increasing domestic emissions; domestic investment changes (especially in the construction sector) were the major contributor to increases in SO2 emissions, and final consumption changes (especially consumption in the food production sector) were the main contributor to the increase in COD emissions. The results yield important implications for China's pollution emissions control policies.

  4. Two-phase flow model for energetic proton beam induced pressure waves in mercury target systems in the planned European Spallation Source

    NASA Astrophysics Data System (ADS)

    Barna, I. F.; Imre, A. R.; Rosta, L.; Mezei, F.

    2008-12-01

    Two-phase flow calculations are presented to investigate the thermo-hydraulical effects of the interaction between 2 ms long 1.3 GeV proton pulses with a closed mercury loop which can be considered as a model system of the target of the planned European Spallation Source (ESS) facility. The two-fluid model consists of six first-order partial differential equations that present one dimensional mass, momentum and energy balances for mercury vapor and liquid phases are capable to describe quick transients like cavitation effects or shock waves. The absorption of the proton beam is represented as instantaneous heat source in the energy balance equations. Densities and internal energies of the mercury liquid-vapor system is calculated from the van der Waals equation, but general method how to obtain such properties using arbitrary equation of state is also presented. A second order accurate high-resolution shock-capturing numerical scheme is applied with different kind of limiters in the numerical calculations. Our analysis show that even 75 degree temperature heat shocks cannot cause considerable cavitation effects in mercury.

  5. SU-E-T-331: Dosimetric Impact of Multileaf Collimator Leaf Width On Stereotactic Radiosurgery (SRS) RapidArc Treatment Plans for Single and Multiple Brain Metastases

    SciTech Connect

    Hossain, S; Keeling, V; Ahmad, S; Algan, O

    2015-06-15

    Purpose: To determine the effects of multileaf collimator (MLC) leaf width on normal-brain-tissue doses and dose conformity of SRS RapidArc treatment plans for brain tumors. Methods: Ten patients with 24 intracranial tumors (seven with 1–2 and three with 4–6 lesions) were planned using RapidArc for both Varian Millennium 120 MLC (5 mm leaf width) and high definition (HD) MLC (2.5 mm leaf width). Between 2 and 8 arcs were used with two full coplanar arcs and the rest non-coplanar half arcs. 6 MV beams were used and plans were optimized with a high priority to the Normal Tissue Objective (to achieve dose conformity and sharp dose fall-off) and normal brain tissue. Calculation was done using AAA on a 1 mm grid size. The prescription dose ranged from 14–22 Gy. Plans were normalized such that 99% of the target received the prescription dose. Identical beam geometries, optimizations, calculations, and normalizations were used for both plans. Paddick Conformity Index (PCI), V4, V8 and V12 Gy for normal brain tissue and Integral Dose were used for analysis. Results: In all cases, HD MLC plans performed better in sparing normal brain tissue, achieving a higher PCI with a lower Integral Dose. The average PCI for all 24 targets was 0.75±0.23 and 0.70±0.23 (p ≤0.0015) for HD MLC and Millennium MLC plans, respectively. The average ratio of normal brain doses for Millennium MLC to HD MLC plans was 1.30±0.16, 1.27±0.15, and 1.31±0.18 for the V4, V8, and V12, respectively. The differences in normal brain dose for all criteria were statistically significant with p-value < 0.02. On average Millennium MLC plans had a 16% higher integral dose than HD MLC plans. Conclusion: Significantly better dose conformity with reduced volume of normal brain tissue and integral dose was achieved with HD MLC plans compared to Millennium MLC plans.

  6. Improving plan quality and consistency by standardization of dose constraints in prostate cancer patients treated with CyberKnife.

    PubMed

    Descovich, Martina; Carrara, Mauro; Morlino, Sara; Pinnaduwage, Dilini S; Saltiel, Daniel; Pouliot, Jean; Nash, Marc B; Pignoli, Emanuele; Valdagni, Riccardo; Roach, Mack; Gottschalk, Alexander R

    2013-09-06

    Treatment plans for prostate cancer patients undergoing stereotactic body radiation therapy (SBRT) are often challenging due to the proximity of organs at risk. Today, there are no objective criteria to determine whether an optimal treatment plan has been achieved, and physicians rely on their personal experience to evaluate the plan's quality. In this study, we propose a method for determining rectal and bladder dose constraints achievable for a given patient's anatomy. We expect that this method will improve the overall plan quality and consistency, and facilitate comparison of clinical outcomes across different institutions. The 3D proximity of the organs at risk to the target is quantified by means of the expansion-intersection volume (EIV), which is defined as the intersection volume between the target and the organ at risk expanded by 5 mm. We determine a relationship between EIV and relevant dosimetric parameters, such as the volume of bladder and rectum receiving 75% of the prescription dose (V75%). This relationship can be used to establish institution-specific criteria to guide the treatment planning and evaluation process. A database of 25 prostate patients treated with CyberKnife SBRT is used to validate this approach. There is a linear correlation between EIV and V75% of bladder and rectum, confirming that the dose delivered to rectum and bladder increases with increasing extension and proximity of these organs to the target. This information can be used during the planning stage to facilitate the plan optimization process, and to standardize plan quality and consistency. We have developed a method for determining customized dose constraints for prostate patients treated with robotic SBRT. Although the results are technology specific and based on the experience of a single institution, we expect that the application of this method by other institutions will result in improved standardization of clinical practice.

  7. Computing proton dose to irregularly moving targets

    NASA Astrophysics Data System (ADS)

    Phillips, Justin; Gueorguiev, Gueorgui; Shackleford, James A.; Grassberger, Clemens; Dowdell, Stephen; Paganetti, Harald; Sharp, Gregory C.

    2014-08-01

    Purpose: While four-dimensional computed tomography (4DCT) and deformable registration can be used to assess the dose delivered to regularly moving targets, there are few methods available for irregularly moving targets. 4DCT captures an idealized waveform, but human respiration during treatment is characterized by gradual baseline shifts and other deviations from a periodic signal. This paper describes a method for computing the dose delivered to irregularly moving targets based on 1D or 3D waveforms captured at the time of delivery. Methods: The procedure uses CT or 4DCT images for dose calculation, and 1D or 3D respiratory waveforms of the target position at time of delivery. Dose volumes are converted from their Cartesian geometry into a beam-specific radiological depth space, parameterized in 2D by the beam aperture, and longitudinally by the radiological depth. In this new frame of reference, the proton doses are translated according to the motion found in the 1D or 3D trajectory. These translated dose volumes are weighted and summed, then transformed back into Cartesian space, yielding an estimate of the dose that includes the effect of the measured breathing motion. The method was validated using a synthetic lung phantom and a single representative patient CT. Simulated 4DCT was generated for the phantom with 2 cm peak-to-peak motion. Results: A passively-scattered proton treatment plan was generated using 6 mm and 5 mm smearing for the phantom and patient plans, respectively. The method was tested without motion, and with two simulated breathing signals: a 2 cm amplitude sinusoid, and a 2 cm amplitude sinusoid with 3 cm linear drift in the phantom. The tumor positions were equally weighted for the patient calculation. Motion-corrected dose was computed based on the mid-ventilation CT image in the phantom and the peak exhale position in the patient. Gamma evaluation was 97.8% without motion, 95.7% for 2 cm sinusoidal motion, 95.7% with 3 cm drift in the

  8. Computing Proton Dose to Irregularly Moving Targets

    PubMed Central

    Phillips, Justin; Gueorguiev, Gueorgui; Shackleford, James A.; Grassberger, Clemens; Dowdell, Stephen; Paganetti, Harald; Sharp, Gregory C.

    2014-01-01

    Purpose While four-dimensional computed tomography (4DCT) and deformable registration can be used to assess the dose delivered to regularly moving targets, there are few methods available for irregularly moving targets. 4DCT captures an idealized waveform, but human respiration during treatment is characterized by gradual baseline shifts and other deviations from a periodic signal. This paper describes a method for computing the dose delivered to irregularly moving targets based on 1D or 3D waveforms captured at the time of delivery. Methods The procedure uses CT or 4DCT images for dose calculation, and 1D or 3D respiratory waveforms of the target position at time of delivery. Dose volumes are converted from their Cartesian geometry into a beam-specific radiological depth space, parameterized in 2D by the beam aperture, and longitudinally by the radiological depth. In this new frame of reference, the proton doses are translated according to the motion found in the 1D or 3D trajectory. These translated dose volumes are weighted and summed, then transformed back into Cartesian space, yielding an estimate of the dose that includes the effect of the measured breathing motion. The method was validated using a synthetic lung phantom and a single representative patient CT. Simulated 4DCT was generated for the phantom with 2 cm peak-to-peak motion. Results A passively-scattered proton treatment plan was generated using 6 mm and 5 mm smearing for the phantom and patient plans, respectively. The method was tested without motion, and with two simulated breathing signals: a 2 cm amplitude sinusoid, and a 2 cm amplitude sinusoid with 3 cm linear drift in the phantom. The tumor positions were equally weighted for the patient calculation. Motion-corrected dose was computed based on the mid-ventilation CT image in the phantom and the peak exhale position in the patient. Gamma evaluation was 97.8% without motion, 95.7% for 2 cm sinusoidal motion, and 95.7% with 3 cm drift in the

  9. Influence of increased target dose inhomogeneity on margins for breathing motion compensation in conformal stereotactic body radiotherapy

    PubMed Central

    Richter, Anne; Baier, Kurt; Meyer, Juergen; Wilbert, Juergen; Krieger, Thomas; Flentje, Michael; Guckenberger, Matthias

    2008-01-01

    Background Breathing motion should be considered for stereotactic body radiotherapy (SBRT) of lung tumors. Four-dimensional computer tomography (4D-CT) offers detailed information of tumor motion. The aim of this work is to evaluate the influence of inhomogeneous dose distributions in the presence of breathing induced target motion and to calculate margins for motion compensation. Methods Based on 4D-CT examinations, the probability density function of pulmonary tumors was generated for ten patients. The time-accumulated dose to the tumor was calculated using one-dimensional (1D) convolution simulations of a 'static' dose distribution and target probability density function (PDF). In analogy to stereotactic body radiotherapy (SBRT), different degrees of dose inhomogeneity were allowed in the target volume: minimum doses of 100% were prescribed to the edge of the target and maximum doses varied between 102% (P102) and 150% (P150). The dose loss due to breathing motion was quantified and margins were added until this loss was completely compensated. Results With the time-weighted mean tumor position as the isocentre, a close correlation with a quadratic relationship between the standard deviation of the PDF and the margin size was observed. Increased dose inhomogeneity in the target volume required smaller margins for motion compensation: margins of 2.5 mm, 2.4 mm and 1.3 mm were sufficient for compensation of 11.5 mm motion range and standard deviation of 3.9 mm in P105, P125 and P150, respectively. This effect of smaller margins for increased dose inhomogeneity was observed for all patients. Optimal sparing of the organ-at-risk surrounding the target was achieved for dose prescriptions P105 to P118. The internal target volume concept over-compensated breathing motion with higher than planned doses to the target and increased doses to the surrounding normal tissue. Conclusion Treatment planning with inhomogeneous dose distributions in the target volume required

  10. Magnetic Resonance Imaging-Based Target Volume Delineation in Radiation Therapy Treatment Planning for Brain Tumors Using Localized Region-Based Active Contour

    SciTech Connect

    Aslian, Hossein; Sadeghi, Mahdi; Mahdavi, Seied Rabie; Babapour Mofrad, Farshid; Astarakee, Mahdi; Khaledi, Navid; Fadavi, Pedram

    2013-09-01

    Purpose: To evaluate the clinical application of a robust semiautomatic image segmentation method to determine the brain target volumes in radiation therapy treatment planning. Methods and Materials: A local robust region-based algorithm was used on MRI brain images to study the clinical target volume (CTV) of several patients. First, 3 oncologists delineated CTVs of 10 patients manually, and the process time for each patient was calculated. The averages of the oncologists’ contours were evaluated and considered as reference contours. Then, to determine the CTV through the semiautomatic method, a fourth oncologist who was blind to all manual contours selected 4-8 points around the edema and defined the initial contour. The time to obtain the final contour was calculated again for each patient. Manual and semiautomatic segmentation were compared using 3 different metric criteria: Dice coefficient, Hausdorff distance, and mean absolute distance. A comparison also was performed between volumes obtained from semiautomatic and manual methods. Results: Manual delineation processing time of tumors for each patient was dependent on its size and complexity and had a mean (±SD) of 12.33 ± 2.47 minutes, whereas it was 3.254 ± 1.7507 minutes for the semiautomatic method. Means of Dice coefficient, Hausdorff distance, and mean absolute distance between manual contours were 0.84 ± 0.02, 2.05 ± 0.66 cm, and 0.78 ± 0.15 cm, and they were 0.82 ± 0.03, 1.91 ± 0.65 cm, and 0.7 ± 0.22 cm between manual and semiautomatic contours, respectively. Moreover, the mean volume ratio (=semiautomatic/manual) calculated for all samples was 0.87. Conclusions: Given the deformability of this method, the results showed reasonable accuracy and similarity to the results of manual contouring by the oncologists. This study shows that the localized region-based algorithms can have great ability in determining the CTV and can be appropriate alternatives for manual approaches in brain cancer.

  11. Image Registration for Targeted MRI-guided Transperineal Prostate Biopsy

    PubMed Central

    Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Tokuda, Junichi; Hata, Nobuhiko; Wells, William M.; Kikinis, Ron; Tempany, Clare M.

    2012-01-01

    Purpose To develop and evaluate image registration methodology for automated re-identification of tumor-suspicious foci from pre-procedural MR exams during MR-guided transperineal prostate core biopsy. Materials and Methods A hierarchical approach for automated registration between planning and intra-procedural T2-weighted prostate MRI was developed and evaluated on the images acquired during 10 consecutive MR-guided biopsies. Registration accuracy was quantified at image-based landmarks and by evaluating spatial overlap for the manually segmented prostate and sub-structures. Registration reliability was evaluated by simulating initial mis-registration and analyzing the convergence behavior. Registration precision was characterized at the planned biopsy targets. Results The total computation time was compatible with a clinical setting, being at most 2 minutes. Deformable registration led to a significant improvement in spatial overlap of the prostate and peripheral zone contours compared to both rigid and affine registration. Average in-slice landmark registration error was 1.3±0.5 mm. Experiments simulating initial mis-registration resulted in an estimated average capture range of 6 mm and an average in-slice registration precision of ±0.3 mm. Conclusion Our registration approach requires minimum user interaction and is compatible with the time constraints of our interventional clinical workflow. The initial evaluation shows acceptable accuracy, reliability and consistency of the method. PMID:22645031

  12. Dose-Volume Differences for Computed Tomography and Magnetic Resonance Imaging Segmentation and Planning for Proton Prostate Cancer Therapy

    SciTech Connect

    Yeung, Anamaria R.; Vargas, Carlos E. Falchook, Aaron; Louis, Debbie C.; Olivier, Kenneth; Keole, Sameer; Yeung, Daniel; Mendenhall, Nancy P.; Li Zuofeng

    2008-12-01

    Purpose: To determine the influence of magnetic-resonance-imaging (MRI)-vs. computed-tomography (CT)-based prostate and normal structure delineation on the dose to the target and organs at risk during proton therapy. Methods and Materials: Fourteen patients were simulated in the supine position using both CT and T2 MRI. The prostate, rectum, and bladder were delineated on both imaging modalities. The planning target volume (PTV) was generated from the delineated prostates with a 5-mm axial and 8-mm superior and inferior margin. Two plans were generated and analyzed for each patient: an MRI plan based on the MRI-delineated PTV, and a CT plan based on the CT-delineated PTV. Doses of 78 Gy equivalents (GE) were prescribed to the PTV. Results: Doses to normal structures were lower when MRI was used to delineate the rectum and bladder compared with CT: bladder V50 was 15.3% lower (p = 0.04), and rectum V50 was 23.9% lower (p = 0.003). Poor agreement on the definition of the prostate apex was seen between CT and MRI (p = 0.007). The CT-defined prostate apex was within 2 mm of the apex on MRI only 35.7% of the time. Coverage of the MRI-delineated PTV was significantly decreased with the CT-based plan: the minimum dose to the PTV was reduced by 43% (p < 0.001), and the PTV V99% was reduced by 11% (p < 0.001). Conclusions: Using MRI to delineate the prostate results in more accurate target definition and a smaller target volume compared with CT, allowing for improved target coverage and decreased doses to critical normal structures.

  13. Poster — Thur Eve — 32: Stereotactic Body Radiation Therapy for Peripheral Lung Lesion: Treatment Planning and Quality Assurance

    SciTech Connect

    Wan, Shuying; Oliver, Michael; Wang, Xiaofang

    2014-08-15

    Stereotactic body radiation therapy (SBRT), due to its high precision for target localizing, has become widely used to treat tumours at various locations, including the lungs. Lung SBRT program was started at our institution a year ago. Eighteen patients with peripheral lesions up to 3 cm diameter have been treated with 48 Gy in 4 fractions. Based on four-dimensional computed tomography (4DCT) simulation, internal target volume (ITV) was delineated to encompass the respiratory motion of the lesion. A margin of 5 mm was then added to create the planning target volume (PTV) for setup uncertainties. There was no expansion from gross tumour volume (GTV) to clinical target volume (CTV). Pinnacle 9.6 was used as the primary treatment planning system. Volumetric modulated arc therapy (VMAT) technique, with one or two coplanar arcs, generally worked well. For quality assurance (QA), each plan was exported to Eclipse 10 and dose calculation was repeated. Dose volume histograms (DVHs) of the targets and organs at risk (OARs) were then compared between the two treatment planning systems. Winston-Lutz tests were carried out as routine machine QA. Patient-specific QA included ArcCheck measurement with an insert, where an ionization chamber was placed at the centre to measure dose at the isocenter. For the first several patients, and subsequently for the plans with extremely strong modulation, Gafchromic film dosimetry was also employed. For each patient, a mock setup was scheduled prior to treatments. Daily pre- and post-CBCT were acquired for setup and assessment of intra-fractional motion, respectively.

  14. Whole Brain Irradiation With Hippocampal Sparing and Dose Escalation on Multiple Brain Metastases: A Planning Study on Treatment Concepts

    SciTech Connect

    Prokic, Vesna; Wiedenmann, Nicole; Fels, Franziska; Schmucker, Marianne; Nieder, Carsten; Grosu, Anca-Ligia

    2013-01-01

    Purpose: To develop a new treatment planning strategy in patients with multiple brain metastases. The goal was to perform whole brain irradiation (WBI) with hippocampal sparing and dose escalation on multiple brain metastases. Two treatment concepts were investigated: simultaneously integrated boost (SIB) and WBI followed by stereotactic fractionated radiation therapy sequential concept (SC). Methods and Materials: Treatment plans for both concepts were calculated for 10 patients with 2-8 brain metastases using volumetric modulated arc therapy. In the SIB concept, the prescribed dose was 30 Gy in 12 fractions to the whole brain and 51 Gy in 12 fractions to individual brain metastases. In the SC concept, the prescription was 30 Gy in 12 fractions to the whole brain followed by 18 Gy in 2 fractions to brain metastases. All plans were optimized for dose coverage of whole brain and lesions, simultaneously minimizing dose to the hippocampus. The treatment plans were evaluated on target coverage, homogeneity, and minimal dose to the hippocampus and organs at risk. Results: The SIB concept enabled more successful sparing of the hippocampus; the mean dose to the hippocampus was 7.55 {+-} 0.62 Gy and 6.29 {+-} 0.62 Gy, respectively, when 5-mm and 10-mm avoidance regions around the hippocampus were used, normalized to 2-Gy fractions. In the SC concept, the mean dose to hippocampus was 9.8 {+-} 1.75 Gy. The mean dose to the whole brain (excluding metastases) was 33.2 {+-} 0.7 Gy and 32.7 {+-} 0.96 Gy, respectively, in the SIB concept, for 5-mm and 10-mm hippocampus avoidance regions, and 37.23 {+-} 1.42 Gy in SC. Conclusions: Both concepts, SIB and SC, were able to achieve adequate whole brain coverage and radiosurgery-equivalent dose distributions to individual brain metastases. The SIB technique achieved better sparing of the hippocampus, especially when a10-mm hippocampal avoidance region was used.

  15. The impact of breathing motion versus heterogeneity effects in lung cancer treatment planning

    SciTech Connect

    Rosu, Mihaela; Chetty, Indrin J.; Tatro, Daniel S.; Haken, Randall K. ten

    2007-04-15

    The purpose of this study is to investigate the effects of tissue heterogeneity and breathing-induced motion/deformation on conformal treatment planning for pulmonary tumors and to compare the magnitude and the clinical importance of changes induced by these effects. Treatment planning scans were acquired at normal exhale/inhale breathing states for fifteen patients. The internal target volume (ITV) was defined as the union of exhale and inhale gross tumor volumes uniformly expanded by 5 mm. Anterior/posterior opposed beams (AP/PA) and three-dimensional (3D)-conformal plans were designed using the unit-density exhale (''static'') dataset. These plans were further used to calculate (a) density-corrected (''heterogeneous'') static dose and (b) heterogeneous cumulative dose, including breathing deformations. The DPM Monte Carlo code was used for dose computations. For larger than coin-sized tumors, relative to unit-density plans, tumor and lung doses increased in the heterogeneity-corrected plans. In comparing cumulative and static plans, larger normal tissue complication probability changes were observed for tumors with larger motion amplitudes and uncompensated breathing-induced hot/cold spots in lung. Accounting for tissue heterogeneity resulted in average increases of 9% and 7% in mean lung dose (MLD) for the 6 MV and 15 MV photon beams, respectively. Breathing-induced effects resulted in approximately 1% and 2% average decreases in MLD from the static value, for the 6 and 15 MV photon beams, respectively. The magnitude of these effects was not found to correlate with the treatment plan technique, i.e., AP/PA versus 3D-CRT. Given a properly designed ITV, tissue heterogeneity effects are likely to have a larger clinical significance on tumor and normal lung treatment evaluation metrics than four-dimensional respiratory-induced changes.

  16. Production Target Design Report

    SciTech Connect

    Woloshun, Keith Albert; Dale, Gregory E.; Olivas, Eric Richard

    2015-07-28

    The Northstar 99Mo production target, a cylindrical length of 100Mo rod, has evolved considerably since its first conception.  The cylinder was very early sliced into disks to increase the heat transfer area, first to 1 mm thick disks then to the current 0.5 mm thick.  The coolant was changed early in the target development from water to helium to eliminate corrosion and dissolution.  The diameter has increased from initially 6 mm to 12 mm, the current diameter of the test target now at ANL, to nominally 28 mm (26-30.6 mm, depending upon optimal beam spot size and shape).  The length has also changed to improve the production to cost ratio, so now the target is nominally 41 mm long (excluding coolant gaps between disks), and irradiated on both ends.  This report summarizes the current status of the plant target design.

  17. SU-E-T-364: Estimating the Minimum Number of Patients Required to Estimate the Required Planning Target Volume Margins for Prostate Glands

    SciTech Connect

    Bakhtiari, M; Schmitt, J; Sarfaraz, M; Osik, C

    2015-06-15

    Purpose: To establish a minimum number of patients required to obtain statistically accurate Planning Target Volume (PTV) margins for prostate Intensity Modulated Radiation Therapy (IMRT). Methods: A total of 320 prostate patients, consisting of a total number of 9311 daily setups, were analyzed. These patients had gone under IMRT treatments. Daily localization was done using the skin marks and the proper shifts were determined by the CBCT to match the prostate gland. The Van Herk formalism is used to obtain the margins using the systematic and random setup variations. The total patient population was divided into different grouping sizes varying from 1 group of 320 patients to 64 groups of 5 patients. Each grouping was used to determine the average PTV margin and its associated standard deviation. Results: Analyzing all 320 patients lead to an average Superior-Inferior margin of 1.15 cm. The grouping with 10 patients per group (32 groups) resulted to an average PTV margin between 0.6–1.7 cm with the mean value of 1.09 cm and a standard deviation (STD) of 0.30 cm. As the number of patients in groups increases the mean value of average margin between groups tends to converge to the true average PTV of 1.15 cm and STD decreases. For groups of 20, 64, and 160 patients a Superior-Inferior margin of 1.12, 1.14, and 1.16 cm with STD of 0.22, 0.11, and 0.01 cm were found, respectively. Similar tendency was observed for Left-Right and Anterior-Posterior margins. Conclusion: The estimation of the required margin for PTV strongly depends on the number of patients studied. According to this study at least ∼60 patients are needed to calculate a statistically acceptable PTV margin for a criterion of STD < 0.1 cm. Numbers greater than ∼60 patients do little to increase the accuracy of the PTV margin estimation.

  18. SU-E-T-780: Use Robustness Optimization (RO) Method to Improve the Planning Efficiency for Pencil Beam Scanning Cranial Spinal Irradiation

    SciTech Connect

    Ding, X; Zhang, J; Rosen, L; Wu, H; Traneus, E; Lin, H; Zhai, H

    2015-06-15

    Purpose: We evaluate the feasibility of using robustness optimization (RO) function to improve the planning efficiency of pencil beam scanning (PBS) craniospinal irradiation (CSI) with gradient matching technique. Methods: A CSI patient was planned with 2 lateral brain fields and 4 posterior fields to cover the entire spine to maximal field of 24 cm × 20 cm on a compact PBS gantry, ProteusONE. CSI plans were generated using traditional volumetric gradient dose optimization (VGDO) and robustness optimization (RO) method respectively. In traditional VGDO, besides the sectioned spine target volumes, gradient volume (GV) were generated as 4 equally spaced structures e.g. 80%, 60%, 40%, and 20% of prescription dose. In RO method, only sectioned spine target volumes with an overlap of 4cm were created. In the robustness optimization settings, 5mm uncertainty in superior and inferior direction was defined for auto gradient optimization. Dosimetric metrics of conformity number (CN), homogeneity index (HI), and maximal cord doses were compared in Raystation version 4.6.100.6. Results: In VGDO method, total 16 GV structures and five 100% dose level target structures were contoured compared to total 5 target structures in RO method which saves 30 min in contour. With the same PTV coverage (95% volume receive 30.6Gy prescription dose), maximum cord dose is 32.64Gy in VGDO and 31.94Gy in RO. HI is 1.03 and 1.04 for VGDO and RO respectively. CN is 0.93 and 0.94 for VGDO and RO respectively. Conclusions: The dosimetric comparison demonstrated both methods are equivalent in terms of plan quality. With robust optimization for CSI gradient matching, it efficiently reduces the amount of planning target contour structure by factor of 4 and thus improves the planning efficiency especially for 4 or more gradient junction area.

  19. Planning law and public health at an impasse in Australia: the need for targeted law reforms to improve local food environments to reduce overweight and obesity.

    PubMed

    Mills, Caroline

    2014-09-01

    Australia's high rates of overweight and obesity, and the associated increased population risk of non-communicable diseases, pose a challenge to policymakers across sectors beyond the health portfolio. In the last decade, strategies to promote healthy lifestyles and address non-communicable diseases have increasingly interested urban planners in Australia and internationally. However, Australian planning laws continue to operate largely without regard to public health goals, thus limiting the ability of communities to shape healthy built environments. In recent years, local governments have increasingly taken on responsibility for improving public health through community-based initiatives; however, their efforts are hindered by their limited capacity to influence planning priorities under current State-legislated planning schemes. This article considers the emerging body of research exploring the impact of urban planning on health and non-communicable diseases in Australia. It is contended that planning law in Australia is out of step with the evidence of planning's potential impact on health, and reforms are required to ensure consistency with public health priorities.

  20. The dosimetric impact of daily setup error on target volumes and surrounding normal tissue in the treatment of prostate cancer with intensity-modulated radiation therapy

    SciTech Connect

    Algan, Ozer; Jamgade, Ambarish; Ali, Imad; Christie, Alana; Thompson, J. Spencer; Thompson, David; Ahmad, Salahuddin; Herman, Terence

    2012-01-01

    The purpose of this study was to evaluate the impact of daily setup error and interfraction organ motion on the overall dosimetric radiation treatment plans. Twelve patients undergoing definitive intensity-modulated radiation therapy (IMRT) treatments for prostate cancer were evaluated in this institutional review board-approved study. Each patient had fiducial markers placed into the prostate gland before treatment planning computed tomography scan. IMRT plans were generated using the Eclipse treatment planning system. Each patient was treated to a dose of 8100 cGy given in 45 fractions. In this study, we retrospectively created a plan for each treatment day that had a shift available. To calculate the dose, the patient would have received under this plan, we mathematically 'negated' the shift by moving the isocenter in the exact opposite direction of the shift. The individualized daily plans were combined to generate an overall plan sum. The dose distributions from these plans were compared with the treatment plans that were used to treat the patients. Three-hundred ninety daily shifts were negated and their corresponding plans evaluated. The mean isocenter shift based on the location of the fiducial markers was 3.3 {+-} 6.5 mm to the right, 1.6 {+-} 5.1 mm posteriorly, and 1.0 {+-} 5.0 mm along the caudal direction. The mean D95 doses for the prostate gland when setup error was corrected and uncorrected were 8228 and 7844 cGy (p < 0.002), respectively, and for the planning target volume (PTV8100) was 8089 and 7303 cGy (p < 0.001), respectively. The mean V95 values when patient setup was corrected and uncorrected were 99.9% and 87.3%, respectively, for the PTV8100 volume (p < 0.0001). At an individual patient level, the difference in the D95 value for the prostate volume could be >1200 cGy and for the PTV8100 could approach almost 2000 cGy when comparing corrected against uncorrected plans. There was no statistically significant difference in the D35 parameter

  1. Sensitivity of postplanning target and OAR coverage estimates to dosimetric margin distribution sampling parameters

    SciTech Connect

    Xu Huijun; Gordon, J. James; Siebers, Jeffrey V.

    2011-02-15

    {omega}{sub eff} and {delta}. Results: The accuracy of coverage estimates depends on angular and radial DMD sampling parameters {omega} or {omega}{sub eff} and {delta}, as well as the employed sampling technique. Target |{Delta}Q|<1% and OAR |{Delta}Q|<3% can be achieved with sampling parameters {omega} or {omega}{sub eff}=20 deg., {delta}=1 mm. Better accuracy (target |{Delta}Q|<0.5% and OAR |{Delta}Q|<{approx}1%) can be achieved with {omega} or {omega}{sub eff}=10 deg., {delta}=0.5 mm. As the number of sampling points decreases, the isotropic sampling method maintains better accuracy than fixed angular sampling. Conclusions: Coverage estimates for post-planning evaluation are essential since coverage values of targets and OARs often differ from the values implied by the static margin-based plans. Finer sampling of the DMD enables more accurate assessment of the effect of geometric uncertainties on coverage estimates prior to treatment. DMD sampling with {omega} or {omega}{sub eff}=10 deg. and {delta}=0.5 mm should be adequate for planning purposes.

  2. SU-E-J-231: Comparison of 3D Angiogram and MRI in Delineating the AVM Target for Frameless Stereotactic Radiosurgery

    SciTech Connect

    Avkshtol, V; Tanny, S; Reddy, K; Chen, C; Parsai, E

    2014-06-01

    Purpose: Stereotactic radiation therapy (SRT) provides an excellent alternative to embolization and surgical excision for the management of appropriately selected cerebral arteriovenous malformations (AVMs). The currently accepted standard for delineating AVMs is planar digital subtraction angiography (DSA). DSA can be used to acquire a 3D data set that preserves osseous structures (3D-DA) at the time of the angiography for SRT planning. Magnetic resonance imaging (MRI) provides an alternative noninvasive method of visualizing the AVM nidus with comparable spatial resolution. We utilized 3D-DA and T1 post-contrast MRI data to evaluate the differences in SRT target volumes. Methods: Four patients underwent 3D-DA and high-resolution MRI. 3D T1 post-contrast images were obtained in all three reconstruction planes. A planning CT was fused with MRI and 3D-DA data sets. The AVMs were contoured utilizing one of the image sets at a time. Target volume, centroid, and maximum and minimum dimensions were analyzed for each patient. Results: Targets delineated using post-contrast MRI demonstrated a larger mean volume. AVMs >2 cc were found to have a larger difference between MRI and 3D-DA volumes. Larger AVMs also demonstrated a smaller relative uncertainty in contour centroid position (1 mm). AVM targets <2 cc had smaller absolute differences in volume, but larger differences in contour centroid position (2.5 mm). MRI targets demonstrated a more irregular shape compared to 3D-DA targets. Conclusions: Our preliminary data supports the use of MRI alone to delineate AVM targets >2 cc. The greater centroid stability for AVMs >2 cc ensures accurate target localization during image fusion. The larger MRI target volumes did not result in prohibitively greater volumes of normal brain tissue receiving the prescription dose. The larger centroid instability for AVMs <2 cc precludes the use of MRI alone for target delineation. We recommend incorporating a 3D-DA for these patients.

  3. Localization accuracy from automatic and semi-automatic rigid registration of locally-advanced lung cancer targets during image-guided radiation therapy

    SciTech Connect

    Robertson, Scott P.; Weiss, Elisabeth; Hugo, Geoffrey D.

    2012-01-15

    Purpose: To evaluate localization accuracy resulting from rigid registration of locally-advanced lung cancer targets using fully automatic and semi-automatic protocols for image-guided radiation therapy. Methods: Seventeen lung cancer patients, fourteen also presenting with involved lymph nodes, received computed tomography (CT) scans once per week throughout treatment under active breathing control. A physician contoured both lung and lymph node targets for all weekly scans. Various automatic and semi-automatic rigid registration techniques were then performed for both individual and simultaneous alignments of the primary gross tumor volume (GTV{sub P}) and involved lymph nodes (GTV{sub LN}) to simulate the localization process in image-guided radiation therapy. Techniques included ''standard'' (direct registration of weekly images to a planning CT), ''seeded'' (manual prealignment of targets to guide standard registration), ''transitive-based'' (alignment of pretreatment and planning CTs through one or more intermediate images), and ''rereferenced'' (designation of a new reference image for registration). Localization error (LE) was assessed as the residual centroid and border distances between targets from planning and weekly CTs after registration. Results: Initial bony alignment resulted in centroid LE of 7.3 {+-} 5.4 mm and 5.4 {+-} 3.4 mm for the GTV{sub P} and GTV{sub LN}, respectively. Compared to bony alignment, transitive-based and seeded registrations significantly reduced GTV{sub P} centroid LE to 4.7 {+-} 3.7 mm (p = 0.011) and 4.3 {+-} 2.5 mm (p < 1 x 10{sup -3}), respectively, but the smallest GTV{sub P} LE of 2.4 {+-} 2.1 mm was provided by rereferenced registration (p < 1 x 10{sup -6}). Standard registration significantly reduced GTV{sub LN} centroid LE to 3.2 {+-} 2.5 mm (p < 1 x 10{sup -3}) compared to bony alignment, with little additional gain offered by the other registration techniques. For simultaneous target alignment, centroid LE as low

  4. [Identifying residential areas with heat-related health risks. Sociodemographic and climate data mapping as a planning tool for targeted prevention strategies].

    PubMed

    Blättner, B; Heckenhahn, M; Georgy, S; Grewe, H A; Kupski, S

    2010-01-01

    Prognosticated heat waves in the context of climate change require appropriate strategies to prevent harmful health effects in the population. In a model project within the public health department of the Kassel region, elderly living in areas at risk of over-heating will be identified and advised. The localization of high-risk residential areas was part of the planning process. Through mapping of demographic and microclimate data and the characteristics of the material of the residential buildings, high-risk areas that require preventive measures as a top priority were identified. The prevention of heat-related mortality and morbidity by communal health authorities requires close cooperation with other administrative bodies, especially with town planning departments. Mapping demographic and microclimate data and the characteristics of the material of the residential buildings can facilitate the planning of preventive measures.

  5. Continuous Monitoring and Intrafraction Target Position Correction During Treatment Improves Target Coverage for Patients Undergoing SBRT Prostate Therapy

    SciTech Connect

    Lovelock, D. Michael; Messineo, Alessandra P.; Cox, Brett W.; Kollmeier, Marisa A.; Zelefsky, Michael J.

    2015-03-01

    Purpose: To compare the potential benefits of continuous monitoring of prostate position and intervention (CMI) using 2-mm displacement thresholds during stereotactic body radiation therapy (SBRT) treatment to those of a conventional image-guided procedure involving single localization prior to treatment. Methods and Materials: Eighty-nine patients accrued to a prostate SBRT dose escalation protocol were implanted with radiofrequency transponder beacons. The planning target volume (PTV) margin was 5 mm in all directions, except for 3 mm in the posterior direction. The prostate was kept within 2 mm of its planned position by the therapists halting dose delivery and, if necessary, correcting the couch position. We computed the number, type, and time required for interventions and where the prostate would have been during dose delivery had there been, instead, a single image-guided setup procedure prior to each treatment. Distributions of prostate displacements were computed as a function of time. Results: After the initial setup, 1.7 interventions per fraction were required, with a concomitant increase in time for dose delivery of approximately 65 seconds. Small systematic drifts in prostate position in the posterior and inferior directions were observed in the study patients. Without CMI, intrafractional motion would have resulted in approximately 10% of patients having a delivered dose that did not meet our clinical coverage requirement, that is, a PTV D95 of >90%. The posterior PTV margin required for 95% of the dose to be delivered with the target positioned within the PTV was computed as a function of time. The margin necessary was found to increase by 2 mm every 5 minutes, starting from the time of the imaging procedure. Conclusions: CMI using a tight 2-mm displacement threshold was not only feasible but was found to deliver superior PTV coverage compared with the conventional image-guided procedure in the SBRT setting.

  6. SU-E-J-222: Feasibility Study of MRI-Only Proton Therapy Planning

    SciTech Connect

    Spadea, M; Izquierdo, D; Catana, C; Collins-Fekete, C; Bortfeld, T; Seco, J

    2015-06-15

    Purpose: To assess the dosimetric equivalence of MRI based proton planning vs. single energy x-ray CT. Methods: 8 glioblastoma patients were imaged with CT and MRI after surgical resection. T1-weighted 3DMPRAGE was used to delineate the GTV, which was subsequently rigidly registered to the CT volume. A pseudoCT was generated from the aligned MRI by combining segmentation and atlas-based approaches. The spatial resolution both for pseudo- and real CT was 0.6×0.6×2.5mm. Three orthogonal proton beams were simulated on the pseudoCT. Two co-planar beams were set on the axial plane. The third one was planned parallel to the cranio-caudal (CC) direction. Each beam was set to cover the GTV at 98% of the nominal dose (18Gy). The proton plan was copied and transferred to the real CT, including aperture/compensator geometry. Dose comparison between pseudoCT and CT plan was performed beam-by-beam by quantifying the range shift of dose profile on each slice of the GTV. The GTV’s V{sub 98} was computed for the CT. Results: For beams in axial plane the median absolute value of the range shift was 0.3mm, with 0.9mm and 1.4mm as 95th percentile and maximum, respectively. Worst scenarios were found for the CC beam, where we measured 1.1mm (median), 2.7mm (95thpercentile) and 5mm (maximum). Regardless the direction, beams passing through the surgical site, where metal (Titanium MRI-compatible) staples were present, were mostly affected by range shift. GTV’s V{sub 98} for CT was not lower than 99.3%. Conclusion: The study showed the clinical feasibility of an MRI-alone proton plan. Advantages include the possibility to rely on better soft tissue contrast for target and organs at risk delineation without the need of further CT scan and image registration. Additional investigation is required in presence of metal implants along the beam path and to account for partial volume effects due to slice thickness.

  7. Three-Dimensional Display Of Radiation Therapy Planning

    NASA Astrophysics Data System (ADS)

    Cook, L. T.; Lee, K. R.; Cytacki, E. P.; Dwyer, S. J.

    1987-06-01

    Three-dimensional (3-D) treatment planning has been widely recognized as the ultimate method for radiation therapy for several decades. Recently, interest in developing 3-D treatment planning has been stimulated by the advent of computed tomography (CT), magnetic resonance imaging, and advanced computer technology. A 3-D treatment planning system requires an interactive computer system which is capable of performing the following functions: Demonstration of the tumor volume and normal anatomy in three dimensions, Calculation of the tumor volume, Definition of the target volume, Measurement of the distance and angles from outer surface reference points (e.g., external meatus) to specific anatomic points of interest (e.g., center of tumor), Projection of the spatial relationship between the therapy beam and normal anatomy, and calculation and display of dose distribution in three-dimensions. We have used a commercially available computer display system with a host microcomputer (M68000) to satisfy the above display and interaction requirements except for the calculation of 3-D dose distributions. The system has been applied to several cases which used CT as the imaging modality. A scanning protocol was established which called for contiguous 5mm thick slices from 2 cm above to 2 cm below the skin markers for the designated treatment field. Each patient was scanned in the treatment position, possibly using a fixation device. The outer skin contours, the tumor and adjacent contours were manually traced using a digitizing pen. The surfaces of the skin, the tumor, and normal anatomic structures were reconstructed in the display computer which then allowed a variety of interactions with the data, including beam definition and the real time positioning of the beam. After beam positions were established, the dose distribution within the treatment volume was computed, reconstructed, and then displayed along with the anatomic structures.

  8. PTV-based IMPT optimization incorporating planning risk volumes vs robust optimization

    SciTech Connect

    Liu Wei; Li Xiaoqiang; Zhu, Ron. X.; Mohan, Radhe; Frank, Steven J.; Li Yupeng

    2013-02-15

    Purpose: Robust optimization leads to intensity-modulated proton therapy (IMPT) plans that are less sensitive to uncertainties and superior in terms of organs-at-risk (OARs) sparing, target dose coverage, and homogeneity compared to planning target volume (PTV)-based optimized plans. Robust optimization incorporates setup and range uncertainties, which implicitly adds margins to both targets and OARs and is also able to compensate for perturbations in dose distributions within targets and OARs caused by uncertainties. In contrast, the traditional PTV-based optimization considers only setup uncertainties and adds a margin only to targets but no margins to the OARs. It also ignores range uncertainty. The purpose of this work is to determine if robustly optimized plans are superior to PTV-based plans simply because the latter do not assign margins to OARs during optimization. Methods: The authors retrospectively selected from their institutional database five patients with head and neck (H and N) cancer and one with prostate cancer for this analysis. Using their original images and prescriptions, the authors created new IMPT plans using three methods: PTV-based optimization, optimization based on the PTV and planning risk volumes (PRVs) (i.e., 'PTV+PRV-based optimization'), and robust optimization using the 'worst-case' dose distribution. The PRVs were generated by uniformly expanding OARs by 3 mm for the H and N cases and 5 mm for the prostate case. The dose-volume histograms (DVHs) from the worst-case dose distributions were used to assess and compare plan quality. Families of DVHs for each uncertainty for all structures of interest were plotted along with the nominal DVHs. The width of the 'bands' of DVHs was used to quantify the plan sensitivity to uncertainty. Results: Compared with conventional PTV-based and PTV+PRV-based planning, robust optimization led to a smaller bandwidth for the targets in the face of uncertainties {l_brace}clinical target volume [CTV

  9. Evaluation of three types of reference image data for external beam radiotherapy target localization using digital tomosynthesis (DTS)

    SciTech Connect

    Godfrey, Devon J.; Ren Lei; Yan Hui; Wu, Q.; Yoo Sua; Oldham, M.; Yin Fangfang

    2007-08-15

    Digital tomosynthesis (DTS) is a fast, low-dose three-dimensional (3D) imaging approach which yields slice images with excellent in-plane resolution, though low plane-to-plane resolution. A stack of DTS slices can be reconstructed from a single limited-angle scan, with typical scan angles ranging from 10 deg. to 40 deg. and acquisition times of less than 10 s. The resulting DTS slices show soft tissue contrast approaching that of full cone-beam CT. External beam radiotherapy target localization using DTS requires the registration of on-board DTS images with corresponding reference image data. This study evaluates three types of reference volume: original reference CT, exact reference DTS (RDTS), and a more computationally efficient approximate reference DTS (RDTS{sub approx}), as well as three different DTS scan angles (22 deg., 44 deg., and 65 deg.) for the DTS target localization task. Three-dimensional mutual information (MI) shared between reference and on-board DTS volumes was computed in a region surrounding the spine of a chest phantom, as translations spanning {+-}5 mm and rotations spanning {+-}5 deg. were simulated along each dimension in the reference volumes. The locations of the MI maxima were used as surrogates for registration accuracy, and the width of the MI peaks were used to characterize the registration robustness. The results show that conventional treatment planning CT volumes are inadequate reference volumes for direct registration with on-board DTS data. The efficient RDTS{sub approx} method also appears insufficient for MI-based registration without further refinement of the technique, though it may be suitable for manual registration performed by a human observer. The exact RDTS volumes, on the other hand, delivered a 3D DTS localization accuracy of 0.5 mm and 0.5 deg. along each axis, using only a single 44 deg. coronal on-board DTS scan of the chest phantom.

  10. Evaluation of three types of reference image data for external beam radiotherapy target localization using digital tomosynthesis (DTS).

    PubMed

    Godfrey, Devon J; Ren, Lei; Yan, Hui; Wu, Q; Yoo, Sua; Oldham, M; Yin, Fang Fang

    2007-08-01

    Digital tomosynthesis (DTS) is a fast, low-dose three-dimensional (3D) imaging approach which yields slice images with excellent in-plane resolution, though low plane-to-plane resolution. A stack of DTS slices can be reconstructed from a single limited-angle scan, with typical scan angles ranging from 10 degrees to 40 degrees and acquisition times of less than 10 s. The resulting DTS slices show soft tissue contrast approaching that of full cone-beam CT. External beam radiotherapy target localization using DTS requires the registration of on-board DTS images with corresponding reference image data. This study evaluates three types of reference volume: original reference CT, exact reference DTS (RDTS), and a more computationally efficient approximate reference DTS (RDTSapprox), as well as three different DTS scan angles (22 degrees, 44 degrees, and 65 degrees) for the DTS target localization task. Three-dimensional mutual information (MI) shared between reference and onboard DTS volumes was computed in a region surrounding the spine of a chest phantom, as translations spanning +/-5 mm and rotations spanning +/-5 degrees were simulated along each dimension in the reference volumes. The locations of the MI maxima were used as surrogates for registration accuracy, and the width of the MI peaks were used to characterize the registration robustness. The results show that conventional treatment planning CT volumes are inadequate reference volumes for direct registration with on-board DTS data. The efficient RDTSapprox method also appears insufficient for MI-based registration without further refinement of the technique, though it may be suitable for manual registration performed by a human observer. The exact RDTS volumes, on the other hand, delivered a 3D DTS localization accuracy of 0.5 mm and 0.50 along each axis, using only a single 44 degrees coronal on-board DTS scan of the chest phantom.

  11. SU-E-J-72: Geant4 Simulations of Spot-Scanned Proton Beam Treatment Plans

    SciTech Connect

    Kanehira, T; Sutherland, K; Matsuura, T; Umegaki, K; Shirato, H

    2014-06-01

    Purpose: To evaluate density inhomogeneities which can effect dose distributions for real-time image gated spot-scanning proton therapy (RGPT), a dose calculation system, using treatment planning system VQA (Hitachi Ltd., Tokyo) spot position data, was developed based on Geant4. Methods: A Geant4 application was developed to simulate spot-scanned proton beams at Hokkaido University Hospital. A CT scan (0.98 × 0.98 × 1.25 mm) was performed for prostate cancer treatment with three or four inserted gold markers (diameter 1.5 mm, volume 1.77 mm3) in or near the target tumor. The CT data was read into VQA. A spot scanning plan was generated and exported to text files, specifying the beam energy and position of each spot. The text files were converted and read into our Geant4-based software. The spot position was converted into steering magnet field strength (in Tesla) for our beam nozzle. Individual protons were tracked from the vacuum chamber, through the helium chamber, steering magnets, dose monitors, etc., in a straight, horizontal line. The patient CT data was converted into materials with variable density and placed in a parametrized volume at the isocenter. Gold fiducial markers were represented in the CT data by two adjacent voxels (volume 2.38 mm3). 600,000 proton histories were tracked for each target spot. As one beam contained about 1,000 spots, approximately 600 million histories were recorded for each beam on a blade server. Two plans were considered: two beam horizontal opposed (90 and 270 degree) and three beam (0, 90 and 270 degree). Results: We are able to convert spot scanning plans from VQA and simulate them with our Geant4-based code. Our system can be used to evaluate the effect of dose reduction caused by gold markers used for RGPT. Conclusion: Our Geant4 application is able to calculate dose distributions for spot scanned proton therapy.

  12. Design of the NIF Cryogenic Target System

    SciTech Connect

    Gibson, C; Baltz, J; Malsbury, T; Atkinson, D; Brugmann, V; Coffield, F; Edwards, O; Haid, B; Locke, S; Shiromizu, S; Skulina, K

    2008-06-10

    The United States Department of Energy has embarked on a campaign to conduct credible fusion ignition experiments on the National Ignition Facility (NIF) at the Lawrence Livermore National Laboratory in 2010. The target assembly specified for this campaign requires the formation of a deuterium/tritium (DT) fuel ice layer in a 2 mm diameter capsule at the center of a 9 mm long by 5 mm diameter cylinder, called a hohlraum. The ice layer must be formed and maintained at temperatures below 20 K. At laser shot time, the target is positioned at the center of the NIF target chamber, aligned to the laser beams and held stable to less than 7 {micro}m rms. We have completed the final design of the Cryogenic Target System and are integrating the devices necessary to create, characterize and position the cryogenic target for ignition experiments. These designs, with supporting analysis and prototype test results, will be presented.

  13. Higher Education Accountability Plans

    ERIC Educational Resources Information Center

    Washington Higher Education Coordinating Board, 2003

    2003-01-01

    Washington state's public four-year universities and college have submitted their 2003-05 accountability plans to the Higher Education Coordinating Board (HECB). The state operating budget directs the Board to review these plans and set biennial performance targets for each institution. For 2003-05, the four-year institutions are reporting on a…

  14. Building robust conservation plans.

    PubMed

    Visconti, Piero; Joppa, Lucas

    2015-04-01

    Systematic conservation planning optimizes trade-offs between biodiversity conservation and human activities by accounting for socioeconomic costs while aiming to achieve prescribed conservation objectives. However, the most cost-efficient conservation plan can be very dissimilar to any other plan achieving the set of conservation objectives. This is problematic under conditions of implementation uncertainty (e.g., if all or part of the plan becomes unattainable). We determined through simulations of parallel implementation of conservation plans and habitat loss the conditions under which optimal plans have limited chances of implementation and where implementation attempts would fail to meet objectives. We then devised a new, flexible method for identifying conservation priorities and scheduling conservation actions. This method entails generating a number of alternative plans, calculating the similarity in site composition among all plans, and selecting the plan with the highest density of neighboring plans in similarity space. We compared our method with the classic method that maximizes cost efficiency with synthetic and real data sets. When implementation was uncertain--a common reality--our method provided higher likelihood of achieving conservation targets. We found that χ, a measure of the shortfall in objectives achieved by a conservation plan if the plan could not be implemented entirely, was the main factor determining the relative performance of a flexibility enhanced approach to conservation prioritization. Our findings should help planning authorities prioritize conservation efforts in the face of uncertainty about future condition and availability of sites.

  15. Evaluation of atlas based auto-segmentation for head and neck target volume delineation in adaptive/replan IMRT

    NASA Astrophysics Data System (ADS)

    Speight, R.; Karakaya, E.; Prestwich, R.; Sen, M.; Lindsay, R.; Harding, R.; Sykes, J.

    2014-03-01

    IMRT for head and neck patients requires clinicians to delineate clinical target volumes (CTV) on a planning-CT (>2hrs/patient). When patients require a replan-CT, CTVs must be re-delineated. This work assesses the performance of atlas-based autosegmentation (ABAS), which uses deformable image registration between planning and replan-CTs to auto-segment CTVs on the replan-CT, based on the planning contours. Fifteen patients with planning-CT and replan-CTs were selected. One clinician delineated CTVs on the planning-CTs and up to three clinicians delineated CTVs on the replan-CTs. Replan-CT volumes were auto-segmented using ABAS using the manual CTVs from the planning-CT as an atlas. ABAS CTVs were edited manually to make them clinically acceptable. Clinicians were timed to estimate savings using ABAS. CTVs were compared using dice similarity coefficient (DSC) and mean distance to agreement (MDA). Mean inter-observer variability (DSC>0.79 and MDA<2.1mm) was found to be greater than intra-observer variability (DSC>0.91 and MDA<1.5mm). Comparing ABAS to manual CTVs gave DSC=0.86 and MDA=2.07mm. Once edited, ABAS volumes agreed more closely with the manual CTVs (DSC=0.87 and MDA=1.87mm). The mean clinician time required to produce CTVs reduced from 169min to 57min when using ABAS. ABAS segments volumes with accuracy close to inter-observer variability however the volumes require some editing before clinical use. Using ABAS reduces contouring time by a factor of three.

  16. SU-E-T-539: Fixed Versus Variable Optimization Points in Combined-Mode Modulated Arc Therapy Planning

    SciTech Connect

    Kainz, K; Prah, D; Ahunbay, E; Li, X

    2014-06-01

    Purpose: A novel modulated arc therapy technique, mARC, enables superposition of step-and-shoot IMRT segments upon a subset of the optimization points (OPs) of a continuous-arc delivery. We compare two approaches to mARC planning: one with the number of OPs fixed throughout optimization, and another where the planning system determines the number of OPs in the final plan, subject to an upper limit defined at the outset. Methods: Fixed-OP mARC planning was performed for representative cases using Panther v. 5.01 (Prowess, Inc.), while variable-OP mARC planning used Monaco v. 5.00 (Elekta, Inc.). All Monaco planning used an upper limit of 91 OPs; those OPs with minimal MU were removed during optimization. Plans were delivered, and delivery times recorded, on a Siemens Artiste accelerator using a flat 6MV beam with 300 MU/min rate. Dose distributions measured using ArcCheck (Sun Nuclear Corporation, Inc.) were compared with the plan calculation; the two were deemed consistent if they agreed to within 3.5% in absolute dose and 3.5 mm in distance-to-agreement among > 95% of the diodes within the direct beam. Results: Example cases included a prostate and a head-and-neck planned with a single arc and fraction doses of 1.8 and 2.0 Gy, respectively. Aside from slightly more uniform target dose for the variable-OP plans, the DVHs for the two techniques were similar. For the fixed-OP technique, the number of OPs was 38 and 39, and the delivery time was 228 and 259 seconds, respectively, for the prostate and head-and-neck cases. For the final variable-OP plans, there were 91 and 85 OPs, and the delivery time was 296 and 440 seconds, correspondingly longer than for fixed-OP. Conclusion: For mARC, both the fixed-OP and variable-OP approaches produced comparable-quality plans whose delivery was successfully verified. To keep delivery time per fraction short, a fixed-OP planning approach is preferred.

  17. Comparison between target margins derived from 4DCT scans and real-time tumor motion tracking: Insights from lung tumor patients treated with robotic radiosurgery

    SciTech Connect

    Descovich, Martina McGuinness, Christopher; Kannarunimit, Danita; Chen, Josephine; Pinnaduwage, Dilini; Pouliot, Jean; Kased, Norbert; Gottschalk, Alexander R.; Yom, Sue S.

    2015-03-15

    Purpose: A unique capability of the CyberKnife system is dynamic target tracking. However, not all patients are eligible for this approach. Rather, their tumors are tracked statically using the vertebral column for alignment. When using static tracking, the internal target volume (ITV) is delineated on the four-dimensional (4D) CT scan and an additional margin is added to account for setup uncertainty [planning target volume (PTV)]. Treatment margins are difficult to estimate due to unpredictable variations in tumor motion and respiratory pattern during the course of treatment. The inability to track the target and detect changes in respiratory characteristics might result in geographic misses and local tumor recurrences. The purpose of this study is to develop a method to evaluate the adequacy of ITV-to-PTV margins for patients treated in this manner. Methods: Data from 24 patients with lesions in the upper lobe (n = 12), middle lobe (n = 3), and lower lobe (n = 9) were included in this study. Each patient was treated with dynamic tracking and underwent 4DCT scanning at the time of simulation. Data including the 3D coordinates of the target over the course of treatment were extracted from the treatment log files and used to determine actual target motion in the superior–inferior (S–I), anterior–posterior (A–P), and left–right (L–R) directions. Different approaches were used to calculate anisotropic and isotropic margins, assuming that the tumor moves as a rigid body. Anisotropic margins were calculated by separating target motion in the three anatomical directions, and a uniform margin was calculated by shifting the gross tumor volume contours in the 3D space and by computing the percentage of overlap with the PTV. The analysis was validated by means of a theoretical formulation. Results: The three methods provided consistent results. A uniform margin of 4.5 mm around the ITV was necessary to assure 95% target coverage for 95% of the fractions included

  18. SU-E-J-75: Importance of 4DCT for Target Volume Definition in Stereotactic Lung Radiotherapy

    SciTech Connect

    Goksel, E; Cone, D; Kucucuk, H; Senkesen, O; Yilmaz, M; Aslay, I; Tezcanli, E; Garipagaoglu, M; Sengoz, M

    2014-06-01

    Purpose: We aimed to investigate the importance of 4DCT for lung tumors treated with SBRT and whether maximum intensity projection (MIP) and free breathing (FB) images can compansate for tumor movement. Methods: Six patients with primary lung cancer and 2 patients with lung metastasis with a median age of 69.5 (42–86) were included. Patients were positioned supine on a vacuum bag. In addition to FB planning CT images, 4DCT images were obtained at 3 mm intervals using Varian RPM system with (Siemens Somatom Sensetion 64). MIP series were reconstructed using 4DCT images. PTV-FB and PTV-MIP (GTV+5mm) volumes were contoured using FB and MIP series, respectively. GTVs were defined on each of eight different breathing phase images and were merged to create the ITV. PTV-4D was generated with a 5 mm margin to ITV. PTV-MIP and PTV-4D contours were copied to FB CT series and treatment plans for PTV-MIP and PTV-FB were generated using RapidArc (2 partial arc) technique in Eclipse (version 11, AAA algorithm). The prescription dose was 5600cGy in 7 fractions. ITV volumes receiving prescription dose (%) and V95 for ITV were calculated for each treatment plan. Results: The mean PTV-4B, PTV-MIP and PTV-FB volumes were 23.2 cc, 15.4cc ve 11cc respectively. Median volume of ITV receiving the prescription dose was 34.6% (16.4–70 %) and median V95 dose for ITV was 1699cGy (232cGy-5117cGy) in the plan optimized for PTV-FB as the reference. When the plan was optimized for PTV-MIP, median ITV volume receiving the prescription dose was 67.15% (26–86%) and median V95 dose for ITV was 4231cGy (1735cGy-5290cGy). Conclusion: Images used in lung SBRT are critical for treatment quality; FB and MIP images did not compensate target movement, therefore 4DCT images should be obtained for all patients undergoing lung SBRT or the safety margins should be adjusted.

  19. Offline multiple adaptive planning strategy for concurrent irradiation of the prostate and pelvic lymph nodes

    SciTech Connect

    Qi, Peng; Xia, Ping; Pouliot, Jean; Roach, Mack

    2014-02-15

    Purpose: Concurrent irradiation of the prostate and pelvic lymph nodes (PLNs) can be challenging due to the independent motion of the two target volumes. To address this challenge, the authors have proposed a strategy referred to as Multiple Adaptive Planning (MAP). To minimize the number of MAP plans, the authors’ previous work only considered the prostate motion in one major direction. After analyzing the pattern of the prostate motion, the authors investigated a practical number of intensity-modulated radiotherapy (IMRT) plans needed to accommodate the prostate motion in two major directions simultaneously. Methods: Six patients, who received concurrent irradiation of the prostate and PLNs, were selected for this study. Nine MAP-IMRT plans were created for each patient with nine prostate contours that represented the prostate at nine locations with respect to the PLNs, including the original prostate contour and eight contours shifted either 5 mm in a single anterior-posterior (A-P), or superior-inferior (S-I) direction, or 5 mm in both A-P and S-I directions simultaneously. From archived megavoltage cone beam CT (MV-CBCT) and a dual imaging registration, 17 MV-CBCTs from 33 available MV-CBCT from these patients showed large prostate displacements (>3 mm in any direction) with respect to the pelvic bones. For each of these 17 fractions, one of nine MAP-IMRT plans was retrospectively selected and applied to the MV-CBCT for dose calculation. For comparison, a simulated isocenter-shifting plan and a reoptimized plan were also created for each of these 17 fractions. The doses to 95% (D95) of the prostate and PLNs, and the doses to 5% (D5) of the rectum and bladder were calculated and analyzed. Results: For the prostate, D95 > 97% of the prescription dose was observed in 16, 16, and 17 of 17 fractions for the MAP, isocenter-shifted, and reoptimized plans, respectively. For PLNs, D95 > 97% of the prescription doses was observed in 10, 3, and 17 of 17 fractions for

  20. The development and evaluation of a holistic needs assessment and care planning learning package targeted at cancer nurses in the UK.

    PubMed

    Henry, R; Hartley, B; Simpson, M; Doyle, N

    2014-01-01

    A project team from the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing the holistic needs of people with cancer. The project team identified three areas which were integral to an holistic needs assessment (HNA) implementation project. These were project support information, project management skills, and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents, and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created. www.hnaforcancer.com was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These subjects are packaged as videoed presentations with supporting learning material and can be accessed via the UKONS website. By the end of the programme participants were equipped to identify and explore the essential requirements for HNA and care planning, more able to recognise potential need, and initiate care to prevent or minimise the risk of complications. Participants had also developed confidence and competency in new skills, including basic project management.

  1. Automatic planning of head and neck treatment plans.

    PubMed

    Hazell, Irene; Bzdusek, Karl; Kumar, Prashant; Hansen, Christian R; Bertelsen, Anders; Eriksen, Jesper G; Johansen, Jørgen; Brink, Carsten

    2016-01-01

    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 provide a method to reduce the variation between persons performing 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 Pinnacle(3) radiation therapy treatment planning system. Twenty-six clinically delivered head and neck treatment plans were reoptimized with the Auto-Planning module. Comparison of the two types of treatment plans were performed using DVH metrics and a blinded clinical evaluation by two senior radiation oncologists using a scale from one to six. Both evaluations investigated dose coverage of target and dose to healthy tissues. Auto-Planning was able to produce clinically acceptable treatment plans in all 26 cases. Target coverages in the two types of plans were similar, but automatically generated plans had less irradiation of healthy tissue. In 94% of the evaluations, the autoplans scored at least as high 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 quality since consistent, high-quality plans are generated which even can be further optimized, if necessary. This makes it possible for the dosimetrist to focus more time on difficult dose planning goals and to spend less time on the more tedious parts of the planning process. PACS number: 87.55.de.

  2. Automatic planning of head and neck treatment plans.

    PubMed

    Hazell, Irene; Bzdusek, Karl; Kumar, Prashant; Hansen, Christian R; Bertelsen, Anders; Eriksen, Jesper G; Johansen, Jørgen; Brink, Carsten

    2016-01-08

    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 provide a method to reduce the variation between persons performing 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 treatment plans were reoptimized with the Auto-Planning module. Comparison of the two types of treatment plans were performed using DVH metrics and a blinded clinical evaluation by two senior radiation oncologists using a scale from one to six. Both evaluations investigated dose coverage of target and dose to healthy tissues. Auto-Planning was able to produce clinically acceptable treatment plans in all 26 cases. Target coverages in the two types of plans were similar, but automatically generated plans had less irradiation of healthy tissue. In 94% of the evaluations, the autoplans scored at least as high 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 quality since consistent, high-quality plans are generated which even can be further optimized, if necessary. This makes it possible for the dosimetrist to focus more time on difficult dose planning goals and to spend less time on the more tedious parts of the planning process.

  3. A Plan for All Seasons.

    ERIC Educational Resources Information Center

    Golden, Sandra

    1993-01-01

    Planning can help college public relations officials make the most of their time and energy. One approach includes reviewing institutional mission and strategic plan; setting department goals; identifying and targeting audiences; establishing interdepartmental links; and setting out action, crisis, budget, and evaluation plans in writing. (MSE)

  4. SU-E-T-351: Verification of Monitor Unit Calculation for Lung Stereotactic Body Radiation Therapy Using a Secondary Independent Planning System

    SciTech Connect

    Tsuruta, Y; Nakata, M; Higashimura, K; Nakamura, M; Miyabe, Y; Akimoto, M; Ono, T; Mukumoto, N; Ishihara, Y; Matsuo, Y; Mizowaki, T; Hiraoka, M

    2014-06-01

    Purpose: To compare isocenter (IC) dose between X-ray Voxel Monte Carlo (XVMC) and Acuros XB (AXB) as part of an independent verification of monitor unit (MU) calculation for lung stereotactic body radiation therapy (SBRT) using a secondary independent treatment planning system (TPS). Methods: Treatment plans of 110 lesions from 101 patients who underwent lung SBRT with Vero4DRT (Mitsubishi Heavy Industries, Ltd., Japan, and BrainLAB, Feldkirchen, Germany) were evaluated retrospectively. Dose distribution was calculated with X-ray Voxel Monte Carlo (XVMC) in iPlan 4.5.1 (BrainLAB, Feldkirchen, Germany) on averaged intensity projection images. A spatial resolution and mean variance were 2 mm and 2%, respectively. The clinical treatment plans were transferred from iPlan to Eclipse (Varian Medical Systems, Palo Alto, CA, USA), and doses were recalculated with well commissioned AXB ver. 11.0.31 while maintaining the XVMC-calculated MUs and beam arrangement. Dose calculations were made in the dose-to-medium dose reporting mode with the calculation grid size of 2.5 mm. The mean and standard deviation (SD) of the IC dose difference between XVMC and AXB were calculated. The tolerance level was defined as |mean|+2SD. Additionally, the relationship between IC dose difference and the size of planning target volume (PTV) or computed tomography (CT) value of internal target volume (ITV) was evaluated. Results: The mean±SD of the IC dose difference between XVMC and AXB was −0.32±0.73%. The tolerance level was 1.8%. Absolute IC dose differences exceeding the tolerance level were observed in 3 patients (2.8%). There were no strong correlations between IC dose difference and PTV size (R=−0.14) or CT value of ITV (R=−0.33). Conclusion: The present study suggested that independent verification of MU calculation for lung SBRT using a secondary TPS is useful.

  5. Poster — Thur Eve — 13: Inter-Fraction Target Movement in Image-Guided Radiation Therapy of Prostate Cancer

    SciTech Connect

    Cui, Congwu; Zeng, Grace G.

    2014-08-15

    We investigated the setup variations over the treatment courses of 113 patients with intact prostate treated with 78Gy/39fx. Institutional standard bladder and bowel preparation and image guidance protocols were used in CT simulation and treatment. The RapidArc treatment plans were optimized in Varian Eclipse treatment planning system and delivered on Varian 2100X Clinacs equipped with On-Board Imager to localize the target before beam-on. The setup variations were calculated in terms of mean and standard deviation of couch shifts. No correlation was observed between the mean shift and standard deviation over the treatment course and patient age, initial prostate volume and rectum size. The mean shifts in the first and last 5 fractions are highly correlated (P < 10{sup −10}) while the correlation of the standard deviations cannot be determined. The Mann-Kendall tests indicate trends of the mean daily Ant-Post and Sup-Inf shifts of the group. The target is inferior by ∼1mm to the planned position when the treatment starts and moves superiorly, approaching the planned position at 10th fraction, and then gradually moves back inferiorly by ∼1mm in the remain fractions. In the Ant-Post direction, the prostate gradually moves posteriorly during the treatment course from a mean shift of ∼2.5mm in the first fraction to ∼1mm in the last fraction. It may be related to a systematic rectum size change in the progress of treatment. The biased mean shifts in Ant-Post and Sup-Inf direction of most patients suggest systematically larger rectum and smaller bladder during the treatment than at CT simulation.

  6. Stereotactic Body Radiotherapy for Primary Lung Cancer at a Dose of 50 Gy Total in Five Fractions to the Periphery of the Planning Target Volume Calculated Using a Superposition Algorithm

    SciTech Connect

    Takeda, Atsuya; Sanuki, Naoko; Kunieda, Etsuo Ohashi, Toshio; Oku, Yohei; Takeda, Toshiaki; Shigematsu, Naoyuki; Kubo, Atsushi

    2009-02-01

    Purpose: To retrospectively analyze the clinical outcomes of stereotactic body radiotherapy (SBRT) for patients with Stages 1A and 1B non-small-cell lung cancer. Methods and Materials: We reviewed the records of patients with non-small-cell lung cancer treated with curative intent between Dec 2001 and May 2007. All patients had histopathologically or cytologically confirmed disease, increased levels of tumor markers, and/or positive findings on fluorodeoxyglucose positron emission tomography. Staging studies identified their disease as Stage 1A or 1B. Performance status was 2 or less according to World Health Organization guidelines in all cases. The prescribed dose of 50 Gy total in five fractions, calculated by using a superposition algorithm, was defined for the periphery of the planning target volume. Results: One hundred twenty-one patients underwent SBRT during the study period, and 63 were eligible for this analysis. Thirty-eight patients had Stage 1A (T1N0M0) and 25 had Stage 1B (T2N0M0). Forty-nine patients were not appropriate candidates for surgery because of chronic pulmonary disease. Median follow-up of these 49 patients was 31 months (range, 10-72 months). The 3-year local control, disease-free, and overall survival rates in patients with Stages 1A and 1B were 93% and 96% (p = 0.86), 76% and 77% (p = 0.83), and 90% and 63% (p = 0.09), respectively. No acute toxicity was observed. Grade 2 or higher radiation pneumonitis was experienced by 3 patients, and 1 of them had fatal bacterial pneumonia. Conclusions: The SBRT at 50 Gy total in five fractions to the periphery of the planning target volume calculated by using a superposition algorithm is feasible. High local control rates were achieved for both T2 and T1 tumors.

  7. SU-E-J-43: Deformed Planning CT as An Electron Density Substitute for Cone-Beam CT

    SciTech Connect

    Mishra, K; Godley, A

    2014-06-01

    Purpose: To confirm that deforming the planning CT to the daily Cone-Beam CTs (CBCT) can provide suitable electron density for adaptive planning. We quantify the dosimetric difference between plans calculated on deformed planning CTs (DPCT) and daily CT-on-rails images (CTOR). CTOR is used as a test of the method as CTOR already contains accurate electron density to compare against. Methods: Five prostate only IMRT patients, each with five CTOR images, were selected and re-planned on Panther (Prowess Inc.) with a uniform 5 mm PTV expansion, prescribed 78 Gy. The planning CT was deformed to match each CTOR using ABAS (Elekta Inc.). Contours were drawn on the CTOR, and copied to the DPCT. The original treatment plan was copied to both the CTOR and DPCT, keeping the center of the prostate as the isocenter. The plans were then calculated using the collapsed cone heterogeneous dose engine of Prowess and typical DVH planning parameters used to compare them. Results: Each DPCT was visually compared to its CTOR with no differences observed. The agreement of the copied CTOR contours with the DPCT anatomy further demonstrated the deformation accuracy. The plans calculated using CTOR and DPCT were compared. Over the 25 plan pairs, the average difference between them for prostate D100, D98 and D95 were 0.5%, 0.2%, and 0.2%; PTV D98, D95 and mean dose: 0.3%, 0.2% and 0.3%; bladder V70, V60 and mean dose: 1.1%, 0.7%, and 0.2%; and rectum mean dose: 0.3%. (D100 is the dose covering 100% of the target; V70 is the volume of the organ receiving 70 Gy). Conclusion: We observe negligible difference between the dose calculated on the DPCT and the CTOR, implying that deformed planning CTs are a suitable substitute for electron density. The method can now be applied to CBCTs. Research version of Panther provided by Prowess Inc. Research version of ABAS provided by Elekta Inc.

  8. Impact of grid size on uniform scanning and IMPT plans in XiO treatment planning system for brain cancer.

    PubMed

    Rana, Suresh; Zheng, Yuanshui

    2015-09-01

    sizes of 1, 1.5, 2, and 2.5 mm; these dosimetric results were then compared with that of 3 mm grid size. Phantom study results: There was no distinct trend exhibiting the dependence of grid size on dose calculation accuracy when calculated point dose of different grid sizes were compared to the measured point (TLD) doses. On average, the calculated point dose was higher than the measured dose by 1.49% and 2.63% for the right and left TLDs, respectively. The gamma analysis showed very minimal differences among planar dose distributions of various grid sizes, with percentage of points meeting gamma index criteria 1% and 1 mm to be from 97.92% to 99.97%. The gamma evaluation using 2% and 2 mm criteria showed both the IMPT and USPT plans have 100% points meeting the criteria. Patient study results: In USPT, there was no very distinct relationship between the absolute difference in mean planning target volume (PTV) dose and grid size, whereas in IMPT, it was found that the decrease in grid size slightly increased the PTV maximum dose and decreased the PTV mean dose and PTV D50%. For the PTV doses, the average differences were up to 0.35 Gy (RBE) and 1.47 Gy (RBE) in the USPT and IMPT plans, respectively. Dependency on grid size was not very clear for the organs at risk (OARs), with average difference ranged from -0.61 Gy (RBE) to 0.53 Gy (RBE) in the USPT plans and from -0.83 Gy (RBE) to 1.39 Gy (RBE) in the IMPT plans. In conclusion, the difference in the calculated point dose between the smallest grid size (1 mm) and the largest grid size (3 mm) in phantom for USPT was typically less than 0.1%. Patient study results showed that the decrease in grid size slightly increased the PTV maximum dose in both the USPT and IMPT plans. However, no distinct trend was obtained between the absolute difference in dosimetric parameter and dose calculation grid size for the OARs. Grid size has a large effect on dose calculation efficiency, and use of 2 mm or less grid size can increase

  9. Impact of grid size on uniform scanning and IMPT plans in XiO treatment planning system for brain cancer.

    PubMed

    Rana, Suresh; Zheng, Yuanshui

    2015-09-08

    sizes of 1, 1.5, 2, and 2.5 mm; these dosimetric results were then compared with that of 3 mm grid size. Phantom study results: There was no distinct trend exhibiting the dependence of grid size on dose calculation accuracy when calculated point dose of different grid sizes were compared to the measured point (TLD) doses. On average, the calculated point dose was higher than the measured dose by 1.49% and 2.63% for the right and left TLDs, respectively. The gamma analysis showed very minimal differences among planar dose distributions of various grid sizes, with percentage of points meeting gamma index criteria 1% and 1 mm to be from 97.92% to 99.97%. The gamma evaluation using 2% and 2mm criteria showed both the IMPT and USPT plans have 100% points meeting the criteria. Patient study results: In USPT, there was no very distinct relationship between the absolute difference in mean planning target volume (PTV) dose and grid size, whereas in IMPT, it was found that the decrease in grid size slightly increased the PTV maximum dose and decreased the PTV mean dose and PTVD99% . For the PTV doses, the average differences were up to 0.35 Gy (RBE) and 1.47 Gy (RBE) in the USPT and IMPT plans, respectively. Dependency on grid size was not very clear for the organs at risk (OARs), with average difference ranged from -0.61 Gy (RBE) to 0.53 Gy (RBE) in the USPT plans and from -0.83 Gy (RBE) to 1.39 Gy (RBE) in the IMPT plans. In conclusion, the difference in the calculated point dose between the smallest grid size (1 mm) and the largest grid size (3 mm) in phantom for USPT was typically less than 0.1%. Patient study results showed that the decrease in grid size slightly increased the PTV maximum dose in both the USPT and IMPT plans. However, no distinct trend was obtained between the absolute difference in dosimetric parameter and dose calculation grid size for the OARs. Grid size has a large effect on dose calculation efficiency, and use of 2 mm or less grid size can increase the

  10. Targeting: The Joint Targeting Process and Procedures for Targeting Time-Critical Targets

    DTIC Science & Technology

    1997-07-01

    680-3153 COMM (757) 727-3153 Marine Corps Commanding General US Marine Corps Combat Development Command ATTN: C42 3300 Russell Road Quantico VA...Plans Division) - Boblingen, GE Marine Corps Combat Development Command, C42 - Quantico VA Marine Corps Combat Development Command, MSTP - Quantico VA...as the target reference point ( TRP ) concept, that are used to quickly identify a target off of a known geographic point. (a) Bullseye Design

  11. Will weight loss cause significant dosimetric changes of target volumes and organs at risk in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy?

    SciTech Connect

    Chen, Chuanben; Fei, Zhaodong; Chen, Lisha; Bai, Penggang; Lin, Xiang; Pan, Jianji

    2014-04-01

    This study aimed to quantify dosimetric effects of weight loss for nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Overall, 25 patients with NPC treated with IMRT were enrolled. We simulated weight loss during IMRT on the computer. Weight loss model was based on the planning computed tomography (CT) images. The original external contour of head and neck was labeled plan 0, and its volume was regarded as pretreatment normal weight. We shrank the external contour with different margins (2, 3, and 5 mm) and generated new external contours of head and neck. The volumes of reconstructed external contours were regarded as weight during radiotherapy. After recontouring outlines, the initial treatment plan was mapped to the redefined CT scans with the same beam configurations, yielding new plans. The computer model represented a theoretical proportional weight loss of 3.4% to 13.7% during the course of IMRT. The dose delivered to the planning target volume (PTV) of primary gross tumor volume and clinical target volume significantly increased by 1.9% to 2.9% and 1.8% to 2.9% because of weight loss, respectively. The dose to the PTV of gross tumor volume of lymph nodes fluctuated from −2.0% to 1.0%. The dose to the brain stem and the spinal cord was increased (p < 0.001), whereas the dose to the parotid gland was decreased (p < 0.001). Weight loss may lead to significant dosimetric change during IMRT. Repeated scanning and replanning for patients with NPC with an obvious weight loss may be necessary.

  12. TH-C-BRD-10: An Evaluation of Three Robust Optimization Approaches in IMPT Treatment Planning

    SciTech Connect

    Cao, W; Randeniya, S; Mohan, R; Zaghian, M; Kardar, L; Lim, G; Liu, W

    2014-06-15

    Purpose: Various robust optimization approaches have been proposed to ensure the robustness of intensity modulated proton therapy (IMPT) in the face of uncertainty. In this study, we aim to investigate the performance of three classes of robust optimization approaches regarding plan optimality and robustness. Methods: Three robust optimization models were implemented in our in-house IMPT treatment planning system: 1) L2 optimization based on worst-case dose; 2) L2 optimization based on minmax objective; and 3) L1 optimization with constraints on all uncertain doses. The first model was solved by a L-BFGS algorithm; the second was solved by a gradient projection algorithm; and the third was solved by an interior point method. One nominal scenario and eight maximum uncertainty scenarios (proton range over and under 3.5%, and setup error of 5 mm for x, y, z directions) were considered in optimization. Dosimetric measurements of optimized plans from the three approaches were compared for four prostate cancer patients retrospectively selected at our institution. Results: For the nominal scenario, all three optimization approaches yielded the same coverage to the clinical treatment volume (CTV) and the L2 worst-case approach demonstrated better rectum and bladder sparing than others. For the uncertainty scenarios, the L1 approach resulted in the most robust CTV coverage against uncertainties, while the plans from L2 worst-case were less robust than others. In addition, we observed that the number of scanning spots with positive MUs from the L2 approaches was approximately twice as many as that from the L1 approach. This indicates that L1 optimization may lead to more efficient IMPT delivery. Conclusion: Our study indicated that the L1 approach best conserved the target coverage in the face of uncertainty but its resulting OAR sparing was slightly inferior to other two approaches.

  13. WE-EF-BRA-04: Evaluation of Dosimetric Uncertainties in Individualized Targeted Radionuclide Therapy (TRT) Treatment Planning Using Pre-Clinical Data

    SciTech Connect

    Besemer, A; Bednarz, J B; Grudzinski, J; Titz, B

    2015-06-15

    Purpose: Dosimetry for targeted radionuclide therapy (TRT) is moving away from conventional model-based methods towards patient-specific approaches. To address this need, a Monte Carlo (MC) dosimetry platform was developed to estimate patient-specific therapeutic 3D dose distributions based on pre-treatment imaging. However, because a standard practice for patient-specific internal dosimetry has not yet been established, there are many sources of dosimetric uncertainties. The goal of this work was to quantify the sensitivity of various parameters on MC dose estimations. Methods: The ‘diapeutic’ agent, CLR1404, was used as a proof-of-principle compound in this work. CLR1404 can be radiolabeled with either {sup 124}I for PET imaging or {sup 131}I for radiotherapy or SPECT imaging. PET/CT images of 5 mice were acquired out to 240 hrs post-injection of {sup 124}I-CLR1404. The therapeutic {sup 131}I-CLR1404 absorbed dose (AD) distribution was calculated using a Geant4-based MC dosimetry platform. A series of sensitivity studies were performed. The variables that were investigated included the PET/CT voxel resolution, partial volume corrections (PVC), material segmentation, inter-observer contouring variability, and the pre-treatment image acquisition frequency. Results: Resampling the PET/CT voxel size between 0.2–0.8 mm resulted in up to a 13% variation in the mean AD. Application of the PVC increased the mean AD by 0.5–11.2%. Less than 1% differences in ROI mean AD were observed between the tissue segmentation schemes using 4 and 27 different material compositions. Inter-observer contouring variability led to up to a 20% CoV (stdev/mean) in the mean AD between the users. Varying the number and frequency of pre-treatment images used resulted in changes in mean AD up to 176% compared to the case using all 12 images. Conclusion: Voxel resolution, contour segmentation, the image acquisition protocol most significantly impacted patient-specific TRT dosimetry

  14. SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

    SciTech Connect

    McGuire, S; Bhatia, S; Sun, W; Menda, Y; Ponto, L; Gross, B; Buatti, J

    2015-06-15

    Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bones from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.

  15. Target-Rich Environment

    ERIC Educational Resources Information Center

    Perna, Mark C.

    2005-01-01

    Target marketing is defining school enrollment goals and then developing a strategic plan to accomplish those goals through the use of specific communication vehicles and community focus. It is critical to reach the right audience, with the right message, at the right time, for the right cost. In this brief article, the author describes several…

  16. Future Fixed Target Facilities

    SciTech Connect

    Melnitchouk, Wolodymyr

    2009-01-01

    We review plans for future fixed target lepton- and hadron-scattering facilities, including the 12 GeV upgraded CEBAF accelerator at Jefferson Lab, neutrino beam facilities at Fermilab, and the antiproton PANDA facility at FAIR. We also briefly review recent theoretical developments which will aid in the interpretation of the data expected from these facilities.

  17. SU-E-T-574: Novel Chance-Constrained Optimization in Intensity-Modulated Proton Therapy Planning to Account for Range and Patient Setup Uncertainties

    SciTech Connect

    An, Y; Liang, J; Liu, W

    2015-06-15

    Purpose: We propose to apply a probabilistic framework, namely chanceconstrained optimization, in the intensity-modulated proton therapy (IMPT) planning subject to range and patient setup uncertainties. The purpose is to hedge against the influence of uncertainties and improve robustness of treatment plans. Methods: IMPT plans were generated for a typical prostate patient. Nine dose distributions are computed — the nominal one and one each for ±5mm setup uncertainties along three cardinal axes and for ±3.5% range uncertainty. These nine dose distributions are supplied to the solver CPLEX as chance constraints to explicitly control plan robustness under these representative uncertainty scenarios with certain probability. This probability is determined by the tolerance level. We make the chance-constrained model tractable by converting it to a mixed integer optimization problem. The quality of plans derived from this method is evaluated using dose-volume histogram (DVH) indices such as tumor dose homogeneity (D5% – D95%) and coverage (D95%) and normal tissue sparing like V70 of rectum, V65, and V40 of bladder. We also compare the results from this novel method with the conventional PTV-based method to further demonstrate its effectiveness Results: Our model can yield clinically acceptable plans within 50 seconds. The chance-constrained optimization produces IMPT plans with comparable target coverage, better target dose homogeneity, and better normal tissue sparing compared to the PTV-based optimization [D95% CTV: 67.9 vs 68.7 (Gy), D5% – D95% CTV: 11.9 vs 18 (Gy), V70 rectum: 0.0 % vs 0.33%, V65 bladder: 2.17% vs 9.33%, V40 bladder: 8.83% vs 21.83%]. It also simultaneously makes the plan more robust [Width of DVH band at D50%: 2.0 vs 10.0 (Gy)]. The tolerance level may be varied to control the tradeoff between plan robustness and quality. Conclusion: The chance-constrained optimization generates superior IMPT plan compared to the PTV-based optimization with

  18. A strategic action plan for achieving uncompromising "treat to target" in individuals with insulin-dependent diabetes: a report by the Center for Insulin-Dependent Diabetes Access' Blue Ribbon Panel.

    PubMed

    Rudolf, Paul; Bartelme, Amanda

    2005-10-01

    management and the "team" approach for treating diabetes in improving quality of life and reducing the incidence of long-term diabetes-related complications. Finding 6: Demographic characteristics of individuals with insulin-dependent diabetes require innovative approaches to patient education, outreach, and patient-centric care in order to achieve a "Treat to Target" objective. In the detailed report that follows, each finding is accompanied by a series of recommended action items intended to address the barriers that the Panel identified. A number of entities and organizations have ongoing and planned activities intended to improve diabetes care, particularly for individuals with insulin-dependent diabetes. The Panel recommended that the diabetes community work to coordinate those efforts in order to avoid duplication and ensure more effective program management of those activities.

  19. Prostate Planning Treatment Volume Margin Calculation Based on the ExacTrac X-Ray 6D Image-Guided System: Margins for Various Clinical Implementations

    SciTech Connect

    Alonso-Arrizabalaga, Sara Brualla Gonzalez, Luis; Rosello Ferrando, Juan V.; Pastor Peidro, Jorge; Lopez Torrecilla, Jose; Planes Meseguer, Domingo; Garcia Hernandez, Trinidad

    2007-11-01

    Purpose: To assess the prostate motion from day-to-day setup, as well as during irradiation time, to calculate planning target volume (PTV) margins. PTV margins differ depending on the clinical implementation of an image-guided system. Three cases were considered in this study: daily bony anatomy match, center of gravity of the implanted marker seeds calculated with a limited number of imaged days, and daily online correction based on implanted marker seeds. Methods and Materials: A cohort of 30 nonrandomized patients and 1,330 pairs of stereoscopic kV images have been used to determine the prostate movement. The commercial image guided positioning tool employed was ExacTrac X-Ray 6D (BrainLAB AG, Feldkirchen, Germany). Results: Planning target volume margins such that a minimum of 95% of the prescribed dose covers the clinical target volume for 90% of the population are presented. PTV margins based on daily bony anatomy match, including intrafraction correction, would be 11.5, 13.5, and 4.5 mm in the anterior-posterior, superior-inferior, and right-left directions, respectively. This margin can be further reduced to 8.1, 8.6, and 4.8 mm (including intrafraction motion) if implanted marker seeds are used. Finally, daily on line correction based on marker seeds would result in the smallest of the studied margins: 4.7, 6.2, and 1.9 mm. Conclusion: Planning target volume margins are dependent on the local clinical use of the image-guided RT system available in any radiotherapy department.

  20. SU-D-19A-06: The Effect of Beam Parameters On Very High-Energy Electron Radiotherapy: A Planning Study

    SciTech Connect

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

    2014-06-01

    Purpose: We evaluated the effect of very high-energy electron (VHEE) beam parameters on the planning of a lung cancer case by means of Monte Carlo simulations. Methods: We simulated VHEE radiotherapy plans using the EGSnrc/BEAMnrc-DOSXYZnrc code. We selected a lung cancer case that was treated with 6MV photon VMAT to be planned with VHEE. We studied the effect of beam energy (80 MeV, 100 MeV, and 120 MeV), number of equidistant beams (16 or 32), and beamlets sizes (3 mm, 5 mm or 7 mm) on PTV coverage, sparing of organs at risk (OARs) and dose conformity. Inverse-planning optimization was performed in a research version of RayStation (RaySearch Laboratories AB) using identical objective functions and constraints for all VHEE plans. Results: Similar PTV coverage and dose conformity was achieved by all the VHEE plans. The 100 MeV and 120 MeV VHEE plans were equivalent amongst them and were superior to the 80 MeV plan in terms of OARs sparing. The effect of using 16 or 32 equidistant beams was a mean difference in average dose of 2.4% (0%–7.7%) between the two plans. The use of 3 mm beamlet size systematically reduced the dose to all the OARs. Based on these results we selected the 100MeV-16beams-3mm-beamlet-size plan to compare it against VMAT. The selected VHEE plan was more conformal than VMAT and improved OAR sparing (heart and trachea received 125% and 177% lower dose, respectively) especially in the low-dose region. Conclusion: We determined the VHEE beam parameters that maximized the OAR dose sparing and dose conformity of the actually delivered VMAT plan of a lung cancer case. The selected parameters could be used for the planning of other treatment sites with similar size, shape, and location. For larger targets, a larger beamlet size might be used without significantly increasing the dose. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Americas. E Hynning: Employee, RaySearch Americas. B Qu: None. B Loo Jr.: Research support, Ray

  1. SU-E-T-461: Validation of Planning Algorithms in Dynamic Conformal Arc in IPlan Using ArcCHECK and 3DVH

    SciTech Connect

    Lei, Y; Zhang, Q; Li, S; Morgan, B; Driewer, J; Zhou, S

    2014-06-01

    Purpose: To study the effect of limited angular resolution of pencil beam calculation (PBC) on dynamic conformal arc plan (DCAP) in iPlan (BrainLab) using the ArcCHECK sytem and 3DVH software (Sun Nuclear Corporation). Methods: Four DCAPs were generated in iPlan RT Dose 4.5 treatment planning system on the ArcCHECK cylindrical phantom with central planning target volume (PTV). A cylindrical shell structure (SHELL) 2.85cm from phantom surface and 1.5 mm thickness was created to simulate the ArcCHECK diode array. Planned doses were calculated using both Monte Carlo calculation (MCC) and PBC algorithms, and exported to 3DVH software for global and target based comparisons using the 3Dgamma index. Four additional DCAPs were created and calculated on patient CT images and mapped onto the ArcCHECK phantom for measurement using a Varian TrueBeam STx. The measurements were compared against both MC and PB calculation using gamma index analysis. Results: For the ArcCHECK phantom, the dose distribution agreement quantified with 3D-gamma index is better (average-gamma (<γ>)=99.9%vs.79.1% and 96.8%vs45.7%, p=0.0294, 0.0286 for gamma (2mm,2%) and (1mm,1%) criteria respectively using Mann-Whitney U test) in the PTV than in the SHELL. The measurements show better agreement with MCC than the PB (<γ>=100%vs.86.7%, 99.6%vs.72.3%, 85.5%vs.50.8%, p=0.021, 0.026, 0.029 for gamma (3mm,3%), (2mm,2%) and (1mm,1%) criteria using Mann-Whitney U test respectively). The effect due to limited (10 degree) angular resolution of the PBC was observed, and it can be one of the possible reasons for poor agreement between measurement and PB calculation. Conclusion: The PBC of iPlan shows poor peripheral dose calculation accuracy for dynamic conformal arc plans due to limited angular resolution, but it performs well in the area close to target volume without considering heterogeneity. Since the user cannot change the 10 degree angular resolution of PBC, MCC is more appropriate for dynamic conformal

  2. 23 CFR 1200.25 - Improvement plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Improvement plan. 1200.25 Section 1200.25 Highways... Implementation and Management of the Highway Safety Program § 1200.25 Improvement plan. If a review of the Annual... improvement plan. This plan will detail strategies, program activities, and funding targets to meet...

  3. An efficient Volumetric Arc Therapy treatment planning approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT)

    SciTech Connect

    Shen, Jin; Bender, Edward; Yaparpalvi, Ravindra; Kuo, Hsiang-Chi; Basavatia, Amar; Hong, Linda; Bodner, William; Garg, Madhur K.; Kalnicki, Shalom; Tomé, Wolfgang A.

    2015-10-01

    An efficient and simple class solution is proposed for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT) planning using the Volumetric Arc Therapy (VMAT) delivery technique following the NRG Oncology protocol NRG-CC001 treatment planning guidelines. The whole-brain planning target volume (PTV) was subdivided into subplanning volumes that lie in plane and out of plane with the hippocampal-avoidance volume. To further improve VMAT treatment plans, a partial-field dual-arc technique was developed. Both the arcs were allowed to overlap on the in-plane subtarget volume, and in addition, one arc covered the superior out-of-plane sub-PTV, while the other covered the inferior out-of-plane subtarget volume. For all plans (n = 20), the NRG-CC001 protocol dose-volume criteria were met. Mean values of volumes for the hippocampus and the hippocampal-avoidance volume were 4.1 cm{sup 3} ± 1.0 cm{sup 3} and 28.52 cm{sup 3} ± 3.22 cm{sup 3}, respectively. For the PTV, the average values of D{sub 2%} and D{sub 98%} were 36.1 Gy ± 0.8 Gy and 26.2 Gy ± 0.6 Gy, respectively. The hippocampus D{sub 100%} mean value was 8.5 Gy ± 0.2 Gy and the maximum dose was 15.7 Gy ± 0.3 Gy. The corresponding plan quality indices were 0.30 ± 0.01 (homogeneity index), 0.94 ± 0.01 (target conformality), and 0.75 ± 0.02 (confirmation number). The median total monitor unit (MU) per fraction was 806 MU (interquartile range [IQR]: 792 to 818 MU) and the average beam total delivery time was 121.2 seconds (IQR: 120.6 to 121.35 seconds). All plans passed the gamma evaluation using the 5-mm, 4% criteria, with γ > 1 of not more than 9.1% data points for all fields. An efficient and simple planning class solution for HA-WBRT using VMAT has been developed that allows all protocol constraints of NRG-CC001 to be met.

  4. Thermal Test on Target with Pressed Disks

    SciTech Connect

    Woloshun, Keith Albert; Dale, Gregory E.; Olivas, Eric Richard; Romero, Frank Patrick; Dalmas, Dale Allen; Chemerisov, Sergey; Gromov, Roman; Lowden, Rick

    2016-05-27

    A thorough test of the thermal performance of a target for Mo99 production using solid Mo100 target to produce the Mo99 via a gamma-n reaction has previously been conducted at Argonne National Laboratory (ANL). The results are reported in “Zero Degree Line Mo Target Thermal Test Results and Analysis,” LANL report Number LA-UR-15-23134 dated 3/27/15. This target was comprised of 25 disks 1 mm thick and 12 mm in diameter, separated by helium coolant gaps 0.5 mm wide. The test reported in the above referenced report was conducted with natural Mo disks all cut from commercial rod. The production plant will have Mo100 disks pressed and sintered using a process being developed at Oak Ridge National Laboratory (ORNL). The structural integrity of press-and-sinter disks is of some concern. The test reported herein included 4 disks made by the ORNL process and placed in the high heat, and therefore high thermal stress, region of the target. The electron beam energy was 23 MeV for these tests. Beam spot size was 3.5 mm horizontal and 3 mm vertical, FWHM. The thermal stress test of pressed-and-sintered disks resulted in no mechanical failures. The induced thermal stresses were below yield stress for natural Mo, indicating that up to that stress state no inherent deficiencies in the mechanical properties of the fabricated disks were evident.

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

    PubMed

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

    2006-05-01

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

  6. Maximum-Intensity Volumes for Fast Contouring of Lung Tumors Including Respiratory Motion in 4DCT Planning

    SciTech Connect

    Rietzel, Eike Liu, Arthur K.; Chen, George T.Y.; Choi, Noah C.

    2008-07-15

    Purpose: To assess the accuracy of maximum-intensity volumes (MIV) for fast contouring of lung tumors including respiratory motion. Methods and Materials: Four-dimensional computed tomography (4DCT) data of 10 patients were acquired. Maximum-intensity volumes were constructed by assigning the maximum Hounsfield unit in all CT volumes per geometric voxel to a new, synthetic volume. Gross tumor volumes (GTVs) were contoured on all CT volumes, and their union was constructed. The GTV with all its respiratory motion was contoured on the MIV as well. Union GTVs and GTVs including motion were compared visually. Furthermore, planning target volumes (PTVs) were constructed for the union of GTVs and the GTV on MIV. These PTVs were compared by centroid position, volume, geometric extent, and surface distance. Results: Visual comparison of GTVs demonstrated failure of the MIV technique for 5 of 10 patients. For adequate GTV{sub MIV}s, differences between PTVs were <1.0 mm in centroid position, 5% in volume, {+-}5 mm in geometric extent, and {+-}0.5 {+-} 2.0 mm in surface distance. These values represent the uncertainties for successful MIV contouring. Conclusion: Maximum-intensity volumes are a good first estimate for target volume definition including respiratory motion. However, it seems mandatory to validate each individual MIV by overlaying it on a movie loop displaying the 4DCT data and editing it for possible inadequate coverage of GTVs on additional 4DCT motion states.

  7. SU-E-T-450: Dosimetric Impact of Rotational Error On Multiple-Target Intensity-Modulated Radiosurgery (IMRS) with Single-Isocenter

    SciTech Connect

    Jang, S; Huq, M

    2014-06-01

    Purpose: Evaluating the dosimetric-impact on multiple-targets placed away from the isocenter-target with varying rotational-error introduced by initial setup uncertainty and/or intrafractional-movement Methods: CyberKnife-Phantom was scanned with the Intracranial SRS-protocol of 1.25mm slice-thickness and the multiple-targets(GTV) of 1mm and 10mm in diameter were contoured on the Eclipse. PTV for distal-target only was drawn with 1mm expansion around the GTV to find out how much margin is needed to compensate for the rotational-error. The separation between the isocenter-target and distal-target was varied from 3cm to 7cm. RapidArc-based IMRS plans of 16Gy single-fraction were generated with five non-coplanar arcs by using Varian TrueBeam-STx equipped with high resolution MLC leaves of 2.5mm at center and with dose-rate of 1400MU/min at 6MV for flatteringfilter- free(FFF). An identical CT image with intentionally introduced 1° rotational-error was registered with the planning CT image, and the isodose distribution and Dose-Volume-Histogram(DVH) were compared with the original plans. Additionally, the dosimetric-impact of rotational error was evaluated with that of 6X photon energy which was generated with the same target-coverage. Results: For the 1mm-target with 6X-FFF, PTV-coverage(D100) of the distal-target with 1° rotational-error decreased from 1.00 to 0.35 as the separation between isocenter-target and distal-target increased from 3cm to 7cm. However, GTV-coverage(D100) was 1.0 except that of 7cm-separation(0.55), which resulted from the 1mm-margin around the distal-target. For 6X photon, GTV-coverage remained at 1.0 regardless of the separation of targets, showing that the dosimetric-impact of rotational error depends on the degree of rotational-error, separation of targets, and dose distribution around targets. For 10mm-target, PTV-coverage of distaltarget located 3cm-away was better than that of 1mm-target(0.93 versus 0.7) and GTV-coverage was 1

  8. Sputter target

    DOEpatents

    Gates, Willard G.; Hale, Gerald J.

    1980-01-01

    The disclosure relates to an improved sputter target for use in the deposition of hard coatings. An exemplary target is given wherein titanium diboride is brazed to a tantalum backing plate using a gold-palladium-nickel braze alloy.

  9. Two-dimensional inverse planning and delivery with a preclinical image guided microirradiator

    SciTech Connect

    Stewart, James M. P.; Lindsay, Patricia E.; Jaffray, David A.

    2013-10-15

    Purpose: Recent advances in preclinical radiotherapy systems have provided the foundation for scaling many of the elements of clinical radiation therapy practice to the dimensions and energy demanded in small animal studies. Such systems support the technical capabilities to accurately deliver highly complex dose distributions, but methods to optimize and deliver such distributions remain in their infancy. This study developed an optimization method based on empirically measured two-dimensional dose kernel measurements to deliver arbitrary planar dose distributions on a recently developed small animal radiotherapy platform.Methods: A two-dimensional dose kernel was measured with repeated radiochromic film measurements for the circular 1 mm diameter fixed collimator of the small animal radiotherapy system at 1 cm depth in a solid water phantom. This kernel was utilized in a sequential quadratic programming optimization framework to determine optimal beam positions and weights to deliver an arbitrary desired dose distribution. The positions and weights were then translated to a set of stage motions to automatically deliver the optimized dose distribution. End-to-end efficacy of the framework was quantified through five repeated deliveries of two dosimetric challenges: (1) a 5 mm radius bullseye distribution, and (2) a “sock” distribution contained within a 9 × 13 mm bounding box incorporating rectangular, semicircular, and exponentially decaying geometric constructs and a rectangular linear dose gradient region. These two challenges were designed to gauge targeting, geometric, and dosimetric fidelity.Results: Optimization of the bullseye and sock distributions required 2.1 and 5.9 min and utilized 50 and 77 individual beams for delivery, respectively. Automated delivery of the resulting optimized distributions, validated using radiochromic film measurements, revealed an average targeting accuracy of 0.32 mm, and a dosimetric delivery error along four line

  10. Targeted Cleaning.

    ERIC Educational Resources Information Center

    Frank, David J.

    1998-01-01

    Discusses the creation of an effective carpet vacuuming program by combining area usage assessment and vacuuming requirements with a scheduling plan. Also explains vacuum cleaner suction and filtration and how it makes custodian work more efficient. A complementary article discusses creating an effective floor-maintenance plan for resilient…

  11. Leaders as Targets

    DTIC Science & Technology

    2008-05-16

    military commanders, when they plan the use of mili- tary power in crisis resolution. Belligerents in modern history have generally balked at... political structures cul- tivated their view that “. . . by 1632 a collective understanding was emerging that the ‘appropriate and legitimate’ means...13 Moreover, “during peacetime, the targeted killing of any individual, whether a combatant or not, is generally considered an assassination and is

  12. Cassini science planning process

    NASA Technical Reports Server (NTRS)

    Paczkowski, Brian G.; Ray, Trina L.

    2004-01-01

    The mission design for Cassini-Huygens calls for a four-year orbital survey of the Saturnian system and the descent into the Titan atmosphere and eventual soft-landing of the Huygens probe. The Cassini orbiter tour consists of 76 orbits around Saturn with 44 close Titan flybys and 8 targeted icy satellite flybys. The Cassini orbiter spacecraft carries twelve scientific instruments that will perform a wide range of observations on a multitude of designated targets. The science opportunities, frequency of encounters, the length of the Tour, and the use of distributed operations pose significant challenges for developing the science plan for the orbiter mission. The Cassini Science Planning Process is the process used to develop and integrate the science and engineering plan that incorporates an acceptable level of science required to meet the primary mission objectives far the orbiter. The bulk of the integrated science and engineering plan will be developed prior to Saturn Orbit Insertion (Sol). The Science Planning Process consists of three elements: 1) the creation of the Tour Atlas, which identifies the science opportunities in the tour, 2) the development of the Science Operations Plan (SOP), which is the conflict-free timeline of all science observations and engineering activities, a constraint-checked spacecraft pointing profile, and data volume allocations to the science instruments, and 3) an Aftermarket and SOP Update process, which is used to update the SOP while in tour with the latest information on spacecraft performance, science opportunities, and ephemerides. This paper will discuss the various elements of the Science Planning Process used on the Cassini Mission to integrate, implement, and adapt the science and engineering activity plans for Tour.

  13. Quantitative Analysis of Extracapsular Extension of Metastatic Lymph Nodes and its Significance in Radiotherapy Planning in Head and Neck Squamous Cell Carcinoma

    SciTech Connect

    Ghadjar, Pirus; Schreiber-Facklam, Heide; Graeter, Ruth; Evers, Christina; Simcock, Mathew; Geretschlaeger, Andreas; Blumstein, Norbert M.; Zbaeren, Peter; Zimmer, Yitzhak; Wilkens, Ludwig; Aebersold, Daniel M.

    2010-03-15

    Purpose: We performed a histopathologic analysis to assess the extent of the extracapsular extension (ECE) beyond the capsule of metastatic lymph nodes (LN) in head and neck cancer to determine appropriate clinical target volume (CTV) expansions. Methods and Materials: All tumor-positive LN of 98 patients who underwent a neck dissection with evidence of ECE in at least one LN were analyzed by a single pathologist. The largest diameters of all LN, and in the case of ECE, the maximal linear distance, from the capsule to the farthest extent of tumor or tumoral reaction were recorded. Results: A total of 231 LN with ECE and 200 tumor-positive LN without ECE were analyzed. The incidence of ECE was associated with larger LN size (p < 0.001). Of all tumor-positive LN with a diameter of < 10 mm or < 5 mm, 105/220 (48%) nodes or 17/59 (29%) nodes, respectively, showed evidence of ECE. The mean and median extent values of ECE were 2 and 1 mm (range, 1-10 mm) and the ECE was <= 5 mm in 97% and <= 3 mm in 91% of the LN, respectively. Overall, the extent of ECE was significantly correlated with larger LN size (Spearman's correlation coefficient = 0.21; p = 0.001). Conclusions: The incidence of ECE is associated with larger LN size. However, ECE is found in a substantial number of LN with a diameter of < 10 mm. The use of 10-mm CTV margins around the gross tumor volume seems appropriate to account for ECE in radiotherapy planning of head and neck cancer.

  14. Fire Plans

    ERIC Educational Resources Information Center

    Power, June

    2011-01-01

    Many libraries have disaster recovery plans, but not all have prevention and action plans to prepare for an emergency in advance. This article presents the author's review of the prevention and action plans of several libraries: (1) Evergreen State College; (2) Interlochen Public Library; (3) University of Maryland, Baltimore-Marshall Law Library;…

  15. Planning Handbook.

    ERIC Educational Resources Information Center

    Paddock, Susan C.; Mercure, Nancy

    This handbook was designed to assist advisory councils, program staff and administrators, and community members in planning community education programs and in managing those programs effectively. Chapter I defines and describes planning: what it is, why it is used, and how to engage in the process. The critical role of planning leaders is…

  16. Anatomic Boundaries of the Clinical Target Volume (Prostate Bed) After Radical Prostatectomy

    SciTech Connect

    Wiltshire, Kirsty L.; Brock, Kristy K.; Haider, Masoom A.; Zwahlen, Daniel; Kong, Vickie; Chan, Elisa; Moseley, Joanne; Bayley, Andrew; Catton, Charles; Chung, Peter W.M.; Gospodarowicz, Mary; Milosevic, Michael; Kneebone, Andrew; Warde, Padraig; Menard, Cynthia

    2007-11-15

    Purpose: We sought to derive and validate an interdisciplinary consensus definition for the anatomic boundaries of the postoperative clinical target volume (CTV, prostate bed). Methods and Materials: Thirty one patients who had planned for radiotherapy after radical prostatectomy were enrolled and underwent computed tomography and magnetic resonance imaging (MRI) simulation prior to radiotherapy. Through an iterative process of consultation and discussion, an interdisciplinary consensus definition was derived based on a review of published data, patterns of local failure, surgical practice, and radiologic anatomy. In validation, we analyzed the distribution of surgical clips in reference to the consensus CTV and measured spatial uncertainties in delineating the CTV and vesicourethral anastomosis. Clinical radiotherapy plans were retrospectively evaluated against the consensus CTV (prostate bed). Results: Anatomic boundaries of the consensus CTV (prostate bed) are described. Surgical clips (n = 339) were well distributed throughout the CTV. The vesicourethral anastomosis was accurately localized using central sagittal computed tomography reconstruction, with a mean {+-} standard deviation uncertainty of 1.8 {+-} 2.5 mm. Delineation uncertainties were small for both MRI and computed tomography (mean reproducibility, 0-3.8 mm; standard deviation, 1.0-2.3); they were most pronounced in the anteroposterior and superoinferior dimensions and at the superior/posterior-most aspect of the CTV. Retrospectively, the mean {+-} standard deviation CTV (prostate bed) percentage of volume receiving 100% of prescribed dose was only 77% {+-} 26%. Conclusions: We propose anatomic boundaries for the CTV (prostate bed) and present evidence supporting its validity. In the absence of gross recurrence, the role of MRI in delineating the CTV remains to be confirmed. The CTV is larger than historically practiced at our institution and should be encompassed by a microscopic tumoricidal dose.

  17. SU-E-T-615: Plan Comparison Between Photon IMRT and Proton Plans Incorporating Uncertainty Analysis

    SciTech Connect

    Cheng, C; Wessels, B; Jesseph, F; Mattson, D; Mansur, D

    2015-06-15

    Purpose: In this study, we investigate the effect of setup uncertainty on DVH calculations which may impact plan comparison. Methods: Treatment plans (6 MV VMAT calculated on Pinnacle TPS) were chosen for different disease sites: brain, prostate, H&N and spine in this retrospective study. A proton plan (PP) using double scattering beams was generated for each selected VMAT plan subject to the same set of dose-volume constraints as in VMAT. An uncertainty analysis was incorporated on the DVH calculations in which isocenter shifts from 1 to 5 mm in each of the ±x, ±y and ±z directions were used to simulate the setup uncertainty and residual positioning errors. A total of 40 different combinations of isocenter shifts were used in the re-calculation of DVH of the PTV and the various OARs for both the VMAT and the corresponding PT. Results: For the brain case, both VMAT and PP are comparable in PTV coverage and OAR sparing, and VMAT is a clear choice for treatment due to its ease of delivery. However, when incorporating isoshifts in DVH calculations, a significant change in dose-volume relationship emerges. For example, both VMAT and PT provide adequate coverage, even with ±3mm isoshift. However, +3mm isoshift results in increase of V40(Lcochlea, VMAT) from 7.2% in the original plan to 45% and V40(R cochlea, VMAT) from 75% to 92%. For protons, V40(Lcochlea, PT) increases from 62% in the initial plan to 75%, while V40(Rcochea, PT) increases from 7% to 26%. Conclusion: DVH alone may not be sufficient to allow an unequivocal decision in plan comparison, especially when two rival plans are very similar in both PTV coverage and OAR sparing. It is a good practice to incorporate uncertainty analysis on photon and proton plan comparison studies to test the plan robustness in plan evaluation.

  18. Magnetic Resonance Imaging Distortion and Targeting Errors from Strong Rare Earth Metal Magnetic Dental Implant Requiring Revision.

    PubMed

    Seong-Cheol, Park; Chong Sik, Lee; Seok Min, Kim; Eu Jene, Choi; Do Hee, Lee; Jung Kyo, Lee

    2016-12-22

    Recently, the use of magnetic dental implants has been re-popularized with the introduction of strong rare earth metal, for example, neodymium, magnets. Unrecognized magnetic dental implants can cause critical magnetic resonance image distortions. We report a case involving surgical failure caused by a magnetic dental implant. A 62-year-old man underwent deep brain stimulation for medically insufficiently controlled Parkinson's disease. Stereotactic magnetic resonance imaging performed for the first deep brain stimulation showed that the overdenture was removed. However, a dental implant remained and contained a neodymium magnet, which was unrecognized at the time of imaging; the magnet caused localized non-linear distortions that were the largest around the dental magnets. In the magnetic field, the subthalamic area was distorted by a 4.6 mm right shift and counter clockwise rotation. However, distortions were visually subtle in the operation field and small for distant stereotactic markers, with approximately 1-2 mm distortions. The surgeon considered the distortion to be normal asymmetry or variation. Stereotactic marker distortion was calculated to be in the acceptable range in the surgical planning software. Targeting errors, approximately 5 mm on the right side and 2 mm on the left side, occurred postoperatively. Both leads were revised after the removal of dental magnets. Dental magnets may cause surgical failures and should be checked and removed before stereotactic surgery. Our findings should be considered when reviewing surgical precautions and making distortion-detection algorithm improvements.

  19. Men and Family Planning. Worldwatch Paper 41.

    ERIC Educational Resources Information Center

    Stokes, Bruce

    This monograph focuses on men's potentially positive role in family planning. In addition, it identifies reasons why so few organized family planning programs have targeted men as clients and why men have so often played a peripheral or negative role in family planning. The document is presented in seven chapters. Chapter I introduces the topic…

  20. A study on repainting strategies for treating moderately moving targets with proton pencil beam scanning at the new Gantry 2 at PSI

    NASA Astrophysics Data System (ADS)

    Zenklusen, S. M.; Pedroni, E.; Meer, D.

    2010-09-01

    Treating moving targets using a scanning gantry for proton therapy is a promising but very challenging, not yet clinically demonstrated treatment modality. The interference of organ motion with the sequence of the beam delivery produces uncontrolled dose inhomogeneities within the target. One promising approach to overcome this difficulty is to increase the speed of scanning in order to apply the dose repeatedly (so-called repainting). To obtain sufficiently high scanning speeds a new, technologically improved gantry—Gantry 2—has been designed and is currently under construction at PSI. As there are many possible repainting strategies, the way repainting will be implemented on Gantry 2 will depend on the result of a careful analysis of the various treatment delivery strategies available. To achieve this aim, and prior to the start of experimental work with Gantry 2, simulations of dose distribution errors due to organ motion under various beam delivery strategies were investigated. The effects of motion on the dose distribution were studied for moderate motion amplitudes (5 mm) for spherical target volumes in a homogeneous medium and with homogeneous dose. In total over 200 000 dose distributions have been simulated and analyzed and selected results are discussed. From the obtained results we are confident to be able to treat moderately moving targets on Gantry 2 using repainted pencil-beam spot scanning. Continuous line scanning seems to be the most elegant solution; it provides higher repainting rates and produces superior results but is probably more difficult to realize. For larger motion amplitudes, continuous line scanning still shows good results, but we plan anyways to use a gating system for these cases, not only to reduce the inhomogeneity within the target volume but also to reduce safety margins.

  1. Shot Planning and Analysis Tools

    SciTech Connect

    Casey, A; Beeler, R; Conder, A; Fallejo, R; Flegel, M; Hutton, M; Jancaitis, K; Lakamsani, V; Potter, D; Reisdorf, S; Tappero, J; Whitman, P; Carr, W; Liao, Z

    2011-07-25

    Shot planning and analysis tools (SPLAT) integrate components necessary to help achieve a high over-all operational efficiency of the National Ignition Facility (NIF) by combining near and long-term shot planning, final optics demand and supply loops, target diagnostics planning, and target fabrication requirements. Currently, the SPLAT project is comprised of two primary tool suites for shot planning and optics demand. The shot planning component provides a web-based interface to selecting and building a sequence of proposed shots for the NIF. These shot sequences, or 'lanes' as they are referred to by shot planners, provide for planning both near-term shots in the Facility and long-term 'campaigns' in the months and years to come. The shot planning capabilities integrate with the Configuration Management Tool (CMT) for experiment details and the NIF calendar for availability. Future enhancements will additionally integrate with target diagnostics planning and target fabrication requirements tools. The optics demand component is built upon predictive modelling of maintenance requirements on the final optics as a result of the proposed shots assembled during shot planning. The predictive models integrate energetics from a Laser Performance Operations Model (LPOM), the status of the deployed optics as provided by the online Final Optics Inspection system, and physics-based mathematical 'rules' that predict optic flaw growth and new flaw initiations. These models are then run on an analytical cluster comprised of forty-eight Linux-based compute nodes. Results from the predictive models are used to produce decision-support reports in the areas of optics inspection planning, optics maintenance exchanges, and optics beam blocker placement advisories. Over time, the SPLAT project will evolve to provide a variety of decision-support and operation optimization tools.

  2. Recce mission planning

    NASA Astrophysics Data System (ADS)

    York, Andrew M.

    2000-11-01

    The ever increasing sophistication of reconnaissance sensors reinforces the importance of timely, accurate, and equally sophisticated mission planning capabilities. Precision targeting and zero-tolerance for collateral damage and civilian casualties, stress the need for accuracy and timeliness. Recent events have highlighted the need for improvement in current planning procedures and systems. Annotating printed maps takes time and does not allow flexibility for rapid changes required in today's conflicts. We must give aircrew the ability to accurately navigate their aircraft to an area of interest, correctly position the sensor to obtain the required sensor coverage, adapt missions as required, and ensure mission success. The growth in automated mission planning system capability and the expansion of those systems to include dedicated and integrated reconnaissance modules, helps to overcome current limitations. Mission planning systems, coupled with extensive integrated visualization capabilities, allow aircrew to not only plan accurately and quickly, but know precisely when they will locate the target and visualize what the sensor will see during its operation. This paper will provide a broad overview of the current capabilities and describe how automated mission planning and visualization systems can improve and enhance the reconnaissance planning process and contribute to mission success. Think about the ultimate objective of the reconnaissance mission as we consider areas that technology can offer improvement. As we briefly review the fundamentals, remember where and how TAC RECCE systems will be used. Try to put yourself in the mindset of those who are on the front lines, working long hours at increasingly demanding tasks, trying to become familiar with new operating areas and equipment, while striving to minimize risk and optimize mission success. Technical advancements that can reduce the TAC RECCE timeline, simplify operations and instill Warfighter

  3. LIQUID TARGET

    DOEpatents

    Martin, M.D.; Salsig, W.W. Jr.

    1959-01-13

    A liquid handling apparatus is presented for a liquid material which is to be irradiated. The apparatus consists essentially of a reservoir for the liquid, a target element, a drain tank and a drain lock chamber. The target is in the form of a looped tube, the upper end of which is adapted to be disposed in a beam of atomic particles. The lower end of the target tube is in communication with the liquid in the reservoir and a means is provided to continuously circulate the liquid material to be irradiated through the target tube. Means to heat the reservoir tank is provided in the event that a metal is to be used as the target material. The apparatus is provided with suitable valves and shielding to provide maximum safety in operation.

  4. Powder Metallurgy Fabrication of Molybdenum Accelerator Target Disks

    SciTech Connect

    Lowden, Richard Andrew; Kiggans Jr., James O.; Nunn, Stephen D.; Parten, Randy J.

    2015-07-01

    Powder metallurgy approaches for the fabrication of accelerator target disks are being examined to support the development of Mo-99 production by NorthStar Medical Technologies, LLC. An advantage of powder metallurgy is that very little material is wasted and, at present, dense, quality parts are routinely produced from molybdenum powder. The proposed targets, however, are thin wafers, 29 mm in diameter with a thickness of 0.5 mm, with very stringent dimensional tolerances. Although tooling can be machined to very high tolerance levels, the operations of powder feed, pressing and sintering involve complicated mechanisms, each of which affects green density and shrinkage, and therefore the dimensions and shape of the final product. Combinations of powder morphology, lubricants and pressing technique have been explored to produce target disks with minimal variations in thickness and little or no distortion. In addition, sintering conditions that produce densities for optimum target dissolvability are being determined.

  5. Micro-channel-based high specific power lithium target

    NASA Astrophysics Data System (ADS)

    Mastinu, P.; Martın-Hernández, G.; Praena, J.; Gramegna, F.; Prete, G.; Agostini, P.; Aiello, A.; Phoenix, B.

    2016-11-01

    A micro-channel-based heat sink has been produced and tested. The device has been developed to be used as a Lithium target for the LENOS (Legnaro Neutron Source) facility and for the production of radioisotope. Nevertheless, applications of such device can span on many areas: cooling of electronic devices, diode laser array, automotive applications etc. The target has been tested using a proton beam of 2.8MeV energy and delivering total power shots from 100W to 1500W with beam spots varying from 5mm2 to 19mm2. Since the target has been designed to be used with a thin deposit of lithium and since lithium is a low-melting-point material, we have measured that, for such application, a specific power of about 3kW/cm2 can be delivered to the target, keeping the maximum surface temperature not exceeding 150° C.

  6. Time-Adjusted Internal Target Volume: A Novel Approach Focusing on Heterogeneity of Tumor Motion Based on 4-Dimensional Computed Tomography Imaging for Radiation Therapy Planning of Lung Cancer

    SciTech Connect

    Nishibuchi, Ikuno; Kimura, Tomoki; Nakashima, Takeo; Ochi, Yusuke; Takahashi, Ippei; Doi, Yoshiko; Kenjo, Masahiro; Kaneyasu, Yuko; Ozawa, Syuichi; Murakami, Yuji; Wadasaki, Koichi; Nagata, Yasushi

    2014-08-01

    Purpose: To consider nonuniform tumor motion within the internal target volume (ITV) by defining time-adjusted ITV (TTV), a volume designed to include heterogeneity of tumor existence on the basis of 4-dimensional computed tomography (4D-CT). Methods and Materials: We evaluated 30 lung cancer patients. Breath-hold CT (BH-CT) and free-breathing 4D-CT scans were acquired for each patient. The tumors were manually delineated using a lung CT window setting (window, 1600 HU; level, −300 HU). Tumor in BH-CT images was defined as gross tumor volume (GTV), and the sum of tumors in 4D-CT images was defined as ITV-4D. The TTV images were generated from the 4D-CT datasets, and the tumor existence probability within ITV-4D was calculated. We calculated the TTV{sub 80} value, which is the percentage of the volume with a tumor existence probability that exceeded 80% on ITV-4D. Several factors that affected the TTV{sub 80} value, such as the ITV-4D/GTV ratio or tumor centroid deviation, were evaluated. Results: Time-adjusted ITV images were acquired for all patients, and tumor respiratory motion heterogeneity was visualized. The median (range) ITV-4D/GTV ratio and median tumor centroid deviation were 1.6 (1.0-4.1) and 6.3 mm (0.1-30.3 mm), respectively. The median TTV{sub 80} value was 43.3% (2.9-98.7%). Strong correlations were observed between the TTV{sub 80} value and the ITV-4D/GTV ratio (R=−0.71) and tumor centroid deviation (R=−0.72). The TTV images revealed the tumor motion pattern features within ITV. Conclusions: The TTV images reflected nonuniform tumor motion, and they revealed the tumor motion pattern features, suggesting that the TTV concept may facilitate various aspects of radiation therapy planning of lung cancer while incorporating respiratory motion in the future.

  7. Dispersion of Projectile and Target Debris Upon Penetration of Thin Targets

    NASA Astrophysics Data System (ADS)

    Gwynn, D.; Bernhard, R. P.; See, T. H.; Horz, F.

    1996-03-01

    We continue to conduct penetration experiments of thin foils to support the development of cosmic-dust flight instruments that utilize thin films for the measurement of particle trajectories, or for the potential soft capture of hypervelocity impactors for subsequent compositional analysis upon retrieval to Earth. Each experiment is equipped with a witness plate, mounted to the rear of the target and fabricated from soft Aluminum-1100, ~30 x 30 cm in size and ranging from 2 to 5 mm thick; these witness plates essentially simulate the rear wall of a capture cell onto which the projectile material will plate out, including material that is being dislodged from the penetrated foil itself. Using compositionally contrasting projectile and foil materials in the laboratory, such as soda-lime glass impactors and aluminum targets, one produces two distinct populations of craters on the witness plates.

  8. The benefit of using bladder sub-volume equivalent uniform dose constraints in prostate intensity-modulated radiotherapy planning

    PubMed Central

    Zhu, Jian; Simon, Antoine; Haigron, Pascal; Lafond, Caroline; Acosta, Oscar; Shu, Huazhong; Castelli, Joel; Li, Baosheng; De Crevoisier, Renaud

    2016-01-01

    Background To assess the benefits of bladder wall sub-volume equivalent uniform dose (EUD) constraints in prostate cancer intensity-modulated radiotherapy (IMRT) planning. Methods Two IMRT plans, with and without EUD constraints on the bladder wall, were generated using beams that deliver 80 Gy to the prostate and 46 Gy to the seminal vesicles and were compared in 53 prostate cancer patients. The bladder wall was defined as the volume between the external manually delineated wall and a contraction of 7 mm apart from it. The bladder wall was then separated into two parts: the internal-bladder wall (bla-in) represented by the portion of the bladder wall that intersected with the planning target volume (PTV) plus 5 mm extension; the external-bladder wall (bla-ex) represented by the remaining part of the bladder wall. In the IMRT plan with EUD constraints, the values of “a” parameter for the EUD models were 10.0 for bla-in and 2.3 for bla-ex. The plans with and without EUD constraints were compared in terms of dose–volume histograms, 5-year bladder and rectum normal tissue complication probability values, as well as tumor control probability (TCP) values. Results The use of bladder sub-volume EUD constraints decreased both the doses to the bladder wall (V70: 22.76% vs 19.65%, Dmean: 39.82 Gy vs 35.45 Gy) and the 5-year bladder complication probabilities (≥LENT/SOMA Grade 2: 20.35% vs 17.96%; bladder bleeding: 10.63% vs 8.64%). The doses to the rectum wall and the rectum complication probabilities were also slightly decreased by the EUD constraints compared to physical constraints only. The minimal dose and the V76Gy of PTVprostate were, however, slightly decreased by EUD optimization, nevertheless without significant difference in TCP values between the two plans, and the PTV parameters finally respected the Groupe d’Etude des Tumeurs Uro-Génitales recommendations. Conclusion Separating the bladder wall into two parts with appropriate EUD optimization may

  9. 26 CFR 1.430(i)-1 - Special rules for plans in at-risk status.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... target for a plan in at-risk status. Paragraph (d) of this section describes the target normal cost for a... and the target normal cost are determined for a plan that has been in at-risk status for fewer than 5... present value of benefits for this purpose. (d) Target normal cost of plans in at-risk status—(1)...

  10. AMMONIA MONITORING NEAR 1.5 MM WITH DIODE LASER ABSORPTION SENSORS. (R827123)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  11. New Strategies for 0.5 mm Resolution, High Sensitivity, Multi- Radionuclide Imaging

    SciTech Connect

    Levin, Craig S.

    2015-02-28

    This project constitutes a 0.5-millimeter resolution radionuclide detector system built from CZT. (1) A novel dual-crystal photon detector module design with cross-strip electrode patterns was developed; (2) The module mechanical assembly was built; (3) A data acquisition (DAQ) chain for the module was produced; (4) A software tool was developed to incorporate novel time and energy measurement calibration techniques. (5) A small multi-detector prototype of the radionuclide imaging system was built from this module for system-level characterizations.

  12. Use of 5-mm-diameter implants: Periotest values related to a clinical and radiographic evaluation.

    PubMed

    Aparicio, C; Orozco, P

    1998-12-01

    A modified design of the original Brånemark implant consisting of a cp. Titanium 5.0-mm-diameter self-tapping implant threaded up to the marginal platform has been proposed for specific indications. From February 1992 to November 1995, a total of 185 machined screw implants (Nobel Biocare, Gothenburg, Sweden) were installed in 45 patients to withstand 58 prostheses. Of these, 91 were 3.75-mm diameter and 94 were 5.0-mm wide. Most of the implants were placed in type B and C bone quantity and type 2 and 3 bone quality. A retrospective evaluation with regard to indications, marginal bone remodelling, Periotest values (PTv) and survival rate is presented. PTv and radiographic measurements were made at abutment connection and repeated 3, 6 and 12 months later and thereafter every year. The follow-up ranged from 16 to 55 months (mean 32.9 months) post-loading. Three patients with 8 5.0-mm implants dropped-out of the study at different stages. Out of the wide implants, 1 was expelled during the healing period; 3 were found mobile at the abutment connection; 1 lost its osseointegration suddenly after 2 years of function; 4 belonging to 1 patient did not meet the success criteria due to continuous marginal bone loss. The cumulative success rate of 5.0-mm implants (CSR) after 1 year of function was 97.2% for upper jaws and 88.4% in mandibles, whereas the CSR in maxilla after 48 months was 97.2% and 83.4% in mandibles. The obtained PTv from 5.0-mm-wide fixtures in maxilla and mandibles were respectively 1.1 and 0.6 units lower than those obtained PTv for 3.75-mm-diameter implants in the same patients. The hypothesis that there are differences in the damping capacity of the bone surrounding a 5.0-mm-wide implant compared to the 3.75-mm-diameter implant is supported by the PTv results.

  13. Rotating Target Development for SNS Second Target Station

    SciTech Connect

    McManamy, Thomas J; Rennich, Mark J; Crawford, Roy K; Geoghegan, Patrick J; Janney, Jim G

    2010-01-01

    A rotating target for the second target station (STS) at SNS has been identified as an option along with a mercury target. Evaluation of the rotating target alternative for STS has started at 1.5 MW which is considered an upper bound for the power. Previous preconceptual design work for a 3 MW rotating target is being modified for the lower power level. Transient thermal analysis for a total loss of active water cooling has been done for a simplified 2D model of the target and shielding monolith which shows that peak temperatures are well below the level at which tungsten vaporization by steam could exceed site boundary dose limits. Design analysis and integration configuration studies have been done for the target-moderator-reflector assembly which maximizes the number of neutron beam lines and provides for replacement of the target and moderators. Target building hot cell arrangement for this option will be described. An option for operation in rough vacuum without a proton beam window using Ferro fluid seals on a vertical shaft is being developed. A full scale prototypic drive module based on the 3 MW preconceptual design has been fabricated and successfully tested with a shaft and mock up target supplied by the ESS-Bilbao team. Overall planning leading to decision between mercury and the rotating target in 2011 will be discussed

  14. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    SciTech Connect

    Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

    2014-07-15

    tumor was consistently greater when using spherical tumor shapes as opposed to no shape assumption. However, an assumption of spherical tumor shape for RMSE = 3.5 mm led to a mean overestimation of tumor sampling probabilities of 3%, implying that assuming spherical tumor shape may be reasonable for many prostate tumors. The authors also determined that a biopsy system would need to have a RMS needle delivery error of no more than 1.6 mm in order to sample 95% of tumors with one core. The authors’ experiments also indicated that the effect of axial-direction error on the measured tumor burden was mitigated by the 18 mm core length at 3.5 mm RMSE. Conclusions: For biopsy systems with RMSE ≥ 3.5 mm, more than one biopsy core must be taken from the majority of tumors to achieveP ≥ 95%. These observations support the authors’ perspective that some tumors of clinically significant sizes may require more than one biopsy attempt in order to be sampled during the first biopsy session. This motivates the authors’ ongoing development of an approach to optimize biopsy plans with the aim of achieving a desired probability of obtaining a sample from each tumor, while minimizing the number of biopsies. Optimized planning of within-tumor targets for MRI-3D TRUS fusion biopsy could support earlier diagnosis of prostate cancer while it remains localized to the gland and curable.

  15. A study of IMRT planning parameters on planning efficiency, delivery efficiency, and plan quality

    SciTech Connect

    Mittauer, Kathryn; Lu Bo; Yan Guanghua; Kahler, Darren; Amdur, Robert; Liu Chihray; Gopal, Arun

    2013-06-15

    Purpose: To improve planning and delivery efficiency of head and neck IMRT without compromising planning quality through the evaluation of inverse planning parameters.Methods: Eleven head and neck patients with pre-existing IMRT treatment plans were selected for this retrospective study. The Pinnacle treatment planning system (TPS) was used to compute new treatment plans for each patient by varying the individual or the combined parameters of dose/fluence grid resolution, minimum MU per segment, and minimum segment area. Forty-five plans per patient were generated with the following variations: 4 dose/fluence grid resolution plans, 12 minimum segment area plans, 9 minimum MU plans, and 20 combined minimum segment area/minimum MU plans. Each plan was evaluated and compared to others based on dose volume histograms (DVHs) (i.e., plan quality), planning time, and delivery time. To evaluate delivery efficiency, a model was developed that estimated the delivery time of a treatment plan, and validated through measurements on an Elekta Synergy linear accelerator. Results: The uncertainty (i.e., variation) of the dose-volume index due to dose calculation grid variation was as high as 8.2% (5.5 Gy in absolute dose) for planning target volumes (PTVs) and 13.3% (2.1 Gy in absolute dose) for planning at risk volumes (PRVs). Comparison results of dose distributions indicated that smaller volumes were more susceptible to uncertainties. The grid resolution of a 4 mm dose grid with a 2 mm fluence grid was recommended, since it can reduce the final dose calculation time by 63% compared to the accepted standard (2 mm dose grid with a 2 mm fluence grid resolution) while maintaining a similar level of dose-volume index variation. Threshold values that maintained adequate plan quality (DVH results of the PTVs and PRVs remained satisfied for their dose objectives) were 5 cm{sup 2} for minimum segment area and 5 MU for minimum MU. As the minimum MU parameter was increased, the number of

  16. Systems engineering management plans.

    SciTech Connect

    Rodriguez, Tamara S.

    2009-10-01

    The Systems Engineering Management Plan (SEMP) is a comprehensive and effective tool used to assist in the management of systems engineering efforts. It is intended to guide the work of all those involved in the project. The SEMP is comprised of three main sections: technical project planning and control, systems engineering process, and engineering specialty integration. The contents of each section must be tailored to the specific effort. A model outline and example SEMP are provided. The target audience is those who are familiar with the systems engineering approach and who have an interest in employing the SEMP as a tool for systems management. The goal of this document is to provide the reader with an appreciation for the use and importance of the SEMP, as well as provide a framework that can be used to create the management plan.

  17. Target localization accuracy in a respiratory phantom using BrainLAB ExacTrac and 4DCT imaging.

    PubMed

    Matney, Jason E; Parker, Brent C; Neck, Daniel W; Henkelmann, Greg; Rosen, Isaac I

    2011-03-08

    This study evaluated the accuracy of measuring the motion of an internal target using four-dimensional computed tomography (4DCT) scanning and the BrainLAB ExacTrac X-ray imaging system. Displacements of a metal coil implanted in a commercial respiratory phantom were measured in each system and compared to the known motion. A commercial respiratory motion phantom containing a metal coil as a surrogate target was used. Phantom longitudinal motions were sinusoidal with a 4.0 second period and amplitudes ranging from 5-25 mm. We acquired 4DCT and ExacTrac images of the coil at specified respiratory phases and recorded the coordinates of the coil ends. Coil displacement relative to the 0% phase (full-inhale) position were computed for the ExacTrac and 4DCT imaging systems. Coil displacements were compared to known displacements based on the phantom's sinusoidal motion. Coil length distortion due to 4DCT phase binning was compared to the known physical length of the coil (31 mm). The maximum localization error for both coil endpoints for all motion settings was 3.5 mm for the 4DCT and 0.8 mm for the ExacTrac gating system. Coil length errors measured on the 4DCT were less than 0.8 mm at end inhale/exhale phases, but up to 8.3 mm at mid-inhalation phases at the largest motion amplitude (25 mm). Due to the fast image acquisition time (100 ms), no coil distortion was observable in the ExacTrac system. 4DCT showed problems imaging the coil during mid-respiratory phases of higher velocity (phases 20%-30% and 70%-80%) due to distortion caused by residual motion within the 4DCT phase bin. The ExacTrac imaging system was able to accurately localize the coil in the respiratory phantom over all phases of respiration. For our clinic, where end-respiration phases from 4DCT may be used for treatment planning calculations, the ExacTrac system is used to measure internal target motion. With the ExacTrac system, planning target size and motion uncertainties are minimized, potentially

  18. Impact of Node Negative Target Volume Delineation on Contralateral Parotid Gland Dose Sparing Using IMRT in Head and Neck Cancer.

    PubMed

    Magnuson, William J; Urban, Erich; Bayliss, R Adam; Harari, Paul M

    2015-06-01

    There is considerable practice variation in treatment of the node negative (N0) contralateral neck in patients with head and neck cancer. In this study, we examined the impact of N0 neck target delineation volume on radiation dose to the contralateral parotid gland. Following institutional review board approval, 12 patients with head and neck cancer were studied. All had indications for treatment of the N0 neck, such as midline base of tongue or soft palate extension or advanced ipsilateral nodal disease. The N0 neck volumes were created using the Radiation Therapy Oncology Group head and neck contouring atlas. The physician-drawn N0 neck clinical target volume (CTV) was expanded by 25% to 200% to generate volume variation, followed by a 3-mm planning target volume (PTV) expansion. Surrounding organs at risk were contoured and complete intensity-modulated radiation therapy plans were generated for each N0 volume expansion. The median N0 target volume drawn by the radiation oncologist measured 93 cm(3) (range 71-145). Volumetric expansion of the N0 CTV by 25% to 200% increased the resultant mean dose to the contralateral parotid gland by 1.4 to 8.5 Gray (Gy). For example, a 4.1-mm increase in the N0 neck CTV translated to a 2.0-Gy dose increase to the parotid, 7.4 mm to a 4.5 Gy dose increase, and 12.5 mm to an 8.5 Gy dose increase, respectively. The treatment volume designated for the N0 neck has profound impact on resultant dose to the contralateral parotid gland. Variations of up to 15 mm are routine across physicians in target contouring, reflecting individual preference and training expertise. Depending on the availability of immobilization and image guidance techniques, experts commonly recommend 3 to 10 mm margin expansions to generate the PTV. Careful attention to the original volume of the N0 neck CTV, as well as expansion margins, is important in achieving effective contralateral gland sparing to reduce the resultant xerostomia and dysguesia that may ensue

  19. Three-dimensional assessment of the effects of high-density embolization material on the absorbed dose in the target for Gamma Knife radiosurgery of arteriovenous malformations.

    PubMed

    Watanabe, Yoichi; Sandhu, Divyajot; Warmington, Leighton; Moen, Sean; Tummala, Ramachandra

    2016-12-01

    OBJECTIVE Arteriovenous malformation (AVM) is an intracranial vascular disorder. Gamma Knife radiosurgery (GKRS) is used in conjunction with intraarterial embolization to eradicate the nidus of AVMs. Clinical results indicate that patients with prior embolization tend to gain less benefit from GKRS. The authors hypothesized that this was partly caused by dosimetric deficiency. The actual dose delivered to the target may be smaller than the intended dose because of increased photon attenuation by high-density embolic materials. The authors performed a phantom-based study to quantitatively evaluate the 3D dosimetric effect of embolic material on GKRS. METHODS A 16-cm-diameter and 12-cm-long cylindrical phantom with a 16-cm-diameter hemispherical dome was printed by a 3D printer. The phantom was filled with radiologically tissue-equivalent polymer gel. To simulate AVM treatment with embolization, phantoms contained Onyx 18. The material was injected into an AVM model, which was suspended in the polymer gel. The phantom was attached to a Leksell frame by standard GK fixation method, using aluminum screws, for imaging. The phantom was scanned by a Phillips CT scanner with the standard axial-scanning protocol (120 kV and 1.5-mm slice thickness). CT-based treatment planning was performed with the GammaPlan treatment planning system (version 10.1.1). The plan was created to cover a fictitious AVM target volume near the embolization areas with eleven 8-mm shots and a prescription dose of 20 Gy to 50% isodose level. Dose distributions were computed using both tissue maximum ratio (TMR) 10 and convolution dose-calculation algorithms. These two 3D dose distributions were compared using an in-house program. Additionally, the same analysis method was applied to evaluate the dosimetric effects for 2 patients previously treated by GKRS. RESULTS The phantom-based analyses showed that the mean dose difference between TMR 10 and convolution doses of the AVM target was no larger than

  20. Transition Planning

    ERIC Educational Resources Information Center

    Statfeld, Jenna L.

    2011-01-01

    Post-school transition is the movement of a child with disabilities from school to activities that occur after the completion of school. This paper provides information about: (1) post-school transition; (2) transition plan; (3) transition services; (4) transition planning; (5) vocational rehabilitation services; (6) services that are available…

  1. Test plan :

    SciTech Connect

    Dwyer, Stephen F.

    2013-05-01

    This test plan is a document that provides a systematic approach to the planned testing of rooftop structures to determine their actual load carrying capacity. This document identifies typical tests to be performed, the responsible parties for testing, the general feature of the tests, the testing approach, test deliverables, testing schedule, monitoring requirements, and environmental and safety compliance.

  2. Campus Planning.

    ERIC Educational Resources Information Center

    Dober, Richard P.

    This book suggests ways and means by which the development of campuses can be controlled so that functional goals can be aesthetically expressed. The first section, "Prospectus," defines campus planning, illuminating through historical examples the evolution of the campus as a design form, and describes the conditions that make campus planning so…

  3. Third Floor Plan, Second Floor Plan, First Floor Plan, Ground ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Third Floor Plan, Second Floor Plan, First Floor Plan, Ground Floor Plan, West Bunkhouse - Kennecott Copper Corporation, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  4. Southwest elevation, roof plan, site plan & main floor plan, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Southwest elevation, roof plan, site plan & main floor plan, loft plan, section looking east, north window head detail - Richard Buckminster Fuller & Anne Hewlett Fuller Dome Home, 407 South Forest Avenue, Carbondale, Jackson County, IL

  5. 1990-1991 Marketing Plan. Year II: Planning To Meet the Future.

    ERIC Educational Resources Information Center

    Turcott, Frances; And Others

    In Maryland, Catonsville Community College's (CCC) 1990-91 marketing plan deals with the community's perceptions of the institution and strategies to improve CCC's image. Both the 1989-90 and 1990-91 plans targeted the same markets for special recruitment strategies; i.e., high school graduates with transfer plans, part-time adult students,…

  6. The Ursinus College Liquid Hydrogen Target

    NASA Astrophysics Data System (ADS)

    Palardy, Jessica; Ferrante, Nicholas; Riley, Lewis; Zegers, Remco

    2010-11-01

    The Ursinus College Liquid Hydrogen Target has been constructed at the National Superconducting Cyclotron Laboratory (NSCL) at Michigan State University, for the purpose of eliminating unwanted gamma-rays from carbon in polyethylene or deuterated polyethylene targets that are commonly used in experiments requiring thick proton targets. Existing geant4 simulations of the Segmented Germanium Array (SeGA) and the CAESium iodide ARray (CAESAR) have been modified to incorporate the liquid hydrogen target. The impact of the target on gamma-ray detection efficiencies and the use of the simulations to plan experiments with the target are discussed.

  7. NFE--Planning and Organizing for Action. Courier No. 27.

    ERIC Educational Resources Information Center

    ASPBAE Courier Service, 1983

    1983-01-01

    This issue contains six articles, reports, and essays on planning and organizing nonformal education in the Asian-South Pacific area. A chapter reprinted from "Planning Nonformal Education" discusses the need for planning, past efforts, and five steps in a strategy suggested for planning locally-oriented and target-specific nonformal…

  8. Tackling Targets.

    ERIC Educational Resources Information Center

    Further Education Unit, London (England).

    This document is designed to help British training and enterprise councils (TECs) and further education (FE) colleges develop and implement strategies for achieving the National Targets for Education and Training (NTET), which were developed by the Confederation of British Industry in 1992 and endorsed by the British government. The findings from…

  9. On Target.

    ERIC Educational Resources Information Center

    Barbalich, Andrea

    1991-01-01

    Campus public relations professionals offer advice for improving the effectiveness of public relations efforts by (1) setting behavioral goals; (2) targeting audiences carefully; (3) focusing appeals by making messages explicit; (4) connecting the public relations message with larger societal issues; and (5) reaching internal as well as external…

  10. astroplan: Observation Planning for Astronomers

    NASA Astrophysics Data System (ADS)

    Morris, Brett

    2016-03-01

    Astroplan is an observation planning package for astronomers. It is an astropy-affiliated package which began as a Google Summer of Code project. Astroplan facilitates convenient calculation of common observational quantities, like target altitudes and azimuths, airmasses, and rise/set times. Astroplan also computes when targets are observable given various extensible observing constraints, for example: within a range of airmasses or altitudes, or at a given separation from the Moon. Astroplan is taught in the undergraduate programming for astronomy class, and enables observational Pre- MAP projects at the University of Washington. In the near future, we plan to implement scheduling capabilities in astroplan on top of the constraints framework.

  11. Localization Accuracy of the Clinical Target Volume During Image-Guided Radiotherapy of Lung Cancer

    SciTech Connect

    Hugo, Geoffrey D.; Weiss, Elisabeth; Badawi, Ahmed; Orton, Matthew

    2011-10-01

    Purpose: To evaluate the position and shape of the originally defined clinical target volume (CTV) over the treatment course, and to assess the impact of gross tumor volume (GTV)-based online computed tomography (CT) guidance on CTV localization accuracy. Methods and Materials: Weekly breath-hold CT scans were acquired in 17 patients undergoing radiotherapy. Deformable registration was used to propagate the GTV and CTV from the first weekly CT image to all other weekly CT images. The on-treatment CT scans were registered rigidly to the planning CT scan based on the GTV location to simulate online guidance, and residual error in the CTV centroids and borders was calculated. Results: The mean GTV after 5 weeks relative to volume at the beginning of treatment was 77% {+-} 20%, whereas for the prescribed CTV, it was 92% {+-} 10%. The mean absolute residual error magnitude in the CTV centroid position after a GTV-based localization was 2.9 {+-} 3.0 mm, and it varied from 0.3 to 20.0 mm over all patients. Residual error of the CTV centroid was associated with GTV regression and anisotropy of regression during treatment (p = 0.02 and p = 0.03, respectively; Spearman rank correlation). A residual error in CTV border position greater than 2 mm was present in 77% of patients and 50% of fractions. Among these fractions, residual error of the CTV borders was 3.5 {+-} 1.6 mm (left-right), 3.1 {+-} 0.9 mm (anterior-posterior), and 6.4 {+-} 7.5 mm (superior-inferior). Conclusions: Online guidance based on the visible GTV produces substantial error in CTV localization, particularly for highly regressing tumors. The results of this study will be useful in designing margins for CTV localization or for developing new online CTV localization strategies.

  12. Takeover targets

    SciTech Connect

    Jeffs, E.

    1995-11-01

    The latest chapter in the saga of privatization of the British Electricity Supply Industry has been the growing number of take-over bids for the Regional Electricity Companies (RECs). With privatization, the Scottish generators entered a large number of direct power supply contracts to large industrial consumers in England. The RECs also have diversified into other utility services including gas and cable television; some are also looking at overseas contracts in planning and installing electricity distribution systems in developing countries. Those seeking to take over RECs are mainly American utilities.

  13. Target assembly

    DOEpatents

    Lewis, Richard A.

    1980-01-01

    A target for a proton beam which is capable of generating neutrons for absorption in a breeding blanket includes a plurality of solid pins formed of a neutron emissive target material disposed parallel to the path of the beam and which are arranged axially in a plurality of layers so that pins in each layer are offset with respect to pins in all other layers, enough layers being used so that each proton in the beam will strike at least one pin with means being provided to cool the pins. For a 300 mA, 1 GeV beam (300 MW), stainless steel pins, 12 inches long and 0.23 inches in diameter are arranged in triangular array in six layers with one sixth of the pins in each layer, the number of pins being such that the entire cross sectional area of the beam is covered by the pins with minimum overlap of pins.

  14. Saying goodbye to targets.

    PubMed

    Chhabra, R

    1997-01-01

    This article discusses India's shift from target-driven family planning services to reproductive health services in accordance with the recommendations of the International Conference on Population and Development in Cairo. This Ministry of Health and Welfare policy marks a shift away from population control towards a Reproductive and Child Health program that will include the prevention of unwanted pregnancy; prenatal, delivery, and postpartum services; child survival; safe motherhood; and management of reproductive tract infections (RTIs) and sexually transmitted diseases (STDs). The project will cost about $400 million, and some donor support is expected from the European Union and the World Bank. The official Manual on a Target Free Approach in the Family Welfare Programme describes the new approach and the operational changes and management of a client-oriented and demand-driven quality service program. It is expected that program changes will be gradual due to the population size of India and the status quo nature of program functions over a 50-year period. The program will be based on a decentralized primary health care (PHC) model that uses "bottom up" methods. In 1997, 21,000 PHCs conducted their own Needs Assessment Exercise. The PHC plan will cover all family welfare activities, materials, and supplies. Plans are being coordinated at the district, state, and country levels. Panchayats will eventually be involved. Each worker in the PHC system will have prescribed duties. State officials from the 32 states will undergo 2 days of training in RCH management. Each of the 466 administrators in districts will receive similar training that will be used for training in 5886 community development blocks. The integrated approach will require much more funding than applied for and greater priority in areas with the greatest need.

  15. Overview of Target Fabrication in Support of Sandia National Laboratories

    NASA Astrophysics Data System (ADS)

    Schroen, Diana; Breden, Eric; Florio, Joseph; Grine-Jones, Suzi; Holt, Randy; Krych, Wojtek; Metzler, James; Russell, Chris; Stolp, Justin; Streit, Jonathan; Youngblood, Kelly

    2004-11-01

    Sandia National Laboratories has succeeded in making its pulsed power driver, the Z machine, a valuable testbed for a great variety of experiments. These experiments include ICF, weapon physics, Equation of State and astrophysics. There are four main target types: Dynamic Hohlraum, Double Pinch, Fast Igniter and EOS. The target sizes are comparable to projected NIF sizes. For example, capsules up to 5 mm have been fielded. This talk will focus on the assembly challenges and the use of foams to create these targets. For many targets, diagnostics and capsules are embedded in the foams, and foam dopants have been added. It is the 14 mg/cc foam target with an embedded capsule (containing deuterium) that has reproducibly produced thermonuclear neutrons. For all target types, the characterization and documentation has had to develop to ensure understanding of target performance. To achieve the required resolution we are using a Nikon automated microscope and a custom OMEGA/NIF target assembly system. Our drive for quality has lead us develop a management system that been registered to ISO 9001.

  16. Respiratory-gated segment reconstruction for radiation treatment planning using 256-slice CT-scanner during free breathing

    NASA Astrophysics Data System (ADS)

    Mori, Shinichiro; Endo, Masahiro; Kohno, Ryosuke; Minohara, Shinichi; Kohno, Kazutoshi; Asakura, Hiroshi; Fujiwara, Hideaki; Murase, Kenya

    2005-04-01

    The conventional respiratory-gated CT scan technique includes anatomic motion induced artifacts due to the low temporal resolution. They are a significant source of error in radiotherapy treatment planning for the thorax and upper abdomen. Temporal resolution and image quality are important factors to minimize planning target volume margin due to the respiratory motion. To achieve high temporal resolution and high signal-to-noise ratio, we developed a respiratory gated segment reconstruction algorithm and adapted it to Feldkamp-Davis-Kress algorithm (FDK) with a 256-detector row CT. The 256-detector row CT could scan approximately 100 mm in the cranio-caudal direction with 0.5 mm slice thickness in one rotation. Data acquisition for the RS-FDK relies on the assistance of the respiratory sensing system by a cine scan mode (table remains stationary). We evaluated RS-FDK in phantom study with the 256-detector row CT and compared it with full scan (FS-FDK) and HS-FDK results with regard to volume accuracy and image noise, and finally adapted the RS-FDK to an animal study. The RS-FDK gave a more accurate volume than the others and it had the same signal-to-noise ratio as the FS-FDK. In the animal study, the RS-FDK visualized the clearest edges of the liver and pulmonary vessels of all the algorithms. In conclusion, the RS-FDK algorithm has a capability of high temporal resolution and high signal-to-noise ratio. Therefore it will be useful when combined with new radiotherapy techniques including image guided radiation therapy (IGRT) and 4D radiation therapy.

  17. Depth-targeted transvascular drug delivery by using annular-shaped photomechanical waves

    NASA Astrophysics Data System (ADS)

    Akiyama, Takuya; Sato, Shunichi; Ashida, Hiroshi; Terakawa, Mitsuhiro

    2011-02-01

    Laser-based drug delivery is attractive for the targeting capability due to high spatial controllability of laser energy. Recently, we found that photomechanical waves (PMWs) can transiently increase the permeability of blood vessels in skin, muscle and brain of rats. In this study, we examined the use of annular-shaped PMWs to increase pressure at target depths due to superposition effect of pressure waves. This can increase the permeability of blood vessels located in the specific depth regions, enabling depth-targeted transvascular drug delivery. Annular PMWs were produced by irradiating a laser-absorbing material with annular-shaped pulsed laser beams that were produced by using an axicon lens. We first examined propagation and pressure characteristics of annular PMWs in tissue phantoms and confirmed an increased pressure at a target depth, which can be controlled by changing laser parameters. We injected Evans blue (EB) into a rat tail vein, and annular PMWs (inner diameter, 3 mm; outer diameter, 5 mm) were applied from the myofascial surface of the anterior tibialis muscle. After perfusion fixation, we observed fluorescence originating from EB in the tissue. We observed intense fluorescence at a target depth region of around 5 mm. These results demonstrate the capability of annular PMWs for depth-targeted transvascular drug delivery.

  18. Accelerator target

    DOEpatents

    Schlyer, D.J.; Ferrieri, R.A.; Koehler, C.

    1999-06-29

    A target includes a body having a depression in a front side for holding a sample for irradiation by a particle beam to produce a radioisotope. Cooling fins are disposed on a backside of the body opposite the depression. A foil is joined to the body front side to cover the depression and sample therein. A perforate grid is joined to the body atop the foil for supporting the foil and for transmitting the particle beam therethrough. A coolant is circulated over the fins to cool the body during the particle beam irradiation of the sample in the depression. 5 figs.

  19. Accelerator target

    DOEpatents

    Schlyer, David J.; Ferrieri, Richard A.; Koehler, Conrad

    1999-01-01

    A target includes a body having a depression in a front side for holding a sample for irradiation by a particle beam to produce a radioisotope. Cooling fins are disposed on a backside of the body opposite the depression. A foil is joined to the body front side to cover the depression and sample therein. A perforate grid is joined to the body atop the foil for supporting the foil and for transmitting the particle beam therethrough. A coolant is circulated over the fins to cool the body during the particle beam irradiation of the sample in the depression.

  20. PLUTONIUM-238 PRODUCTION TARGET DESIGN STUDIES

    SciTech Connect

    Hurt, Christopher J; Wham, Robert M; Hobbs, Randall W; Owens, R Steven; Chandler, David; Freels, James D; Maldonado, G Ivan

    2014-01-01

    A new supply chain is planned for plutonium-238 using existing reactors at the Oak Ridge National Laboratory (ORNL) and Idaho National Laboratory (INL) and existing chemical recovery facilities at ORNL. Validation and testing activities for new irradiation target designs have been conducted in three phases over a 2 year period to provide data for scale-up to production. Target design, qualification, target fabrication, and irradiation of fully-loaded targets have been accomplished. Data from post-irradiation examination (PIE) supports safety analysis and irradiation of future target designs.

  1. Snakes: An Integrated Unit Plan.

    ERIC Educational Resources Information Center

    Lawrence, Lisa

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

  2. Targeting circuits

    PubMed Central

    Rajasethupathy, Priyamvada; Ferenczi, Emily; Deisseroth, Karl

    2017-01-01

    Current optogenetic methodology enables precise inhibition or excitation of neural circuits, spanning timescales as needed from the acute (milliseconds) to the chronic (many days or more), for experimental modulation of network activity and animal behavior. Such broad temporal versatility, unique to optogenetic control, is particularly powerful when combined with brain activity measurements that span both acute and chronic timescales as well. This enables, for instance, the study of adaptive circuit dynamics across the intact brain, and tuning interventions to match activity patterns naturally observed during behavior in the same individual. Although the impact of this approach has been greater on basic research than on clinical translation, it is natural to ask if specific neural circuit activity patterns discovered to be involved in controlling adaptive or maladaptive behaviors could become targets for treatment of neuropsychiatric diseases. Here we consider the landscape of such ideas related to therapeutic targeting of circuit dynamics, taking note of developments not only in optical but also in ultrasonic, magnetic, and thermal methods. We note the recent emergence of first-in-kind optogenetically-guided clinical outcomes, as well as opportunities related to the integration of interventions and readouts spanning diverse circuit-physiology, molecular, and behavioral modalities. PMID:27104976

  3. Schoolhouse Planning.

    ERIC Educational Resources Information Center

    Association of School Business Officials, Chicago, IL.

    This publication was developed to suggest approaches to solving some of the basic problems faced by those planning new facilities and renovations or alterations of existing buildings. It is not intended as a total resource reference for school construction. The chapters in the book are presented in the same sequence as their subjects would…

  4. A case study of IMRT planning (Plan B) subsequent to a previously treated IMRT plan (Plan A)

    NASA Astrophysics Data System (ADS)

    Cao, F.; Leong, C.; Schroeder, J.; Lee, B.

    2014-03-01

    Background and purpose: Treatment of the contralateral neck after previous ipsilateral intensity modulated radiation therapy (IMRT) for head and neck cancer is a challenging problem. We have developed a technique that limits the cumulative dose to the spinal cord and brainstem while maximizing coverage of a planning target volume (PTV) in the contralateral neck. Our case involves a patient with right tonsil carcinoma who was given ipsilateral IMRT with 70Gy in 35 fractions (Plan A). A left neck recurrence was detected 14 months later. The patient underwent a neck dissection followed by postoperative left neck radiation to a dose of 66 Gy in 33 fractions (Plan B). Materials and Methods: The spinal cord-brainstem margin (SCBM) was defined as the spinal cord and brainstem with a 1.0 cm margin. Plan A was recalculated on the postoperative CT scan but the fluence outside of SCBM was deleted. A further modification of Plan A resulted in a base plan that was summed with Plan B to evaluate the cumulative dose received by the spinal cord and brainstem. Plan B alone was used to evaluate for coverage of the contralateral neck PTV. Results: The maximum cumulative doses to the spinal cord with 0.5cm margin and brainstem with 0.5cm margin were 51.96 Gy and 45.60 Gy respectively. For Plan B, 100% of the prescribed dose covered 95% of PTVb1. Conclusion: The use of a modified ipsilateral IMRT plan as a base plan is an effective way to limit the cumulative dose to the spinal cord and brainstem while enabling coverage of a PTV in the contralateral neck.

  5. Reflected Deck Plan, Reflected Roof Plan, Deck Plan Bridgeport ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Reflected Deck Plan, Reflected Roof Plan, Deck Plan - Bridgeport Covered Bridge, Spanning South Fork of Yuba River at bypassed section of Pleasant Valley Road (originally Virginia Turnpike) in South Yuba River State Park , Bridgeport, Nevada County, CA

  6. Gates Fund Creates Plan for College Completion

    ERIC Educational Resources Information Center

    Gose, Ben

    2008-01-01

    The Bill & Melinda Gates Foundation plans to spend several hundred million dollars over the next five years to double the number of low-income young people who complete a college degree or certificate program by age 26. Foundation officials described the ambitious plan to an exclusive group of education leaders, citing 2025 as a target goal. If…

  7. Marketing Academic Libraries: A Necessary Plan.

    ERIC Educational Resources Information Center

    Dodsworth, Ellen

    1998-01-01

    To coordinate an academic-library marketing effort effectively, a comprehensive plan is essential. A traditional marketing plan consists of four activities: determining what to promote, defining target audiences, choosing type of outreach, and evaluating program. Suggestions for promotional activities, forms of publicity, and examples from the…

  8. Project Execution Plan for the Installation of Two FORACS (Fleet Operational Readiness Accuracy Check Site) Targets at AUTEC (Atlantic Underwater Testing and Evaluation Center) and One FORACS Target and One SSRNM (Surface Ship Radiated Noise Measurement) Array at St. Croix UTR (Underwater Tracking Range)

    DTIC Science & Technology

    1984-03-01

    prior to the arrival of the OCP SEACON at AUTEC. ,U .-. 5 "-° 2.𔃼 ""’"" * a - - ---- - - - - - - - - - - - - - - ..- - I’ --- wrF -p -I...ck’d by: date:______________ _________ AUTEC DEEP WATER FORACS TARGET VESSEL HYDRO TOUCH DOWN BOTTOM PAYOUT CABLE SPEED CONST ALPHA TRACK I Y SLOPE...Caics ck’d by: date: ____ _____________________ AUTEC SHALLON MATER FORACS TARGET *VESSEL HYDRO TOUCH NOII BOTTON PAYOUT CABLE SPEED

  9. A comparison of HDR near source dosimetry using a treatment planning system, Monte Carlo simulation, and radiochromic film.

    PubMed

    Amoush, Ahmad; Luckstead, Marcus; Lamba, Michael; Elson, Howard; Kassing, William

    2013-01-01

    This study aimed to investigate the high-dose rate Iridium-192 brachytherapy, including near source dosimetry, of a catheter-based applicator from 0.5mm to 1cm along the transverse axis. Radiochromic film and Monte Carlo (MC) simulation were used to generate absolute dose for the catheter-based applicator. Results from radiochromic film and MC simulation were compared directly to the treatment planning system (TPS) based on the American Association of Physicists in Medicine Updated Task Group 43 (TG-43U1) dose calculation formalism. The difference between dose measured using radiochromic film along the transverse plane at 0.5mm from the surface and the predicted dose by the TPS was 24%±13%. The dose difference between the MC simulation along the transverse plane at 0.5mm from the surface and the predicted dose by the TPS was 22.1%±3%. For distances from 1.5mm to 1cm from the surface, radiochromic film and MC simulation agreed with TPS within an uncertainty of 3%. The TPS under-predicts the dose at the surface of the applicator, i.e., 0.5mm from the catheter surface, as compared to the measured and MC simulation predicted dose. MC simulation results demonstrated that 15% of this error is due to neglecting the beta particles and discrete electrons emanating from the sources and not considered by the TPS, and 7% of the difference was due to the photon alone, potentially due to the differences in MC dose modeling, photon spectrum, scoring techniques, and effect of the presence of the catheter and the air gap. Beyond 1mm from the surface, the TPS dose algorithm agrees with the experimental and MC data within 3%.

  10. Statistical modeling of interfractional tissue deformation and its application in radiation therapy planning

    NASA Astrophysics Data System (ADS)

    Vile, Douglas J.

    In radiation therapy, interfraction organ motion introduces a level of geometric uncertainty into the planning process. Plans, which are typically based upon a single instance of anatomy, must be robust against daily anatomical variations. For this problem, a model of the magnitude, direction, and likelihood of deformation is useful. In this thesis, principal component analysis (PCA) is used to statistically model the 3D organ motion for 19 prostate cancer patients, each with 8-13 fractional computed tomography (CT) images. Deformable image registration and the resultant displacement vector fields (DVFs) are used to quantify the interfraction systematic and random motion. By applying the PCA technique to the random DVFs, principal modes of random tissue deformation were determined for each patient, and a method for sampling synthetic random DVFs was developed. The PCA model was then extended to describe the principal modes of systematic and random organ motion for the population of patients. A leave-one-out study tested both the systematic and random motion model's ability to represent PCA training set DVFs. The random and systematic DVF PCA models allowed the reconstruction of these data with absolute mean errors between 0.5-0.9 mm and 1-2 mm, respectively. To the best of the author's knowledge, this study is the first successful effort to build a fully 3D statistical PCA model of systematic tissue deformation in a population of patients. By sampling synthetic systematic and random errors, organ occupancy maps were created for bony and prostate-centroid patient setup processes. By thresholding these maps, PCA-based planning target volume (PTV) was created and tested against conventional margin recipes (van Herk for bony alignment and 5 mm fixed [3 mm posterior] margin for centroid alignment) in a virtual clinical trial for low-risk prostate cancer. Deformably accumulated delivered dose served as a surrogate for clinical outcome. For the bony landmark setup

  11. Toward 3D-guided prostate biopsy target optimization: an estimation of tumor sampling probabilities

    NASA Astrophysics Data System (ADS)

    Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

    2014-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the ~23% false negative rate of clinical 2D TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsy still yields false negatives. Therefore, we propose optimization of biopsy targeting to meet the clinician's desired tumor sampling probability, optimizing needle targets within each tumor and accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. We obtained multiparametric MRI and 3D TRUS images from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D surfaces that were registered to 3D TRUS. We estimated the probability, P, of obtaining a tumor sample with a single biopsy. Given an RMS needle delivery error of 3.5 mm for a contemporary fusion biopsy system, P >= 95% for 21 out of 81 tumors when the point of optimal sampling probability was targeted. Therefore, more than one biopsy core must be taken from 74% of the tumors to achieve P >= 95% for a biopsy system with an error of 3.5 mm. Our experiments indicated that the effect of error along the needle axis on the percentage of core involvement (and thus the measured tumor burden) was mitigated by the 18 mm core length.

  12. Energy planning and management plan

    SciTech Connect

    1996-01-01

    This paper contains printed copies of 60FR 53181, October 12, 1995 and 60 FR 54151. This is a record of decision concerning the Western Area Power Administration`s final draft and environmental impact statement, and Energy Planning and Management Program.

  13. Multicriteria optimization informed VMAT planning

    SciTech Connect

    Chen, Huixiao; Craft, David L.; Gierga, David P.

    2014-04-01

    We developed a patient-specific volumetric-modulated arc therapy (VMAT) optimization procedure using dose-volume histogram (DVH) information from multicriteria optimization (MCO) of intensity-modulated radiotherapy (IMRT) plans. The study included 10 patients with prostate cancer undergoing standard fractionation treatment, 10 patients with prostate cancer undergoing hypofractionation treatment, and 5 patients with head/neck cancer. MCO-IMRT plans using 20 and 7 treatment fields were generated for each patient on the RayStation treatment planning system (clinical version 2.5, RaySearch Laboratories, Stockholm, Sweden). The resulting DVH of the 20-field MCO-IMRT plan for each patient was used as the reference DVH, and the extracted point values of the resulting DVH of the MCO-IMRT plan were used as objectives and constraints for VMAT optimization. Weights of objectives or constraints of VMAT optimization or both were further tuned to generate the best match with the reference DVH of the MCO-IMRT plan. The final optimal VMAT plan quality was evaluated by comparison with MCO-IMRT plans based on homogeneity index, conformity number of planning target volume, and organ at risk sparing. The influence of gantry spacing, arc number, and delivery time on VMAT plan quality for different tumor sites was also evaluated. The resulting VMAT plan quality essentially matched the 20-field MCO-IMRT plan but with a shorter delivery time and less monitor units. VMAT plan quality of head/neck cancer cases improved using dual arcs whereas prostate cases did not. VMAT plan quality was improved by fine gantry spacing of 2 for the head/neck cancer cases and the hypofractionation-treated prostate cancer cases but not for the standard fractionation–treated prostate cancer cases. MCO-informed VMAT optimization is a useful and valuable way to generate patient-specific optimal VMAT plans, though modification of the weights of objectives or constraints extracted from resulting DVH of MCO

  14. Polarized tritium target development

    SciTech Connect

    Jones, C.E.; Fedchak, J.A.; Kowalczyk, R.S.

    1995-08-01

    Work began on the development of a completely sealed polarized tritium target for experiments at CEBAF. Because of the similarities between optical pumping of tritium and hydrogen, all prototype work is done with hydrogen. We constructed a test station for filling glassware with hydrogen, where we can dissociate molecular hydrogen and monitor the purity of the gas. A simple two-cell glass system was constructed, consisting of a region in which the molecular hydrogen is dissociated with an RF discharge and a region where the atoms can be optically pumped. So far, a clean discharge was obtained in the glassware. With this system, we plan to investigate ways to eliminate the discharge from the optical pumping region and test the quality of the discharge once the pumping cell is coated with drifilm.

  15. Students' Target

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03648 Ascraeus Mons

    After examining numerous THEMIS images and using the JMars targeting software, eighth grade students from Charleston Middle School in Charleston, IL, selected the location of -8.37N and 276.66E for capture by the THEMIS visible camera during Mars Odyssey's sixth orbit of Mars on Nov. 22, 2005. The students are investigating relationships between channels, craters, and basins on Mars. The Charleston Middle School students participated in the Mars Student Imaging Project (MSIP) and submitted a proposal to use the THEMIS visible camera.

    Image information: VIS instrument. Latitude 8.8S, Longitude 279.6E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  16. National Ignition Facility Target Chamber

    SciTech Connect

    Wavrik, R W; Cox, J R; Fleming, P J

    2000-10-05

    On June 11, 1999 the Department of Energy dedicated the single largest piece of the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) in Livermore, California. The ten (10) meter diameter aluminum target high vacuum chamber will serve as the working end of the largest laser in the world. The output of 192 laser beams will converge at the precise center of the chamber. The laser beams will enter the chamber in two by two arrays to illuminate 10 millimeter long gold cylinders called hohlraums enclosing 2 millimeter capsule containing deuterium, tritium and isotopes of hydrogen. The two isotopes will fuse, thereby creating temperatures and pressures resembling those found only inside stars and in detonated nuclear weapons, but on a minute scale. The NIF Project will serve as an essential facility to insure safety and reliability of our nation's nuclear arsenal as well as demonstrating inertial fusion's contribution to creating electrical power. The paper will discuss the requirements that had to be addressed during the design, fabrication and testing of the target chamber. A team from Sandia National Laboratories (SNL) and LLNL with input from industry performed the configuration and basic design of the target chamber. The method of fabrication and construction of the aluminum target chamber was devised by Pitt-Des Moines, Inc. (PDM). PDM also participated in the design of the chamber in areas such as the Target Chamber Realignment and Adjustment System, which would allow realignment of the sphere laser beams in the event of earth settlement or movement from a seismic event. During the fabrication of the target chamber the sphericity tolerances had to be addressed for the individual plates. Procedures were developed for forming, edge preparation and welding of individual plates. Construction plans were developed to allow the field construction of the target chamber to occur parallel to other NIF construction activities. This was

  17. A high power beam-on-target test of liquid lithium target for RIA.

    SciTech Connect

    Nolen, J.; Reed, C.; Novick, V.; Specht, J.; Plotkin, P.; Momozaki,Y.; Gomes, I.

    2005-08-29

    Experiments were conducted to demonstrate the stable operation of a windowless liquid lithium target under extreme thermal loads that are equivalent to uranium beams from the proposed Rare Isotope Accelerator (RIA) driver linac. The engineering and safety issues accompanying liquid lithium systems are first discussed. The liquid metal technology knowledge base generated primarily for fast reactors, and liquid metal cooled fusion reactors, was applied to the development of these systems in a nuclear physics laboratory setting. The use of a high energy electron beam for simulating a high power uranium beam produced by the RIA driver linac is also described. Calculations were performed to obtain energy deposition profiles produced by electron beams at up to a few MeV to compare with expected uranium beam energy deposition profiles. It was concluded that an experimental simulation using a 1-MeV electron beam would be a valuable tool to assess beam-jet interaction. In the experiments, the cross section of the windowless liquid lithium target was 5 mm x 10 mm, which is a 1/3rd scale prototype target, and the velocity of the liquid lithium was varied up to 6 m/s. Thermal loads up to 20 kW within a beam spot diameter of 1mm were applied on the windowless liquid lithium target by the 1-MeV electron beam. The calculations showed that the maximum power density and total power deposited within the target, from the electron beam, was equivalent to that of a 200-kW, 400-MeV/u uranium beam. It was demonstrated that the windowless liquid lithium target flowing at velocities as low as 1.8 m/s stably operated under beam powers up to 20 kW without disruption or excessive vaporization.

  18. Tracking Sentence Planning and Production

    PubMed Central

    Bontempo, Daniel; McKedy, Whitney; Schmalzried, RaLynn; Tagliaferri, Bruno; Kieweg, Doug

    2011-01-01

    Objective. To assess age differences in the costs of language planning and production. Methods. A controlled sentence production task was combined with digital pursuit rotor tracking. Participants were asked to track a moving target while formulating a sentence using specified nouns and verbs and to continue to track the moving target while producing their response. The length of the critical noun phrase (NP) as well as the type of verb provided were manipulated. Results. The analysis indicated that sentence planning was more costly than sentence production, and sentence planning costs increased when participants had to incorporate a long NP into their sentence. The long NPs also tended to be shifted to the end of the sentence, whereas short NPs tended to be positioned after the verb. Planning or producing responses with long NPs was especially difficult for older adults, although verb type and NP shift had similar costs for young and older adults. Discussion. Pursuit rotor tracking during controlled sentence production reveals the effects of aging on sentence planning and production. PMID:21060066

  19. Inverse planning incorporating organ motion.

    PubMed

    Li, J G; Xing, L

    2000-07-01

    Accurate targeting is important in intensity-modulated radiation therapy (IMRT). The positional uncertainties of structures with respect to the external beams arise in part from random organ motion and patient setup errors. While it is important to improve immobilization and reduce the influence of organ motion, the residual effects should be included in the IMRT plan design. Current inverse planning algorithms follow the conventional approach and include uncertainties by assuming population-based margins to the target and sensitive structures. Margin around a structure represents a "hard boundary" and the fact that a structure has a spatial probability distribution has been completely ignored. With increasing understanding of spatial uncertainties of structures and the technical capability of fine-tuning the dose distribution on an individual beamlet level in IMRT, it seems timely and important to fully utilize the information in the planning process. This will reduce the "effective" margins of the structures and facilitate dose escalation. Instead of specifying a "hard margin," we describe an inverse planning algorithm which takes into consideration positional uncertainty in terms of spatial probability distribution. The algorithm was demonstrated by assuming that the random organ motion can be represented by a three-dimensional Gaussian distribution function. Other probability distributions can be dealt with similarly. In particular, the commonly used "hard margin" is a special case of the current approach with a uniform probability distribution within a specified range. The algorithm was applied to plan treatment for a prostate case and a pancreatic case. The results were compared with those obtained by adding a margin to the clinical target volume. Better sparing of the sensitive structures were obtained in both cases using the proposed method for approximately the same target coverage.

  20. National Ignition Facility: Experimental plan

    NASA Astrophysics Data System (ADS)

    1994-05-01

    As part of the Conceptual Design Report (CDR) for the National Ignition Facility (NIF), scientists from Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Sandia National Laboratory (SNL), the University of Rochester's Laboratory for Laser Energetics (UR/LLE), and EG&G formed an NIF Target Diagnostics Working Group. The purpose of the Target Diagnostics Working Group is to prepare conceptual designs of target diagnostics for inclusion in the facility CDR and to determine how these specifications impact the CDR. To accomplish this, a subgroup has directed its efforts at constructing an approximate experimental plan for the ignition campaign of the NIF CDR. The results of this effort are contained in this document, the Experimental Plan for achieving fusion ignition in the NIF. This group initially concentrated on the flow-down requirements of the experimental campaign leading to ignition, which will dominate the initial efforts of the NIF. It is envisaged, however, that before ignition, there will be parallel campaigns supporting weapons physics, weapons effects, and other research. This plan was developed by analyzing the sequence of activities required to finally fire the laser at the level of power and precision necessary to achieve the conditions of an ignition hohlraum target, and to then use our experience in activating and running Nova experiments to estimate the rate of completing these activities.

  1. SU-C-303-06: Treatment Planning Study for Non-Invasive Cardiac Arrhythmia Ablation with Scanned Carbon Ions in An Animal Model

    SciTech Connect

    Eichhorn, A; Constantinescu, A; Prall, M; Kaderka, R; Durante, M; Graeff, C; Lehmann, H I; Takami, M; Packer, D L; Lugenbiel, P; Thomas, D; Richter, D; Bert, C

    2015-06-15

    Purpose: Scanned carbon ion beams might offer a non-invasive alternative treatment for cardiac arrhythmia, which are a major health-burden. We studied the feasibility of this procedure in an animal model. The underlying treatment planning and motion mitigation strategies will be presented. Methods: The study was carried out in 15 pigs, randomly distributed to 3 target groups: atrioventricular node (AVN, 8 animals with 25, 40, and 55 Gy target dose), left ventricular free-wall (LV, 4 animals with 40 Gy) and superior pulmonary vein (SPV, 3 animals with 40 Gy). Breathing motion was suppressed by repeated enforced breathholds at end exhale. Cardiac motion was mitigated by an inhomogeneous rescanning scheme with up to 15 rescans. The treatment planning was performed using the GSI in-house software TRiP4D on cardiac-gated 4DCTs, applying a range-considering ITV based on an extended CTV. For AVN and SPV isotropic 5 mm margins were applied to the CTV, while for the LV 2mm+2% range margins were used. The opposing fields for AVN and LV targets were optimized independently (SFUD), while SPV treatments were optimized as IMPT deliveries, including dose restrictions to the radiosensitive AVN. Results: Median value of D{sub 95} over all rescanning simulations was 99.1% (AVN), 98.0% (SPV) and 98.3% (LV) for the CTV and 94.7% (AVN) and 92.7% (SPV) for the PTV, respectively. The median D{sub 5}-D{sub 95} was improved with rescanning compared to unmitigated delivery from 13.3 to 6.5% (CTV) and from 23.4 to 11.6% (PTV). ICRP dose limits for aorta, trachea, esophagus and skin were respected. The maximal dose in the coronary arteries was limited to 30 Gy. Conclusion: We demonstrated the feasibility of a homogeneous dose delivery to different cardiac structures in a porcine model using a time-optimized inhomogeneous rescanning scheme. The presented treatment planning strategies were applied in a pig study with the analysis ongoing. Funding: This work was supported in part by the

  2. The Faure Report: A Turning Point in Educational Planning.

    ERIC Educational Resources Information Center

    Platt, William J.

    The Report of the International Commission for the Development of Education reinforces the advances that are occurring in education and in overall development policy. At this turning point in education, planning must contribute to needed mutation and reform. Vector planning seems likely to supplement target planning as a means of identifying and…

  3. How to inject consumerism into your existing health plans.

    PubMed

    Havlin, Linda J; McAllister, Michael F; Slavney, David H

    2003-09-01

    Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).

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

    ERIC Educational Resources Information Center

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

    1980-01-01

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

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

    ERIC Educational Resources Information Center

    Wood, Elizabeth J.

    1983-01-01

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

  6. Diagnostic reasoning and treatment planning: II. Treatment.

    PubMed

    Nurcombe, B

    1987-12-01

    The concepts of therapy-oriented and problem-oriented plans are discussed and their advantages and disadvantages considered. Goal-directed planning is proposed as an alternative to intuitive decision making. Goal-directed planning involves the abstraction of pivotal problems from a diagnostic formulation, the restatement of problems as goals, the selection of appropriate therapy, the designation of a target date, the stipulation of objectives, the selection of methods of evaluation and the monitoring of progress. Systematic goal-directed planning fosters teamwork, promotes accountability, obviates therapeutic drift and enhances outcome evaluation. Its chief disadvantage is its unfamiliarity.

  7. Meaning and Problems of Planning

    ERIC Educational Resources Information Center

    Brieve, Fred J.; Johnston, A. P.

    1973-01-01

    Examines the educational planning process. Discusses what planning is, how methodological planning can work in education, misunderstandings about planning, and difficulties in applying the planning methodology. (DN)

  8. Targeting and Localization for Mars Rover Operations

    NASA Technical Reports Server (NTRS)

    Powell, Mark W.; Crockett, Thomas; Fox, Jason M.; Joswig, Joseph C.; Norris, Jeffrey S.; Rabe, Kenneth J.

    2008-01-01

    A design and a partially developed application framework were presented for improving localization and targeting for surface spacecraft. The program has value for the Mars Science Laboratory mission, and has been delivered to support the Mars Exploration Rovers as part of the latest version of the Maestro science planning tool. It also has applications for future missions involving either surface-based or low-altitude atmospheric robotic vehicles. The targeting and localization solutions solve the problem of how to integrate localization estimate updates into operational planning tools, operational data product generalizations, and flight software by adding expanded flexibility to flight software, the operations data product pipeline, and operations planning tools based on coordinate frame updates during a planning cycle.

  9. The demand for family planning: a new approach.

    PubMed

    Easterlin, R A; Wongboonsin, K; Ahmed, M A

    1988-01-01

    A new "supply-demand" measure of family planning demand is compared with others commonly used to target prospective family planning clients. In analyses of data from six cross-sectional surveys the new measure consistently explains past contraceptive use better than the others. Time series analysis for two countries yields similar results. Family planning program officials may wish to consider exploring the use of this measure to target prospective clients.

  10. Radiation Treatment Planning Using Positron Emission and Computed Tomography for Lung and Pharyngeal Cancers: A Multiple-Threshold Method for [{sup 18}F]Fluoro-2-Deoxyglucose Activity

    SciTech Connect

    Okubo, Mitsuru; Nishimura, Yasumasa; Nakamatsu, Kiyoshi; Okumura, Masahiko R.T.; Shibata, Toru; Kanamori, Shuichi; Hanaoka, Kouhei R.T.; Hosono, Makoto

    2010-06-01

    Purpose: Clinical applicability of a multiple-threshold method for [{sup 18}F]fluoro-2-deoxyglucose (FDG) activity in radiation treatment planning was evaluated. Methods and Materials: A total of 32 patients who underwent positron emission and computed tomography (PET/CT) simulation were included; 18 patients had lung cancer, and 14 patients had pharyngeal cancer. For tumors of <=2 cm, 2 to 5 cm, and >5 cm, thresholds were defined as 2.5 standardized uptake value (SUV), 35%, and 20% of the maximum FDG activity, respectively. The cervical and mediastinal lymph nodes with the shortest axial diameter of >=10 mm were considered to be metastatic on CT (LNCT). The retropharyngeal lymph nodes with the shortest axial diameter of >=5 mm on CT and MRI were also defined as metastatic. Lymph nodes showing maximum FDG activity greater than the adopted thresholds for radiation therapy planning were designated LNPET-RTP, and lymph nodes with a maximum FDG activity of >=2.5 SUV were regarded as malignant and were designated LNPET-2.5 SUV. Results: The sizes of gross tumor volumes on PET (GTVPET) with the adopted thresholds in the axial plane were visually well fitted to those of GTV on CT (GTVCT). However, the volumes of GTVPET were larger than those of GTVCT, with significant differences (p < 0.0001) for lung cancer, due to respiratory motion. For lung cancer, the numbers of LNCT, LNPET-RTP, and LNPET-2.5 SUV were 29, 28, and 34, respectively. For pharyngeal cancer, the numbers of LNCT, LNPET-RTP, and LNPET-2.5 SUV were 14, 9, and 15, respectively. Conclusions: Our multiple thresholds were applicable for delineating the primary target on PET/CT simulation. However, these thresholds were inaccurate for depicting malignant lymph nodes.

  11. Automated Gamma Knife dose planning

    NASA Astrophysics Data System (ADS)

    Leichtman, Gregg S.; Aita, Anthony L.; Goldman, H. W.

    1998-06-01

    The Gamma Knife (Elekta Instruments, Inc., Atlanta, GA), a neurosurgical, highly focused radiation delivery device, is used to eradicate deep-seated anomalous tissue within the human brain by delivering a lethal dose of radiation to target tissue. This dose is the accumulated result of delivering sequential `shots' of radiation to the target where each shot is approximately 3D Gaussian in shape. The size and intensity of each shot can be adjusted by varying the time of radiation exposure and by using one of four collimator sizes ranging from 4 - 18 mm. Current dose planning requires that the dose plan be developed manually to cover the target, and only the target, with a desired minimum radiation intensity using a minimum number of shots. This is a laborious and subjective process which typically leads to suboptimal conformal target coverage by the dose. We have used adaptive simulated annealing/quenching followed by Nelder-Mead simplex optimization to automate the selection and placement of Gaussian-based `shots' to form a simulated dose plane. In order to make the computation of the problem tractable, the algorithm, based upon contouring and polygon clipping, takes a 2 1/2-D approach to defining the cost function. Several experiments have been performed where the optimizers have been given the freedom to vary the number of shots and the weight, collimator size, and 3D location of each shot. To data best results have been obtained by forcing the optimizers to use a fixed number of unweighted shots with each optimizer set free to vary the 3D location and collimator size of each shot. Our preliminary results indicate that this technology will radically decrease planning time while significantly increasing accuracy of conformal target coverage and reproducibility over current manual methods.

  12. Planning documents: a business planning strategy.

    PubMed

    Kaehrle, P A

    2000-06-01

    Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

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

    SciTech Connect

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

    2013-11-15

    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

  14. Plan Representations for Distributed Planning and Execution

    DTIC Science & Technology

    2011-08-01

    Representation Planning is commonly associated with intelligent behavior in agents [Russell and Norvig , 2003]. The activity of planning can be defined...formulation [Russell and Norvig , 2003], is essential for enabling efficient problem-solving though search [Amarel, 1968]. The Planning Domain Definition... Norvig , 2003]. Preprocessing of planning domains is a technique that has been used to speed up the planning pro- cess [Dawson and Siklossy, 1977]. Perhaps

  15. Succession planning.

    PubMed

    Catanzaro, Thomas E

    2006-03-01

    This article provides the reader with an appreciation of the diverse elements that go into a buy-sell, affiliation, or merger situation for veterinary practices. In the changing market place of American veterinary medicine, old paradigms no longer hold comfort. The generational differences are briefly explored herein as well as the new economic realities. A few examples are offered to illustrate just how much variability exists in the current business of veterinary medicine and the subsequent practice transitions needed to enhance value. Functioning models are explored, as well as affiliation and merger options. Practice valuation is discussed in general terms, referencing the cutting-edge factors. The six-point summary provides almost all practices a solid operational base for daily operations and succession planning.

  16. TH-C-12A-11: Target Correlation of a 3D Surface Surrogate for Left Breast Irradiation Using the Respiratory-Gated Deep-Inspiration Breath-Hold Technique

    SciTech Connect

    Rong, Y; Walston, S

    2014-06-15

    Purpose: To evaluate the use of 3D optical surface imaging as a new surrogate for respiratory motion gated deep-inspiration breath-hold (DIBH) technique for left breast cancer patients. Methods: Patients with left-sided breast cancer after lumpectomy or mastectomy were selected as candidates for DIBH technique for their external beam radiation therapy. Treatment plans were created on both free breathing (FB) and DIBH CTs to determine whether DIBH was beneficial in reducing heart doses. The Real-time Position Management (RPM) system was used to acquire patient's breathing trace during DIBH CT acquisition and treatment delivery. The reference 3D surface models from FB and DIBH CTs were generated and transferred to the “AlignRT” system for patient positioning and real-time treatment monitoring. MV Cine images were acquired for each beam as quality assurance for intra-fractional position verification. The chest wall excursions measured on these images were used to define the actual target position during treatment, and to investigate the accuracy and reproducibility of RPM and AlignRT. Results: Reduction in heart dose can be achieved for left-sided breast patients using DIBH. Results showed that RPM has poor correlation with target position, as determined by the MV Cine imaging. This indicates that RPM may not be an adequate surrogate in defining the breath-hold level when used alone. Alternatively, the AlignRT surface imaging demonstrated a better correlation with the actual CW excursion during DIBH. Both the vertical and magnitude real-time deltas (RTDs) reported by AlignRT can be used as the gating parameter, with a recommend threshold of ±3 mm and 5 mm, respectively. Conclusion: 3D optical surface imaging serves as a superior target surrogate for the left breast treatment when compared to RPM. Working together with the realtime MV Cine imaging, they ensure accurate patient setup and dose delivery, while minimizing the imaging dose to patients.

  17. Target Design Optimization of KIPT Neutron Source Facility

    SciTech Connect

    Zhong, Zhaopeng; Gohar, Yousry; Merzari, Elia; Kraus, Adam; Sofu, Tanju

    2015-01-01

    Argonne National Laboratory (ANL) of the United States developed and designed a neutron source facility for Kharkov Institute of Physics and Technology (KIPT) of Ukraine. The facility was constructed at Kharkov, Ukraine and its commissioning process has been started. The facility has an electron accelerator driving a subcritical assembly. The electron beam power is 100 kW using 100 MeV electrons. The subcritical assembly has WWR-M2 fuel assemblies with U-235 enrichment of 19.7 wt%. The facility will be utilized to perform basic and applied nuclear research, to produce medical isotopes, and to train young nuclear specialists. Solid target design with stacked disks is selected and each target disk is cooled by water from both side. Tungsten or natural uranium is the target material. This paper presents the target design optimization to maximize the neutron yield and the neutron flux level of the facility while satisfying the thermal-hydraulic design criteria. Monte Carlo computer code MCNPX is utilized for the neutron yield analyses with ENDF/B-VII.0 nuclear data libraries, as a function of target thickness using a simplified target model without cladding or coolant channels. It’s found that the neutron yield saturates at target thickness 60 ~ 70 mm for both tungsten and uranium materials. For the final target design with cladding and coolant channels, the total uranium thickness is 56.5 mm, and the total tungsten thickness is only 33.0 mm. The tungsten material has a large absorption cross section for thermal neutrons. If the tungsten thickness is increased, the neutron yield gain is offset by the neutron absorption reaction. The paper presents the design optimization analyses for both target materials.

  18. 4D tumor centroid tracking using orthogonal 2D dynamic MRI: Implications for radiotherapy planning

    SciTech Connect

    Tryggestad, Erik; Flammang, Aaron; Shea, Steven M.; Hales, Russell; Herman, Joseph; Lee, Junghoon; McNutt, Todd; Roland, Teboh; Wong, John

    2013-09-15

    Purpose: Current pretreatment, 4D imaging techniques are suboptimal in that they sample breathing motion over a very limited “snapshot” in time. Heretofore, long-duration, 4D motion characterization for radiotherapy planning, margin optimization, and validation have been impractical for safety reasons, requiring invasive markers imaged under x-ray fluoroscopy. To characterize 3D tumor motion and associated variability over durations more consistent with treatments, the authors have developed a practical dynamic MRI (dMRI) technique employing two orthogonal planes acquired in a continuous, interleaved fashion.Methods: 2D balanced steady-state free precession MRI was acquired continuously over 9–14 min at approximately 4 Hz in three healthy volunteers using a commercial 1.5 T system; alternating orthogonal imaging planes (sagittal, coronal, sagittal, etc.) were employed. The 2D in-plane pixel resolution was 2 × 2 mm{sup 2} with a 5 mm slice profile. Simultaneous with image acquisition, the authors monitored a 1D surrogate respiratory signal using a device available with the MRI system. 2D template matching-based anatomic feature registration, or tracking, was performed independently in each orientation. 4D feature tracking at the raw frame rate was derived using spline interpolation.Results: Tracking vascular features in the lung for two volunteers and pancreatic features in one volunteer, the authors have successfully demonstrated this method. Registration error, defined here as the difference between the sagittal and coronal tracking result in the SI direction, ranged from 0.7 to 1.6 mm (1σ) which was less than the acquired image resolution. Although the healthy volunteers were instructed to relax and breathe normally, significantly variable respiration was observed. To demonstrate potential applications of this technique, the authors subsequently explored the intrafraction stability of hypothetical tumoral internal target volumes and 3D spatial probability

  19. Conservation Planning for Ecosystem Services

    PubMed Central

    Chan, Kai M. A; Shaw, M. Rebecca; Cameron, David R; Underwood, Emma C; Daily, Gretchen C

    2006-01-01

    Despite increasing attention to the human dimension of conservation projects, a rigorous, systematic methodology for planning for ecosystem services has not been developed. This is in part because flows of ecosystem services remain poorly characterized at local-to-regional scales, and their protection has not generally been made a priority. We used a spatially explicit conservation planning framework to explore the trade-offs and opportunities for aligning conservation goals for biodiversity with six ecosystem services (carbon storage, flood control, forage production, outdoor recreation, crop pollination, and water provision) in the Central Coast ecoregion of California, United States. We found weak positive and some weak negative associations between the priority areas for biodiversity conservation and the flows of the six ecosystem services across the ecoregion. Excluding the two agriculture-focused services—crop pollination and forage production—eliminates all negative correlations. We compared the degree to which four contrasting conservation network designs protect biodiversity and the flow of the six services. We found that biodiversity conservation protects substantial collateral flows of services. Targeting ecosystem services directly can meet the multiple ecosystem services and biodiversity goals more efficiently but cannot substitute for targeted biodiversity protection (biodiversity losses of 44% relative to targeting biodiversity alone). Strategically targeting only biodiversity plus the four positively associated services offers much promise (relative biodiversity losses of 7%). Here we present an initial analytical framework for integrating biodiversity and ecosystem services in conservation planning and illustrate its application. We found that although there are important potential trade-offs between conservation for biodiversity and for ecosystem services, a systematic planning framework offers scope for identifying valuable synergies. PMID

  20. Hanford Facility contingency plan

    SciTech Connect

    Sutton, L.N.; Miskho, A.G.; Brunke, R.C.

    1993-10-01

    The Hanford Facility Contingency Plan, together with each TSD unit-specific contingency plan, meets the WAC 173-303 requirements for a contingency plan. This plan includes descriptions of responses to a nonradiological hazardous materials spill or release at Hanford Facility locations not covered by TSD unit-specific contingency plans or building emergency plans. This plan includes descriptions of responses for spills or releases as a result of transportation activities, movement of materials, packaging, and storage of hazardous materials.

  1. Roof Plans: Section "CC", Roof Plan; Roof Framing Plans: Section ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Roof Plans: Section "C-C", Roof Plan; Roof Framing Plans: Section "C-C", Section "D-D"; Roof Framing Sections: Cross Section "G-G", Cross Section "H-H" - Fort Washington, Fort Washington Light, Northeast side of Potomac River at Fort Washington Park, Fort Washington, Prince George's County, MD

  2. An Analysis of Plan Robustness for Esophageal Tumors: Comparing Volumetric Modulated Arc Therapy Plans and Spot Scanning Proton Planning

    PubMed Central

    Warren, Samantha; Partridge, Mike; Bolsi, Alessandra; Lomax, Anthony J.; Hurt, Chris; Crosby, Thomas; Hawkins, Maria A.

    2016-01-01

    Purpose Planning studies to compare x-ray and proton techniques and to select the most suitable technique for each patient have been hampered by the nonequivalence of several aspects of treatment planning and delivery. A fair comparison should compare similarly advanced delivery techniques from current clinical practice and also assess the robustness of each technique. The present study therefore compared volumetric modulated arc therapy (VMAT) and single-field optimization (SFO) spot scanning proton therapy plans created using a simultaneous integrated boost (SIB) for dose escalation in midesophageal cancer and analyzed the effect of setup and range uncertainties on these plans. Methods and Materials For 21 patients, SIB plans with a physical dose prescription of 2 Gy or 2.5 Gy/fraction in 25 fractions to planning target volume (PTV)50Gy or PTV62.5Gy (primary tumor with 0.5 cm margins) were created and evaluated for robustness to random setup errors and proton range errors. Dose–volume metrics were compared for the optimal and uncertainty plans, with P<.05 (Wilcoxon) considered significant. Results SFO reduced the mean lung dose by 51.4% (range 35.1%-76.1%) and the mean heart dose by 40.9% (range 15.0%-57.4%) compared with VMAT. Proton plan robustness to a 3.5% range error was acceptable. For all patients, the clinical target volume D98 was 95.0% to 100.4% of the prescribed dose and gross tumor volume (GTV) D98 was 98.8% to 101%. Setup error robustness was patient anatomy dependent, and the potential minimum dose per fraction was always lower with SFO than with VMAT. The clinical target volume D98 was lower by 0.6% to 7.8% of the prescribed dose, and the GTV D98 was lower by 0.3% to 2.2% of the prescribed GTV dose. Conclusions The SFO plans achieved significant sparing of normal tissue compared with the VMAT plans for midesophageal cancer. The target dose coverage in the SIB proton plans was less robust to random setup errors and might be unacceptable for

  3. Floor-plan radar

    NASA Astrophysics Data System (ADS)

    Falconer, David G.; Ueberschaer, Ronald M.

    2000-07-01

    Urban-warfare specialists, law-enforcement officers, counter-drug agents, and counter-terrorism experts encounter operational situations where they must assault a target building and capture or rescue its occupants. To minimize potential casualties, the assault team needs a picture of the building's interior and a copy of its floor plan. With this need in mind, we constructed a scale model of a single- story house and imaged its interior using synthetic-aperture techniques. The interior and exterior walls nearest the radar set were imaged with good fidelity, but the distal ones appear poorly defined and surrounded by ghosts and artifacts. The latter defects are traceable to beam attenuation, wavefront distortion, multiple scattering, traveling waves, resonance phenomena, and other effects not accounted for in the traditional (noninteracting, isotropic point scatterer) model for radar imaging.

  4. SU-E-T-189: Commission Range Shifter On a Spot Scanning Proton System Using Raystation Treatment Planning System

    SciTech Connect

    Ding, X; Wu, H; Rosen, L

    2015-06-15

    Purpose: To treat superficial target e.g. chest wall, head&neck or cranial cases, we commissioned two range shifter(RS) in Raystation4.0 with 7.37cm(RS1) and 4.1cm(RS2) Water Equivalent Thickness(WET) respectively. However, current beam model has limitations due to the secondary scattered proton. This study provides a detailed and critical commission data and provides suggestions for using RS in clinic. Methods: RS’ WET was verified by Multi-Layer Ionization Chamber from 120MeV to 226.7MeV before TPS modeling. Spot characteristics were measured using 2D scintillate detector at ISO with different air gap. A 8×8×10cm3 cube is created in 8cm depth of water to verify the absolute dose accuracy. Plans were created with different air gap using both RS. Absolute dose verification was measured along the central axis from distal end to surface using PPC05. 10 clinical RS2 plans were measured using MatriXXPT in 3 planes (proximal, distal and midSOBP). Results: RS material’s proton stopping power is energy dependent(from 70MeV to 226.7MeV) ranging from 7.42 to 7.31cm and from 4.10 to 4.03cm respectively. We chose 7.37cm (RS1) and 4.10cm (RS2) to favor the low and median proton energy. With different air gap(3cm to 32cm), spot size expands from 3.2mm to 5.5mm(RS1) and from 3.1mm to 4.1mm(RS2) respectively(226.7MeV in air, 1-sigma). For the absolute dose verification, the larger air gap and shallower depth causes larger discrepancy between TPS and measurements. All 10 clinical plans with 5–10cm air gap passed gamma index 95% with 3%/3mm criteria and outputs differences were within 3%. Conclusion: We strongly recommend each institution to verify the WET independently and choose the value to fit the clinical needs. To minimize the output difference in Raystation4.0 while avoid potential collision to the patient, we recommend to use 5–10cm air gap to minimize the output difference within 2% and preferably use RS with smaller WET if possible.

  5. Hanford Site Development Plan

    SciTech Connect

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

    1990-01-01

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

  6. Teaching Treatment Planning.

    ERIC Educational Resources Information Center

    Seligman, Linda

    1993-01-01

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

  7. The Individual Education Plan: A Gendered Assessment Practice?

    ERIC Educational Resources Information Center

    Hirsh, Asa

    2012-01-01

    The focus of this study is gendered differences and similarities in the distribution of individual education plan (IEP) targets given to pupils in Swedish schools. IEP writing is seen as part of teachers' formal assessment practice. Through qualitative content analysis of data, two main target types emerged: "learning targets," related…

  8. Comparison of composite prostate radiotherapy plan doses with dependent and independent boost phases.

    PubMed

    Narayanasamy, Ganesh; Avila, Gabrielle; Mavroidis, Panayiotis; Papanikolaou, Niko; Gutierrez, Alonso; Baacke, Diana; Shi, Zheng; Stathakis, Sotirios

    2016-09-01

    Prostate cases commonly consist of dual phase planning with a primary plan followed by a boost. Traditionally, the boost phase is planned independently from the primary plan with the risk of generating hot or cold spots in the composite plan. Alternatively, boost phase can be planned taking into account the primary dose. The aim of this study was to compare the composite plans from independently and dependently planned boosts using dosimetric and radiobiological metrics. Ten consecutive prostate patients previously treated at our institution were used to conduct this study on the Raystation™ 4.0 treatment planning system. For each patient, two composite plans were developed: a primary plan with an independently planned boost and a primary plan with a dependently planned boost phase. The primary plan was prescribed to 54 Gy in 30 fractions to the primary planning target volume (PTV1) which includes prostate and seminal vesicles, while the boost phases were prescribed to 24 Gy in 12 fractions to the boost planning target volume (PTV2) that targets only the prostate. PTV coverage, max dose, median dose, target conformity, dose homogeneity, dose to OARs, and probabilities of benefit, injury, and complication-free tumor control (P+) were compared. Statistical significance was tested using either a 2-tailed Student's t-test or Wilcoxon signed-rank test. Dosimetrically, the composite plan with dependent boost phase exhibited smaller hotspots, lower maximum dose to the target without any significant change to normal tissue dose. Radiobiologically, for all but one patient, the percent difference in the P+ values between the two methods was not significant. A large percent difference in P+ value could be attributed to an inferior primary plan. The benefits of considering the dose in primary plan while planning the boost is not significant unless a poor primary plan was achieved.

  9. Design of a distributed radiator target for inertial fusion driven from two sides with heavy ion beams

    SciTech Connect

    Tabak, M.; Callahan-Miller, D.

    1997-11-10

    We describe the status of a distributed radiator heavy ion target design. In integrated calculations this target ignited and produced 390-430 MJ of yieldwhen driven with 5.8-6.5 MJ of 3-4 GeV Pb ions. The target has cylindrical symmetry with disk endplates. The ions uniformly illuminate these endplates in a 5mm radius spot. We discuss the considerations which led to this design together with some previously unused design features: low density hohlraum walls in approximate pressure balance with internal low-Z fill materials, radiationsymmetry determined by the position of the radiator materials and particle ranges, and early time pressure symmetry possibly influenced by radiation shims. We discuss how this target scales to lower input energy or to lower beam power. Variant designs with more realistic beam focusing strategies are also discussed. We show the tradeoffs required for targets which accept higher particle energies.

  10. Planning Efficient NIRSpec MSA Observations

    NASA Astrophysics Data System (ADS)

    Karakla, Diane M.; Beck, Tracy L.; Gilbert, Karoline; Shyrokov, Alexander

    2015-01-01

    It is projected that JWST's NIRSpec Microshutter Array (MSA), which will provide simultaneous multi-object spectroscopy capability for 100+ sources, will be the most heavily used mode of the NIRSpec instrument. Efficient observational plans for the NIRSpec MSA mode are difficult to make manually for several reasons - target positions must be computed with a high degree of accuracy (including optical distortions of the telescope and instrument fore-optics, and correction for observatory motion relative to the target) to avoid the fixed grid of MSA bars and place targets into shutters. Dithering is also highly recommended to mitigate the effects of detector artifacts and areas of poorer detector response. Given these considerations, designing and managing observations of a large number of targets through a set of dithers is made easier and more efficient for the general observer through the use of the MSA Planning Tool (MPT) in APT. We will discuss the recent developments in MPT and introduce a custom MSA observation planner which we call the "interactive planner". The effect of specific parameter choices on multiplexing efficiency in certain science cases is demonstrated. Finally, we describe how members of the community may provide input to the development process.

  11. A transverse electron target for heavy ion storage rings

    SciTech Connect

    Geyer, Sabrina Meusel, Oliver; Kester, Oliver

    2015-01-09

    Electron-ion interaction processes are of fundamental interest for several research fields like atomic and astrophysics as well as plasma applications. To address this topic, a transverse electron target based on the crossed beam technique was designed and constructed for the application in storage rings. Using a sheet beam of free electrons in crossed beam geometry promises a good energy resolution and gives access to the interaction region for spectroscopy. The produced electron beam has a length of 10 cm in ion beam direction and a width in the transverse plane of 5 mm. Therewith, electron densities of up to 10{sup 9} electrons/cm{sup 3} are reachable in the interaction region. The target allows the adjustment of the electron beam current and energy in the region of several 10 eV to a few keV. Simulations have been performed regarding the energy resolution for electron-ion collisions and its influence on spectroscopic measurements. Also, the effect on ion-beam optics due to the space charge of the electron beam was investigated. Presently the electron target is integrated into a test bench to evaluate its performance for its dedicated installation at the storage rings of the FAIR facility. Therefore, optical diagnostics of the interaction region and charge state analysis with a magnetic spectrometer is used. Subsequently, the target will be installed temporarily at the Frankfurt Low-Energy Storage Ring (FLSR) for further test measurements.

  12. Family planning and maternal and child health services.

    PubMed

    Singh, A

    1975-12-01

    Considerable effort has been made in the area of family planning in the State of Punjab. Family planning personnel has been recruited and trained at the State Family Planning Training and Research Center in Kharar; supplies of Nirodh, IUDs, oral contraceptives, and hospital equipment along with transportation facilities have been made available; and there has been some building construction. The State Health Education Bureau has worked to produce publicity material and has also used the mass media to create awareness of family planning among the people. As many as 120 rural and 49 urban Family Welfare Planning Centers are providing family planning services along with 856 subcenters in rural areas. 1123 other institutions are also doing family planning work in addition to the efforts of 34 mobile sterilization and IUD units attached to the District Family Planning Bureau and the contributions of some voluntary organizations. Although the state has adopted the cafeteria approach to family planning and the focus is on provision of family planning services on routine days in the various institutions to well-motivated couples, mass family planning camps for vasectomy, tubal ligations, and IUD insertions have been held with considerable success. Additionally, the State has integrated family planning programs with maternal and child health care in order to provide a totality of service. This precedes the total integration of this national program w ith general health services. Punjab has done well in achieving its targets for 1974-1975. Sterilization targets were set at 38,300 and 36,460 sterilizations, 95.2% of the target, were performed. IUD targets were 27,000, and the number achieved was 39,637 or 109.4%. The conventional contraceptive user target was 99,800, and 151,976 or 152.3% of the target figure became conventional contraceptive users.

  13. Real-time inverse planning for Gamma Knife radiosurgery.

    PubMed

    Wu, Q Jackie; Chankong, Vira; Jitprapaikulsarn, Suradet; Wessels, Barry W; Einstein, Douglas B; Mathayomchan, Boonyanit; Kinsella, Timothy J

    2003-11-01

    The challenges of real-time Gamma Knife inverse planning are the large number of variables involved and the unknown search space a priori. With limited collimator sizes, shots have to be heavily overlapped to form a smooth prescription isodose line that conforms to the irregular target shape. Such overlaps greatly influence the total number of shots per plan, making pre-determination of the total number of shots impractical. However, this total number of shots usually defines the search space, a pre-requisite for most of the optimization methods. Since each shot only covers part of the target, a collection of shots in different locations and various collimator sizes selected makes up the global dose distribution that conforms to the target. Hence, planning or placing these shots is a combinatorial optimization process that is computationally expensive by nature. We have previously developed a theory of shot placement and optimization based on skeletonization. The real-time inverse planning process, reported in this paper, is an expansion and the clinical implementation of this theory. The complete planning process consists of two steps. The first step is to determine an optimal number of shots including locations and sizes and to assign initial collimator size to each of the shots. The second step is to fine-tune the weights using a linear-programming technique. The objective function is to minimize the total dose to the target boundary (i.e., maximize the dose conformity). Results of an ellipsoid test target and ten clinical cases are presented. The clinical cases are also compared with physician's manual plans. The target coverage is more than 99% for manual plans and 97% for all the inverse plans. The RTOG PITV conformity indices for the manual plans are between 1.16 and 3.46, compared to 1.36 to 2.4 for the inverse plans. All the inverse plans are generated in less than 2 min, making real-time inverse planning a reality.

  14. Drug Plan Coverage Rules

    MedlinePlus

    ... Medication Therapy Management programs Drug plan coverage rules , current page Using your drug plan for the first time Filling a prescription without your new plan card Costs for Medicare drug coverage Joining a health or ...

  15. Plan by Increments

    ERIC Educational Resources Information Center

    Kingsbury, M. E.

    1972-01-01

    The think big; paint an elephant" philosophy of planning is appealing in theory but appalling in practice. Too often, making no small plans results in making no plans at all. (11 references) (Author/NH)

  16. Maintenance Business Plans.

    ERIC Educational Resources Information Center

    Adams, Matt

    2002-01-01

    Discusses maintenance business plans, statements which provide accountability for facilities maintenance organizations' considerable budgets. Discusses the plan's components: statement of plan objectives, macro and detailed description of the facility assets, maintenance function descriptions, description of key performance indicators, milestone…

  17. Understanding health insurance plans

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  18. TARGET Publication Guidelines | Office of Cancer Genomics

    Cancer.gov

    Like other NCI large-scale genomics initiatives, TARGET is a community resource project and data are made available rapidly after validation for use by other researchers. To act in accord with the Fort Lauderdale principles and support the continued prompt public release of large-scale genomic data prior to publication, researchers who plan to prepare manuscripts containing descriptions of TARGET pediatric cancer data that would be of comparable scope to an initial TARGET disease-specific comprehensive, global analysis publication, and journal editors who receive such manuscripts, are

  19. Particle production of a graphite target system for the intensity frontier

    SciTech Connect

    Ding, X.; Kirk, H.; McDonald, K. T.

    2015-05-03

    A solid graphite target system is considered for an intense muon and/or neutrino source in support of physics at the intensity frontier. We previously optimized the geometric parameters of the beam and target to maximize particle production at low energies by incoming protons with kinetic energy of 6.75 GeV and an rms geometric emittance of 5 mm-mrad using the MARS15(2014) code. In this study, we ran MARS15 with ROOT-based geometry and also considered a mercury-jet target as an upgrade option. The optimization was extended to focused proton beams with transverse emittances from 5 to 50 mm-mrad, showing that the particle production decreases slowly with increasing emittance. We also studied beam-dump configurations to suppress the rate of undesirable high-energy secondary particles in the beam.

  20. Targeted Therapy for Cancer

    Cancer.gov

    Targeted therapy is a type of cancer treatment that targets the changes in cancer cells that help them grow, divide, and spread. Learn how targeted therapy works against cancer and about side effects that may occur.

  1. 11. Strategic planning.

    PubMed

    2014-05-01

    There are several types of planning processes and plans, including strategic, operational, tactical, and contingency. For this document, operational planning includes tactical planning. This chapter examines the strategic planning process and includes an introduction into disaster response plans. "A strategic plan is an outline of steps designed with the goals of the entire organisation as a whole in mind, rather than with the goals of specific divisions or departments". Strategic planning includes all measures taken to provide a broad picture of what must be achieved and in which order, including how to organise a system capable of achieving the overall goals. Strategic planning often is done pre-event, based on previous experience and expertise. The strategic planning for disasters converts needs into a strategic plan of action. Strategic plans detail the goals that must be achieved. The process of converting needs into plans has been deconstructed into its components and includes consideration of: (1) disaster response plans; (2) interventions underway or planned; (3) available resources; (4) current status vs. pre-event status; (5) history and experience of the planners; and (6) access to the affected population. These factors are tempered by the local: (a) geography; (b) climate; (c) culture; (d) safety; and (e) practicality. The planning process consumes resources (costs). All plans must be adapted to the actual conditions--things never happen exactly as planned.

  2. Colombia's national plan for sexual education.

    PubMed

    1993-01-01

    The brief summary of Colombia's government's plan for sex education emphasized the active involvement of all sectors of society and targeted individuals, families, and society. The National Plan for Sex Education (PNES) was established by the Colombian presidential program for youth, women, and the family (PROMOVER). The plan is an evolution of rights and duties laid out in the National Constitution of 1991 on sexuality. The plan has the support of the First Lady of Colombia. The Foundation of Human and Social Development will provide technical support, and activities will be coordinated between the Ministry of Health, Ministry of Education, and the Colombian Institute of Family Welfare. The objectives of PNES are to promote the development of attitudes that value sexuality, value social gender equality, value autonomy, value responsibility, value harmony of interactions and solidarity, and value sexual health. PNES will begin with planning, coordinating between ministries and sectors, and implementing the decentralized and participatory action plan. The plan involves training, research, communication, services, and institutionalization. Training will be the first priority and will be directed to sensitizing officials and officials administering the plan about sexuality and sex education, to case workers involved with therapeutic interventions, and to youth, parents, and sexually active adolescents. The plan includes criteria for selecting legal advisors and staff from nongovernmental organizations, who will administer the training and evaluations.

  3. Targets set to reduce Lake Erie algae

    USGS Publications Warehouse

    Evans, Mary

    2016-01-01

    In February 2016, the Great Lakes Executive Committee, which oversees the implementation of the Great Lakes Water Quality Agreement (GLWQA) between the U.S. and Canada, approved phosphorus loading targets for Lake Erie to reduce the size of harmful algal blooms (HABs), reduce the presence of the low oxygen zone in the central basin, and protect nearshore water quality. The targets are set with respect to the nutrient loads calculated for 2008. To reduce the impacts of HABs on Lake Erie a target was set of a 40 percent reduction in total and soluble reactive phosphorus loads in the spring from two Canadian rivers and several Michigan and Ohio rivers, especially the Maumee River (https://binational.net/2016/02/22/ finalptargets-ciblesfinalesdep/). States and the province of Ontario are already developing Domestic Action Plans to accomplish the reductions and scientists are developing research and monitoring plans to assess progress.

  4. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the conservation plan, forest stewardship plan, or equivalent plan. Such tree planting plan may allow... 7 Agriculture 10 2014-01-01 2014-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation...

  5. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the conservation plan, forest stewardship plan, or equivalent plan. Such tree planting plan may allow... 7 Agriculture 10 2012-01-01 2012-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation...

  6. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the conservation plan, forest stewardship plan, or equivalent plan. Such tree planting plan may allow... 7 Agriculture 10 2013-01-01 2013-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation...

  7. THE RELATIONSHIP BETWEEN REAL-TIME AND TIME-INTEGRATED COARSE (2.5-10MM), INTERMEDIATE (1-2.5MM), AND FINE (<2.5MM) PARTICULATE MATTER IN THE LOS ANGELES BASIN

    EPA Science Inventory

    Population exposure to ambient particulate matter (PM) has received considerable attention due to the association between ambient particulate concentrations and mortality. Current toxicological and epidemiological studies and controlled human and animal exposures suggest that a...

  8. Environmental Management System Plan

    SciTech Connect

    Fox, Robert; Thorson, Patrick; Horst, Blair; Speros, John; Rothermich, Nancy; Hatayama, Howard

    2009-03-24

    DOE Orders and associated policies establish goals and sustainable stewardship practices that are protective of environmental, natural, and cultural resources, and take a life cycle approach that considers aspects such as: (1) Acquisition and use of environmentally preferable products; (2) Electronics stewardship; (3) Energy conservation, energy efficiency, and renewable energy; (4) Pollution prevention, with emphasis on toxic and hazardous chemical and material reduction; (5) Procurement of efficient energy and water consuming materials and equipment; (6) Recycling and reuse; (7) Sustainable and high-performance building design; (8) Transportation and fleet management; and (9) Water conservation. LBNL's approach to sustainable environmental stewardship required under Order 450.1A poses the challenge of implementing its EMS in a compliance-based, performance-based, and cost-effective manner. In other words, the EMS must deliver real and tangible business value at a minimal cost. The purpose of this plan is to describe Berkeley Lab's approach for achieving such an EMS, including an overview of the roles and responsibilities of key Laboratory parties. This approach begins with a broad-based environmental policy consistent with that stated in Chapter 11 of the LBNL Health and Safety Manual (PUB-3000). This policy states that Berkeley Lab is committed to the following: (1) Complying with applicable environmental, public health, and resource conservation laws and regulations. (2) Preventing pollution, minimizing waste, and conserving natural resources. (3) Correcting environmental hazards and cleaning up existing environmental problems, and (4) Continually improving the Laboratory's environmental performance while maintaining operational capability and sustaining the overall mission of the Laboratory. A continual cycle of planning, implementing, evaluating, and improving processes will be performed to achieve goals, objectives, and targets that will help LBNL carry out

  9. Quasar target selection fiber efficiency

    SciTech Connect

    Newberg, H.; Yanny, B.

    1996-05-01

    We present estimates of the efficiency for finding QSOs as a function of limiting magnitude and galactic latitude. From these estimates, we have formulated a target selection strategy that should net 80,000 QSOs in the north galactic cap with an average of 70 fibers per plate, not including fibers reserved for high-redshift quasars. With this plan, we expect 54% of the targets to be QSOs. The North Galactic Cap is divided into two zones of high and low stellar density. We use about five times as many fibers for QSO candidates in the half of the survey with the lower stellar density as we use in the half with higher stellar density. The current plan assigns 15% of the fibers to FIRST radio sources; if these are not available, those fibers would be allocated to lower probability QSO sources, dropping the total number of QSOs by a small factor (5%). We will find about 17,000 additional quasars in the southern strips, and maybe a few more at very high redshift. Use was made of two data sets: the star and quasar simulated test data generated by Don Schneider, and the data from UJFN plate surveys by Koo (1986) and Kron (1980). This data was compared to results from the Palomar-Green Survey and a recent survey by Pat Osmer and collaborators.

  10. More Accurate Definition of Clinical Target Volume Based on the Measurement of Microscopic Extensions of the Primary Tumor Toward the Uterus Body in International Federation of Gynecology and Obstetrics Ib-IIa Squamous Cell Carcinoma of the Cervix

    SciTech Connect

    Xie, Wen-Jia; Wu, Xiao; Xue, Ren-Liang; Lin, Xiang-Ying; Kidd, Elizabeth A.; Yan, Shu-Mei; Zhang, Yao-Hong; Zhai, Tian-Tian; Lu, Jia-Yang; Wu, Li-Li; Zhang, Hao; Huang, Hai-Hua; Chen, Zhi-Jian; Li, De-Rui; Xie, Liang-Xi

    2015-01-01

    Purpose: To more accurately define clinical target volume for cervical cancer radiation treatment planning by evaluating tumor microscopic extension toward the uterus body (METU) in International Federation of Gynecology and Obstetrics stage Ib-IIa squamous cell carcinoma of the cervix (SCCC). Patients and Methods: In this multicenter study, surgical resection specimens from 318 cases of stage Ib-IIa SCCC that underwent radical hysterectomy were included. Patients who had undergone preoperative chemotherapy, radiation, or both were excluded from this study. Microscopic extension of primary tumor toward the uterus body was measured. The association between other pathologic factors and METU was analyzed. Results: Microscopic extension toward the uterus body was not common, with only 12.3% of patients (39 of 318) demonstrating METU. The mean (±SD) distance of METU was 0.32 ± 1.079 mm (range, 0-10 mm). Lymphovascular space invasion was associated with METU distance and occurrence rate. A margin of 5 mm added to gross tumor would adequately cover 99.4% and 99% of the METU in the whole group and in patients with lymphovascular space invasion, respectively. Conclusion: According to our analysis of 318 SCCC specimens for METU, using a 5-mm gross tumor volume to clinical target volume margin in the direction of the uterus should be adequate for International Federation of Gynecology and Obstetrics stage Ib-IIa SCCC. Considering the discrepancy between imaging and pathologic methods in determining gross tumor volume extent, we recommend a safer 10-mm margin in the uterine direction as the standard for clinical practice when using MRI for contouring tumor volume.

  11. Energy Management Plan.

    ERIC Educational Resources Information Center

    Tasmania Dept. of Education, Hobart (Australia). Facilities Services Section.

    This report presents an overview of the energy management plan for Tasmanian schools designed to minimize the costs of all forms of energy usage within these facilities. The policy and objectives of the plan are provided along with details of the plan itself and its current status. Appendices contain an extract from Asset Management Plan for Real…

  12. Family Planning & Literacy.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    This publication is an International Planned Parenthood Federation (IPPF) annotated bibliography of books and articles concerned with family planning and literacy. The subject is divided into four major listings: (1) Literacy; (2) Education; (3) Literacy and Family Planning; and (4) Functional Literacy/Family Planning Projects and Programs.…

  13. SU-E-T-810: Volumetric Modulated Arc Therapy and Conventional Intensity-Modulated Radiotherapy for Non-Small-Cell Lung Cancer with Simultaneously Integrated Boost Radiation Therapy: A Planning Comparison Study

    SciTech Connect

    Liu, T; Chen, J; Zhang, G; Sun, T

    2015-06-15

    Purpose: To compare and analyze the characteristics of intensity-modulated arc therapy(IMAT) versus fixed-gantry intensity-modulated radiotherapy(IMRT) in treatment of non-small-cell lung cancer. Methods: Twelve patients treated in our radiotherapy center were selected for this study. The patient subsequently underwent 4D-CT simulation.Margins of 5mm and 10mm were added to the ITV to generate the CTV and PTV respectively. Three treatment plans (IMRT,one single arc (RA1),double arcs (RA2))were generated with Eclipse ver.8.6 planning systems. Using a dose level of 75Gy in 15fractions to the ITV,60Gy in 15fractions to the CTV and 45Gy in 15fractions to the PTV respectively. The target and normol tissue volumes were compared,as were the dosimetry parameters. Results: There were no significant differences in CI of ITV,PTV,HI of ITV,CTV and PTV, V5,V10,V15,V20,V25,V30,V45,V50 of total-lung and mean lung dose (all p>0.05). However, the differences were significant in terms of CI of CTV,V5 of B-P (all p<0.05). On the MU, IMRT=1540MU,RA1=1006 MU and RA2=1096 MU. (F=12.00,P=0.000).On the treatment time, IMRT= 13.5min,RA1= 1.5min,and RA2=2.5 min (F= 30.11,P=0.000 ). Conclusion: IMAT is equal to IMRT in dosimetril evaluation. Due to much less Mu and delivery time,IMAT is an ideal technique in treating patients by reduceing the uncomfortable influnce which could effect the treatment.

  14. Dual Target Design for CLAS12

    NASA Astrophysics Data System (ADS)

    Alam, Omair; Gilfoyle, Gerard; Christo, Steve

    2015-10-01

    An experiment to measure the neutron magnetic form factor (GnM) is planned for the new CLAS12 detector in Hall B at Jefferson Lab. This form factor will be extracted from the ratio of the quasielastic electron-neutron to electron-proton scattering off a liquid deuterium (LD2) target. A collinear liquid hydrogen (LH2) target will be used to measure efficiencies at the same time as production data is collected from the LD2 target. To test target designs we have simulated CLAS12 and the target geometry. Electron-nucleon events are produced first with the QUasiElastic Event Generator (QUEEG) which models the internal motion of the nucleons in deuterium.1 The results are used as input to the CLAS12 Monte Caro code gemc; a Geant4-based program that simulates the particle's interactions with each component of CLAS12 including the target material. The dual target geometry has been added to gemc including support structures and cryogenic transport systems. A Perl script was written to define the target materials and geometries. The output of the script is a set of database entries read by gemc at runtime. An initial study of the impact of this dual-target structure revealed limited effects on the electron momentum and angular resolutions. Work supported by the University of Richmond and the US Department of Energy.

  15. Geodesy by radio interferometry - Determination of a 1.24-km base line vector with approximately 5-mm repeatability

    NASA Technical Reports Server (NTRS)

    Rogers, A. E. E.; Knight, C. A.; Hinteregger, H. F.; Whitney, A. R.; Counselman, C. C., III; Shapiro, I. I.; Gourevitch, S. A.; Clark, T. A.

    1978-01-01

    The paper describes a new method for determining the base line vector from X band radio interferometric observations of extragalactic sources. The procedure utilizes the precision inherent in fringe phase measurements. Eleven separate experiments were conducted to measure the 1.24-km base line vector between the two antennas of the Haystack Observatory in Westford, Mass. The repeatability, scatter, and level of accuracy are discussed.

  16. VizieR Online Data Catalog: A 3.5mm polarimetric survey of radio-loud AGNs (Agudo+, 2010)

    NASA Astrophysics Data System (ADS)

    Agudo, I.; Thum, C.; Wiesemeyer, H.; Krichbaum, T. P.

    2010-09-01

    In Table 1, we present our sample of 145 observed sources (see also Fig. 1) which has been built essentially from the 138 radio-loud AGNs in the IRAM pointing sources that were contained in the 1Jy catalog (Kuhr et al. 1981, Cat. VIII/5) and/or in the catalog of 404 compact radio sources by Perley (1982, Cat. J/AJ/87/859). (2 data files).

  17. Clinician's guide to prostate IMRT plan assessment and optimisation.

    PubMed

    Martin, J M; Frantzis, J; Eade, T; Chung, P

    2010-12-01

    Intensity-modulated radiotherapy (IMRT) offers dosimetric benefit for irregularly shaped treatment volumes compared to three-dimensional conformal approaches. Some groups advocate IMRT as the standard of care for prostate radiotherapy. For clinicians, assessment of an IMRT plan can introduce new opportunities and challenges. Although a standard IMRT plan may be deemed acceptable by meeting pre-set dose constraints, further optimisation may yield a superior treatment plan by further reducing dose to critical structures or improving target volume homogeneity. The aim of this article is to present aspects of IMRT planning relevant to clinicians to aid in plan critiquing.

  18. Maine DOE/EPSCoR: 5-year planning grant

    SciTech Connect

    Hawk, B.

    1992-09-28

    Maine EPSCoR has developed a five year plan to further improve Maine`s research and education capacity in the field of Energy. The initiatives of this Energy Education and Research Plan are integrated with other major science policy initiatives in the state, specifically the state`s Science and Technology Strategic Plan (1992), the NSF Statewide Systemic Initiative (1992), and the Report of the Maine Commission on Comprehensive Energy Planning. The plan was developed with the support of US Department of Energy and State of Maine funds. The planning process was led by the Maine DOE EPSCoR planning committee of Maine EPSCoR. Researchers, educators, and business people assisted the committee in the development of the plan. This plan draws from priorities established by focus groups, the strengths and weaknesses revealed by the resource assessment, and the suggestions offered in the solicited research and education briefs. The plan outlines strategies for the improvement of energy education, communication networks, support of individual research, and the formation of collaborative research groups in targeted areas. Five energy-related areas have been targeted for possible development of collaborative research groups: Energy Technology Research, Energy and the Environment, the Gulf of Maine and Its Watershed, the Human Genome, and Renewable Energy. The targeted areas are not boundaries limiting the extent of collaborations to be pursued but represent research themes through which the state`s resources can be combined and improved.

  19. MILITARY RESEARCH: Researchers Target Flaws in Ballistic Missile Defense Plan.

    PubMed

    Malakoff, D; Cho, A

    2000-06-16

    More than three dozen scientists journeyed to Washington, D.C., this week to warn lawmakers that a proposed $60 billion U.S. missile defense system, designed to knock incoming warheads out of the sky, is technically flawed because it can't pick out real warheads from decoys. Pentagon officials heatedly deny a new report by one scientist that contractors have rigged trials to hide the problem, although they admit that some tests were simplified to save time. In the wake of these events, a leading Democrat is urging President Bill Clinton to delay a pending decision on building the system.

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

    SciTech Connect

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

    2015-05-15

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

  1. Polarized internal target apparatus

    DOEpatents

    Holt, R.J.

    1984-10-10

    A polarized internal target apparatus with a polarized gas target of improved polarization and density (achieved by mixing target gas atoms with a small amount of alkali metal gas atoms, and passing a high intensity polarized light source into the mixture to cause the alkali metal gas atoms to become polarized which interact in spin exchange collisions with target gas atoms yielding polarized target gas atoms) is described.

  2. Polarized internal target apparatus

    DOEpatents

    Holt, Roy J.

    1986-01-01

    A polarized internal target apparatus with a polarized gas target of improved polarization and density achieved by mixing target gas atoms with a small amount of alkali metal gas atoms, and passing a high intensity polarized light source into the mixture to cause the alkali metal gas atoms to become polarized which interact in spin exchange collisions with target gas atoms yielding polarized target gas atoms.

  3. Electrically charged targets

    DOEpatents

    Goodman, Ronald K.; Hunt, Angus L.

    1984-01-01

    Electrically chargeable laser targets and method for forming such charged targets in order to improve their guidance along a predetermined desired trajectory. This is accomplished by the incorporation of a small amount of an additive to the target material which will increase the electrical conductivity thereof, and thereby enhance the charge placed upon the target material for guidance thereof by electrostatic or magnetic steering mechanisms, without adversely affecting the target when illuminated by laser energy.

  4. Rotorcraft master plan

    NASA Technical Reports Server (NTRS)

    Hwoschinsky, Peter V.

    1992-01-01

    The Rotorcraft Master Plan contains a comprehensive summary of active and planned FAA vertical flight research and development. Since the Master Plan is not sufficient for tracking project status and monitoring progress, the Vertical Flight Program Plan will provide that capability. It will be consistent with the Master Plan and, in conjunction with it, will serve to ensure a hospitable environment if the industry presents a practical vertical-flight initiative.

  5. Circular on planned parenthood, 1987.

    PubMed

    1987-01-01

    In 1987 fourteen units of the Government of Henan issued a Circular stating that: "Planned parenthood must be publicized deep into the grass roots and among the people, and importance must be attached to results." The Circular stresses: "In the propaganda drive, it is necessary to successfully grasp three key links: 1. It is necessary to disseminate intensively the important directive on population problems that is contained in the report of the 13th CPC National Congress and the seriousness of the population situation of our country and province so that the cadres and the masses can understand the relationship between population control and the achievement of the strategic target of the three big steps, understand the reason for carrying out planned parenthood, understand that the one-child policy is still advocated, and conscientiously carry out planned parenthood. 2. It is essential to succeed in propagating knowledge of contraception, sterilization, childbirth, and child care and in conducting ideological education for those who undergo operations and for their family members. 3. It is imperative to visit those who have undergone operations and to help them solve practically their difficulties in making a living." The Circular concludes by demanding that under the unified leadership of party committees and governments at all levels, the propaganda drive be carried out by relying on the efforts of all of society. In conjunction with their own work, departments, including the propaganda, education, public health, and cultural departments, must carry out propaganda and education for planned parenthood.

  6. 76 FR 40394 - Final Plan for Fiscal Year 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... of congressional earmark programs; research; training and technical assistance; funding of... National Leadership: OJJDP provides ] targeted funding, sponsors research and demonstration programs... funded under the Final Plan for FY 2011. These funding opportunities are announced via OJJDP's...

  7. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  8. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  9. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  10. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  11. 42 CFR 457.310 - Targeted low-income child.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Targeted low-income child. 457.310 Section 457.310... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child....

  12. Preferred Provider Organization (PPO) Plans

    MedlinePlus

    ... change plans Types of Medicare health plans Medicare Advantage Plans + Share widget - Select to show Subcategories Getting ... Types of Medicare health plans , current subcategory Medicare Advantage Plans , current page Medicare Medical Savings Account (MSA) ...

  13. Medicare Special Needs Plan (SNP)

    MedlinePlus

    ... change plans Types of Medicare health plans Medicare Advantage Plans + Share widget - Select to show Subcategories Getting ... Types of Medicare health plans , current subcategory Medicare Advantage Plans , current page Medicare Medical Savings Account (MSA) ...

  14. Hospitals: Soft Target for Terrorism?

    PubMed

    De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J

    2017-02-01

    In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning

  15. A new plan quality index for nasopharyngeal cancer SIB IMRT.

    PubMed

    Jin, X; Yi, J; Zhou, Y; Yan, H; Han, C; Xie, C

    2014-02-01

    A new plan quality index integrating dosimetric and radiobiological indices was proposed to facilitate the evaluation and comparison of simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) plans for nasopharyngeal cancer (NPC) patients. Ten NPC patients treated by SIB-IMRT were enrolled in the study. Custom software was developed to read dose-volume histogram (DVH) curves from the treatment planning system (TPS). A plan filtering matrix was introduced to filter plans that fail to satisfy treatment protocol. Target plan quality indices and organ at risk (OAR) plan quality indices were calculated for qualified plans. A unique composite plan quality index (CPQI) was proposed based on the relative weight of these indices to evaluate and compare competing plans. Plan ranking results were compared with detailed statistical analysis, radiation oncology quality system (ROQS) scoring results and physician's evaluation results to verify the accuracy of this new plan quality index. The average CPQI values for plans with OAR priority of low, normal, high, and PTV only were 0.22 ± 0.08, 0.49 ± 0.077, 0.71 ± 0.062, and -0.21 ± 0.16, respectively. There were significant differences among these plan quality indices (One-way ANOVA test, p < 0.01). This was consistent with statistical analysis, ROQS results and physician's ranking results in which 90% OAR high plans were selected. Plan filtering matrix was able to speed up the plan evaluation process. The new matrix plan quality index CPQI showed good consistence with physician ranking results. It is a promising index for NPC SIB-IMRT plan evaluation.

  16. Action Planning in Young Children's Tool Use

    ERIC Educational Resources Information Center

    Cox, Ralf F. A.; Smitsman, Ad W.

    2006-01-01

    Tool use consists of at least two coupled phases of activities, involving multi-step problem solving. It therefore provides an interesting window on the development of planning in goal-directed behavior. This study investigated 2-year-olds' and 3-year-olds' hand use in picking up and subsequently using a tool for displacing a target-object towards…

  17. MI high power operation and future plans

    SciTech Connect

    Kourbanis, Ioanis; /Fermilab

    2008-09-01

    Fermilab's Main Injector on acceleration cycles to 120 GeV has been running a mixed mode operation delivering beam to both the antiproton source for pbar production and to the NuMI[1] target for neutrino production since 2005. On January 2008 the slip stacking process used to increase the beam to the pbar target was expanded to include the beam to the NuMI target increasing both the beam intensity and power. The current high power MI operation will be described along with the near future plans.

  18. Site Development Planning Handbook

    SciTech Connect

    1981-01-01

    The Handbook provides facility managers and site planners at DOE organizations responsible for planning site developments and facilities utilization a step-by-step planning checklist to ensure that planners at each site are focusing on Department-wide goals and objectives. It begins with a brief discussion of a site development-by-objectives program design to promote, recognize, and implement opportunities for improvements in site utilization through planning. Additional information is included on: assembling existing data, plans, programs, and procedures; establishing realistic objectives; identifying site problems, opportunities; and development needs; determining priorities among development needs; developing short and long-range plans; choosing the right development solutions and meeting minimum legal site restrictions; presenting the plan; implementing elements of the plan; monitoring and reporting plan status; and modifying development program plans. (MCW)

  19. Not planning a sustainable transport system

    SciTech Connect

    Finnveden, Göran Åkerman, Jonas

    2014-04-01

    The overall objective of the Swedish transport policy is to ensure the economically efficient and sustainable provision of transport services for people and business throughout the country. More specifically, the transport sector shall, among other things, contribute to the achievement of environmental quality objectives in which the development of the transport system plays an important role in the achievement of the objectives. The aim of this study is to analyse if current transport planning supports this policy. This is done by analysing two recent cases: the National Infrastructure Plan 2010–2021, and the planning of Bypass Stockholm, a major road investment. Our results show that the plans are in conflict with several of the environmental quality objectives. Another interesting aspect of the planning processes is that the long-term climate goals are not included in the planning processes, neither as a clear goal nor as factor that will influence future transport systems. In this way, the long-term sustainability aspects are not present in the planning. We conclude that the two cases do not contribute to a sustainable transport system. Thus, several changes must be made in the processes, including putting up clear targets for emissions. Also, the methodology for the environmental assessments needs to be further developed and discussed. - Highlights: • Two cases are studied to analyse if current planning supports a sustainable transport system. • Results show that the plans are in conflict with several of the environmental quality objectives. • Long-term climate goals are not included in the planning processes. • Current practices do not contribute to a sustainable planning processes. • Methodology and process for environmental assessments must be further developed and discussed.

  20. Transit administration and planning research

    SciTech Connect

    de Corla-Souza; Gupta.

    1989-01-01

    The 10 papers in the report deal with the following areas: Evaluation of demand-management strategies for Toledo's year 2010 transportation plan; Accommodating deaf and hard-of-hearing persons on public transportation systems in Massachusetts; Quick approach to compare highway and bus transit alternatives using the arterial analysis package; Panel survey approach to measuring transit route service elasticity of demand; UMTA and major investments: evaluation process and results; Using early performance to project transit route ridership: comparison of methods; Institutional requirements for competition: labor issues; Updating ride checks with multiple point checks; Producing section 15 service-consumed data: challenge for large transit; Parkrose targeted marketing campaign pass-incentive program.

  1. Human target acquisition performance

    NASA Astrophysics Data System (ADS)

    Teaney, Brian P.; Du Bosq, Todd W.; Reynolds, Joseph P.; Thompson, Roger; Aghera, Sameer; Moyer, Steven K.; Flug, Eric; Espinola, Richard; Hixson, Jonathan

    2012-06-01

    The battlefield has shifted from armored vehicles to armed insurgents. Target acquisition (identification, recognition, and detection) range performance involving humans as targets is vital for modern warfare. The acquisition and neutralization of armed insurgents while at the same time minimizing fratricide and civilian casualties is a mounting concern. U.S. Army RDECOM CERDEC NVESD has conducted many experiments involving human targets for infrared and reflective band sensors. The target sets include human activities, hand-held objects, uniforms & armament, and other tactically relevant targets. This paper will define a set of standard task difficulty values for identification and recognition associated with human target acquisition performance.

  2. Magnetically attached sputter targets

    DOEpatents

    Makowiecki, D.M.; McKernan, M.A.

    1994-02-15

    An improved method and assembly for attaching sputtering targets to cathode assemblies of sputtering systems which includes a magnetically permeable material is described. The magnetically permeable material is imbedded in a target base that is brazed, welded, or soldered to the sputter target, or is mechanically retained in the target material. Target attachment to the cathode is achieved by virtue of the permanent magnets and/or the pole pieces in the cathode assembly that create magnetic flux lines adjacent to the backing plate, which strongly attract the magnetically permeable material in the target assembly. 11 figures.

  3. Magnetically attached sputter targets

    DOEpatents

    Makowiecki, Daniel M.; McKernan, Mark A.

    1994-01-01

    An improved method and assembly for attaching sputtering targets to cathode assemblies of sputtering systems which includes a magnetically permeable material. The magnetically permeable material is imbedded in a target base that is brazed, welded, or soldered to the sputter target, or is mechanically retained in the target material. Target attachment to the cathode is achieved by virtue of the permanent magnets and/or the pole pieces in the cathode assembly that create magnetic flux lines adjacent to the backing plate, which strongly attract the magnetically permeable material in the target assembly.

  4. An Innovative Multi-Agent Search-and-Rescue Path Planning Approach

    DTIC Science & Technology

    2015-03-09

    path planning may be found in the robotics literature in the area of robot motion planning [8] and, namely, terrain acquisition [9], [10] and coverage...path planning [11],[12], [13]. Robot motion planning explored search path planning, primarily providing constrained shortest path type solutions...involving unknown sparsely distributed static targets and obstacles. Separate work on robot search algorithms is also referenced on the pursuit

  5. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... purposes as determined by CCC. (c) If applicable, a tree planting plan must be developed and included in the conservation plan, forest stewardship plan, or equivalent plan. Such tree planting plan may...

  6. Model compilation for embedded real-time planning and diagnosis

    NASA Technical Reports Server (NTRS)

    Barrett, Anthony

    2004-01-01

    This paper describes MEXEC, an implemented micro executive that compiles a device model into an interal structure. Not only does this structure facilitate computing the most likely current device mode from n sets of sensor measurements, but it also facilitates generating an n step reconfiguration plan that is most likely not to result in reaching a target mode - if such a plan exists.

  7. Planning for Applications of Communications Satellites in Education.

    ERIC Educational Resources Information Center

    O'Connell, William K.

    This report of a project to develop and test a prototype system for the delivery of continuing education (CE) to two defined target groups of registered dietitians includes user needs, alternative approaches, the operational plan, the management plan, and personnel. Major tasks involved in the project are described: (1) development,…

  8. Adult Basic Skills: Developing a Local Action Plan.

    ERIC Educational Resources Information Center

    Basic Skills Agency, London (England).

    This document presents advice from the United Kingdom's Basic Skills Agency regarding developing local action plans. The first 20% of the document defines basic skills and discusses the following action plan components: (1) an estimate of the area's need for basic skills training; (2) a target to reduce the area's estimated scale of need; (3)…

  9. Probabilistic objective functions for margin-less IMRT planning.

    PubMed

    Bohoslavsky, Román; Witte, Marnix G; Janssen, Tomas M; van Herk, Marcel

    2013-06-07

    We present a method to implement probabilistic treatment planning of intensity-modulated radiation therapy using custom software plugins in a commercial treatment planning system. Our method avoids the definition of safety-margins by directly including the effect of geometrical uncertainties during optimization when objective functions are evaluated. Because the shape of the resulting dose distribution implicitly defines the robustness of the plan, the optimizer has much more flexibility than with a margin-based approach. We expect that this added flexibility helps to automatically strike a better balance between target coverage and dose reduction for surrounding healthy tissue, especially for cases where the planning target volume overlaps organs at risk. Prostate cancer treatment planning was chosen to develop our method, including a novel technique to include rotational uncertainties. Based on population statistics, translations and rotations are simulated independently following a marker-based IGRT correction strategy. The effects of random and systematic errors are incorporated by first blurring and then shifting the dose distribution with respect to the clinical target volume. For simplicity and efficiency, dose-shift invariance and a rigid-body approximation are assumed. Three prostate cases were replanned using our probabilistic objective functions. To compare clinical and probabilistic plans, an evaluation tool was used that explicitly incorporates geometric uncertainties using Monte-Carlo methods. The new plans achieved similar or better dose distributions than the original clinical plans in terms of expected target coverage and rectum wall sparing. Plan optimization times were only about a factor of two higher than in the original clinical system. In conclusion, we have developed a practical planning tool that enables margin-less probability-based treatment planning with acceptable planning times, achieving the first system that is feasible for clinical

  10. Predicting target vessel location on robot-assisted coronary artery bypass graft using CT to ultrasound registration

    SciTech Connect

    Cho, Daniel S.; Linte, Cristian; Chen, Elvis C. S.; Bainbridge, Daniel; Wedlake, Chris; Moore, John; Barron, John; Patel, Rajni; Peters, Terry

    2012-03-15

    {sub 2}. Conclusions: The authors proposed a method to measure and validate peri-operative shifts of the heart during RA-CABG. In vitro and clinical validation studies were conducted and yielded a TRE in the order of 5 mm for all cases. As the desired clinical accuracy imposed by this procedure is on the order of one intercostal space (10-15 mm), our technique suits the clinical requirements. The authors therefore believe this technique has the potential to improve the pre-operative planning by updating peri-operative migration patterns of the heart and, consequently, will lead to reduced conversion to conventional open thoracic procedures.

  11. Liner target interaction experiments on Pegasus II

    SciTech Connect

    Hockaday, M.P.; Chrien, R.E.; Bartsch, R.

    1995-09-01

    The Los Alamos High Energy Density Physics program uses capacitively driven low voltage, inductive-storage pulse power to implode cylindrical targets for hydrodynamics experiments. Once a precision driver liner was characterized an experimental series characterizing the aluminum target dynamics was performed. The target was developed for shock-induced quasi-particle ejecta experiments including holography. The concept for the Liner shock experiment is that the driver liner is used to impact the target liner which then accelerates toward a collimator with a slit in it. A shock wave is set up in the target liner and as the shock emerges from the back side of the target liner, ejecta are generated. By taking a laser hologram the particle distribution of the ejecta are hoped to be determined. The goal for the second experimental series was to characterize the target dynamics and not to measure and generate the ejecta. Only the results from the third shot, Pegasus II-26 fired April 26th, 1994, from the series is discussed in detail. The second experimental series successfully characterized the target dynamics necessary to move forward towards the planned quasi-ejecta experiments.

  12. Targeting Air Interdiction in Support of Airland Battle.

    DTIC Science & Technology

    2014-09-26

    and execute air attacks against Army nominated targets are. described in detail. The impact of emerging technology in the form of advanced sensors...Element (BCE) are defined. Coordinating procedures used by the TACC- BCE to plan and execute air attacks against Army nominated targets are described...in capi- talizing on on-going procedural and equipment related improvements that allow the Army and the Air Force to locate, target and attack enemy

  13. Technology Planning: Thinking Strategically for Planning.

    ERIC Educational Resources Information Center

    Westbrook, Kathleen C.

    1993-01-01

    Sound educational planning is essential in an era faced with declining resources, increasing accountability demands, and reluctance to fund higher taxation requests. Planners are seriously challenged by shift from an industrial to a paperless, technological society. This article compares long-range and strategic planning approaches, describes…

  14. 30 CFR 780.14 - Operation plan: Maps and plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Operation plan: Maps and plans. 780.14 Section... PLAN § 780.14 Operation plan: Maps and plans. Each application shall contain maps and plans as follows: (a) The maps and plans shall show the lands proposed to be affected throughout the operation and...

  15. 30 CFR 784.23 - Operation plan: Maps and plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Operation plan: Maps and plans. 784.23 Section... PLAN § 784.23 Operation plan: Maps and plans. Each application shall contain maps and plans as follows: (a) The maps, plans and cross-sections shall show the underground mining activities to be...

  16. Comparison of computer-assisted planning and manual planning for depth electrode implantations in epilepsy.

    PubMed

    Nowell, Mark; Sparks, Rachel; Zombori, Gergely; Miserocchi, Anna; Rodionov, Roman; Diehl, Beate; Wehner, Tim; Baio, Gianluca; Trevisi, Gianluca; Tisdall, Martin; Ourselin, Sebastien; McEvoy, Andrew W; Duncan, John

    2016-06-01

    OBJECT The objective of this study was to evaluate the clinical utility of multitrajectory computer-assisted planning software (CAP) to plan stereoelectroencephalography (SEEG) electrode arrangements. METHODS A cohort of 18 patients underwent SEEG for evaluation of epilepsy at a single center between August 2013 and August 2014. Planning of electrodes was performed manually and stored using EpiNav software. CAP was developed as a planning tool in EpiNav. The user preselects a set of cerebral targets and optimized trajectory constraints, and then runs an automated search of potential scalp entry points and associated trajectories. Each trajectory is associated with metrics for a safety profile, derived from the minimal distance to vascular structures, and an efficacy profile, derived from the proportion of depth electrodes that are within or adjacent to gray matter. CAP was applied to the cerebral targets used in the cohort of 18 previous manually planned implantations to generate new multitrajectory implantation plans. A comparison was then undertaken for trajectory safety and efficacy. RESULTS CAP was applied to 166 electrode targets in 18 patients. There were significant improvements in both the safety profile and efficacy profile of trajectories generated by CAP compared with manual planning (p < 0.05). Three independent neurosurgeons assessed the feasibility of the trajectories generated by CAP, with 131 (78.9%) of 166 trajectories deemed suitable for implementation in clinical practice. CAP was performed in real time, with a median duration of 8 minutes for each patient, although this does not include the time taken for data preparation. CONCLUSIONS CAP is a promising tool to plan SEEG implantations. CAP provides feasible depth electrode arrangements, with quantitatively greater safety and efficacy profiles, and with a substantial reduction in duration of planning within the 3D multimodality framework.

  17. Distributed Operations Planning

    NASA Technical Reports Server (NTRS)

    Fox, Jason; Norris, Jeffrey; Powell, Mark; Rabe, Kenneth; Shams, Khawaja

    2007-01-01

    Maestro software provides a secure and distributed mission planning system for long-term missions in general, and the Mars Exploration Rover Mission (MER) specifically. Maestro, the successor to the Science Activity Planner, has a heavy emphasis on portability and distributed operations, and requires no data replication or expensive hardware, instead relying on a set of services functioning on JPL institutional servers. Maestro works on most current computers with network connections, including laptops. When browsing down-link data from a spacecraft, Maestro functions similarly to being on a Web browser. After authenticating the user, it connects to a database server to query an index of data products. It then contacts a Web server to download and display the actual data products. The software also includes collaboration support based upon a highly reliable messaging system. Modifications made to targets in one instance are quickly and securely transmitted to other instances of Maestro. The back end that has been developed for Maestro could benefit many future missions by reducing the cost of centralized operations system architecture.

  18. Online Planning Algorithm

    NASA Technical Reports Server (NTRS)

    Rabideau, Gregg R.; Chien, Steve A.

    2010-01-01

    AVA v2 software selects goals for execution from a set of goals that oversubscribe shared resources. The term goal refers to a science or engineering request to execute a possibly complex command sequence, such as image targets or ground-station downlinks. Developed as an extension to the Virtual Machine Language (VML) execution system, the software enables onboard and remote goal triggering through the use of an embedded, dynamic goal set that can oversubscribe resources. From the set of conflicting goals, a subset must be chosen that maximizes a given quality metric, which in this case is strict priority selection. A goal can never be pre-empted by a lower priority goal, and high-level goals can be added, removed, or updated at any time, and the "best" goals will be selected for execution. The software addresses the issue of re-planning that must be performed in a short time frame by the embedded system where computational resources are constrained. In particular, the algorithm addresses problems with well-defined goal requests without temporal flexibility that oversubscribes available resources. By using a fast, incremental algorithm, goal selection can be postponed in a "just-in-time" fashion allowing requests to be changed or added at the last minute. Thereby enabling shorter response times and greater autonomy for the system under control.

  19. Pitfalls in normalization for intensity-modulated radiation therapy planning

    SciTech Connect

    Williams, Greg . E-mail: greg.williams@hci.utah.edu; Tobler, Matt; Leavitt, Dennis

    2005-01-01

    Three-dimensional (3D) treatment planning often involves complex combinations of beam energies, treatment fields, and beam modifying devices. Even when a plan is devised that meets many treatment-planning objectives, limitations in the planner's ability to further adjust beam characteristics may require the radiation dose prescription to be normalized to an isodose level that best covers the target volume. While these normalizations help meet the volume coverage goals, they also result in adjustment of the dose delivered to the normal tissues and must be carefully evaluated. Intensity-modulated radiation therapy (IMRT) treatment planning allows combinations of complex dose patterns, in order to achieve the desired treatment planning goals. These dose patterns are created by defining a set of treatment planning objectives and then allowing the treatment planning computer to create intensity patterns, through the use of moving multileaf collimation that will meet the requested goals. Often, when an IMRT treatment plan is created that meets many of the treatment planning goals but falls short of volume coverage requirements, the planner is tempted to apply normalization principles similar to those utilized with 3D treatment planning. Again, these normalizations help meet the volume coverage goals, but unlike 3D planning situations, may result in avoidable delivery of additional doses to the normal tissues. The focus of this study is to evaluate the effect of application of normalization for IMRT planning using multiple patient situations. Recommendations would favor re-optimization over normalization in most planning situations.

  20. Compliance of Australian threatened species recovery plans with legislative requirements.

    PubMed

    Ortega-Argueta, Alejandro; Baxter, Greg; Hockings, Marc

    2011-08-01

    Recovery plans are the main documents supporting management decision-making for threatened species. We evaluated Australian recovery plans to assess their appropriateness as conservation and management planning instruments. Six legislative requirements (species information and general requirements, species distribution and location, known and potential threats, objectives, performance criteria and actions, duration of the plan, and estimated costs of plan implementation) were used to assess the degree of compliance of recovery plans with the relevant legislation. We assessed all 236 official recovery plans which had been adopted as at January 2006. The results showed that plans were most compliant regarding the setting of objectives, performance criteria, recovery actions, and duration of plan. Most plans included a single performance criterion that was generally related to the population status of target species. Improvement is required in relation to identification of current threats and critical habitats, and the establishment of basic elements of monitoring and evaluation for measuring recovery progress. Gaps in ecological information are the main factors affecting adequate compliance with legislative requirements as opposed to managerial information (e.g. clarity in establishing the implementation schedule, costs and resource allocation). Planning deficiencies could be addressed by improving the recovery planning guidelines and more carefully reviewing the drafting and adoption of new plans.

  1. Targeted Cancer Therapies

    MedlinePlus

    ... targets is to determine whether cancer cells produce mutant (altered) proteins that drive cancer progression . For example, ... V600E) in many melanomas . Vemurafenib (Zelboraf®) targets this mutant form of the BRAF protein and is approved ...

  2. High Power Cryogenic Targets

    SciTech Connect

    Gregory Smith

    2011-08-01

    The development of high power cryogenic targets for use in parity violating electron scattering has been a crucial ingredient in the success of those experiments. As we chase the precision frontier, the demands and requirements for these targets have grown accordingly. We discuss the state of the art, and describe recent developments and strategies in the design of the next generation of these targets.

  3. An actionable climate target

    NASA Astrophysics Data System (ADS)

    Geden, Oliver

    2016-05-01

    The Paris Agreement introduced three mitigation targets. In the future, the main focus should not be on temperature targets such as 2 or 1.5 °C, but on the target with the greatest potential to effectively guide policy: net zero emissions.

  4. Adaptive infrared target detection

    NASA Astrophysics Data System (ADS)

    McBride, Jonah C.; Stevens, Mark R.; Eaton, Ross S.; Snorrason, Magnus S.

    2004-09-01

    Automatic Target Recognition (ATR) algorithms are extremely sensitive to differences between the operating conditions under which they are trained and the extended operating conditions (EOCs) in which the fielded algorithms are tested. These extended operating conditions can cause a target's signature to be drastically different from training exemplars/models. For example, a target's signature can be influenced by: the time of day, the time of year, the weather, atmospheric conditions, position of the sun or other illumination sources, the target surface and material properties, the target composition, the target geometry, sensor characteristics, sensor viewing angle and range, the target surroundings and environment, and the target and scene temperature. Recognition rates degrade if an ATR is not trained for a particular EOC. Most infrared target detection techniques are based on a very simple probabilistic theory. This theory states that a pixel should be assigned the label of "target" if a set of measurements (features) is more likely to have come from an assumed (or learned) distribution of target features than from the distribution of background features. However, most detection systems treat these learned distributions as static and they are not adapted to changing EOCs. In this paper, we present an algorithm for assigning a pixel the label of target or background based on a statistical comparison of the distributions of measurements surrounding that pixel in the image. This method provides a feature-level adaptation to changing EOCs. Results are demonstrated on infrared imagery containing several military vehicles.

  5. Air Quality Implementation Plans

    EPA Pesticide Factsheets

    States must develop plans to attain and maintain air quality standards. These plans, known as SIPs, are submitted to EPA for approval. This web site contains information about this process and the current status of the submittals.

  6. Line Up a Plan.

    ERIC Educational Resources Information Center

    Miller, Lamoine J.; Beattie, John R.

    1992-01-01

    This article presents a lesson plan for teaching students the third of five steps for solving mathematical problems, "lining up a plan." Steps for teaching students to visualize the problem and draw a picture of the problem are given. (DB)

  7. Developing the plan

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The basic sequence in the planning development process is discussed. Alternative ways of satisfying estimated needs, and the selection of an alternative are described along with the development of a plan to implement the selected alternative.

  8. Planning for Office Automation.

    ERIC Educational Resources Information Center

    Mick, Colin K.

    1983-01-01

    Outlines a practical approach to planning for office automation termed the "Focused Process Approach" (the "what" phase, "how" phase, "doing" phase) which is a synthesis of the problem-solving and participatory planning approaches. Thirteen references are provided. (EJS)

  9. Advance Care Planning.

    PubMed

    Stallworthy, Elizabeth J

    2013-04-16

    Advance care planning should be available to all patients with chronic kidney disease, including end-stage kidney disease on renal replacement therapy. Advance care planning is a process of patient-centred discussion, ideally involving family/significant others, to assist the patient to understand how their illness might affect them, identify their goals and establish how medical treatment might help them to achieve these. An Advance Care Plan is only one useful outcome from the Advance Care Planning process, the education of patient and family around prognosis and treatment options is likely to be beneficial whether or not a plan is written or the individual loses decision making capacity at the end of life. Facilitating Advance Care Planning discussions requires an understanding of their purpose and communication skills which need to be taught. Advance Care Planning needs to be supported by effective systems to enable the discussions and any resulting Plans to be used to aid subsequent decision making.

  10. Human Resource Planning

    ERIC Educational Resources Information Center

    Hoffman, W. H.; Wyatt, L. L.

    1977-01-01

    By using the total resource approach, we have focused attention on the need to integrate human resource planning with other business plans and highlighted the importance of a productivity strategy. (Author)

  11. SU-E-T-626: Accuracy of Dose Calculation Algorithms in MultiPlan Treatment Planning System in Presence of Heterogeneities

    SciTech Connect

    Moignier, C; Huet, C; Barraux, V; Loiseau, C; Sebe-Mercier, K; Batalla, A; Makovicka, L

    2014-06-15

    Purpose: Advanced stereotactic radiotherapy (SRT) treatments require accurate dose calculation for treatment planning especially for treatment sites involving heterogeneous patient anatomy. The purpose of this study was to evaluate the accuracy of dose calculation algorithms, Raytracing and Monte Carlo (MC), implemented in the MultiPlan treatment planning system (TPS) in presence of heterogeneities. Methods: First, the LINAC of a CyberKnife radiotherapy facility was modeled with the PENELOPE MC code. A protocol for the measurement of dose distributions with EBT3 films was established and validated thanks to comparison between experimental dose distributions and calculated dose distributions obtained with MultiPlan Raytracing and MC algorithms as well as with the PENELOPE MC model for treatments planned with the homogenous Easycube phantom. Finally, bones and lungs inserts were used to set up a heterogeneous Easycube phantom. Treatment plans with the 10, 7.5 or the 5 mm field sizes were generated in Multiplan TPS with different tumor localizations (in the lung and at the lung/bone/soft tissue interface). Experimental dose distributions were compared to the PENELOPE MC and Multiplan calculations using the gamma index method. Results: Regarding the experiment in the homogenous phantom, 100% of the points passed for the 3%/3mm tolerance criteria. These criteria include the global error of the method (CT-scan resolution, EBT3 dosimetry, LINAC positionning …), and were used afterwards to estimate the accuracy of the MultiPlan algorithms in heterogeneous media. Comparison of the dose distributions obtained in the heterogeneous phantom is in progress. Conclusion: This work has led to the development of numerical and experimental dosimetric tools for small beam dosimetry. Raytracing and MC algorithms implemented in MultiPlan TPS were evaluated in heterogeneous media.

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

    SciTech Connect

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

    2014-06-01

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

  13. Decoupling eye and hand movement control: visual short-term memory influences reach planning more than saccade planning.

    PubMed

    Issen, Laurel A; Knill, David C

    2012-01-04

    When reaching for objects, humans make saccades to fixate the object at or near the time the hand begins to move. In order to address whether the CNS relies on a common representation of target positions to plan both saccades and hand movements, we quantified the contributions of visual short-term memory (VSTM) to hand and eye movements executed during the same coordinated actions. Subjects performed a sequential movement task in which they picked up one of two objects on the right side of a virtual display (the "weapon"), moved it to the left side of the display (to a "reloading station") and then moved it back to the right side to hit the other object (the target). On some trials, the target was perturbed by 1° of visual angle while subjects moved the weapon to the reloading station. Although subjects did not notice the change, the original position of the target, encoded in VSTM, influenced the motor plans for both the hand and the eye back to the target. Memory influenced motor plans for distant targets more than for near targets, indicating that sensorimotor planning is sensitive to the reliability of available information; however, memory had a larger influence on hand movements than on eye movements. This suggests that spatial planning for coordinated saccades and hand movements are dissociated at the level of processing at which online visual information is integrated with information in short-term memory.

  14. Microgravity strategic plan, 1988

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The NASA agency-wide microgravity strategic plan is presented, and its research, applications, and commercialization for the 1990's is addressed. The plan presents an analysis of the current situation, identifies critical factors, and defines goals, objectives, and strategies, which are intended to: (1) provide a context for decision making; (2) assure realism in long-range planning and direction for hardware development; and (3) establish a framework for developing a national microgravity research plan.

  15. SU-E-T-580: Comparison of Cervical Carcinoma IMRT Plans From Four Commercial Treatment Planning Systems (TPS)

    SciTech Connect

    Cao, Y; Li, R; Chi, Z; Zhu, S

    2014-06-01

    Purpose: Different treatment planning systems (TPS) use different treatment optimization and leaf sequencing algorithms. This work compares cervical carcinoma IMRT plans optimized with four commercial TPSs to investigate the plan quality in terms of target conformity and delivery efficiency. Methods: Five cervical carcinoma cases were planned with the Corvus, Monaco, Pinnacle and Xio TPSs by experienced planners using appropriate optimization parameters and dose constraints to meet the clinical acceptance criteria. Plans were normalized for at least 95% of PTV to receive the prescription dose (Dp). Dose-volume histograms and isodose distributions were compared. Other quantities such as Dmin(the minimum dose received by 99% of GTV/PTV), Dmax(the maximum dose received by 1% of GTV/PTV), D100, D95, D90, V110%, V105%, V100% (the volume of GTV/PTV receiving 110%, 105%, 100% of Dp), conformity index(CI), homogeneity index (HI), the volume of receiving 40Gy and 50 Gy to rectum (V40,V50) ; the volume of receiving 30Gy and 50 Gy to bladder (V30,V50) were evaluated. Total segments and MUs were also compared. Results: While all plans meet target dose specifications and normal tissue constraints, the maximum GTVCI of Pinnacle plans was up to 0.74 and the minimum of Corvus plans was only 0.21, these four TPSs PTVCI had significant difference. The GTVHI and PTVHI of Pinnacle plans are all very low and show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans require significantly less segments and MUs to deliver than the other plans. Conclusion: To deliver on a Varian linear-accelerator, the Pinnacle plans show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans have faster beam delivery.

  16. STARS MDT-II targets mission

    SciTech Connect

    Sims, B.A.; White, J.E.

    1997-08-01

    The Strategic Target System (STARS) was launched successfully on August 31, 1996 from the Kauai Test Facility (KTF) at the Pacific Missile Range Facility (PMRF). The STARS II booster delivered a payload complement of 26 vehicles atop a post boost vehicle. These targets were designed and the mission planning was achieved to provide for a dedicated mission for view by the Midcourse Space Experiment (MSX) Satellite Sensor Suite. Along with the MSX Satellite, other corollary sensors were involved. Included in these were the Airborne Surveillance Test Bed (AST) aircraft, the Cobra Judy sea based radar platform, Kwajalein Missile Range (KMR), and the Kiernan Reentry Measurements Site (KREMS). The launch was a huge success from all aspects. The STARS Booster flew a perfect mission from hardware, software and mission planning respects. The payload complement achieved its desired goals. All sensors (space, air, ship, and ground) attained excellent coverage and data recording.

  17. Planning for School Emergencies.

    ERIC Educational Resources Information Center

    Della-Giustina, Daniel E.

    This document is designed to provide civil leaders and school administrators with a resource that will enable them to develop comprehensive contingency plans for specific emergency situations. A discussion of disaster and emergency management planning includes an outline of the objectives of emergency planning that were established for this guide.…

  18. Planning Homemaking Departments.

    ERIC Educational Resources Information Center

    Schooler, Ruth; Mather, Mary

    1961-01-01

    A comprehensive guide for home economists, the article treats five major ideas for planning home economics departments in schools, as follows--(1) the importance of sharing the planning responsibility among teacher, parent, and administrator, citing an example of successful planning, (2) the need for teaching methods, course content and equipment…

  19. Perspectives on Educational Planning.

    ERIC Educational Resources Information Center

    Miklos, E.; And Others

    This overview is designed to provide those readers who have just begun to study educational planning with a useful point of departure for the more intensive examination of educational planning literature. The first chapter offers definitions of concepts that are the subject of chapters to follow. The discussion of educational planning in Chapter…

  20. Strategies for Planning.

    ERIC Educational Resources Information Center

    Broadbent, H. E., III

    1981-01-01

    Provides a definition of the planning process drawing upon models from management science, outlines the steps library administrators should take in developing a planning program, and describes some of the recent planning processes for public libraries, school media centers, academic libraries, and special libraries. A reference list is provided.…

  1. Budget and Planning.

    ERIC Educational Resources Information Center

    Haeuser, Patricia N.

    2000-01-01

    Explores how a close integration of university-level planning and budgeting is required to drive change. Discusses major professional challenges of achieving this integration, the infrastructure of an office of budget and planning, and professional pathways for planning and budgeting officers. Also describes the author's personal career path in…

  2. Disaster: Planning, Preparation, Prevention.

    ERIC Educational Resources Information Center

    Rutherford, Christine

    1990-01-01

    Discusses causes of library disasters and provides several examples of disasters. Emphasis is on the importance of awareness, insurance protection, a written disaster plan, cooperation with the fire marshall and insurance agent in planning, and staff training. Several elements of the written plan are listed. (22 references) (MES)

  3. Conceptualizing 2000: Proactive Planning.

    ERIC Educational Resources Information Center

    Angel, Dan, Ed.; DeVault, Mike, Ed.

    As community, technical, and junior colleges approach the 21st century, faculty shortages, an increasingly diverse student body, dwindling financial resources, and accountability mandates will require careful, action-oriented college planning. This two-part book presents 10 articles on the dynamics of planning and specific planning models, and…

  4. Involving Faculty in Planning.

    ERIC Educational Resources Information Center

    Andrew, Lloyd D.

    1979-01-01

    Firm planning objectives, clearly stated relationships to overall institutional objectives, faculty involvement, and active leadership are advocated for successful academic planning. Faculty involvement is dependent on the strength of the technical, marketing, and budgeting staffs, and involvement in the planning process may kindle faculty…

  5. Technology Simplifies Master Planning.

    ERIC Educational Resources Information Center

    Kollie, Ellen

    1999-01-01

    Describes the use of digital ortho photography in the master planning process conducted at the University of Alabama that made planning easy and quick to do. What the benefits are in going digital for master planning are highlighted as is a description of what hardware and software are needed. (GR)

  6. Electricity demand curtailment planning

    SciTech Connect

    Allentuck, J; Carroll, O; Schnader, M

    1980-01-01

    The state of electricity demand curtailment planning for long term electricity supply disruptions is reviewed. Legal, institutional and technological problems associated with demand curtailment plans are examined, and the existence of well defined social objectives on the part of planners is questioned. A linear programming approach to electricity demand curtailment planning is presented.

  7. NASA Strategic Plan

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The aforementioned strategic decisions and the overarching direction for America's aeronautics and space program are addressed in the Strategic Plan. Our Strategic Plan is critical to our ability to meet the challenges of this new era and deliver a vibrant aeronautics and space program that strengthens and inspires the Nation. The Plan is our top-level strategy.

  8. Identifying Executable Plans

    NASA Technical Reports Server (NTRS)

    Bedrax-Weiss, Tania; Jonsson, Ari K.; Frank, Jeremy D.; McGann, Conor

    2003-01-01

    Generating plans for execution imposes a different set of requirements on the planning process than those imposed by planning alone. In highly unpredictable execution environments, a fully-grounded plan may become inconsistent frequently when the world fails to behave as expected. Intelligent execution permits making decisions when the most up-to-date information is available, ensuring fewer failures. Planning should acknowledge the capabilities of the execution system, both to ensure robust execution in the face of uncertainty, which also relieves the planner of the burden of making premature commitments. We present Plan Identification Functions (PIFs), which formalize what it means for a plan to be executable, md are used in conjunction with a complete model of system behavior to halt the planning process when an executable plan is found. We describe the implementation of plan identification functions for a temporal, constraint-based planner. This particular implementation allows the description of many different plan identification functions. characteristics crf the xectieonfvii rnm-enft,h e best plan to hand to the execution system will contain more or less commitment and information.

  9. Sandia Strategic Plan 1997

    SciTech Connect

    1997-12-01

    Sandia embarked on its first exercise in corporate strategic planning during the winter of 1989. The results of that effort were disseminated with the publication of Strategic Plan 1990. Four years later Sandia conducted their second major planning effort and published Strategic Plan 1994. Sandia`s 1994 planning effort linked very clearly to the Department of Energy`s first strategic plan, Fueling a Competitive Economy. It benefited as well from the leadership of Lockheed Martin Corporation, the management and operating contractor. Lockheed Martin`s corporate success is founded on visionary strategic planning and annual operational planning driven by customer requirements and technology opportunities. In 1996 Sandia conducted another major planning effort that resulted in the development of eight long-term Strategic Objectives. Strategic Plan 1997 differs from its predecessors in that the robust elements of previous efforts have been integrated into one comprehensive body. The changes implemented so far have helped establish a living strategic plan with a stronger business focus and with clear deployment throughout Sandia. The concept of a personal line of sight for all employees to this strategic plan and its objectives, goals, and annual milestones is becoming a reality.

  10. Long Range Technology Planning.

    ERIC Educational Resources Information Center

    Ambron, Sueann, Ed.

    1986-01-01

    This summary of a meeting of the Apple Education Advisory Council, on long range technology plans at the state, county, district, and school levels, includes highlights from group discussions on future planning, staff development, and curriculum. Three long range technology plans at the state level are provided: Long Range Educational Technology…

  11. Planning as Action Research

    ERIC Educational Resources Information Center

    de Gonzalez, Carmen Beatriz; Hernandez, Teresa; Kusch, Jim; Ryan, Charly

    2004-01-01

    Planning contains so much more than the written plan. Early in 2000, an invitation came from the Collaborative Action Research Network (CARN), to people experienced in action research who might want to help plan and present an action research event for elementary school science teachers in Venezuela, South America, in Autumn 2000. This article…

  12. Disaster Planning in Libraries

    ERIC Educational Resources Information Center

    Wong, Yi Ling; Green, Ravonne

    2006-01-01

    Disaster preparedness is an important issue in library management today. This article presents a general overview of the theoretical aspects of disaster planning in libraries. The stages of disaster planning are a circular process of planning, prevention, response, recovery, preparedness, and training.

  13. Generalizable Class Solutions for Treatment Planning of Spinal Stereotactic Body Radiation Therapy

    SciTech Connect

    Weksberg, David C.; Palmer, Matthew B.; Vu, Khoi N.; Rebueno, Neal C.; Sharp, Hadley J.; Luo, Dershan; Yang, James N.; Shiu, Almon S.; Rhines, Laurence D.; McAleer, Mary Frances; Brown, Paul D.; Chang, Eric L.

    2012-11-01

    Purpose: Spinal stereotactic body radiation therapy (SBRT) continues to emerge as an effective therapeutic approach to spinal metastases; however, treatment planning and delivery remain resource intensive at many centers, which may hamper efficient implementation in clinical practice. We sought to develop a generalizable class solution approach for spinal SBRT treatment planning that would allow confidence that a given plan provides optimal target coverage, reduce integral dose, and maximize planning efficiency. Methods and Materials: We examined 91 patients treated with spinal SBRT at our institution. Treatment plans were categorized by lesion location, clinical target volume (CTV) configuration, and dose fractionation scheme, and then analyzed to determine the technically achievable dose gradient. A radial cord expansion was subtracted from the CTV to yield a planning CTV (pCTV) construct for plan evaluation. We reviewed the treatment plans with respect to target coverage, dose gradient, integral dose, conformality, and maximum cord dose to select the best plans and develop a set of class solutions. Results: The class solution technique generated plans that maintained target coverage and improved conformality (1.2-fold increase in the 95% van't Riet Conformation Number describing the conformality of a reference dose to the target) while reducing normal tissue integral dose (1.3-fold decrease in the volume receiving 4 Gy (V{sub 4Gy}) and machine output (19% monitor unit (MU) reduction). In trials of planning efficiency, the class solution technique reduced treatment planning time by 30% to 60% and MUs required by {approx}20%: an effect independent of prior planning experience. Conclusions: We have developed a set of class solutions for spinal SBRT that incorporate a pCTV metric for plan evaluation while yielding dosimetrically superior treatment plans with increased planning efficiency. Our technique thus allows for efficient, reproducible, and high-quality spinal

  14. Targets for the National Ignition Campaign

    SciTech Connect

    Atherton, L J

    2007-09-07

    . The ablator capsule has a 5 mm diameter hole laser drilled to permit removal of the mandrel and introduction of the DT fuel. A 10 mm diameter fill tube is bonded to the capsule to enable filling with the DT gas. These components must then be assembled to tolerances of approximately 5-10 microns, with comprehensive characterization and metrology. The DT ice is formed through controlled seeding, aided by beta decay of the tritium to help smooth the layer, and differential heating of the hohlraum to counteract the effects of natural convection. We present an overview of the technologies for target fabrication, assembly and metrology and advances in growth and imaging of DT ice layers. The sum of these efforts represents a quantum leap in target precision, characterization, manufacturing rate and flexibility over current state-of-the-art.

  15. Conservation plan based on the concept of integrity

    NASA Astrophysics Data System (ADS)

    Yen, Y. N.; Cheng, C. F.

    2015-08-01

    Value based concept has been accepted as a universal principle for the conservation of Cultural Heritage. Authenticity and integrity are two main issues protecting those values. Authenticity is the major tool in the value assessment and integrity plays an important role in the procedure of conservation plan. From the perspective of integrity, this research explores the principle of conservation plan and discusses its relation with the restoration plan and urban plan. A conservation plan in Quing-Lin village, Kinmen, will be taken as an example for implementation. The research shows that a conservation plan with integrity in mind helps to clarify the conservation target areas and their buffer zones. It also serves as a tool for developing control and risk management. Cultural mapping is an efficient tool for the communication with stakeholders in the process of the conservation plan.

  16. Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients

    SciTech Connect

    Sörnsen de Koste, John R. van; Dahele, Max; Senan, Suresh; Weide, Lineke van der; Slotman, Ben J.; Verbakel, Wilko F. A. R.; Mostafavi, Hassan

    2013-09-15

    -CBCT difference was 0.8 mm (1 SD = 0.6 mm) and for a 35° arc the mean was 2.4 mm (1 SD = 1.7 mm). DTS plus triangulation using nonoverlapping-arcs increased accuracy in Z-direction for tested arc lengths ≤55° (P < 0.01). Overlapping arcs increased accuracy in Y-direction for tumors with motion >4 mm (P < 0.02) but increased Z-direction accuracy was only observed with 55° total gantry rotation. The 95th percentile deviations with this overlapping technique in X-, Y-, and Z-directions were 1.3, 2.0, and 2.5 mm, respectively. For the five patients with mobile tumors where DTS + triangulation was performed with 45° intervals, the pooled deviation from online CBCT correction showed, for X-, Y-, and Z-directions, mean of 1.1 mm, standard deviations (SD) of 0.9, 1.0, and 0.9 mm, respectively. The mean + 2 SD was <3 mm for each direction.Conclusions: Short-arc DTS verification of time averaged lung tumor position is feasible using free-breathing kV projection data and the AvIP of the 4DCT as a reference. Observed differences between DTS and online CBCT registration with AvIP were ≤3 mm (mean + 2 SD), however, the increased temporal resolution of DTS + triangulation also identified short period deviations from the average target position on the CBCT. Short-arc DTS appears promising for intrafraction tumor position monitoring during stereotactic lung radiotherapy delivered with a rotational technique.

  17. Cylindrical target Li-beam-driven hohlraum experiments

    SciTech Connect

    Derzon, M.S.; Aubert, J.; Chandler, G.A.

    1998-06-01

    The authors performed a series of experiments on the Particle Beam Fusion Accelerator II (PBFA II) in May, 1994, and obtained a brightness temperature of 61 {+-} 2 eV for an ion-beam heated hohlraum. The hohlraum was a 4-mm-diameter, right-circular cylinder with a 1.5-mm-thick gold wall, a low-density CH foam fill, and a 1.5- or 3-mm-diameter diagnostic aperture in the top. The nominal parameters of the radially-incident PBFA II Li ion beam were 9 MeV peak energy ({approximately}10 MeV at the gas cell) at the target at a peak power of 2.5 {+-} 0.3 TW/cm{sup 2} and a 15 ns pulse width. Azimuthal variations in intensity of a factor of 3, with respect to the mean, were observed. Nonuniformities in thermal x-ray emission across the area of the diagnostic hole were also observed. Time-dependent hole-closure velocities were measured: the time-averaged velocity of {approximately}2 cm/{micro}s is in good agreement with sound speed estimates. Unfolded x-ray spectra and brightness temperatures as a function of time are reported and compared to simulations. Hole closure corrections are discussed with comparisons between XRD and bolometer measurements. Temperature scaling with power on target is also presented.

  18. Manpower and project planning

    NASA Technical Reports Server (NTRS)

    Johnson, David W.

    1991-01-01

    The purpose was to study how manpower and projects are planned at the Facilities Engineering Division (FENGD) within the Systems Engineering and Operations Directorate of the LaRC and to make recommendations for improving the effectiveness and productivity ot the tools that are used. The existing manpower and project planning processes (including the management plan for the FENGD, existing manpower planning reports, project reporting to LaRC and NASA Headquarters, employee time reporting, financial reporting, and coordination/tracking reports for procurement) were discussed with several people, and project planning software was evaluated.

  19. Physician transition plans: planning for physician slowdown.

    PubMed

    Walker Keegan, Deborah

    2008-01-01

    Transition is a natural progression for physicians in a medical practice. At some point, at least one physician will seek to deviate from the work norm of the group, either due to retirement, need for part-time status, or other reason. Medical practices that have a formal transition plan in place have a competitive advantage over other practices in terms of physician recruitment and retention. Not only do the formal transition plans permit physicians to proactively plan for work slowdown, but they also permit the medical practice to ensure its financial health and effectively position itself for the future. Key issues addressed in physician transition plans include governance, continuity of care, eligibility, time limits, on-call schedules, practice overhead, and physician compensation.

  20. Fertility targets and policy options in Asia.

    PubMed

    Bulatao, R A

    1984-11-01

    The 3rd Asian and Pacific Population Conference in Colombo in 1982 recommended that countries review and modify existing demographic targets and goals for reducing birth and death rates in order to attain low levels as early as possible and to attain replacement level by the year 2000. The demographic goals of selected Asian countries (Bangladesh, Indonesia, Korea, Thailand, India, Pakistan, and the Philippines are assessed and compared to World Bank population projections. It also discusses the underlying rationale for setting fertility targets, and considers what government actions could make them more achievable. 6 stages for controlling population are distinguished: 1) collection and publication of reliable demographic data; 2) enunciation of an official policy to reduce population growth; 3) development of appropriate institutions to integrate demographic projections into economic plans; 4) promotion of family planning; 5) provision of incentives and disincentives, including elimination of all implicit and explicit subsidies for child bearing; and 6) restitution of birth quotas requiring permission for each child born. Principles to maintain and accelerate fertility declines to meet demographic targets include creating appropriate and equitable development policies, increasing the standard of family planning programs, confronting organizational problems, providing easier and more equal access to contraceptive methods, exploring innovative approaches to encourage smaller families and making a firm political commitment to population control. Rapid fertility decline will also require financial commitment. Willingness to spend the necessary amounts, and the capacity to spend them as well, will determine whether the countries of Asia enter the next century in control of their population.

  1. Large area 3-D optical coherence tomography imaging of lumpectomy specimens for radiation treatment planning

    NASA Astrophysics Data System (ADS)

    Wang, Cuihuan; Kim, Leonard; Barnard, Nicola; Khan, Atif; Pierce, Mark C.

    2016-02-01

    Our long term goal is to develop a high-resolution imaging method for comprehensive assessment of tissue removed during lumpectomy procedures. By identifying regions of high-grade disease within the excised specimen, we aim to develop patient-specific post-operative radiation treatment regimens. We have assembled a benchtop spectral-domain optical coherence tomography (SD-OCT) system with 1320 nm center wavelength. Automated beam scanning enables "sub-volumes" spanning 5 mm x 5 mm x 2 mm (500 A-lines x 500 B-scans x 2 mm in depth) to be collected in under 15 seconds. A motorized sample positioning stage enables multiple sub-volumes to be acquired across an entire tissue specimen. Sub-volumes are rendered from individual B-scans in 3D Slicer software and en face (XY) images are extracted at specific depths. These images are then tiled together using MosaicJ software to produce a large area en face view (up to 40 mm x 25 mm). After OCT imaging, specimens were sectioned and stained with HE, allowing comparison between OCT image features and disease markers on histopathology. This manuscript describes the technical aspects of image acquisition and reconstruction, and reports initial qualitative comparison between large area en face OCT images and HE stained tissue sections. Future goals include developing image reconstruction algorithms for mapping an entire sample, and registering OCT image volumes with clinical CT and MRI images for post-operative treatment planning.

  2. Transfusion service disaster planning.

    PubMed

    Bundy, K L; Foss, M L; Stubbs, J R

    2008-01-01

    The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

  3. Mo100 to Mo99 Target Cooling Enhancements Report

    SciTech Connect

    Woloshun, Keith Albert; Dale, Gregory E.; Olivas, Eric Richard; Mocko, Michal

    2016-02-16

    Target design requirements changed significantly over the past year to a much higher beam current on larger diameter disks, and with a beam impingement on both ends of the target. Scaling from the previous design, that required significantly more mass flow rate of helium coolant, and also thinner disks. A new Aerzen GM12.4 blower was selected that can deliver up to 400 g/s at 400 psi, compared to about 100 g/s possible with the Tuthill blower previously selected.Further, to accommodate the 42 MeV, 2.7 mA beam on each side of the target, the disk thickness and the coolant gaps were halved to create the current baseline design: 0.5 mm disk thickness (at 29 mm diameter) and 0.25 mm coolant gap. Thermal-hydraulic analysis of this target, presented below for reference, gave very good results, suggesting that the target could be improved with fewer, thicker disks and with disk thickness increasing toward the target center. The total thickness of Mo100 in the target remaining the same, that reduces the number of coolant gaps. This allows for the gap width to be increased, increasing the mass flow in each gap and consequently increasing heat transfer. A preliminary geometry was selected and analyzed with variable disk thickness and wider coolant gaps. The result of analysis of this target shows that disk thickness increase near the window was too aggressive and further resizing of the disks is necessary, but it does illustrate the potential improvements that are possible. Experimental and analytical study of diffusers on the target exit has been done. This shows modest improvement in requcing pressure drop, as will be summarized below. However, the benefit is not significant, and implementation becomes problematic when disk thickness is varying. A bull nose at the entrance does offer significant benefit and is relatively easy to incorporate. A bull nose on both ends is now a feature of the baseline design, and will be a feature of any redesign or enhanced designs that

  4. Operating plan FY 1998

    SciTech Connect

    1997-10-01

    This document is the first edition of Argonne`s new Operating Plan. The Operating Plan complements the strategic planning in the Laboratory`s Institutional Plan by focusing on activities that are being pursued in the immediate fiscal year, FY 1998. It reflects planning that has been done to date, and it will serve in the future as a resource and a benchmark for understanding the Laboratory`s performance. The heart of the Institutional Plan is the set of major research initiatives that the Laboratory is proposing to implement in future years. In contrast, this Operating Plan focuses on Argonne`s ongoing R&D programs, along with cost-saving measures and other improvements being implemented in Laboratory support operations.

  5. Bar coded retroreflective target

    DOEpatents

    Vann, Charles S.

    2000-01-01

    This small, inexpensive, non-contact laser sensor can detect the location of a retroreflective target in a relatively large volume and up to six degrees of position. The tracker's laser beam is formed into a plane of light which is swept across the space of interest. When the beam illuminates the retroreflector, some of the light returns to the tracker. The intensity, angle, and time of the return beam is measured to calculate the three dimensional location of the target. With three retroreflectors on the target, the locations of three points on the target are measured, enabling the calculation of all six degrees of target position. Until now, devices for three-dimensional tracking of objects in a large volume have been heavy, large, and very expensive. Because of the simplicity and unique characteristics of this tracker, it is capable of three-dimensional tracking of one to several objects in a large volume, yet it is compact, light-weight, and relatively inexpensive. Alternatively, a tracker produces a diverging laser beam which is directed towards a fixed position, and senses when a retroreflective target enters the fixed field of view. An optically bar coded target can be read by the tracker to provide information about the target. The target can be formed of a ball lens with a bar code on one end. As the target moves through the field, the ball lens causes the laser beam to scan across the bar code.

  6. Three-dimensional conformal versus intensity-modulated radiotherapy dose planning in stereotactic radiotherapy: Application of standard quality parameters for plan evaluation

    SciTech Connect

    Grzadziel, Aleksandra; Grosu, Anca-Ligia . E-mail: anca-ligia.grosu@lrz.tum.de; Kneschaurek, Peter

    2006-11-15

    Purpose: The implementation of intensity-modulated radiotherapy (IMRT) technique into clinical practice is becoming routine, but still lacks a generally accepted method for plan evaluation. We present a comparison of the dose distribution of conformal three-dimensional radiotherapy plans with IMRT plans for cranial lesions in stereotactic radiotherapy. The primary aim of this study was to judge the quality of the treatment plans. The next purpose was to assess the usefulness of several quality factors for plan evaluation. Methods and Materials: Five patients, who were treated in our department, were analyzed. Four had meningioma and one had pituitary adenoma. For each case, 10 different plans were created and analyzed: 2 conventional conformal three-dimensional plans and 8 IMRT plans, using the 'step and shoot' delivery method. The first conventional plan was an individually designed beam arrangement and was used for patient treatment. The second plan was a standard plan with the same beam arrangement for all patients. Beam arrangements from the conformal plans were the base for the inversely planned IMRT. To evaluate the plans, the following factors were investigated: minimal and maximal dose to the planning target volume, homogeneity index, coverage index, conformity index, and tumor control probabilities and normal tissue complication probabilities. These quantities were incorporated into scoring factors and assigned to each plan. Results: The greatest homogeneity was reached in the conformal plans and IMRT plans with high planning target volume priority in the optimization process. This consequently led to a better probability of tumor control. Better protection of organs at risk and thereby lower normal tissue complication probabilities were achieved in the IMRT plans with increased weighting of the organs at risk. Conclusion: These results show the efficiency, as well as some limitations, of the IMRT techniques. The use of different quality factors allowed us

  7. Microelectrode targeting of the subthalamic nucleus for deep brain stimulation surgery.

    PubMed

    Montgomery, Erwin B

    2012-09-15

    Though microelectrode recordings likely increase the risks and costs of DBS, incremental improvement in accuracy may translate into improved outcomes that justify these risks and costs. Clinically based, controlled studies to resolve these issues are problematic. Until such studies are reported, physicians must rely on indirect evidence. The spatial variability of physiologically defined optimal targets, as determined by microelectrode recording (MER), necessary for targeting the STN was calculated. Study of the effectiveness of a MER algorithm was based on the number of penetrations required. The radius of the volume with a 99% chance of including the physiologically defined optimal target, based on 108 cases, was 4.5 mm. This is larger than the estimated radius of the DBS effect, which is variously estimated to be 2 to 3.9 mm. The 99% confidence radius in the plane orthogonal to the lead was 3.2 mm. In 70% of cases, the imaging-based trajectories corresponded to the physiologically defined optimal target. For the remaining 30% of cases, 70% required only a single additional MER tract. The radii of the 99% confidence volume and area may be larger than the effective radius of stimulation. Surveying within those volumes or areas is therefore necessary to assure that at least 99% of cases will cover the physiologically defined target. The MER algorithm was robust in detecting the physiologically defined optimal target. However, there are significant caveats in interpretation of the data.

  8. 40 CFR 264.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure plan; amendment of plan. 264... Closure and Post-Closure § 264.112 Closure plan; amendment of plan. (a) Written plan. (1) The owner or operator of a hazardous waste management facility must have a written closure plan. In addition,...

  9. 40 CFR 265.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure plan; amendment of plan. 265... DISPOSAL FACILITIES Closure and Post-Closure § 265.112 Closure plan; amendment of plan. (a) Written plan... have a written closure plan. Until final closure is completed and certified in accordance with §...

  10. 40 CFR 264.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure plan; amendment of plan. 264... Closure and Post-Closure § 264.112 Closure plan; amendment of plan. (a) Written plan. (1) The owner or operator of a hazardous waste management facility must have a written closure plan. In addition,...

  11. 40 CFR 265.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure plan; amendment of plan. 265... DISPOSAL FACILITIES Closure and Post-Closure § 265.112 Closure plan; amendment of plan. (a) Written plan... have a written closure plan. Until final closure is completed and certified in accordance with §...

  12. 40 CFR 265.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure plan; amendment of plan. 265... DISPOSAL FACILITIES Closure and Post-Closure § 265.112 Closure plan; amendment of plan. (a) Written plan... have a written closure plan. Until final closure is completed and certified in accordance with §...

  13. 40 CFR 264.112 - Closure plan; amendment of plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure plan; amendment of plan. 264... Closure and Post-Closure § 264.112 Closure plan; amendment of plan. (a) Written plan. (1) The owner or operator of a hazardous waste management facility must have a written closure plan. In addition,...

  14. Proceedings of the workshop on polarized targets in storage rings

    SciTech Connect

    Holt, R.J.

    1984-08-01

    Polarization phenomena have played an increasingly important part in the study of nuclei and nucleons in recent years. Polarization studies have been hampered by the relatively few and rather fragile polarized targets which are presently available. The concept of polarized gas targets in storage rings opens a much wider range of possibilities than is available in the external target geometry. This novel method will represent a considerable advance in nuclear physics and will continue to receive much attention in plans for future facilities. An internal, polarized-target station is being planned for the cooler ring at the Indiana University Cyclotron Facility. Internal targets are compatible with recent designs of electron accelerators proposed by the Massachusetts Institute of Technology and the Southeastern Universities Research Association. The key to nuclear-science programs based on internal targets pivots on recent developments in polarized atomic beam methods, which include the more recent laser-driven polarized targets. The workshop drew together a unique group of physicists in the fields of high-energy, nuclear and atomic physics. The meeting was organized in a manner that stimulated discussion among the 58 participants and focused on developments in polarized target technology and the underlying atomic physics. An impressive array of future possibilities for polarized targets as well as current developments in polarized target technology were discussed at the workshop. Abstracts of individual items from the workshop were prepared separately for the data base.

  15. Vision 2015: The West Virginia Science and Technology Strategic Plan. Progress Report

    ERIC Educational Resources Information Center

    West Virginia Higher Education Policy Commission, 2014

    2014-01-01

    In 2005, West Virginia science and education leaders developed a strategic plan entitled: "Vision 2015: The West Virginia Science and Technology Strategic Plan." The plan is comprised of five (5) target areas for infrastructure development, with 14 goals for action by designated leaders from higher education, state government, and…

  16. Feasibility of four-dimensional conformal planning for robotic radiosurgery

    SciTech Connect

    Schlaefer, A.; Fisseler, J.; Dieterich, S.; Shiomi, H.; Cleary, K.; Schweikard, A.

    2005-12-15

    Organ motion can have a severe impact on the dose delivered by radiation therapy, and different procedures have been developed to address its effects. Conventional techniques include breath h