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Sample records for accurate treatment planning

  1. Fast and accurate sensitivity analysis of IMPT treatment plans using Polynomial Chaos Expansion

    NASA Astrophysics Data System (ADS)

    Perkó, Zoltán; van der Voort, Sebastian R.; van de Water, Steven; Hartman, Charlotte M. H.; Hoogeman, Mischa; Lathouwers, Danny

    2016-06-01

    The highly conformal planned dose distribution achievable in intensity modulated proton therapy (IMPT) can severely be compromised by uncertainties in patient setup and proton range. While several robust optimization approaches have been presented to address this issue, appropriate methods to accurately estimate the robustness of treatment plans are still lacking. To fill this gap we present Polynomial Chaos Expansion (PCE) techniques which are easily applicable and create a meta-model of the dose engine by approximating the dose in every voxel with multidimensional polynomials. This Polynomial Chaos (PC) model can be built in an automated fashion relatively cheaply and subsequently it can be used to perform comprehensive robustness analysis. We adapted PC to provide among others the expected dose, the dose variance, accurate probability distribution of dose-volume histogram (DVH) metrics (e.g. minimum tumor or maximum organ dose), exact bandwidths of DVHs, and to separate the effects of random and systematic errors. We present the outcome of our verification experiments based on 6 head-and-neck (HN) patients, and exemplify the usefulness of PCE by comparing a robust and a non-robust treatment plan for a selected HN case. The results suggest that PCE is highly valuable for both research and clinical applications.

  2. Fast and accurate sensitivity analysis of IMPT treatment plans using Polynomial Chaos Expansion.

    PubMed

    Perkó, Zoltán; van der Voort, Sebastian R; van de Water, Steven; Hartman, Charlotte M H; Hoogeman, Mischa; Lathouwers, Danny

    2016-06-21

    The highly conformal planned dose distribution achievable in intensity modulated proton therapy (IMPT) can severely be compromised by uncertainties in patient setup and proton range. While several robust optimization approaches have been presented to address this issue, appropriate methods to accurately estimate the robustness of treatment plans are still lacking. To fill this gap we present Polynomial Chaos Expansion (PCE) techniques which are easily applicable and create a meta-model of the dose engine by approximating the dose in every voxel with multidimensional polynomials. This Polynomial Chaos (PC) model can be built in an automated fashion relatively cheaply and subsequently it can be used to perform comprehensive robustness analysis. We adapted PC to provide among others the expected dose, the dose variance, accurate probability distribution of dose-volume histogram (DVH) metrics (e.g. minimum tumor or maximum organ dose), exact bandwidths of DVHs, and to separate the effects of random and systematic errors. We present the outcome of our verification experiments based on 6 head-and-neck (HN) patients, and exemplify the usefulness of PCE by comparing a robust and a non-robust treatment plan for a selected HN case. The results suggest that PCE is highly valuable for both research and clinical applications. PMID:27227661

  3. Can radiation therapy treatment planning system accurately predict surface doses in postmastectomy radiation therapy patients?

    SciTech Connect

    Wong, Sharon; Back, Michael; Tan, Poh Wee; Lee, Khai Mun; Baggarley, Shaun; Lu, Jaide Jay

    2012-07-01

    Skin doses have been an important factor in the dose prescription for breast radiotherapy. Recent advances in radiotherapy treatment techniques, such as intensity-modulated radiation therapy (IMRT) and new treatment schemes such as hypofractionated breast therapy have made the precise determination of the surface dose necessary. Detailed information of the dose at various depths of the skin is also critical in designing new treatment strategies. The purpose of this work was to assess the accuracy of surface dose calculation by a clinically used treatment planning system and those measured by thermoluminescence dosimeters (TLDs) in a customized chest wall phantom. This study involved the construction of a chest wall phantom for skin dose assessment. Seven TLDs were distributed throughout each right chest wall phantom to give adequate representation of measured radiation doses. Point doses from the CMS Xio Registered-Sign treatment planning system (TPS) were calculated for each relevant TLD positions and results correlated. There were no significant difference between measured absorbed dose by TLD and calculated doses by the TPS (p > 0.05 (1-tailed). Dose accuracy of up to 2.21% was found. The deviations from the calculated absorbed doses were overall larger (3.4%) when wedges and bolus were used. 3D radiotherapy TPS is a useful and accurate tool to assess the accuracy of surface dose. Our studies have shown that radiation treatment accuracy expressed as a comparison between calculated doses (by TPS) and measured doses (by TLD dosimetry) can be accurately predicted for tangential treatment of the chest wall after mastectomy.

  4. Reconstruction of applicator positions from multiple-view images for accurate superficial hyperthermia treatment planning

    NASA Astrophysics Data System (ADS)

    Drizdal, T.; Paulides, M. M.; Linthorst, M.; van Rhoon, G. C.

    2012-05-01

    In the current clinical practice, prior to superficial hyperthermia treatments (HT), temperature probes are placed in tissue to document a thermal dose. To investigate whether the painful procedure of catheter placement can be replaced by superficial HT planning, we study if the specific absorption rate (SAR) coverage is predictive for treatment outcome. An absolute requirement for such a study is the accurate reconstruction of the applicator setup. The purpose of this study was to investigate the feasibility of the applicator setup reconstruction from multiple-view images. The accuracy of the multiple-view reconstruction method has been assessed for two experimental setups using six lucite cone applicators (LCAs) representing the largest array applied at our clinic and also the most difficult scenario for the reconstruction. For the two experimental setups and 112 distances, the mean difference between photogrametry reconstructed and manually measured distances was 0.25 ± 0.79 mm (mean±1 standard deviation). By a parameter study of translation T (mm) and rotation R (°) of LCAs, we showed that these inaccuracies are clinically acceptable, i.e. they are either from ±1.02 mm error in translation or ±0.48° in rotation, or combinations expressed by 4.35R2 + 0.97T2 = 1. We anticipate that such small errors will not have a relevant influence on the SAR distribution in the treated region. The clinical applicability of the procedure is shown on a patient with a breast cancer recurrence treated with reirradiation plus superficial hyperthermia using the six-LCA array. The total reconstruction procedure of six LCAs from a set of ten photos currently takes around 1.5 h. We conclude that the reconstruction of superficial HT setup from multiple-view images is feasible and only minor errors are found that will have a negligible influence on treatment planning quality.

  5. Development of a geometrically accurate imaging protocol at 3 Tesla MRI for stereotactic radiosurgery treatment planning

    NASA Astrophysics Data System (ADS)

    Zhang, B.; MacFadden, D.; Damyanovich, A. Z.; Rieker, M.; Stainsby, J.; Bernstein, M.; Jaffray, D. A.; Mikulis, D.; Ménard, C.

    2010-11-01

    The purpose of this study is to develop a geometrically accurate imaging protocol at 3 T magnetic resonance imaging (MRI) for stereotactic radiosurgery (SRS) treatment planning. In order to achieve this purpose, a methodology is developed to investigate the geometric accuracy and stability of 3 T MRI for SRS in phantom and patient evaluations. Forty patients were enrolled on a prospective clinical trial. After frame placement prior to SRS, each patient underwent 3 T MRI after 1.5 T MRI and CT. MR imaging protocols included a T1-weighted gradient echo sequence and a T2-weighted spin echo sequence. Phantom imaging was performed on 3 T prior to patient imaging using the same set-up and imaging protocols. Geometric accuracy in patients and phantoms yielded comparable results for external fiducial reference deviations and internal landmarks between 3 T and 1.5 T MRI (mean <=0.6 mm; standard deviation <=0.3 mm). Mean stereotactic reference deviations between phantoms and patients correlated well (T1: R = 0.79; T2: R = 0.84). Statistical process control analysis on phantom QA data demonstrated the stability of our SRS imaging protocols, where the geometric accuracy of the 3 T SRS imaging protocol is operating within the appropriate tolerance. Our data provide evidence supporting the spatial validity of 3 T MRI for targeting SRS under imaging conditions investigated. We have developed a systematic approach to achieve confidence on the geometric integrity of a given imaging system/technique for clinical integration in SRS application.

  6. New law requires 'medically accurate' lesson plans.

    PubMed

    1999-09-17

    The California Legislature has passed a bill requiring all textbooks and materials used to teach about AIDS be medically accurate and objective. Statements made within the curriculum must be supported by research conducted in compliance with scientific methods, and published in peer-reviewed journals. Some of the current lesson plans were found to contain scientifically unsupported and biased information. In addition, the bill requires material to be "free of racial, ethnic, or gender biases." The legislation is supported by a wide range of interests, but opposed by the California Right to Life Education Fund, because they believe it discredits abstinence-only material. PMID:11366835

  7. Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media

    PubMed Central

    Zeinali-Rafsanjani, B.; Mosleh-Shirazi, M. A.; Faghihi, R.; Karbasi, S.; Mosalaei, A.

    2015-01-01

    To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam. PMID:26170553

  8. Fast and accurate Monte Carlo modeling of a kilovoltage X-ray therapy unit using a photon-source approximation for treatment planning in complex media.

    PubMed

    Zeinali-Rafsanjani, B; Mosleh-Shirazi, M A; Faghihi, R; Karbasi, S; Mosalaei, A

    2015-01-01

    To accurately recompute dose distributions in chest-wall radiotherapy with 120 kVp kilovoltage X-rays, an MCNP4C Monte Carlo model is presented using a fast method that obviates the need to fully model the tube components. To validate the model, half-value layer (HVL), percentage depth doses (PDDs) and beam profiles were measured. Dose measurements were performed for a more complex situation using thermoluminescence dosimeters (TLDs) placed within a Rando phantom. The measured and computed first and second HVLs were 3.8, 10.3 mm Al and 3.8, 10.6 mm Al, respectively. The differences between measured and calculated PDDs and beam profiles in water were within 2 mm/2% for all data points. In the Rando phantom, differences for majority of data points were within 2%. The proposed model offered an approximately 9500-fold reduced run time compared to the conventional full simulation. The acceptable agreement, based on international criteria, between the simulations and the measurements validates the accuracy of the model for its use in treatment planning and radiobiological modeling studies of superficial therapies including chest-wall irradiation using kilovoltage beam. PMID:26170553

  9. MO-A-BRD-10: A Fast and Accurate GPU-Based Proton Transport Monte Carlo Simulation for Validating Proton Therapy Treatment Plans

    SciTech Connect

    Wan Chan Tseung, H; Ma, J; Beltran, C

    2014-06-15

    Purpose: To build a GPU-based Monte Carlo (MC) simulation of proton transport with detailed modeling of elastic and non-elastic (NE) protonnucleus interactions, for use in a very fast and cost-effective proton therapy treatment plan verification system. Methods: Using the CUDA framework, we implemented kernels for the following tasks: (1) Simulation of beam spots from our possible scanning nozzle configurations, (2) Proton propagation through CT geometry, taking into account nuclear elastic and multiple scattering, as well as energy straggling, (3) Bertini-style modeling of the intranuclear cascade stage of NE interactions, and (4) Simulation of nuclear evaporation. To validate our MC, we performed: (1) Secondary particle yield calculations in NE collisions with therapeutically-relevant nuclei, (2) Pencil-beam dose calculations in homogeneous phantoms, (3) A large number of treatment plan dose recalculations, and compared with Geant4.9.6p2/TOPAS. A workflow was devised for calculating plans from a commercially available treatment planning system, with scripts for reading DICOM files and generating inputs for our MC. Results: Yields, energy and angular distributions of secondaries from NE collisions on various nuclei are in good agreement with the Geant4.9.6p2 Bertini and Binary cascade models. The 3D-gamma pass rate at 2%–2mm for 70–230 MeV pencil-beam dose distributions in water, soft tissue, bone and Ti phantoms is 100%. The pass rate at 2%–2mm for treatment plan calculations is typically above 98%. The net computational time on a NVIDIA GTX680 card, including all CPU-GPU data transfers, is around 20s for 1×10{sup 7} proton histories. Conclusion: Our GPU-based proton transport MC is the first of its kind to include a detailed nuclear model to handle NE interactions on any nucleus. Dosimetric calculations demonstrate very good agreement with Geant4.9.6p2/TOPAS. Our MC is being integrated into a framework to perform fast routine clinical QA of pencil

  10. [Myasthenia gravis - optimal treatment and accurate diagnosis].

    PubMed

    Gilhus, Nils Erik; Kerty, Emilia; Løseth, Sissel; Mygland, Åse; Tallaksen, Chantal

    2016-07-01

    Around 700 people in Norway have myasthenia gravis, an autoimmune disease that affects neuromuscular transmission and results in fluctuating weakness in some muscles as its sole symptom. The diagnosis is based on typical symptoms and findings, detection of antibodies and neurophysiological examination. Symptomatic treatment with acetylcholinesterase inhibitors is generally effective, but most patients also require immunosuppressive drug treatment. Antigen-specific therapy is being tested in experimental disease models. PMID:27381787

  11. Personalized treatment planning.

    PubMed

    Pitts, N B; Richards, D

    2009-01-01

    This chapter aims to outline a flexible framework which the dental team can use to bring together key elements of information about their patients and their patients' teeth in order to plan appropriate, patient-centred, caries management based on the application of best current evidence and practice. This framework can be enabled by the use of the International Caries Detection and Assessment System (ICDAS) clinical visual scoring systems for caries detection and activity, but also needs additional information about lesions and the patient to plan and then monitor the effectiveness of personalized caries care. The treatment planning process has evolved from restorative treatment decisions being largely made during clinical assessment as an examination of wet teeth proceeds, with limited charting and a minor role for patient factors. Best practice now involves a comprehensive examination being made systematically of clean dry teeth using sharp eyes and blunt probes. The ICDAS-enabled framework provides for information to be collected at the tooth/surface level (clinical visual lesion detection, lesion detection aids and lesion activity assessment) and at the patient level (patient caries risk assessment, dentition and lesion history and patient behavioural assessment). This information is then synthesized to inform integrated, personalized treatment planning which involves the choice of appropriate treatment options (background level care, preventive treatment options, operative treatment options) and then recall, reassessment and monitoring. Examples of international moves towards using integrated, personalized treatment planning for caries control are given, drawing on experiences in the UK, the USA and from the ICDAS Committee. PMID:19494680

  12. Careful Planning Key to Accurate Fixed Reports Assets.

    ERIC Educational Resources Information Center

    MaRous, Arnold M.

    1986-01-01

    Only with careful planning can school business managers develop fixed asset information and good recordkeeping. Use of a simple inventory system and discussion with school districts already utilizing this system will assist planning. (CJH)

  13. Complete, accurate, mammalian phylogenies aid conservation planning, but not much

    PubMed Central

    Rodrigues, Ana S. L.; Grenyer, Richard; Baillie, Jonathan E. M.; Bininda-Emonds, Olaf R. P.; Gittlemann, John L.; Hoffmann, Michael; Safi, Kamran; Schipper, Jan; Stuart, Simon N.; Brooks, Thomas

    2011-01-01

    In the face of unprecedented global biodiversity loss, conservation planning must balance between refining and deepening knowledge versus acting on current information to preserve species and communities. Phylogenetic diversity (PD), a biodiversity measure that takes into account the evolutionary relationships between species, is arguably a more meaningful measure of biodiversity than species diversity, but cannot yet be applied to conservation planning for the majority of taxa for which phylogenetic trees have not yet been developed. Here, we investigate how the quality of data on the taxonomy and/or phylogeny of species affects the results of spatial conservation planning in terms of the representation of overall mammalian PD. The results show that the better the quality of the biodiversity data the better they can serve as a basis for conservation planning. However, decisions based on incomplete data are remarkably robust across different levels of degrading quality concerning the description of new species and the availability of phylogenetic information. Thus, given the level of urgency and the need for action, conservation planning can safely make use of the best available systematic data, limited as these data may be. PMID:21844044

  14. Treatment planning for restorative implantology.

    PubMed

    Boyce, Ricardo A; Klemons, Gary

    2015-04-01

    In this article, current literature on fixed and removable prosthodontics is reviewed along with evidence-based systematic reviews, including advice from those in the dental profession with years of experience, which help restorative dentists manage and treat their cases successfully. Treatment planning for restorative implantology should be looked at in 4 sections: (1) review of past medical history, (2) oral examination and occlusion, (3) dental imaging (ie, cone-beam computed tomography), and (4) fixed versus removable prosthodontics. These 4 concepts of treatment planning, along with proper surgical placements of the implant(s), result in successful cases. PMID:25835794

  15. Treatment planning for molecular targeted radionuclide therapy.

    PubMed

    Siantar, Christine Hartmann; Vetter, Kai; DeNardo, Gerald L; DeNardo, Sally J

    2002-06-01

    Molecular targeted radionuclide therapy promises to expand the usefulness of radiation to successfully treat widespread cancer. The unique properties of radioactive tags make it possible to plan treatments by predicting the radiation absorbed dose to both tumors and normal organs, using a pre-treatment test dose of radiopharmaceutical. This requires a combination of quantitative, high-resolution, radiation-detection hardware and computerized dose-estimation software, and would ideally include biological dose-response data in order to translate radiation absorbed dose into biological effects. Data derived from conventional (external beam) radiation therapy suggests that accurate assessment of the radiation absorbed dose in dose-limiting normal organs could substantially improve the observed clinical response for current agents used in a myeloablative regimen, enabling higher levels of tumor control at lower tumor-to-normal tissue therapeutic indices. Treatment planning based on current radiation detection and simulations technology is sufficient to impact on clinical response. The incorporation of new imaging methods, combined with patient-specific radiation transport simulations, promises to provide unprecedented levels of resolution and quantitative accuracy, which are likely to increase the impact of treatment planning in targeted radionuclide therapy. PMID:12136519

  16. Optimization of BNCT treatment planning

    SciTech Connect

    Wheeler, F.J.

    1996-10-01

    Treatment planning for epithermal neutron capture therapy applications to date has relied on rigorous Monte Carlo calculations. Although many improvements have been made, the Monte Carlo process still requires a large amount of computer time and planning labor. With single-field, fixed-aperture irradiation, a near-optimum field can be found with an intuition-aided trial and error approach, however methods to more rapidly determine optimum irradiation configurations will significantly aid the process. As efforts become more aggressive, having the ability to select aperture size and number of fields, it will become expensive to manually find the optimum plan for a patient. Also, as the modality moves to clinical applications, patient throughput will not permit the resource-expenditure currently utilized in clinical trials.

  17. Treatment planning for radio-immunotherapy

    NASA Astrophysics Data System (ADS)

    Erdi, Alev K.; Erdi, Yusuf E.; Yorke, Ellen D.; Wessels, Barry W.

    1996-10-01

    To foster the success of clinical trials in radio-immunotherapy (RIT), one needs to determine (i) the quantity and spatial distribution of the administered radionuclide carrier in the patient over time, (ii) the absorbed dose in the tumour sites and critical organs based on this distribution and (iii) the volume of tumour mass(es) and normal organs from computerized tomography or magnetic resonance imaging and appropriately correlated with nuclear medicine imaging techniques (such as planar, single-photon emission computerized tomography or positron-emission tomography). Treatment planning for RIT has become an important tool in predicting the relative benefit of therapy based on individualized dosimetry as derived from diagnostic, pre-therapy administration of the radiolabelled antibody. This allows the investigator to pre-select those patients who have `favourable' dosimetry characteristics (high time-averaged target: non-target ratios) so that the chances for treatment success may be more accurately quantified before placing the patient at risk for treatment-related organ toxicities. The future prospects for RIT treatment planning may yield a more accurate correlation of response and critical organ toxicity with computed absorbed dose, and the compilation of dose - volume histogram information for tumour(s) and normal organ(s) such that computing tumour control probabilities and normal tissue complication probabilities becomes possible for heterogeneous distributions of the radiolabelled antibody. Additionally, radiobiological consequences of depositing absorbed doses from exponentially decaying sources must be factored into the interpretation when trying to compute the effects of standard external beam isodose display patterns combined with those associated with RIT.

  18. Treatment planning optimisation in proton therapy

    PubMed Central

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

    2013-01-01

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

  19. Accurate treatment of spontaneous polarization in III-nitrides

    NASA Astrophysics Data System (ADS)

    Dreyer, Cyrus E.; Janotti, Anderson; van de Walle, Chris G.

    2015-03-01

    The III-nitride compounds assume the wurtzite crystal structure in the ground state and therefore exhibit spontaneous and piezoelectric dipole moments in the c direction. Discontinuities in these moments at heterostructure interfaces result in electric fields in the layers, which can be detrimental because they separate electrons and holes in quantum wells. Accurate values for polarization differences are critical for understanding and engineering III-nitride heterostructures. Direct experimental measurement of spontaneous polarization has not been possible to date, and calculations are complicated by the necessity to choose a reference structure. The universal choice of reference structure for wurtzite has been zincblende; we demonstrate that this choice does not allow consistent determination of the differences of spontaneous polarizations between materials, which determine their physical manifestation. Using first-principles techniques based on hybrid density functional theory, we have determined polarization discontinuities using a consistent reference based on the hexagonal layered structure of these materials. We will discuss the results in light of available experimental data, and outline consequences for device simulations. Work supported by DOE.

  20. Translation research: from accurate diagnosis to appropriate treatment

    PubMed Central

    Webb, Craig P; Pass, Harvey I

    2004-01-01

    This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB) and Health Insurance Portability and Accountability Act (HIPAA) compliance, data standardization, sample procurement, quality control (QC), quality assurance (QA), data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease. PMID:15496233

  1. Tolerance doses for treatment planning

    SciTech Connect

    Lyman, J.T.

    1985-10-01

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

  2. 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. PMID:3502386

  3. 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

  4. Training Psychotherapists in Hierarchical Treatment Planning

    PubMed Central

    MAKOVER, RICHARD B.

    1992-01-01

    Treatment planning is a central and persistent challenge in psychotherapy. This paper outlines a four-level planning hierarchy that encourages the therapist to conceptualize a desired overall outcome (the "aim") that can be realized through subsidiary objectives (the "goals"). The "strategies" by which goals are pursued and the "tactics" that carry out those strategies are subordinate and instrumental elements of the treatment process. Greater emphasis on this type of treatment planning in the training and supervision of psychotherapists should make therapy more effective, improve treatment outcomes, and allow more efficient use of therapy resources. PMID:22700115

  5. Asthma control cost-utility randomized trial evaluation (ACCURATE): the goals of asthma treatment

    PubMed Central

    2011-01-01

    Background Despite the availability of effective therapies, asthma remains a source of significant morbidity and use of health care resources. The central research question of the ACCURATE trial is whether maximal doses of (combination) therapy should be used for long periods in an attempt to achieve complete control of all features of asthma. An additional question is whether patients and society value the potential incremental benefit, if any, sufficiently to concur with such a treatment approach. We assessed patient preferences and cost-effectiveness of three treatment strategies aimed at achieving different levels of clinical control: 1. sufficiently controlled asthma 2. strictly controlled asthma 3. strictly controlled asthma based on exhaled nitric oxide as an additional disease marker Design 720 Patients with mild to moderate persistent asthma from general practices with a practice nurse, age 18-50 yr, daily treatment with inhaled corticosteroids (more then 3 months usage of inhaled corticosteroids in the previous year), will be identified via patient registries of general practices in the Leiden, Nijmegen, and Amsterdam areas in The Netherlands. The design is a 12-month cluster-randomised parallel trial with 40 general practices in each of the three arms. The patients will visit the general practice at baseline, 3, 6, 9, and 12 months. At each planned and unplanned visit to the general practice treatment will be adjusted with support of an internet-based asthma monitoring system supervised by a central coordinating specialist nurse. Patient preferences and utilities will be assessed by questionnaire and interview. Data on asthma control, treatment step, adherence to treatment, utilities and costs will be obtained every 3 months and at each unplanned visit. Differences in societal costs (medication, other (health) care and productivity) will be compared to differences in the number of limited activity days and in quality adjusted life years (Dutch EQ5D, SF6D

  6. A method for integrating computed tomography into radiotherapy planning and treatment.

    PubMed

    Ash, D V; Andrews, B; Stubbs, B

    1983-01-01

    A technique is described for accurate localisation and radiotherapy treatment planning for a wide range of intrathoracic, abdominal and pelvic tumours. It allows the patient to proceed in one step from a single examination by computed tomography (CT) to treatment and avoids the need for separate treatment simulation. Compatible laser-beam positioning systems between the CT scanner and treatment-machine rooms ensure accurate reproduction of patient position, so that CT data are directly applicable to treatment. The use of appropriate skin markers, which appear on the CT scan, allows accurate measurements of the distance of the centre of the planned volume from a tattoo placed on the patient at the time of the scan, and ensures that the planned treatment fields are accurately directed. PMID:6822045

  7. Implant treatment planning: endodontic considerations.

    PubMed

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

    2014-12-01

    Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible. PMID:25928961

  8. Emergency Planning for Municipal Wastewater Treatment Facilities.

    ERIC Educational Resources Information Center

    Lemon, R. A.; And Others

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

  9. Strategies for microwave thermal treatment planning, navigation, and assessment

    NASA Astrophysics Data System (ADS)

    Ryan, Thomas P.

    2011-03-01

    Thermal treatment is commonly performed interstitially in either surgical or percutaneous procedures, using microwave antenna sources at 915 or 2540 MHz. There are a number of tools or aids as well as challenges for clinicians performing these procedures in the course of patient treatment. These challenges will be present whether the procedure is surgical, laparoscopic, or percutaneous, and include treatment planning, image guidance, navigation, coregistration in 3D, and treatment assessment. Treatment planning has been used historically in hyperthermia for microwave antenna arrays, but has yet to be properly applied in thermal ablation. Image assessment of thermal treatment is not typically performed in real time, although these tools will provide the clinician with further information to understand the extent of treatment and whether further treatment is needed. 3D imaging is available, but not coregistered to patient space. Navigation has been used in many medical specialties, but is also not in the clinician's toolbox in thermal treatment. Although treatment planning will lay out the skin entry and trajectory for each antenna placed, subsequently, each antenna needs to be tracked to accurately show placement in the patient and overlaid in patient space, along with the tumor target location. Some patient treatments may consist of multiple, but sequential single placements of an antenna, and guidance is even more critical to track positions and plan for the next insertion. Lastly, real-time image assessment will show the extent and shape of the coagulated lesion and which targets may have been undertreated. If used synchronously in arrays, MW power steering may also aid in filling in the ablation as the treatment progresses. This paper will analyze the present state-of-the art as well as a strategy to incorporate the various facets of planning, guidance, and assessment of treatment. The integration of thermal treatment planning, navigation and guidance, robotics

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

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  11. Planning for mARC treatments with the Eclipse treatment planning system.

    PubMed

    Sarkar, Vikren; Huang, Long; Rassiah-Szegedi, Prema; Zhao, Hui; Huang, Jessica; Szegedi, Martin; Salter, Bill J

    2015-01-01

    While modulated arc (mARC) capabilities have been available on Siemens linear accelerators for almost two years now, there was, until recently, only one treatment planning system capable of planning these treatments. The Eclipse treatment planning system now offers a module that can plan for mARC treatments. The purpose of this work was to test the module to determine whether it is capable of creating clinically acceptable plans. A total of 23 plans were created for various clinical sites and all plans delivered without anomaly. The average 3%/3 mm gamma pass rate for the plans was 98.0%, with a standard deviation of 1.7%. For a total of 14 plans, an equivalent static gantry IMRT plan was also created to compare delivery time. In all but two cases, the mARC plans delivered significantly faster than the static gantry plan. We have confirmed the successful creation of mARC plans that are deliverable with high fidelity on an ARTISTE linear accelerator, thus demonstrating the successful implementation of the Eclipse mARC module. PMID:26103202

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Li, Zhen; Vogel, Martin; Maccarini, Paolo F; Arabe, Omar A; Stakhursky, Vadim; Crawford, Devin; Joines, Williams T; Stauffer, Paul R

    2008-01-01

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

  14. Improved treatment planning for COMS eye plaques

    SciTech Connect

    Astrahan, Melvin A. . E-mail: astrahan@usc.edu

    2005-03-15

    distribution surrounding a single {sup 125}I seed centered in a COMS 20 mm plaque was found to be consistent with previously published examples that used thermoluminescent dosimetry measurements and Monte Carlo methods. For fully loaded 12 and 20 mm plaques, calculated dose to critical ocular structures ranged from 16%-50% less than would have been reported using the standard COMS dose calculation protocol. Conclusions: Treatment planning for COMS eye plaques that accurately accounts for the presence of the gold, Silastic and extraocular air is both possible and practical.

  15. Automatic Treatment Planning with Convex Imputing

    NASA Astrophysics Data System (ADS)

    Sayre, G. A.; Ruan, D.

    2014-03-01

    Current inverse optimization-based treatment planning for radiotherapy requires a set of complex DVH objectives to be simultaneously minimized. This process, known as multi-objective optimization, is challenging due to non-convexity in individual objectives and insufficient knowledge in the tradeoffs among the objective set. As such, clinical practice involves numerous iterations of human intervention that is costly and often inconsistent. In this work, we propose to address treatment planning with convex imputing, a new-data mining technique that explores the existence of a latent convex objective whose optimizer reflects the DVH and dose-shaping properties of previously optimized cases. Using ten clinical prostate cases as the basis for comparison, we imputed a simple least-squares problem from the optimized solutions of the prostate cases, and show that the imputed plans are more consistent than their clinical counterparts in achieving planning goals.

  16. The evolution of brachytherapy treatment planning

    SciTech Connect

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

    2009-06-15

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

  17. The effect of dose calculation accuracy on inverse treatment planning

    NASA Astrophysics Data System (ADS)

    Jeraj, Robert; Keall, Paul J.; Siebers, Jeffrey V.

    2002-02-01

    The effect of dose calculation accuracy during inverse treatment planning for intensity modulated radiotherapy (IMRT) was studied in this work. Three dose calculation methods were compared: Monte Carlo, superposition and pencil beam. These algorithms were used to calculate beamlets, which were subsequently used by a simulated annealing algorithm to determine beamlet weights which comprised the optimal solution to the objective function. Three different cases (lung, prostate and head and neck) were investigated and several different objective functions were tested for their effect on inverse treatment planning. It is shown that the use of inaccurate dose calculation introduces two errors in a treatment plan, a systematic error and a convergence error. The systematic error is present because of the inaccuracy of the dose calculation algorithm. The convergence error appears because the optimal intensity distribution for inaccurate beamlets differs from the optimal solution for the accurate beamlets. While the systematic error for superposition was found to be ~1% of Dmax in the tumour and slightly larger outside, the error for the pencil beam method is typically ~5% of Dmax and is rather insensitive to the given objectives. On the other hand, the convergence error was found to be very sensitive to the objective function, is only slightly correlated to the systematic error and should be determined for each case individually. Our results suggest that because of the large systematic and convergence errors, inverse treatment planning systems based on pencil beam algorithms alone should be upgraded either to superposition or Monte Carlo based dose calculations.

  18. The development and verification of a highly accurate collision prediction model for automated noncoplanar plan delivery

    SciTech Connect

    Yu, Victoria Y.; Tran, Angelia; Nguyen, Dan; Cao, Minsong; Ruan, Dan; Low, Daniel A.; Sheng, Ke

    2015-11-15

    Purpose: Significant dosimetric benefits had been previously demonstrated in highly noncoplanar treatment plans. In this study, the authors developed and verified an individualized collision model for the purpose of delivering highly noncoplanar radiotherapy and tested the feasibility of total delivery automation with Varian TrueBeam developer mode. Methods: A hand-held 3D scanner was used to capture the surfaces of an anthropomorphic phantom and a human subject, which were positioned with a computer-aided design model of a TrueBeam machine to create a detailed virtual geometrical collision model. The collision model included gantry, collimator, and couch motion degrees of freedom. The accuracy of the 3D scanner was validated by scanning a rigid cubical phantom with known dimensions. The collision model was then validated by generating 300 linear accelerator orientations corresponding to 300 gantry-to-couch and gantry-to-phantom distances, and comparing the corresponding distance measurements to their corresponding models. The linear accelerator orientations reflected uniformly sampled noncoplanar beam angles to the head, lung, and prostate. The distance discrepancies between measurements on the physical and virtual systems were used to estimate treatment-site-specific safety buffer distances with 0.1%, 0.01%, and 0.001% probability of collision between the gantry and couch or phantom. Plans containing 20 noncoplanar beams to the brain, lung, and prostate optimized via an in-house noncoplanar radiotherapy platform were converted into XML script for automated delivery and the entire delivery was recorded and timed to demonstrate the feasibility of automated delivery. Results: The 3D scanner measured the dimension of the 14 cm cubic phantom within 0.5 mm. The maximal absolute discrepancy between machine and model measurements for gantry-to-couch and gantry-to-phantom was 0.95 and 2.97 cm, respectively. The reduced accuracy of gantry-to-phantom measurements was

  19. Treatment planning for volumetric modulated arc therapy

    SciTech Connect

    Bedford, James L.

    2009-11-15

    Purpose: Volumetric modulated arc therapy (VMAT) is a specific type of intensity-modulated radiation therapy (IMRT) in which the gantry speed, multileaf collimator (MLC) leaf position, and dose rate vary continuously during delivery. A treatment planning system for VMAT is presented. Methods: Arc control points are created uniformly throughout one or more arcs. An iterative least-squares algorithm is used to generate a fluence profile at every control point. The control points are then grouped and all of the control points in a given group are used to approximate the fluence profiles. A direct-aperture optimization is then used to improve the solution, taking into account the allowed range of leaf motion of the MLC. Dose is calculated using a fast convolution algorithm and the motion between control points is approximated by 100 interpolated dose calculation points. The method has been applied to five cases, consisting of lung, rectum, prostate and seminal vesicles, prostate and pelvic lymph nodes, and head and neck. The resulting plans have been compared with segmental (step-and-shoot) IMRT and delivered and verified on an Elekta Synergy to ensure practicality. Results: For the lung, prostate and seminal vesicles, and rectum cases, VMAT provides a plan of similar quality to segmental IMRT but with faster delivery by up to a factor of 4. For the prostate and pelvic nodes and head-and-neck cases, the critical structure doses are reduced with VMAT, both of these cases having a longer delivery time than IMRT. The plans in general verify successfully, although the agreement between planned and measured doses is not very close for the more complex cases, particularly the head-and-neck case. Conclusions: Depending upon the emphasis in the treatment planning, VMAT provides treatment plans which are higher in quality and/or faster to deliver than IMRT. The scheme described has been successfully introduced into clinical use.

  20. Cost-Effective Fuel Treatment Planning

    NASA Astrophysics Data System (ADS)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  1. Automated radiotherapy treatment plan integrity verification

    SciTech Connect

    Yang Deshan; Moore, Kevin L.

    2012-03-15

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

  2. Clinical knowledge-based inverse treatment planning

    NASA Astrophysics Data System (ADS)

    Yang, Yong; Xing, Lei

    2004-11-01

    Clinical IMRT treatment plans are currently made using dose-based optimization algorithms, which do not consider the nonlinear dose-volume effects for tumours and normal structures. The choice of structure specific importance factors represents an additional degree of freedom of the system and makes rigorous optimization intractable. The purpose of this work is to circumvent the two problems by developing a biologically more sensible yet clinically practical inverse planning framework. To implement this, the dose-volume status of a structure was characterized by using the effective volume in the voxel domain. A new objective function was constructed with the incorporation of the volumetric information of the system so that the figure of merit of a given IMRT plan depends not only on the dose deviation from the desired distribution but also the dose-volume status of the involved organs. The conventional importance factor of an organ was written into a product of two components: (i) a generic importance that parametrizes the relative importance of the organs in the ideal situation when the goals for all the organs are met; (ii) a dose-dependent factor that quantifies our level of clinical/dosimetric satisfaction for a given plan. The generic importance can be determined a priori, and in most circumstances, does not need adjustment, whereas the second one, which is responsible for the intractable behaviour of the trade-off seen in conventional inverse planning, was determined automatically. An inverse planning module based on the proposed formalism was implemented and applied to a prostate case and a head-neck case. A comparison with the conventional inverse planning technique indicated that, for the same target dose coverage, the critical structure sparing was substantially improved for both cases. The incorporation of clinical knowledge allows us to obtain better IMRT plans and makes it possible to auto-select the importance factors, greatly facilitating the inverse

  3. [Understanding and implementing the Party's policies on family planning accurately in an all-around way].

    PubMed

    Liang, J; Peng, Z

    1984-05-29

    Recently, the Party's Central Committee held numerous meetings to study the problem of family planning. The main goal of these meetings was to find a correct family planning policy, which should be based on common sense, support from the people, and reasonable work from the cadres. Family planning policies and regulations should be realistic and creative. In the implementation of policies, different methods should be adopted for varied situations, and there should also be appropriate guiding principles for different categories. To cope with a new situation, creative methods and approaches should be chosen in order to implement the family planning policy. The correct method will ensure complete implementation of the policy. In family planning work, the first step is the improvement of ideological education, so that the people may have a correct understanding of the need for family planning. In the technical management work of family planning, a constant improvement in the quality of service should be the goal. Through practical working experience in family planning, some rules and regulations will be found, and they should be used to promote the management level and the level of family planning work in general. PMID:12159337

  4. Automatic liver contouring for radiotherapy treatment planning.

    PubMed

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

    2015-10-01

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

  5. Automatic liver contouring for radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

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

    2015-09-01

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

  6. Application of a dummy eye shield for electron treatment planning

    PubMed Central

    Kang, Sei-Kwon; Park, Soah; Hwang, Taejin; Cheong, Kwang-Ho; Han, Taejin; Kim, Haeyoung; Lee, Me-Yeon; Kim, Kyoung Ju; Oh, Do Hoon; Bae, Hoonsik

    2013-01-01

    Metallic eye shields have been widely used for near-eye treatments to protect critical regions, but have never been incorporated into treatment plans because of the unwanted appearance of the metal artifacts on CT images. The purpose of this work was to test the use of an acrylic dummy eye shield as a substitute for a metallic eye shield during CT scans. An acrylic dummy shield of the same size as the tungsten eye shield was machined and CT scanned. The BEAMnrc and the DOSXYZnrc were used for the Monte Carlo (MC) simulation, with the appropriate material information and density for the aluminum cover, steel knob and tungsten body of the eye shield. The Pinnacle adopting the Hogstrom electron pencil-beam algorithm was used for the one-port 6-MeV beam plan after delineation and density override of the metallic parts. The results were confirmed with the metal oxide semiconductor field effect transistor (MOSFET) detectors and the Gafchromic EBT2 film measurements. For both the maximum eyelid dose over the shield and the maximum dose under the shield, the MC results agreed with the EBT2 measurements within 1.7%. For the Pinnacle plan, the maximum dose under the shield agreed with the MC within 0.3%; however, the eyelid dose differed by –19.3%. The adoption of the acrylic dummy eye shield was successful for the treatment plan. However, the Pinnacle pencil-beam algorithm was not sufficient to predict the eyelid dose on the tungsten shield, and more accurate algorithms like MC should be considered for a treatment plan. PMID:22915776

  7. Application of a dummy eye shield for electron treatment planning.

    PubMed

    Kang, Sei-Kwon; Park, Soah; Hwang, Taejin; Cheong, Kwang-Ho; Han, Taejin; Kim, Haeyoung; Lee, Me-Yeon; Kim, Kyoung Ju; Oh, Do Hoon; Bae, Hoonsik

    2013-01-01

    Metallic eye shields have been widely used for near-eye treatments to protect critical regions, but have never been incorporated into treatment plans because of the unwanted appearance of the metal artifacts on CT images. The purpose of this work was to test the use of an acrylic dummy eye shield as a substitute for a metallic eye shield during CT scans. An acrylic dummy shield of the same size as the tungsten eye shield was machined and CT scanned. The BEAMnrc and the DOSXYZnrc were used for the Monte Carlo (MC) simulation, with the appropriate material information and density for the aluminum cover, steel knob and tungsten body of the eye shield. The Pinnacle adopting the Hogstrom electron pencil-beam algorithm was used for the one-port 6-MeV beam plan after delineation and density override of the metallic parts. The results were confirmed with the metal oxide semiconductor field effect transistor (MOSFET) detectors and the Gafchromic EBT2 film measurements. For both the maximum eyelid dose over the shield and the maximum dose under the shield, the MC results agreed with the EBT2 measurements within 1.7%. For the Pinnacle plan, the maximum dose under the shield agreed with the MC within 0.3%; however, the eyelid dose differed by -19.3%. The adoption of the acrylic dummy eye shield was successful for the treatment plan. However, the Pinnacle pencil-beam algorithm was not sufficient to predict the eyelid dose on the tungsten shield, and more accurate algorithms like MC should be considered for a treatment plan. PMID:22915776

  8. Electron Density Calibration for Radiotherapy Treatment Planning

    SciTech Connect

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

    2006-09-08

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

  9. Electron Density Calibration for Radiotherapy Treatment Planning

    NASA Astrophysics Data System (ADS)

    Herrera-Martínez, F.; Rodríguez-Villafuerte, M.; Martínez-Dávalos, A.; Ruiz-Trejo, C.; Celis-López, M. A.; Lárraga-Gutiérrez, J. M.; García-Garduño, A.

    2006-09-01

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

  10. Simple Case Treatment Planning: Diastema Closure.

    PubMed

    Calamia, Vincent; Pantzis, Alexandria

    2015-07-01

    This article demonstrates the use of a smile evaluation form as an adjunct in arriving at diagnosis and developing a treatment plan for a patient desiring Diastema closure. It also shows the importance of the diagnostic wax-up for temporization and visualization of case outcome. The case also demonstrates the use of soft tissue lasers to create a gingival harmony that enhanced the resulting esthetics. Feldspathic porcelain was used for the final restorations because they provide optimal esthetics and translucency. PMID:26140972

  11. Monte Carlo treatment planning for photon and electron beams

    NASA Astrophysics Data System (ADS)

    Reynaert, N.; van der Marck, S. C.; Schaart, D. R.; Van der Zee, W.; Van Vliet-Vroegindeweij, C.; Tomsej, M.; Jansen, J.; Heijmen, B.; Coghe, M.; De Wagter, C.

    2007-04-01

    During the last few decades, accuracy in photon and electron radiotherapy has increased substantially. This is partly due to enhanced linear accelerator technology, providing more flexibility in field definition (e.g. the usage of computer-controlled dynamic multileaf collimators), which led to intensity modulated radiotherapy (IMRT). Important improvements have also been made in the treatment planning process, more specifically in the dose calculations. Originally, dose calculations relied heavily on analytic, semi-analytic and empirical algorithms. The more accurate convolution/superposition codes use pre-calculated Monte Carlo dose "kernels" partly accounting for tissue density heterogeneities. It is generally recognized that the Monte Carlo method is able to increase accuracy even further. Since the second half of the 1990s, several Monte Carlo dose engines for radiotherapy treatment planning have been introduced. To enable the use of a Monte Carlo treatment planning (MCTP) dose engine in clinical circumstances, approximations have been introduced to limit the calculation time. In this paper, the literature on MCTP is reviewed, focussing on patient modeling, approximations in linear accelerator modeling and variance reduction techniques. An overview of published comparisons between MC dose engines and conventional dose calculations is provided for phantom studies and clinical examples, evaluating the added value of MCTP in the clinic. An overview of existing Monte Carlo dose engines and commercial MCTP systems is presented and some specific issues concerning the commissioning of a MCTP system are discussed.

  12. A treatment planning system for pleural PDT

    NASA Astrophysics Data System (ADS)

    Sandell, Julia; Chang, Chang; Finlay, Jarod C.; Zhu, Timothy C.

    2010-02-01

    Uniform light fluence distribution for patients undergoing photodynamic therapy (PDT) is critical to ensure predictable PDT outcome. However, common practice uses a point source to deliver light to the pleural cavity. To improve the uniformity of light fluence rate distribution, we have developed a treatment planning system using an infrared camera to track the movement of the point source. This study examines the light fluence (rate) delivered to chest phantom to simulate a patient undergoing pleural PDT. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) was monitored at 7 different sites during the entire light treatment delivery. Isotropic detectors were used for in-vivo light dosimetry. Light fluence rate in the pleural cavity is also calculated using the diffusion approximation with a finite-element model. We have established a correlation between the light fluence rate distribution and the light fluence rate measured on the selected points based on a spherical cavity model. Integrating sphere theory is used to aid the calculation of light fluence rate on the surface of the sphere as well as inside tissue assuming uniform optical properties. The resulting treatment planning tool can be valuable as a clinical guideline for future pleural PDT treatment.

  13. Review of Fast Monte Carlo Codes for Dose Calculation in Radiation Therapy Treatment Planning

    PubMed Central

    Jabbari, Keyvan

    2011-01-01

    An important requirement in radiation therapy is a fast and accurate treatment planning system. This system, using computed tomography (CT) data, direction, and characteristics of the beam, calculates the dose at all points of the patient's volume. The two main factors in treatment planning system are accuracy and speed. According to these factors, various generations of treatment planning systems are developed. This article is a review of the Fast Monte Carlo treatment planning algorithms, which are accurate and fast at the same time. The Monte Carlo techniques are based on the transport of each individual particle (e.g., photon or electron) in the tissue. The transport of the particle is done using the physics of the interaction of the particles with matter. Other techniques transport the particles as a group. For a typical dose calculation in radiation therapy the code has to transport several millions particles, which take a few hours, therefore, the Monte Carlo techniques are accurate, but slow for clinical use. In recent years, with the development of the ‘fast’ Monte Carlo systems, one is able to perform dose calculation in a reasonable time for clinical use. The acceptable time for dose calculation is in the range of one minute. There is currently a growing interest in the fast Monte Carlo treatment planning systems and there are many commercial treatment planning systems that perform dose calculation in radiation therapy based on the Monte Carlo technique. PMID:22606661

  14. Nevada Test Site Treatment Plan. Revision 2

    SciTech Connect

    1996-03-01

    Treatment Plans (STPS) are required for facilities at which the US Department of Energy (DOE) or stores mixed waste, defined by the Federal Facility Compliance Act (FFCAct) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act and a radioactive material subject to the Atomic Energy Act. On April 6, 1993, DOE published a Federal Register notice (58 FR 17875) describing its proposed process for developing the STPs in three phases including a Conceptual, a Draft, and a Proposed Site Treatment Plan (PSTP). All of the DOE Nevada Operations Office STP iterations have been developed with the state of Nevada`s input. The options and schedules reflect a ``bottoms-up`` approach and have been evaluated for impacts on other DOE sites, as well as impacts to the overall DOE program. Changes may have occurred in the preferred option and associated schedules between the PSTP, which was submitted to the state of Nevada and US Environmental Protection Agency April 1995, and the Final STP (hereafter referred to as the STP) as treatment evaluations progressed. The STP includes changes that have occurred since the submittal of the PSTP as a result of state-to-state and DOE-to-state discussions.

  15. Treatment planning concepts for the ageing patient.

    PubMed

    Ettinger, R L

    2015-03-01

    There is an ageing imperative in Australia as in many other industrialized nations, and these populations are extremely heterogeneous. In young adults, the factors which influence decision making for oral health care are whether the patient has the will, the time or the finances to pay for care, while for clinicians, the decisions are whether they have the skill and the resources to carry out the treatment plan. For older adults, the decision making includes all of the previous identified factors, but they are now complicated by the patient's medical and medication problems, the side effects of the medications they are taking, their cognitive status as well as the cumulative effects of a lifetime of physiological, traumatic and iatrogenic effects on the dentition and the oral cavity. The decision-making process which has evolved has been called many names, from cost-effective care to minimal invasive dentistry to rational dental care. Fundamentally, they are similar. Rational dental care has been defined as the process of decision making, which develops a treatment plan that is in the best interest of the patient after evaluating all of the modifying factors. This article will discuss the various concepts, and the strengths and weaknesses of some of these systems. It will also illustrate some of the clinical problems as there is very little evidence-based data to support any of these concepts. However, treatment planning is still an art, which can only be carried out for an individual and not a group, and the result must serve the needs of the patient and enhance the quality of his or her life. PMID:25762044

  16. Simulation techniques in hyperthermia treatment planning

    PubMed Central

    Paulides, MM; Stauffer, PR; Neufeld, E; Maccarini, P; Kyriakou, A; Canters, RAM; Diederich, C; Bakker, JF; Van Rhoon, GC

    2013-01-01

    Clinical trials have shown that hyperthermia (HT), i.e. an increase of tissue temperature to 39-44°C, significantly enhance radiotherapy and chemotherapy effectiveness (1). Driven by the developments in computational techniques and computing power, personalized hyperthermia treatment planning (HTP) has matured and has become a powerful tool for optimizing treatment quality. Electromagnetic, ultrasound, and thermal simulations using realistic clinical setups are now being performed to achieve patient-specific treatment optimization. In addition, extensive studies aimed to properly implement novel HT tools and techniques, and to assess the quality of HT, are becoming more common. In this paper, we review the simulation tools and techniques developed for clinical hyperthermia, and evaluate their current status on the path from “model” to “clinic”. In addition, we illustrate the major techniques employed for validation and optimization. HTP has become an essential tool for improvement, control, and assessment of HT treatment quality. As such, it plays a pivotal role in the quest to establish HT as an efficacious addition to multi-modality treatment of cancer. PMID:23672453

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

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

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

    PubMed

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

    2016-06-01

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

  19. Alopecia areata: a new treatment plan

    PubMed Central

    Alsantali, Adel

    2011-01-01

    Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. Unfortunately, none of these agents is curative or preventive. Also, many of these therapeutic agents have not been subjected to randomized, controlled trials, and, except for topical immunotherapy, there are few published studies on long-term outcomes. The treatment plan is designed according to the patient’s age and extent of disease. In this paper, the therapeutic agents are organized according to their efficacy and safety profiles into first-line, second-line, and third-line options. PMID:21833161

  20. Treatment planning and dose calculation in radiation ecology

    SciTech Connect

    Bentel, G.C.; Nelson, C.E.; Noell, K.T.

    1989-01-01

    This book focuses on treatment planning of cancer therapy. The following topics are discussed: elements of clinical radiation oncology; radiation physics; dose calculation for external beams; pretreatment procedures; brachytherapy; principles of external beam treatment planning; practical treatment planning; and normal tissue consequences. Eight chapters have been processed separately for inclusion in the appropriate data bases.

  1. Dentofacial Asymmetries: Challenging Diagnosis and Treatment Planning

    PubMed Central

    Agrawal, Manish; Agrawal, Jiwan Asha; Nanjannawar, Lalita; Fulari, Sangamesh; Kagi, Vishwal

    2015-01-01

    Dentofacial asymmetry is quite common and when sufficiently severe can require surgical orthodontic intervention. Asymmetries can be classified according to the structures involved into skeletal, dental and functional. In diagnosing asymmetries, a thorough clinical examination and radiographic survey are essential to determine the extent of soft tissue, skeletal, dental and functional involvement. Dental asymmetries, as well as a variety of functional deviations, can be managed orthodontically, whereas significant structural facial asymmetries require a comprehensive orthodontic and orthognathic management. With less severe dental, skeletal and soft tissue deviations the advisability of treatment should be carefully considered. The following article also contains a case report highlighting the importance of proper diagnosis in treatment plan for management of dentofacial asymmetry. PMID:26229387

  2. Dentofacial Asymmetries: Challenging Diagnosis and Treatment Planning.

    PubMed

    Agrawal, Manish; Agrawal, Jiwan Asha; Nanjannawar, Lalita; Fulari, Sangamesh; Kagi, Vishwal

    2015-07-01

    Dentofacial asymmetry is quite common and when sufficiently severe can require surgical orthodontic intervention. Asymmetries can be classified according to the structures involved into skeletal, dental and functional. In diagnosing asymmetries, a thorough clinical examination and radiographic survey are essential to determine the extent of soft tissue, skeletal, dental and functional involvement. Dental asymmetries, as well as a variety of functional deviations, can be managed orthodontically, whereas significant structural facial asymmetries require a comprehensive orthodontic and orthognathic management. With less severe dental, skeletal and soft tissue deviations the advisability of treatment should be carefully considered. The following article also contains a case report highlighting the importance of proper diagnosis in treatment plan for management of dentofacial asymmetry. PMID:26229387

  3. Dosimetric verification of a commercial inverse treatment planning system

    NASA Astrophysics Data System (ADS)

    Xing, Lei; Curran, Bruce; Hill, Robert; Holmes, Tim; Ma, Lijun; Forster, Kenneth M.; Boyer, Arthur L.

    1999-02-01

    A commercial three-dimensional (3D) inverse treatment planning system, Corvus (Nomos Corporation, Sewickley, PA), was recently made available. This paper reports our preliminary results and experience with commissioning this system for clinical implementation. This system uses a simulated annealing inverse planning algorithm to calculate intensity-modulated fields. The intensity-modulated fields are divided into beam profiles that can be delivered by means of a sequence of leaf settings by a multileaf collimator (MLC). The treatments are delivered using a computer-controlled MLC. To test the dose calculation algorithm used by the Corvus software, the dose distributions for single rectangularly shaped fields were compared with water phantom scan data. The dose distributions predicted to be delivered by multiple fields were measured using an ion chamber that could be positioned in a rotatable cylindrical water phantom. Integrated charge collected by the ion chamber was used to check the absolute dose of single- and multifield intensity modulated treatments at various spatial points. The measured and predicted doses were found to agree to within 4% at all measurement points. Another set of measurements used a cubic polystyrene phantom with radiographic film to record the radiation dose distribution. The films were calibrated and scanned to yield two-dimensional isodose distributions. Finally, a beam imaging system (BIS) was used to measure the intensity-modulated x-ray beam patterns in the beam's-eye view. The BIS-measured images were then compared with a theoretical calculation based on the MLC leaf sequence files to verify that the treatment would be executed accurately and without machine faults. Excellent correlation (correlation coefficients ) was found for all cases. Treatment plans generated using intensity

  4. Recovery post treatment: plans, barriers and motivators

    PubMed Central

    2013-01-01

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

  5. Accurate and general treatment of electrostatic interaction in Hamiltonian adaptive resolution simulations

    NASA Astrophysics Data System (ADS)

    Heidari, M.; Cortes-Huerto, R.; Donadio, D.; Potestio, R.

    2016-07-01

    In adaptive resolution simulations the same system is concurrently modeled with different resolution in different subdomains of the simulation box, thereby enabling an accurate description in a small but relevant region, while the rest is treated with a computationally parsimonious model. In this framework, electrostatic interaction, whose accurate treatment is a crucial aspect in the realistic modeling of soft matter and biological systems, represents a particularly acute problem due to the intrinsic long-range nature of Coulomb potential. In the present work we propose and validate the usage of a short-range modification of Coulomb potential, the Damped shifted force (DSF) model, in the context of the Hamiltonian adaptive resolution simulation (H-AdResS) scheme. This approach, which is here validated on bulk water, ensures a reliable reproduction of the structural and dynamical properties of the liquid, and enables a seamless embedding in the H-AdResS framework. The resulting dual-resolution setup is implemented in the LAMMPS simulation package, and its customized version employed in the present work is made publicly available.

  6. Clinical Practice Guideline for Accurate Diagnosis and Effective Treatment of Gastrointestinal Stromal Tumor in Korea

    PubMed Central

    Kim, Kyoung-Mee; Sohn, Taesung; Choi, Dongil; Kang, Hye Jin; Ryu, Min-Hee; Kim, Woo Ho; Yang, Han-Kwang

    2010-01-01

    Despite the rarity in incidence and prevalence, gastrointestinal stromal tumor (GIST) has emerged as a distinct pathogenetic entity. And the clinical management of GIST has been evolving very rapidly due to the recent recognition of its oncogenic signal transduction pathway and the introduction of new molecular-targeted therapy. Successful management of GIST requires a multidisciplinary approach firmly based on accurate histopathologic diagnosis. However, there was no standardized guideline for the management of Korean GIST patients. In 2007, the Korean GIST study group (KGSG) published the first guideline for optimal diagnosis and treatment of GIST in Korea. As the second version of the guideline, we herein have updated recent clinical recommendations and reflected changes in diagnosis, surgical and medical treatments for more optimal clinical practice for GIST in Korea. We hope the guideline can be of help in enhancing the quality of diagnosis by members of the Korean associate of physicians involving in GIST patients's care and subsequently in achieving optimal efficacy of treatment. PMID:21060741

  7. Initial evaluation of automated treatment planning software.

    PubMed

    Gintz, Dawn; Latifi, Kujtim; Caudell, Jimmy; Nelms, Benjamin; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir

    2016-01-01

    Even with advanced inverse-planning techniques, radiation treatment plan opti-mization remains a very time-consuming task with great output variability, which prompted the development of more automated approaches. One commercially available technique mimics the actions of experienced human operators to pro-gressively guide the traditional optimization process with automatically created regions of interest and associated dose-volume objectives. We report on the initial evaluation of this algorithm on 10 challenging cases of locoreginally advanced head and neck cancer. All patients were treated with VMAT to 70 Gy to the gross disease and 56 Gy to the elective bilateral nodes. The results of post-treatment autoplanning (AP) were compared to the original human-driven plans (HDP). We used an objective scoring system based on defining a collection of specific dosimetric metrics and corresponding numeric score functions for each. Five AP techniques with different input dose goals were applied to all patients. The best of them averaged the composite score 8% lower than the HDP, across the patient population. The difference in median values was statistically significant at the 95% confidence level (Wilcoxon paired signed-rank test p = 0.027). This result reflects the premium the institution places on dose homogeneity, which was consistently higher with the HDPs. The OAR sparing was consistently better with the APs, the differences reaching statistical significance for the mean doses to the parotid glands (p < 0.001) and the inferior pharyngeal constrictor (p = 0.016), as well as for the maximum doses to the spinal cord (p = 0.018) and brainstem (p = 0.040). If one is prepared to accept less stringent dose homogeneity criteria from the RTOG 1016 protocol, nine APs would comply with the protocol, while providing lower OAR doses than the HDPs. Overall, AP is a promising clinical tool, but it could benefit from a better process for shifting the balance between the target dose

  8. A new method for commissioning Monte Carlo treatment planning systems

    NASA Astrophysics Data System (ADS)

    Aljarrah, Khaled Mohammed

    2005-11-01

    The Monte Carlo method is an accurate method for solving numerical problems in different fields. It has been used for accurate radiation dose calculation for radiation treatment of cancer. However, the modeling of an individual radiation beam produced by a medical linear accelerator for Monte Carlo dose calculation, i.e., the commissioning of a Monte Carlo treatment planning system, has been the bottleneck for the clinical implementation of Monte Carlo treatment planning. In this study a new method has been developed to determine the parameters of the initial electron beam incident on the target for a clinical linear accelerator. The interaction of the initial electron beam with the accelerator target produces x-ray and secondary charge particles. After successive interactions in the linac head components, the x-ray photons and the secondary charge particles interact with the patient's anatomy and deliver dose to the region of interest. The determination of the initial electron beam parameters is important for estimating the delivered dose to the patients. These parameters, such as beam energy and radial intensity distribution, are usually estimated through a trial and error process. In this work an easy and efficient method was developed to determine these parameters. This was accomplished by comparing calculated 3D dose distributions for a grid of assumed beam energies and radii in a water phantom with measurements data. Different cost functions were studied to choose the appropriate function for the data comparison. The beam parameters were determined on the light of this method. Due to the assumption that same type of linacs are exactly the same in their geometries and only differ by the initial phase space parameters, the results of this method were considered as a source data to commission other machines of the same type.

  9. Voxel model in BNCT treatment planning: performance analysis and improvements

    NASA Astrophysics Data System (ADS)

    González, Sara J.; Carando, Daniel G.; Santa Cruz, Gustavo A.; Zamenhof, Robert G.

    2005-02-01

    In recent years, many efforts have been made to study the performance of treatment planning systems in deriving an accurate dosimetry of the complex radiation fields involved in boron neutron capture therapy (BNCT). The computational model of the patient's anatomy is one of the main factors involved in this subject. This work presents a detailed analysis of the performance of the 1 cm based voxel reconstruction approach. First, a new and improved material assignment algorithm implemented in NCTPlan treatment planning system for BNCT is described. Based on previous works, the performances of the 1 cm based voxel methods used in the MacNCTPlan and NCTPlan treatment planning systems are compared by standard simulation tests. In addition, the NCTPlan voxel model is benchmarked against in-phantom physical dosimetry of the RA-6 reactor of Argentina. This investigation shows the 1 cm resolution to be accurate enough for all reported tests, even in the extreme cases such as a parallelepiped phantom irradiated through one of its sharp edges. This accuracy can be degraded at very shallow depths in which, to improve the estimates, the anatomy images need to be positioned in a suitable way. Rules for this positioning are presented. The skin is considered one of the organs at risk in all BNCT treatments and, in the particular case of cutaneous melanoma of extremities, limits the delivered dose to the patient. Therefore, the performance of the voxel technique is deeply analysed in these shallow regions. A theoretical analysis is carried out to assess the distortion caused by homogenization and material percentage rounding processes. Then, a new strategy for the treatment of surface voxels is proposed and tested using two different irradiation problems. For a parallelepiped phantom perpendicularly irradiated with a 5 keV neutron source, the large thermal neutron fluence deviation present at shallow depths (from 54% at 0 mm depth to 5% at 4 mm depth) is reduced to 2% on average

  10. 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

  11. Treatment Planning for Ion Beam Therapy

    NASA Astrophysics Data System (ADS)

    Greilich, Steffen; Jäkel, Oliver

    2010-01-01

    Beams of charged particles offer an improved dose conformation to the target volume as compared to photon radiotherapy, with better sparing of normal tissue structures close to the target. In addition, beams of ions heavier than helium exhibit a strong increase of the Linear Energy Transfer (LET) in the Bragg peak as compared to the entrance region, resulting in a higher biological efficiency in the target region. These physical and biological properties make ion beams more favorable for radiation therapy of cancer than photon beams. As a consequence, particle therapy with heavy ions has gained increasing interest worldwide. To fully benefit from the advantages of ion radiotherapy, appropriate treatment planning has to be done—taking into account the specific characteristics of ion beams, e.g. the inverted depth-dose profile, nuclear fragmentation, and increase radiobiological effectiveness. This paper describes in brief the approach taken at GSI Darmstadt and HIT Heidelberg for an active 3D beam scanning system.

  12. Verification of the accuracy of BNCT treatment planning system THORplan.

    PubMed

    Li, H S; Liu, Y-W H; Lee, C Y; Lin, T Y; Hsu, F Y

    2009-07-01

    THORplan is a treatment planning system developed at Tsing Hua University, Taiwan, for boron neutron capture therapy (BNCT) purpose. It is recently developed with user-friendly interface using Interactive Data Language. In this article the accuracy of THORplan is verified by comparing results of Snyder phantom calculation with the analytical model results of MCNP. Neutron source from THOR epithermal neutron beam is used as the source for the calculation. The thermal neutron flux calculated by THORplan is very close to the reference results. SERA overestimates thermal neutron flux by 2-5%. NCTPlan underestimates thermal neutron flux by 4-9% in most locations. The total weighted dose calculated by THORplan is accurate to within 3% except at the tissue interface. SERA overestimates the total weighted dose at depth >1.5 cm by 2-5%. NCTPlan underestimates the total weighted dose by approximately 10% at depth >1cm. PMID:19386507

  13. IMRT Quality Assurance Using a Second Treatment Planning System

    SciTech Connect

    Anjum, Muhammad Naeem; Parker, William; Ruo, Russell; Aldahlawi, Ismail; Afzal, Muhammad

    2010-01-01

    We used a second treatment planning system (TPS) for independent verification of the dose calculated by our primary TPS in the context of patient-specific quality assurance (QA) for intensity-modulated radiation therapy (IMRT). QA plans for 24 patients treated with inverse planned dynamic IMRT were generated using the Nomos Corvus TPS. The plans were calculated on a computed tomography scan of our QA phantom that consists of three Solid Water slabs sandwiching radiochromic films, and an ion chamber that is inserted into the center slab of the phantom. For the independent verification, the dose was recalculated using the Varian Eclipse TPS using the multileaf collimator files and beam geometry from the original plan. The data was then compared in terms of absolute dose to the ion chamber volume as well as relative dose on isodoses calculated at the film plane. The calculation results were also compared with measurements performed for each case. When comparing ion chamber doses, the mean ratio was 0.999 (SD 0.010) for Eclipse vs. Corvus, 0.988 (SD 0.020) for the ionization chamber measurements vs. Corvus, and 0.989 (SD 0.017) for the ionization chamber measurements vs. Eclipse. For 2D doses with gamma histogram, the mean value of the percentage of pixels passing the criteria of 3%, 3 mm was 94.4 (SD 5.3) for Eclipse vs. Corvus, 85.1 (SD 10.6) for Corvus vs. film, and 93.7 (SD 4.1) for Eclipse vs. film; and for the criteria of 5%, 3 mm, 98.7 (SD 1.5) for Eclipse vs. Corvus, 93.0 (SD 7.8) for Corvus vs. film, and 98.0 (SD 1.9) for Eclipse vs. film. We feel that the use of the Eclipse TPS as an independent, accurate, robust, and time-efficient method for patient-specific IMRT QA is feasible in clinic.

  14. Aperture shape optimization for IMRT treatment planning

    NASA Astrophysics Data System (ADS)

    Cassioli, A.; Unkelbach, J.

    2013-01-01

    We propose an algorithm for aperture shape optimization (ASO) for step and shoot delivery of intensity-modulated radiotherapy. The method is an approach to direct aperture optimization (DAO) that exploits gradient information to locally optimize the positions of the leafs of a multileaf collimator. Based on the dose-influence matrix, the dose distribution is locally approximated as a linear function of the leaf positions. Since this approximation is valid only in a small interval around the current leaf positions, we use a trust-region-like method to optimize the leaf positions: in one iteration, the leaf motion is confined to the beamlets where the leaf edges are currently positioned. This yields a well-behaved optimization problem for the leaf positions and the aperture weights, which can be solved efficiently. If, in one iteration, a leaf is moved to the edge of a beamlet, the leaf motion can be confined to the neighboring beamlet in the next iteration. This allows for large leaf position changes over the course of the algorithm. In this paper, the ASO algorithm is embedded into a column-generation approach to DAO. After a new aperture is added to the treatment plan, we use the ASO algorithm to simultaneously optimize aperture weights and leaf positions for the new set of apertures. We present results for a paraspinal tumor case, a prostate case and a head and neck case. The computational results indicate that, using this approach, treatment plans close to the ideal fluence map optimization solution can be obtained.

  15. Monte Carlo validation of EYEPLAN proton therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Russo, G.; Salamone, V.

    2007-10-01

    Protons, thanks to their physical features, offer the dosimetric advantage of an highly conformal dose region and the possibility of covering the tumor volume with an elevated accuracy. On the other hand, their precision has to match with the accuracy in the patient positioning and in the dose distributions calculated by the Treatment Planning Systems (TPSs). One of the major application of proton therapy is the treatment of ocular melanoma. In this case the software EYEPLAN is commonly adopted as TPS. In this work we verified the EYEPLAN dose calculations via the GEANT4 Monte Carlo toolkit quantitatively evaluating the agreement between dose distribution curves. The generally accepted parameters, as Distance to Agreement (DTA) and Dose Difference (DD), were adopted for the comparisons. The maximum differences between profiles were 5% for the Dose Difference and 1.2 mm for the Distance To Agreement. These results eventually demonstrated that a Monte Carlo approach can be considered the most accurate method to verify the dose distribution planned by a TPS.

  16. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

    SciTech Connect

    McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

    2014-12-15

    was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.

  17. Health literacy in HIV treatment: accurate understanding of key biological treatment principles is not required for good ART adherence.

    PubMed

    Laws, M Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B

    2015-04-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors' instructions, without the need for deep understanding. PMID:25354736

  18. Health Literacy in HIV Treatment: Accurate Understanding of Key Biological Treatment Principles is Not Required for Good ART Adherence

    PubMed Central

    Laws, M. Barton; Danielewicz, Michael; Rana, Aadia; Kogelman, Laura; Wilson, Ira B.

    2016-01-01

    Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors’ instructions, without the need for deep understanding. PMID:25354736

  19. Radiotherapy Treatment Planning for Testicular Seminoma

    SciTech Connect

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

    2012-07-15

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

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

    SciTech Connect

    Akino, Yuichi; Das, Indra J.; Bartlett, Gregory K.; Zhang Hualin; Thompson, Elizabeth; Zook, Jennifer E.

    2013-01-15

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

  1. Bayesian statistical treatment of the fluorescence of AFLP bands leads to accurate genetic structure inference.

    PubMed

    Gaggiotti, Oscar E

    2010-11-01

    Ever since the introduction of allozymes in the 1960s, evolutionary biologists and ecologists have continued to search for more powerful molecular markers to estimate important parameters such as effective population size and migration rates and to make inferences about the demographic history of populations, the relationships between individuals and the genetic architecture of phenotypic variation (Bensch & Akesson 2005; Bonin et al. 2007). Choosing a marker requires a thorough consideration of the trade-offs associated with the different techniques and the type of data obtained from them. Some markers can be very informative but require substantial amounts of start-up time (e.g. microsatellites), while others require very little time but are much less polymorphic. Amplified fragment length polymorphism (AFLP) is a firmly established molecular marker technique that falls in this latter category. AFLPs are widely distributed throughout the genome and can be used on organisms for which there is no a priori sequence information (Meudt & Clarke 2007). These properties together with their moderate cost and short start-up time have made them the method of choice for many molecular ecology studies of wild species (Bensch & Akesson 2005). However, they have a major disadvantage, they are dominant. This represents a very important limitation because many statistical genetics methods appropriate for molecular ecology studies require the use of codominant markers. In this issue, Foll et al. (2010) present an innovative hierarchical Bayesian method that overcomes this limitation. The proposed approach represents a comprehensive statistical treatment of the fluorescence of AFLP bands and leads to accurate inferences about the genetic structure of natural populations. Besides allowing a quasi-codominant treatment of AFLPs, this new method also solves the difficult problems posed by subjectivity in the scoring of AFLP bands. PMID:20958811

  2. CPR methodology with new steady-state criterion and more accurate statistical treatment of channel bow

    SciTech Connect

    Baumgartner, S.; Bieli, R.; Bergmann, U. C.

    2012-07-01

    An overview is given of existing CPR design criteria and the methods used in BWR reload analysis to evaluate the impact of channel bow on CPR margins. Potential weaknesses in today's methodologies are discussed. Westinghouse in collaboration with KKL and Axpo - operator and owner of the Leibstadt NPP - has developed an optimized CPR methodology based on a new criterion to protect against dryout during normal operation and with a more rigorous treatment of channel bow. The new steady-state criterion is expressed in terms of an upper limit of 0.01 for the dryout failure probability per year. This is considered a meaningful and appropriate criterion that can be directly related to the probabilistic criteria set-up for the analyses of Anticipated Operation Occurrences (AOOs) and accidents. In the Monte Carlo approach a statistical modeling of channel bow and an accurate evaluation of CPR response functions allow the associated CPR penalties to be included directly in the plant SLMCPR and OLMCPR in a best-estimate manner. In this way, the treatment of channel bow is equivalent to all other uncertainties affecting CPR. Emphasis is put on quantifying the statistical distribution of channel bow throughout the core using measurement data. The optimized CPR methodology has been implemented in the Westinghouse Monte Carlo code, McSLAP. The methodology improves the quality of dryout safety assessments by supplying more valuable information and better control of conservatisms in establishing operational limits for CPR. The methodology is demonstrated with application examples from the introduction at KKL. (authors)

  3. A New Method for Accurate Treatment of Flow Equations in Cylindrical Coordinates Using Series Expansions

    NASA Technical Reports Server (NTRS)

    Constantinescu, G.S.; Lele, S. K.

    2000-01-01

    The motivation of this work is the ongoing effort at the Center for Turbulence Research (CTR) to use large eddy simulation (LES) techniques to calculate the noise radiated by jet engines. The focus on engine exhaust noise reduction is motivated by the fact that a significant reduction has been achieved over the last decade on the other main sources of acoustic emissions of jet engines, such as the fan and turbomachinery noise, which gives increased priority to jet noise. To be able to propose methods to reduce the jet noise based on results of numerical simulations, one first has to be able to accurately predict the spatio-temporal distribution of the noise sources in the jet. Though a great deal of understanding of the fundamental turbulence mechanisms in high-speed jets was obtained from direct numerical simulations (DNS) at low Reynolds numbers, LES seems to be the only realistic available tool to obtain the necessary near-field information that is required to estimate the acoustic radiation of the turbulent compressible engine exhaust jets. The quality of jet-noise predictions is determined by the accuracy of the numerical method that has to capture the wide range of pressure fluctuations associated with the turbulence in the jet and with the resulting radiated noise, and by the boundary condition treatment and the quality of the mesh. Higher Reynolds numbers and coarser grids put in turn a higher burden on the robustness and accuracy of the numerical method used in this kind of jet LES simulations. As these calculations are often done in cylindrical coordinates, one of the most important requirements for the numerical method is to provide a flow solution that is not contaminated by numerical artifacts. The coordinate singularity is known to be a source of such artifacts. In the present work we use 6th order Pade schemes in the non-periodic directions to discretize the full compressible flow equations. It turns out that the quality of jet-noise predictions

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

    SciTech Connect

    1993-10-29

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

  5. 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.

  6. Modeling the Agility MLC in the Monaco treatment planning system.

    PubMed

    Snyder, Michael; Halford, Robert; Knill, Cory; Adams, Jeffrey N; Bossenberger, Todd; Nalichowski, Adrian; Hammoud, Ahmad; Burmeister, Jay

    2016-01-01

    We investigate the relationship between the various parameters in the Monaco MLC model and dose calculation accuracy for an Elekta Agility MLC. The vendor-provided MLC modeling procedure - completed first with external vendor participation and then exclusively in-house - was used in combination with our own procedures to investigate several sets of MLC modeling parameters to determine their effect on dose distributions and point-dose measurements. Simple plans provided in the vendor procedure were used to elucidate specific mechanical characteristics of the MLC, while ten complex treatment plans - five IMRT and five VMAT - created using TG-119-based structure sets were used to test clinical dosimetric effects of particular parameter choices. EDR2 film was used for the vendor fields to give high spatial resolution, while a combination of MapCHECK and ion chambers were used for the in-house TG-119-based proced-ures. The vendor-determined parameter set provided a reasonable starting point for the MLC model and largely delivered acceptable gamma pass rates for clinical plans - including a passing external evaluation using the IROC H&N phantom. However, the vendor model did not provide point-dose accuracy consistent with that seen in other treatment systems at our center. Through further internal testing it was found that there existed many sets of MLC parameters, often at opposite ends of their allowable ranges, that provided similar dosimetric characteristics and good agreement with planar and point-dose measurements. In particular, the leaf offset and tip leakage parameters compensated for one another if adjusted in opposite directions, which provided a level curve of acceptable parameter sets across all plans. Interestingly, gamma pass rates of the plans were less dependent upon parameter choices than point-dose measurements, suggesting that MLC modeling using only gamma evaluation may be generally an insufficient approach. It was also found that exploring all

  7. Validation of OSLD and a treatment planning system for surface dose determination in IMRT treatments

    SciTech Connect

    Zhuang, Audrey H.; Olch, Arthur J.

    2014-08-15

    Purpose: To evaluate the accuracy of skin dose determination for composite multibeam 3D conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) treatments using optically stimulated luminescent dosimeters (OSLDs) and Eclipse treatment planning system. Methods: Surface doses measured by OSLDs in the buildup region for open field 6 MV beams, either perpendicular or oblique to the surface, were evaluated by comparing against dose measured by Markus Parallel Plate (PP) chamber, surface diodes, and calculated by Monte Carlo simulations. The accuracy of percent depth dose (PDD) calculation in the buildup region from the authors’ Eclipse system (Version 10), which was precisely commissioned in the buildup region and was used with 1 mm calculation grid, was also evaluated by comparing to PP chamber measurements and Monte Carlo simulations. Finally, an anthropomorphic pelvic phantom was CT scanned with OSLDs in place at three locations. A planning target volume (PTV) was defined that extended close to the surface. Both an 8 beam 3DCRT and IMRT plan were generated in Eclipse. OSLDs were placed at the CT scanned reference locations to measure the skin doses and were compared to diode measurements and Eclipse calculations. Efforts were made to ensure that the dose comparison was done at the effective measurement points of each detector and corresponding locations in CT images. Results: The depth of the effective measurement point is 0.8 mm for OSLD when used in the buildup region in a 6 MV beam and is 0.7 mm for the authors’ surface diode. OSLDs and Eclipse system both agree well with Monte Carlo and/or Markus PP ion chamber and/or diode in buildup regions in 6 MV beams with normal or oblique incidence and across different field sizes. For the multiple beam 3DCRT plan and IMRT plans, the differences between OSLDs and Eclipse calculations on the surface of the anthropomorphic phantom were within 3% and distance-to-agreement less than 0.3 mm

  8. A plan for accurate estimation of daily area-mean rainfall during the CaPE experiment

    NASA Technical Reports Server (NTRS)

    Duchon, Claude E.

    1992-01-01

    The Convection and Precipitation/Electrification (CaPE) experiment took place in east central Florida from 8 July to 18 August, 1991. There were five research themes associated with CaPE. In broad terms they are: investigation of the evolution of the electric field in convective clouds, determination of meteorological and electrical conditions associated with lightning, development of mesoscale numerical forecasts (2-12 hr) and nowcasts (less than 2 hr) of convective initiation and remote estimation of rainfall. It is the last theme coupled with numerous raingage and streamgage measurements, satellite and aircraft remote sensing, radiosondes and other meteorological measurements in the atmospheric boundary layer that provide the basis for determining the hydrologic cycle for the CaPE experiment area. The largest component of the hydrologic cycle in this region is rainfall. An accurate determination of daily area-mean rainfall is important in correctly modeling its apportionment into runoff, infiltration and evapotranspiration. In order to achieve this goal a research plan was devised and initial analysis begun. The overall research plan is discussed with special emphasis placed on the adjustment of radar rainfall estimates to raingage rainfall.

  9. Inverse treatment planning for spinal robotic radiosurgery: an international multi-institutional benchmark trial.

    PubMed

    Blanck, Oliver; Wang, Lei; Baus, Wolfgang; Grimm, Jimm; Lacornerie, Thomas; Nilsson, Joakim; Luchkovskyi, Sergii; Palazon Cano, Isabel; Shou, Zhenyu; Ayadi, Myriam; Treuer, Harald; Viard, Romain; Siebert, Frank-Andre; Chan, Mark K H; Hildebrandt, Guido; Dunst, Jürgen; Imhoff, Detlef; Wurster, Stefan; Wolff, Robert; Romanelli, Pantaleo; Lartigau, Eric; Semrau, Robert; Soltys, Scott G; Schweikard, Achim

    2016-01-01

    Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high-dose radiation to well-defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user-dependent. We performed an international, multi-institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex-shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord (V14Gy < 2 cc, V18Gy < 0.1 cc) and target (coverage > 95%). The resulting plans were rated on a scale from 1 to 4 (excellent-poor) in five categories (constraint compliance, optimization goals, low-dose regions, ITP complexity, and clinical acceptability) by a blinded review panel. Additionally, the plans were mathemati-cally rated based on plan indices (critical structure and target doses, conformity, monitor units, normal tissue complication probability, and treatment time) and compared to the human rankings. The treatment plans and the reviewers' rankings varied substantially among the participating centers. The average mean overall rank was 2.4 (1.2-4.0) and 8/10 plans were rated excellent in at least one category by at least one reviewer. The mathematical rankings agreed with the mean overall human rankings in 9/10 cases pointing toward the possibility for sole mathematical plan quality comparison. The final rankings revealed that a plan with a well-balanced trade-off among all planning objectives was preferred for treatment by most par-ticipants, reviewers, and the mathematical ranking system. Furthermore, this plan was generated with simple planning techniques. Our multi-institutional planning study found wide variability in ITP approaches for spinal robotic radiosurgery. The participants', reviewers', and mathematical match

  10. Dosimetry audit of radiotherapy treatment planning systems.

    PubMed

    Bulski, Wojciech; Chełmiński, Krzysztof; Rostkowska, Joanna

    2015-07-01

    In radiotherapy Treatment Planning Systems (TPS) various calculation algorithms are used. The accuracy of dose calculations has to be verified. Numerous phantom types, detectors and measurement methodologies are proposed to verify the TPS calculations with dosimetric measurements. A heterogeneous slab phantom has been designed within a Coordinated Research Project (CRP) of the IAEA. The heterogeneous phantom was developed in the frame of the IAEA CRP. The phantom consists of frame slabs made with polystyrene and exchangeable inhomogeneity slabs equivalent to bone or lung tissue. Special inserts allow to position thermoluminescent dosimeters (TLD) capsules within the polystyrene slabs below the bone or lung equivalent slabs and also within the lung equivalent material. Additionally, there are inserts that allow to position films or ionisation chamber in the phantom. Ten Polish radiotherapy centres (of 30 in total) were audited during on-site visits. Six different TPSs and five calculation algorithms were examined in the presence of inhomogeneities. Generally, most of the results from TLD were within 5 % tolerance. Differences between doses calculated by TPSs and measured with TLD did not exceed 4 % for bone and polystyrene equivalent materials. Under the lung equivalent material, on the beam axis the differences were lower than 5 %, whereas inside the lung equivalent material, off the beam axis, in some cases they were of around 7 %. The TLD results were confirmed with the ionisation chamber measurements. The comparison results of the calculations and the measurements allow to detect limitations of TPS calculation algorithms. The audits performed with the use of heterogeneous phantom and TLD seem to be an effective tool for detecting the limitations in the TPS performance or beam configuration errors at audited radiotherapy departments. PMID:25848119

  11. Quantified diagnostic work-up casts: applications for interdisciplinary treatment planning.

    PubMed

    Solow, Roger A

    2016-01-01

    Diagnostic casts that accurately replicate a patient's occlusion are essential for planning comprehensive care and interdisciplinary treatment. These casts can reveal the actual problem in the spatial relationship between the maxilla and the mandible, which may not be apparent on intraoral examination. Duplicate casts can be altered and measured to quantify the extent of the correction necessary for a predictable result. Treatment planning for interdisciplinary cases requires thorough evaluation of the entire problem and solution set as well as coordination of all procedures. Severe problems and invasive treatments require precise treatment planning. This case report illustrates these principles through multiple applications of quantified diagnostic work-up casts for a patient requiring orthognathic surgery, orthodontics, and occlusal adjustment after a mandibular subcondylar fracture. PMID:27148655

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

    PubMed Central

    Tarakji, Bassel

    2014-01-01

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

  13. MINERVA - A Multi-Modal Radiation Treatment Planning System

    SciTech Connect

    D. E. Wessol; C. A. Wemple; D. W. Nigg; J. J. Cogliati; M. L. Milvich; C. Frederickson; M. Perkins; G. A. Harkin

    2004-10-01

    Recently, research efforts have begun to examine the combination of BNCT with external beam photon radiotherapy (Barth et al. 2004). In order to properly prepare treatment plans for patients being treated with combinations of radiation modalities, appropriate planning tools must be available. To facilitiate this, researchers at the Idaho National Engineering and Environmental Laboratory (INEEL)and Montana State University (MSU) have undertaken development of a fully multi-modal radiation treatment planning system.

  14. Recent developments and best practice in brachytherapy treatment planning

    PubMed Central

    2014-01-01

    Brachytherapy has evolved over many decades, but more recently, there have been significant changes in the way that brachytherapy is used for different treatment sites. This has been due to the development of new, technologically advanced computer planning systems and treatment delivery techniques. Modern, three-dimensional (3D) imaging modalities have been incorporated into treatment planning methods, allowing full 3D dose distributions to be computed. Treatment techniques involving online planning have emerged, allowing dose distributions to be calculated and updated in real time based on the actual clinical situation. In the case of early stage breast cancer treatment, for example, electronic brachytherapy treatment techniques are being used in which the radiation dose is delivered during the same procedure as the surgery. There have also been significant advances in treatment applicator design, which allow the use of modern 3D imaging techniques for planning, and manufacturers have begun to implement new dose calculation algorithms that will correct for applicator shielding and tissue inhomogeneities. This article aims to review the recent developments and best practice in brachytherapy techniques and treatments. It will look at how imaging developments have been incorporated into current brachytherapy treatment and how these developments have played an integral role in the modern brachytherapy era. The planning requirements for different treatments sites are reviewed as well as the future developments of brachytherapy in radiobiology and treatment planning dose calculation. PMID:24734939

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

    NASA Astrophysics Data System (ADS)

    Alexander, Andrew William

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

  16. A Technique for Stereotactic Radiosurgery Treatment Planning with Helical Tomotherapy

    PubMed Central

    Soisson, Emilie T.; Hoban, Peter W.; Kammeyer, Thomas; Kapatoes, Jeffrey M.; Westerly, David C.; Basavatia, Amar; Tomé, Wolfgang A.

    2009-01-01

    Purpose The purpose of this study was to develop an efficient and effective planning technique for stereotactic radiosurgery using helical tomotherapy. Methods and Materials Planning CTs and contours of twenty patients, previously treated in our clinic for brain metastases with Linac-based radiosurgery using circular collimators, were used to develop a robust Tomotherapy planning technique. Plan calculation times as well as delivery times were recorded for all patients to allow for an efficiency evaluation. In addition, conformation and homogeneity indices were calculated as metrics to compare plan quality to that which is achieved with conventional radiosurgery delivery systems. Results A robust and efficient planning technique was identified to produce plans of radiosurgical quality using the TomoTherapy treatment planning system. Dose calculation did not exceed a few hours and resulting delivery times were less than an hour, which allows the process to fit into a single day radiosurgery workflow. Plan conformity compared favorably with published results for Gamma Knife radiosurgery. In addition, plan homogeneity was similar to Linac-based approaches. Conclusions The TomoTherapy planning software can be used to create plans of acceptable quality for stereotactic radiosurgery in a time that is appropriate for a radiosurgery workflow that requires that planning and delivery occur within one treatment day. PMID:20138501

  17. A Technique for Stereotactic Radiosurgery Treatment Planning with Helical Tomotherapy

    SciTech Connect

    Soisson, Emilie T.; Hoban, Peter W.; Kammeyer, Thomas; Kapatoes, Jeffrey M.; Westerly, David C.; Basavatia, Amar; Tome, Wolfgang A.

    2011-04-01

    The purpose of this study was to develop an efficient and effective planning technique for stereotactic radiosurgery using helical tomotherapy. Planning CTs and contours of 20 patients, previously treated in our clinic for brain metastases with linac-based radiosurgery using circular collimators, were used to develop a robust TomoTherapy planning technique. Plan calculation times as well as delivery times were recorded for all patients to allow for an efficiency evaluation. In addition, conformation and homogeneity indices were calculated as metrics to compare plan quality with that which is achieved with conventional radiosurgery delivery systems. A robust and efficient planning technique was identified to produce plans of radiosurgical quality using the TomoTherapy treatment planning system. Dose calculation did not exceed a few hours and resulting delivery times were less than 1 hour, which allows the process to fit into a single day radiosurgery workflow. Plan conformity compared favorably with published results for gamma knife radiosurgery. In addition, plan homogeneity was similar to linac-based approaches. The TomoTherapy planning software can be used to create plans of acceptable quality for stereotactic radiosurgery in a time that is appropriate for a radiosurgery workflow that requires that planning and delivery occur within 1 treatment day.

  18. A Treatment Planning Method for Sequentially Combining Radiopharmaceutical Therapy and External Radiation Therapy;External beam therapy; Radiopharmaceutical therapy; Three-dimensional dosimetry; Treatment planning

    SciTech Connect

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

    2011-07-15

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

  19. A homotopy-based sparse representation for fast and accurate shape prior modeling in liver surgical planning.

    PubMed

    Wang, Guotai; Zhang, Shaoting; Xie, Hongzhi; Metaxas, Dimitris N; Gu, Lixu

    2015-01-01

    Shape prior plays an important role in accurate and robust liver segmentation. However, liver shapes have complex variations and accurate modeling of liver shapes is challenging. Using large-scale training data can improve the accuracy but it limits the computational efficiency. In order to obtain accurate liver shape priors without sacrificing the efficiency when dealing with large-scale training data, we investigate effective and scalable shape prior modeling method that is more applicable in clinical liver surgical planning system. We employed the Sparse Shape Composition (SSC) to represent liver shapes by an optimized sparse combination of shapes in the repository, without any assumptions on parametric distributions of liver shapes. To leverage large-scale training data and improve the computational efficiency of SSC, we also introduced a homotopy-based method to quickly solve the L1-norm optimization problem in SSC. This method takes advantage of the sparsity of shape modeling, and solves the original optimization problem in SSC by continuously transforming it into a series of simplified problems whose solution is fast to compute. When new training shapes arrive gradually, the homotopy strategy updates the optimal solution on the fly and avoids re-computing it from scratch. Experiments showed that SSC had a high accuracy and efficiency in dealing with complex liver shape variations, excluding gross errors and preserving local details on the input liver shape. The homotopy-based SSC had a high computational efficiency, and its runtime increased very slowly when repository's capacity and vertex number rose to a large degree. When repository's capacity was 10,000, with 2000 vertices on each shape, homotopy method cost merely about 11.29 s to solve the optimization problem in SSC, nearly 2000 times faster than interior point method. The dice similarity coefficient (DSC), average symmetric surface distance (ASD), and maximum symmetric surface distance measurement

  20. Tailoring individualized treatment plans for acne.

    PubMed

    Harper, Julie C

    2008-01-01

    Because acne is a complex multifactorial disorder, combination treatment may be required to target its various pathogenic factors. Combination treatments also offer the most improvement over the shortest time. Oral contraceptives (OCs) are an excellent treatment, and clinicians should consider them a first-line option as part of combination therapy in women with acne. PMID:18338655

  1. SU-D-BRD-04: The Impact of Automatic Radiation Therapy Plan Checks in Treatment Planning

    SciTech Connect

    Gopan, O; Yang, F; Ford, E

    2015-06-15

    Purpose: The physics plan check verifies various aspects of a treatment plan after dosimetrists have finished creating the plan. Some errors in the plan which are caught by the physics check could be caught earlier in the departmental workflow. The purpose of this project was to evaluate a plan checking script that can be run within the treatment planning system (TPS) by the dosimetrists prior to plan approval and export to the record and verify system. Methods: A script was created in the Pinnacle TPS to automatically check 15 aspects of a plan for clinical practice conformity. The script outputs a list of checks which the plan has passed and a list of checks which the plan has failed so that appropriate adjustments can be made. For this study, the script was run on a total of 108 plans: IMRT (46/108), VMAT (35/108) and SBRT (27/108). Results: Of the plans checked by the script, 77/108 (71%) failed at least one of the fifteen checks. IMRT plans resulted in more failed checks (91%) than VMAT (51%) or SBRT (63%), due to the high failure rate of an IMRT-specific check, which checks that no IMRT segment < 5 MU. The dose grid size and couch removal checks caught errors in 10% and 14% of all plans – errors that ultimately may have resulted in harm to the patient. Conclusion: Approximately three-fourths of the plans being examined contain errors that could be caught by dosimetrists running an automated script embedded in the TPS. The results of this study will improve the departmental workflow by cutting down on the number of plans that, due to these types of errors, necessitate re-planning and re-approval of plans, increase dosimetrist and physician workload and, in urgent cases, inconvenience patients by causing treatment delays.

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

    PubMed

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

    2014-09-01

    The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate. PMID:24810792

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

    SciTech Connect

    1995-02-22

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

  4. Manpower Planning for Wastewater Treatment Plants.

    ERIC Educational Resources Information Center

    Davies, J. Kenneth; And Others

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

  5. A Guide to Planning Alcoholism Treatment Programs.

    ERIC Educational Resources Information Center

    McGough, Dixie P.; Hindman, Margaret H.

    This guide contains information from the alcoholism literature and from interviews with people in state alcoholism agencies, major professional associations, and public and private service programs. It is designed to help readers plan and develop community alcoholism programs by providing an overview of the many considerations involved in starting…

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

    SciTech Connect

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

    2007-12-15

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

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

  8. Coupling treatment planning with navigation system: a new technological approach in treatment of head and neck tumors by electrochemotherapy

    PubMed Central

    2015-01-01

    Background Electrochemotherapy provides highly effective local treatment for a variety of tumors. In deep-seated tumors of the head and neck, due to complex anatomy of the region or inability to cover the whole tumor with standard electrodes, the use of long single needle electrodes is mandatory. In such cases, a treatment plan provides the information on the optimal configuration of the electrodes to adequately cover the tumor with electric field, while the accurate placement of the electrodes in the surgical room in patients can remain a problem. Therefore, during electrochemotherapy of two head and neck lymph-node metastases of squamous cell carcinoma origin, a navigation system for placement of electrodes was used. Patient and methods Electrochemotherapy of two lymph-node metastases of cutaneous squamous cell carcinoma, one in the left parotid gland and the other in the neck just behind the left mandibular angle, was performed using intravenous administration of bleomycin and long single needle electrodes. The tumors were treated according to the prepared treatment plan, and executed with the use of navigation system. Results Coupling of treatment plan with the navigation system aided to an accurate placement of the electrodes. The navigation system helped the surgeon to identify the exact location of the tumors, and helped with the positioning of the long needle electrodes during their insertion, according to treatment plan. Five electrodes were inserted for each metastasis, one centrally in the tumor and four in the periphery of the tumor. Five weeks after electrochemotherapy, computed tomography images demonstrated partial response of the first metastasis and complete response of the second one. Six weeks after electrochemotherapy, fine-needle aspiration biopsy specimen obtained from the treated lesions revealed necrosis and inflammatory cells, without any viable tumor cells. Conclusion We describe a new technological approach for electrochemotherapy of deep

  9. Orthovoltage radiation therapy treatment planning using Monte Carlo simulation: treatment of neuroendocrine carcinoma of the maxillary sinus

    NASA Astrophysics Data System (ADS)

    Gao, Wanbao; Raeside, David E.

    1997-12-01

    Dose distributions that result from treating a patient with orthovoltage beams are best determined with a treatment planning system that uses the Monte Carlo method, and such systems are not readily available. In the present work, the Monte Carlo method was used to develop a computer code for determining absorbed dose distributions in orthovoltage radiation therapy. The code was used in planning treatment of a patient with a neuroendocrine carcinoma of the maxillary sinus. Two lateral high-energy photon beams supplemented by an anterior orthovoltage photon beam were utilized in the treatment plan. For the clinical case and radiation beams considered, a reasonably uniform dose distribution is achieved within the target volume, while the dose to the lens of each eye is 4 - 8% of the prescribed dose. Therefore, an orthovoltage photon beam, when properly filtered and optimally combined with megavoltage beams, can be effective in the treatment of cancers below the skin, providing that accurate treatment planning is carried out to establish with accuracy and precision the doses to critical structures.

  10. Annual update for the Nevada Test Site site treatment plan

    SciTech Connect

    1997-04-01

    This document describes the purpose and scope of the Draft Annual Update for the Nevada Test Site Treatment Plan, the framework for developing the Annual Update, and the current inventory of mixed waste covered under the Site Treatment Plan and the Federal Facility Compliance Act Consent Order and stored at the Nevada Test Site. No Site Treatment Plan milestones or Federal Facility Cleanup Act Consent Order deadlines have been missed for fiscal year 1996. The Shipping Cask, a portion of the solvent sludge waste stream, and eight B-25 boxes from the lead-contaminated soil waste stream have been deleted from the Site Treatment Plan and the Federal Facility Cleanup Act Consent Order, in accordance with Part XI of the Federal Facility Cleanup Act Consent Order.

  11. 300 Area waste acid treatment system closure plan. Revision 1

    SciTech Connect

    1996-03-01

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

  12. Application of combined rigid choledochoscope and accurate positioning method in the adjuvant treatment of bile duct stones

    PubMed Central

    Wang, Ping; Chen, Xiaowu; Sun, Beiwang; Liu, Yanmin

    2015-01-01

    To explore the clinical effect of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) combined with rigid choledochoscope and accurate positioning in the treatment of calculus of bile duct. This study retrospectively reviewed 162 patients with hepatolithiasis at the First Affiliated Hospital of Guangzhou Medical University between 2001 and 2013 were assigned to hard lens group or traditional PTCSL group. Compared with the traditional PTCSL, PTCSL with rigid choledochoscope can shorten the interval time which limit the PTCSL application. The operation time (45 vs 78, P=0.003), the number of operation (1.62 vs 1.97, P=0.031), and blood loss (37.8 vs 55.1, P=0.022) were better in hard lens group while the stone residual and complication had no significant differences. Rigid choledochoscope is a safe, minimally invasive and effective method in the treatment of bile duct stones. Accurate positioning method can effectively shorten operation process time. PMID:26629183

  13. [Cognitive-behavioural therapy for sexual dysfunctions: treatment, etiology and accurate diagnosing of premature ejaculation].

    PubMed

    Rawińska, Marta; Fijałkowska, Sylwia

    2014-01-01

    Premature ejaculation (PE) is one of the most common male sexual dysfunctions. Successful treatment of PE has been hampered by the existence of a variety of definitions and diagnostic criteria and the lack of large, long-term studies of treatment efficacy. Numerous, diverse treatment approaches with varying degrees of efficacy have been used; these include behavioral, cognitive, and sex therapy techniques, and pharmacologic management with antidepressants, phosphodiesterase-5 inhibitors, and topical anesthetics. Combining a specific pharmacologic treatment for premature ejaculation with appropriate cognitive, behavioral, and sex therapy techniques should improve the overall understanding and management of sexual dysfunction, resulting in a sustainable increase in sexual satisfaction and decrease in distress for man. The aim of this article is to raise awareness of the prevalence of PE, its symptoms, and the impact it has on both partners and to discuss the benefits of adding limited behavioral and cognitive sex therapy techniques to drug therapy. PMID:24645584

  14. Evolving treatment plan quality criteria from institution-specific experience

    SciTech Connect

    Ruan, D.; Shao, W.; DeMarco, J.; Tenn, S.; King, C.; Low, D.; Kupelian, P.; Steinberg, M.

    2012-05-15

    Purpose: The dosimetric aspects of radiation therapy treatment plan quality are usually evaluated and reported with dose volume histogram (DVH) endpoints. For clinical practicality, a small number of representative quantities derived from the DVH are often used as dose endpoints to summarize the plan quality. National guidelines on reference values for such quantities for some standard treatment approaches are often used as acceptance criteria to trigger treatment plan review. On the other hand, treatment prescription and planning approaches specific to each institution warrants the need to report plan quality in terms of practice consistency and with respect to institution-specific experience. The purpose of this study is to investigate and develop a systematic approach to record and characterize the institution-specific plan experience and use such information to guide the design of plan quality criteria. In the clinical setting, this approach will assist in (1) improving overall plan quality and consistency and (2) detecting abnormal plan behavior for retrospective analysis. Methods: The authors propose a self-evolving methodology and have developed an in-house prototype software suite that (1) extracts the dose endpoints from a treatment plan and evaluates them against both national standard and institution-specific criteria and (2) evolves the statistics for the dose endpoints and updates institution-specific criteria. Results: The validity of the proposed methodology was demonstrated with a database of prostate stereotactic body radiotherapy cases. As more data sets are accumulated, the evolving institution-specific criteria can serve as a reliable and stable consistency measure for plan quality and reveals the potential use of the ''tighter'' criteria than national standards or projected criteria, leading to practice that may push to shrink the gap between plans deemed acceptable and the underlying unknown optimality. Conclusions: The authors have developed

  15. Towards an objective evaluation of tolerances for beam modeling in a treatment planning system

    NASA Astrophysics Data System (ADS)

    Rangel, A.; Ploquin, N.; Kay, I.; Dunscombe, P.

    2007-09-01

    The performance of a convolution/superposition based treatment planning system depends on the ability of the dose calculation algorithm to accurately account for physical interactions taking place in the tissue, key components of the linac head and on the accuracy of the photon beam model. Generally the user has little or no control over the performance of the dose calculation algorithm but is responsible for the accuracy of the beam model within the constraints imposed by the system. This study explores the dosimetric impact of limitations in photon beam modeling accuracy on complex 3D clinical treatment plans. A total of 70 photon beam models was created in the Pinnacle™ treatment planning system. Two of the models served as references for 6 MV and 15 MV beams, while the rest were created by perturbing the reference models in order to produce specific deviations in specific regions of the calculated dose profiles (central axis and transverse). The beam models were then used to generate 3D plans on seven CT data sets each for four different treatment sites (breast and conformal prostate, lung and brain). The equivalent uniform doses (EUD) of the targets and the principal organs at risk (OARs) of all plans (~1000) were calculated and compared to the EUDs delivered by the reference beam models. In general, accurate dosimetry of the target is most greatly compromised by poor modeling of the central axis depth dose and the horns, while the EUDs of the OARs exhibited the greatest sensitivity to beam width accuracy. Based on the results of this analysis we suggest a set of tolerances to be met during commissioning of the beam models in a treatment planning system that are consistent in terms of clinical outcomes as predicted by the EUD.

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

    SciTech Connect

    Nigg, David Waler

    2003-03-01

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

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

    PubMed Central

    Rivard, Mark J.

    2014-01-01

    Purpose To outline the evolution of computerized brachytherapy treatment planning in the United States through a review of technological developments and clinical practice refinements. Material and methods A literature review was performed and interviews were conducted with six participants in the development of computerized treatment planning for brachytherapy. Results Computerized brachytherapy treatment planning software was initially developed in the Physics Departments of New York's Memorial Hospital (by Nelson, Meurk and Balter), and Houston's M. D. Anderson Hospital (by Stovall and Shalek). These public-domain programs could be used by institutions with adequate computational resources; other clinics had access to them via Memorial's and Anderson's teletype-based computational services. Commercial brachytherapy treatment planning programs designed to run on smaller computers (Prowess, ROCS, MMS), were developed in the late 1980s and early 1990s. These systems brought interactive dosimetry into the clinic and surgical theatre. Conclusions Brachytherapy treatment planning has evolved from systems of rigid implant rules to individualized pre- and intra-operative treatment plans, and post-operative dosimetric assessments. Brachytherapy dose distributions were initially calculated on public domain programs on large regionally located computers. With the progression of computer miniaturization and increase in processor speeds, proprietary software was commercially developed for microcomputers that offered increased functionality and integration with clinical practice. PMID:25097560

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

    PubMed

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

    2014-12-01

    FoCa is an in-house modular treatment planning system, developed entirely in MATLAB, which includes forward dose calculation of proton radiotherapy plans in both active and passive modalities as well as a generic optimization suite for inverse treatment planning. The software has a dual education and research purpose. From the educational point of view, it can be an invaluable teaching tool for educating medical physicists, showing the insights of a treatment planning system from a well-known and widely accessible software platform. From the research point of view, its current and potential uses range from the fast calculation of any physical, radiobiological or clinical quantity in a patient CT geometry, to the development of new treatment modalities not yet available in commercial treatment planning systems. The physical models in FoCa were compared with the commissioning data from our institution and show an excellent agreement in depth dose distributions and longitudinal and transversal fluence profiles for both passive scattering and active scanning modalities. 3D dose distributions in phantom and patient geometries were compared with a commercial treatment planning system, yielding a gamma-index pass rate of above 94% (using FoCa's most accurate algorithm) for all cases considered. Finally, the inverse treatment planning suite was used to produce the first prototype of intensity-modulated, passive-scattered proton therapy, using 13 passive scattering proton fields and multi-leaf modulation to produce a concave dose distribution on a cylindrical solid water phantom without any field-specific compensator. PMID:25387249

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  20. 300 Area waste acid treatment system closure plan

    SciTech Connect

    LUKE, S.N.

    1999-05-17

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

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

    ERIC Educational Resources Information Center

    Milgrom, Peter; And Others

    1981-01-01

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

  2. Maimonides: an early but accurate view on the treatment of haemorrhoids

    PubMed Central

    Magrill, Dan; Sekaran, Prabhu

    2007-01-01

    Moses Maimonides was not only one of the most influential religious figures of the middle ages, but also a pioneer in a wide variety of medical practices. A brief history of his life, and what is known about his medical education, is given here. His paper on haemorrhoids is summarised, as well as a review of the current understanding of the pathogenesis, prevention and treatment of this common condition. The comparison of Maimonides' writings to modern understanding of not only the prevention and treatment of haemorrhoids, but also his approach to the patient as a whole in terms of pre‐ and postoperative care, demonstrate how ahead of his time this great philosopher was. PMID:17488868

  3. Optimization of tomotherapy treatment planning for patients with bilateral hip prostheses

    PubMed Central

    2014-01-01

    Background To determine the effect of different imaging options and the most efficient imaging strategy for treatment planning of patients with hip prostheses. Methods The planning kilovoltage CT (kVCT) and daily megavoltage CT (MVCT) studies for three prostate cancer patients with bilateral hip prostheses were used for creating hybrid kVCT/MVCT image sets. Treatment plans were created for kVCT images alone, hybrid kVCT/MVCT images, and MVCT images alone using the same dose prescription and planning parameters. The resulting dose volume histograms were compared. The orthopedic metal artifact reduction (O-MAR) reconstruction tool for kVCT images and different MVCT options were investigated with a water tank fit with double hip prostheses. Treatment plans were created for all imaging options and calculated dose was compared with the one measured by a pin-point ion chamber. Results On average for three patients, the D35% for the bladder was 8% higher in plans based on MVCT images and 7% higher in plans based on hybrid images, compared to the plans based on kVCT images alone. Likewise, the D35% for the rectum was 3% higher than the kVCT based plan for both hybrid and MVCT plans. The average difference in planned D99% in the PTV compared to kVCT plans was 0.9% and 0.1% for MVCT and hybrid plans, respectively. For the water tank with hip prostheses phantom, the kVCT plan with O-MAR correction applied showed better agreement between the measured and calculated dose than the original image set, with a difference of -1.9% compared to 3.3%. The measured doses for the MVCT plans were lower than the calculated dose due to image size limitations. The best agreement was for the kVCT/MVCT hybrid plans with the difference between calculated and measured dose around 1%. Conclusion MVCT image provides better visualization of patient anatomy and hybrid kVCT/MVCT study enables more accurate calculations using updated MVCT relative electron density calibration. PMID:24491230

  4. Dosimetric feasibility of cone-beam CT-based treatment planning compared to CT-based treatment planning

    SciTech Connect

    Yoo, Sua . E-mail: sua.yoo@duke.edu; Yin, F.-F.

    2006-12-01

    Purpose: Cone-beam computed tomography (CBCT) images are currently used for positioning verification. However, it is yet unknown whether CBCT could be used in dose calculation for replanning in adaptive radiation therapy. This study investigates the dosimetric feasibility of CBCT-based treatment planning. Methods and Materials: Hounsfield unit (HU) values and profiles of Catphan, homogeneous/inhomogeneous phantoms, and various tissue regions of patients in CBCT images were compared to those in CT. The dosimetric consequence of the HU variation was investigated by comparing CBCT-based treatment plans to conventional CT-based plans for both phantoms and patients. Results: The maximum HU difference between CBCT and CT of Catphan was 34 HU in the Teflon. The differences in other materials were less than 10 HU. The profiles for the homogeneous phantoms in CBCT displayed reduced HU values up to 150 HU in the peripheral regions compared to those in CT. The scatter and artifacts in CBCT became severe surrounding inhomogeneous tissues with reduced HU values up to 200 HU. The MU/cGy differences were less than 1% for most phantom cases. The isodose distributions between CBCT-based and CT-based plans agreed very well. However, the discrepancy was larger when CBCT was scanned without a bowtie filter than with bowtie filter. Also, up to 3% dosimetric error was observed in the plans for the inhomogeneous phantom. In the patient studies, the discrepancies of isodose lines between CT-based and CBCT-based plans, both 3D and IMRT, were less than 2 mm. Again, larger discrepancy occurred for the lung cancer patients. Conclusion: This study demonstrated the feasibility of CBCT-based treatment planning. CBCT-based treatment plans were dosimetrically comparable to CT-based treatment plans. Dosimetric data in the inhomogeneous tissue regions should be carefully validated.

  5. Standardized treatment planning methodology for passively scattered proton craniospinal irradiation

    PubMed Central

    2013-01-01

    Background As the number of proton therapy centers increases, so does the need for studies which compare proton treatments between institutions and with photon therapy. However, results of such studies are highly dependent on target volume definition and treatment planning techniques. Thus, standardized methods of treatment planning are needed, particularly for proton treatment planning, in which special consideration is paid to the depth and sharp distal fall-off of the proton distribution. This study presents and evaluates a standardized method of proton treatment planning for craniospinal irradiation (CSI). Methods We applied our institution’s planning methodology for proton CSI, at the time of the study, to an anatomically diverse population of 18 pediatric patients. We evaluated our dosimetric results for the population as a whole and for the two subgroups having two different age-specific target volumes using the minimum, maximum, and mean dose values in 10 organs (i.e., the spinal cord, brain, eyes, lenses, esophagus, lungs, kidneys, thyroid, heart, and liver). We also report isodose distributions and dose-volume histograms (DVH) for 2 representative patients. Additionally we report population-averaged DVHs for various organs. Results The planning methodology here describes various techniques used to achieve normal tissue sparing. In particular, we found pronounced dose reductions in three radiosensitive organs (i.e., eyes, esophagus, and thyroid) which were identified for optimization. Mean doses to the thyroid, eyes, and esophagus were 0.2%, 69% and 0.2%, respectively, of the prescribed dose. In four organs not specifically identified for optimization (i.e., lungs, liver, kidneys, and heart) we found that organs lateral to the treatment field (lungs and kidneys) received relatively low mean doses (less than 8% of the prescribed dose), whereas the heart and liver, organs distal to the treatment field, received less than 1% of the prescribed dose

  6. The index of orthognathic functional treatment need accurately prioritises those patients already selected for orthognathic surgery within the NHS.

    PubMed

    Shah, Rupal; Breeze, John; Chand, Mohit; Stockton, Peter

    2016-06-01

    The index of orthognathic functional treatment need (IOFTN) is a newly-proposed system to help to prioritise patients for orthognathic treatment. The five categories are similar to those used in orthodontics, but include additional parameters such as sleep apnoea and facial asymmetry. The aim of this audit was to validate the index and find out the potential future implications, should such a system ever be adopted by commissioners. We calculated the IOFTN category of 100 consecutive patients who had orthognathic surgery between 2010-14 using clinical notes, photographs, study models, and radiographs, and determined the number in categories 4 or 5, analogous to the current indications for orthodontic treatment within the NHS. Sufficient clinical information was available to categorise 59/100 patients, and 56 of the 59 (95%) were in either category 4 or 5. All three of the remaining patients (in categories 1-3) who were operated on were treated because of the anticipated favourable impact on their quality of life. The IOFTN has been proposed for use in future commissioning of orthognathic services within the NHS, and this study has confirmed its efficacy in prioritising treatment accurately, with 95% of patients being in categories 4 or 5. We recommend that the orthognathic treatment index be adapted to include additional psychosocial assessment so that patients who fall into the lower functional categories are not automatically excluded from this potentially life-changing treatment. PMID:26935212

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  8. Treatment planning for resected abdominal tumors: Differences in organ position between diagnostic and radiation-planning computed tomography scans

    SciTech Connect

    Chen, Aileen B.; Mamon, Harvey . E-mail: hmamon@lroc.harvard.edu

    2005-12-01

    Purpose: To evaluate whether organ location, determined from preoperative diagnostic computed tomography scans (CTs), accurately reflects organ location when patients are positioned for radiation therapy. Methods and Materials: We identified patients with upper abdominal malignancies treated with surgery and/or radiation therapy. Comparisons of organ position relative to fixed bony landmarks were made among preoperative diagnostic CTs, postoperative diagnostic CTs, and radiation-planning CTs. We studied 18 patients who had CTs differing only in scanning technique, 11 patients who had CTs differing only in operative state, and 7 patients with CTs differing in both scanning technique and operative state. Results: For patients with diagnostic CTs and radiation-planning CTs that were either both preoperative or both postoperative, mean organ position, measured relative to a fixed bony landmark, ranged from 1.9 to 3.2 cm superior on radiation-planning CTs compared with diagnostic CTs (p < 0.0001). Mean organ position ranged from 0.9 to 1.7 cm posterior on radiation-planning CTs compared with diagnostic CTs (p {<=} 0.008). Shifts in the right-left direction were small and variable. For patients with pre- and postoperative diagnostic CTs, organ shifts were variable and not significant. Organ shifts for patients with preoperative diagnostic CTs and postoperative radiation-planning CTs were similar to shifts observed for the first group. Conclusions: Relative to bony landmarks, there are superior and posterior shifts in organ position for radiation-planning CTs compared with diagnostic CTs. These shifts should be considered during treatment planning for resected abdominal tumors.

  9. Treatment planning with external beams. Introduction and historical overview.

    PubMed

    Rozenfeld, M

    1988-05-01

    In this first of a series of articles on Radiation Treatment Planning based on the Basic Physics Symposium of the American Association of Physicists in Medicine at the 73rd Annual meeting of the RSNA, an attempt has been made to provide a broad overview of the process of designing an optimal radiation therapy regimen. The essentials of treatment planning have been identified and essential terms have been defined. Variables to be selected have been identified and constraints in choosing treatment plans have been noted. The effect of combining multiple beams to achieve the most advantageous distribution of radiation dose within the patient has been discussed and the vital importance of appropriate quality control has been emphasized. Future articles will consider specific aspects of this discipline in detail. PMID:3289101

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

    SciTech Connect

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

    1999-06-01

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

  11. Optimized radiotherapy treatment planning using the Complication Probability Factor (CPF)

    SciTech Connect

    Wolbarst, A.B.; Sternick, E.S.; Curran, B.H.; Dritschilo, A.

    1980-06-01

    A major obstacle to effective computerized optimization of radiotherapy treatment planning has been the lack of a biologically meaningful and clinically useful objective function. Our approach employs a Complication Probability Factor (CPF) based directly on radiobiological principles and clinical data. The CPF measures the likelihood that a given dose distribution will lead to serious complications in the patient as a result of damage to healthy tissue. A computerized search can be made for a treatment plan which delivers an acceptable tumoricidal dose, yet minimizes the CPF as averaged over the total volume of healthy tissue irradiated. The program is run on a PDP 11/55 in conjunction with a commercial treatment planning package.

  12. Sampling and Analysis Plan - Waste Treatment Plant Seismic Boreholes Project

    SciTech Connect

    Reidel, Steve P.

    2006-05-26

    This sampling and analysis plan (SAP) describes planned data collection activities for four entry boreholes through the sediment overlying the basalt, up to three new deep rotary boreholes through the basalt and sedimentary interbeds, and one corehole through the basalt and sedimentary interbeds at the Waste Treatment Plant (WTP) site. The SAP will be used in concert with the quality assurance plan for the project to guide the procedure development and data collection activities needed to support borehole drilling, geophysical measurements, and sampling. This SAP identifies the American Society of Testing Materials standards, Hanford Site procedures, and other guidance to be followed for data collection activities.

  13. Commissioning kilovoltage cone-beam CT beams in a radiation therapy treatment planning system.

    PubMed

    Alaei, Parham; Spezi, Emiliano

    2012-01-01

    The feasibility of accounting of the dose from kilovoltage cone-beam CT in treatment planning has been discussed previously for a single cone-beam CT (CBCT) beam from one manufacturer. Modeling the beams and computing the dose from the full set of beams produced by a kilovoltage cone-beam CT system requires extensive beam data collection and verification, and is the purpose of this work. The beams generated by Elekta X-ray volume imaging (XVI) kilovoltage CBCT (kV CBCT) system for various cassettes and filters have been modeled in the Philips Pinnacle treatment planning system (TPS) and used to compute dose to stack and anthropomorphic phantoms. The results were then compared to measurements made using thermoluminescent dosimeters (TLDs) and Monte Carlo (MC) simulations. The agreement between modeled and measured depth-dose and cross profiles is within 2% at depths beyond 1 cm for depth-dose curves, and for regions within the beam (excluding penumbra) for cross profiles. The agreements between TPS-calculated doses, TLD measurements, and Monte Carlo simulations are generally within 5% in the stack phantom and 10% in the anthropomorphic phantom, with larger variations observed for some of the measurement/calculation points. Dose computation using modeled beams is reasonably accurate, except for regions that include bony anatomy. Inclusion of this dose in treatment plans can lead to more accurate dose prediction, especially when the doses to organs at risk are of importance. PMID:23149789

  14. [Research on integrated application of tumor magnetic induction hyperthermia treatment planning system and modern medical information systems].

    PubMed

    Zhuo, Zihan; Zhai, Weiming; Cai, Dongyang; Wang, Jie; Zhang, Xiaodong; Tang, Jintian

    2014-02-01

    Magnetic induction hyperthermia becomes a very important tumor treatment method at present. In order to ensure a successful operation, doctors should make hyperthermia treatment planning before surgery. Based on Integration Healthcare Enterprise (IHE) framework and Digital Imaging and Communications in Medcine (DICOM) standard, we proposed and carried out a network workflow integrated with modern medical information systems for the dissemination of information in magnetic induction hyperthermia like accurate accessing patient information and radiology image data, storing processed images, sharing and verifying hyperthermia reports. The results proved that our system could not only improve the efficiency of magnetic induction hyperthermia treatment planning, but also save medical resources and reduce labor costs. PMID:24804509

  15. Methodology for commissioning a brachytherapy treatment planning system in the era of 3D planning.

    PubMed

    Dempsey, Claire

    2010-12-01

    To describe the steps undertaken to commission a 3D high dose rate (HDR) brachytherapy treatment planning system (TPS). Emphasis was placed on validating previously published recommendations, in addition to checking 3D parameters such as treatment optimization and dose volume histogram (DVH) analysis. Commissioning was performed of the brachytherapy module of the Nucletron Oncentra MasterPlan treatment planning system (version 3.2). Commissioning test results were compared to an independent external beam TPS (Varian Eclipse v 8.6) and the previously commissioned Nucletron Plato (v 14.3.7) brachytherapy treatment planning system, with point doses also independently verified using the brachytherapy module in RadCalc (v 6.0) independent point dose calculation software. Tests were divided into eight categories: (i) Image import accuracy, (ii) Reconstruction accuracy, (iii) Source configuration data check, (iv) Dose calculation accuracy, (v) Treatment optimization validation, (vi) DVH reproducibility, (vii) Treatment export check and (viii) Printout consistency. Point dose agreement between Oncentra, Plato and RadCalc was better than 5% with source data and dose calculation protocols following the American Association of Physicists in Medicine (AAPM) guidelines. Testing of image accuracy (import and reconstruction), along with validation of automated treatment optimization and DVH analysis generated a more comprehensive set of testing procedures than previously listed in published recommendations. PMID:21053116

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

    SciTech Connect

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

    2015-06-15

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

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

    SciTech Connect

    D`Amelio, J.

    1994-08-30

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

  18. Accurate treatments of electrostatics for computer simulations of biological systems: A brief survey of developments and existing problems

    NASA Astrophysics Data System (ADS)

    Yi, Sha-Sha; Pan, Cong; Hu, Zhong-Han

    2015-12-01

    Modern computer simulations of biological systems often involve an explicit treatment of the complex interactions among a large number of molecules. While it is straightforward to compute the short-ranged Van der Waals interaction in classical molecular dynamics simulations, it has been a long-lasting issue to develop accurate methods for the longranged Coulomb interaction. In this short review, we discuss three types of methodologies for the accurate treatment of electrostatics in simulations of explicit molecules: truncation-type methods, Ewald-type methods, and mean-field-type methods. Throughout the discussion, we brief the formulations and developments of these methods, emphasize the intrinsic connections among the three types of methods, and focus on the existing problems which are often associated with the boundary conditions of electrostatics. This brief survey is summarized with a short perspective on future trends along the method developments and applications in the field of biological simulations. Project supported by the National Natural Science Foundation of China (Grant Nos. 91127015 and 21522304) and the Open Project from the State Key Laboratory of Theoretical Physics, and the Innovation Project from the State Key Laboratory of Supramolecular Structure and Materials.

  19. TRU Management in the Site Treatment Plan at the INEEL

    SciTech Connect

    Davis, M.; Rasch, D.

    2002-02-25

    The storage of any form of hazardous waste is prohibited unless the waste has available treatment to meet land disposal restriction (LDR) requirements in accordance with 40 CFR 268 of the Resource Conservation and Recovery Act (RCRA). In 1992, Congress passed the Federal Facility Compliance Act (FFCA), which allows for the storage of radioactive and hazardous mixed waste (mixed waste) until available treatment can be developed that meets the LDR requirements. Transuranic-contaminated mixed (TRU) waste is covered under the FFCA through the Site Treatment Plan (STP) since the implementation of the plan in November, 1995. The Idaho National Engineering and Environmental Laboratory (INEEL) STP required schedules and milestones for the treatment and shipment of TRU waste to the Waste Isolation Pilot Plant (WIPP). Potential enforcement actions for missing compliance milestones exist in the INEEL STP.

  20. The metal-free approach to restorative treatment planning.

    PubMed

    Cortellini, Davide; Valenti, Marco; Canale, Angelo

    2006-01-01

    Considerable developments in the area of metal-free restorations--in response to increasing esthetic demands from patients--are offering the clinician and dental technician new therapeutic paths to follow when performing restorative treatments. Effective and reliable high-strength ceramic systems, suitable for anterior and posterior sites, may allow the achievement of predictable esthetics and function. Along with the evident indications for the treatment of anterior compromised elements, these types of restorations may be used in a wider variety of clinical cases, including complex prosthetic rehabilitations. Appropriate usage of different materials according to the specific clinical situation is mandatory for long-lasting, functional, and esthetic results. Therefore, a thorough application of metal-free restorations may be considered a "metal-free approach", which includes a specific formulation of treatment planning. In this article, the different materials, selection criteria, clinical indications, and benefits are evaluated, with a particular regard for treatment planning. PMID:19655489

  1. Novel tools for stepping source brachytherapy treatment planning: Enhanced geometrical optimization and interactive inverse planning

    SciTech Connect

    Dinkla, Anna M. Laarse, Rob van der; Koedooder, Kees; Petra Kok, H.; Wieringen, Niek van; Pieters, Bradley R.; Bel, Arjan

    2015-01-15

    Purpose: Dose optimization for stepping source brachytherapy can nowadays be performed using automated inverse algorithms. Although much quicker than graphical optimization, an experienced treatment planner is required for both methods. With automated inverse algorithms, the procedure to achieve the desired dose distribution is often based on trial-and-error. Methods: A new approach for stepping source prostate brachytherapy treatment planning was developed as a quick and user-friendly alternative. This approach consists of the combined use of two novel tools: Enhanced geometrical optimization (EGO) and interactive inverse planning (IIP). EGO is an extended version of the common geometrical optimization method and is applied to create a dose distribution as homogeneous as possible. With the second tool, IIP, this dose distribution is tailored to a specific patient anatomy by interactively changing the highest and lowest dose on the contours. Results: The combined use of EGO–IIP was evaluated on 24 prostate cancer patients, by having an inexperienced user create treatment plans, compliant to clinical dose objectives. This user was able to create dose plans of 24 patients in an average time of 4.4 min/patient. An experienced treatment planner without extensive training in EGO–IIP also created 24 plans. The resulting dose-volume histogram parameters were comparable to the clinical plans and showed high conformance to clinical standards. Conclusions: Even for an inexperienced user, treatment planning with EGO–IIP for stepping source prostate brachytherapy is feasible as an alternative to current optimization algorithms, offering speed, simplicity for the user, and local control of the dose levels.

  2. Treatment planning aspects and Monte Carlo methods in proton therapy

    NASA Astrophysics Data System (ADS)

    Fix, Michael K.; Manser, Peter

    2015-05-01

    Over the last years, the interest in proton radiotherapy is rapidly increasing. Protons provide superior physical properties compared with conventional radiotherapy using photons. These properties result in depth dose curves with a large dose peak at the end of the proton track and the finite proton range allows sparing the distally located healthy tissue. These properties offer an increased flexibility in proton radiotherapy, but also increase the demand in accurate dose estimations. To carry out accurate dose calculations, first an accurate and detailed characterization of the physical proton beam exiting the treatment head is necessary for both currently available delivery techniques: scattered and scanned proton beams. Since Monte Carlo (MC) methods follow the particle track simulating the interactions from first principles, this technique is perfectly suited to accurately model the treatment head. Nevertheless, careful validation of these MC models is necessary. While for the dose estimation pencil beam algorithms provide the advantage of fast computations, they are limited in accuracy. In contrast, MC dose calculation algorithms overcome these limitations and due to recent improvements in efficiency, these algorithms are expected to improve the accuracy of the calculated dose distributions and to be introduced in clinical routine in the near future.

  3. An MRI guided system for prostate laser ablation with treatment planning and multi-planar temperature monitoring

    NASA Astrophysics Data System (ADS)

    Xu, Sheng; Agarwal, Harsh; Bernardo, Marcelino; Seifabadi, Reza; Turkbey, Baris; Partanen, Ari; Negussie, Ayele; Glossop, Neil; Choyke, Peter; Pinto, Peter; Wood, Bradford J.

    2016-03-01

    Prostate cancer is often over treated with standard treatment options which impact the patients' quality of life. Laser ablation has emerged as a new approach to treat prostate cancer while sparing the healthy tissue around the tumor. Since laser ablation has a small treatment zone with high temperature, it is necessary to use accurate image guidance and treatment planning to enable full ablation of the tumor. Intraoperative temperature monitoring is also desirable to protect critical structures from being damaged in laser ablation. In response to these problems, we developed a navigation platform and integrated it with a clinical MRI scanner and a side firing laser ablation device. The system allows imaging, image guidance, treatment planning and temperature monitoring to be carried out on the same platform. Temperature sensing phantoms were developed to demonstrate the concept of iterative treatment planning and intraoperative temperature monitoring. Retrospective patient studies were also conducted to show the clinical feasibility of the system.

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

    PubMed

    Zabalegui, B

    1990-01-01

    More and more often the general dentist is finding the presence of endodontically treated teeth during his treatment planning procedure. He has to ask himself if the endo-treated tooth functions and will continue to function function successfully, when deciding which final endo-restorative procedure to apply. For this reason the dentist or the endodontist with whom he works should clinically evaluate these teeth, establish a diagnostic criteria of their success or failure and a treatment plan according to the prognosis. The purpose of this article is to offer an organized clinical view of the steps to follow when evaluating an endodontically treated tooth and how to establish a final endo-restorative plan. PMID:2168732

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

    SciTech Connect

    Lawrence, B.

    1999-04-20

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

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

    SciTech Connect

    Lawrence, B.

    2000-04-20

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

  7. WE-A-BRD-01: Innovation in Radiation Therapy Planning I: Knowledge Guided Treatment Planning

    SciTech Connect

    Wu, Q; Olsen, L

    2014-06-15

    Intensity modulated radiation therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) offer the capability of normal tissues and organs sparing. However, the exact amount of sparing is often unknown until the plan is complete. This lack of prior guidance has led to the iterative, trial and-error approach in current planning practice. Even with this effort the search for patient-specific optimal organ sparing is still strongly influenced by planner's experience. While experience generally helps in maximizing the dosimetric advantages of IMRT/VMAT, there have been several reports showing unnecessarily high degree of plan quality variability at individual institutions and amongst different institutions, even with a large amount of experience and the best available tools. Further, when physician and physicist evaluate a plan, the dosimetric quality of the plan is often compared with a standard protocol that ignores individual patient anatomy and tumor characteristic variations. In recent years, developments of knowledge models for clinical IMRT/VMAT planning guidance have shown promising clinical potentials. These knowledge models extract past expert clinical experience into mathematical models that predict dose sparing references at patient-specific level. For physicians and planners, these references provide objective values that reflect best achievable dosimetric constraints. For quality assurance, applying patient-specific dosimetry requirements will enable more quantitative and objective assessment of protocol compliance for complex IMRT planning. Learning Objectives: Modeling and representation of knowledge for knowledge-guided treatment planning. Demonstrations of knowledge-guided treatment planning with a few clinical caanatomical sites. Validation and evaluation of knowledge models for cost and quality effective standardization of plan optimization.

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

    SciTech Connect

    1991-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

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

    PubMed

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

    2013-12-21

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

  11. Optimizing global liver function in radiation therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Wu, Victor W.; Epelman, Marina A.; Wang, Hesheng; Romeijn, H. Edwin; Feng, Mary; Cao, Yue; Ten Haken, Randall K.; Matuszak, Martha M.

    2016-09-01

    Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases. The normal-liver-based objective functions are the linearized equivalent uniform dose (\\ell \\text{EUD} ) (conventional ‘\\ell \\text{EUD} model’), the so-called perfusion-weighted \\ell \\text{EUD} (\\text{fEUD} ) (proposed ‘fEUD model’), and post-treatment global liver function (GLF) (proposed ‘GLF model’), predicted by a new liver-perfusion-based dose-response model. The resulting \\ell \\text{EUD} , fEUD, and GLF plans delivering the same target \\ell \\text{EUD} are compared with respect to their post-treatment function and various dose-based metrics. Voxel-based portal venous liver perfusion, used as a measure of local function, is computed using DCE-MRI. In cases used in our experiments, the GLF plan preserves up to 4.6 % ≤ft(7.5 % \\right) more liver function than the fEUD (\\ell \\text{EUD} ) plan does in 2D cases, and up to 4.5 % ≤ft(5.6 % \\right) in 3D cases. The GLF and fEUD plans worsen in \\ell \\text{EUD} of functional liver on average by 1.0 Gy and 0.5 Gy in 2D and 3D cases, respectively. Liver perfusion information can be used during treatment planning to minimize the risk of toxicity by improving expected GLF; the degree of benefit varies with perfusion pattern. Although fEUD model optimization is computationally inexpensive and

  12. Optimizing global liver function in radiation therapy treatment planning.

    PubMed

    Wu, Victor W; Epelman, Marina A; Wang, Hesheng; Edwin Romeijn, H; Feng, Mary; Cao, Yue; Ten Haken, Randall K; Matuszak, Martha M

    2016-09-01

    Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases. The normal-liver-based objective functions are the linearized equivalent uniform dose ([Formula: see text]) (conventional '[Formula: see text] model'), the so-called perfusion-weighted [Formula: see text] ([Formula: see text]) (proposed 'fEUD model'), and post-treatment global liver function (GLF) (proposed 'GLF model'), predicted by a new liver-perfusion-based dose-response model. The resulting [Formula: see text], fEUD, and GLF plans delivering the same target [Formula: see text] are compared with respect to their post-treatment function and various dose-based metrics. Voxel-based portal venous liver perfusion, used as a measure of local function, is computed using DCE-MRI. In cases used in our experiments, the GLF plan preserves up to [Formula: see text] more liver function than the fEUD ([Formula: see text]) plan does in 2D cases, and up to [Formula: see text] in 3D cases. The GLF and fEUD plans worsen in [Formula: see text] of functional liver on average by 1.0 Gy and 0.5 Gy in 2D and 3D cases, respectively. Liver perfusion information can be used during treatment planning to minimize the risk of toxicity by improving expected GLF; the degree of benefit varies with perfusion pattern. Although fEUD model optimization is computationally inexpensive and often

  13. A treatment planning study comparing Elekta VMAT and fixed field IMRT using the varian treatment planning system eclipse

    PubMed Central

    2014-01-01

    Background The newest release of the Eclipse (Varian) treatment planning system (TPS) includes an optimizing engine for Elekta volumetric-modulated arc therapy (VMAT) planning. The purpose of this study was to evaluate this new algorithm and to compare it to intensity-modulated radiation therapy (IMRT) for various disease sites by creating single- and double-arc VMAT plans. Methods A total of 162 plans were evaluated in this study, including 38 endometrial, 57 head and neck, 12 brain, 10 breast and 45 prostate cancer cases. The real-life IMRT plans were developed during routine clinical cases using the TPS Eclipse. VMAT plans were generated using a preclinical version of Eclipse with tumor-region-specific optimizing templates without interference of the operator: with one full arc (1A) and with two full arcs (2A), and with partial arcs for breast and prostate with hip implant cases. All plans were evaluated based on target coverage, homogeneity and conformity. The organs at risk (OARs) were analyzed according to plan objectives, such as the mean and maximum doses. If one or more objectives were exceeded, the plan was considered clinically unacceptable, and a second VMAT plan was created by adapting the optimization penalties once. Results Compared to IMRT, single- and double-arc VMAT plans showed comparable or better results concerning the target coverage: the maximum dose in the target for 1A is the same as that for IMRT; for 2A, an average reduction of 1.3% over all plans was observed. The conformity showed a statistically significant improvement for both 1A (+3%) and 2A (+6%). The mean total body dose was statistically significant lower for the considered arc techniques (IMRT: 16.0 Gy, VMAT: 15.3 Gy, p < 0.001). However, the sparing of OARs shows individual behavior that depends strongly on the different tumor regions. A clear difference is found in the number of monitor units (MUs) per plan: VMAT shows a reduction of 31%. Conclusion These findings

  14. Emergency assessment and treatment planning for traumatic dental injuries.

    PubMed

    Moule, A; Cohenca, N

    2016-03-01

    Trauma involving the dentoalveolar region is a frequent occurrence which can result in the fracturing and displacement of teeth, crushing and/or fracturing of bone and soft tissue injuries including contusions, abrasions and lacerations. This review describes the assessment of patients with these injuries, not in a didactic sense by repeating excellent already published classifications and treatment options, but by addressing questions that arise during assessment. It covers trauma first aid, examination of the patient, factors that affect treatment planning decisions, and the importance of communicating treatment options and prognosis to traumatized patients. PMID:26923446

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

    PubMed Central

    Athiyaman, Hemalatha; Mayilvaganan, Athiyaman; Singh, Daleep

    2014-01-01

    A new planning method for Craniospinal Irradiation by Eclipse treatment planning system using Field alignment, Field-in-Field technique was developed. Advantage of this planning method was also studied retrospectively for previously treated five patients of medulloblastoma with variable spine length. Plan consists of half beam blocked parallel opposed cranium, and a single posterior cervicospine field was created by sharing the same isocenter, which obviates divergence matching. Further, a single symmetrical field was created to treat remaining Lumbosacral spine. Matching between a inferior diverging edge of cervicospine field and superior diverging edge of a Lumbosacral field was done using the field alignment option. ′Field alignment′ is specific option in the Eclipse Treatment Planning System, which automatically matches the field edge divergence as per field alignment rule. Multiple segments were applied in both the spine field to manage with hot and cold spots created by varying depth of spinal cord. Plan becomes fully computerized using this field alignment option and multiple segments. Plan evaluation and calculated mean modified Homogeneity Index (1.04 and 0.1) ensured that dose to target volume is homogeneous and critical organ doses were within tolerance. Dose variation at the spinal field junction was verified using ionization chamber array (I′MatriXX) for matched, overlapped and gap junction spine fields; the delivered dose distribution confirmed the ideal clinical match, over exposure and under exposure at the junction, respectively. This method is simple to plan, executable in Record and Verify mode and can be adopted for various length of spinal cord with only two isocenter in shorter treatment time. PMID:25525314

  16. The NUKDOS software for treatment planning in molecular radiotherapy.

    PubMed

    Kletting, Peter; Schimmel, Sebastian; Hänscheid, Heribert; Luster, Markus; Fernández, Maria; Nosske, Dietmar; Lassmann, Michael; Glatting, Gerhard

    2015-09-01

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

  17. Pictorial review. Magnetic resonance for radiotherapy management and treatment planning in prostatic carcinoma.

    PubMed

    Lim, Christopher; Malone, Shawn C; Avruch, Leonard; Breau, Rodney H; Flood, Trevor A; Lim, Megan; Morash, Christopher; Quon, Jeff S; Walsh, Cynthia; Schieda, Nicola

    2015-10-01

    MRI has an important role for radiotherapy (RT) treatment planning in prostate cancer (PCa) providing accurate visualization of the dominant intraprostatic lesion (DIL) and locoregional anatomy, assessment of local staging and depiction of implanted devices. MRI enables the radiation oncologist to optimize RT planning by better defining target tumour volumes (thereby increasing local tumour control), as well as decreasing morbidity (by minimizing the dose to adjacent normal structures). Using MRI, radiation oncologists can define the DIL for delivery of boost doses of RT using a variety of techniques including: stereotactic body radiotherapy, intensity-modulated radiotherapy, proton RT or brachytherapy to improve tumour control. Radiologists require a familiarity with the different RT methods used to treat PCa, as well as an understanding of the advantages and disadvantages of the various MR pulse sequences available for RT planning in order to provide an optimal multidisciplinary RT treatment approach to PCa. Understanding the expected post-RT appearance of the prostate and typical characteristics of local tumour recurrence is also important because MRI is rapidly becoming an integral component for diagnosis, image-guided histological sampling and treatment planning in the setting of biochemical failure after RT or surgery. PMID:26279086

  18. Comparison of selected dose calculation algorithms in radiotherapy treatment planning for tissues with inhomogeneities

    NASA Astrophysics Data System (ADS)

    Woon, Y. L.; Heng, S. P.; Wong, J. H. D.; Ung, N. M.

    2016-03-01

    Inhomogeneity correction is recommended for accurate dose calculation in radiotherapy treatment planning since human body are highly inhomogeneous with the presence of bones and air cavities. However, each dose calculation algorithm has its own limitations. This study is to assess the accuracy of five algorithms that are currently implemented for treatment planning, including pencil beam convolution (PBC), superposition (SP), anisotropic analytical algorithm (AAA), Monte Carlo (MC) and Acuros XB (AXB). The calculated dose was compared with the measured dose using radiochromic film (Gafchromic EBT2) in inhomogeneous phantoms. In addition, the dosimetric impact of different algorithms on intensity modulated radiotherapy (IMRT) was studied for head and neck region. MC had the best agreement with the measured percentage depth dose (PDD) within the inhomogeneous region. This was followed by AXB, AAA, SP and PBC. For IMRT planning, MC algorithm is recommended for treatment planning in preference to PBC and SP. The MC and AXB algorithms were found to have better accuracy in terms of inhomogeneity correction and should be used for tumour volume within the proximity of inhomogeneous structures.

  19. Upright 3D Treatment Planning Using a Vertical CT

    SciTech Connect

    Shah, Anand P. Strauss, Jonathan B.; Kirk, Michael C.; Chen, Sea S.; Kroc, Thomas K.; Zusag, Thomas W.

    2009-04-01

    In this report, we describe a novel technique used to plan and administer external beam radiation therapy to a patient in the upright position. A patient required reirradiation for thymic carcinoma but was unable to tolerate the supine position due to bilateral phrenic nerve injury and paralysis of the diaphragm. Computed tomography (CT) images in the upright position were acquired at the Northern Illinois University Institute for Neutron Therapy at Fermilab. The CT data were imported into a standard 3-dimensional (3D) treatment planning system. Treatment was designed to deliver 24 Gy to the target volume while respecting normal tissue tolerances. A custom chair that locked into the treatment table indexing system was constructed for immobilization, and port films verified the reproducibility of setup. Radiation was administered using mixed photon and electron AP fields.

  20. Assessing the quality of conformal treatment planning: a new tool for quantitative comparison.

    PubMed

    Menhel, J; Levin, D; Alezra, D; Symon, Z; Pfeffer, R

    2006-10-21

    We develop a novel radiotherapy plan comparison index, critical organ scoring index (COSI), which is a measure of both target coverage and critical organ overdose. COSI is defined as COSI=1-(V(OAR)>tol/TC), where V(OAR)>tol is the fraction of volume of organ at risk receiving more than tolerance dose, and TC is the target coverage, VT,PI/VT, where VT,PI is the target volume receiving at a least prescription dose and VT is the total target volume. COSI approaches unity when the critical structure is completely spared and the target coverage is unity. We propose a two-dimensional, graphical representation of COSI versus conformity index (CI), where CI is a measure of a normal tissue overdose. We show that this 2D representation is a reliable, visual quantitative tool for evaluating competing plans. We generate COSI-CI plots for three sites: head and neck, cavernous sinus, and pancreas, and evaluate competing non-coplanar 3D and IMRT treatment plans. For all three sites this novel 2D representation assisted the physician in choosing the optimal plan, both in terms of target coverage and in terms of critical organ sparing. We verified each choice by analysing individual DVHs and isodose lines. Comparing our results to the widely used conformation number, we found that in all cases where there were discrepancies in the choice of the best treatment plan, the COSI-CI choice was considered the correct one, in several cases indicating that a non-coplanar 3D plan was superior to the IMRT plans. The choice of plan was quick, simple and accurate using the new graphical representation. PMID:17019044

  1. Implementation of Monte Carlo Dose calculation for CyberKnife treatment planning

    NASA Astrophysics Data System (ADS)

    Ma, C.-M.; Li, J. S.; Deng, J.; Fan, J.

    2008-02-01

    Accurate dose calculation is essential to advanced stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) especially for treatment planning involving heterogeneous patient anatomy. This paper describes the implementation of a fast Monte Carlo dose calculation algorithm in SRS/SRT treatment planning for the CyberKnife® SRS/SRT system. A superposition Monte Carlo algorithm is developed for this application. Photon mean free paths and interaction types for different materials and energies as well as the tracks of secondary electrons are pre-simulated using the MCSIM system. Photon interaction forcing and splitting are applied to the source photons in the patient calculation and the pre-simulated electron tracks are repeated with proper corrections based on the tissue density and electron stopping powers. Electron energy is deposited along the tracks and accumulated in the simulation geometry. Scattered and bremsstrahlung photons are transported, after applying the Russian roulette technique, in the same way as the primary photons. Dose calculations are compared with full Monte Carlo simulations performed using EGS4/MCSIM and the CyberKnife treatment planning system (TPS) for lung, head & neck and liver treatments. Comparisons with full Monte Carlo simulations show excellent agreement (within 0.5%). More than 10% differences in the target dose are found between Monte Carlo simulations and the CyberKnife TPS for SRS/SRT lung treatment while negligible differences are shown in head and neck and liver for the cases investigated. The calculation time using our superposition Monte Carlo algorithm is reduced up to 62 times (46 times on average for 10 typical clinical cases) compared to full Monte Carlo simulations. SRS/SRT dose distributions calculated by simple dose algorithms may be significantly overestimated for small lung target volumes, which can be improved by accurate Monte Carlo dose calculations.

  2. Application of the "bioeffects" algorithm of a treatment planning system.

    PubMed

    Ho, A K; Podgorsak, M B; Sibata, C H; Shin, K H

    1995-01-01

    In this study, both a four-field box and two-field AP/PA treatment plan are combined with two insertions of Cs-137 in a tandem and ovoids setup, to evaluate the bioeffects program of a treatment planning system. External beam energies studied are 18 and 6 MV. It is shown that there is a slight difference in the 50-70 time dose fractionation (TDF) isolines when comparing 6 MV and 18 MV, for the AP/PA setup. There is practically no difference for TDF isoline values larger than 80 for both energies with either the four-field or the two-field setup. This is because the brachytherapy contributed the majority of the dose to the regions near the applicator and the TDF values reflect the higher dose delivered by the brachytherapy relative to the external beams in that region. For this simple evaluation of the bioeffects program, the combination of the external beam plan and the brachytherapy plan does not give us enhanced information on the effectiveness of the plan. PMID:7632348

  3. A treatment planning comparison of BPA- or BSH-based BNCT of malignant gliomas

    SciTech Connect

    Capala, J.; Coderre, J.A.; Chanana, A.D.

    1996-12-31

    Accurate delivery of the prescribed dose during clinical BNCT requires knowledge (or reasonably valid assumptions) about the boron concentrations in tumor and normal tissues. For conversion of physical dose (Gy) into photon-equivalent dose (Gy-Eq), relative biological effectiveness (RBE) and/or compound-adjusted biological effectiveness (CBE) factors are required for each tissue. The BNCT treatment planning software requires input of the following values: the boron concentration in blood and tumor, RBEs in brain, tumor and skin for the high-LET beam components, the CBE factors for brain, tumor, and skin, and the RBE for the gamma component.

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

    SciTech Connect

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

    1996-03-22

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

  5. Use Dose Bricks Concept to Implement Nasopharyngeal Carcinoma Treatment Planning

    PubMed Central

    Wu, Jia-Ming; Yu, Tsan-Jung; Yeh, Shyh-An; Chao, Pei-Ju; Huang, Chih-Jou

    2014-01-01

    Purpose. A “dose bricks” concept has been used to implement nasopharyngeal carcinoma treatment plan; this method specializes particularly in the case with bell shape nasopharyngeal carcinoma case. Materials and Methods. Five noncoplanar fields were used to accomplish the dose bricks technique treatment plan. These five fields include (a) right superior anterior oblique (RSAO), (b) left superior anterior oblique (LSAO), (c) right anterior oblique (RAO), (d) left anterior oblique (LAO), and (e) superior inferior vertex (SIV). Nondivergence collimator central axis planes were used to create different abutting field edge while normal organs were blocked by multileaf collimators in this technique. Results. The resulting 92% isodose curves encompassed the CTV, while maximum dose was about 115%. Approximately 50% volume of parotid glands obtained 10–15% of total dose and 50% volume of brain obtained less than 20% of total dose. Spinal cord receives only 5% from the scatter dose. Conclusions. Compared with IMRT, the expenditure of planning time and costing, “dose bricks” may after all be accepted as an optional implementation in nasopharyngeal carcinoma conformal treatment plan; furthermore, this method also fits the need of other nonhead and neck lesions if organ sparing and noncoplanar technique can be executed. PMID:24967395

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

    SciTech Connect

    Lawrence, B.; Berry, M.

    1998-03-01

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

  7. 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

  8. 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

    2005-03-01

    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 the

  9. 4D Proton treatment planning strategy for mobile lung tumors

    SciTech Connect

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

    2007-03-01

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

  10. 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.

  11. Continuity of Care: Sharing the Medication Treatment Plan.

    PubMed

    Spahni, Stéphane

    2016-01-01

    The shared medication treatment plan is a key element for supporting the continuity of care. Indeed a substantial amount of emergency hospitalization is linked to medication - 5% to 10% according to some studies. Methods and tools helping all healthcare providers to have a better knowledge of the complete medication plan are therefore required in order to limit side effects linked to an insufficient knowledge of what the patient is taking. The workshop intends to present various initiatives and open the discussion about the limits, pros and cons of various initiatives. PMID:27332315

  12. Commissioning and quality assurance of the Pinnacle(3) radiotherapy treatment planning system for external beam photons.

    PubMed

    Bedford, J L; Childs, P J; Nordmark Hansen, V; Mosleh-Shirazi, M A; Verhaegen, F; Warrington, A P

    2003-03-01

    The commissioning of a Pinnacle(3) treatment planning system is described. Four Elekta linear accelerators were commissioned for external beam photons. Measured data were used to derive parameter values for the Pinnacle(3) beam model by (1). fitting a Monte Carlo model of the accelerator head to measured data and then extracting the parameters for the Pinnacle(3) beam model, and by (2). using the auto-modelling facility within Pinnacle(3). Both of these methods yielded dose distributions in accord with published recommendations. A separate small-field beam model, customized for an in-house compact blocking system, was also created, which satisfied appropriate acceptance criteria for stereotactically guided conformal brain treatments. Inhomogeneous, oblique, asymmetrical and irregular fields were also assessed, with calculated and measured doses agreeing to within +/-3%. Dose-volume histogram calculation was found to be accurate to within +/-5% dose or volume for a grid size of 4 mm x 4 mm x 4 mm, with better accuracy being achieved for finer grids. Isocentric doses were compared between Pinnacle(3)'s collapsed cone convolution algorithm and the Bentley-Milan algorithm within the Target-2 treatment planning system. Dose differences were generally less than 3% in the dose prescribed, with larger values for breast plans, where the Pinnacle(3) algorithm calculated scatter more accurately. Pelvic and thoracic plans were also verified using an anthropomorphic phantom, with local dose differences between calculated and delivered dose of up to 8%, but mainly less than 3%, and with no systematic difference. Ionization chamber verifications using START and RT-01 trial procedures demonstrated differences between calculated and measured doses of less than 2%. Following satisfactory performance in the commissioning process, Pinnacle(3) has now been introduced into routine clinical use. PMID:12684232

  13. Generalized Tumor Dose for Treatment Planning Decision Support

    NASA Astrophysics Data System (ADS)

    Zuniga, Areli A.

    Modern radiation therapy techniques allow for improved target conformity and normal tissue sparing. These highly conformal treatment plans have allowed dose escalation techniques increasing the probability of tumor control. At the same time this conformation has introduced inhomogeneous dose distributions, making delivered dose characterizations more difficult. The concept of equivalent uniform dose (EUD) characterizes a heterogeneous dose distribution within irradiated structures as a single value and has been used in biologically based treatment planning (BBTP); however, there are no substantial validation studies on clinical outcome data supporting EUD's use and therefore has not been widely adopted as decision-making support. These highly conformal treatment plans have also introduced the need for safety margins around the target volume. These margins are designed to minimize geometrical misses, and to compensate for dosimetric and treatment delivery uncertainties. The margin's purpose is to reduce the chance of tumor recurrence. This dissertation introduces a new EUD formulation designed especially for tumor volumes, called generalized Tumor Dose (gTD). It also investigates, as a second objective, margins extensions for potential improvements in local control while maintaining or minimizing toxicity. The suitability of gTD to rank LC was assessed by means of retrospective studies in a head and neck (HN) squamous cell carcinoma (SCC) and non-small cell lung cancer (NSCLC) cohorts. The formulation was optimized based on two datasets (one of each type) and then, model validation was assessed on independent cohorts. The second objective of this dissertation was investigated by ranking the probability of LC of the primary disease adding different margin sizes. In order to do so, an already published EUD formula was used retrospectively in a HN and a NSCLC datasets. Finally, recommendations for the viability to implement this new formulation into a routine treatment

  14. Volumetric Modulated Arc Therapy for Spine Radiosurgery: Superior Treatment Planning and Delivery Compared to Static Beam Intensity Modulated Radiotherapy

    PubMed Central

    Zach, Leor; Tsvang, Lev; Alezra, Dror; Ben Ayun, Maoz

    2016-01-01

    Purpose. Spine stereotactic radiosurgery (SRS) delivers an accurate and efficient high radiation dose to vertebral metastases in 1–5 fractions. We aimed to compare volumetric modulated arc therapy (VMAT) to static beam intensity modulated radiotherapy (IMRT) for spine SRS. Methods and Materials. Ten spine lesions of previously treated SRS patients were planned retrospectively using both IMRT and VMAT with a prescribed dose of 16 Gy to 100% of the planning target volume (PTV). The plans were compared for conformity, homogeneity, treatment delivery time, and safety (spinal cord dose). Results. All evaluated parameters favored the VMAT plan over the IMRT plans. Dmin in the IMRT was significantly lower than in the VMAT plan (7.65 Gy/10.88 Gy, p < 0.001), the Dice Similarity Coefficient (DSC) was found to be significantly better for the VMAT plans compared to the IMRT plans (0.77/0.58, resp., p  value < 0.01), and an almost 50% reduction in the net treatment time was calculated for the VMAT compared to the IMRT plans (6.73 min/12.96 min, p < 0.001). Conclusions. In our report, VMAT provides better conformity, homogeneity, and safety profile. The shorter treatment time is a major advantage and not only provides convenience to the painful patient but also contributes to the precision of this high dose radiation therapy. PMID:26885513

  15. Treatment Integrity Assessment in the Schools: An Evaluation of the Treatment Integrity Planning Protocol

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2009-01-01

    The Treatment Integrity Planning Protocol (TIPP) provides a structured process for collaboratively creating a treatment integrity assessment within a consultation framework. The authors evaluated the effect of the TIPP on the implementation of an intervention designed to improve the consistency of students' mathematics performance. Treatment…

  16. Radiation treatment planning techniques for lymphoma of the stomach

    SciTech Connect

    Della Biancia, Cesar; Hunt, Margie; Furhang, Eli; Wu, Elisa; Yahalom, Joachim . E-mail: yahalomj@mskcc.org

    2005-07-01

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

  17. Advance end-of-life treatment planning. A research review.

    PubMed

    Miles, S H; Koepp, R; Weber, E P

    1996-05-27

    The year 1996 marks the fifth anniversary of the federal Patient Self-Determination Act. The Patient Self-Determination Act required hospitals, nursing homes, and health plans to ask whether patients have advance directives and to incorporate them into the medical record. A "living will" is an advance directive by which a person tells caregivers the circumstances in which life-sustaining treatment is to be provided or forgone if the patient is unable to communicate. A "durable power of attorney for health care" enables one to designate a person to speak on his or her behalf if the author loses decision-making capacity. "Advance planning" is the process of reflection, discussion, and communication of treatment preferences for end-of-life care that precedes and may lead to an advance directive. PMID:8638992

  18. How accurately can current, planned and proposed InSAR missions measure slow, long-wavelength tectonic strain? (Invited)

    NASA Astrophysics Data System (ADS)

    Wright, T. J.; Garthwaite, M.; Jung, H.; Shepherd, A.

    2010-12-01

    Since the launch of ERS-1 in 1991, InSAR has been widely used to measure large deformation events such as earthquakes or volcanic eruptions. In the last decade, small strains accumulating around locked crustal faults and dormant volcanic edifices have also been measured, in certain favourable conditions. In this presentation, we discuss the accuracy of current, planned and proposed InSAR missions. We quantify the main contributions to the error budget of a single interferogram at different spatial scales: atmospheric and orbital errors dominate at long wavelengths (tens of kilometres), and errors from system noise and surface incoherence at short spatial scales (tens of metres). We show that the optimum method for combining multiple interferograms to measure the average line-of-sight (LOS) deformation rate is via a weighted linear inversion of a connected network of short-interval interferograms. The LOS accuracy is strongly dependent on the mission length and satellite revisit time, as well as the spatial length scale. For example, to obtain an LOS accuracy of 1 mm/yr over 100 km requires 5 years of observation with a 13-day repeat, or 7 years for a 35-day repeat. We assess the ability of current (ERS/Envisat), planned (Sentinel-1), and proposed (SuperSAR, DesDYNI) satellite missions to measure long wavelength tectonic strain by estimating the proportion of global straining areas (as defined by the Global Strain Rate Map) where the strain rates are higher than the measurement error. The results highlight the importance of obtaining measurements in three dimensions in order to monitor all actively deforming regions. Of the planned/proposed missions, only SuperSAR (submitted to ESA’s Earth Explorer 8 call) has the ability to achieve 1 mm/yr accuracy over 100 km in all three dimensions after 5 years of observation. This is sufficient to map strain accumulating around faults that are responsible for 95% of damaging onshore earthquakes.

  19. Treatment planning and dose calculation in radiation oncology

    SciTech Connect

    Bentel, G.C.; Nelson, C.E.; Noell, K.T.

    1989-01-01

    This book focuses on planning radiotherapy for the treatment of cancer. The procedures described have in some cases have been invented, in many cases improved, and in all cases thoroughly tested by the authors. There are no careless repetition of errors so often perpetuated by authors who copy down the mistakes of other texts. Eight chapters have been processed separately for inclusion in the appropriate data bases.

  20. Can dental registrants use the Index of Orthodontic Treatment Need accurately? Part 1: Knowledge of IOTN among dental registrants.

    PubMed

    Jawad, Z; Bates, C; Hodge, T

    2016-05-27

    Aim To determine whether dental registrants can use the dental health component (DHC) and aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) 'accurately' to an acceptable level of agreement and diagnostic validity.Method Participants from six different registrant groups were asked to score the IOTN for 14 cases based on study models and photographs as well as completing a short questionnaire. Participants in the study were all recruited at study days and annual conferences. The main outcome measures include the different registrant groups IOTN scores compared to expert panel scores using kappa statistics. To assess for diagnostic validity, individual participants sensitivity and specificity scores were calculated.Result Overall, 229 registrants took part in the study. For the DHC the specialist orthodontist (SO), postgraduate orthodontic student (PGOS) and the qualified orthodontic therapist (QOT) groups achieved a mean kappa ≥0.60 indicating 'acceptable' agreement with the expert panel scores. The dental foundation trainee (DFT) and general dental practitioner (GDP) group achieved a mean kappa of 0.20 and 0.22 respectively indicating poor and fair agreement. The student orthodontic therapist (SOT) group achieved a mean kappa of 0.55 indicating moderate agreement. For the AC none of the registrant groups achieved an acceptable level of agreement with the mean kappa scores for the different groups ranging from kappa 0.13-0.21, indicating poor to fair agreement.Conclusion Overall agreement for the DHC was varied for the different registrant groups ranging from fair to substantial agreement. Registrants were better at applying the DHC compared to the AC with agreement ranging from poor to fair. More needs to done to help registrants use the IOTN more 'accurately'. PMID:27228933

  1. A comparison between anisotropic analytical and multigrid superposition dose calculation algorithms in radiotherapy treatment planning.

    PubMed

    Wu, Vincent W C; Tse, Teddy K H; Ho, Cola L M; Yeung, Eric C Y

    2013-01-01

    Monte Carlo (MC) simulation is currently the most accurate dose calculation algorithm in radiotherapy planning but requires relatively long processing time. Faster model-based algorithms such as the anisotropic analytical algorithm (AAA) by the Eclipse treatment planning system and multigrid superposition (MGS) by the XiO treatment planning system are 2 commonly used algorithms. This study compared AAA and MGS against MC, as the gold standard, on brain, nasopharynx, lung, and prostate cancer patients. Computed tomography of 6 patients of each cancer type was used. The same hypothetical treatment plan using the same machine and treatment prescription was computed for each case by each planning system using their respective dose calculation algorithm. The doses at reference points including (1) soft tissues only, (2) bones only, (3) air cavities only, (4) soft tissue-bone boundary (Soft/Bone), (5) soft tissue-air boundary (Soft/Air), and (6) bone-air boundary (Bone/Air), were measured and compared using the mean absolute percentage error (MAPE), which was a function of the percentage dose deviations from MC. Besides, the computation time of each treatment plan was recorded and compared. The MAPEs of MGS were significantly lower than AAA in all types of cancers (p<0.001). With regards to body density combinations, the MAPE of AAA ranged from 1.8% (soft tissue) to 4.9% (Bone/Air), whereas that of MGS from 1.6% (air cavities) to 2.9% (Soft/Bone). The MAPEs of MGS (2.6%±2.1) were significantly lower than that of AAA (3.7%±2.5) in all tissue density combinations (p<0.001). The mean computation time of AAA for all treatment plans was significantly lower than that of the MGS (p<0.001). Both AAA and MGS algorithms demonstrated dose deviations of less than 4.0% in most clinical cases and their performance was better in homogeneous tissues than at tissue boundaries. In general, MGS demonstrated relatively smaller dose deviations than AAA but required longer computation time

  2. A comparison between anisotropic analytical and multigrid superposition dose calculation algorithms in radiotherapy treatment planning

    SciTech Connect

    Wu, Vincent W.C.; Tse, Teddy K.H.; Ho, Cola L.M.; Yeung, Eric C.Y.

    2013-07-01

    Monte Carlo (MC) simulation is currently the most accurate dose calculation algorithm in radiotherapy planning but requires relatively long processing time. Faster model-based algorithms such as the anisotropic analytical algorithm (AAA) by the Eclipse treatment planning system and multigrid superposition (MGS) by the XiO treatment planning system are 2 commonly used algorithms. This study compared AAA and MGS against MC, as the gold standard, on brain, nasopharynx, lung, and prostate cancer patients. Computed tomography of 6 patients of each cancer type was used. The same hypothetical treatment plan using the same machine and treatment prescription was computed for each case by each planning system using their respective dose calculation algorithm. The doses at reference points including (1) soft tissues only, (2) bones only, (3) air cavities only, (4) soft tissue-bone boundary (Soft/Bone), (5) soft tissue-air boundary (Soft/Air), and (6) bone-air boundary (Bone/Air), were measured and compared using the mean absolute percentage error (MAPE), which was a function of the percentage dose deviations from MC. Besides, the computation time of each treatment plan was recorded and compared. The MAPEs of MGS were significantly lower than AAA in all types of cancers (p<0.001). With regards to body density combinations, the MAPE of AAA ranged from 1.8% (soft tissue) to 4.9% (Bone/Air), whereas that of MGS from 1.6% (air cavities) to 2.9% (Soft/Bone). The MAPEs of MGS (2.6%±2.1) were significantly lower than that of AAA (3.7%±2.5) in all tissue density combinations (p<0.001). The mean computation time of AAA for all treatment plans was significantly lower than that of the MGS (p<0.001). Both AAA and MGS algorithms demonstrated dose deviations of less than 4.0% in most clinical cases and their performance was better in homogeneous tissues than at tissue boundaries. In general, MGS demonstrated relatively smaller dose deviations than AAA but required longer computation time.

  3. Quality assurance methodology for Varian RapidArc treatment plans.

    PubMed

    Iftimia, Ileana; Cirino, Eileen T; Xiong, Li; Mower, Herbert W

    2010-01-01

    With the commercial introduction of the Varian RapidArc, a new modality for treatment planning and delivery, the need has arisen for consistent and efficient techniques for performing patient-specific quality assurance (QA) tests. In this paper we present our methodology for a RapidArc treatment plan QA procedure. For our measurements we used a 2D diode array (MapCHECK) embedded at 5 cm water equivalent depth in MapPHAN 5 phantom and an Exradin A16 ion chamber placed in six different positions in a cylindrical homogeneous phantom (QUASAR). We also checked the MUs for the RapidArc plans by using independent software (RadCalc). The agreement between Eclipse calculations and MapCHECK/MapPHAN5 measurements was evaluated using both absolute distance-to-agreement (DTA) and gamma index with 10% dose threshold (TH), 3% dose difference (DD), and 3 mm DTA. The average agreement was 94.4% for the DTA approach and 96.3% for the gamma index approach. In high-dose areas, the discrepancy between calculations and ion chamber measurements using the QUASAR phantom was within 4.5% for prostate cases. For the RadCalc calculations, we used the average SSD along the arc; however, for some patients the agreement for the MUs obtained with RadCalc versus Eclipse was inadequate (discrepancy > 5%). In these cases, the plan was divided into partial arc plans so that RadCalc could perform a better estimation of the MUs. The discrepancy was further reduced to within ~4% using this approach. Regardless of the variation in prescribed dose and location of the treated areas, we obtained very good results for all patients studied in this paper. PMID:21081873

  4. Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT)

    SciTech Connect

    Men Chunhua; Romeijn, H. Edwin; Jia Xun; Jiang, Steve B.

    2010-11-15

    Purpose: To develop a novel aperture-based algorithm for volumetric modulated arc therapy (VMAT) treatment plan optimization with high quality and high efficiency. Methods: The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequential way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. Results: The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. Conclusions: The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.

  5. Comparing Treatment Plan in All Locations of Esophageal Cancer

    PubMed Central

    Lin, Jang-Chun; Tsai, Jo-Ting; Chang, Chih-Chieh; Jen, Yee-Min; Li, Ming-Hsien; Liu, Wei-Hsiu

    2015-01-01

    Abstract The aim of this study was to compare treatment plans of volumetric modulated arc therapy (VMAT) with intensity-modulated radiotherapy (IMRT) for all esophageal cancer (EC) tumor locations. This retrospective study from July 2009 to June 2014 included 20 patients with EC who received definitive concurrent chemoradiotherapy with radiation doses >50.4 Gy. Version 9.2 of Pinnacle3 with SmartArc was used for treatment planning. Dosimetric quality was evaluated based on doses to several organs at risk, including the spinal cord, heart, and lung, over the same coverage of gross tumor volume. In upper thoracic EC, the IMRT treatment plan had a lower lung mean dose (P = 0.0126) and lung V5 (P = 0.0037) compared with VMAT; both techniques had similar coverage of the planning target volumes (PTVs) (P = 0.3575). In middle thoracic EC, a lower lung mean dose (P = 0.0010) and V5 (P = 0.0145), but higher lung V20 (P = 0.0034), spinal cord Dmax (P = 0.0262), and heart mean dose (P = 0.0054), were observed for IMRT compared with VMAT; IMRT provided better PTV coverage. Patients with lower thoracic ECs had a lower lung mean dose (P = 0.0469) and V5 (P = 0.0039), but higher spinal cord Dmax (P = 0.0301) and heart mean dose (P = 0.0020), with IMRT compared with VMAT. PTV coverage was similar (P = 0.0858) for the 2 techniques. IMRT provided a lower mean dose and lung V5 in upper thoracic EC compared with VMAT, but exhibited different advantages and disadvantages in patients with middle or lower thoracic ECs. Thus, choosing different techniques for different EC locations is warranted. PMID:25929910

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

    SciTech Connect

    Olch, A; Hua, C

    2014-06-15

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

  7. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    PubMed

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan. PMID:22128118

  8. Accuracy of out-of-field dose calculations by a commercial treatment planning system

    PubMed Central

    Howell, Rebecca M; Scarboro, Sarah B; Kry, S F; Yaldo, Derek Z

    2011-01-01

    The dosimetric accuracy of treatment planning systems (TPSs) decreases for locations outside the treatment field borders. However, the true accuracy of specific TPSs for locations beyond the treatment field borders is not well documented. Our objective was to quantify the accuracy of out-of-field dose predicted by the commercially available Eclipse version 8.6 TPS (Varian Medical Systems, Palo Alto, CA) for a clinical treatment delivered on a Varian Clinac 2100. We calculated (in the TPS) and determined (with thermoluminescent dosimeters) doses at a total of 238 points of measurement (with distance from the field edge ranging from 3.75 to 11.25 cm). Our comparisons determined that the Eclipse TPS underestimated out-of-field doses by an average of 40% over the range of distances examined. As the distance from the treatment field increased, the TPS underestimated the dose with increasing magnitude—up to 55% at 11.25 cm from the treatment field border. These data confirm that accuracy beyond the treatment border is inadequate, and out-of-field data from TPSs should be used only with a clear understanding of this limitation. Studies that require accurate out-of-field dose should use other dose reconstruction methods, such as direct measurements or Monte Carlo calculations. PMID:21076191

  9. B Plant treatment, storage, and disposal (TSD) units inspection plan

    SciTech Connect

    Beam, T.G.

    1996-04-26

    This inspection plan is written to meet the requirements of WAC 173-303 for operations of a TSD facility. Owners/operators of TSD facilities are required to inspection their facility and active waste management units to prevent and/or detect malfunctions, discharges and other conditions potentially hazardous to human health and the environment. A written plan detailing these inspection efforts must be maintained at the facility in accordance with Washington Administrative Code (WAC), Chapter 173-303, ``Dangerous Waste Regulations`` (WAC 173-303), a written inspection plan is required for the operation of a treatment, storage and disposal (TSD) facility and individual TSD units. B Plant is a permitted TSD facility currently operating under interim status with an approved Part A Permit. Various operational systems and locations within or under the control of B Plant have been permitted for waste management activities. Included are the following TSD units: Cell 4 Container Storage Area; B Plant Containment Building; Low Level Waste Tank System; Organic Waste Tank System; Neutralized Current Acid Waste (NCAW) Tank System; Low Level Waste Concentrator Tank System. This inspection plan complies with the requirements of WAC 173-303. It addresses both general TSD facility and TSD unit-specific inspection requirements. Sections on each of the TSD units provide a brief description of the system configuration and the permitted waste management activity, a summary of the inspection requirements, and details on the activities B Plant uses to maintain compliance with those requirements.

  10. In-house quality check of external beam plans using 3D treatment planning systems - a DVH comparison.

    PubMed

    Kumar, Ayyalasomayajula Anil; Akula, Roopa Rani; Ayyangar, Komanduri; P, Krishna Reddy; Vuppu, Srinivas; Narayana, P V Lakshmi; Rao, A Durga Prasada

    2016-01-01

    This paper presents a new approach towards the quality assurance of external beam plans using in-house-developed DICOM import and export software in a clinical setup. The new approach is different from what is currently used in most clinics, viz., only MU and point dose are verified. The DICOM-RT software generates ASCII files to import/export structure sets, treatment beam data, and dose-volume histo-grams (DVH) from one treatment planning system (TPS) to the other. An efficient and reliable 3D planning system, ROPS, was used for verifying the accuracy of treatment plans and treatment plan parameters. With the use of this new approach, treatment plans planned using Varian Eclipse planning system were exported to ROPS planning system. Important treatment and dosimetrical data, such as the beam setup accuracy, target dose coverage, and dose to critical structures, were also quantitatively verified using DVH comparisons. Two external beam plans with diverse photon energies were selected to test the new approach. The satisfactory results show that the new approach is feasible, easy to use, and can be used as an adjunct test for patient treatment quality check. PMID:27167271

  11. Planning and executing a lampricide treatment of the St. Marys River using georeferenced data

    USGS Publications Warehouse

    Fodale, Michael F.; Bergstedt, Roger A.; Cuddy, Douglas W.; Adams, Jean V.; Stolyarenko, Dimitri A.

    2003-01-01

    The St. Marys River is believed to be the primary source of sea lampreys (Petromyzon marinus) in Lake Huron. Planning or evaluating lampricide treatments required knowing where lampricides could effectively be placed and where larvae were located. Accurate maps of larval density were therefore critical to formulating or evaluating management strategies using lampricides. Larval abundance was systematically assessed with a deepwater electrofishing device at 12,000 georeferenced locations during 1993 to 1996. Maps were produced from catches at those locations, providing georeferenced detail previously unavailable. Catches were processed with a geographic information system (GIS), to create a map of larval density. Whole-river treatment scenarios using TFM (3-trifluoromethyl-4-nitrophenol) were evaluated by combining the map with one of lethal conditions predicted by a lampricide-transport model. The map was also used to evaluate spot treatment scenarios with a granular, bottom-release formulation of another lampricide, Bayluscide (2',5-dichloro-4'-nitro-salicylanilide). Potential high-density plots for Bayluscide treatment were selected from the map and estimates of area, cost, and larval population were developed using the GIS. Plots were ranked by the cost per larva killed. Spot treatments were found to be more cost effective than a conventional TFM treatment and Bayluscide was applied to 82 ha in 1998 and 759 ha in 1999. Effectiveness was estimated with stratified-random sampling before and after treatment in 1999 at 35%. Ten percent already had been removed in 1998, for a total reduction of 45% percent. This marked a change in how research and planning were combined in sea lamprey management to minimize treatment costs and evaluate success.

  12. Automated medial axis seeding and guided evolutionary simulated annealing for optimization of gamma knife radiosurgery treatment plans

    NASA Astrophysics Data System (ADS)

    Zhang, Pengpeng

    The Leksell Gamma KnifeRTM (LGK) is a tool for providing accurate stereotactic radiosurgical treatment of brain lesions, especially tumors. Currently, the treatment planning team "forward" plans radiation treatment parameters while viewing a series of 2D MR scans. This primarily manual process is cumbersome and time consuming because the difficulty in visualizing the large search space for the radiation parameters (i.e., shot overlap, number, location, size, and weight). I hypothesize that a computer-aided "inverse" planning procedure that utilizes tumor geometry and treatment goals could significantly improve the planning process and therapeutic outcome of LGK radiosurgery. My basic observation is that the treatment team is best at identification of the location of the lesion and prescribing a lethal, yet safe, radiation dose. The treatment planning computer is best at determining both the 3D tumor geometry and optimal LGK shot parameters necessary to deliver a desirable dose pattern to the tumor while sparing adjacent normal tissue. My treatment planning procedure asks the neurosurgeon to identify the tumor and critical structures in MR images and the oncologist to prescribe a tumoricidal radiation dose. Computer-assistance begins with geometric modeling of the 3D tumor's medial axis properties. This begins with a new algorithm, a Gradient-Phase Plot (G-P Plot) decomposition of the tumor object's medial axis. I have found that medial axis seeding, while insufficient in most cases to produce an acceptable treatment plan, greatly reduces the solution space for Guided Evolutionary Simulated Annealing (GESA) treatment plan optimization by specifying an initial estimate for shot number, size, and location, but not weight. They are used to generate multiple initial plans which become initial seed plans for GESA. The shot location and weight parameters evolve and compete in the GESA procedure. The GESA objective function optimizes tumor irradiation (i.e., as close to

  13. Towards treatment planning and treatment of deep-seated solid tumors by electrochemotherapy

    PubMed Central

    2010-01-01

    Background Electrochemotherapy treats tumors by combining specific chemotherapeutic drugs with an intracellular target and electric pulses, which increases drug uptake into the tumor cells. Electrochemotherapy has been successfully used for treatment of easily accessible superficial tumor nodules. In this paper, we present the first case of deep-seated tumor electrochemotherapy based on numerical treatment planning. Methods The aim of our study was to treat a melanoma metastasis in the thigh of a patient. Treatment planning for electrode positioning and electrical pulse parameters was performed for two different electrode configurations: one with four and another with five long needle electrodes. During the procedure, the four electrode treatment plan was adopted and the patient was treated accordingly by electrochemotherapy with bleomycin. The response to treatment was clinically and radiographically evaluated. Due to a partial response of the treated tumor, the metastasis was surgically removed after 2 months and pathological analysis was performed. Results A partial response of the tumor to electrochemotherapy was obtained. Histologically, the metastasis showed partial necrosis due to electrochemotherapy, estimated to represent 40-50% of the tumor. Based on the data obtained, we re-evaluated the electrical treatment parameters in order to correlate the treatment plan with the clinical response. Electrode positions in the numerical model were updated according to the actual positions during treatment. We compared the maximum value of the measured electric current with the current predicted by the model and good agreement was obtained. Finally, tumor coverage with an electric field above the reversible threshold was recalculated and determined to be approximately 94%. Therefore, according to the calculations, a small volume of tumor cells remained viable after electrochemotherapy, and these were sufficient for tumor regrowth. Conclusions In this, the first

  14. Evaluation of clinical margins via simulation of patient setup errors in prostate IMRT treatment plans

    SciTech Connect

    Gordon, J. J.; Crimaldi, A. J.; Hagan, M.; Moore, J.; Siebers, J. V.

    2007-01-15

    This work evaluates: (i) the size of random and systematic setup errors that can be absorbed by 5 mm clinical target volume (CTV) to planning target volume (PTV) margins in prostate intensity modulated radiation therapy (IMRT); (ii) agreement between simulation results and published margin recipes; and (iii) whether shifting contours with respect to a static dose distribution accurately predicts dose coverage due to setup errors. In 27 IMRT treatment plans created with 5 mm CTV-to-PTV margins, random setup errors with standard deviations (SDs) of 1.5, 3, 5 and 10 mm were simulated by fluence convolution. Systematic errors with identical SDs were simulated using two methods: (a) shifting the isocenter and recomputing dose (isocenter shift), and (b) shifting patient contours with respect to the static dose distribution (contour shift). Maximum tolerated setup errors were evaluated such that 90% of plans had target coverage equal to the planned PTV coverage. For coverage criteria consistent with published margin formulas, plans with 5 mm margins were found to absorb combined random and systematic SDs{approx_equal}3 mm. Published recipes require margins of 8-10 mm for 3 mm SDs. For the prostate IMRT cases presented here a 5 mm margin would suffice, indicating that published recipes may be pessimistic. We found significant errors in individual plan doses given by the contour shift method. However, dose population plots (DPPs) given by the contour shift method agreed with the isocenter shift method for all structures except the nodal CTV and small bowel. For the nodal CTV, contour shift DPP differences were due to the structure moving outside the patient. Small bowel DPP errors were an artifact of large relative differences at low doses. Estimating individual plan doses by shifting contours with respect to a static dose distribution is not recommended. However, approximating DPPs is acceptable, provided care is taken with structures such as the nodal CTV which lie close

  15. 3D volume visualization in remote radiation treatment planning

    NASA Astrophysics Data System (ADS)

    Yun, David Y.; Garcia, Hong-Mei C.; Mun, Seong K.; Rogers, James E.; Tohme, Walid G.; Carlson, Wayne E.; May, Stephen; Yagel, Roni

    1996-03-01

    This paper reports a novel applications of 3D visualization in an ARPA-funded remote radiation treatment planning (RTP) experiment, utilizing supercomputer 3D volumetric modeling power and NASA ACTS (Advanced Communication Technology Satellite) communication bandwidths at the Ka-band range. The objective of radiation treatment is to deliver a tumorcidal dose of radiation to a tumor volume while minimizing doses to surrounding normal tissues. High performance graphics computers are required to allow physicians to view a 3D anatomy, specify proposed radiation beams, and evaluate the dose distribution around the tumor. Supercomputing power is needed to compute and even optimize dose distribution according to pre-specified requirements. High speed communications offer possibilities for sharing scarce and expensive computing resources (e.g., hardware, software, personnel, etc.) as well as medical expertise for 3D treatment planning among hospitals. This paper provides initial technical insights into the feasibility of such resource sharing. The overall deployment of the RTP experiment, visualization procedures, and parallel volume rendering in support of remote interactive 3D volume visualization will be described.

  16. A Monte Carlo dose calculation tool for radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Ma, C.-M.; Li, J. S.; Pawlicki, T.; Jiang, S. B.; Deng, J.; Lee, M. C.; Koumrian, T.; Luxton, M.; Brain, S.

    2002-05-01

    A Monte Carlo user code, MCDOSE, has been developed for radiotherapy treatment planning (RTP) dose calculations. MCDOSE is designed as a dose calculation module suitable for adaptation to host RTP systems. MCDOSE can be used for both conventional photon/electron beam calculation and intensity modulated radiotherapy (IMRT) treatment planning. MCDOSE uses a multiple-source model to reconstruct the treatment beam phase space. Based on Monte Carlo simulated or measured beam data acquired during commissioning, source-model parameters are adjusted through an automated procedure. Beam modifiers such as jaws, physical and dynamic wedges, compensators, blocks, electron cut-outs and bolus are simulated by MCDOSE together with a 3D rectilinear patient geometry model built from CT data. Dose distributions calculated using MCDOSE agreed well with those calculated by the EGS4/DOSXYZ code using different beam set-ups and beam modifiers. Heterogeneity correction factors for layered-lung or layered-bone phantoms as calculated by both codes were consistent with measured data to within 1%. The effect of energy cut-offs for particle transport was investigated. Variance reduction techniques were implemented in MCDOSE to achieve a speedup factor of 10-30 compared to DOSXYZ.

  17. Dose calculation and treatment planning for the Brookhaven NCT Facility

    SciTech Connect

    Liu, H.B.; Brugger, R.M.

    1992-12-31

    Consistency of the calculated to measured fluxes and doses in phantoms is important for confidence in treatment planning for Boron Neutron Capture Therapy at the Brookhaven Medical Research Reactor (BMRR). Two phantoms have been used to measure the thermal and epithermal flux and gamma dose distributions for irradiations at the BMRR and these are compared to MCNP calculations. Since MCNP calculations in phantoms or models would be lengthy if the calculations started each time with fission neutrons from the reactor core, a neutron source plane, which was verified by spectrum and flux measurements at the irradiation port, was designed. Measured doses in phantoms are especially important to verify the simulated neutron source plane. Good agreement between the calculated and measured values has been achieved and this neutron source plane is now used to predict flux and dose information for oncologists to form treatment plans as well as designing collimator and room shielding. In addition, a program using MCNP calculated results as input has been developed to predict reliable flux and dose distributions in the central coronal section of a head model for irradiation by the BMRR beam. Dosimetric comparisons and treatment examples are presented.

  18. Dose calculation and treatment planning for the Brookhaven NCT Facility

    SciTech Connect

    Liu, H.B.; Brugger, R.M.

    1992-01-01

    Consistency of the calculated to measured fluxes and doses in phantoms is important for confidence in treatment planning for Boron Neutron Capture Therapy at the Brookhaven Medical Research Reactor (BMRR). Two phantoms have been used to measure the thermal and epithermal flux and gamma dose distributions for irradiations at the BMRR and these are compared to MCNP calculations. Since MCNP calculations in phantoms or models would be lengthy if the calculations started each time with fission neutrons from the reactor core, a neutron source plane, which was verified by spectrum and flux measurements at the irradiation port, was designed. Measured doses in phantoms are especially important to verify the simulated neutron source plane. Good agreement between the calculated and measured values has been achieved and this neutron source plane is now used to predict flux and dose information for oncologists to form treatment plans as well as designing collimator and room shielding. In addition, a program using MCNP calculated results as input has been developed to predict reliable flux and dose distributions in the central coronal section of a head model for irradiation by the BMRR beam. Dosimetric comparisons and treatment examples are presented.

  19. Generic Planning Target Margin for Rectal Cancer Treatment Setup Variation

    SciTech Connect

    Robertson, John M. Campbell, Jonathon P.; Yan Di

    2009-08-01

    Purpose: To calculate the generic planning target margin (GPTM) for patients receiving radiation therapy (RT) for rectal cancer placed in a prone position with a customized cradle for small-bowel exclusion. Methods and Materials: A total of 25 consecutive rectal cancer patients were treated for 25 or 28 fractions in a prone position using a cradle to maximize small bowel exclusion. Treatment planning computed tomography (CT) scans were used to create orthogonally digitally reconstructed radiographs (DRRs) for portal image registration, which were compared with daily portal images from an electronic portal-imaging device (EPID). Translation values needed to align the DRRs and EPIDs were recorded for the superior to inferior (SI), right to left (RL), and anterior to posterior (AP) directions, and used to calculate the GPTM using the four-parameter model. Age, weight, and body mass index were tested compared with the setup variation using a Pearson correlation and a t test for significance. Gender versus setup variation was compared with a t test. Results: A total of 1,723 EPID images were reviewed. The GPTM was 10 mm superior, 8 mm inferior, 7 mm RL and 10 mm AP. Age and gender were unrelated to setup variation. Weight was significantly associated with systematic AP variation (p < 0.05). BMI was significantly associated with systematic SI (p < 0.05) and AP (p < 0.01) variation and random RL variation (p < 0.05). Conclusions: The GPTM for rectal cancer is asymmetric with a maximum of 10 mm in the superior, anterior and posterior dimensions. Body mass index may effect setup variation. Research using advanced treatment planning should include these margins in the planning target volume definition.

  20. Treatment planning in the radiation therapy of cancer

    SciTech Connect

    Vaeth, J.M.; Meyer, J.

    1987-01-01

    This book provides an overview of aspects involved in the most advanced radiotherapy techniques, and examines in detail their application in planning and delivering optimal treatments in a large number of different forms of cancer. Coverage is given to squamous cell carcinoma of the head and neck, carcinoma of the lung, breast cancer, cancers of the genitourinary system, tumors of the central nervous system, cancer of the esophagus, pancreas, stomach and rectum, soft tissue sarcomas, pediatric radiotherapy, Hodgkin's disease, and finally non-Hodgkin's lymphomas. A general discussion concludes the text.

  1. Current state of the art brachytherapy treatment planning dosimetry algorithms

    PubMed Central

    Pantelis, E; Karaiskos, P

    2014-01-01

    Following literature contributions delineating the deficiencies introduced by the approximations of conventional brachytherapy dosimetry, different model-based dosimetry algorithms have been incorporated into commercial systems for 192Ir brachytherapy treatment planning. The calculation settings of these algorithms are pre-configured according to criteria established by their developers for optimizing computation speed vs accuracy. Their clinical use is hence straightforward. A basic understanding of these algorithms and their limitations is essential, however, for commissioning; detecting differences from conventional algorithms; explaining their origin; assessing their impact; and maintaining global uniformity of clinical practice. PMID:25027247

  2. PREFACE: First European Workshop on Monte Carlo Treatment Planning

    NASA Astrophysics Data System (ADS)

    Reynaert, Nick

    2007-07-01

    The "First European Workshop on Monte Carlo treatment planning", was an initiative of the European working group on Monte Carlo treatment planning (EWG-MCTP). It was organised at Ghent University (Belgium) on 22-25October 2006. The meeting was very successful and was attended by 150 participants. The impressive list of invited speakers and the scientific contributions (posters and oral presentations) have led to a very interesting program, that was well appreciated by all attendants. In addition, the presence of seven vendors of commercial MCTP software systems provided serious added value to the workshop. For each vendor, a representative has given a presentation in a dedicated session, explaining the current status of their system. It is clear that, for "traditional" radiotherapy applications (using photon or electron beams), Monte Carlo dose calculations have become the state of the art, and are being introduced into almost all commercial treatment planning systems. Invited lectures illustrated that scientific challenges are currently associated with 4D applications (e.g. respiratory motion) and the introduction of MC dose calculations in inverse planning. But it was striking that the Monte Carlo technique is also becoming very important in more novel treatment modalities such as BNCT, hadron therapy, stereotactic radiosurgery, Tomotherapy, etc. This emphasizes the continuous growing interest in MCTP. The people who attended the dosimetry session will certainly remember the high level discussion on the determination of correction factors for different ion chambers, used in small fields. The following proceedings will certainly confirm the high scientific level of the meeting. I would like to thank the members of the local organizing committee for all the hard work done before, during and after this meeting. The organisation of such an event is not a trivial task and it would not have been possible without the help of all my colleagues. I would also like to thank

  3. Reducing the Need for Accurate Stream Flow Forecasting for Water Supply Planning by Augmenting Reservoir Operations with Seawater Desalination and Wastewater Recycling

    NASA Astrophysics Data System (ADS)

    Bhushan, R.; Ng, T. L.

    2014-12-01

    Accurate stream flow forecasts are critical for reservoir operations for water supply planning. As the world urban population increases, the demand for water in cities is also increasing, making accurate forecasts even more important. However, accurate forecasting of stream flows is difficult owing to short- and long-term weather variations. We propose to reduce this need for accurate stream flow forecasts by augmenting reservoir operations with seawater desalination and wastewater recycling. We develop a robust operating policy for the joint operation of the three sources. With the joint model, we tap into the unlimited reserve of seawater through desalination, and make use of local supplies of wastewater through recycling. However, both seawater desalination and recycling are energy intensive and relatively expensive. Reservoir water on the other hand, is generally cheaper but is limited and variable in its availability, increasing the risk of water shortage during extreme climate events. We operate the joint system by optimizing it using a genetic algorithm to maximize water supply reliability and resilience while minimizing vulnerability subject to a budget constraint and for a given stream flow forecast. To compute the total cost of the system, we take into account the pumping cost of transporting reservoir water to its final destination, and the capital and operating costs of desalinating seawater and recycling wastewater. We produce results for different hydro climatic regions based on artificial stream flows we generate using a simple hydrological model and an autoregressive time series model. The artificial flows are generated from precipitation and temperature data from the Canadian Regional Climate model for present and future scenarios. We observe that the joint operation is able to effectively minimize the negative effects of stream flow forecast uncertainty on system performance at an overall cost that is not significantly greater than the cost of a

  4. IMRT treatment plans and functional planning with functional lung imaging from 4D-CT for thoracic cancer patients

    PubMed Central

    2013-01-01

    Background and purpose Currently, the inhomogeneity of the pulmonary function is not considered when treatment plans are generated in thoracic cancer radiotherapy. This study evaluates the dose of treatment plans on highly-functional volumes and performs functional treatment planning by incorporation of ventilation data from 4D-CT. Materials and methods Eleven patients were included in this retrospective study. Ventilation was calculated using 4D-CT. Two treatment plans were generated for each case, the first one without the incorporation of the ventilation and the second with it. The dose of the first plans was overlapped with the ventilation and analyzed. Highly-functional regions were avoided in the second treatment plans. Results For small targets in the first plans (PTV < 400 cc, 6 cases), all V5, V20 and the mean lung dose values for the highly-functional regions were lower than that of the total lung. For large targets, two out of five cases had higher V5 and V20 values for the highly-functional regions. All the second plans were within constraints. Conclusion Radiation treatments affect functional lung more seriously in large tumor cases. With compromise of dose to other critical organs, functional treatment planning to reduce dose in highly-functional lung volumes can be achieved PMID:23281734

  5. SU-C-17A-07: The Development of An MR Accelerator-Enabled Planning-To-Delivery Technique for Stereotactic Palliative Radiotherapy Treatment of Spinal Metastases

    SciTech Connect

    Hoogcarspel, S J; Kontaxis, C; Velden, J M van der; Bol, G H; Vulpen, M van; Lagendijk, J J W; Raaymakers, B W

    2014-06-01

    Purpose: To develop an MR accelerator-enabled online planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases. The technical challenges include; automated stereotactic treatment planning, online MR-based dose calculation and MR guidance during treatment. Methods: Using the CT data of 20 patients previously treated at our institution, a class solution for automated treatment planning for spinal bone metastases was created. For accurate dose simulation right before treatment, we fused geometrically correct online MR data with pretreatment CT data of the target volume (TV). For target tracking during treatment, a dynamic T2-weighted TSE MR sequence was developed. An in house developed GPU based IMRT optimization and dose calculation algorithm was used for fast treatment planning and simulation. An automatically generated treatment plan developed with this treatment planning system was irradiated on a clinical 6 MV linear accelerator and evaluated using a Delta4 dosimeter. Results: The automated treatment planning method yielded clinically viable plans for all patients. The MR-CT fusion based dose calculation accuracy was within 2% as compared to calculations performed with original CT data. The dynamic T2-weighted TSE MR Sequence was able to provide an update of the anatomical location of the TV every 10 seconds. Dose calculation and optimization of the automatically generated treatment plans using only one GPU took on average 8 minutes. The Delta4 measurement of the irradiated plan agreed with the dose calculation with a 3%/3mm gamma pass rate of 86.4%. Conclusions: The development of an MR accelerator-enabled planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases was presented. Future work will involve developing an intrafraction motion adaptation strategy, MR-only dose calculation, radiotherapy quality-assurance in a magnetic field, and streamlining the entire treatment

  6. SU-E-T-595: Design of a Graphical User Interface for An In-House Monte Carlo Based Treatment Planning System: Planning and Contouring Tools

    SciTech Connect

    EMAM, M; Eldib, A; Lin, M; Li, J; Chibani, O; Ma, C

    2014-06-01

    Purpose: An in-house Monte Carlo based treatment planning system (MC TPS) has been developed for modulated electron radiation therapy (MERT). Our preliminary MERT planning experience called for a more user friendly graphical user interface. The current work aimed to design graphical windows and tools to facilitate the contouring and planning process. Methods: Our In-house GUI MC TPS is built on a set of EGS4 user codes namely MCPLAN and MCBEAM in addition to an in-house optimization code, which was named as MCOPTIM. Patient virtual phantom is constructed using the tomographic images in DICOM format exported from clinical treatment planning systems (TPS). Treatment target volumes and critical structures were usually contoured on clinical TPS and then sent as a structure set file. In our GUI program we developed a visualization tool to allow the planner to visualize the DICOM images and delineate the various structures. We implemented an option in our code for automatic contouring of the patient body and lungs. We also created an interface window displaying a three dimensional representation of the target and also showing a graphical representation of the treatment beams. Results: The new GUI features helped streamline the planning process. The implemented contouring option eliminated the need for performing this step on clinical TPS. The auto detection option for contouring the outer patient body and lungs was tested on patient CTs and it was shown to be accurate as compared to that of clinical TPS. The three dimensional representation of the target and the beams allows better selection of the gantry, collimator and couch angles. Conclusion: An in-house GUI program has been developed for more efficient MERT planning. The application of aiding tools implemented in the program is time saving and gives better control of the planning process.

  7. Developing an open platform for evidence-based microwave ablation treatment planning and validation

    NASA Astrophysics Data System (ADS)

    Deshazer, Garron; Dupuy, Damian E.; Walsh, Edward; Prakash, Punit; Fairchild, Dillon; Glidden, David; Collins, Scott A.; Cook, Madeleine L.; Ryan, Thomas P.; Merck, Derek

    2015-03-01

    The clinical utility of current thermal ablation planning tools is severely limited by treatment variability. We discuss the development of an open platform for evidence-based thermal ablation treatment planning and validation. Improved predictive treatment modeling and consistent outcome analysis are crucial components for useful planning and guidance tools.

  8. Validity of the Butcher Treatment Planning Inventory as a Measure of Negative Treatment Attitudes

    ERIC Educational Resources Information Center

    Hatchett, Gregory T.

    2007-01-01

    This study evaluated the validity of the Butcher Treatment Planning Inventory (BTPI) as a measure of negative expectations and attitudes toward counseling. Undergraduate students completed the BTPI, the Attitudes Toward Seeking Professional Psychological Help Scale-Abbreviated Version, and the Expectations About Counseling-Brief Form during one…

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

    SciTech Connect

    1999-03-01

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

  10. Sampling and Analysis Plan Waste Treatment Plant Seismic Boreholes Project.

    SciTech Connect

    Brouns, Thomas M.

    2007-07-15

    This sampling and analysis plan (SAP) describes planned data collection activities for four entry boreholes through the sediment overlying the Saddle Mountains Basalt, up to three new deep rotary boreholes through the Saddle Mountains Basalt and sedimentary interbeds, and one corehole through the Saddle Mountains Basalt and sedimentary interbeds at the Waste Treatment Plant (WTP) site. The SAP will be used in concert with the quality assurance plan for the project to guide the procedure development and data collection activities needed to support borehole drilling, geophysical measurements, and sampling. This SAP identifies the American Society of Testing Materials standards, Hanford Site procedures, and other guidance to be followed for data collection activities. Revision 3 incorporates all interim change notices (ICN) that were issued to Revision 2 prior to completion of sampling and analysis activities for the WTP Seismic Boreholes Project. This revision also incorporates changes to the exact number of samples submitted for dynamic testing as directed by the U.S. Army Corps of Engineers. Revision 3 represents the final version of the SAP.

  11. IMRT dose delivery effects in radiotherapy treatment planning using Monte Carlo methods

    NASA Astrophysics Data System (ADS)

    Tyagi, Neelam

    Inter- and intra-leaf transmission and head scatter can play significant roles in Intensity Modulated Radiation Therapy (IMRT)-based treatment deliveries. In order to accurately calculate the dose in the IMRT planning process, it is therefore important that the detailed geometry of the multi-leaf collimator (MLC), in addition to other components in the accelerator treatment head be accurately modeled. In this thesis Monte Carlo (MC) methods have been used to model the treatment head of a Varian linear accelerator. A comprehensive model of the Varian 120-leaf MLC has been developed within the DPM MC code and has been verified against measurements in homogeneous and heterogeneous phantom geometries under different IMRT delivery circumstances. Accuracy of the MLC model in simulating details in the leaf geometry has been established over a range of arbitrarily shaped fields and IMRT fields. A sensitivity analysis of the effect of the electron-on-target parameters and the structure of the flattening filter on the accuracy of calculated dose distributions has been conducted. Adjustment of the electron-on-target parameters resulting in optimal agreement with measurements was an iterative process, with the final parameters representing a tradeoff between small (3x3 cm2) and large (40x40 cm2) field sizes. A novel method based on adaptive kernel density estimation, in the phase space simulation process is also presented as an alternative to particle recycling. Using this model dosimetric differences between MLC-based static (SMLC) and dynamic (DMLC) deliveries have been investigated. Differences between SMLC and DMLC, possibly related to fluence and/or spectral changes, appear to vary systematically with the density of the medium. The effect of fluence modulation due to leaf sequencing shows differences, up to 10% between plans developed with 1% and 10% fluence intervals for both SMLC and DMLC-delivered sequences. Dose differences between planned and delivered leaf sequences

  12. Adjoint methods for external beam inverse treatment planning

    NASA Astrophysics Data System (ADS)

    Kowalok, Michael E.

    Forward and adjoint radiation transport methods may both be used to determine the dosimetric relationship between source parameters and voxel elements of a phantom. Forward methods consider one specific tuple of source parameters and calculate the response in all voxels of interest. This response is often cast as the dose delivered per unit source-weight. Adjoint transport methods, conversely, consider one particular voxel and calculate the response of that voxel in relation to all possible source parameters. In this regard, adjoint methods provide an "adjoint function" in addition to a dose value. Although the dose is for a single voxel only, the adjoint function illustrates the source parameters, (e.g. beam positions and directions) that are most important to delivering the dose to that voxel. In this regard, adjoint methods of analysis lend themselves in a natural way to optimization problems and perturbation studies. This work investigates the utility of adjoint analytic methods for treatment planning and for Monte Carlo dose calculations. Various methods for implementing this approach are discussed, along with their strengths and weaknesses. The complementary nature of adjoint and forward techniques is illustrated and exploited. Also, several features of the Monte Carlo codes MCNP and MCNPX are reviewed for treatment planning applications.

  13. Integrated Waste Treatment Unit GFSI Risk Management Plan

    SciTech Connect

    W. A. Owca

    2007-06-21

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

  14. Dose calculation accuracy of lung planning with a commercial IMRT treatment planning system.

    PubMed

    McDermott, Patrick N; He, Tongming; DeYoung, A

    2003-01-01

    The dose calculation accuracy of a commercial pencil beam IMRT planning system is evaluated by comparison with Monte Carlo calculations and measurements in an anthropomorphic phantom. The target volume is in the right lung and mediastinum and thus significant tissue inhomogeneities are present. The Monte Carlo code is an adaptation of the MCNP code and the measurements were made with TLD and film. Both the Monte Carlo code and the measurements show very good agreement with the treatment planning system except in regions where the dose is high and the electron density is low. In these regions the commercial system shows doses up to 10% higher than Monte Carlo and film. The average calculated dose for the CTV is 5% higher with the commercial system as compared to Monte Carlo. PMID:14604424

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

    SciTech Connect

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

    2007-12-01

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

  16. Feasibility and limitations of bulk density assignment in MRI for head and neck IMRT treatment planning.

    PubMed

    Chin, Alexander L; Lin, Alexander; Anamalayil, Shibu; Teo, Boon-Keng Kevin

    2014-01-01

    Head and neck cancers centered at the base of skull are better visualized on MRI than on CT. The purpose of this investigation was to investigate the accuracy of bulk density assignment in head and neck intensity-modulated radiation therapy (IMRT) treatment plan optimization. Our study investigates dose calculation differences between density-assigned MRI and CT, and identifies potential limitations related to dental implants and MRI geometrical distortion in the framework of MRI-only-based treatment planning. Bulk density assignment was performed and applied onto MRI to generate three MRI image sets with increasing levels of heterogeneity for seven patients: 1) MRIW: all water-equivalent; 2) MRIW+B: included bone with density of 1.53 g/cm3; and 3) MRIW+B+A: included bone and air. Using identical planning and optimization parameters, MRI-based IMRT plans were generated and compared to corresponding, forward-calculated, CT-based plans on the basis of target coverage, isodose distributions, and dose-volume histograms (DVHs). Phantom studies were performed to assess the magnitude and spatial dependence of MRI geometrical distortion. MRIW-based dose calculations overestimated target coverage by 16.1%. Segmentation of bone reduced differences to within 2% of the coverage area on the CT-based plan. Further segmentation of air improved conformity near air-tissue interfaces. Dental artifacts caused substantial target coverage overestimation even on MRIW+B+A. Geometrical distortion was less than 1 mm in an imaging volume 20 × 20 × 20 cm3 around scanner isocenter, but up to 4 mm at 17 cm lateral to isocenter. Bulk density assignment in the framework of MRI-only IMRT head and neck treatment planning is a feasible method with certain limitations. Bone and teeth account for the majority of density heterogeneity effects. While soft tissue is well visualized on MRI compared to CT, dental implants may not be visible on MRI and must be identified by other means and assigned

  17. Development and validation of a treatment planning model for magnetic nanoparticle hyperthermia cancer therapy

    NASA Astrophysics Data System (ADS)

    Stigliano, Robert Vincent

    The use of magnetic nanoparticles (mNPs) to induce local hyperthermia has been emerging in recent years as a promising cancer therapy, in both a stand-alone and combination treatment setting, including surgery radiation and chemotherapy. The mNP solution can be injected either directly into the tumor, or administered intravenously. Studies have shown that some cancer cells associate with, internalize, and aggregate mNPs more preferentially than normal cells, with and without antibody targeting. Once the mNPs are delivered inside the cells, a low frequency (30-300kHz) alternating electromagnetic field is used to activate the mNPs. The nanoparticles absorb the applied field and provide localized heat generation at nano-micron scales. Treatment planning models have been shown to improve treatment efficacy in radiation therapy by limiting normal tissue damage while maximizing dose to the tumor. To date, there does not exist a clinical treatment planning model for magnetic nanoparticle hyperthermia which is robust, validated, and commercially available. The focus of this research is on the development and experimental validation of a treatment planning model, consisting of a coupled electromagnetic and thermal model that predicts dynamic thermal distributions during treatment. When allowed to incubate, the mNPs are often sequestered by cancer cells and packed into endosomes. The proximity of the mNPs has a strong influence on their ability to heat due to interparticle magnetic interaction effects. A model of mNP heating which takes into account the effects of magnetic interaction was developed, and validated against experimental data. An animal study in mice was conducted to determine the effects of mNP solution injection duration and PEGylation on macroscale mNP distribution within the tumor, in order to further inform the treatment planning model and future experimental technique. In clinical applications, a critical limiting factor for the maximum applied field is

  18. Coverage-based treatment planning to accommodate delineation uncertainties in prostate cancer treatment

    PubMed Central

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

    2015-01-01

    Purpose: To compare two coverage-based planning (CP) techniques with fixed margin-based (FM) planning for high-risk prostate cancer treatments, with the exclusive consideration of the dosimetric impact of delineation uncertainties of target structures and normal tissues. Methods: In this work, 19-patient data sets were involved. To estimate structure dose for each delineated contour under the influence of interobserver contour variability and CT image quality limitations, 1000 alternative structures were simulated by an average-surface-of-standard-deviation model, which utilized the patient-specific information of delineated structure and CT image contrast. An IMRT plan with zero planning-target-volume (PTV) margin on the delineated prostate and seminal vesicles [clinical-target-volume (CTVprostate) and CTVSV] was created and dose degradation due to contour variability was quantified by the dosimetric consequences of 1000 alternative structures. When D98 failed to achieve a 95% coverage probability objective D98,95 ≥ 78 Gy (CTVprostate) or D98,95 ≥ 66 Gy (CTVSV), replanning was performed using three planning techniques: (1) FM (PTVprostate margin = 4,5,6 mm and PTVSV margin = 4,5,7 mm for RL, PA, and SI directions, respectively), (2) CPOM which optimized uniform PTV margins for CTVprostate and CTVSV to meet the D98,95 objectives, and (3) CPCOP which directly optimized coverage-based objectives for all the structures. These plans were intercompared by computing percentile dose-volume histograms and tumor-control probability/normal tissue complication probability (TCP/NTCP) distributions. Results: Inherent contour variability resulted in unacceptable CTV coverage for the zero-PTV-margin plans for all patients. For plans designed to accommodate contour variability, 18/19 CP plans were most favored by achieving desirable D98,95 and TCP/NTCP values. The average improvement of probability of complication free control was 9.3% for CPCOP plans and 3.4% for CPOM plans

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  20. Plutonium Finishing Plan (PFP) Treatment and Storage Unit Waste Analysis Plan

    SciTech Connect

    PRIGNANO, A.L.

    2000-07-01

    The purpose of this waste analysis plan (WAP) is to document waste analysis activities associated with the Plutonium Finishing Plant Treatment and Storage Unit (PFP Treatment and Storage Unit) to comply with Washington Administrative Code (WAC) 173-303-300(1), (2), (4)(a) and (5). The PFP Treatment and Storage Unit is an interim status container management unit for plutonium bearing mixed waste radiologically managed as transuranic (TRU) waste. TRU mixed (TRUM) waste managed at the PFP Treatment and Storage Unit is destined for the Waste Isolation Pilot Plant (WIPP) and therefore is not subject to land disposal restrictions [WAC 173-303-140 and 40 CFR 268]. The PFP Treatment and Storage Unit is located in the 200 West Area of the Hanford Facility, Richland Washington (Figure 1). Because dangerous waste does not include source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of this documentation. The information on radionuclides is provided only for general knowledge.

  1. PDT in the thoracic cavity: Spectroscopic methods and fluence modeling for treatment planning

    NASA Astrophysics Data System (ADS)

    Meo, Julia Lauren

    oxygenation (reflectance measurements) and drug concentration (fluorescence measurements) of different tissues in vivo, before and after treatment, in patients enrolled the Phase I HPPH study ongoing at the University of Pennsylvania. This work aims to provide the building blocks essential to pleural PDT treatment planning by more accurately calculating the required fluence using a model that accounts for the effects of treatment geometry and optical properties measured in vivo.

  2. Practical implementation of enhanced dynamic wedge in the CadPlan treatment planning system.

    PubMed

    Samuelsson, A; Johansson, K A; Mattsson, O; Palm, A; Puurunen, H; Sernbo, G

    1997-01-01

    The Varian CadPlan algorithm for computation of relative dose distributions and monitor unit calculations for Enhanced Dynamic Wedge (EDW) fields is based on a combination of open field beam data and Segmented Treatment data Tables. Calculation of dose by the pencil beam convolution model uses scatter kernels and boundary kernels to create the distribution. The principles of the pencil beam convolution model is presented. Comparison of measured and calculated monitor units and relative dose distributions showed good agreement and the deviations are within international accepted tolerans. Test results indicate that the EDW model works satisfactorily for all energies and wedge angles. PMID:9307952

  3. 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

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

    SciTech Connect

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

    2014-06-01

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

  5. Image guidance, treatment planning and evaluation of cancer interstitial focal therapy using liposomal radionuclides

    NASA Astrophysics Data System (ADS)

    Ware, Steve William

    Focally ablative therapy of cancer has gained significant interest recently. Improvements in diagnostic techniques have created possibilities for treatment which were once clinically unfeasible. Imaging must be capable of allowing accurate diagnosis, staging and planning upon initiation of therapy. Recent improvements in MRI and molecular imaging techniques have made it possible to accurately localize lesions and in so doing, improve the accuracy of proposed focal treatments. Using multimodality imaging it is now possible to target, plan and evaluate interstitial focal treatment using liposome encapsulated beta emitting radionuclides in a variety of cancer types. Since most absorbed dose is deposited early and heterogeneously in beta-radionuclide therapy, investigation of the resultant molecular and cellular events during this time is important for evaluating treatment efficacy. Additionally, investigating a multifocal entity such as prostate cancer is helpful for determining whether MRI is capable of discriminating the proper lesion for therapy. Correlation of MRI findings with histopathology can further improve the accuracy of interstitial focal radionuclide therapy by providing non-invasive surrogates for tissue compartment sizes. In the application of such therapies, compartmental sizes are known to heavily influence the distribution of injected agents. This has clear dosimetric implications with the potential to significantly alter the efficacy of treatment. The hypothesis of this project was that multimodality imaging with magnetic resonance imaging (MRI), autoradiography (AR), and single photon emission computed tomography (SPECT) could be used to target, plan, and evaluate interstitial focal therapy with non-sealed source, liposome-encapsulated 186Re beta emitting radionuclides. The specific aims of this project were to 1) Identify suitable targets for interstitial focal therapy. This was done by retrospectively analyzing MRI data to characterize the tumor

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

    SciTech Connect

    Hickey, Eva E.; Strom, Daniel J.

    2005-08-01

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

  7. A trichrome beam model for biological dose calculation in scanned carbon-ion radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Inaniwa, T.; Kanematsu, N.

    2015-01-01

    underestimated the RBE within the target due to the assumption of no radial variations in radiation quality. Conversely, the trichrome model accurately predicted the RBE even in a small target. Our results verify the applicability of the trichrome model for clinical use in C-ion radiotherapy treatment planning.

  8. BNCT-RTPE: BNCT radiation treatment planning environment

    SciTech Connect

    Wessol, D.E.; Wheeler, F.J.; Babcock, R.S.

    1995-11-01

    Several improvements have been developed for the BNCT radiation treatment planning environment (BNCT-Rtpe) during 1994. These improvements have been incorporated into Version 1.0 of BNCT-Rtpe which is currently installed at the INEL, BNL, Japanese Research Center (JRC), and Finland`s Technical Research Center. Platforms supported by this software include Hewlett-Packard (HP), SUN, International Business Machines (IBM), and Silicon Graphics Incorporated (SGI). A draft version of the BNCT-Rtpe user manual is available. Version 1.1 of BNCT-Rtpe is scheduled for release in March 1995. It is anticipated that Version 2.x of BNCT-Rtpe, which includes the nonproprietary NURBS library and data structures, will be released in September 1995.

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

    SciTech Connect

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

    2014-06-15

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

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

    SciTech Connect

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

    2012-08-01

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

  11. The Potential for an Enhanced Role for MRI in Radiation-therapy Treatment Planning

    PubMed Central

    Metcalfe, P.; Liney, G. P.; Holloway, L.; Walker, A.; Barton, M.; Delaney, G. P.; Vinod, S.; Tomé, W.

    2013-01-01

    The exquisite soft-tissue contrast of magnetic resonance imaging (MRI) has meant that the technique is having an increasing role in contouring the gross tumor volume (GTV) and organs at risk (OAR) in radiation therapy treatment planning systems (TPS). MRI-planning scans from diagnostic MRI scanners are currently incorporated into the planning process by being registered to CT data. The soft-tissue data from the MRI provides target outline guidance and the CT provides a solid geometric and electron density map for accurate dose calculation on the TPS computer. There is increasing interest in MRI machine placement in radiotherapy clinics as an adjunct to CT simulators. Most vendors now offer 70 cm bores with flat couch inserts and specialised RF coil designs. We would refer to these devices as MR-simulators. There is also research into the future application of MR-simulators independent of CT and as in-room image-guidance devices. It is within the background of this increased interest in the utility of MRI in radiotherapy treatment planning that this paper is couched. The paper outlines publications that deal with standard MRI sequences used in current clinical practice. It then discusses the potential for using processed functional diffusion maps (fDM) derived from diffusion weighted image sequences in tracking tumor activity and tumor recurrence. Next, this paper reviews publications that describe the use of MRI in patient-management applications that may, in turn, be relevant to radiotherapy treatment planning. The review briefly discusses the concepts behind functional techniques such as dynamic contrast enhanced (DCE), diffusion-weighted (DW) MRI sequences and magnetic resonance spectroscopic imaging (MRSI). Significant applications of MR are discussed in terms of the following treatment sites: brain, head and neck, breast, lung, prostate and cervix. While not yet routine, the use of apparent diffusion coefficient (ADC) map analysis indicates an exciting future

  12. SU-C-BRB-03: Novel Technique to Implement GRID Therapy in a Commercial Treatment Planning System

    SciTech Connect

    Park, H; Mohiuddin, M; Yaldo, D; Tom, B; Worlikar, N

    2015-06-15

    Purpose: Due to the difficulty of creating an accurate multi-aperture block in treatment planning systems (TPS), spatially fractionated radiation therapy (GRID Therapy) is limited to clinical setups using simple monitor unit calculations. In this work, we present a novel approach to accurately model a grid block in a TPS and evaluate its dosimetric accuracy. Methods: An acrylic GRID block was fashioned such that the hole size and spacing were the same dimensions of the brass GRID block (dotDecimal) at isocenter. Holes were non-divergent and drilled 1 cm deep. CT scans (RT Lightspeed, GE Healthcare) of the block were acquired using axial slices with a thickness of 0.625 mm. These were imported into Eclipse (version 11, Varian Medical Systems) and holes were auto-contoured into structures. The GRID block was created in Eclipse by forming apertures around the hole structures using a simple three step process. Treatment plans were created in a water-equivalent phantom using 6 and 10 MV beams, delivered with a linear accelerator (Clinac iX, Varian Medical Systems) and measured using a water tank, film and a diode array. Results: Comparisons of percent depth dose curves and profiles at depths of maximum dose, 5cm, and 10cm for field sizes ranging from 5 cm{sup 2} to 25 cm{sup 2} using water and film were within 3% of their respective positions in Eclipse. GRID plans utilizing various jaw sizes and MLC blocking measured with film and a diode array showed pass rates with an average of 97% using Gamma analysis at 3%/ 3 mm and no lower than 93%. Conclusion: We have developed a simple yet accurate method of incorporating a GRID block into a commercially available TPS and demonstrated that the TPS accurately reflects the dose delivered. This will allow for real-time planning using patient scans and encourage new methods for GRID therapy. Support provided by dotDecimal, Sanford, FL.

  13. Rational design of antibiotic treatment plans: a treatment strategy for managing evolution and reversing resistance.

    PubMed

    Mira, Portia M; Crona, Kristina; Greene, Devin; Meza, Juan C; Sturmfels, Bernd; Barlow, Miriam

    2015-01-01

    The development of reliable methods for restoring susceptibility after antibiotic resistance arises has proven elusive. A greater understanding of the relationship between antibiotic administration and the evolution of resistance is key to overcoming this challenge. Here we present a data-driven mathematical approach for developing antibiotic treatment plans that can reverse the evolution of antibiotic resistance determinants. We have generated adaptive landscapes for 16 genotypes of the TEM β-lactamase that vary from the wild type genotype "TEM-1" through all combinations of four amino acid substitutions. We determined the growth rate of each genotype when treated with each of 15 β-lactam antibiotics. By using growth rates as a measure of fitness, we computed the probability of each amino acid substitution in each β-lactam treatment using two different models named the Correlated Probability Model (CPM) and the Equal Probability Model (EPM). We then performed an exhaustive search through the 15 treatments for substitution paths leading from each of the 16 genotypes back to the wild type TEM-1. We identified optimized treatment paths that returned the highest probabilities of selecting for reversions of amino acid substitutions and returning TEM to the wild type state. For the CPM model, the optimized probabilities ranged between 0.6 and 1.0. For the EPM model, the optimized probabilities ranged between 0.38 and 1.0. For cyclical CPM treatment plans in which the starting and ending genotype was the wild type, the probabilities were between 0.62 and 0.7. Overall this study shows that there is promise for reversing the evolution of resistance through antibiotic treatment plans. PMID:25946134

  14. A surrogate-based metaheuristic global search method for beam angle selection in radiation treatment planning

    PubMed Central

    Zhang, H H; Gao, S; Chen, W; Shi, L; D’Souza, W D; Meyer, R R

    2013-01-01

    An important element of radiation treatment planning for cancer therapy is the selection of beam angles (out of all possible coplanar and non-coplanar angles in relation to the patient) in order to maximize the delivery of radiation to the tumor site and minimize radiation damage to nearby organs-at-risk. This category of combinatorial optimization problem is particularly difficult because direct evaluation of the quality of treatment corresponding to any proposed selection of beams requires the solution of a large-scale dose optimization problem involving many thousands of variables that represent doses delivered to volume elements (voxels) in the patient. However, if the quality of angle sets can be accurately estimated without expensive computation, a large number of angle sets can be considered, increasing the likelihood of identifying a very high quality set. Using a computationally efficient surrogate beam set evaluation procedure based on single-beam data extracted from plans employing equally-spaced beams (eplans), we have developed a global search metaheuristic process based on the Nested Partitions framework for this combinatorial optimization problem. The surrogate scoring mechanism allows us to assess thousands of beam set samples within a clinically acceptable time frame. Tests on difficult clinical cases demonstrate that the beam sets obtained via our method are superior quality. PMID:23459411

  15. A surrogate-based metaheuristic global search method for beam angle selection in radiation treatment planning

    NASA Astrophysics Data System (ADS)

    Zhang, H. H.; Gao, S.; Chen, W.; Shi, L.; D'Souza, W. D.; Meyer, R. R.

    2013-03-01

    An important element of radiation treatment planning for cancer therapy is the selection of beam angles (out of all possible coplanar and non-coplanar angles in relation to the patient) in order to maximize the delivery of radiation to the tumor site and minimize radiation damage to nearby organs-at-risk. This category of combinatorial optimization problem is particularly difficult because direct evaluation of the quality of treatment corresponding to any proposed selection of beams requires the solution of a large-scale dose optimization problem involving many thousands of variables that represent doses delivered to volume elements (voxels) in the patient. However, if the quality of angle sets can be accurately estimated without expensive computation, a large number of angle sets can be considered, increasing the likelihood of identifying a very high quality set. Using a computationally efficient surrogate beam set evaluation procedure based on single-beam data extracted from plans employing equally-spaced beams (eplans), we have developed a global search metaheuristic process based on the nested partitions framework for this combinatorial optimization problem. The surrogate scoring mechanism allows us to assess thousands of beam set samples within a clinically acceptable time frame. Tests on difficult clinical cases demonstrate that the beam sets obtained via our method are of superior quality.

  16. Concurrent multimodality image segmentation by active contours for radiotherapy treatment planning

    SciTech Connect

    El Naqa, Issam; Yang Deshan; Apte, Aditya; Khullar, Divya; Mutic, Sasa; Zheng Jie; Bradley, Jeffrey D.; Grigsby, Perry; Deasy, Joseph O.

    2007-12-15

    Multimodality imaging information is regularly used now in radiotherapy treatment planning for cancer patients. The authors are investigating methods to take advantage of all the imaging information available for joint target registration and segmentation, including multimodality images or multiple image sets from the same modality. In particular, the authors have developed variational methods based on multivalued level set deformable models for simultaneous 2D or 3D segmentation of multimodality images consisting of combinations of coregistered PET, CT, or MR data sets. The combined information is integrated to define the overall biophysical structure volume. The authors demonstrate the methods on three patient data sets, including a nonsmall cell lung cancer case with PET/CT, a cervix cancer case with PET/CT, and a prostate patient case with CT and MRI. CT, PET, and MR phantom data were also used for quantitative validation of the proposed multimodality segmentation approach. The corresponding Dice similarity coefficient (DSC) was 0.90{+-}0.02 (p<0.0001) with an estimated target volume error of 1.28{+-}1.23% volume. Preliminary results indicate that concurrent multimodality segmentation methods can provide a feasible and accurate framework for combining imaging data from different modalities and are potentially useful tools for the delineation of biophysical structure volumes in radiotherapy treatment planning.

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

    SciTech Connect

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

    2014-11-01

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

  18. Comprehensive Risk-Based Diagnostically Driven Treatment Planning: Developing Sequentially Generated Treatment.

    PubMed

    Kois, Dean E; Kois, John C

    2015-07-01

    The clinical example presented in this article demonstrates a risk-based, diagnostically driven treatment planning approach by focusing on 4 key categories: periodontal, biomechanical, functional, dentofacial. In addition, our unique approach allowed the comprehensive clinical management of a patient with complex restorative needs. A full-mouth rehabilitation was completed sequentially without sacrificing the amount of dentistry necessary to restore health, comfort, function, and esthetics. The result exceeded the patient's expectation and was made financially possible by extending treatment over numerous years. PMID:26140967

  19. Effective spatially fractionated GRID radiation treatment planning for a passive grid block

    PubMed Central

    Mohiuddin, M; Devic, S; Moftah, B

    2015-01-01

    times, having significant impact on patient throughput. Conclusion: The proposed method supports and helps to standardize the clinical implementation of the grid block in a safer and more accurate way. Advances in knowledge: This work describes the method to implement treatment planning for the grid block technique in radiotherapy departments. PMID:25382164

  20. CT based 3D Monte Carlo radiation therapy treatment planning.

    PubMed

    Wallace, S; Allen, B J

    1998-06-01

    This paper outlines the "voxel reconstruction" technique used to model the macroscopic human anatomy of the cranial, abdominal and cervical regions directly from CT scans. Tissue composition, density, and radiation transport characteristics were assigned to each individual volume element (voxel) automatically depending on its greyscale number and physical location. Both external beam and brachytherapy treatment techniques were simulated using the Monte Carlo radiation transport code MCNP (Monte Carlo N-Particle) version 3A. To obtain a high resolution dose calculation, yet not overly extend computational times, variable voxel sizes have been introduced. In regions of interest where high attention to anatomical detail and dose calculation was required, the voxel dimensions were reduced to a few millimetres. In less important regions that only influence the region of interest via scattered radiation, the voxel dimensions were increased to the scale of centimetres. With the use of relatively old (1991) supercomputing hardware, dose calculations were performed in under 10 hours to a standard deviation of 5% in each voxel with a resolution of a few millimetres--current hardware should substantially improve these figures. It is envisaged that with coupled photon/electron transport incorporated into MCNP version 4A and 4B, conventional photon and electron treatment planning will be undertaken using this technique, in addition to neutron and associated photon dosimetry presented here. PMID:9745789

  1. Functional and molecular image guidance in radiotherapy treatment planning optimization.

    PubMed

    Das, Shiva K; Ten Haken, Randall K

    2011-04-01

    Functional and molecular imaging techniques are increasingly being developed and used to quantitatively map the spatial distribution of parameters, such as metabolism, proliferation, hypoxia, perfusion, and ventilation, onto anatomically imaged normal organs and tumor. In radiotherapy optimization, these imaging modalities offer the promise of increased dose sparing to high-functioning subregions of normal organs or dose escalation to selected subregions of the tumor as well as the potential to adapt radiotherapy to functional changes that occur during the course of treatment. The practical use of functional/molecular imaging in radiotherapy optimization must take into cautious consideration several factors whose influences are still not clearly quantified or well understood including patient positioning differences between the planning computed tomography and functional/molecular imaging sessions, image reconstruction parameters and techniques, image registration, target/normal organ functional segmentation, the relationship governing the dose escalation/sparing warranted by the functional/molecular image intensity map, and radiotherapy-induced changes in the image intensity map over the course of treatment. The clinical benefit of functional/molecular image guidance in the form of improved local control or decreased normal organ toxicity has yet to be shown and awaits prospective clinical trials addressing this issue. PMID:21356479

  2. Orthodontic-endodontic treatment planning of traumatized teeth.

    PubMed

    Steiner, D R; West, J D

    1997-03-01

    Occasionally, an orthodontic patient will accidentally traumatize a maxillary anterior tooth before or during orthodontic treatment. In some situations, the trauma will be substantial and avulse the tooth. In other accidents, the tooth may not avulse, but the pulp becomes nonvital. If the pulp is devitalized, and the root has not fully formed, the apex of the root canal may be wide. In this situation, the endodontist may recommend apexification procedures to help close the apex before conventional obturation of the root canal. If the patient is currently undergoing orthodontic movement of the traumatized incisor, what effect will the tooth movement have on the success of the apexification? If the tooth were avulsed, replanted, and then ankylosed, should it be extracted? If so, when should the ankylosed incisor be removed? What effect will further facial growth have on the ankylosed tooth and the potential to achieve a successful esthetic restoration? The answers to these questions are important during the interdisciplinary treatment planning of the patient with traumatized teeth. This article will elucidate the endodontic-orthodontic considerations for patients with traumatized anterior teeth. PMID:9206471

  3. An efficient framework for photon Monte Carlo treatment planning.

    PubMed

    Fix, Michael K; Manser, Peter; Frei, Daniel; Volken, Werner; Mini, Roberto; Born, Ernst J

    2007-10-01

    Currently photon Monte Carlo treatment planning (MCTP) for a patient stored in the patient database of a treatment planning system (TPS) can usually only be performed using a cumbersome multi-step procedure where many user interactions are needed. This means automation is needed for usage in clinical routine. In addition, because of the long computing time in MCTP, optimization of the MC calculations is essential. For these purposes a new graphical user interface (GUI)-based photon MC environment has been developed resulting in a very flexible framework. By this means appropriate MC transport methods are assigned to different geometric regions by still benefiting from the features included in the TPS. In order to provide a flexible MC environment, the MC particle transport has been divided into different parts: the source, beam modifiers and the patient. The source part includes the phase-space source, source models and full MC transport through the treatment head. The beam modifier part consists of one module for each beam modifier. To simulate the radiation transport through each individual beam modifier, one out of three full MC transport codes can be selected independently. Additionally, for each beam modifier a simple or an exact geometry can be chosen. Thereby, different complexity levels of radiation transport are applied during the simulation. For the patient dose calculation, two different MC codes are available. A special plug-in in Eclipse providing all necessary information by means of Dicom streams was used to start the developed MC GUI. The implementation of this framework separates the MC transport from the geometry and the modules pass the particles in memory; hence, no files are used as the interface. The implementation is realized for 6 and 15 MV beams of a Varian Clinac 2300 C/D. Several applications demonstrate the usefulness of the framework. Apart from applications dealing with the beam modifiers, two patient cases are shown. Thereby

  4. 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.

  5. Sci—Thur PM: Planning and Delivery — 02: Treatment planning workflow for very high-energy electron beam radiotherapy

    SciTech Connect

    Bazalova, Magdalena; Qu, Bradley; Palma, Bianey; Maxim, Peter; Loo, Billy; Hårdemark, Bjorn; Hynning, Elin

    2014-08-15

    Purpose: To develop treatment planning workflow for rapid radiotherapy delivered with very-high energy electron (VHEE) scanning beam. Methods: VHEE radiotherapy treatment planning was performed by linking Monte Carlo (MC) dose calculations with inverse optimization in a research version of RayStation. In order to study a number of treatment parameters, a Matlab graphical user interface (GUI) for calculation of VHEE beamlet dose was developed. Through the GUI, EGSnrc MC simulations were run for a number of beam energies, number of beams, beamlet spot and grid sizes, and machine bore sizes. VHEE plans for a pediatric patient with a 4.3 cm{sup 3} brain target optimized with spot-scanning algorithm in RayStation were compared to the clinically delivered 6 MV VMAT plan. Results and Discussion: VHEE beam energy had the largest effect on the quality of dose distributions. For the same target dose, the mean doses to critical organs decreased by 10–15% when planned with 100 MeV compared to 60 MeV. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams. While beamlet spacing and bore size had a small effect on VHEE dose distributions, 0.1-3mm beamlet sizes resulted in identical dose distributions. Critical organ doses were by up to 70% lower in the best VHEE plan compared to the clinical 6 MV VMAT plan. Conclusions: We have developed a GUI for MC beamlet generation for treatment planning of VHEE radiotherapy. We have demonstrated that pediatric VHEE plans resulted in significant critical organ dose sparing compared to the clinical VMAT plan.

  6. Assessments for High Dose Radionuclide Therapy Treatment Planning

    SciTech Connect

    Fisher, Darrell R.

    2003-10-01

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

  7. SU-E-T-575: Isocenter Shifts in Treatment Planning and Its Clinical Implications

    SciTech Connect

    Ahmed, Y; Damiani, S; Cao, Y; Jamshidi, A

    2014-06-01

    Purpose: To investigate causes of isocenter shifts in treatment planning and its clinical impact on patient treatment efficiency and safety. Methods/Materials: Treatment planning data of 340 patients under treatment over 8 weeks period were gathered to identify isocenter shifts according to site of the treatment, types of treatment plan or types of the machine used. Treatment plans included inversed and forward IMRT, as well as 3D plans. Treatment sites included pelvis, chest, abdomen, breasts, head and necks and extremities. Re-planning were performed without the isocenter shift for pelvis and chest plans, the dosimetric parameters such as PTV coverage, and dose sparing of OARs of these plans were analyzed and compared. Results/Discussions: Results showed that the isocenter shift was always necessary for some of sites such as breasts, two or more distinctive PTVs, or special cases such as large PTV treated with enhanced dynamic wedge. Many other cases, the re-planning results indicated 53% of the plans that the same quality of the plan can be achieved without the shift of the isocenter. Repositioning patients on a daily basis demanded unambiguous instructions for therapists for patient setups, and additional time to perform the shifts before treatment. Opportunities for error propagation exist during the communication and hand-over of such plans. Conclusion: Isocenter shifts demanded unambiguous instructions and times for therapists for daily patient setups, therefore it impacted both safety and efficiency of the patient treatment. Based on the analysis, the isocenter shifts were unavoidable for cases such as treatment of multiple sites, overcoming limitations of treatment machines, and/or sometime better dosimetry. However, we found many initially proposed shifts may have been eliminated either by careful planning or by improved CT simulation process such as detailed review of the images and localization of the PTV during simulation.

  8. Feasibility assessment of the interactive use of a Monte Carlo algorithm in treatment planning for intraoperative electron radiation therapy

    NASA Astrophysics Data System (ADS)

    Guerra, Pedro; Udías, José M.; Herranz, Elena; Santos-Miranda, Juan Antonio; Herraiz, Joaquín L.; Valdivieso, Manlio F.; Rodríguez, Raúl; Calama, Juan A.; Pascau, Javier; Calvo, Felipe A.; Illana, Carlos; Ledesma-Carbayo, María J.; Santos, Andrés

    2014-12-01

    This work analysed the feasibility of using a fast, customized Monte Carlo (MC) method to perform accurate computation of dose distributions during pre- and intraplanning of intraoperative electron radiation therapy (IOERT) procedures. The MC method that was implemented, which has been integrated into a specific innovative simulation and planning tool, is able to simulate the fate of thousands of particles per second, and it was the aim of this work to determine the level of interactivity that could be achieved. The planning workflow enabled calibration of the imaging and treatment equipment, as well as manipulation of the surgical frame and insertion of the protection shields around the organs at risk and other beam modifiers. In this way, the multidisciplinary team involved in IOERT has all the tools necessary to perform complex MC dosage simulations adapted to their equipment in an efficient and transparent way. To assess the accuracy and reliability of this MC technique, dose distributions for a monoenergetic source were compared with those obtained using a general-purpose software package used widely in medical physics applications. Once accuracy of the underlying simulator was confirmed, a clinical accelerator was modelled and experimental measurements in water were conducted. A comparison was made with the output from the simulator to identify the conditions under which accurate dose estimations could be obtained in less than 3 min, which is the threshold imposed to allow for interactive use of the tool in treatment planning. Finally, a clinically relevant scenario, namely early-stage breast cancer treatment, was simulated with pre- and intraoperative volumes to verify that it was feasible to use the MC tool intraoperatively and to adjust dose delivery based on the simulation output, without compromising accuracy. The workflow provided a satisfactory model of the treatment head and the imaging system, enabling proper configuration of the treatment planning

  9. Validation of in-house treatment planning system software for cobalt-60 teletherapy unit at two radiotherapy installations

    NASA Astrophysics Data System (ADS)

    Mu'minah, I. A. S.; Toresano, L. O. H. Z.; Wibowo, W. E.; Sugiyantari; Pawiro, S. A.

    2016-03-01

    DSSuperDose v.1.0 is an in-house treatment planning system (TPS) developed by Medical Physics and Biophysics Laboratory (LFMB) Universitas Indonesia as a treatment planning software for Cobalt-60 teletherapy unit. The main objective of this study was the validation of in-house TPS calculation as an essential part in quality assurance (QA) of radiotherapy. Validation of an in-house TPS was performed with two Cobalt-60 teletherapy units by comparison between in-house TPS and ISIS TPS and by measurements of absorbed dose. Mean dose deviations between in-house TPS and measurement were (1.97 ± 2.42)% for open field, (1.32 ± 1.30)% for tray field, and (2.91 ± 2.36)% for wedge field treatments. In-house TPS provide optimal planning for open and tray beam conditions with depth fewer than 10 cm (≤ 10 cm) and field sizes up to 20×20 cm2, while for wedge beam conditions with field sizes fewer than the physical size of the wedge. Comparison of in-house TPS and ISIS TPS demonstrated a good match of 96%. From the results, it is concluded that DSSuperDose v.1.0 is adequately accurate for treatment planning of radiotherapy.

  10. Accurate Treatment of Large Supramolecular Complexes by Double-Hybrid Density Functionals Coupled with Nonlocal van der Waals Corrections.

    PubMed

    Calbo, Joaquín; Ortí, Enrique; Sancho-García, Juan C; Aragó, Juan

    2015-03-10

    In this work, we present a thorough assessment of the performance of some representative double-hybrid density functionals (revPBE0-DH-NL and B2PLYP-NL) as well as their parent hybrid and GGA counterparts, in combination with the most modern version of the nonlocal (NL) van der Waals correction to describe very large weakly interacting molecular systems dominated by noncovalent interactions. Prior to the assessment, an accurate and homogeneous set of reference interaction energies was computed for the supramolecular complexes constituting the L7 and S12L data sets by using the novel, precise, and efficient DLPNO-CCSD(T) method at the complete basis set limit (CBS). The correction of the basis set superposition error and the inclusion of the deformation energies (for the S12L set) have been crucial for obtaining precise DLPNO-CCSD(T)/CBS interaction energies. Among the density functionals evaluated, the double-hybrid revPBE0-DH-NL and B2PLYP-NL with the three-body dispersion correction provide remarkably accurate association energies very close to the chemical accuracy. Overall, the NL van der Waals approach combined with proper density functionals can be seen as an accurate and affordable computational tool for the modeling of large weakly bonded supramolecular systems. PMID:26579747

  11. 7 CFR 632.16 - Methods of applying planned land use and treatment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Methods of applying planned land use and treatment... Qualifications § 632.16 Methods of applying planned land use and treatment. (a) Land users may arrange to apply... administer a contract to perform the required treatment in accordance with 41 CFR chapters I and IV....

  12. 7 CFR 632.16 - Methods of applying planned land use and treatment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Methods of applying planned land use and treatment... Qualifications § 632.16 Methods of applying planned land use and treatment. (a) Land users may arrange to apply... administer a contract to perform the required treatment in accordance with 41 CFR chapters I and IV....

  13. 7 CFR 632.16 - Methods of applying planned land use and treatment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Methods of applying planned land use and treatment... Qualifications § 632.16 Methods of applying planned land use and treatment. (a) Land users may arrange to apply... administer a contract to perform the required treatment in accordance with 41 CFR chapters I and IV....

  14. 7 CFR 632.16 - Methods of applying planned land use and treatment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Methods of applying planned land use and treatment... Qualifications § 632.16 Methods of applying planned land use and treatment. (a) Land users may arrange to apply... administer a contract to perform the required treatment in accordance with 41 CFR chapters I and IV....

  15. 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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  17. Toward a web-based real-time radiation treatment planning system in a cloud computing environment.

    PubMed

    Na, Yong Hum; Suh, Tae-Suk; Kapp, Daniel S; Xing, Lei

    2013-09-21

    To exploit the potential dosimetric advantages of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), an in-depth approach is required to provide efficient computing methods. This needs to incorporate clinically related organ specific constraints, Monte Carlo (MC) dose calculations, and large-scale plan optimization. This paper describes our first steps toward a web-based real-time radiation treatment planning system in a cloud computing environment (CCE). The Amazon Elastic Compute Cloud (EC2) with a master node (named m2.xlarge containing 17.1 GB of memory, two virtual cores with 3.25 EC2 Compute Units each, 420 GB of instance storage, 64-bit platform) is used as the backbone of cloud computing for dose calculation and plan optimization. The master node is able to scale the workers on an 'on-demand' basis. MC dose calculation is employed to generate accurate beamlet dose kernels by parallel tasks. The intensity modulation optimization uses total-variation regularization (TVR) and generates piecewise constant fluence maps for each initial beam direction in a distributed manner over the CCE. The optimized fluence maps are segmented into deliverable apertures. The shape of each aperture is iteratively rectified to be a sequence of arcs using the manufacture's constraints. The output plan file from the EC2 is sent to the simple storage service. Three de-identified clinical cancer treatment plans have been studied for evaluating the performance of the new planning platform with 6 MV flattening filter free beams (40 × 40 cm(2)) from the Varian TrueBeam(TM) STx linear accelerator. A CCE leads to speed-ups of up to 14-fold for both dose kernel calculations and plan optimizations in the head and neck, lung, and prostate cancer cases considered in this study. The proposed system relies on a CCE that is able to provide an infrastructure for parallel and distributed computing. The resultant plans from the cloud computing are

  18. Toward a web-based real-time radiation treatment planning system in a cloud computing environment

    NASA Astrophysics Data System (ADS)

    Hum Na, Yong; Suh, Tae-Suk; Kapp, Daniel S.; Xing, Lei

    2013-09-01

    To exploit the potential dosimetric advantages of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), an in-depth approach is required to provide efficient computing methods. This needs to incorporate clinically related organ specific constraints, Monte Carlo (MC) dose calculations, and large-scale plan optimization. This paper describes our first steps toward a web-based real-time radiation treatment planning system in a cloud computing environment (CCE). The Amazon Elastic Compute Cloud (EC2) with a master node (named m2.xlarge containing 17.1 GB of memory, two virtual cores with 3.25 EC2 Compute Units each, 420 GB of instance storage, 64-bit platform) is used as the backbone of cloud computing for dose calculation and plan optimization. The master node is able to scale the workers on an ‘on-demand’ basis. MC dose calculation is employed to generate accurate beamlet dose kernels by parallel tasks. The intensity modulation optimization uses total-variation regularization (TVR) and generates piecewise constant fluence maps for each initial beam direction in a distributed manner over the CCE. The optimized fluence maps are segmented into deliverable apertures. The shape of each aperture is iteratively rectified to be a sequence of arcs using the manufacture’s constraints. The output plan file from the EC2 is sent to the simple storage service. Three de-identified clinical cancer treatment plans have been studied for evaluating the performance of the new planning platform with 6 MV flattening filter free beams (40 × 40 cm2) from the Varian TrueBeamTM STx linear accelerator. A CCE leads to speed-ups of up to 14-fold for both dose kernel calculations and plan optimizations in the head and neck, lung, and prostate cancer cases considered in this study. The proposed system relies on a CCE that is able to provide an infrastructure for parallel and distributed computing. The resultant plans from the cloud computing are identical

  19. Planning and execution of Raft River stimulation treatments

    SciTech Connect

    Verity, R.V.; Crichlow, H.B.

    1980-02-07

    The following topics are discussed for two Raft River Valley wells: well characteristics and treatment objectives, treatment selection and design, treatment history, mechanical arrangements and job costs. (MHR)

  20. Isodose Curves and Treatment Planning for Boron Neutron Capture Therapy.

    NASA Astrophysics Data System (ADS)

    Liu, Hungyuan B.

    The development of Boron Neutron Capture Therapy (BNCT) has been progressing in both ^{10 }B compound development and testing and neutron beam delivery. Animal tests are now in progress with several ^{10}B compounds and once the results of these animal tests are promising, patient trials can be initiated. The objective of this study is to create a treatment planning method based on the dose calculations by a Monte Carlo code of a mixed radiation field to provide linkage between phantom dosimetry and patient irradiation. The research started with an overall review of the development of BNCT. Three epithermal neutron facilities are described, including the operating Brookhaven Medical Research Reactor (BMRR) beam, the designed Missouri University Research Reactor (MURR) beam, and a designed accelerator based neutron source. The flux and dose distributions in a head model have been calculated for irradiation by these neutron beams. Different beam parameters were inter -compared for effectiveness. Dosimetric measurements in an elliptical lucite phantom and a cylindrical water phantom were made and compared to the MCNP calculations for irradiation by the BMRR beam. Repeated measurements were made and show consistent. To improve the statistical results calculated by MCNP, a neutron source plane was designed to start neutrons at the BMRR irradiation port. The source plane was used with the phantoms for dosimetric calculations. After being verified by different phantom dosimetry and in-air flux measurements at the irradiation port, the source plane was used to calculate the flux and dose distributions in the head model. A treatment planning program was created for use on a PC which uses the MCNP calculated results as input. This program calculates the thermal neutron flux and dose distributions of each component of radiation in the central coronal section of the head model for irradiation by a neutron beam. Different combinations of head orientations and irradiation

  1. Phenomenological modelling of second cancer incidence for radiation treatment planning.

    PubMed

    Pfaffenberger, Asja; Schneider, Uwe; Poppe, Björn; Oelfke, Uwe

    2009-01-01

    It is still an unanswered question whether a relatively low dose of radiation to a large volume or a higher dose to a small volume produces the higher cancer incidence. This is of interest in view of modalities like IMRT or rotation therapy where high conformity to the target volume is achieved at the cost of a large volume of normal tissue exposed to radiation. Knowledge of the shape of the dose response for radiation-induced cancer is essential to answer the question of what risk of second cancer incidence is implied by which treatment modality. This study therefore models the dose response for radiation-induced second cancer after radiation therapy of which the exact mechanisms are still unknown. A second cancer risk estimation tool for treatment planning is presented which has the potential to be used for comparison of different treatment modalities, and risk is estimated on a voxel basis for different organs in two case studies. The presented phenomenological model summarises the impact of microscopic biological processes into effective parameters of mutation and cell sterilisation. In contrast to other models, the effective radiosensitivities of mutated and non-mutated cells are allowed to differ. Based on the number of mutated cells present after irradiation, the model is then linked to macroscopic incidence by summarising model parameters and modifying factors into natural cancer incidence and the dose response in the lower-dose region. It was found that all principal dose-response functions discussed in the literature can be derived from the model. However, from the investigation and due to scarcity of adequate data, rather vague statements about likelihood of dose-response functions can be made than a definite decision for one response. Based on the predicted model parameters, the linear response can probably be rejected using the dynamics described, but both a flattening response and a decrease appear likely, depending strongly on the effective cell

  2. Gemstone spectral imaging: determination of CT to ED conversion curves for radiotherapy treatment planning.

    PubMed

    Yagi, Masashi; Ueguchi, Takashi; Koizumi, Masahiko; Ogata, Toshiyuki; Yamada, Sachiko; Takahashi, Yutaka; Sumida, Iori; Akino, Yuichi; Konishi, Koji; Isohashi, Fumiaki; Tomiyama, Noriyuki; Yoshioka, Yasuo; Ogawa, Kazuhiko

    2013-01-01

    The monochromatic images acquired by Gemstone spectral imaging (GSI) mode on the GE CT750 HD theoretically determines the computed tomography (CT) number more accurately than that of conventional scanner. Using the former, the CT number is calculated from (synthesized) monoenergetic X-ray data. We reasoned that the monochromatic image might be applied to radiotherapy treatment planning (RTP) to calculate dose distribution more accurately. Our goal here was to provide CT to electron density (ED) conversion curves with monochromatic images for RTP. Therefore, we assessed the reproducibility of CT numbers, an important factor on quality assurance, over short and long time periods for different substances at varying energy. CT number difference between measured and theoretical value was investigated. The scanner provided sufficient reproducibility of CT numbers for dose calculation over short and long time periods. The CT numbers of monochromatic images produced by this scanner had reasonable values for dose calculation. The CT to ED conversion curve becomes linear with respect to the relationship between CT numbers and EDs as the energy increases. We conclude that monochromatic imaging from a fast switching system can be applied for the dose calculation, keeping Hounsfield units (HU) stability. PMID:24036870

  3. Determining thyroid {sup 131}I effective half-life for the treatment planning of Graves' disease

    SciTech Connect

    Willegaignon, Jose; Sapienza, Marcelo T.; Barberio Coura Filho, George; Buchpiguel, Carlos A.; Traino, Antonio C.

    2013-02-15

    Purpose: Thyroid {sup 131}I effective half-life (T{sub eff}) is an essential parameter in patient therapy when accurate radiation dose is desirable for producing an intended therapeutic outcome. Multiple {sup 131}I uptake measurements and resources from patients themselves and from nuclear medicine facilities are requisites for determining T{sub eff}, these being limiting factors when implementing the treatment planning of Graves' disease (GD) in radionuclide therapy. With the aim of optimizing this process, this study presents a practical, propitious, and accurate method of determining T{sub eff} for dosimetric purposes. Methods: A total of 50 patients with GD were included in this prospective study. Thyroidal {sup 131}I uptake was measured at 2-h, 6-h, 24-h, 48-h, 96-h, and 220-h postradioiodine administration. T{sub eff} was calculated by considering sets of two measured points (24-48-h, 24-96-h, and 24-220-h), sets of three (24-48-96-h, 24-48-220-h, and 24-96-220-h), and sets of four (24-48-96-220-h). Results: When considering all the measured points, the representative T{sub eff} for all the patients was 6.95 ({+-}0.81) days, whereas when using such sets of points as (24-220-h), (24-96-220-h), and (24-48-220-h), this was 6.85 ({+-}0.81), 6.90 ({+-}0.81), and 6.95 ({+-}0.81) days, respectively. According to the mean deviations 2.2 ({+-}2.4)%, 2.1 ({+-}2.0)%, and 0.04 ({+-}0.09)% found in T{sub eff}, calculated based on all the measured points in time, and with methods using the (24-220-h), (24-48-220-h), and (24-96-220-h) sets, respectively, no meaningful statistical difference was noted among the three methods (p > 0.500, t test). Conclusions: T{sub eff} obtained from only two thyroid {sup 131}I uptakes measured at 24-h and 220-h, besides proving to be sufficient, accurate enough, and easily applicable, attributes additional major cost-benefits for patients, and facilitates the application of the method for dosimetric purposes in the treatment planning of

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

    SciTech Connect

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

    2013-04-01

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

  5. Development of Advanced Multi-Modality Radiation Treatment Planning Software

    SciTech Connect

    Nigg, D W; Hartmann Siantar, C

    2002-02-19

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software product system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. SERA is at a mature level in its life cycle, it has been licensed for research use worldwide, and it has become well established as a computational tool for research. However, along with its strengths, SERA also has some limitations in its structure and computational methodologies. More specifically, it is optimized only for neutron-based applications. Although photon transport can be computed with SERA, the simplified model that is used is designed primarily for photons produced in the neutron transport process. Thus SERA is not appropriate for applications to, for example, standard external-beam photon radiotherapy, which is by far more commonly used in the clinic than neutron based therapy.

  6. Orthodontics: computer-aided diagnosis and treatment planning

    NASA Astrophysics Data System (ADS)

    Yi, Yaxing; Li, Zhongke; Wei, Suyuan; Deng, Fanglin; Yao, Sen

    2000-10-01

    The purpose of this article is to introduce the outline of our newly developed computer-aided 3D dental cast analyzing system with laser scanning, and its preliminary clinical applications. The system is composed of a scanning device and a personal computer as a scanning controller and post processor. The scanning device is composed of a laser beam emitter, two sets of linear CCD cameras and a table which is rotatable by two-degree-of-freedom. The rotating is controlled precisely by a personal computer. The dental cast is projected and scanned with a laser beam. Triangulation is applied to determine the location of each point. Generation of 3D graphics of the dental cast takes approximately 40 minutes. About 170,000 sets of X,Y,Z coordinates are store for one dental cast. Besides the conventional linear and angular measurements of the dental cast, we are also able to demonstrate the size of the top surface area of each molar. The advantage of this system is that it facilitates the otherwise complicated and time- consuming mock surgery necessary for treatment planning in orthognathic surgery.

  7. The role of medical physicists and the AAPM in the development of treatment planning and optimization.

    PubMed

    Orton, Colin G; Bortfeld, Thomas R; Niemierko, Andrzej; Unkelbach, Jan

    2008-11-01

    Developments in radiotherapy treatment planning and optimization by medical physicists and the American Association of Physicists in Medicine are reviewed, with emphasis on recent work in optimization. It is shown that medical physicists have played a vital role in the creation of innovative treatment planning techniques throughout the past century, most significantly since the advent of computerized tomography for three-dimensional (3D) imaging and high-powered computers capable of 3D planning and optimization. Some early advances in 3D planning made by physicists include development of novel planning algorithms, beam's-eye-view, virtual simulation, dose-volume histogram analysis tools, and bioeffect modeling. Most of the recent developments have been driven by the need to develop treatment planning for conformal radiotherapy, especially intensity modulated radiation therapy. These advances include inverse planning, handling the effects of motion and uncertainty, biological planning, and multicriteria optimization. PMID:19070225

  8. Deliverable navigation for multicriteria step and shoot IMRT treatment planning

    NASA Astrophysics Data System (ADS)

    Craft, David; Richter, Christian

    2013-01-01

    We consider Pareto surface based multi-criteria optimization for step and shoot IMRT planning. By analyzing two navigation algorithms, we show both theoretically and in practice that the number of plans needed to form convex combinations of plans during navigation can be kept small (much less than the theoretical maximum number needed in general, which is equal to the number of objectives for on-surface Pareto navigation). Therefore a workable approach for directly deliverable navigation in this setting is to segment the underlying Pareto surface plans and then enforce the mild restriction that only a small number of these plans are active at any time during plan navigation, thus limiting the total number of segments used in the final plan.

  9. Deliverable navigation for multicriteria step and shoot IMRT treatment planning

    PubMed Central

    Craft, David; Richter, Christian

    2012-01-01

    We consider Pareto surface based multi-criteria optimization for step and shoot IMRT planning. By analyzing two navigation algorithms, we show both theoretically and in practice that the number of plans needed to form convex combinations of plans during navigation can be kept small (much less than the theoretical maximum number needed in general, which is equal to the number of objectives for on-surface Pareto navigation). Therefore a workable approach for directly deliverable navigation in this setting is to segment the underlying Pareto surface plans and then enforce the mild restriction that only a small number of these plans are active at any time during plan navigation, thus limiting the total number of segments used in the final plan. PMID:23221364

  10. Four-dimensional IMRT treatment planning using a DMLC motion-tracking algorithm

    NASA Astrophysics Data System (ADS)

    Suh, Yelin; Sawant, Amit; Venkat, Raghu; Keall, Paul J.

    2009-06-01

    The purpose of this study is to develop a four-dimensional (4D) intensity-modulated radiation therapy (IMRT) treatment-planning method by modifying and applying a dynamic multileaf collimator (DMLC) motion-tracking algorithm. The 4D radiotherapy treatment scenario investigated is to obtain a 4D treatment plan based on a 4D computed tomography (CT) planning scan and to have the delivery flexible enough to account for changes in tumor position during treatment delivery. For each of 4D CT planning scans from 12 lung cancer patients, a reference phase plan was created; with its MLC leaf positions and three-dimensional (3D) tumor motion, the DMLC motion-tracking algorithm generated MLC leaf sequences for the plans of other respiratory phases. Then, a deformable dose-summed 4D plan was created by merging the leaf sequences of individual phase plans. Individual phase plans, as well as the deformable dose-summed 4D plan, are similar for each patient, indicating that this method is dosimetrically robust to the variations of fractional time spent in respiratory phases on a given 4D CT planning scan. The 4D IMRT treatment-planning method utilizing the DMLC motion-tracking algorithm explicitly accounts for 3D tumor motion and thus hysteresis and nonlinear motion, and is deliverable on a linear accelerator.

  11. Dose perturbation in the presence of metallic implants: treatment planning system versus Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Wieslander, Elinore; Knöös, Tommy

    2003-10-01

    An increasing number of patients receiving radiation therapy have metallic implants such as hip prostheses. Therefore, beams are normally set up to avoid irradiation through the implant; however, this cannot always be accomplished. In such situations, knowledge of the accuracy of the used treatment planning system (TPS) is required. Two algorithms, the pencil beam (PB) and the collapsed cone (CC), are implemented in the studied TPS. Comparisons are made with Monte Carlo simulations for 6 and 18 MV. The studied materials are steel, CoCrMo, Orthinox® (a stainless steel alloy and registered trademark of Stryker Corporation), TiAlV and Ti. Monte Carlo simulated depth dose curves and dose profiles are compared to CC and PB calculated data. The CC algorithm shows overall a better agreement with Monte Carlo than the PB algorithm. Thus, it is recommended to use the CC algorithm to get the most accurate dose calculation both for the planning target volume and for tissues adjacent to the implants when beams are set up to pass through implants.

  12. Towards integration of PET/MR hybrid imaging into radiation therapy treatment planning

    SciTech Connect

    Paulus, Daniel H.; Thorwath, Daniela; Schmidt, Holger; Quick, Harald H.

    2014-07-15

    Purpose: Multimodality imaging has become an important adjunct of state-of-the-art radiation therapy (RT) treatment planning. Recently, simultaneous PET/MR hybrid imaging has become clinically available and may also contribute to target volume delineation and biological individualization in RT planning. For integration of PET/MR hybrid imaging into RT treatment planning, compatible dedicated RT devices are required for accurate patient positioning. In this study, prototype RT positioning devices intended for PET/MR hybrid imaging are introduced and tested toward PET/MR compatibility and image quality. Methods: A prototype flat RT table overlay and two radiofrequency (RF) coil holders that each fix one flexible body matrix RF coil for RT head/neck imaging have been evaluated within this study. MR image quality with the RT head setup was compared to the actual PET/MR setup with a dedicated head RF coil. PET photon attenuation and CT-based attenuation correction (AC) of the hardware components has been quantitatively evaluated by phantom scans. Clinical application of the new RT setup in PET/MR imaging was evaluated in anin vivo study. Results: The RT table overlay and RF coil holders are fully PET/MR compatible. MR phantom and volunteer imaging with the RT head setup revealed high image quality, comparable to images acquired with the dedicated PET/MR head RF coil, albeit with 25% reduced SNR. Repositioning accuracy of the RF coil holders was below 1 mm. PET photon attenuation of the RT table overlay was calculated to be 3.8% and 13.8% for the RF coil holders. With CT-based AC of the devices, the underestimation error was reduced to 0.6% and 0.8%, respectively. Comparable results were found within the patient study. Conclusions: The newly designed RT devices for hybrid PET/MR imaging are PET and MR compatible. The mechanically rigid design and the reproducible positioning allow for straightforward CT-based AC. The systematic evaluation within this study provides the

  13. Energy Dependence of Measured CT Numbers on Substituted Materials Used for CT Number Calibration of Radiotherapy Treatment Planning Systems

    PubMed Central

    Mahmoudi, Reza; Jabbari, Nasrollah; aghdasi, Mehdi; Khalkhali, Hamid Reza

    2016-01-01

    Introduction For accurate dose calculations, it is necessary to provide a correct relationship between the CT numbers and electron density in radiotherapy treatment planning systems (TPSs). The purpose of this study was to investigate the energy dependence of measured CT numbers on substituted materials used for CT number calibration of radiotherapy TPSs and the resulting errors in the treatment planning calculation doses. Materials and Methods In this study, we designed a cylindrical water phantom with different materials used as tissue equivalent materials for the simulation of tissues and obtaining the related CT numbers. For evaluating the effect of CT number variations of substituted materials due to energy changing of scanner (kVp) on the dose calculation of TPS, the slices of the scanned phantom at three kVp's were imported into the desired TPSs (MIRS and CorePLAN). Dose calculations were performed on two TPSs. Results The mean absolute percentage differences between the CT numbers of CT scanner and two treatment planning systems for all the samples were 3.22%±2.57% for CorePLAN and 2.88%±2.11% for MIRS. It was also found that the maximum absolute percentage difference between all of the calculated doses from each photon beam of linac (6 and 15 MV) at three kVp's was less than 1.2%. Discussion The present study revealed that, for the materials with effective low atomic number, the mean CT number increased with increasing energy, which was opposite for the materials with an effective high atomic number. We concluded that the tissue substitute materials had a different behavior in the energy ranges from 80 to 130 kVp. So, it is necessary to consider the energy dependence of the substitute materials used for the measurement or calibration of CT number for radiotherapy treatment planning systems. PMID:27391672

  14. Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

    SciTech Connect

    Gladstone, D. J.; Li, S.; Jarvis, L. A.; Hartford, A. C.

    2011-07-15

    Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging, the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.

  15. A novel method for vaginal cylinder treatment planning: a seamless transition to 3D brachytherapy

    PubMed Central

    Wu, Vincent; Wang, Zhou; Patil, Sachin

    2012-01-01

    Purpose Standard treatment plan libraries are often used to ensure a quick turn-around time for vaginal cylinder treatments. Recently there is increasing interest in transitioning from conventional 2D radiograph based brachytherapy to 3D image based brachytherapy, which has resulted in a substantial increase in treatment planning time and decrease in patient through-put. We describe a novel technique that significantly reduces the treatment planning time for CT-based vaginal cylinder brachytherapy. Material and methods Oncentra MasterPlan TPS allows multiple sets of data points to be classified as applicator points which has been harnessed in this method. The method relies on two hard anchor points: the first dwell position in a catheter and an applicator configuration specific dwell position as the plan origin and a soft anchor point beyond the last active dwell position to define the axis of the catheter. The spatial location of various data points on the applicator's surface and at 5 mm depth are stored in an Excel file that can easily be transferred into a patient CT data set using window operations and then used for treatment planning. The remainder of the treatment planning process remains unaffected. Results The treatment plans generated on the Oncentra MasterPlan TPS using this novel method yielded results comparable to those generated on the Plato TPS using a standard treatment plan library in terms of treatment times, dwell weights and dwell times for a given optimization method and normalization points. Less than 2% difference was noticed between the treatment times generated between both systems. Using the above method, the entire planning process, including CT importing, catheter reconstruction, multiple data point definition, optimization and dose prescription, can be completed in ~5–10 minutes. Conclusion The proposed method allows a smooth and efficient transition to 3D CT based vaginal cylinder brachytherapy planning. PMID:23349650

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

    NASA Astrophysics Data System (ADS)

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

    2007-07-01

    Radiotherapy research lacks a flexible computational research environment for Monte Carlo (MC) and patient-specific treatment planning. The purpose of this study was to develop a flexible software package on low-cost hardware with the aim of integrating new patient-specific treatment planning with MC dose calculations suitable for large-scale prospective and retrospective treatment planning studies. We designed the software package 'McGill Monte Carlo treatment planning' (MMCTP) for the research development of MC and patient-specific treatment planning. The MMCTP design consists of a graphical user interface (GUI), which runs on a simple workstation connected through standard secure-shell protocol to a cluster for lengthy MC calculations. Treatment planning information (e.g., images, structures, beam geometry properties and dose distributions) is converted into a convenient MMCTP local file storage format designated, the McGill RT format. MMCTP features include (a) DICOM_RT, RTOG and CADPlan CART format imports; (b) 2D and 3D visualization views for images, structure contours, and dose distributions; (c) contouring tools; (d) DVH analysis, and dose matrix comparison tools; (e) external beam editing; (f) MC transport calculation from beam source to patient geometry for photon and electron beams. The MC input files, which are prepared from the beam geometry properties and patient information (e.g., images and structure contours), are uploaded and run on a cluster using shell commands controlled from the MMCTP GUI. The visualization, dose matrix operation and DVH tools offer extensive options for plan analysis and comparison between MC plans and plans imported from commercial treatment planning systems. The MMCTP GUI provides a flexible research platform for the development of patient-specific MC treatment planning for photon and electron external beam radiation therapy. The impact of this tool lies in the fact that it allows for systematic, platform

  17. Comparison of Prostate IMRT and VMAT Biologically Optimised Treatment Plans

    SciTech Connect

    Hardcastle, Nicholas; Tome, Wolfgang A.; Foo, Kerwyn; Miller, Andrew; Carolan, Martin; Metcalfe, Peter

    2011-10-01

    Recently, a new radiotherapy delivery technique has become clinically available-volumetric modulated arc therapy (VMAT). VMAT is the delivery of IMRT while the gantry is in motion using dynamic leaf motion. The perceived benefit of VMAT over IMRT is a reduction in delivery time. In this study, VMAT was compared directly with IMRT for a series of prostate cases. For 10 patients, a biologically optimized seven-field IMRT plan was compared with a biologically optimized VMAT plan using the same planning objectives. The Pinnacle RTPS was used. The resultant target and organ-at-risk dose-volume histograms (DVHs) were compared. The normal tissue complication probability (NTCP) for the IMRT and VMAT plans was calculated for 3 model parameter sets. The delivery efficiency and time for the IMRT and VMAT plans was compared. The VMAT plans resulted in a statistically significant reduction in the rectal V25Gy parameter of 8.2% on average over the IMRT plans. For one of the NTCP parameter sets, the VMAT plans had a statistically significant lower rectal NTCP. These reductions in rectal dose were achieved using 18.6% fewer monitor units and a delivery time reduction of up to 69%. VMAT plans resulted in reductions in rectal doses for all 10 patients in the study. This was achieved with significant reductions in delivery time and monitor units. Given the target coverage was equivalent, the VMAT plans were superior.

  18. IMRT vs. 3D Noncoplanar Treatment Plans for Maxillary Sinus Tumors: A New Tool for Quantitative Evaluation

    SciTech Connect

    Levin, Daphne Menhel, Janna; Alezra, Dror; Pfeffer, Raphael

    2008-01-01

    We compared 9-field, equispaced intensity modulated radiation therapy (IMRT), 4- to 5-field, directionally optimized IMRT, and 3-dimensional (3D) noncoplanar planning approaches for tumors of the maxillary sinus. Ten patients were planned retrospectively to compare the different treatment techniques. Prescription doses were 60 to 70 Gy. Critical structures contoured included optic nerves and chiasm, lacrimal glands, lenses, and retinas. As an aid for plan assessment, we introduced a new tool: Critical Organ Scoring Index (COSI), which allows quantitative evaluation of the tradeoffs between target coverage and critical organ sparing. This index was compared with other, commonly used conformity indices. For a reliable assessment of both tumor coverage and dose to critical organs in the different planning techniques, we introduced a 2D, graphical representation of COSI vs. conformity index (CI). Dose-volume histograms and mean, maximum, and minimum organ doses were also compared. IMRT plans delivered lower doses to ipsilateral structures, but were unable to spare them. 3D plans delivered less dose to contralateral structures, and were more homogeneous, as well. Both IMRT approaches gave similar results. In cases where choice of optimal plan was difficult, the novel 2D COSI-CI representation gave an accurate picture of the tradeoffs between target coverage and organ sparing, even in cases where other conformity indices failed. Due to their unique anatomy, maxillary sinus tumors may benefit more from a noncoplanar approach than from IMRT. The new graphical representation proposed is a quick, visual, reliable tool, which may facilitate the physician's choice of best treatment plan for a given patient.

  19. Optimal Treatment Planning for Skull Base Chordoma: Photons, Protons, or a Combination of Both?

    SciTech Connect

    Torres, Mylin A.; Chang, Eric L.; Mahajan, Anita; Lege, David G.; Riley, Beverly A. C.; Zhang Xiaodong; Lii, M.F.; Kornguth, David G.; Pelloski, Christopher E.; Woo, Shiao Y.

    2009-07-15

    Purpose: We compared dosimetry of proton (PR), intensity modulated radiation therapy (IMRT) photon (PH), and combined PR and IMRT PH (PP) irradiation of skull base chordomas to determine the most optimal technique. Methods and Materials: Computed tomography simulation scans of 5 patients with skull base chordoma were used to generate four treatment plans: an IMRT PH plan with 1-mm planning target volume (PTV; PH1) for stereotactic treatment, an IMRT PH plan with 3-mm PTV (PH3) for routine treatment, a PR plan with beam-specific expansion margins on the clinical target volume, and a PP plan combining PR and PH treatment. All plans were prescribed 74 Gy/Cobalt Gray equivalents (CGE) to the PTV. To facilitate comparison, the primary objective of all plans was 95% or greater PTV prescribed dose coverage. Plans then were optimized to limit dose to normal tissues. Results: PTVs ranged from 4.4 to 36.7 cc in size (mean, 21.6 cc). Mean % PTV receiving 74 Gy was highest in the PP plans (98.4%; range, 96.5-99.2%) and lowest in the PH3 plans (96.1%; range, 95.1-96.7%). PR plans were the least homogeneous and conformal. PH3 plans had the highest mean % volume (V) of brain, brainstem, chiasm, and temporal lobes greater than tolerance doses. The PH1 plans had the lowest brainstem mean % V receiving 67 Gy (V{sub 67Gy}; 2.3 Gy; range, 0-7.8 Gy) and temporal lobe mean % V{sub 65Gy} (4.3 Gy; range, 0.1-7.7 Gy). Global evaluation of the plans based on objective parameters revealed that PH1 and PP plans were more optimal than either single-modality PR or PH3 plans. Conclusions: There are dosimetric advantages to using either PH1 or PP plans, with the latter yielding the best target coverage and conformality.

  20. Treatment of Solar Generation in Electric Utility Resource Planning (Presentation)

    SciTech Connect

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

    2014-01-01

    Today's utility planners have a different market and economic context than their predecessors, including planning for the growth of renewable energy. Through interviews and a questionnaire, the authors gathered information on utility supply planning and how solar is represented. Utilities were asked to provide their resource planning process details, key assumptions (e.g. whether DG is represented as supply or negative load), modeling methodology (e.g. type of risk analytics and candidate portfolio development), capacity expansion and production simulation model software, and solar project representation (project size, capacity value and integration cost adder). This presentation aims to begin the exchange of information between utilities, regulators and other stakeholders by capturing utility-provided information about: 1) how various utilities approach long-range resource planning; 2) methods and tools utilities use to conduct resource planning; and, 3) how solar technologies are considered in the resource planning process.

  1. Radiation therapy treatment plan optimization accounting for random and systematic patient setup uncertainties

    NASA Astrophysics Data System (ADS)

    Moore, Joseph Andrew

    2011-12-01

    External-beam radiotherapy is one of the primary methods for treating cancer. Typically a radiotherapy treatment course consists of radiation delivered to the patient in multiple daily treatment fractions over 6--8 weeks. Each fraction requires the patient to be aligned with the image acquired before the treatment course used in treatment planning. Unfortunately, patient alignment is not perfect and results in residual errors in patient setup. The standard technique for dealing with errors in patient setup is to expand the volume of the target by some margin to ensure the target receives the planned dose in the presence of setup errors. This work develops an alternative to margins for accommodating setup errors in the treatment planning process by directly including patient setup uncertainty in IMRT plan optimization. This probabilistic treatment planning (PTP) operates directly on the planning structure and develops a dose distribution robust to variations in the patient position. Two methods are presented. The first method includes only random setup uncertainty in the planning process by convolving the fluence of each beam with a Gaussian model of the distribution of random setup errors. The second method builds upon this by adding systematic uncertainty to optimization by way of a joint optimization over multiple probable patient positions. To assess the benefit of PTP methods, a PTP plan and a margin-based plan are developed for each of the 28 patients used in this study. Comparisons of plans show that PTP plans generally reduce the dose to normal tissues while maintaining a similar dose to the target structure when compared to margin-based plans. Physician assessment indicates that PTP plans are generally preferred over margin-based plans. PTP methods shows potential for improving patient outcome due to reduced complications associated with treatment.

  2. HTGR Spent Fuel Treatment Program. HTGR Spent Fuel Treatment Development Program Plan

    SciTech Connect

    Not Available

    1984-12-01

    The spent fuel treatment (SFT) program plan addresses spent fuel volume reduction, packaging, storage, transportation, fuel recovery, and disposal to meet the needs of the HTGR Lead Plant and follow-on plants. In the near term, fuel refabrication will be addressed by following developments in fresh fuel fabrication and will be developed in the long term as decisions on the alternatives dictate. The formulation of this revised program plan considered the implications of the Nuclear Waste Policy Act of 1982 (NWPA) which, for the first time, established a definitive national policy for management and disposal of nuclear wastes. Although the primary intent of the program is to address technical issues, the divergence between commercial and government interests, which arises as a result of certain provisions of the NWPA, must be addressed in the economic assessment of technically feasible alternative paths in the management of spent HTGR fuel and waste. This new SFT program plan also incorporates a significant cooperative research and development program between the United States and the Federal Republic of Germany. The major objective of this international program is to reduce costs by avoiding duplicate efforts.

  3. Automatic liver tumor segmentation on computed tomography for patient treatment planning and monitoring

    PubMed Central

    Moghbel, Mehrdad; Mashohor, Syamsiah; Mahmud, Rozi; Saripan, M. Iqbal Bin

    2016-01-01

    Segmentation of liver tumors from Computed Tomography (CT) and tumor burden analysis play an important role in the choice of therapeutic strategies for liver diseases and treatment monitoring. In this paper, a new segmentation method for liver tumors from contrast-enhanced CT imaging is proposed. As manual segmentation of tumors for liver treatment planning is both labor intensive and time-consuming, a highly accurate automatic tumor segmentation is desired. The proposed framework is fully automatic requiring no user interaction. The proposed segmentation evaluated on real-world clinical data from patients is based on a hybrid method integrating cuckoo optimization and fuzzy c-means algorithm with random walkers algorithm. The accuracy of the proposed method was validated using a clinical liver dataset containing one of the highest numbers of tumors utilized for liver tumor segmentation containing 127 tumors in total with further validation of the results by a consultant radiologist. The proposed method was able to achieve one of the highest accuracies reported in the literature for liver tumor segmentation compared to other segmentation methods with a mean overlap error of 22.78 % and dice similarity coefficient of 0.75 in 3Dircadb dataset and a mean overlap error of 15.61 % and dice similarity coefficient of 0.81 in MIDAS dataset. The proposed method was able to outperform most other tumor segmentation methods reported in the literature while representing an overlap error improvement of 6 % compared to one of the best performing automatic methods in the literature. The proposed framework was able to provide consistently accurate results considering the number of tumors and the variations in tumor contrast enhancements and tumor appearances while the tumor burden was estimated with a mean error of 0.84 % in 3Dircadb dataset. PMID:27540353

  4. Automatic liver tumor segmentation on computed tomography for patient treatment planning and monitoring.

    PubMed

    Moghbel, Mehrdad; Mashohor, Syamsiah; Mahmud, Rozi; Saripan, M Iqbal Bin

    2016-01-01

    Segmentation of liver tumors from Computed Tomography (CT) and tumor burden analysis play an important role in the choice of therapeutic strategies for liver diseases and treatment monitoring. In this paper, a new segmentation method for liver tumors from contrast-enhanced CT imaging is proposed. As manual segmentation of tumors for liver treatment planning is both labor intensive and time-consuming, a highly accurate automatic tumor segmentation is desired. The proposed framework is fully automatic requiring no user interaction. The proposed segmentation evaluated on real-world clinical data from patients is based on a hybrid method integrating cuckoo optimization and fuzzy c-means algorithm with random walkers algorithm. The accuracy of the proposed method was validated using a clinical liver dataset containing one of the highest numbers of tumors utilized for liver tumor segmentation containing 127 tumors in total with further validation of the results by a consultant radiologist. The proposed method was able to achieve one of the highest accuracies reported in the literature for liver tumor segmentation compared to other segmentation methods with a mean overlap error of 22.78 % and dice similarity coefficient of 0.75 in 3Dircadb dataset and a mean overlap error of 15.61 % and dice similarity coefficient of 0.81 in MIDAS dataset. The proposed method was able to outperform most other tumor segmentation methods reported in the literature while representing an overlap error improvement of 6 % compared to one of the best performing automatic methods in the literature. The proposed framework was able to provide consistently accurate results considering the number of tumors and the variations in tumor contrast enhancements and tumor appearances while the tumor burden was estimated with a mean error of 0.84 % in 3Dircadb dataset. PMID:27540353

  5. A methodology for automatic intensity-modulated radiation treatment planning for lung cancer

    NASA Astrophysics Data System (ADS)

    Zhang, Xiaodong; Li, Xiaoqiang; Quan, Enzhuo M.; Pan, Xiaoning; Li, Yupeng

    2011-07-01

    In intensity-modulated radiotherapy (IMRT), the quality of the treatment plan, which is highly dependent upon the treatment planner's level of experience, greatly affects the potential benefits of the radiotherapy (RT). Furthermore, the planning process is complicated and requires a great deal of iteration, and is often the most time-consuming aspect of the RT process. In this paper, we describe a methodology to automate the IMRT planning process in lung cancer cases, the goal being to improve the quality and consistency of treatment planning. This methodology (1) automatically sets beam angles based on a beam angle automation algorithm, (2) judiciously designs the planning structures, which were shown to be effective for all the lung cancer cases we studied, and (3) automatically adjusts the objectives of the objective function based on a parameter automation algorithm. We compared treatment plans created in this system (mdaccAutoPlan) based on the overall methodology with plans from a clinical trial of IMRT for lung cancer run at our institution. The 'autoplans' were consistently better, or no worse, than the plans produced by experienced medical dosimetrists in terms of tumor coverage and normal tissue sparing. We conclude that the mdaccAutoPlan system can potentially improve the quality and consistency of treatment planning for lung cancer.

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....180 Section 146.180 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO... § 146.180 Treatment of non-Federal governmental plans. (a) Opt-out election for self-funded non-Federal... plan cannot elect to exempt its plan from requirements under section 2705(a)(6) and 2705(c) through...

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

    SciTech Connect

    McLaughlin, Patrick W. . E-mail: mclaughb@umich.edu; Troyer, Sara; Berri, Sally; Narayana, Vrinda; Meirowitz, Amichay; Roberson, Peter L.; Montie, James

    2005-10-01

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

  8. A Monte Carlo investigation of lung brachytherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Sutherland, J. G. H.; Furutani, K. M.; Thomson, R. M.

    2013-07-01

    Iodine-125 (125I) and Caesium-131 (131Cs) brachytherapy have been used in conjunction with sublobar resection to reduce the local recurrence of stage I non-small cell lung cancer compared with resection alone. Treatment planning for this procedure is typically performed using only a seed activity nomogram or look-up table to determine seed strand spacing for the implanted mesh. Since the post-implant seed geometry is difficult to predict, the nomogram is calculated using the TG-43 formalism for seeds in a planar geometry. In this work, the EGSnrc user-code BrachyDose is used to recalculate nomograms using a variety of tissue models for 125I and 131Cs seeds. Calculated prescription doses are compared to those calculated using TG-43. Additionally, patient CT and contour data are used to generate virtual implants to study the effects that post-implant deformation and patient-specific tissue heterogeneity have on perturbing nomogram-derived dose distributions. Differences of up to 25% in calculated prescription dose are found between TG-43 and Monte Carlo calculations with the TG-43 formalism underestimating prescription doses in general. Differences between the TG-43 formalism and Monte Carlo calculated prescription doses are greater for 125I than for 131Cs seeds. Dose distributions are found to change significantly based on implant deformation and tissues surrounding implants for patient-specific virtual implants. Results suggest that accounting for seed grid deformation and the effects of non-water media, at least approximately, are likely required to reliably predict dose distributions in lung brachytherapy patients.

  9. A comparison of measurement techniques for quality assurance of RapidArc treatment plans

    NASA Astrophysics Data System (ADS)

    Konieczny, Jeff

    in a high level of variation. After calibration, the original five plans and their modified MLC gap variants were tested. A comparison of the Eclipse plans with changes in leaf position to the original plan with 0 mm change in gap shows that the film should have the least sensitivity to changes in average gamma. When looking at the measured results with changes in MLC gap compared to the measured plan with 0 mm change in leaf position, we see that film incorrectly appears to have the highest sensitivity. The cause of this was due to the large variation in average gamma discovered during the repeatability tests. By comparing the repeatability value of 0.31 ± 0.13 to the sensitivity curve generated by Eclipse, it is estimated that film cannot accurately measure changes in systematic gap less than 2 mm. A similar value was found by Yan et al. 15 when using the 2 % / 2 mm γ <= 1 pass rate. The EPID and ArcCheck displayed significantly less variation in average gamma during static tests (0.07 ± 0.03 and 0.10 ± 0.04 respectively). Using the Eclipse calculated graph showing changes in average gamma compared to changes in MLC gap, we find that the EPID and ArcCheck should be able to measure systematic MLC errors of greater than 0.3mm. Previous analysis on MLC motion indicates that most positional errors are below 0.5 mm16 , which makes it difficult to conclude if the repeatability of the device is limited by the detector, or by actual errors in MLC leaf position on the treatment machine. For systematic gap width changes in the range of 0 to 1 mm, the EPID and ArcCheck show similar sensitivity. This thesis has focused on how the average gamma value changes when comparing systematic changes in MLC gap to their original unchanged plan. Although the results are not conclusive, they do indicate that further testing may be warranted. Future testing should involve other treatment sites with steeper dose gradients such as head and neck plans. To ensure clinical relevancy

  10. Psychometric Study of the Clinical Treatment Planning Simulations (CTPS) for Assessing Clinical Judgment.

    ERIC Educational Resources Information Center

    Falvey, Janet Elizabeth; Hebert, David J.

    1992-01-01

    Examined psychometric properties of four clinical treatment planning simulations (CTPS) developed by interdisciplinary mental health experts to examine clinical judgment in treatment planning processes of practitioners. Found that scoring reliability was high and simulations demonstrated adequate content, discriminant, and predictive validity.…

  11. 45 CFR 146.180 - Treatment of non-Federal governmental plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Treatment of non-Federal governmental plans. 146.180 Section 146.180 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET Exclusion of Plans and Enforcement § 146.180 Treatment of...

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

    ERIC Educational Resources Information Center

    Texas State Dept. of Water Resources, Austin.

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

  13. Computed tomography imaging parameters for inhomogeneity correction in radiation treatment planning

    PubMed Central

    Das, Indra J.; Cheng, Chee-Wai; Cao, Minsong; Johnstone, Peter A. S.

    2016-01-01

    Modern treatment planning systems provide accurate dosimetry in heterogeneous media (such as a patient' body) with the help of tissue characterization based on computed tomography (CT) number. However, CT number depends on the type of scanner, tube voltage, field of view (FOV), reconstruction algorithm including artifact reduction and processing filters. The impact of these parameters on CT to electron density (ED) conversion had been subject of investigation for treatment planning in various clinical situations. This is usually performed with a tissue characterization phantom with various density plugs acquired with different tube voltages (kilovoltage peak), FOV reconstruction and different scanners to generate CT number to ED tables. This article provides an overview of inhomogeneity correction in the context of CT scanning and a new evaluation tool, difference volume dose-volume histogram (DVH), dV-DVH. It has been concluded that scanner and CT parameters are important for tissue characterizations, but changes in ED are minimal and only pronounced for higher density materials. For lungs, changes in CT number are minimal among scanners and CT parameters. Dosimetric differences for lung and prostate cases are usually insignificant (<2%) in three-dimensional conformal radiation therapy and < 5% for intensity-modulated radiation therapy (IMRT) with CT parameters. It could be concluded that CT number variability is dependent on acquisition parameters, but its dosimetric impact is pronounced only in high-density media and possibly in IMRT. In view of such small dosimetric changes in low-density medium, the acquisition of additional CT data for financially difficult clinics and countries may not be warranted. PMID:27051164

  14. Computed tomography imaging parameters for inhomogeneity correction in radiation treatment planning.

    PubMed

    Das, Indra J; Cheng, Chee-Wai; Cao, Minsong; Johnstone, Peter A S

    2016-01-01

    Modern treatment planning systems provide accurate dosimetry in heterogeneous media (such as a patient' body) with the help of tissue characterization based on computed tomography (CT) number. However, CT number depends on the type of scanner, tube voltage, field of view (FOV), reconstruction algorithm including artifact reduction and processing filters. The impact of these parameters on CT to electron density (ED) conversion had been subject of investigation for treatment planning in various clinical situations. This is usually performed with a tissue characterization phantom with various density plugs acquired with different tube voltages (kilovoltage peak), FOV reconstruction and different scanners to generate CT number to ED tables. This article provides an overview of inhomogeneity correction in the context of CT scanning and a new evaluation tool, difference volume dose-volume histogram (DVH), dV-DVH. It has been concluded that scanner and CT parameters are important for tissue characterizations, but changes in ED are minimal and only pronounced for higher density materials. For lungs, changes in CT number are minimal among scanners and CT parameters. Dosimetric differences for lung and prostate cases are usually insignificant (<2%) in three-dimensional conformal radiation therapy and < 5% for intensity-modulated radiation therapy (IMRT) with CT parameters. It could be concluded that CT number variability is dependent on acquisition parameters, but its dosimetric impact is pronounced only in high-density media and possibly in IMRT. In view of such small dosimetric changes in low-density medium, the acquisition of additional CT data for financially difficult clinics and countries may not be warranted. PMID:27051164

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

    SciTech Connect

    1994-08-31

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

  16. SU-E-T-379: Concave Approximations of Target Volume Dose Metrics for Intensity- Modulated Radiotherapy Treatment Planning

    SciTech Connect

    Xie, Y; Chen, Y; Wickerhauser, M; Deasy, J

    2014-06-01

    Purpose: The widely used treatment plan metric Dx (mimimum dose to the hottest x% by volume of the target volume) is simple to interpret and use, but is computationally poorly behaved (non-convex), this impedes its use in computationally efficient intensity-modulated radiotherapy (IMRT) treatment planning algorithms. We therefore searched for surrogate metrics that are concave, computationally efficient, and accurately correlated to Dx values in IMRT treatment plans. Methods: To find concave surrogates of D95—and more generally, Dx values with variable x values—we tested equations containing one or two generalized equivalent uniform dose (gEUD) functions. Fits were obtained by varying gEUD ‘a’ parameter values, as well as the linear equation coefficients. Fitting was performed using a dataset of dose-volume histograms from 498 de-identified head and neck IMRT treatment plans. Fit characteristics were tested using a crossvalidation process. Reported root-mean-square error values were averaged over the cross-validation shuffles. Results: As expected, the two-gEUD formula provided a superior fit, compared to the single-gEUD formula. The best approximation uses two gEUD terms: 16.25 x gEUD[a=0.45] – 15.30 x gEUD[a=1.75] – 0.69. The average root-mean-square error on repeated (70/30) cross validation was 0.94 Gy. In addition, a formula was found that reasonably approximates Dx for x between 80% and 96%. Conclusion: A simple concave function using two gEUD terms was found that correlates well with PTV D95s for these head and neck treatment plans. More generally, a formula was found that represents well the Dx for x values from 80% to 96%, thus providing a computationally efficient formula for use in treatment planning optimization. The formula may need to be adjusted for other institutions with different treatment planning protocols. We conclude that the strategy of replacing Dx values with gEUD-based formulas is promising.

  17. Treatment of Solar Generation in Electric Utility Resource Planning

    SciTech Connect

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

    2013-10-01

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

  18. Comparison of Monte Carlo collimator transport methods for photon treatment planning in radiotherapy

    SciTech Connect

    Schmidhalter, D.; Manser, P.; Frei, D.; Volken, W.; Fix, M. K.

    2010-02-15

    %, 88%, 74%, 68%, or 65%, respectively. However, compared to EGSnrc calculations, the gain in efficiency is a factor of up to 10 for VMC++ and up to 48 for the absorbing method. Conclusions: The results of this investigation suggest that it is an option to use a simple transport technique in the initial treatment planning process and use more accurate transport methods for the final dose calculation accepting longer calculation times.

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

    SciTech Connect

    1995-03-24

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

  20. Nuclear-interaction correction of integrated depth dose in carbon-ion radiotherapy treatment planning.

    PubMed

    Inaniwa, T; Kanematsu, N; Hara, Y; Furukawa, T

    2015-01-01

    In treatment planning of charged-particle therapy, tissue heterogeneity is conventionally modeled as water with various densities, i.e. stopping effective densities ρ(S), and the integrated depth dose measured in water (IDD) is applied accordingly for the patient dose calculation. Since the chemical composition of body tissues is different from that of water, this approximation causes dose calculation errors, especially due to difference in nuclear interactions. Here, we propose and validate an IDD correction method for these errors in patient dose calculations. For accurate handling of nuclear interactions, ρ(S) of the patient is converted to nuclear effective density ρ(N), defined as the ratio of the probability of nuclear interactions in the tissue to that in water using a recently formulated semi-empirical relationship between the two. The attenuation correction factor Φ(w)(p), defined as the ratio of the attenuation of primary carbon ions in a patient to that in water, is calculated from a linear integration of ρ(N) along the beam path. In our treatment planning system, a carbon-ion beam is modeled to be composed of three components according to their transverse beam sizes: primary carbon ions, heavier fragments, and lighter fragments. We corrected the dose contribution from primary carbon ions to IDD as proportional to Φ(w)(p), and corrected that from lighter fragments as inversely proportional to Φ(w)(p). We tested the correction method for some non-water materials, e.g. milk, lard, ethanol and water solution of potassium phosphate (K2HPO4), with un-scanned and scanned carbon-ion beams. In un-scanned beams, the difference in IDD between a beam penetrating a 150 mm-thick layer of lard and a beam penetrating water of the corresponding thickness amounted to -4%, while it was +6% for a 150 mm-thick layer of 40% K2HPO4. The observed differences were accurately predicted by the correction method. The corrected IDDs agreed with the measurements within

  1. The use of computed tomography images in Monte Carlo treatment planning

    NASA Astrophysics Data System (ADS)

    Bazalova, Magdalena

    Monte Carlo (MC) dose calculations cannot accurately assess the dose delivered to the patient during radiotherapy unless the patient anatomy is well known. This thesis focuses on the conversion of patient computed tomography (CT) images into MC geometry files. Metal streaking artifacts and their effect on MC dose calculations are first studied. A correction algorithm is applied to artifact-corrupted images and dose errors due to density and tissue mis-assignment are quantified in a phantom and a patient study. The correction algorithm and MC dose calculations for various treatment beams are also investigated using phantoms with real hip prostheses. As a result of this study, we suggest that a metal artifact correction algorithm should be a part of any MC treatment planning. By means of MC simulations, scatter is proven to be a major cause of metal artifacts. The use of dual-energy CT (DECT) for a novel tissue segmentation scheme is thoroughly investigated. First, MC simulations are used to determine the optimal beam filtration for an accurate DECT material extraction. DECT is then tested on a CT scanner with a phantom and a good agreement in the extraction of two material properties, the relative electron density rhoe and the effective atomic number Z is found. Compared to the conventional tissue segmentation based on rhoe-differences, the novel tissue segmentation scheme uses differences in both rhoe and Z. The phantom study demonstrates that the novel method based on rhoe and Z information works well and makes MC dose calculations more accurate. This thesis demonstrates that DECT suppresses streaking artifacts from brachytherapy seeds. Brachytherapy MC dose calculations using single-energy CT images with artifacts and DECT images with suppressed artifacts are performed and the effect of artifact reduction is investigated. The patient and canine DECT studies also show that image noise and object motion are very important factors in DECT. A solution for reduction

  2. SU-E-T-337: Treatment Planning Study of Craniospinal Irradiation with Spot Scanning Proton Therapy

    SciTech Connect

    Tasson, A; Beltran, C; Laack, N; Childs, S; Tryggestad, E; Whitaker, T

    2014-06-01

    Purpose: To develop a treatment planning technique that achieves optimal robustness against systematic position and range uncertainties, and interfield position errors for craniospinal irradiation (CSI) using spot scanning proton radiotherapy. Methods: Eighteen CSI patients who had previously been treated using photon radiation were used for this study. Eight patients were less than 10 years old. The prescription dose was 23.4Gy in 1.8Gy fractions. Two different field arrangement types were investigated: 1 posterior field per isocenter and 2 posterior oblique fields per isocenter. For each field type, two delivery configurations were used: 5cm bolus attached to the treatment table and a 4.5cm range shifter located inside the nozzle. The target for each plan was the whole brain and thecal sac. For children under the age of 10, all plan types were repeated with an additional dose of 21Gy prescribed to the vertebral bodies. Treatment fields were matched by stepping down the dose in 10% increments over 9cm. Robustness against 3% and 3mm uncertainties, as well as a 3mm inter-field error was analyzed. Dose coverage of the target and critical structure sparing for each plan type will be considered. Ease of planning and treatment delivery was also considered for each plan type. Results: The mean dose volume histograms show that the bolus plan with posterior beams gave the best overall plan, and all proton plans were comparable to or better than the photon plans. The plan type that was the most robust against the imposed uncertainties was also the bolus plan with posterior beams. This is also the plan configuration that is the easiest to deliver and plan. Conclusion: The bolus plan with posterior beams achieved optimal robustness against systematic position and range uncertainties, as well as inter-field position errors.

  3. Treatment plan comparison between helical tomotherapy and MLC-based IMRT using radiobiological measures

    NASA Astrophysics Data System (ADS)

    Mavroidis, Panayiotis; Costa Ferreira, Brigida; Shi, Chengyu; Lind, Bengt K.; Papanikolaou, Nikos

    2007-07-01

    The rapid implementation of advanced treatment planning and delivery technologies for radiation therapy has brought new challenges in evaluating the most effective treatment modality. Intensity-modulated radiotherapy (IMRT) using multi-leaf collimators (MLC) and helical tomotherapy (HT) are becoming popular modes of treatment delivery and their application and effectiveness continues to be investigated. Presently, there are several treatment planning systems (TPS) that can generate and optimize IMRT plans based on user-defined objective functions for the internal target volume (ITV) and organs at risk (OAR). However, the radiobiological parameters of the different tumours and normal tissues are typically not taken into account during dose prescription and optimization of a treatment plan or during plan evaluation. The suitability of a treatment plan is typically decided based on dosimetric criteria such as dose-volume histograms (DVH), maximum, minimum, mean and standard deviation of the dose distribution. For a more comprehensive treatment plan evaluation, the biologically effective uniform dose ({\\bar{\\bar{D}}}) is applied together with the complication-free tumour control probability (P+). Its utilization is demonstrated using three clinical cases that were planned with two different forms of IMRT. In this study, three different cancer types at different anatomical sites were investigated: head and neck, lung and prostate cancers. For each cancer type, a linac MLC-based step-and-shoot IMRT plan and a HT plan were developed. The MLC-based IMRT treatment plans were developed on the Philips treatment-planning platform, using the Pinnacle 7.6 software release. For the tomotherapy HiArt plans, the dedicated tomotherapy treatment planning station was used, running version 2.1.2. By using {\\bar{\\bar{D}}} as the common prescription point of the treatment plans and plotting the tissue response probabilities versus {\\bar{\\bar{D}}} for a range of prescription doses

  4. A Comprehensive Comparison of IMRT and VMAT Plan Quality for Prostate Cancer Treatment

    SciTech Connect

    Quan, Enzhuo M.; Li Xiaoqiang; Li Yupeng; Wang Xiaochun; Kudchadker, Rajat J.; Johnson, Jennifer L.; Kuban, Deborah A.; Lee, Andrew K.; Zhang Xiaodong

    2012-07-15

    Purpose: We performed a comprehensive comparative study of the plan quality between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of prostate cancer. Methods and Materials: Eleven patients with prostate cancer treated at our institution were randomly selected for this study. For each patient, a VMAT plan and a series of IMRT plans using an increasing number of beams (8, 12, 16, 20, and 24 beams) were examined. All plans were generated using our in-house-developed automatic inverse planning (AIP) algorithm. An existing eight-beam clinical IMRT plan, which was used to treat the patient, was used as the reference plan. For each patient, all AIP-generated plans were optimized to achieve the same level of planning target volume (PTV) coverage as the reference plan. Plan quality was evaluated by measuring mean dose to and dose-volume statistics of the organs at risk, especially the rectum, from each type of plan. Results: For the same PTV coverage, the AIP-generated VMAT plans had significantly better plan quality in terms of rectum sparing than the eight-beam clinical and AIP-generated IMRT plans (p < 0.0001). However, the differences between the IMRT and VMAT plans in all the dosimetric indices decreased as the number of beams used in IMRT increased. IMRT plan quality was similar or superior to that of VMAT when the number of beams in IMRT was increased to a certain number, which ranged from 12 to 24 for the set of patients studied. The superior VMAT plan quality resulted in approximately 30% more monitor units than the eight-beam IMRT plans, but the delivery time was still less than 3 min. Conclusions: Considering the superior plan quality as well as the delivery efficiency of VMAT compared with that of IMRT, VMAT may be the preferred modality for treating prostate cancer.

  5. Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

    PubMed

    Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

    2016-01-01

    A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of

  6. Maximizing dosimetric benefits of IMRT in the treatment of localized prostate cancer through multicriteria optimization planning

    SciTech Connect

    Wala, Jeremiah; Craft, David; Paly, Jon; Zietman, Anthony; Efstathiou, Jason

    2013-10-01

    We examine the quality of plans created using multicriteria optimization (MCO) treatment planning in intensity-modulated radiation therapy (IMRT) in treatment of localized prostate cancer. Nine random cases of patients receiving IMRT to the prostate were selected. Each case was associated with a clinically approved plan created using Corvus. The cases were replanned using MCO-based planning in RayStation. Dose-volume histogram data from both planning systems were presented to 2 radiation oncologists in a blinded evaluation, and were compared at a number of dose-volume points. Both physicians rated all 9 MCO plans as superior to the clinically approved plans (p<10{sup −5}). Target coverage was equivalent (p = 0.81). Maximum doses to the prostate and bladder and the V50 and V70 to the anterior rectum were reduced in all MCO plans (p<0.05). Treatment planning time with MCO took approximately 60 minutes per case. MCO-based planning for prostate IMRT is efficient and produces high-quality plans with good target homogeneity and sparing of the anterior rectum, bladder, and femoral heads, without sacrificing target coverage.

  7. Preoperative treatment planning with intraoperative optimization can achieve consistent high-quality implants in prostate brachytherapy

    SciTech Connect

    Kudchadker, Rajat J.; Pugh, Thomas J.; Swanson, David A.; Bruno, Teresa L.; Bolukbasi, Yasemin; Frank, Steven J.

    2012-01-01

    Advances in brachytherapy treatment planning systems have allowed the opportunity for brachytherapy to be planned intraoperatively as well as preoperatively. The relative advantages and disadvantages of each approach have been the subject of extensive debate, and some contend that the intraoperative approach is vital to the delivery of optimal therapy. The purpose of this study was to determine whether high-quality permanent prostate implants can be achieved consistently using a preoperative planning approach that allows for, but does not necessitate, intraoperative optimization. To achieve this purpose, we reviewed the records of 100 men with intermediate-risk prostate cancer who had been prospectively treated with brachytherapy monotherapy between 2006 and 2009 at our institution. All patients were treated with iodine-125 stranded seeds; the planned target dose was 145 Gy. Only 8 patients required adjustments to the plan on the basis of intraoperative findings. Consistency and quality were assessed by calculating the correlation coefficient between the planned and implanted amounts of radioactivity and by examining the mean values of the dosimetric parameters obtained on preoperative and 30 days postoperative treatment planning. The amount of radioactivity implanted was essentially identical to that planned (mean planned radioactivity, 41.27 U vs. mean delivered radioactivity, 41.36 U; R{sup 2} = 0.99). The mean planned and day 30 prostate V100 values were 99.9% and 98.6%, respectively. The mean planned and day 30 prostate D90 values were 186.3 and 185.1 Gy, respectively. Consistent, high-quality prostate brachytherapy treatment plans can be achieved using a preoperative planning approach, mostly without the need for intraoperative optimization. Good quality assurance measures during simulation, treatment planning, implantation, and postimplant evaluation are paramount for achieving a high level of quality and consistency.

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

    SciTech Connect

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

    2015-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  10. A Monte Carlo-based treatment planning tool for proton therapy

    NASA Astrophysics Data System (ADS)

    Mairani, A.; Böhlen, T. T.; Schiavi, A.; Tessonnier, T.; Molinelli, S.; Brons, S.; Battistoni, G.; Parodi, K.; Patera, V.

    2013-04-01

    In the field of radiotherapy, Monte Carlo (MC) particle transport calculations are recognized for their superior accuracy in predicting dose and fluence distributions in patient geometries compared to analytical algorithms which are generally used for treatment planning due to their shorter execution times. In this work, a newly developed MC-based treatment planning (MCTP) tool for proton therapy is proposed to support treatment planning studies and research applications. It allows for single-field and simultaneous multiple-field optimization in realistic treatment scenarios and is based on the MC code FLUKA. Relative biological effectiveness (RBE)-weighted dose is optimized either with the common approach using a constant RBE of 1.1 or using a variable RBE according to radiobiological input tables. A validated reimplementation of the local effect model was used in this work to generate radiobiological input tables. Examples of treatment plans in water phantoms and in patient-CT geometries together with an experimental dosimetric validation of the plans are presented for clinical treatment parameters as used at the Italian National Center for Oncological Hadron Therapy. To conclude, a versatile MCTP tool for proton therapy was developed and validated for realistic patient treatment scenarios against dosimetric measurements and commercial analytical TP calculations. It is aimed to be used in future for research and to support treatment planning at state-of-the-art ion beam therapy facilities.

  11. Intensity modulated proton therapy treatment planning using single-field optimization: The impact of monitor unit constraints on plan quality

    SciTech Connect

    Zhu, X. R.; Sahoo, N.; Zhang, X.; Robertson, D.; Li, H.; Choi, S.; Lee, A. K.; Gillin, M. T.

    2010-03-15

    Purpose: To investigate the effect of monitor unit (MU) constraints on the dose distribution created by intensity modulated proton therapy (IMPT) treatment planning using single-field optimization (SFO). Methods: Ninety-four energies between 72.5 and 221.8 MeV are available for scanning beam IMPT delivery at our institution. The minimum and maximum MUs for delivering each pencil beam (spot) are 0.005 and 0.04, respectively. These MU constraints are not considered during optimization by the treatment planning system; spots are converted to deliverable MUs during postprocessing. Treatment plans for delivering uniform doses to rectangular volumes with and without MU constraints were generated for different target doses, spot spacings, spread-out Bragg peak (SOBP) widths, and ranges in a homogeneous phantom. Four prostate cancer patients were planned with and without MU constraints using different spot spacings. Rounding errors were analyzed using an in-house software tool. Results: From the phantom study, the authors have found that both the number of spots that have rounding errors and the magnitude of the distortion of the dose distribution from the ideally optimized distribution increases as the field dose, spot spacing, and range decrease and as the SOBP width increases. From our study of patient plans, it is clear that as the spot spacing decreases the rounding error increases, and the dose coverage of the target volume becomes unacceptable for very small spot spacings. Conclusions: Constraints on deliverable MU for each spot could create a significant distortion from the ideally optimized dose distributions for IMPT fields using SFO. To eliminate this problem, the treatment planning system should incorporate the MU constraints in the optimization process and the delivery system should reliably delivery smaller minimum MUs.

  12. Vocational Rehabilitation of the Drug Abuser: Treatment Planning and Clinical Supervision. No. 5 in a Series.

    ERIC Educational Resources Information Center

    Wolkstein, Eileen; Richman, Alex

    An outline of vocational rehabilitation of the ex-addict is presented, with emphasis placed on the development of treatment plans, counselor inservice training, and clinical procedures. Discussion is based on the Beth Israel Medical Center (BIMC) programs of Methadone Maintenance Treatment and Alcohol Treatment. Section 1, Proceedings, defines…

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

    Purpose: Using a database of prior treated patients, it is possible to predict the dose to critical structures for future patients. Automatic treatment planning speeds the planning process by generating a good initial plan from predicted dose values. Methods: A SQL relational database of previously approved treatment plans is populated via an automated export from Pinnacle3. This script outputs dose and machine information and selected Regions of Interests as well as its associated Dose-Volume Histogram (DVH) and Overlap Volume Histograms (OVHs) with respect to the target structures. Toxicity information is exported from Mosaiq and added to the database for each patient. The SQL query is designed to ask the system for the lowest achievable dose for a specified region of interest (ROI) for each patient with a given volume of that ROI being as close or closer to the target than the current patient. Results: The additional time needed to calculate OVHs is approximately 1.5 minutes for a typical patient. Database lookup of planning objectives takes approximately 4 seconds. The combined additional time is less than that of a typical single plan optimization (2.5 mins). Conclusions: An automatic treatment planning interface has been successfully used by dosimetrists to quickly produce a number of SBRT pancreas treatment plans. The database can be used to compare dose to individual structures with the toxicity experienced and predict toxicities before planning for future patients.

  14. Interactive approach to segment organs at risk in radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Dolz, Jose; Kirisli, Hortense A.; Viard, Romain; Massoptier, Laurent

    2014-03-01

    Accurate delineation of organs at risk (OAR) is required for radiation treatment planning (RTP). However, it is a very time consuming and tedious task. The use in clinic of image guided radiation therapy (IGRT) becomes more and more popular, thus increasing the need of (semi-)automatic methods for delineation of the OAR. In this work, an interactive segmentation approach to delineate OAR is proposed and validated. The method is based on the combination of watershed transformation, which groups small areas of similar intensities in homogeneous labels, and graph cuts approach, which uses these labels to create the graph. Segmentation information can be added in any view - axial, sagittal or coronal -, making the interaction with the algorithm easy and fast. Subsequently, this information is propagated within the whole volume, providing a spatially coherent result. Manual delineations made by experts of 6 OAR - lungs, kidneys, liver, spleen, heart and aorta - over a set of 9 computed tomography (CT) scans were used as reference standard to validate the proposed approach. With a maximum of 4 interactions, a Dice similarity coefficient (DSC) higher than 0.87 was obtained, which demonstrates that, with the proposed segmentation approach, only few interactions are required to achieve similar results as the ones obtained manually. The integration of this method in the RTP process may save a considerable amount of time, and reduce the annotation complexity.

  15. Treatment planning for prostate focal laser ablation in the face of needle placement uncertainty

    SciTech Connect

    Cepek, Jeremy Fenster, Aaron; Lindner, Uri; Trachtenberg, John; Davidson, Sean R. H.; Haider, Masoom A.; Ghai, Sangeet

    2014-01-15

    Purpose: To study the effect of needle placement uncertainty on the expected probability of achieving complete focal target destruction in focal laser ablation (FLA) of prostate cancer. Methods: Using a simplified model of prostate cancer focal target, and focal laser ablation region shapes, Monte Carlo simulations of needle placement error were performed to estimate the probability of completely ablating a region of target tissue. Results: Graphs of the probability of complete focal target ablation are presented over clinically relevant ranges of focal target sizes and shapes, ablation region sizes, and levels of needle placement uncertainty. In addition, a table is provided for estimating the maximum target size that is treatable. The results predict that targets whose length is at least 5 mm smaller than the diameter of each ablation region can be confidently ablated using, at most, four laser fibers if the standard deviation in each component of needle placement error is less than 3 mm. However, targets larger than this (i.e., near to or exceeding the diameter of each ablation region) require more careful planning. This process is facilitated by using the table provided. Conclusions: The probability of completely ablating a focal target using FLA is sensitive to the level of needle placement uncertainty, especially as the target length approaches and becomes greater than the diameter of ablated tissue that each individual laser fiber can achieve. The results of this work can be used to help determine individual patient eligibility for prostate FLA, to guide the planning of prostate FLA, and to quantify the clinical benefit of using advanced systems for accurate needle delivery for this treatment modality.

  16. Developing a Treatment Planning Software Based on TG-43U1 Formalism for Cs-137 LDR Brachytherapy

    PubMed Central

    Sina, Sedigheh; Faghihi, Reza; Soleimani Meigooni, Ali; Siavashpour, Zahra; Mosleh-Shirazi, Mohammad Amin

    2013-01-01

    Background The old Treatment Planning Systems (TPSs) used for intracavitary brachytherapy with Cs-137 Selectron source utilize traditional dose calculation methods, considering each source as a point source. Using such methods introduces significant errors in dose estimation. As of 1995, TG-43 is used as the main dose calculation formalism in treatment TPSs. Objectives The purpose of this study is to design and establish a treatment planning software for Cs-137 Solectron brachytherapy source, based on TG-43U1 formalism by applying the effects of the applicator and dummy spacers. Materials and Methods Two softwares used for treatment planning of Cs-137 sources in Iran (STPS and PLATO), are based on old formalisms. The purpose of this work is to establish and develop a TPS for Selectron source based on TG-43 formalism. In this planning system, the dosimetry parameters of each pellet in different places inside applicators were obtained by MCNP4c code. Then the dose distribution around every combination of active and inactive pellets was obtained by summing the doses. The accuracy of this algorithm was checked by comparing its results for special combination of active and inactive pellets with MC simulations. Finally, the uncertainty of old dose calculation formalism was investigated by comparing the results of STPS and PLATO softwares with those obtained by the new algorithm. Results For a typical arrangement of 10 active pellets in the applicator, the percentage difference between doses obtained by the new algorithm at 1cm distance from the tip of the applicator and those obtained by old formalisms is about 30%, while the difference between the results of MCNP and the new algorithm is less than 5%. Conclusions According to the results, the old dosimetry formalisms, overestimate the dose especially towards the applicator’s tip. While the TG-43U1 based software perform the calculations more accurately. PMID:24578840

  17. Application of dose kernel calculation using a simplified Monte Carlo method to treatment plan for scanned proton beams.

    PubMed

    Mizutani, Shohei; Takada, Yoshihisa; Kohno, Ryosuke; Hotta, Kenji; Tansho, Ryohei; Akimoto, Tetsuo

    2016-01-01

    Full Monte Carlo (FMC) calculation of dose distribution has been recognized to have superior accuracy, compared with the pencil beam algorithm (PBA). However, since the FMC methods require long calculation time, it is difficult to apply them to routine treatment planning at present. In order to improve the situation, a simplified Monte Carlo (SMC) method has been introduced to the dose kernel calculation applicable to dose optimization procedure for the proton pencil beam scanning. We have evaluated accuracy of the SMC calculation by comparing a result of the dose kernel calculation using the SMC method with that using the FMC method in an inhomogeneous phantom. The dose distribution obtained by the SMC method was in good agreement with that obtained by the FMC method. To assess the usefulness of SMC calculation in clinical situations, we have compared results of the dose calculation using the SMC with those using the PBA method for three clinical cases of tumor treatment. The dose distributions calculated with the PBA dose kernels appear to be homogeneous in the planning target volumes (PTVs). In practice, the dose distributions calculated with the SMC dose kernels with the spot weights optimized with the PBA method show largely inhomogeneous dose distributions in the PTVs, while those with the spot weights optimized with the SMC method have moderately homogeneous distributions in the PTVs. Calculation using the SMC method is faster than that using the GEANT4 by three orders of magnitude. In addition, the graphic processing unit (GPU) boosts the calculation speed by 13times for the treatment planning using the SMC method. Thence, the SMC method will be applicable to routine clinical treatment planning for reproduc-tion of the complex dose distribution more accurately than the PBA method in a reasonably short time by use of the GPU-based calculation engine. PMID:27074456

  18. Wastewater treatment plants -- Planning, design, and operation. 2. edition

    SciTech Connect

    Qasim, S.R.

    1999-08-01

    All concepts for planning, designing, and operating are presented clearly and concisely: unit operations and processes, flow schemes, intercepting sewers, screening, pumping stations, grit removal, primary sedimentation disinfection, sludge stabilization, and more. The book contains new information on bar screen design, biological nutrient removal process, UV disinfection, belt filter, and biosolids use.

  19. WETLAND TREATMENT SYSTEMS: A RESEARCH PLAN FOR 1991-1996

    EPA Science Inventory

    The Wetlands Research Program of the U.S. Environmental Protection Agency through the Clean Water Act, is working to provide technical guidance for protecting the chemical and biological integrity of U.S. surface waters. owards this goal, a six year research plan has been develop...

  20. An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

    PubMed

    Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

    2016-01-01

    Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be

  1. An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm

    PubMed Central

    Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

    2016-01-01

    Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be

  2. A Knowledge-Based Approach to Improving and Homogenizing Intensity Modulated Radiation Therapy Planning Quality Among Treatment Centers: An Example Application to Prostate Cancer Planning

    SciTech Connect

    Good, David; Lo, Joseph; Lee, W. Robert; Wu, Q. Jackie; Yin, Fang-Fang; Das, Shiva K.

    2013-09-01

    Purpose: Intensity modulated radiation therapy (IMRT) treatment planning can have wide variation among different treatment centers. We propose a system to leverage the IMRT planning experience of larger institutions to automatically create high-quality plans for outside clinics. We explore feasibility by generating plans for patient datasets from an outside institution by adapting plans from our institution. Methods and Materials: A knowledge database was created from 132 IMRT treatment plans for prostate cancer at our institution. The outside institution, a community hospital, provided the datasets for 55 prostate cancer cases, including their original treatment plans. For each “query” case from the outside institution, a similar “match” case was identified in the knowledge database, and the match case’s plan parameters were then adapted and optimized to the query case by use of a semiautomated approach that required no expert planning knowledge. The plans generated with this knowledge-based approach were compared with the original treatment plans at several dose cutpoints. Results: Compared with the original plan, the knowledge-based plan had a significantly more homogeneous dose to the planning target volume and a significantly lower maximum dose. The volumes of the rectum, bladder, and femoral heads above all cutpoints were nominally lower for the knowledge-based plan; the reductions were significantly lower for the rectum. In 40% of cases, the knowledge-based plan had overall superior (lower) dose–volume histograms for rectum and bladder; in 54% of cases, the comparison was equivocal; in 6% of cases, the knowledge-based plan was inferior for both bladder and rectum. Conclusions: Knowledge-based planning was superior or equivalent to the original plan in 95% of cases. The knowledge-based approach shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced institutions.

  3. Dosimetric verification and clinical evaluation of a new commercially available Monte Carlo-based dose algorithm for application in stereotactic body radiation therapy (SBRT) treatment planning

    NASA Astrophysics Data System (ADS)

    Fragoso, Margarida; Wen, Ning; Kumar, Sanath; Liu, Dezhi; Ryu, Samuel; Movsas, Benjamin; Munther, Ajlouni; Chetty, Indrin J.

    2010-08-01

    Modern cancer treatment techniques, such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have greatly increased the demand for more accurate treatment planning (structure definition, dose calculation, etc) and dose delivery. The ability to use fast and accurate Monte Carlo (MC)-based dose calculations within a commercial treatment planning system (TPS) in the clinical setting is now becoming more of a reality. This study describes the dosimetric verification and initial clinical evaluation of a new commercial MC-based photon beam dose calculation algorithm, within the iPlan v.4.1 TPS (BrainLAB AG, Feldkirchen, Germany). Experimental verification of the MC photon beam model was performed with film and ionization chambers in water phantoms and in heterogeneous solid-water slabs containing bone and lung-equivalent materials for a 6 MV photon beam from a Novalis (BrainLAB) linear accelerator (linac) with a micro-multileaf collimator (m3 MLC). The agreement between calculated and measured dose distributions in the water phantom verification tests was, on average, within 2%/1 mm (high dose/high gradient) and was within ±4%/2 mm in the heterogeneous slab geometries. Example treatment plans in the lung show significant differences between the MC and one-dimensional pencil beam (PB) algorithms within iPlan, especially for small lesions in the lung, where electronic disequilibrium effects are emphasized. Other user-specific features in the iPlan system, such as options to select dose to water or dose to medium, and the mean variance level, have been investigated. Timing results for typical lung treatment plans show the total computation time (including that for processing and I/O) to be less than 10 min for 1-2% mean variance (running on a single PC with 8 Intel Xeon X5355 CPUs, 2.66 GHz). Overall, the iPlan MC algorithm is demonstrated to be an accurate and efficient dose algorithm, incorporating robust tools for MC

  4. Dosimetric verification and clinical evaluation of a new commercially available Monte Carlo-based dose algorithm for application in stereotactic body radiation therapy (SBRT) treatment planning.

    PubMed

    Fragoso, Margarida; Wen, Ning; Kumar, Sanath; Liu, Dezhi; Ryu, Samuel; Movsas, Benjamin; Munther, Ajlouni; Chetty, Indrin J

    2010-08-21

    Modern cancer treatment techniques, such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have greatly increased the demand for more accurate treatment planning (structure definition, dose calculation, etc) and dose delivery. The ability to use fast and accurate Monte Carlo (MC)-based dose calculations within a commercial treatment planning system (TPS) in the clinical setting is now becoming more of a reality. This study describes the dosimetric verification and initial clinical evaluation of a new commercial MC-based photon beam dose calculation algorithm, within the iPlan v.4.1 TPS (BrainLAB AG, Feldkirchen, Germany). Experimental verification of the MC photon beam model was performed with film and ionization chambers in water phantoms and in heterogeneous solid-water slabs containing bone and lung-equivalent materials for a 6 MV photon beam from a Novalis (BrainLAB) linear accelerator (linac) with a micro-multileaf collimator (m(3) MLC). The agreement between calculated and measured dose distributions in the water phantom verification tests was, on average, within 2%/1 mm (high dose/high gradient) and was within +/-4%/2 mm in the heterogeneous slab geometries. Example treatment plans in the lung show significant differences between the MC and one-dimensional pencil beam (PB) algorithms within iPlan, especially for small lesions in the lung, where electronic disequilibrium effects are emphasized. Other user-specific features in the iPlan system, such as options to select dose to water or dose to medium, and the mean variance level, have been investigated. Timing results for typical lung treatment plans show the total computation time (including that for processing and I/O) to be less than 10 min for 1-2% mean variance (running on a single PC with 8 Intel Xeon X5355 CPUs, 2.66 GHz). Overall, the iPlan MC algorithm is demonstrated to be an accurate and efficient dose algorithm, incorporating robust tools for MC

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

    SciTech Connect

    Not Available

    1993-10-01

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

  6. Utility of megavoltage fan-beam CT for treatment planning in a head-and-neck cancer patient with extensive dental fillings undergoing helical tomotherapy.

    PubMed

    Yang, Claus; Liu, Tianxiao; Jennelle, Richard L; Ryu, Janice K; Vijayakumar, Srinivasan; Purdy, James A; Chen, Allen M

    2010-01-01

    The purpose of this study was to demonstrate the potential utility of megavoltage fan-beam computed tomography (MV-FBCT) for treatment planning in a patient undergoing helical tomotherapy for nasopharyngeal carcinoma in the presence of extensive dental artifact. A 28-year-old female with locally advanced nasopharyngeal carcinoma presented for radiation therapy. Due to the extensiveness of the dental artifact present in the oral cavity kV-CT scan acquired at simulation, which made treatment planning impossible on tomotherapy planning system, MV-FBCT imaging was obtained using the HI-ART tomotherapy treatment machine, with the patient in the treatment position, and this information was registered with her original kV-CT scan for the purposes of structure delineation, dose calculation, and treatment planning. To validate the feasibility of the MV-FBCT-generated treatment plan, an electron density CT phantom (model 465, Gammex Inc., Middleton, WI) was scanned using MV-FBCT to obtain CT number to density table. Additionally, both a "cheese" phantom (which came with the tomotherapy treatment machine) with 2 inserted ion chambers and a generic phantom called Quasar phantom (Modus Medical Devices Inc., London, ON, Canada) with one inserted chamber were used to confirm dosimetric accuracy. The MV-FBCT could be used to clearly visualize anatomy in the region of the dental artifact and provide sufficient soft-tissue contrast to assist in the delineation of normal tissue structures and fat planes. With the elimination of the dental artifact, the MV-FBCT images allowed more accurate dose calculation by the tomotherapy system. It was confirmed that the phantom material density was determined correctly by the tomotherapy MV-FBCT number to density table. The ion chamber measurements agreed with the calculations from the MV-FBCT generated phantom plan within 2%. MV-FBCT may be useful in radiation treatment planning for nasopharyngeal cancer patients in the setting of extensive

  7. Utility of Megavoltage Fan-Beam CT for Treatment Planning in a Head-And-Neck Cancer Patient with Extensive Dental Fillings Undergoing Helical Tomotherapy

    SciTech Connect

    Yang, Claus; Liu Tianxiao; Jennelle, Richard L.; Ryu, Janice K.; Vijayakumar, Srinivasan; Purdy, James A.; Chen, Allen M.

    2010-07-01

    The purpose of this study was to demonstrate the potential utility of megavoltage fan-beam computed tomography (MV-FBCT) for treatment planning in a patient undergoing helical tomotherapy for nasopharyngeal carcinoma in the presence of extensive dental artifact. A 28-year-old female with locally advanced nasopharyngeal carcinoma presented for radiation therapy. Due to the extensiveness of the dental artifact present in the oral cavity kV-CT scan acquired at simulation, which made treatment planning impossible on tomotherapy planning system, MV-FBCT imaging was obtained using the HI-ART tomotherapy treatment machine, with the patient in the treatment position, and this information was registered with her original kV-CT scan for the purposes of structure delineation, dose calculation, and treatment planning. To validate the feasibility of the MV-FBCT-generated treatment plan, an electron density CT phantom (model 465, Gammex Inc., Middleton, WI) was scanned using MV-FBCT to obtain CT number to density table. Additionally, both a 'cheese' phantom (which came with the tomotherapy treatment machine) with 2 inserted ion chambers and a generic phantom called Quasar phantom (Modus Medical Devices Inc., London, ON, Canada) with one inserted chamber were used to confirm dosimetric accuracy. The MV-FBCT could be used to clearly visualize anatomy in the region of the dental artifact and provide sufficient soft-tissue contrast to assist in the delineation of normal tissue structures and fat planes. With the elimination of the dental artifact, the MV-FBCT images allowed more accurate dose calculation by the tomotherapy system. It was confirmed that the phantom material density was determined correctly by the tomotherapy MV-FBCT number to density table. The ion chamber measurements agreed with the calculations from the MV-FBCT generated phantom plan within 2%. MV-FBCT may be useful in radiation treatment planning for nasopharyngeal cancer patients in the setting of extensive

  8. Treatment planning for parotid sparing in the patient requiring bilateral neck irradiation.

    PubMed

    Marsh, L; Eisbruch, A; Watson, B; Martel, M K

    1996-01-01

    The use of three dimensional (3-D) planning techniques for treatment of head and neck cancers has primarily been used in cases which require only unilateral neck irradiation. However, tumors that require bilateral neck irradiation are commonly managed with parallel opposed treatment portals. A common morbidity associated with this standard form of treatment is xerostomia. In an effort to reduce the incidence of this debilitating side effect, a protocol has been developed which attempts to balance effective tumor control with preservation of salivary flow. Key to this protocol is the use of 3-D treatment planning. The close proximity of the targeted tissues to critical structures and the related dose requirements and/or restrictions of these tissues often require the treatment planner to utilize "non-standard" approaches to achieve the unique dose distributions necessary to meet protocol eligibility. This may include treatment planning options such as non-coplanar, non-axial beams; and modulation of beam intensity. PMID:8679070

  9. Treatment Planning and Fracture Prediction in Patients with Skeletal Metastasis with CT-based Rigidity Analysis

    PubMed Central

    Nazarian, Ara; Entezari, Vahid; Zurakowski, David; Calderon, Nathan; Hipp, John A.; Villa-Camacho, Juan C.; Lin, Patrick P.; Cheung, Felix H.; Aboulafia, Albert J.; Turcotte, Robert; Anderson, Megan E.; Gebhardt, Mark C.; Cheng, Edward Y.; Terek, Richard M.; Yaszemski, Michael; Damron, Timothy A.; Snyder, Brian D.

    2015-01-01

    Background Pathological fractures could be prevented if reliable methods of fracture risk assessment were available. A multi-center, prospective study was conducted to identify significant predictors of physicians' treatment plan for skeletal metastasis based on clinical fracture risk assessments and the proposed CT-based Rigidity Analysis (CTRA). Methods Orthopaedic oncologists selected a treatment plan for 124 patients with 149 metastatic lesions based on Mirels method. Then, CTRA was performed and the results were provided to the physicians, who were asked to reassess their treatment plan. The pre- and post-CTRA treatment plans were compared to identify cases where the treatment plan was changed based on the CTRA report. Patients were followed for a 4 month period to establish the incidence of pathological fractures. Results Pain, lesion type and lesion size were significant predictors of the pre-CTRA plan. After providing the CTRA results, physicians changed their plan for 36 patients. CTRA results, pain and primary source of metastasis were significant predictors of the post-CTRA plan. Follow up of patients who did not undergo fixation resulted in 7 fractures; CTRA predicted these fractures with 100% sensitivity and 90% specificity, whereas the Mirels method was 71% sensitive and 50% specific. Conclusions Lesion type and size and pain level influenced the physicians’ plans for management of metastatic lesions. Physicians’ treatment plans and fracture risk predictions were significantly influenced by the availability of CTRA results. Due to its high sensitivity and specificity. CTRA could potentially be used as a screening method for pathological fractures. PMID:25724521

  10. Forensic focused treatment planning: a new standard for forensic mental health systems.

    PubMed

    Schaufenbil, Robert J; Kornbluh, Rebecca; Stahl, Stephen M; Warburton, Katherine D

    2015-06-01

    Almost no literature addresses treatment planning for the forensic psychiatric patient. In the absence of such guidance, recovery-oriented multifocal treatment planning has been imported into forensic mental health systems from community psychiatric settings, despite the fact that conditions of admission and discharge are vastly different for forensic psychiatry inpatients. We propose that instead of focusing on recovery, forensic treatment planning should prioritize forensic outcomes, such as restoration of trial competence or mitigation of violence risk, as the first steps in a continuum of care that eventually leads to the patient's ability to resolve forensic issues and return to the community for recovery-oriented care. Here we offer a model for treatment planning in the forensic setting. PMID:25801440

  11. Role of nutrition planning in the treatment for obesity.

    PubMed

    Atkinson, R L

    1996-12-01

    The most sensible eating plans are those that involve a wide selection of foods with a modest percentage of kilocalories as fat. The dietary pyramid developed by the US Government is an excellent basis for the construction of an eating plan for life. Patients should be encouraged to develop healthy eating habits that they can maintain indefinitely, as the early inevitable consequence of finishing a diet is regain of any weight that has been lost when the patient goes back to their old eating habits. The unfortunate fact is that individuals with the disease of obesity must behave differently than those who do not. This usually means that obese persons must eat differently than lean persons, and they must do this for their entire lives. Food is a critical part of the social fabric of our society. The physician, usually in combination with a knowledgeable and empathetic dietitian or other nutritional education resource, can help obese patients choose the series of compromises in eating plans and activity levels that can be maintained for life but still allow a reasonable quality of life. PMID:8977055

  12. A review of treatment planning for precision image-guided photon beam pre-clinical animal radiation studies.

    PubMed

    Verhaegen, Frank; van Hoof, Stefan; Granton, Patrick V; Trani, Daniela

    2014-12-01

    Recently, precision irradiators integrated with a high-resolution CT imaging device became available for pre-clinical studies. These research platforms offer significant advantages over older generations of animal irradiators in terms of precision and accuracy of image-guided radiation targeting. These platforms are expected to play a significant role in defining experiments that will allow translation of research findings to the human clinical setting. In the field of radiotherapy, but also others such as neurology, the platforms create unique opportunities to explore e.g. the synergy between radiation and drugs or other agents. To fully exploit the advantages of this new technology, accurate methods are needed to plan the irradiation and to calculate the three-dimensional radiation dose distribution in the specimen. To this end, dedicated treatment planning systems are needed. In this review we will discuss specific issues for precision irradiation of small animals, we will describe the workflow of animal treatment planning, and we will examine several dose calculation algorithms (factorization, superposition-convolution, Monte Carlo simulation) used for animal irradiation with kilovolt photon beams. Issues such as dose reporting methods, photon scatter, tissue segmentation and motion will also be discussed briefly. PMID:24629309

  13. Re-envisioning Addiction Treatment: A Six-Point Plan

    PubMed Central

    Kellogg, Scott H.

    2012-01-01

    This article is focused on improving the quality of addiction treatment. Based on observations that patients are leaving treatment too early and/or are continuing to use substances during their care, the authors propose six actions that could help reorient and revitalize this kind of clinical work: (1) conceptualize and treat addictive disorders within a psychiatric/mental health framework; (2) make the creation of a strong therapeutic alliance a core part of the healing process; (3) understand patients’ addictions and other problems using models based on multiple internal parts, voices, or modes; (4) make contingency management and the use of positive reinforcement systems a standard and central practice in all treatment settings; (5) envision long-term change and healing through the lens of identity theory; and (6) integrate the growing developments in recovery culture with formal treatment. PMID:22754086

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

    NASA Astrophysics Data System (ADS)

    Fredriksson, Albin; Bokrantz, Rasmus

    2013-11-01

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

  15. Automated VMAT treatment planning for stage III lung cancer: how does it compare with IMRT?

    PubMed Central

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

    2012-01-01

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

  16. Automated generation of IMRT treatment plans for prostate cancer patients with metal hip prostheses: Comparison of different planning strategies

    SciTech Connect

    Voet, Peter W. J.; Dirkx, Maarten L. P.; Breedveld, Sebastiaan; Heijmen, Ben J. M.

    2013-07-15

    sparing. Noncoplanar beam arrangements and, to a larger extent, increasing the number of treatment beams further improved plan quality.

  17. SU-E-T-527: Prior Knowledge Guided TomoTherapy Treatment Planning

    SciTech Connect

    Lian, J; Yuan, L; Wu, Q; Zhu, X; Chera, B; Chang, S

    2014-06-01

    Purpose: The quality and efficiency of radiotherapy treatment planning are highly planer dependent. Previously we have developed a statistical model to correlate anatomical features with dosimetry features of head and neck Tomotherapy treatment. The model enables us to predict the best achievable dosimetry for individual patient prior to treatment planning. The purpose of this work is to study if the prediction model can facilitate the treatment planning in both the efficiency and dosimetric quality. Methods: The anatomy-dosimetry correlation model was used to calculate the expected DVH for nine patients formerly treated. In Group A (3 patients), the model prediction agreed with the clinic plan; in Group B (3 patients), the model predicted lower larynx mean dose than the clinic plan; in Group C (3 patients), the model suggested the brainstem could be further spared. Guided by the prior knowledge, we re-planned all 9 cases. The number of interactions during the optimization process and dosimetric endpoints between the original clinical plan and model-guided re-plan were compared. Results: For Group A, the difference of target coverage and organs-at-risk sparing is insignificant (p>0.05) between the replan and the clinical plan. For Group B, the clinical plan larynx median dose is 49.4±4.7 Gy, while the prediction suggesting 40.0±6.2 Gy (p<0.05). The re-plan achieved 41.5±6.6 Gy, with similar dose on other structures as clinical plan. For Group C, the clinical plan brainstem maximum dose is 44.7±5.5 Gy. The model predicted lower value 32.2±3.8 Gy (p<0.05). The re-plans reduced brainstem maximum dose to 31.8±4.1 Gy without affecting the dosimetry of other structures. In the replanning of the 9 cases, the times operator interacted with TPS are reduced on average about 50% compared to the clinical plan. Conclusion: We have demonstrated that the prior expert knowledge embedded model improved the efficiency and quality of Tomotherapy treatment planning.

  18. Evaluation and comparison of New 4DCT based strategies for proton treatment planning for lung tumors

    PubMed Central

    2013-01-01

    Purpose To evaluate different strategies for proton lung treatment planning based on four-dimensional CT (4DCT) scans. Methods and Materials Twelve cases, involving only gross tumor volumes (GTV), were evaluated. Single image sets of (1) maximum intensity projection (MIP3) of end inhale (EI), middle exhale (ME) and end exhale (EE) images; (2) average intensity projection (AVG) of all phase images; and (3) EE images from 4DCT scans were selected as primary images for proton treatment planning. Internal target volumes (ITVs) outlined by a clinician were imported into MIP3, AVG, and EE images as planning targets. Initially, treatment uncertainties were not included in planning. Each plan was imported into phase images of 4DCT scans. Relative volumes of GTVs covered by 95% of prescribed dose and mean ipsilateral lung dose of a phase image obtained by averaging the dose in inspiration and expiration phases were used to evaluate the quality of a plan for a particular case. For comparing different planning strategies, the mean of the averaged relative volumes of GTVs covered by 95% of prescribed dose and its standard deviation for each planning strategy for all cases were used. Then, treatment uncertainties were included in planning. Each plan was recalculated in phase images of 4DCT scans. Same strategies were used for plan evaluation except dose-volume histograms of the planning target volumes (PTVs) instead of GTVs were used and the mean and standard deviation of the relative volumes of PTVs covered by 95% of prescribed dose and the ipsilateral lung dose were used to compare different planning strategies. Results MIP3 plans without treatment uncertainties yielded 96.7% of the mean relative GTV covered by 95% of prescribed dose (standard deviations of 5.7% for all cases). With treatment uncertainties, MIP3 plans yielded 99.5% of mean relative PTV covered by 95% of prescribed dose (standard deviations of 0.7%). Inclusion of treatment uncertainties improved PTV dose

  19. A 'learning-by-doing' treatment planning tutorial for medical physicists.

    PubMed

    Meyer, J; Hartmann, B; Kalet, I

    2009-06-01

    A framework for a tutorial for treatment planning in radiation oncology physics was developed, based on the University of Washington treatment planning system Prism. The tutorial is aimed at students in Medical Physics to accompany the lectures on treatment planning to enhance their theoretical knowledge. A web-based layout was chosen to allow independent work of the students. The tutorial guides the students through three different learning modules, designed mainly to enhance their understanding of the processes involved in treatment planning but also to learn the specific features of a modern treatment planning system. Each of the modules contains four units, with the aim to introduce the relevant Prism features, practice skills in different tasks and finally check the learning outcomes with a challenge and a self-scoring quiz. A survey for students' feedback completes the tutorial. Various tools and learning methods help to create an interactive, appealing learning environment, in which the emphasis is shifted from teacher-centred to student-centred learning paradigms. In summary, Prism lends itself well for educational purposes. The tutorial covers all main aspects of treatment planning. In its current form the tutorial is self-contained but still adjustable and expandable. The tutorial can be made available upon request to the authors. PMID:19623863

  20. Fundus image fusion in EYEPLAN software: An evaluation of a novel technique for ocular melanoma radiation treatment planning

    SciTech Connect

    Daftari, Inder K.; Mishra, Kavita K.; O'Brien, Joan M.; and others

    2010-10-15

    Purpose: The purpose of this study is to evaluate a novel approach for treatment planning using digital fundus image fusion in EYEPLAN for proton beam radiation therapy (PBRT) planning for ocular melanoma. The authors used a prototype version of EYEPLAN software, which allows for digital registration of high-resolution fundus photographs. The authors examined the improvement in tumor localization by replanning with the addition of fundus photo superimposition in patients with macular area tumors. Methods: The new version of EYEPLAN (v3.05) software allows for the registration of fundus photographs as a background image. This is then used in conjunction with clinical examination, tantalum marker clips, surgeon's mapping, and ultrasound to draw the tumor contour accurately. In order to determine if the fundus image superimposition helps in tumor delineation and treatment planning, the authors identified 79 patients with choroidal melanoma in the macular location that were treated with PBRT. All patients were treated to a dose of 56 GyE in four fractions. The authors reviewed and replanned all 79 macular melanoma cases with superimposition of pretreatment and post-treatment fundus imaging in the new EYEPLAN software. For patients with no local failure, the authors analyzed whether fundus photograph fusion accurately depicted and confirmed tumor volumes as outlined in the original treatment plan. For patients with local failure, the authors determined whether the addition of the fundus photograph might have benefited in terms of more accurate tumor volume delineation. Results: The mean follow-up of patients was 33.6{+-}23 months. Tumor growth was seen in six eyes of the 79 macular lesions. All six patients were marginal failures or tumor miss in the region of dose fall-off, including one patient with both in-field recurrence as well as marginal. Among the six recurrences, three were managed by enucleation and one underwent retreatment with proton therapy. Three

  1. Clinical Realization of Sector Beam Intensity Modulation for Gamma Knife Radiosurgery: A Pilot Treatment Planning Study

    SciTech Connect

    Ma, Lijun; Mason, Erica; Sneed, Penny K.; McDermott, Michael; Polishchuk, Alexei; Larson, David A.; Sahgal, Arjun

    2015-03-01

    Purpose: To demonstrate the clinical feasibility and potential benefits of sector beam intensity modulation (SBIM) specific to Gamma Knife stereotactic radiosurgery (GKSRS). Methods and Materials: SBIM is based on modulating the confocal beam intensities from individual sectors surrounding an isocenter in a nearly 2π geometry. This is in contrast to conventional GKSRS delivery, in which the beam intensities from each sector are restricted to be either 0% or 100% and must be identical for any given isocenter. We developed a SBIM solution based on available clinical planning tools, and we tested it on a cohort of 12 clinical cases as a proof of concept study. The SBIM treatment plans were compared with the original clinically delivered treatment plans to determine dosimetric differences. The goal was to investigate whether SBIM would improve the dose conformity for these treatment plans without prohibitively lengthening the treatment time. Results: A SBIM technique was developed. On average, SBIM improved the Paddick conformity index (PCI) versus the clinically delivered plans (clinical plan PCI = 0.68 ± 0.11 vs SBIM plan PCI = 0.74 ± 0.10, P=.002; 2-tailed paired t test). The SBIM plans also resulted in nearly identical target volume coverage (mean, 97 ± 2%), total beam-on times (clinical plan 58.4 ± 38.9 minutes vs SBIM 63.5 ± 44.7 minutes, P=.057), and gradient indices (clinical plan 3.03 ± 0.27 vs SBIM 3.06 ± 0.29, P=.44) versus the original clinical plans. Conclusion: The SBIM method is clinically feasible with potential dosimetric gains when compared with conventional GKSRS.

  2. Migration check tool: automatic plan verification following treatment management systems upgrade and database migration.

    PubMed

    Hadley, Scott W; White, Dale; Chen, Xiaoping; Moran, Jean M; Keranen, Wayne M

    2013-01-01

    Software upgrades of the treatment management system (TMS) sometimes require that all data be migrated from one version of the database to another. It is necessary to verify that the data are correctly migrated to assure patient safety. It is impossible to verify by hand the thousands of parameters that go into each patient's radiation therapy treatment plan. Repeating pretreatment QA is costly, time-consuming, and may be inadequate in detecting errors that are introduced during the migration. In this work we investigate the use of an automatic Plan Comparison Tool to verify that plan data have been correctly migrated to a new version of a TMS database from an older version. We developed software to query and compare treatment plans between different versions of the TMS. The same plan in the two TMS systems are translated into an XML schema. A plan comparison module takes the two XML schemas as input and reports any differences in parameters between the two versions of the same plan by applying a schema mapping. A console application is used to query the database to obtain a list of active or in-preparation plans to be tested. It then runs in batch mode to compare all the plans, and a report of success or failure of the comparison is saved for review. This software tool was used as part of software upgrade and database migration from Varian's Aria 8.9 to Aria 11 TMS. Parameters were compared for 358 treatment plans in 89 minutes. This direct comparison of all plan parameters in the migrated TMS against the previous TMS surpasses current QA methods that relied on repeating pretreatment QA measurements or labor-intensive and fallible hand comparisons. PMID:24257281

  3. Dynamic Underground Stripping Post-Treatment Characterization Plan

    SciTech Connect

    Vangelas, K.M.

    2001-04-17

    The A/M-Area of the Savannah River Site is a known area of solvent release to the subsurface. The Solvent Storage Tank Area is an area of documented dense non-aqueous phase liquids (DNAPL) in the subsurface. June 30, 2000 a remediation using the Dynamic Underground Stripping (DUS) treatment technology commenced. This technology injects steam into the subsurface through a series of injection wells located within the treatment zone. The steam is pulled through the subsurface to an extraction well where it is removed. The heating of the subsurface causes the DNAPL present to be volatilized and removed through the extraction well.

  4. Comparison of User-Directed and Automatic Mapping of the Planned Isocenter to Treatment Space for Prostate IGRT

    PubMed Central

    Wang, Andrew; Kress, Andrea; Qin, An; Cullip, Timothy; Tracton, Gregg; Yan, Di; Chaney, Edward

    2013-01-01

    Image-guided radiotherapy (IGRT), adaptive radiotherapy (ART), and online reoptimization rely on accurate mapping of the radiation beam isocenter(s) from planning to treatment space. This mapping involves rigid and/or nonrigid registration of planning (pCT) and intratreatment (tCT) CT images. The purpose of this study was to retrospectively compare a fully automatic approach, including a non-rigid step, against a user-directed rigid method implemented in a clinical IGRT protocol for prostate cancer. Isocenters resulting from automatic and clinical mappings were compared to reference isocenters carefully determined in each tCT. Comparison was based on displacements from the reference isocenters and prostate dose-volume histograms (DVHs). Ten patients with a total of 243 tCTs were investigated. Fully automatic registration was found to be as accurate as the clinical protocol but more precise for all patients. The average of the unsigned x, y, and z offsets and the standard deviations (σ) of the signed offsets computed over all images were (avg. ±  σ (mm)): 1.1 ± 1.4, 1.8 ± 2.3, 2.5 ± 3.5 for the clinical protocol and 0.6 ± 0.8, 1.1 ± 1.5 and 1.1 ± 1.4 for the automatic method. No failures or outliers from automatic mapping were observed, while 8 outliers occurred for the clinical protocol. PMID:24348526

  5. A quantitative analysis of intensity-modulated radiation therapy plans and comparison of homogeneity indices for the treatment of gynecological cancers

    PubMed Central

    Pathak, Pushpraj; Vashisht, Sanjeev

    2013-01-01

    The aim of present study was to evaluate the intensity-modulated radiation therapy (IMRT) plans using different homogeneity and conformity indices in gynecological cancers, as well as to compare and find out the most reliable and accurate measure of the dose homogeneity among the available indices. In this study, a cohort of 12 patients were registered for evaluation, those receiving dynamic IMRT treatment on Clinac-2300C/D linear accelerator with 15-Mega Voltage (MV) photon beam. Dynamic IMRT plans were created on Eclipse treatment planning system with Helios dose volume optimization software. Homogeneity indices (HI) such as H index, modified H index, HI index, modified HI index, and S-index (sigma-index) proposed by M Yoon et al. (2007) were calculated and compared. The values of S-index vary from 1.63 to 2.99. The results indicate that the H and HI indices and their modified versions may not provide the correct dose homogeneity information, but the S-index provides accurate information about the dose homogeneity in the Planning Target Volume (PTV). Each plan was compared with 6-MV photon energy on the basis of S-index and conformity index (CI). Organs at risk (OAR) doses with 6-MV and 15-MV beams were also reported. PMID:23776309

  6. Initial experience of ArcCHECK and 3DVH software for RapidArc treatment plan verification

    SciTech Connect

    Infusino, Erminia; Mameli, Alessandra Conti, Roberto; Gaudino, Diego; Stimato, Gerardina; Bellesi, Luca; D’Angelillo, Rolando Maria; Ramella, Sara; Benassi, Marcello; Trodella, Lucio

    2014-10-01

    The purpose of this study was to perform delivery quality assurance with ArcCHECK and 3DVH system (Sun Nuclear, FL) and to evaluate the suitability of this system for volumetric-modulated arc therapy (VMAT) (RapidArc [RA]) verification. This software calculates the delivered dose distributions in patients by perturbing the calculated dose using errors detected in fluence or planar dose measurements. The device is tested to correlate the gamma passing rate (%GP) and the composite dose predicted by 3DVH software. A total of 28 patients with prostate cancer who were treated with RA were analyzed. RA treatments were delivered to a diode array phantom (ArcCHECK), which was used to create a planned dose perturbation (PDP) file. The 3DVH analysis used the dose differences derived from comparing the measured dose with the treatment planning system (TPS)-calculated doses to perturb the initial TPS-calculated dose. The 3DVH then overlays the resultant dose on the patient's structures using the resultant “PDP” beams. Measured dose distributions were compared with the calculated ones using the gamma index (GI) method by applying the global (Van Dyk) normalization and acceptance criteria, i.e., 3%/3 mm. Paired differences tests were used to estimate statistical significance of the differences between the composite dose calculated using 3DVH and %GP. Also, statistical correlation by means of logistic regression analysis has been analyzed. Dose-volume histogram (DVH) analysis for patient plans revealed small differences between treatment plan calculations and 3DVH results for organ at risk (OAR), whereas planning target volume (PTV) of the measured plan was systematically higher than that predicted by the TPS. The t-test results between the planned and the estimated DVH values showed that mean values were incomparable (p < 0.05). The quality assurance (QA) gamma analysis 3%/3 mm showed that in all cases there were only weak-to-moderate correlations (Pearson r: 0.12 to 0

  7. Forward treatment planning for modulated electron radiotherapy (MERT) employing Monte Carlo methods

    SciTech Connect

    Henzen, D. Manser, P.; Frei, D.; Volken, W.; Born, E. J.; Lössl, K.; Aebersold, D. M.; Fix, M. K.; Neuenschwander, H.; Stampanoni, M. F. M.

    2014-03-15

    Purpose: This paper describes the development of a forward planning process for modulated electron radiotherapy (MERT). The approach is based on a previously developed electron beam model used to calculate dose distributions of electron beams shaped by a photon multi leaf collimator (pMLC). Methods: As the electron beam model has already been implemented into the Swiss Monte Carlo Plan environment, the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA) can be included in the planning process for MERT. In a first step, CT data are imported into Eclipse and a pMLC shaped electron beam is set up. This initial electron beam is then divided into segments, with the electron energy in each segment chosen according to the distal depth of the planning target volume (PTV) in beam direction. In order to improve the homogeneity of the dose distribution in the PTV, a feathering process (Gaussian edge feathering) is launched, which results in a number of feathered segments. For each of these segments a dose calculation is performed employing the in-house developed electron beam model along with the macro Monte Carlo dose calculation algorithm. Finally, an automated weight optimization of all segments is carried out and the total dose distribution is read back into Eclipse for display and evaluation. One academic and two clinical situations are investigated for possible benefits of MERT treatment compared to standard treatments performed in our clinics and treatment with a bolus electron conformal (BolusECT) method. Results: The MERT treatment plan of the academic case was superior to the standard single segment electron treatment plan in terms of organs at risk (OAR) sparing. Further, a comparison between an unfeathered and a feathered MERT plan showed better PTV coverage and homogeneity for the feathered plan, with V{sub 95%} increased from 90% to 96% and V{sub 107%} decreased from 8% to nearly 0%. For a clinical breast boost irradiation, the MERT plan

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

    SciTech Connect

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

    2013-08-29

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

  9. Verification of nuclear data for the Tsukuba plan, a newly developed treatment planning system for boron neutron capture therapy.

    PubMed

    Kumada, Hiroaki; Takada, Kenta; Yamanashi, Koichi; Sakae, Takeji; Matsumura, Akira; Sakurai, Hideyuki

    2015-12-01

    Various verifications were performed to apply JENDL-4.0 as nuclear data for a newly developed treatment planning system with a homogeneous or precise human-like phantom. The nitrogen dose calculated by JENDL-4.0 differed slightly from that calculated by ENDF/B-VII.0. However, the total weighted dose-based dose volume histogram in the boron neutron capture therapy (BNCT) treatment for brain tumors calculated by JENDL-4.0 was in good agreement with the results of the ENDF/B-VII.0 calculation. Therefore, calculation with JENDL-4.0 can be applied to the BNCT dose calculation. PMID:26361835

  10. Stereotactic Arrhythmia Radioablation (STAR) of Ventricular Tachycardia: A Treatment Planning Study

    PubMed Central

    Fahimian, Benjamin; Soltys, Scott G; Zei, Paul; Lo, Anthony; Gardner, Edward A; Maguire, Patrick J; Loo Jr., Billy W

    2016-01-01

    Purpose The first stereotactic arrhythmia radioablation (STAR) of ventricular tachycardia (VT) was delivered at Stanford on a robotic radiosurgery system (CyberKnife® G4) in 2012. The results warranted further investigation of this treatment. Here we compare dosimetrically three possible treatment delivery platforms for STAR. Methods The anatomy and target volume of the first treated patient were used for this study. A dose of 25 Gy in one fraction was prescribed to the planning target volume (PTV). Treatment plans were created on three treatment platforms: CyberKnife® G4 system with Iris collimator (Multiplan, V. 4.6)(Plan #1), CyberKnife® M6 system with InCise 2TM multileaf collimator (Multiplan V. 5.3)(Plan #2) and Varian TrueBeamTM STx with HD 120TM MLC and 10MV flattening filter free (FFF) beam (Eclipse planning system, V.11) (Plan #3 coplanar and #4 noncoplanar VMAT plans). The four plans were compared by prescription isodose line, plan conformity index, dose gradient, as well as dose to the nearby critical structures. To assess the delivery efficiency, planned monitor units (MU) and estimated treatment time were evaluated. Results Plans #1-4 delivered 25 Gy to the PTV to the 75.0%, 83.0%, 84.3%, and 84.9% isodose lines and with conformity indices of 1.19, 1.16, 1.05, and 1.05, respectively. The dose gradients for plans #1-4 were 3.62, 3.42, 3.93, and 3.73 with the CyberKnife® MLC plan (Plan #2) the best, and the TrueBeamTM STx co-planar plan (Plan #3) the worst. The dose to nearby critical structures (lung, stomach, bowel, and esophagus) were all well within tolerance. The MUs for plans #1-4 were 27671, 16522, 6275, and 6004 for an estimated total-treatment-time/beam-delivery-time of 99/69, 65/35, 37/7, and 56/6 minutes, respectively, under the assumption of 30 minutes pretreatment setup time. For VMAT gated delivery, a 40% duty cycle, 2400MU/minute dose rate, and an extra 10 minutes per extra arc were assumed. Conclusion Clinically acceptable plans were

  11. Development of Advanced Multi-Modality Radiation Treatment Planning Software for Neutron Radiotherapy and Beyond

    SciTech Connect

    Nigg, D; Wessol, D; Wemple, C; Harkin, G; Hartmann-Siantar, C

    2002-08-20

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. As a logical next step in the development of modern radiotherapy planning tools to support the most advanced research, INEEL and Lawrence Livermore National Laboratory (LLNL), the developers of the PEREGRTNE computational engine for radiotherapy treatment planning applications, have recently launched a new project to collaborate in the development of a ''next-generation'' multi-modality treatment planning software system that will be useful for all modern forms of radiotherapy.

  12. MINERVA: a multi-modality plugin-based radiation therapy treatment planning system.

    PubMed

    Wemple, C A; Wessol, D E; Nigg, D W; Cogliati, J J; Milvich, M; Fredrickson, C M; Perkins, M; Harkin, G J; Hartmann-Siantar, C L; Lehmann, J; Flickinger, T; Pletcher, D; Yuan, A; DeNardo, G L

    2005-01-01

    Researchers at the INEEL, MSU, LLNL and UCD have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system, which can be used for planning and analysing several radiotherapy modalities, either singly or combined, using common treatment planning tools. It employs an integrated, lightweight plugin architecture to accommodate multi-modal treatment planning using standard interface components. The design also facilitates the future integration of improved planning technologies. The code is being developed with the Java programming language for interoperability. The MINERVA design includes the image processing, model definition and data analysis modules with a central module to coordinate communication and data transfer. Dose calculation is performed by source and transport plugin modules, which communicate either directly through the database or through MINERVA's openly published, extensible markup language (XML)-based application programmer's interface (API). All internal data are managed by a database management system and can be exported to other applications or new installations through the API data formats. A full computation path has been established for molecular-targeted radiotherapy treatment planning, with additional treatment modalities presently under development. PMID:16604627

  13. Human applications of the INEL patient treatment planning system

    SciTech Connect

    Wheeler, F.; Wessol, D.; Atkinson, C.; Nigg, D.

    1995-11-01

    During the past few years, murine and large animal research, as well as human studies have provided data to the point where human clinical trials have been initiated at the BMRR using BPA-F for gliomas and at the Massachusetts Institute of Technology Reactor (MITR) using BPA for melanomas of the extremeties. It is expected that glioma trials using BSH will proceed soon at the Petten High Flux Reactor (HFR) in the Netherlands. The first human glioma epithermal boron neutron capture therapy application was performed at the BMRR in the fall of 1994. This was a collaborative effort by BNL, Beth Israel Manhattan hospital, and INEL. The INEL planning system was chosen to perform dose predictions for this application.

  14. Development and validation of MCNPX-based Monte Carlo treatment plan verification system

    PubMed Central

    Jabbari, Iraj; Monadi, Shahram

    2015-01-01

    A Monte Carlo treatment plan verification (MCTPV) system was developed for clinical treatment plan verification (TPV), especially for the conformal and intensity-modulated radiotherapy (IMRT) plans. In the MCTPV, the MCNPX code was used for particle transport through the accelerator head and the patient body. MCTPV has an interface with TiGRT planning system and reads the information which is needed for Monte Carlo calculation transferred in digital image communications in medicine-radiation therapy (DICOM-RT) format. In MCTPV several methods were applied in order to reduce the simulation time. The relative dose distribution of a clinical prostate conformal plan calculated by the MCTPV was compared with that of TiGRT planning system. The results showed well implementation of the beams configuration and patient information in this system. For quantitative evaluation of MCTPV a two-dimensional (2D) diode array (MapCHECK2) and gamma index analysis were used. The gamma passing rate (3%/3 mm) of an IMRT plan was found to be 98.5% for total beams. Also, comparison of the measured and Monte Carlo calculated doses at several points inside an inhomogeneous phantom for 6- and 18-MV photon beams showed a good agreement (within 1.5%). The accuracy and timing results of MCTPV showed that MCTPV could be used very efficiently for additional assessment of complicated plans such as IMRT plan. PMID:26170554

  15. Photon beam characterization and modelling for Monte Carlo treatment planning

    NASA Astrophysics Data System (ADS)

    Deng, Jun; Jiang, Steve B.; Kapur, Ajay; Li, Jinsheng; Pawlicki, Todd; Ma, C.-M.

    2000-02-01

    Photon beams of 4, 6 and 15 MV from Varian Clinac 2100C and 2300C/D accelerators were simulated using the EGS4/BEAM code system. The accelerators were modelled as a combination of component modules (CMs) consisting of a target, primary collimator, exit window, flattening filter, monitor chamber, secondary collimator, ring collimator, photon jaws and protection window. A full phase space file was scored directly above the upper photon jaws and analysed using beam data processing software, BEAMDP, to derive the beam characteristics, such as planar fluence, angular distribution, energy spectrum and the fractional contributions of each individual CM. A multiple-source model has been further developed to reconstruct the original phase space. Separate sources were created with accurate source intensity, energy, fluence and angular distributions for the target, primary collimator and flattening filter. Good agreement (within 2%) between the Monte Carlo calculations with the source model and those with the original phase space was achieved in the dose distributions for field sizes of 4 cm × 4 cm to 40 cm × 40 cm at source surface distances (SSDs) of 80-120 cm. The dose distributions in lung and bone heterogeneous phantoms have also been found to be in good agreement (within 2%) for 4, 6 and 15 MV photon beams for various field sizes between the Monte Carlo calculations with the source model and those with the original phase space.

  16. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    SciTech Connect

    Singh, Hardev; De La Fuente Herman, Tania; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin

    2012-10-23

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem and ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  17. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    NASA Astrophysics Data System (ADS)

    Singh, Hardev; Herman, Tania De La Fuente; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin

    2012-10-01

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem & ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  18. Coverage-based treatment planning: optimizing the IMRT PTV to meet a CTV coverage criterion.

    PubMed

    Gordon, J J; Siebers, J V

    2009-03-01

    This work demonstrates an iterative approach-referred to as coverage-based treatment planning-designed to produce treatment plans that ensure target coverage for a specified percentage of setup errors. In this approach the clinical target volume to planning target volume (CTV-to-PTV) margin is iteratively adjusted until the specified CTV coverage is achieved. The advantage of this approach is that it automatically compensates for the dosimetric margin around the CTV, i.e., the extra margin that is created when the dose distribution extends beyond the PTV. When applied to 27 prostate plans, this approach reduced the average CTV-to-PTV margin from 5 to 2.8 mm. This reduction in PTV size produced a corresponding decrease in the volume of normal tissue receiving high dose. The total volume of tissue receiving > or =65 Gy was reduced on average by 19.3% or about 48 cc. Individual reductions varied from 8.7% to 28.6%. The volume of bladder receiving > or =60 Gy was reduced on average by 5.6% (reductions for individuals varied from 1.7% to 10.6%), and the volume of periprostatic rectum receiving > or =65 Gy was reduced on average by 4.9% (reductions for individuals varied from 0.9% to 12.3%). The iterative method proposed here represents a step toward a probabilistic treatment planning algorithm which can generate dose distributions (i.e., treated volumes) that closely approximate a specified level of coverage in the presence of geometric uncertainties. The general principles of coverage-based treatment planning are applicable to arbitrary treatment sites and delivery techniques. Importantly, observed deviations between coverage implied by specified CTV-to-PTV margins and coverage achieved by a given treatment plan imply a generic need to perform coverage probability analysis on a per-plan basis to ensure that the desired level of coverage is achieved. PMID:19378757

  19. Assessment of Uncertainties in Treatment Planning for Scanned Ion Beam Therapy of Moving Tumors

    SciTech Connect

    Hild, Sebastian; Technische Hochschule Mittelhessen, Giessen ; Durante, Marco; Faculty of Physics, Technische Universitaet Darmstadt, Darmstadt ; Bert, Christoph

    2013-02-01

    Purpose: To provide methods for quantification of uncertainties in 4-dimensional (4D) treatment during treatment planning. Methods and Materials: Uncertainty information was generated by multiple 4D treatment simulations with varying parameters. Sampled data were analyzed using uncertainty visualization methods that have been added to common treatment plan evaluation methods (eg, dose-volume histogram and dose distribution analysis). To illustrate the potential of the introduced methods, uncertainty analysis was completed for a single lung cancer case using 3 motion mitigation techniques: gating, slice-by-slice rescanning, and breath-controlled rescanning. Results: By repeating 4D dose calculations with varying parameters, we were able to show local uncertainties in dose distributions and to evaluate the stability of treatment setups. The new methods were found suitable for uncertainty evaluation in 4D treatment planning of moving tumors. Calculation time of the uncertainty base data was time consuming but contrivable overnight. Conclusions: Uncertainty analysis and visualization for 4D treatment planning provide an important tool in the decision process for an optimal treatment approach.

  20. The VACS Index Accurately Predicts Mortality and Treatment Response among Multi-Drug Resistant HIV Infected Patients Participating in the Options in Management with Antiretrovirals (OPTIMA) Study

    PubMed Central

    Brown, Sheldon T.; Tate, Janet P.; Kyriakides, Tassos C.; Kirkwood, Katherine A.; Holodniy, Mark; Goulet, Joseph L.; Angus, Brian J.; Cameron, D. William; Justice, Amy C.

    2014-01-01

    Objectives The VACS Index is highly predictive of all-cause mortality among HIV infected individuals within the first few years of combination antiretroviral therapy (cART). However, its accuracy among highly treatment experienced individuals and its responsiveness to treatment interventions have yet to be evaluated. We compared the accuracy and responsiveness of the VACS Index with a Restricted Index of age and traditional HIV biomarkers among patients enrolled in the OPTIMA study. Methods Using data from 324/339 (96%) patients in OPTIMA, we evaluated associations between indices and mortality using Kaplan-Meier estimates, proportional hazards models, Harrel’s C-statistic and net reclassification improvement (NRI). We also determined the association between study interventions and risk scores over time, and change in score and mortality. Results Both the Restricted Index (c = 0.70) and VACS Index (c = 0.74) predicted mortality from baseline, but discrimination was improved with the VACS Index (NRI = 23%). Change in score from baseline to 48 weeks was more strongly associated with survival for the VACS Index than the Restricted Index with respective hazard ratios of 0.26 (95% CI 0.14–0.49) and 0.39(95% CI 0.22–0.70) among the 25% most improved scores, and 2.08 (95% CI 1.27–3.38) and 1.51 (95%CI 0.90–2.53) for the 25% least improved scores. Conclusions The VACS Index predicts all-cause mortality more accurately among multi-drug resistant, treatment experienced individuals and is more responsive to changes in risk associated with treatment intervention than an index restricted to age and HIV biomarkers. The VACS Index holds promise as an intermediate outcome for intervention research. PMID:24667813

  1. Treatment planning of electroporation-based medical interventions: electrochemotherapy, gene electrotransfer and irreversible electroporation

    NASA Astrophysics Data System (ADS)

    Zupanic, Anze; Kos, Bor; Miklavcic, Damijan

    2012-09-01

    In recent years, cancer electrochemotherapy (ECT), gene electrotransfer for gene therapy and DNA vaccination (GET) and tissue ablation with irreversible electroporation (IRE) have all entered clinical practice. We present a method for a personalized treatment planning procedure for ECT, GET and IRE, based on medical image analysis, numerical modelling of electroporation and optimization with the genetic algorithm, and several visualization tools for treatment plan assessment. Each treatment plan provides the attending physician with optimal positions of electrodes in the body and electric pulse parameters for optimal electroporation of the target tissues. For the studied case of a deep-seated tumour, the optimal treatment plans for ECT and IRE require at least two electrodes to be inserted into the target tissue, thus lowering the necessary voltage for electroporation and limiting damage to the surrounding healthy tissue. In GET, it is necessary to place the electrodes outside the target tissue to prevent damage to target cells intended to express the transfected genes. The presented treatment planning procedure is a valuable tool for clinical and experimental use and evaluation of electroporation-based treatments.

  2. A Computer-Assisted Interactive Treatment Planning System for Mental Health

    PubMed Central

    Hammond, Kenric W.; Munnecke, Thomas H.

    1981-01-01

    The authors describe a MUMPS based system capable of assisting clinicians in developing written psychiatric treatment plans in inpatient and outpatient services in a VA hospital. This interactive system relies upon a series of hierarchically arranged topical frames addressing a broad range of psychosocial and medical problems, treatment goals, and methods. It speeds multi-disciplinary treatment planning, employs objective language, serves an educational purpose, and structures hierarchically organized entry of detailed information into the data base. Significantly, this system is compatible with other MUMPS applications developed in the VA. Future modifications, expansions, and export of methodology can be accomplished without extensive reworking of existing software or data storage design.

  3. Robustness of IPSA optimized high-dose-rate prostate brachytherapy treatment plans to catheter displacements

    PubMed Central

    Whitaker, May

    2016-01-01

    Purpose Inverse planning simulated annealing (IPSA) optimized brachytherapy treatment plans are characterized with large isolated dwell times at the first or last dwell position of each catheter. The potential of catheter shifts relative to the target and organs at risk in these plans may lead to a more significant change in delivered dose to the volumes of interest relative to plans with more uniform dwell times. Material and methods This study aims to determine if the Nucletron Oncentra dwell time deviation constraint (DTDC) parameter can be optimized to improve the robustness of high-dose-rate (HDR) prostate brachytherapy plans to catheter displacements. A set of 10 clinically acceptable prostate plans were re-optimized with a DTDC parameter of 0 and 0.4. For each plan, catheter displacements of 3, 7, and 14 mm were retrospectively applied and the change in dose volume histogram (DVH) indices and conformity indices analyzed. Results The robustness of clinically acceptable prostate plans to catheter displacements in the caudal direction was found to be dependent on the DTDC parameter. A DTDC value of 0 improves the robustness of planning target volume (PTV) coverage to catheter displacements, whereas a DTDC value of 0.4 improves the robustness of the plans to changes in hotspots. Conclusions The results indicate that if used in conjunction with a pre-treatment catheter displacement correction protocol and a tolerance of 3 mm, a DTDC value of 0.4 may produce clinically superior plans. However, the effect of the DTDC parameter in plan robustness was not observed to be as strong as initially suspected. PMID:27504129

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

    PubMed

    Rana, Suresh; Zheng, Yuanshui

    2015-01-01

    The main purposes of this study are to: 1) evaluate the accuracy of XiO treatment planning system (TPS) for different dose calculation grid size based on head phan-tom measurements in uniform scanning proton therapy (USPT); and 2) compare the dosimetric results for various dose calculation grid sizes based on real computed tomography (CT) dataset of pediatric brain cancer treatment plans generated by USPT and intensity-modulated proton therapy (IMPT) techniques. For phantom study, we have utilized the anthropomorphic head proton phantom provided by Imaging and Radiation Oncology Core (IROC). The imaging, treatment planning, and beam delivery were carried out following the guidelines provided by the IROC. The USPT proton plan was generated in the XiO TPS, and dose calculations were performed for grid size ranged from 1 to 3 mm. The phantom containing thermoluminescent dosimeter (TLDs) and films was irradiated using uniform scanning proton beam. The irradiated TLDs were read by the IROC. The calculated doses from the XiO for different grid sizes were compared to the measured TLD doses provided by the IROC. Gamma evaluation was done by comparing calculated planar dose distribution of 3 mm grid size with measured planar dose distribution. Additionally, IMPT plan was generated based on the same CT dataset of the IROC phantom, and IMPT dose calculations were performed for grid size ranged from 1 to 3 mm. For comparative purpose, additional gamma analysis was done by comparing the planar dose distributions of standard grid size (3 mm) with that of other grid sizes (1, 1.5, 2, and 2.5 mm) for both the USPT and IMPT plans. For patient study, USPT plans of three pediatric brain cancer cases were selected. IMPT plans were generated for each of three pediatric cases. All patient treatment plans (USPT and IMPT) were generated in the XiO TPS for a total dose of 54 Gy (relative biological effectiveness [RBE]). Treatment plans (USPT and IMPT) of each case was recalculated for grid

  5. Controlled mold geometry for surgical deficit treatment planning.

    PubMed

    Anderson, L L; Zlotolow, I M; McCormick, B; Harrison, L B

    1995-03-01

    The relatively precise placement of brachytherapy sources afforded by stereotactic frames for brain implants is not generally achievable for other sites, which lack the fixed geometry of the cranium and its contents. An exception is a source-containing rigid mold that delivers brachytherapy when inserted securely in a surgical defect. A technique has been developed in which an acrylic mold of the region to be treated is suspended in a demountable aluminum box, which is then filled to a suitable level with dental stone to form a casting that supports the mold and that can be removed intact. First, the box is aligned on a mill table and a ball mill is used to drill three parallel holes in the acrylic mold, with precisely known locations and depths and as widely separated as possible. The spherical air cavities that result from plugging these holes with ball-milled acrylic rods become reference markers in subsequent computed tomography (CT) scans. After optimum CT-coordinate locations have been planned for 125I seeds in catheters, they are transformed to mill coordinates using a matrix developed from the known marker coordinates in the two systems. Catheter holes are then drilled with the mold in the reassembled casting and box. The method has been used to treat both recurrent maxillary cancer and recurrent orbital rhabdomyosarcoma. PMID:7596320

  6. Interactive dose shaping part 1: a new paradigm for IMRT treatment planning.

    PubMed

    Ziegenhein, Peter; Ph Kamerling, Cornelis; Oelfke, Uwe

    2016-03-21

    In this work we present a novel treatment planning technique called interactive dose shaping (IDS) to be employed for the optimization of intensity modulated radiation therapy (IMRT). IDS does not rely on a Newton-based optimization algorithm which is driven by an objective function formed of dose volume constraints on pre-segmented volumes of interest (VOIs). Our new planning technique allows for direct, interactive adaptation of localized planning features. This is realized by a dose modification and recovery (DMR) planning engine which implements a two-step approach: firstly, the desired localized plan adaptation is imposed on the current plan (modification) while secondly inevitable, undesired disturbances of the dose pattern elsewhere are compensated for automatically by the recovery module. Together with an ultra-fast dose update calculation method the DMR engine has been implemented in a newly designed 3D therapy planning system Dynaplan enabling true real-time interactive therapy planning. Here we present the underlying strategy and algorithms of the DMR based planning concept. The functionality of the IDS planning approach is demonstrated for a phantom geometry of clinical resolution and size. PMID:26948145

  7. Interactive dose shaping part 1: a new paradigm for IMRT treatment planning

    NASA Astrophysics Data System (ADS)

    Ziegenhein, Peter; Kamerling, Cornelis Ph; Oelfke, Uwe

    2016-03-01

    In this work we present a novel treatment planning technique called interactive dose shaping (IDS) to be employed for the optimization of intensity modulated radiation therapy (IMRT). IDS does not rely on a Newton-based optimization algorithm which is driven by an objective function formed of dose volume constraints on pre-segmented volumes of interest (VOIs). Our new planning technique allows for direct, interactive adaptation of localized planning features. This is realized by a dose modification and recovery (DMR) planning engine which implements a two-step approach: firstly, the desired localized plan adaptation is imposed on the current plan (modification) while secondly inevitable, undesired disturbances of the dose pattern elsewhere are compensated for automatically by the recovery module. Together with an ultra-fast dose update calculation method the DMR engine has been implemented in a newly designed 3D therapy planning system Dynaplan enabling true real-time interactive therapy planning. Here we present the underlying strategy and algorithms of the DMR based planning concept. The functionality of the IDS planning approach is demonstrated for a phantom geometry of clinical resolution and size.

  8. Independent calculation of dose distributions for helical tomotherapy using a conventional treatment planning system

    SciTech Connect

    Klüter, Sebastian Schubert, Kai; Lissner, Steffen; Sterzing, Florian; Oetzel, Dieter; Debus, Jürgen; Schlegel, Wolfgang; Oelfke, Uwe; Nill, Simeon

    2014-08-15

    Purpose: The dosimetric verification of treatment plans in helical tomotherapy usually is carried out via verification measurements. In this study, a method for independent dose calculation of tomotherapy treatment plans is presented, that uses a conventional treatment planning system with a pencil kernel dose calculation algorithm for generation of verification dose distributions based on patient CT data. Methods: A pencil beam algorithm that directly uses measured beam data was configured for dose calculation for a tomotherapy machine. Tomotherapy treatment plans were converted into a format readable by an in-house treatment planning system by assigning each projection to one static treatment field and shifting the calculation isocenter for each field in order to account for the couch movement. The modulation of the fluence for each projection is read out of the delivery sinogram, and with the kernel-based dose calculation, this information can directly be used for dose calculation without the need for decomposition of the sinogram. The sinogram values are only corrected for leaf output and leaf latency. Using the converted treatment plans, dose was recalculated with the independent treatment planning system. Multiple treatment plans ranging from simple static fields to real patient treatment plans were calculated using the new approach and either compared to actual measurements or the 3D dose distribution calculated by the tomotherapy treatment planning system. In addition, dose–volume histograms were calculated for the patient plans. Results: Except for minor deviations at the maximum field size, the pencil beam dose calculation for static beams agreed with measurements in a water tank within 2%/2 mm. A mean deviation to point dose measurements in the cheese phantom of 0.89% ± 0.81% was found for unmodulated helical plans. A mean voxel-based deviation of −0.67% ± 1.11% for all voxels in the respective high dose region (dose values >80%), and a mean local

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

    PubMed

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

    2014-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  11. Evaluation of an electron Monte Carlo dose calculation algorithm for treatment planning.

    PubMed

    Chamberland, Eve; Beaulieu, Luc; Lachance, Bernard

    2015-01-01

    The purpose of this study is to evaluate the accuracy of the electron Monte Carlo (eMC) dose calculation algorithm included in a commercial treatment planning system and compare its performance against an electron pencil beam algorithm. Several tests were performed to explore the system's behavior in simple geometries and in configurations encountered in clinical practice. The first series of tests were executed in a homogeneous water phantom, where experimental measurements and eMC-calculated dose distributions were compared for various combinations of energy and applicator. More specifically, we compared beam profiles and depth-dose curves at different source-to-surface distances (SSDs) and gantry angles, by using dose difference and distance to agreement. Also, we compared output factors, we studied the effects of algorithm input parameters, which are the random number generator seed, as well as the calculation grid size, and we performed a calculation time evaluation. Three different inhomogeneous solid phantoms were built, using high- and low-density materials inserts, to clinically simulate relevant heterogeneity conditions: a small air cylinder within a homogeneous phantom, a lung phantom, and a chest wall phantom. We also used an anthropomorphic phantom to perform comparison of eMC calculations to measurements. Finally, we proceeded with an evaluation of the eMC algorithm on a clinical case of nose cancer. In all mentioned cases, measurements, carried out by means of XV-2 films, radiographic films or EBT2 Gafchromic films. were used to compare eMC calculations with dose distributions obtained from an electron pencil beam algorithm. eMC calculations in the water phantom were accurate. Discrepancies for depth-dose curves and beam profiles were under 2.5% and 2 mm. Dose calculations with eMC for the small air cylinder and the lung phantom agreed within 2% and 4%, respectively. eMC calculations for the chest wall phantom and the anthropomorphic phantom also

  12. Water: from the source to the treatment plan

    NASA Astrophysics Data System (ADS)

    Baude, I.; Marquet, V.

    2012-04-01

    Isabelle BAUDE isa.baude@free.fr Lycee français de Vienne Liechtensteinstrasse 37AVienna As a physics and chemistry teacher, I have worked on water from the source to the treatment plant with 27 pupils between 14 and 15 years old enrolled in the option "Science and laboratory". The objectives of this option are to interest students in science, to introduce them to practical methods of laboratory analyses, and let them use computer technology. Teaching takes place every two weeks and lasts 1.5 hours. The theme of water is a common project with the biology and geology teacher, Mrs. Virginie Marquet. Lesson 1: Introduction: The water in Vienna The pupils have to consider why the water is so important in Vienna (history, economy etc.) and where tap water comes from. Activities: Brainstorming about where and why we use water every day and why the water is different in Vienna. Lesson 2: Objectives of the session: What are the differences between mineral waters? Activities: Compare water from different origins (France: Evian, Vittel, Contrex. Austria: Vöslauer, Juvina, Gasteiner and tap water from Vienna) by tasting and finding the main ions they contain. Testing ions: Calcium, magnesium, sulphate, chloride, sodium, and potassium Lesson 3: Objectives of the session: Build a hydrometer Activities: Producing a range of calibration solutions, build and calibrate the hydrometer with different salt-water solutions. Measure the density of the Dead Sea's water and other mineral waters. Lesson 4: Objectives of the session: How does a fountain work? Activities: Construction of a fountain as Heron of Alexandria with simple equipment and try to understand the hydrostatic principles. Lesson 5: Objectives of the session: Study of the physical processes of water treatment (decantation, filtration, screening) Activities: Build a natural filter with sand, stone, carbon, and cotton wool. Retrieve the filtered water to test it during lesson 7. Lesson 6: Visit of the biggest treatment

  13. TH-A-9A-08: Knowledge-Based Quality Control of Clinical Stereotactic Radiosurgery Treatment Plans

    SciTech Connect

    Shiraishi, S; Moore, K L; Tan, J; Olsen, L

    2014-06-15

    Purpose: To develop a quality control tool to reduce stereotactic radiosurgery (SRS) planning variability using models that predict achievable plan quality metrics (QMs) based on individual patient anatomy. Methods: Using a knowledge-based methodology that quantitatively correlates anatomical geometric features to resultant organ-at-risk (OAR) dosimetry, we developed models for predicting achievable OAR dose-volume histograms (DVHs) by training with a cohort of previously treated SRS patients. The DVH-based QMs used in this work are the gradient measure, GM=(3/4pi)^1/3*[V50%^1/3−V100%^1/3], and V10Gy of normal brain. As GM quantifies the total rate of dose fall-off around the planning target volume (PTV), all voxels inside the patient's body contour were treated as OAR for DVH prediction. 35 previously treated SRS plans from our institution were collected; all were planned with non-coplanar volumetric-modulated arc therapy to prescription doses of 12–25 Gy. Of the 35-patient cohort, 15 were used for model training and 20 for model validation. Accuracies of the predictions were quantified by the mean and the standard deviation of the difference between clinical and predicted QMs, δQM=QM-clin−QM-pred. Results: Best agreement between predicted and clinical QMs was obtained when models were built separately for V-PTV<2.5cc and V-PTV>2.5cc. Eight patients trained the V-PTV<2.5cc model and seven patients trained the V-PTV>2.5cc models, respectively. The mean and the standard deviation of δGM were 0.3±0.4mm for the training sets and −0.1±0.6mm for the validation sets, demonstrating highly accurate GM predictions. V10Gy predictions were also highly accurate, with δV10Gy=0.8±0.7cc for the training sets and δV10Gy=0.7±1.4cc for the validation sets. Conclusion: The accuracy of the models in predicting two key SRS quality metrics highlights the potential of this technique for quality control for SRS treatments. Future investigations will seek to determine

  14. Coverage-based treatment planning: Optimizing the IMRT PTV to meet a CTV coverage criterion

    PubMed Central

    Gordon, J. J.; Siebers, J. V.

    2009-01-01

    This work demonstrates an iterative approach—referred to as coverage-based treatment planning—designed to produce treatment plans that ensure target coverage for a specified percentage of setup errors. In this approach the clinical target volume to planning target volume (CTV-to-PTV) margin is iteratively adjusted until the specified CTV coverage is achieved. The advantage of this approach is that it automatically compensates for the dosimetric margin around the CTV, i.e., the extra margin that is created when the dose distribution extends beyond the PTV. When applied to 27 prostate plans, this approach reduced the average CTV-to-PTV margin from 5 to 2.8 mm. This reduction in PTV size produced a corresponding decrease in the volume of normal tissue receiving high dose. The total volume of tissue receiving ≥65 Gy was reduced on average by 19.3% or about 48 cc. Individual reductions varied from 8.7% to 28.6%. The volume of bladder receiving ≥60 Gy was reduced on average by 5.6% (reductions for individuals varied from 1.7% to 10.6%), and the volume of periprostatic rectum receiving ≥65 Gy was reduced on average by 4.9% (reductions for individuals varied from 0.9% to 12.3%). The iterative method proposed here represents a step toward a probabilistic treatment planning algorithm which can generate dose distributions (i.e., treated volumes) that closely approximate a specified level of coverage in the presence of geometric uncertainties. The general principles of coverage-based treatment planning are applicable to arbitrary treatment sites and delivery techniques. Importantly, observed deviations between coverage implied by specified CTV-to-PTV margins and coverage achieved by a given treatment plan imply a generic need to perform coverage probability analysis on a per-plan basis to ensure that the desired level of coverage is achieved. PMID:19378757

  15. A planning study investigating dual-gated volumetric arc stereotactic treatment of primary renal cell carcinoma

    SciTech Connect

    Devereux, Thomas; Pham, Daniel; Kron, Tomas; Foroudi, Farshad; Supple, Jeremy; Siva, Shankar

    2015-04-01

    This is a planning study investigating the dosimetric advantages of gated volumetric-modulated arc therapy (VMAT) to the end-exhale and end-inhale breathing phases for patients undergoing stereotactic treatment of primary renal cell carcinoma. VMAT plans were developed from the end-inhale (VMATinh) and the end-exhale (VMATexh) phases of the breathing cycle as well as a VMAT plan and 3-dimensional conformal radiation therapy plan based on an internal target volume (ITV) (VMATitv). An additional VMAT plan was created by giving the respective gated VMAT plan a 50% weighting and summing the inhale and exhale plans together to create a summed gated plan. Dose to organs at risk (OARs) as well as comparison of intermediate and low-dose conformity was evaluated. There was no difference in the volume of healthy tissue receiving the prescribed dose for the planned target volume (PTV) (CI100%) for all the VMAT plans; however, the mean volume of healthy tissue receiving 50% of the prescribed dose for the PTV (CI50%) values were 4.7 (± 0.2), 4.6 (± 0.2), and 4.7 (± 0.6) for the VMATitv, VMATinh, and VMATexh plans, respectively. The VMAT plans based on the exhale and inhale breathing phases showed a 4.8% and 2.4% reduction in dose to 30 cm{sup 3} of the small bowel, respectively, compared with that of the ITV-based VMAT plan. The summed gated VMAT plans showed a 6.2% reduction in dose to 30 cm{sup 3} of the small bowel compared with that of the VMAT plans based on the ITV. Additionally, when compared with the inhale and the exhale VMAT plans, a 4% and 1.5%, respectively, reduction was observed. Gating VMAT was able to reduce the amount of prescribed, intermediate, and integral dose to healthy tissue when compared with VMAT plans based on an ITV. When summing the inhale and exhale plans together, dose to healthy tissue and OARs was optimized. However, gating VMAT plans would take longer to treat and is a factor that needs to be considered.

  16. Ichthyosis with confetti: a rare diagnosis and treatment plan

    PubMed Central

    Long, Myra C

    2014-01-01

    Congenital ichthyosis includes a group of rare skin disorders known for tiles of hyperkeratotic skin resembling fish scales. With age, the hyperkeratosis generally becomes more concentrated around joints which increases impairment. Ichthyosis with confetti, also known as ichthyosis variegata or congenital reticular ichthyosiform erythroderma, is an extremely rare form of ichthyosis. It usually begins as non-bullous congenital ichthyosiform erythroderma with the expected scaling. However, with time patients develop widespread ‘confetti-like’ patches of healthy skin. The healthy skin reflects clonal expansion of ‘normal’ or reverted cells. Cell reversion has potential for future therapies using revertant stem cells. Controlling symptoms with emollients is the goal of treatment for ichthyosis since it has no cure. PMID:25012887

  17. Women who conceived with infertility treatment were more likely to receive planned cesarean deliveries in Taiwan.

    PubMed

    Chien, Li-Yin; Lee, Yu-Hsiang; Lin, Yu-Hung; Tai, Chen-Jei

    2015-06-01

    The objective of this study was to examine the effect of conception with infertility treatment on planned cesarean delivery. The participants were from a panel of primiparous pregnant women in northern Taiwan. The data analysis included 771 women with a singleton pregnancy, of whom 160 had a planned cesarean delivery and 611 who had a vaginal delivery. The study women answered structured questionnaires during the second and third trimesters of pregnancy, and at one-month postpartum. Women who conceived with infertility treatment were more likely to have planned cesarean deliveries than women who conceived without it (44.7% versus 18.1%, p < 0.001; crude odds ratio: 3.66, 95% confidence interval [CI]: 2.24-5.98). After adjustment for maternal age over 35 years, whether they were currently unmarried, selection of time for birth in advance, gestational hypertension, and birthweight < 2500 g, women who conceived with infertility treatment were 2.95 times (95% CI: 1.47-5.92) more likely to have planned cesarean deliveries. The increased risk for planned cesarean deliveries among singleton women who conceived with infertility treatment cannot be explained by older maternal age or higher number of morbidities during pregnancy. Counseling for women who conceive with infertility treatments may be needed to decrease unnecessary cesarean deliveries. PMID:25581216

  18. A new column-generation-based algorithm for VMAT treatment plan optimization.

    PubMed

    Peng, Fei; Jia, Xun; Gu, Xuejun; Epelman, Marina A; Romeijn, H Edwin; Jiang, Steve B

    2012-07-21

    We study the treatment plan optimization problem for volumetric modulated arc therapy (VMAT). We propose a new column-generation-based algorithm that takes into account bounds on the gantry speed and dose rate, as well as an upper bound on the rate of change of the gantry speed, in addition to MLC constraints. The algorithm iteratively adds one aperture at each control point along the treatment arc. In each iteration, a restricted problem optimizing intensities at previously selected apertures is solved, and its solution is used to formulate a pricing problem, which selects an aperture at another control point that is compatible with previously selected apertures and leads to the largest rate of improvement in the objective function value of the restricted problem. Once a complete set of apertures is obtained, their intensities are optimized and the gantry speeds and dose rates are adjusted to minimize treatment time while satisfying all machine restrictions. Comparisons of treatment plans obtained by our algorithm to idealized IMRT plans of 177 beams on five clinical prostate cancer cases demonstrate high quality with respect to clinical dose-volume criteria. For all cases, our algorithm yields treatment plans that can be delivered in around 2 min. Implementation on a graphic processing unit enables us to finish the optimization of a VMAT plan in 25-55 s. PMID:22722760

  19. Toolkit for determination of dose-response relations, validation of radiobiological parameters and treatment plan optimization based on radiobiological measures.

    PubMed

    Mavroidis, Panayiotis; Tzikas, Athanasios; Papanikolaou, Nikos; Lind, Bengt K

    2010-10-01

    Accurately determined dose-response relations of the different tumors and normal tissues should be estimated and used in the clinic. The aim of this study is to demonstrate developed tools that are necessary for determining the dose-response parameters of tumors and normal tissues, for clinically verifying already published parameter sets using local patient materials and for making use of all this information in the optimization and comparison of different treatment plans and radiation techniques. One of the software modules (the Parameter Determination Module) is designed to determine the dose-response parameters of tumors and normal tissues. This is accomplished by performing a maximum likelihood fitting to calculate the best estimates and confidence intervals of the parameters used by different radiobiological models. Another module of this software (the Parameter Validation Module) concerns the validation and compatibility of external or reported dose-response parameters describing tumor control and normal tissue complications. This is accomplished by associating the expected response rates, which are calculated using different models and published parameter sets, with the clinical follow-up records of the local patient population. Finally, the last module of the software (the Radiobiological Plan Evaluation Module) is used for estimating and optimizing the effectiveness a treatment plan in terms of complication-free tumor control, P(+). The use of the Parameter Determination Module is demonstrated by deriving the dose-response relation of proximal esophagus from head and neck cancer radiotherapy. The application of the Parameter Validation Module is illustrated by verifying the clinical compatibility of those dose-response parameters with the examined treatment methodologies. The Radiobiological Plan Evaluation Module is demonstrated by evaluating and optimizing the effectiveness of head and neck cancer treatment plans. The results of the radiobiological

  20. Report of the AAPM Task Group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning

    SciTech Connect

    Chetty, Indrin J.; Curran, Bruce; Cygler, Joanna E.; DeMarco, John J.; Ezzell, Gary; Faddegon, Bruce A.; Kawrakow, Iwan; Keall, Paul J.; Liu, Helen; Ma, C.-M. Charlie; Rogers, D. W. O.; Seuntjens, Jan; Sheikh-Bagheri, Daryoush; Siebers, Jeffrey V.

    2007-12-15

    The Monte Carlo (MC) method has been shown through many research studies to calculate accurate dose distributions for clinical radiotherapy, particularly in heterogeneous patient tissues where the effects of electron transport cannot be accurately handled with conventional, deterministic dose algorithms. Despite its proven accuracy and the potential for improved dose distributions to influence treatment outcomes, the long calculation times previously associated with MC simulation rendered this method impractical for routine clinical treatment planning. However, the development of faster codes optimized for radiotherapy calculations and improvements in computer processor technology have substantially reduced calculation times to, in some instances, within minutes on a single processor. These advances have motivated several major treatment planning system vendors to embark upon the path of MC techniques. Several commercial vendors have already released or are currently in the process of releasing MC algorithms for photon and/or electron beam treatment planning. Consequently, the accessibility and use of MC treatment planning algorithms may well become widespread in the radiotherapy community. With MC simulation, dose is computed stochastically using first principles; this method is therefore quite different from conventional dose algorithms. Issues such as statistical uncertainties, the use of variance reduction techniques, the ability to account for geometric details in the accelerator treatment head simulation, and other features, are all unique components of a MC treatment planning algorithm. Successful implementation by the clinical physicist of such a system will require an understanding of the basic principles of MC techniques. The purpose of this report, while providing education and review on the use of MC simulation in radiotherapy planning, is to set out, for both users and developers, the salient issues associated with clinical implementation and

  1. Cobalt-60 tomotherapy: Clinical treatment planning and phantom dose delivery studies

    SciTech Connect

    Dhanesar, Sandeep; Darko, Johnson; Joshi, Chandra P.; Kerr, Andrew; John Schreiner, L.

    2013-08-15

    Purpose: Investigations have shown that a Cobalt-60 (Co-60) radioactive source has the potential to play a role in intensity modulated radiation therapy (IMRT). In this paper, Co-60 tomotherapy's conformal dose delivery potential is evaluated by delivering conformal dose plans on a cylindrical homogeneous phantom containing clinical structures similar to those found in a typical head and neck (H and N) cancer. Also, the clinical potential of Co-60 tomotherapy is investigated by generating 2D clinical treatment plans for H and N and prostate anatomical regions. These plans are compared with the 6 MV based treatment plans for modalities such as linear accelerator-based tomotherapy and broad beam IMRT, and 15 MV based 3D conformal radiation therapy (3DCRT).Methods: For experimental validation studies, clinical and nonclinical conformal dose patterns were delivered on circular, homogeneous phantoms containing GafChromic film. For clinical planning study, dose calculations were performed with the EGSnrc Monte Carlo program, where a Theratronics 780C Co-60 unit and a 6 MV linear accelerator were modeled with a MIMiC binary multileaf collimator. An inhouse inverse treatment planning system was used to optimize tomotherapy plans using the same optimization parameters for both Co-60 and 6 MV beams. The IMRT and 3DCRT plans for the clinical cases were generated entirely in the Eclipse treatment planning system based on inhouse IMRT and 3DCRT site specific protocols.Results: The doses delivered to the homogeneous phantoms agreed with the calculations, indicating that it is possible to deliver highly conformal doses with the Co-60 unit. The dose distributions for Co-60 tomotherapy clinical plans for both clinical cases were similar to those obtained with 6 MV based tomotherapy and IMRT, and much more conformal compared to 3DCRT plans. The dose area histograms showed that the Co-60 plans achieve the dose objectives for the targets and organs at risk.Conclusions: These results

  2. Evaluation of computed tomography assisted and transit dosimetry treatment planning with thermoluminescent dosimetry measurements. [4 meV photons

    SciTech Connect

    Velkley, D.E.; Cunningham, D.E.

    1980-12-01

    Transit dosimetry methods have been compared with computer plans which use computed tomography (CT) determined patient geometry to make corrections for inhomogeneities in radiation therapy treatment planning. These two planning methods have been applied to treatment sites in the head and chest of an anthropomorphic phantom. The results of the treatment plans are compared to delivered doses as measured with thermoluminescent dosimeters (TLD) in the phantom. The treatment planning results from two independent commercial computer systems have been found to agree with each other and with transit dosimetry calculations to within 2%.

  3. Treatment planning and verification of proton therapy using spot scanning: Initial experiences

    SciTech Connect

    Lomax, Antony J.; Boehringer, Terence; Bolsi, Alessandra; Coray, Doelf; Emert, Frank; Goitein, Gudrun; Jermann, Martin; Lin, Shixiong; Pedroni, Eros; Rutz, Hanspeter; Stadelmann, Otto; Timmermann, Beate; Verwey, Jorn; Weber, Damien C.

    2004-11-01

    Since the end of 1996, we have treated more than 160 patients at PSI using spot-scanned protons. The range of indications treated has been quite wide and includes, in the head region, base-of-skull sarcomas, low-grade gliomas, meningiomas, and para-nasal sinus tumors. In addition, we have treated bone sarcomas in the neck and trunk - mainly in the sacral area - as well as prostate cases and some soft tissue sarcomas. PTV volumes for our treated cases are in the range 20-4500 ml, indicating the flexibility of the spot scanning system for treating lesions of all types and sizes. The number of fields per applied plan ranges from between 1 and 4, with a mean of just under 3 beams per plan, and the number of fluence modulated Bragg peaks delivered per field has ranged from 200 to 45 000. With the current delivery rate of roughly 3000 Bragg peaks per minute, this translates into delivery times per field of between a few seconds to 20-25 min. Bragg peak weight analysis of these spots has shown that over all fields, only about 10% of delivered spots have a weight of more than 10% of the maximum in any given field, indicating that there is some scope for optimizing the number of spots delivered per field. Field specific dosimetry shows that these treatments can be delivered accurately and precisely to within {+-}1 mm (1 SD) orthogonal to the field direction and to within 1.5 mm in range. With our current delivery system the mean widths of delivered pencil beams at the Bragg peak is about 8 mm ({sigma}) for all energies, indicating that this is an area where some improvements can be made. In addition, an analysis of the spot weights and energies of individual Bragg peaks shows a relatively broad spread of low and high weighted Bragg peaks over all energy steps, indicating that there is at best only a limited relationship between pencil beam weighting and depth of penetration. This latter observation may have some consequences when considering strategies for fast re

  4. Development of a Monte Carlo model for treatment planning dose verification of the Leksell Gamma Knife Perfexion radiosurgery system.

    PubMed

    Yuan, Jiankui; Lo, Simon S; Zheng, Yiran; Sohn, Jason W; Sloan, Andrew E; Ellis, Rodney; Machtay, Mitchell; Wessels, Barry

    2016-01-01

    Detailed Monte Carlo (MC) modeling of the Leksell Gamma Knife (GK) Perfexion (PFX) collimator system is the only accurate ab initio approach appearing in the literature. As a different approach, in this work, we present a MC model based on film measurement. By adjusting the model parameters and fine-tuning the derived fluence map for each individual source to match the manufacturer's ring output factors, we created a reasonable virtual source model for MC simulations to verify treatment planning dose for the GK PFX radiosurgery system. The MC simulation model was commissioned by simple single shots. Dose profiles and both ring and collimator output factors were compared with the treatment planning system (TPS). Good agreement was achieved for dose profiles especially for the region of plateau (< 2%), while larger difference (< 5%) came from the penumbra region. The maximum difference of the calculated output factor was within 0.7%. The model was further validated by a clinical test case. Good agreement was obtained. The DVHs for brainstem and the skull were almost identical and, for the target, the volume covered by the prescription (12.5 Gy to 50% isodose line) was 95.6% from MC calculation versus 100% from the TPS. PMID:27455497

  5. The adaptation of megavoltage cone beam CT for use in standard radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Thomas, T. Hannah Mary; Devakumar, D.; Purnima, S.; Ravindran, B. Paul

    2009-04-01

    Potential areas where megavoltage computed tomography (MVCT) could be used are second- and third-phase treatment planning in 3D conformal radiotherapy and IMRT, adaptive radiation therapy, single fraction palliative treatment and for the treatment of patients with metal prostheses. A feasibility study was done on using MV cone beam CT (CBCT) images generated by proprietary 3D reconstruction software based on the FDK algorithm for megavoltage treatment planning. The reconstructed images were converted to a DICOM file set. The pixel values of megavoltage cone beam computed tomography (MV CBCT) were rescaled to those of kV CT for use with a treatment planning system. A calibration phantom was designed and developed for verification of geometric accuracy and CT number calibration. The distance measured between two marker points on the CBCT image and the physical dimension on the phantom were in good agreement. Point dose verification for a 10 cm × 10 cm beam at a gantry angle of 0° and SAD of 100 cm were performed for a 6 MV beam for both kV and MV CBCT images. The point doses were found to vary between ±6.1% of the dose calculated from the kV CT image. The isodose curves for 6 MV for both kV CT and MV CBCT images were within 2% and 3 mm distance-to-agreement. A plan with three beams was performed on MV CBCT, simulating a treatment plan for cancer of the pituitary. The distribution obtained was compared with those corresponding to that obtained using the kV CT. This study has shown that treatment planning with MV cone beam CT images is feasible.

  6. The adaptation of megavoltage cone beam CT for use in standard radiotherapy treatment planning.

    PubMed

    Thomas, T Hannah Mary; Devakumar, D; Purnima, S; Ravindran, B Paul

    2009-04-01

    Potential areas where megavoltage computed tomography (MVCT) could be used are second- and third-phase treatment planning in 3D conformal radiotherapy and IMRT, adaptive radiation therapy, single fraction palliative treatment and for the treatment of patients with metal prostheses. A feasibility study was done on using MV cone beam CT (CBCT) images generated by proprietary 3D reconstruction software based on the FDK algorithm for megavoltage treatment planning. The reconstructed images were converted to a DICOM file set. The pixel values of megavoltage cone beam computed tomography (MV CBCT) were rescaled to those of kV CT for use with a treatment planning system. A calibration phantom was designed and developed for verification of geometric accuracy and CT number calibration. The distance measured between two marker points on the CBCT image and the physical dimension on the phantom were in good agreement. Point dose verification for a 10 cm x 10 cm beam at a gantry angle of 0 degrees and SAD of 100 cm were performed for a 6 MV beam for both kV and MV CBCT images. The point doses were found to vary between +/-6.1% of the dose calculated from the kV CT image. The isodose curves for 6 MV for both kV CT and MV CBCT images were within 2% and 3 mm distance-to-agreement. A plan with three beams was performed on MV CBCT, simulating a treatment plan for cancer of the pituitary. The distribution obtained was compared with those corresponding to that obtained using the kV CT. This study has shown that treatment planning with MV cone beam CT images is feasible. PMID:19287087

  7. Records Needed for Orthodontic Diagnosis and Treatment Planning: A Systematic Review

    PubMed Central

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

    2013-01-01

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

  8. American Association of Physicists in Medicine Radiation Therapy Committee Task Group 53: quality assurance for clinical radiotherapy treatment planning.

    PubMed

    Fraass, B; Doppke, K; Hunt, M; Kutcher, G; Starkschall, G; Stern, R; Van Dyke, J

    1998-10-01

    In recent years, the sophistication and complexity of clinical treatment planning and treatment planning systems has increased significantly, particularly including three-dimensional (3D) treatment planning systems, and the use of conformal treatment planning and delivery techniques. This has led to the need for a comprehensive set of quality assurance (QA) guidelines that can be applied to clinical treatment planning. This document is the report of Task Group 53 of the Radiation Therapy Committee of the American Association of Physicists in Medicine. The purpose of this report is to guide and assist the clinical medical physicist in developing and implementing a comprehensive but viable program of quality assurance for modern radiotherapy treatment planning. The scope of the QA needs for treatment planning is quite broad, encompassing image-based definition of patient anatomy, 3D beam descriptions for complex beams including multileaf collimator apertures, 3D dose calculation algorithms, and complex plan evaluation tools including dose volume histograms. The Task Group recommends an organizational framework for the task of creating a QA program which is individualized to the needs of each institution and addresses the issues of acceptance testing, commissioning the planning system and planning process, routine quality assurance, and ongoing QA of the planning process. This report, while not prescribing specific QA tests, provides the framework and guidance to allow radiation oncology physicists to design comprehensive and practical treatment planning QA programs for their clinics. PMID:9800687

  9. TH-A-BRF-01: A Probabilistic Bayesian Approach to Derive Electron Density From MRI for Radiation Therapy Treatment Planning

    SciTech Connect

    Gudur, M; Hara, W; Wang, L; Xing, L; Li, R

    2014-06-15

    Purpose: MRI significantly improves the accuracy and reliability of target delineation for patient simulation and treatment planning in radiation therapy, due to its superior soft tissue contrast as compared to CT. An MRI based simulation will reduce cost and simplify clinical workflow with zero ionizing radiation. However, MRI lacks the key electron density information. The purpose of this work is to develop a reliable method to derive electron density from MRI. Methods: We adopt a probabilistic Bayesian approach for electron density mapping based on T1-weighted head MRI. For each voxel, we compute conditional probability of electron densities given its: (1) T1 intensity and (2) geometry in a reference anatomy, obtained by deformable image registration between the MRI of test patient and atlas. Intensity and geometry information are combined into a unifying posterior probability density function whose mean gives the electron density. Mean absolute HU error between the estimated and true CT, as well as ROC's for bone detection (HU>200) were calculated for 8 patients. The performance was compared with a global intensity approach based on T1 and no density correction (set whole head to water). Results: The proposed technique significantly reduced the errors in electron density estimation, with a mean absolute HU error of 132, compared with 139 for deformable registration (p=10{sup −3}), 371 for the intensity approach (p=10{sup −5}) and 282 without density correction (p=2×10{sup −4}). For 90% sensitivity in bone detection, the proposed method had a specificity of 85% and that for deformable registration, intensity and without density correction are 80%, 24% and 10% respectively. Conclusion: The proposed unifying method provides accurate electron density estimation and bone detection from MRI of the head with highly heterogeneous regions. This paves the way for accurate dose calculation and generating reference images for patient setup in MRI-based treatment

  10. Water: from the source to the treatment plan

    NASA Astrophysics Data System (ADS)

    Marquet, V.; Baude, I.

    2012-04-01

    As a biology and geology teacher, I have worked on water, from the source to the treatment plant, with pupils between 14 and 15 years old. Lesson 1. Introduction, the water in Vienna Aim: The pupils have to consider why the water is so important in Vienna (history, economy etc.) Activities: Brainstorming about where and why we use water every day and why the water is different in Vienna. Lesson 2. Soil, rock and water Aim: Permeability/ impermeability of the different layers of earth Activities: The pupils have measure the permeability and porosity of different stones: granite, clay, sand, carbonate and basalt. Lesson 3. Relationship between water's ion composition and the stone's mineralogy Aim: Each water source has the same ion composition as the soil where the water comes from. Activities: Comparison between the stone's mineralogy and ions in water. They had a diagram with the ions of granite, clay, sand, carbonate and basalt and the label of different water. They had to make hypotheses about the type of soil where the water came from. They verified this with a geology map of France and Austria. They have to make a profile of the area where the water comes from. They had to confirm or reject their hypothesis. Lesson 4 .Water-catchment and reservoir rocks Aim: Construction of a confined aquifer and artesian well Activities: With sand, clay and a basin, they have to model a confined aquifer and make an artesian well, using what they have learned in lesson 2. Lesson 5. Organic material breakdown and it's affect on the oxygen levels in an aquatic ecosystem Aim: Evaluate the relationship between oxygen levels and the amount of organic matter in an aquatic ecosystem. Explain the relationship between oxygen levels, bacteria and the breakdown of organic matter using an indicator solution. Activities: Put 5 ml of a different water sample in each tube with 20 drops of methylene blue. Observe the tubes after 1 month. Lesson 6. Visit to the biggest water treatment plant in

  11. WE-G-16A-01: Evolution of Radiation Treatment Planning

    SciTech Connect

    Rothenberg, L; Mohan, R; Van Dyk, J; Fraass, B; Bortfeld, T

    2014-06-15

    Welcome and Introduction - Lawrence N. Rothenberg This symposium is one a continuing series of presentations at AAPM Annual Meetings on the historical aspects of medical physics, radiology, and radiation oncology that have been organized by the AAPM History Committee. Information on previous presentations including “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen's Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website. The Austin 2014 History Symposium will be on “Evolution of Radiation Treatment Planning.” Overview - Radhe Mohan Treatment planning is one of the most critical components in the chain of radiation therapy of cancers. Treatment plans of today contain a wide variety of sophisticated information conveying the potential clinical effectiveness of the designed treatment to practitioners. Examples of such information include dose distributions superimposed on three- or even four-dimensional anatomic images; dose volume histograms, dose, dose-volume and dose-response indices for anatomic structures of interest; etc. These data are used for evaluating treatment plans and for making treatment decisions. The current state-of-the-art has evolved from the 1940s era when the dose to the tumor and normal tissues was estimated approximately by manual means. However, the symposium will cover the history of the field from the late-1950's, when computers were first introduced for treatment planning, to the present state involving the use of high performance computing and advanced multi-dimensional anatomic, functional and biological imaging, focusing only on external beam treatment planning. The symposium will start with a general overview of the treatment planning process including imaging, structure

  12. Multi-Case Knowledge-Based IMRT Treatment Planning in Head and Neck Cancer

    NASA Astrophysics Data System (ADS)

    Grzetic, Shelby Mariah

    Head and neck cancer (HNC) IMRT treatment planning is a challenging process that relies heavily on the planner's experience. Previously, we used the single, best match from a library of manually planned cases to semi-automatically generate IMRT plans for a new patient. The current multi-case Knowledge Based Radiation Therapy (MC-KBRT) study utilized different matching cases for each of six individual organs-at-risk (OARs), then combined those six cases to create the new treatment plan. From a database of 103 patient plans created by experienced planners, MC-KBRT plans were created for 40 (17 unilateral and 23 bilateral) HNC "query" patients. For each case, 2D beam's-eye-view images were used to find similar geometric "match" patients separately for each of 6 OARs. Dose distributions for each OAR from the 6 matching cases were combined and then warped to suit the query case's geometry. The dose-volume constraints were used to create the new query treatment plan without the need for human decision-making throughout the IMRT optimization. The optimized MC-KBRT plans were compared against the clinically approved plans and Version 1 (previous KBRT using only one matching case with dose warping) using the dose metrics: mean, median, and maximum (brainstem and cord+5mm) doses. Compared to Version 1, MC-KBRT had no significant reduction of the dose to any of the OARs in either unilateral or bilateral cases. Compared to the manually planned unilateral cases, there was significant reduction of the oral cavity mean/median dose (>2Gy) at the expense of the contralateral parotid. Compared to the manually planned bilateral cases, reduction of dose was significant in the ipsilateral parotid, larynx, and oral cavity (>3Gy mean/median) while maintaining PTV coverage. MC-KBRT planning in head and neck cancer generates IMRT plans with better dose sparing than manually created plans. MC-KBRT using multiple case matches does not show significant dose reduction compared to using a

  13. Three-dimensional treatment planning for para-aortic node irradiation in patients with cervical cancer

    SciTech Connect

    Munzenrider, J.E.; Doppke, K.P.; Brown, A.P.; Burman, C.; Cheng, E.; Chu, J.; Chui, C.; Drzymala, R.E.; Goitein, M.; Manolis, J.M. )

    1991-05-15

    Three-dimensional treatment planning has been used by four cooperating centers to prepare and analyze multiple treatment plans on two cervix cancer patients. One patient had biopsy-proven and CT-demonstrable metastasis to the para-aortic nodes, while the other was at high risk for metastatic involvement of para-aortic nodes. Volume dose distributions were analyzed, and an attempt was made to define the role of 3-D treatment planning to the para-aortic region, where moderate to high doses (50-66 Gy) are required to sterilize microscopic and gross metastasis. Plans were prepared using the 3-D capabilities for tailoring fields to the target volumes, but using standard field arrangements (3-D standard), and with full utilization of the 3-D capabilities (3-D unconstrained). In some but not all 3-D unconstrained plans, higher doses were delivered to the large nodal volume and to the volume containing gross nodal disease than in plans analyzed but not prepared with full 3-D capability (3-D standard). The small bowel was the major dose limiting organ. Its tolerance would have been exceeded in all plans which prescribed 66 Gy to the gross nodal mass, although some reduction in small bowel near-maximum dose was achieved in the 3-D unconstrained plans. All plans were able to limit doses to other normal organs to tolerance levels or less, with significant reductions seen in doses to spinal cord, kidneys, and large bowel in the 3-D unconstrained plans, as compared to the 3-D standard plans. A high probability of small bowel injury was detected in one of four 3-D standard plans prescribed to receive 50 Gy to the large para-aortic nodal volume; the small bowel dose was reduced to an acceptable level in the corresponding 3-D unconstrained plan. An optimum beam energy for treating this site was not identified, with plans using 4, 6, 10, 15, 18, and 25 MV photons all being equally acceptable. (Abstract Truncated)

  14. Treatment Planning for Accelerator-Based Boron Neutron Capture Therapy

    SciTech Connect

    Herrera, Maria S.; Gonzalez, Sara J.; Minsky, Daniel M.; Kreiner, Andres J.

    2010-08-04

    Glioblastoma multiforme and metastatic melanoma are frequent brain tumors in adults and presently still incurable diseases. Boron Neutron Capture Therapy (BNCT) is a promising alternative for this kind of pathologies. Accelerators have been proposed for BNCT as a way to circumvent the problem of siting reactors in hospitals and for their relative simplicity and lower cost among other advantages. Considerable effort is going into the development of accelerator-based BNCT neutron sources in Argentina. Epithermal neutron beams will be produced through appropriate proton-induced nuclear reactions and optimized beam shaping assemblies. Using these sources, computational dose distributions were evaluated in a real patient with diagnosed glioblastoma treated with BNCT. The simulated irradiation was delivered in order to optimize dose to the tumors within the normal tissue constraints. Using Monte Carlo radiation transport calculations, dose distributions were generated for brain, skin and tumor. Also, the dosimetry was studied by computing cumulative dose-volume histograms for volumes of interest. The results suggest acceptable skin average dose and a significant dose delivered to tumor with low average whole brain dose for irradiation times less than 60 minutes, indicating a good performance of an accelerator-based BNCT treatment.

  15. Treatment Planning for Accelerator-Based Boron Neutron Capture Therapy

    NASA Astrophysics Data System (ADS)

    Herrera, María S.; González, Sara J.; Minsky, Daniel M.; Kreiner, Andrés J.

    2010-08-01

    Glioblastoma multiforme and metastatic melanoma are frequent brain tumors in adults and presently still incurable diseases. Boron Neutron Capture Therapy (BNCT) is a promising alternative for this kind of pathologies. Accelerators have been proposed for BNCT as a way to circumvent the problem of siting reactors in hospitals and for their relative simplicity and lower cost among other advantages. Considerable effort is going into the development of accelerator-based BNCT neutron sources in Argentina. Epithermal neutron beams will be produced through appropriate proton-induced nuclear reactions and optimized beam shaping assemblies. Using these sources, computational dose distributions were evaluated in a real patient with diagnosed glioblastoma treated with BNCT. The simulated irradiation was delivered in order to optimize dose to the tumors within the normal tissue constraints. Using Monte Carlo radiation transport calculations, dose distributions were generated for brain, skin and tumor. Also, the dosimetry was studied by computing cumulative dose-volume histograms for volumes of interest. The results suggest acceptable skin average dose and a significant dose delivered to tumor with low average whole brain dose for irradiation times less than 60 minutes, indicating a good performance of an accelerator-based BNCT treatment.

  16. TH-A-9A-04: Incorporating Liver Functionality in Radiation Therapy Treatment Planning

    SciTech Connect

    Wu, V; Epelman, M; Feng, M; Cao, Y; Wang, H; Romeijn, E; Matuszak, M

    2014-06-15

    Purpose: Liver SBRT patients have both variable pretreatment liver function (e.g., due to degree of cirrhosis and/or prior treatments) and sensitivity to radiation, leading to high variability in potential liver toxicity with similar doses. This work aims to explicitly incorporate liver perfusion into treatment planning to redistribute dose to preserve well-functioning areas without compromising target coverage. Methods: Voxel-based liver perfusion, a measure of functionality, was computed from dynamic contrast-enhanced MRI. Two optimization models with different cost functions subject to the same dose constraints (e.g., minimum target EUD and maximum critical structure EUDs) were compared. The cost functions minimized were EUD (standard model) and functionality-weighted EUD (functional model) to the liver. The resulting treatment plans delivering the same target EUD were compared with respect to their DVHs, their dose wash difference, the average dose delivered to voxels of a particular perfusion level, and change in number of high-/low-functioning voxels receiving a particular dose. Two-dimensional synthetic and three-dimensional clinical examples were studied. Results: The DVHs of all structures of plans from each model were comparable. In contrast, in plans obtained with the functional model, the average dose delivered to high-/low-functioning voxels was lower/higher than in plans obtained with its standard counterpart. The number of high-/low-functioning voxels receiving high/low dose was lower in the plans that considered perfusion in the cost function than in the plans that did not. Redistribution of dose can be observed in the dose wash differences. Conclusion: Liver perfusion can be used during treatment planning potentially to minimize the risk of toxicity during liver SBRT, resulting in better global liver function. The functional model redistributes dose in the standard model from higher to lower functioning voxels, while achieving the same target EUD

  17. 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.

  18. Interactive Dose Shaping - efficient strategies for CPU-based real-time treatment planning

    NASA Astrophysics Data System (ADS)

    Ziegenhein, P.; Kamerling, C. P.; Oelfke, U.

    2014-03-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  19. Three-Dimensional Dose Optimization for Noncoplanar Treatment Planning with Conformal Fields.

    NASA Astrophysics Data System (ADS)

    Ma, Ying-Chang L.

    1990-01-01

    Recent advances in imaging techniques, especially three dimensional reconstruction of CT images, have made precision tumor localization feasible. These imaging techniques along with developments in computer controlled radiation treatment machines have provided an important thrust in developing better techniques for cancer treatment. This often requires a complex noncoplanar beam arrangements and elaborate treatment planning, which, unfortunately, are time consuming, costly and dependent on operator expertise and experience. A reliable operator-independent dose optimization tool is therefore desirable, especially for 3D treatment planning. In this dissertation, several approaches (linear programming, quadratic programming, and direct search methods) of computer optimization using various criteria including least sire fitting on the 90% isodose to target periphery, dose uniformity, and integral dose are presented. All of these methods are subject to restrictions on the upper limit of the dose to critical organs. In the quadratic programming approach, Kuhn-Tucker theory was employed to convert the quadratic problem into one which permits application of the very powerful, revised simplex method. Several examples are used to analyze the effectiveness of these dose optimization approaches. The studies show that the quadratic programming approach with the criteria of least square fitting and critical organ constraints is superior in efficiency for dose optimization in 3D treatment planning, particularly for cases with a large number of beams. Use of least square fitting allows one to deduce optimized plans for irregularly shaped targets by employing a multi-isocentric technique. Our studies also illustrate the advantages of using irregular conformal fields, optimized beam energy, and noncoplanar beam arrangements in contrast to the conventional treatment which uses a symmetrical rectangular collimator, fixed beam energy, and coplanar beam arrangements. Optimized plans can

  20. An overview of imaging techniques and physical aspects of treatment planning in radioimmunotherapy

    SciTech Connect

    Leichner, P.K. ); Koral, K.F. ); Jaszczak, R.J. ); Green, A.J. ); Chen, G.T.Y.; Roeske, J.C. )

    1993-03-01

    Planar and tomographic imaging techniques and methods of treatment planning in clinical radioimmunotherapy are reviewed. In clinical trials, the data needed for dosimetry and treatment planning are, in most cases, obtained from noninvasive imaging procedures. The required data include tumor and normal organ volumes, the activity of radiolabeled antibodies taken up in these volumes, and the pharmacokinetics of the administered activity of radiolabeled antibodies. Therefore, the topics addressed in this review include: (1) Volume determinations of tumors and normal organs from x-ray-computed tomography and magnetic resonance imaging, (2) quantitation of the activity of radiolabeled antibodies in tumors and normal organs from planar gamma camera views, (3) quantitative single-photon emission computed tomography and positron emission tomography, (4) correlative image analysis, and (5) treatment planning in clinical radioimmunotherapy.

  1. Interim Status Closure Plan Open Burning Treatment Unit Technical Area 16-399 Burn Tray

    SciTech Connect

    Vigil-Holterman, Luciana R.

    2012-05-07

    This closure plan describes the activities necessary to close one of the interim status hazardous waste open burning treatment units at Technical Area (TA) 16 at the Los Alamos National Laboratory (LANL or the Facility), hereinafter referred to as the 'TA-16-399 Burn Tray' or 'the unit'. The information provided in this closure plan addresses the closure requirements specified in the Code of Federal Regulations (CFR), Title 40, Part 265, Subparts G and P for the thermal treatment units operated at the Facility under the Resource Conservation and Recovery Act (RCRA) and the New Mexico Hazardous Waste Act. Closure of the open burning treatment unit will be completed in accordance with Section 4.1 of this closure plan.

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

    PubMed

    Zhu, Jiahua; Penfold, Scott N

    2016-06-01

    Correct modelling of the interaction parameters of patient tissues is of vital importance in proton therapy treatment planning because of the large dose gradients associated with the Bragg peak. Different 3D imaging techniques yield different information regarding these interaction parameters. Given the rapidly expanding interest in proton therapy, this review is written to make readers aware of the current challenges in accounting for tissue heterogeneities and the imaging systems that are proposed to tackle these challenges. A summary of the interaction parameters of interest in proton therapy and the current and developmental 3D imaging techniques used in proton therapy treatment planning is given. The different methods to translate the imaging data to the interaction parameters of interest are reviewed and a summary of the implementations in several commercial treatment planning systems is presented. PMID:27115163

  3. Using Fluorescence Imaging to Track Drug Delivery and Guide Treatment Planning In Vivo.

    PubMed

    Lin, Qiaoya; Huang, Huang; Chen, Juan; Zheng, Gang

    2016-01-01

    Imaging has become an indispensable tool in both clinical medicine and preclinical sciences. It enables doctors to locate sites of cancer/disease, track drug delivery, and guide operative planning, thus enhancing the treatment efficacy. Recently, we developed a multimodal theranostic lipid nanoparticles, named HPPS(NIR)-chol-siRNA with its built-in near-infrared (NIR) fluorescent probe core as a useful surrogate for tracking small interfering RNA (siRNA) delivery. By using the image co-registration of computed tomography (CT) and fluorescence molecular tomography (FMT), we achieved noninvasive assessment and treatment planning of siRNA delivery into the orthotopic tumor, thus enabling efficacious RNA interference (RNAi) therapy. In this chapter, we introduce this method to illustrate the use of CT-FMT co-registration for tracking drug delivery and guiding treatment planning in vivo. PMID:27283425

  4. Dosimetric differences in flattened and flattening filter-free beam treatment plans

    PubMed Central

    Yan, Yue; Yadav, Poonam; Bassetti, Michael; Du, Kaifang; Saenz, Daniel; Harari, Paul; Paliwal, Bhudatt R.

    2016-01-01

    This study investigated the dosimetric differences in treatment plans from flattened and flattening filter-free (FFF) beams from the TrueBeam System. A total of 104 treatment plans with static (sliding window) intensity-modulated radiotherapy beams and volumetric-modulated arc therapy (VMAT) beams were generated for 15 patients involving three cancer sites. In general, the FFF beam provides similar target coverage as the flattened beam with improved dose sparing to organ-at-risk (OAR). Among all three cancer sites, the head and neck showed more important differences between the flattened beam and FFF beam. The maximum reduction of the FFF beam in the mean dose reached up to 2.82 Gy for larynx in head and neck case. Compared to the 6 MV flattened beam, the 10 MV FFF beam provided improved dose sparing to certain OARs, especially for VMAT cases. Thus, 10 MV FFF beam could be used to improve the treatment plan. PMID:27217620

  5. Treatment Planning and Image Guidance for Radiofrequency Ablations of Large Tumors

    PubMed Central

    Ren, Hongliang; Campos-Nanez, Enrique; Yaniv, Ziv; Banovac, Filip; Abeledo, Hernan; Hata, Nobuhiko; Cleary, Kevin

    2014-01-01

    This article addresses the two key challenges in computer-assisted percutaneous tumor ablation: planning multiple overlapping ablations for large tumors while avoiding critical structures, and executing the prescribed plan. Towards semi-automatic treatment planning for image-guided surgical interventions, we develop a systematic approach to the needle-based ablation placement task, ranging from pre-operative planning algorithms to an intra-operative execution platform. The planning system incorporates clinical constraints on ablations and trajectories using a multiple objective optimization formulation, which consists of optimal path selection and ablation coverage optimization based on integer programming. The system implementation is presented and validated in phantom studies and on an animal model. The presented system can potentially be further extended for other ablation techniques such as cryotherapy. PMID:24235279

  6. The role of Cobalt-60 source in Intensity Modulated Radiation Therapy: From modeling finite sources to treatment planning and conformal dose delivery

    NASA Astrophysics Data System (ADS)

    Dhanesar, Sandeep Kaur

    Cobalt-60 (Co-60) units played an integral role in radiation therapy from the mid-1950s to the 1970s. Although they continue to be used to treat cancer in some parts of the world, their role has been significantly reduced due to the invention of medical linear accelerators. A number of groups have indicated a strong potential for Co-60 units in modern radiation therapy. The Medical Physics group at the Cancer Center of the Southeastern Ontario and Queen's University has shown the feasibility of Intensity Modulated Radiation Therapy (IMRT) via simple conformal treatment planning and dose delivery using a Co-60 unit. In this thesis, initial Co-60 tomotherapy planning investigations on simple uniform phantoms are extended to actual clinical cases based on patient CT data. The planning is based on radiation dose data from a clinical Co-60 unit fitted with a multileaf collimator (MLC) and modeled in the EGSnrc Monte Carlo system. An in house treatment planning program is used to calculate IMRT dose distributions. Conformal delivery in a single slice on a uniform phantom based on sequentially delivered pencil beams is verified by Gafchromic film. Volumetric dose distributions for Co-60 serial tomotherapy are then generated for typical clinical sites that had been treated at our clinic by conventional 6MV IMRT using Varian Eclipse treatment plans. The Co-60 treatment plans are compared with the clinical IMRT plans using conventional matrices such as dose volume histograms (DVH). Dose delivery based on simultaneously opened MLC leaves is also explored and a novel MLC segmentation method is proposed. In order to increase efficiency of dose calculations, a novel convolution based fluence model for treatment planning is also proposed. The ion chamber measurements showed that the Monte Carlo modeling of the beam data under the MIMiC MLC is accurate. The film measurements from the uniform phantom irradiations confirm that IMRT plans from our in-house treatment planning system

  7. A Comparative Dosimetric Analysis of the Effect of Heterogeneity Corrections Used in Three Treatment Planning Algorithms

    NASA Astrophysics Data System (ADS)

    Herrick, Andrea Celeste

    Successful treatment in radiation oncology relies on the evaluation of a plan for each individual patient based on delivering the maximum dose to the tumor while sparing the surrounding normal tissue (organs at risk) in the patient. Organs at risk (OAR) typically considered include the heart, the spinal cord, healthy lung tissue, and any other organ in the vicinity of the target that is not affected by the disease being treated. Depending on the location of the tumor and its proximity to these OARs, several plans may be created and evaluated in order to assess which "solution" most closely meets all of the specified criteria. In order to successfully review a treatment plan and take the correct course of action, a physician needs to rely on the computer model (treatment planning algorithm) of dose distribution to reconstruct CT scan data to proceed with the plan that best achieves all of the goals. There are many available treatment planning systems from which a Radiation Oncology center can choose from. While the radiation interactions considered are identical among clinics, the way the chosen algorithm handles these interactions can vary immensely. The goal of this study was to provide a comparison between two commonly used treatment planning systems (Pinnacle and Eclipse) and their associated dose calculation algorithms. In order to this, heterogeneity correction models were evaluated via test plans, and the effects of going from heterogeneity uncorrected patient representation to a heterogeneity correction representation were studied. The results of this study indicate that the actual dose delivered to the patient varies greatly between treatment planning algorithms in areas of low density tissue such as in the lungs. Although treatment planning algorithms are attempting to come to the same result with heterogeneity corrections, the reality is that the results depend strongly on the algorithm used in the situations studied. While the Anisotropic Analytic Method

  8. Commissioning and initial acceptance tests for a commercial convolution dose calculation algorithm for radiotherapy treatment planning in comparison with Monte Carlo simulation and measurement

    PubMed Central

    Moradi, Farhad; Mahdavi, Seyed Rabi; Mostaar, Ahmad; Motamedi, Mohsen

    2012-01-01

    In this study the commissioning of a dose calculation algorithm in a currently used treatment planning system was performed and the calculation accuracy of two available methods in the treatment planning system i.e., collapsed cone convolution (CCC) and equivalent tissue air ratio (ETAR) was verified in tissue heterogeneities. For this purpose an inhomogeneous phantom (IMRT thorax phantom) was used and dose curves obtained by the TPS (treatment planning system) were compared with experimental measurements and Monte Carlo (MCNP code) simulation. Dose measurements were performed by using EDR2 radiographic films within the phantom. Dose difference (DD) between experimental results and two calculation methods was obtained. Results indicate maximum difference of 12% in the lung and 3% in the bone tissue of the phantom between two methods and the CCC algorithm shows more accurate depth dose curves in tissue heterogeneities. Simulation results show the accurate dose estimation by MCNP4C in soft tissue region of the phantom and also better results than ETAR method in bone and lung tissues. PMID:22973081

  9. Commissioning and initial acceptance tests for a commercial convolution dose calculation algorithm for radiotherapy treatment planning in comparison with Monte Carlo simulation and measurement.

    PubMed

    Moradi, Farhad; Mahdavi, Seyed Rabi; Mostaar, Ahmad; Motamedi, Mohsen

    2012-07-01

    In this study the commissioning of a dose calculation algorithm in a currently used treatment planning system was performed and the calculation accuracy of two available methods in the treatment planning system i.e., collapsed cone convolution (CCC) and equivalent tissue air ratio (ETAR) was verified in tissue heterogeneities. For this purpose an inhomogeneous phantom (IMRT thorax phantom) was used and dose curves obtained by the TPS (treatment planning system) were compared with experimental measurements and Monte Carlo (MCNP code) simulation. Dose measurements were performed by using EDR2 radiographic films within the phantom. Dose difference (DD) between experimental results and two calculation methods was obtained. Results indicate maximum difference of 12% in the lung and 3% in the bone tissue of the phantom between two methods and the CCC algorithm shows more accurate depth dose curves in tissue heterogeneities. Simulation results show the accurate dose estimation by MCNP4C in soft tissue region of the phantom and also better results than ETAR method in bone and lung tissues. PMID:22973081

  10. Spherical cluster analysis for beam angle optimization in intensity-modulated radiation therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Bangert, Mark; Oelfke, Uwe

    2010-10-01

    An intuitive heuristic to establish beam configurations for intensity-modulated radiation therapy is introduced as an extension of beam ensemble selection strategies applying scalar scoring functions. It is validated by treatment plan comparisons for three intra-cranial, pancreas, and prostate cases each. Based on a patient specific matrix listing the radiological quality of candidate beam directions individually for every target voxel, a set of locally ideal beam angles is generated. The spherical distribution of locally ideal beam angles is characteristic for every treatment site and patient: ideal beam angles typically cluster around distinct orientations. We interpret the cluster centroids, which are identified with a spherical K-means algorithm, as irradiation angles of an intensity-modulated radiation therapy treatment plan. The fluence profiles are subsequently optimized during a conventional inverse planning process. The average computation time for the pre-optimization of a beam ensemble is six minutes on a state-of-the-art work station. The treatment planning study demonstrates the potential benefit of the proposed beam angle optimization strategy. For the three prostate cases under investigation, the standard treatment plans applying nine coplanar equi-spaced beams and treatment plans applying an optimized non-coplanar nine-beam ensemble yield clinically comparable dose distributions. For symmetric patient geometries, the dose distribution formed by nine equi-spaced coplanar beams cannot be improved significantly. For the three pancreas and intra-cranial cases under investigation, the optimized non-coplanar beam ensembles enable better sparing of organs at risk while guaranteeing equivalent target coverage. Beam angle optimization by spherical cluster analysis shows the biggest impact for target volumes located asymmetrically within the patient and close to organs at risk.

  11. Dose distribution transfer from CyberKnife to Varian treatment planning system

    NASA Astrophysics Data System (ADS)

    Osewski, W.; Ślosarek, K.; Karaszewska, B.

    2014-03-01

    The aim of this paper was to introduce one of the options of the locally developed DDcon.exe which gives the possibility to transfer the dose distribution from CyberKnife (Accuray) treatment planning system (CK TPS) to Varian treatment planning system (Eclipse TPS, Varian). DICOM format is known as a universal format for medical data. The dose distribution is stored as RTdose file in DICOM format, so there should be a possibility to transfer it between different treatment planning systems. Trying to transfer RTdose file from CK TPS to Eclipse TPS the error message occurs. That's because the RTdose file in CK TPS is connected with Structure_Set_Sequence against Eclipse TPS where it's connected with RT_Plan_Sequence. To make it transferable RTdose file from CK TPS have to be 'disconnected' from Structure_Set_Sequence and 'connected' with RT_Plan_Sequence. This is possible thanks DDcon software which creates new RTdose file by changing proper DICOM tags in original RTdose file. New homemade software gives us an opportunity to transfer dose distribution from CyberKnife TPS to TPS Eclipse. This method opens new possibilities to combine or compare different treatment techniques in Varian TPS.

  12. BNCT treatment planning of recurrent head-and-neck cancer using THORplan.

    PubMed

    Yu, Hui-Ting; Liu, Yen-Wan Hsueh; Lin, Tzung-Yi; Wang, Ling-Wei

    2011-12-01

    A cooperation program on Boron Neutron Capture Therapy (BNCT) between National Tsing Hua University (NTHU) and Taipei Veterans General Hospital (TPEVGH) was established in 2008. Clinical trial of recurrent head-and-neck cancer is the goal of the program. In this study, treatment plannings of two head-and-neck cancer cases are performed using treatment planning system THORplan developed at NTHU of Taiwan. The patients are assumed to be irradiated under current THOR epithermal neutron beam. The prescription dose is 20 Gy-Eq for at least 80% of tumor volume. The irradiation time to reach the target tumor dose can be kept within 1h. The skin dose is within the limiting dose of 11 Gy-Eq. The spinal cord dose is well within the limiting dose of 10 Gy-Eq. The use of an extension collimator for easier patient positioning is helpful in reducing the dose of eye lens to within the dose limit of 5 Gy-Eq. The irradiation time, however, will increase slightly due to the increase of source-to-tumor distance. The CPU time for treatment planning calculation is ~10 h. With the use of user friendly treatment planning system THORplan, dose planning for BNCT at THOR can be easily performed. PMID:21458281

  13. An integrated Monte Carlo dosimetric verification system for radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Yamamoto, T.; Mizowaki, T.; Miyabe, Y.; Takegawa, H.; Narita, Y.; Yano, S.; Nagata, Y.; Teshima, T.; Hiraoka, M.

    2007-04-01

    An integrated Monte Carlo (MC) dose calculation system, MCRTV (Monte Carlo for radiotherapy treatment plan verification), has been developed for clinical treatment plan verification, especially for routine quality assurance (QA) of intensity-modulated radiotherapy (IMRT) plans. The MCRTV system consists of the EGS4/PRESTA MC codes originally written for particle transport through the accelerator, the multileaf collimator (MLC), and the patient/phantom, which run on a 28-CPU Linux cluster, and the associated software developed for the clinical implementation. MCRTV has an interface with a commercial treatment planning system (TPS) (Eclipse, Varian Medical Systems, Palo Alto, CA, USA) and reads the information needed for MC computation transferred in DICOM-RT format. The key features of MCRTV have been presented in detail in this paper. The phase-space data of our 15 MV photon beam from a Varian Clinac 2300C/D have been developed and several benchmarks have been performed under homogeneous and several inhomogeneous conditions (including water, aluminium, lung and bone media). The MC results agreed with the ionization chamber measurements to within 1% and 2% for homogeneous and inhomogeneous conditions, respectively. The MC calculation for a clinical prostate IMRT treatment plan validated the implementation of the beams and the patient/phantom configuration in MCRTV.

  14. Segmentation of hepatic vessels from MRI images for planning of electroporation-based treatments in the liver

    PubMed Central

    Marcan, Marija; Pavliha, Denis; Music, Maja Marolt; Fuckan, Igor; Magjarevic, Ratko; Miklavcic, Damijan

    2014-01-01

    Introduction. Electroporation-based treatments rely on increasing the permeability of the cell membrane by high voltage electric pulses delivered to tissue via electrodes. To ensure that the whole tumor is covered by the sufficiently high electric field, accurate numerical models are built based on individual patient geometry. For the purpose of reconstruction of hepatic vessels from MRI images we searched for an optimal segmentation method that would meet the following initial criteria: identify major hepatic vessels, be robust and work with minimal user input. Materials and methods. We tested the approaches based on vessel enhancement filtering, thresholding, and their combination in local thresholding. The methods were evaluated on a phantom and clinical data. Results Results show that thresholding based on variance minimization provides less error than the one based on entropy maximization. Best results were achieved by performing local thresholding of the original de-biased image in the regions of interest which were determined through previous vessel-enhancement filtering. In evaluation on clinical cases the proposed method scored in average sensitivity of 93.68%, average symmetric surface distance of 0.89 mm and Hausdorff distance of 4.04 mm. Conclusions The proposed method to segment hepatic vessels from MRI images based on local thresholding meets all the initial criteria set at the beginning of the study and necessary to be used in treatment planning of electroporation-based treatments: it identifies the major vessels, provides results with consistent accuracy and works completely automatically. Whether the achieved accuracy is acceptable or not for treatment planning models remains to be verified through numerical modeling of effects of the segmentation error on the distribution of the electric field. PMID:25177241

  15. Application of magnetic resonance imaging and three-dimensional treatment planning in the treatment of orbital lymphoma.

    PubMed

    Rudoltz, M S; Ayyangar, K; Mohiuddin, M

    1993-01-01

    Radiotherapy for lymphoma of the orbit must be individualized for each patient and clinical setting. Most techniques focus on optimizing the dose to the tumor while sparing the lens. This study describes a technique utilizing magnetic resonance imaging (MRI) and three dimensional (3D) planning in the treatment of orbital lymphoma. A patient presented with an intermediate grade lymphoma of the right orbit. The prescribed tumor dose was 4050 cGy in 18 fractions. Three D planning was carried out and tumor volumes, retina, and lens were subsequently outlined. Dose calculations including dose volume histograms of the target, retina, and lens were then performed. Part of the retina was outside of the treatment volume while 50% of the retina received 90% or more of the prescribed dose. The patient was clinically NED when last seen 2 years following therapy with no treatment-related morbidity. Patients with lymphomas of the orbit can be optimally treated using MRI based 3D treatment planning. PMID:8280364

  16. Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap

    PubMed Central

    Kim, Nam-Kyoo; Kim, Hyun Young; Kim, Hyung Jun; Cha, In-Ho; Nam, Woong

    2014-01-01

    Purpose: The reconstruction of mandibular defects poses many difficulties due to the unique, complex shape of the mandible and the temporomandibular joints. With development of microvascular anastomosis, free tissue transplantation techniques, such as deep circumflex iliac artery (DCIA) flap and fibular free flap (FFF), were developed. The DCIA offers good quality and quantity of bone tissue for mandibular segmental defect and implant for dental rehabilitation. Virtual surgical planning (VSP) and stereolithography-guided osteotomy are currently successfully applied in three-dimensional mandibular reconstruction, but most use FFF. There are only a few articles on reconstruction with the DCIA that assess the postoperative results. Methods: Three patients admitted during a five month period (April of 2013 to August of 2013) underwent resection of mandible and DCIA musculo-osseous reconstruction using a VSP and stereolithographic modeling and assessment of outcomes included technical accuracy, esthetic contour, and functional outcomes. Results: This technique yielded iliac bone segment with excellent apposition and duplication of the preoperative plan. Flap survival was 100 percent and all patients maintained preoperative occlusion and contour. Conclusion: Based on our experience, we offer considerations and logically consistent protocols by classification of mandibular defects, and demonstrate the benefits in VSP and stereolithographic modeling of mandibular reconstructive surgery with DCIA flap. PMID:27489828

  17. Registration of CT to pre-treatment MRI for planning of MR-HIFU ablation treatment of painful bone metastases

    NASA Astrophysics Data System (ADS)

    Noorda, Yolanda H.; Bartels, Lambertus W.; Huisman, Merel; Nijenhuis, Robbert J.; AAJ van den Bosch, Maurice; Pluim, Josien PW

    2014-08-01

    MR-HIFU is a new non-invasive treatment modality that can be used for palliation in patients with painful bone metastases. Since treatment strategies are mainly focused on the ablation of periosteal nerves, information on the presence and geometry of cortical bone influences the treatment strategy, both in determining the acoustic power and in avoiding safety issues related to far-field heating. Although MRI is available for imaging during treatment, CT is best used for examining the cortical bone. We present a registration method for registering CT and MR images of patients with bone metastases prior to therapy. CT and MRI data were obtained from nine patients with metastatic bone lesions at varying locations. A two-step registration approach was used, performing simultaneous rigid registration of all available MR images in the first step and an affine and deformable registration with an additional bone metric in the second step. The performance was evaluated using landmark annotation by clinical observers. An average registration error of 4.5 mm was obtained, which was comparable to the slice thickness of the data. The performance of the registration algorithm was satisfactory, even with differences in MRI acquisition parameters and for various anatomical sites. The obtained CT overlay is useful for treatment planning, as it allows an assessment of the integrity of the cortical bone. CT-MR registration is therefore recommended for HIFU treatment planning of patients with bone metastases.

  18. Use of convolution/superposition-based treatment planning system for dose calculations in the kilovoltage energy range

    NASA Astrophysics Data System (ADS)

    Alaei, Parham

    2000-11-01

    A number of procedures in diagnostic radiology and cardiology make use of long exposures to x rays from fluoroscopy units. Adverse effects of these long exposure times on the patients' skin have been documented in recent years. These include epilation, erythema, and, in severe cases, moist desquamation and tissue necrosis. Potential biological effects from these exposures to other organs include radiation-induced cataracts and pneumonitis. Although there have been numerous studies to measure or calculate the dose to skin from these procedures, there have only been a handful of studies to determine the dose to other organs. Therefore, there is a need for accurate methods to measure the dose in tissues and organs other than the skin. This research was concentrated in devising a method to determine accurately the radiation dose to these tissues and organs. The work was performed in several stages: First, a three dimensional (3D) treatment planning system used in radiation oncology was modified and complemented to make it usable with the low energies of x rays used in diagnostic radiology. Using the system for low energies required generation of energy deposition kernels using Monte Carlo methods. These kernels were generated using the EGS4 Monte Carlo system of codes and added to the treatment planning system. Following modification, the treatment planning system was evaluated for its accuracy of calculations in low energies within homogeneous and heterogeneous media. A study of the effects of lungs and bones on the dose distribution was also performed. The next step was the calculation of dose distributions in humanoid phantoms using this modified system. The system was used to calculate organ doses in these phantoms and the results were compared to those obtained from other methods. These dose distributions can subsequently be used to create dose-volume histograms (DVHs) for internal organs irradiated by these beams. Using this data and the concept of normal tissue

  19. eIMRT: a web platform for the verification and optimization of radiation treatment plans.

    PubMed

    González-Castaño, Diego M; Pena, Javier; Gómez, Faustino; Gago-Arias, Araceli; González-Castaño, Francisco J; Rodríguez-Silva, Daniel A; Gómez, Andrés; Mouriño, Carlos; Pombar, Miguel; Sánchez, Manuel

    2009-01-01

    The eIMRT platform is a remote distributed computing tool that provides users with Internet access to three different services: Monte Carlo optimization of treatment plans, CRT & IMRT treatment optimization, and a database of relevant radiation treatments/clinical cases. These services are accessible through a user-friendly and platform independent web page. Its flexible and scalable design focuses on providing the final users with services rather than a collection of software pieces. All input and output data (CT, contours, treatment plans and dose distributions) are handled using the DICOM format. The design, implementation, and support of the verification and optimization algorithms are hidden to the user. This allows a unified, robust handling of the software and hardware that enables these computation-intensive services. The eIMRT platform is currently hosted by the Galician Supercomputing Center (CESGA) and may be accessible upon request (there is a demo version at http://eimrt.cesga.es:8080/eIMRT2/demo; request access in http://eimrt.cesga.es/signup.html). This paper describes all aspects of the eIMRT algorithms in depth, its user interface, and its services. Due to the flexible design of the platform, it has numerous applications including the intercenter comparison of treatment planning, the quality assurance of radiation treatments, the design and implementation of new approaches to certain types of treatments, and the sharing of information on radiation treatment techniques. In addition, the web platform and software tools developed for treatment verification and optimization have a modular design that allows the user to extend them with new algorithms. This software is not a commercial product. It is the result of the collaborative effort of different public research institutions and is planned to be distributed as an open source project. In this way, it will be available to any user; new releases will be generated with the new implemented codes or

  20. Automated gamma knife radiosurgery treatment planning with image registration, data-mining, and Nelder-Mead simplex optimization

    SciTech Connect

    Lee, Kuan J.; Barber, David C.; Walton, Lee

    2006-07-15

    Gamma knife treatments are usually planned manually, requiring much expertise and time. We describe a new, fully automatic method of treatment planning. The treatment volume to be planned is first compared with a database of past treatments to find volumes closely matching in size and shape. The treatment parameters of the closest matches are used as starting points for the new treatment plan. Further optimization is performed with the Nelder-Mead simplex method: the coordinates and weight of the isocenters are allowed to vary until a maximally conformal plan specific to the new treatment volume is found. The method was tested on a randomly selected set of 10 acoustic neuromas and 10 meningiomas. Typically, matching a new volume took under 30 seconds. The time for simplex optimization, on a 3 GHz Xeon processor, ranged from under a minute for small volumes (<1000 cubic mm, 2-3 isocenters), to several tens of hours for large volumes (>30 000 cubic mm,>20 isocenters). In 8/10 acoustic neuromas and 8/10 meningiomas, the automatic method found plans with conformation number equal or better than that of the manual plan. In 4/10 acoustic neuromas and 5/10 meningiomas, both overtreatment and undertreatment ratios were equal or better in automated plans. In conclusion, data-mining of past treatments can be used to derive starting parameters for treatment planning. These parameters can then be computer optimized to give good plans automatically.

  1. Automated gamma knife radiosurgery treatment planning with image registration, data-mining, and Nelder-Mead simplex optimization.

    PubMed

    Lee, Kuan J; Barber, David C; Walton, Lee

    2006-07-01

    Gamma knife treatments are usually planned manually, requiring much expertise and time. We describe a new, fully automatic method of treatment planning. The treatment volume to be planned is first compared with a database of past treatments to find volumes closely matching in size and shape. The treatment parameters of the closest matches are used as starting points for the new treatment plan. Further optimization is performed with the Nelder-Mead simplex method: the coordinates and weight of the isocenters are allowed to vary until a maximally conformal plan specific to the new treatment volume is found. The method was tested on a randomly selected set of 10 acoustic neuromas and 10 meningiomas. Typically, matching a new volume took under 30 seconds. The time for simplex optimization, on a 3 GHz Xeon processor, ranged from under a minute for small volumes (<1000 cubic mm, 2-3 isocenters), to several tens of hours for large volumes (>30,000 cubic mm, >20 isocenters). In 8/10 acoustic neuromas and 8/10 meningiomas, the automatic method found plans with conformation number equal or better than that of the manual plan. In 4/10 acoustic neuromas and 5/10 meningiomas, both overtreatment and undertreatment ratios were equal or better in automated plans. In conclusion, data-mining of past treatments can be used to derive starting parameters for treatment planning. These parameters can then be computer optimized to give good plans automatically. PMID:16898457

  2. Multidisciplinary management of congenital and acquired compensated malocclusions: diagnosis, etiology and treatment planning.

    PubMed

    Roberts, W E; Hartsfield, J K

    1997-01-01

    Restoration of optimal occlusal function, consistent with desirable esthetics and a favorable long-term prognosis, is the clinical goal for management of compensated malocclusions in partially edentulous patients. An appropriate diagnostic work-up includes a careful assessment of etiology, relative to both genetic and environmental factors. Esthetic and cost-effective restoration of occlusal function often requires adjunctive orthodontic therapy, integrated into a comprehensive treatment plan. Alignment of abutments, management of edentulous space and enhancement of soft tissue contours are important preprosthetic objectives. Osseointegrated dental implants provide occlusal stops to open the vertical dimension of occlusion and serve as rigid anchorage for three-dimensional orthodontic alignment of the residual dentition. Carefully coordinated preprosthetic treatment to establish bilateral posterior occlusion (molars and/or implants) is an important goal for achieving a biomechanically-optimized restoration of occlusion. Fundamental diagnostic and treatment planning procedures are reviewed for the multidisciplinary management of partially edentulous, compensated malocclusions. Determining the probable etiology of a malocclusion is an important prerequisite for formulating a treatment plan with a reasonable probability of success. Diagnostic considerations are presented and clinical examples of specific orthodontic methods are illustrated. To demonstrate the application of fundamental principles at the clinical level, a case report is presented with a diagnosis and treatment plan for a malocclusion with both genetic and functional implications. PMID:9517363

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

    SciTech Connect

    Costlow, Heather N.; Zhang, Hualin; Das, Indra J.

    2014-10-01

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

  4. Predicting substance abuse treatment completion using a new scale based on the theory of planned behavior.

    PubMed

    Zemore, Sarah E; Ajzen, Icek

    2014-02-01

    We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and intention was positively associated with treatment completion even including clinical and demographic covariates (model R-squared=.24). TPB components were generally associated with the alternative readiness scales as expected, and the TPB remained predictive at higher levels of coercion. Meanwhile, none of the standard measures of readiness (e.g., the URICA and TREAT) or treatment coercion were positively associated with treatment participation. Results suggest promise for application of the TPB to treatment completion and support use of the intention component as a screener, though some refinements are suggested. PMID:23953167

  5. Dosimetric evaluation of two treatment planning systems for high dose rate brachytherapy applications

    SciTech Connect

    Shwetha, Bondel; Ravikumar, Manickam; Supe, Sanjay S.; Sathiyan, Saminathan; Lokesh, Vishwanath; Keshava, Subbarao L.

    2012-04-01

    Various treatment planning systems are used to design plans for the treatment of cervical cancer using high-dose-rate brachytherapy. The purpose of this study was to make a dosimetric comparison of the 2 treatment planning systems from Varian medical systems, namely ABACUS and BrachyVision. The dose distribution of Ir-192 source generated with a single dwell position was compared using ABACUS (version 3.1) and BrachyVision (version 6.5) planning systems. Ten patients with intracavitary applications were planned on both systems using orthogonal radiographs. Doses were calculated at the prescription points (point A, right and left) and reference points RU, LU, RM, LM, bladder, and rectum. For single dwell position, little difference was observed in the doses to points along the perpendicular bisector. The mean difference between ABACUS and BrachyVision for these points was 1.88%. The mean difference in the dose calculated toward the distal end of the cable by ABACUS and BrachyVision was 3.78%, whereas along the proximal end the difference was 19.82%. For the patient case there was approximately 2% difference between ABACUS and BrachyVision planning for dose to the prescription points. The dose difference for the reference points ranged from 0.4-1.5%. For bladder and rectum, the differences were 5.2% and 13.5%, respectively. The dose difference between the rectum points was statistically significant. There is considerable difference between the dose calculations performed by the 2 treatment planning systems. It is seen that these discrepancies are caused by the differences in the calculation methodology adopted by the 2 systems.

  6. Quantification of beam complexity in intensity-modulated radiation therapy treatment plans

    SciTech Connect

    Du, Weiliang Cho, Sang Hyun; Zhang, Xiaodong; Kudchadker, Rajat J.; Hoffman, Karen E.

    2014-02-15

    Purpose: Excessive complexity in intensity-modulated radiation therapy (IMRT) plans increases the dose uncertainty, prolongs the treatment time, and increases the susceptibility to changes in patient or target geometry. To date, the tools for quantitative assessment of IMRT beam complexity are still lacking. In this study, The authors have sought to develop metrics to characterize different aspects of beam complexity and investigate the beam complexity for IMRT plans of different disease sites. Methods: The authors evaluated the beam complexity scores for 65 step-and-shoot IMRT plans from three sites (prostate, head and neck, and spine) and 26 volumetric-modulated arc therapy (VMAT) plans for the prostate. On the basis of the beam apertures and monitor unit weights of all segments, the authors calculated the mean aperture area, extent of aperture shape irregularity, and degree of beam modulation for each beam. Then the beam complexity values were averaged to obtain the complexity metrics of the IMRT plans. The authors studied the correlation between the beam complexity metrics and the quality assurance (QA) results. Finally, the effects of treatment planning parameters on beam complexity were studied. Results: The beam complexity scores were not uniform among the prostate IMRT beams from different gantry angles. The lateral beams had larger monitor units and smaller shape irregularity, while the anterior-posterior beams had larger modulation values. On average, the prostate IMRT plans had the smallest aperture irregularity, beam modulation, and normalized monitor units; the head and neck IMRT plans had large beam irregularity and beam modulation; and the spine stereotactic radiation therapy plans often had small beam apertures, which may have been associated with the relatively large discrepancies between planned and QA measured doses. There were weak correlations between the beam complexity scores and the measured dose errors. The prostate VMAT beams showed

  7. A plan analysis of pedophile sexual abusers' motivations for treatment: a qualitative pilot study.

    PubMed

    Drapeau, Martin; Körner, Annett; Granger, Luc; Brunet, Louis; Caspar, Franz

    2005-06-01

    Many authors have suggested adapting treatment programs to the specific needs of sexual abusers. However, little research has been conducted to understand what these patients seek in therapy or what elements play a key role in keeping them in treatment. In this pilot study, fifteen (N=15) pedophile sexual abusers from La Macaza clinic for sexual abusers were interviewed. Plan analysis was used to investigate the most prevalent components involved in staying in or leaving therapy. Results suggest that many components involved in the plans leading to doing and to avoiding treatment were similar. Differences were found in regards to the outcome of confrontations with the therapists, a tendency to isolate and overcomply, guilt related to the abuse, a need for a stable environment, and a need to be accepted. These results are discussed along with possible ways to improve the patients' involvement in treatment. PMID:15851510

  8. Modeling of body tissues for Monte Carlo simulation of radiotherapy treatments planned with conventional x-ray CT systems.

    PubMed

    Kanematsu, Nobuyuki; Inaniwa, Taku; Nakao, Minoru

    2016-07-01

    In the conventional procedure for accurate Monte Carlo simulation of radiotherapy, a CT number given to each pixel of a patient image is directly converted to mass density and elemental composition using their respective functions that have been calibrated specifically for the relevant x-ray CT system. We propose an alternative approach that is a conversion in two steps: the first from CT number to density and the second from density to composition. Based on the latest compilation of standard tissues for reference adult male and female phantoms, we sorted the standard tissues into groups by mass density and defined the representative tissues by averaging the material properties per group. With these representative tissues, we formulated polyline relations between mass density and each of the following; electron density, stopping-power ratio and elemental densities. We also revised a procedure of stoichiometric calibration for CT-number conversion and demonstrated the two-step conversion method for a theoretically emulated CT system with hypothetical 80 keV photons. For the standard tissues, high correlation was generally observed between mass density and the other densities excluding those of C and O for the light spongiosa tissues between 1.0 g cm(-3) and 1.1 g cm(-3) occupying 1% of the human body mass. The polylines fitted to the dominant tissues were generally consistent with similar formulations in the literature. The two-step conversion procedure was demonstrated to be practical and will potentially facilitate Monte Carlo simulation for treatment planning and for retrospective analysis of treatment plans with little impact on the management of planning CT systems. PMID:27300449

  9. Modeling of body tissues for Monte Carlo simulation of radiotherapy treatments planned with conventional x-ray CT systems

    NASA Astrophysics Data System (ADS)

    Kanematsu, Nobuyuki; Inaniwa, Taku; Nakao, Minoru

    2016-07-01

    In the conventional procedure for accurate Monte Carlo simulation of radiotherapy, a CT number given to each pixel of a patient image is directly converted to mass density and elemental composition using their respective functions that have been calibrated specifically for the relevant x-ray CT system. We propose an alternative approach that is a conversion in two steps: the first from CT number to density and the second from density to composition. Based on the latest compilation of standard tissues for reference adult male and female phantoms, we sorted the standard tissues into groups by mass density and defined the representative tissues by averaging the material properties per group. With these representative tissues, we formulated polyline relations between mass density and each of the following; electron density, stopping-power ratio and elemental densities. We also revised a procedure of stoichiometric calibration for CT-number conversion and demonstrated the two-step conversion method for a theoretically emulated CT system with hypothetical 80 keV photons. For the standard tissues, high correlation was generally observed between mass density and the other densities excluding those of C and O for the light spongiosa tissues between 1.0 g cm‑3 and 1.1 g cm‑3 occupying 1% of the human body mass. The polylines fitted to the dominant tissues were generally consistent with similar formulations in the literature. The two-step conversion procedure was demonstrated to be practical and will potentially facilitate Monte Carlo simulation for treatment planning and for retrospective analysis of treatment plans with little impact on the management of planning CT systems.

  10. EDITORIAL: Special section: Selected papers from the Second European Workshop on Monte Carlo Treatment Planning (MCTP2009) Special section: Selected papers from the Second European Workshop on Monte Carlo Treatment Planning (MCTP2009)

    NASA Astrophysics Data System (ADS)

    Spezi, Emiliano

    2010-08-01

    Sixty years after the paper 'The Monte Carlo method' by N Metropolis and S Ulam in The Journal of the American Statistical Association (Metropolis and Ulam 1949), use of the most accurate algorithm for computer modelling of radiotherapy linear accelerators, radiation detectors and three dimensional patient dose was discussed in Wales (UK). The Second European Workshop on Monte Carlo Treatment Planning (MCTP2009) was held at the National Museum of Wales in Cardiff. The event, organized by Velindre NHS Trust, Cardiff University and Cancer Research Wales, lasted two and a half days, during which leading experts and contributing authors presented and discussed the latest advances in the field of Monte Carlo treatment planning (MCTP). MCTP2009 was highly successful, judging from the number of participants which was in excess of 140. Of the attendees, 24% came from the UK, 46% from the rest of Europe, 12% from North America and 18% from the rest of the World. Fifty-three oral presentations and 24 posters were delivered in a total of 12 scientific sessions. MCTP2009 follows the success of previous similar initiatives (Verhaegen and Seuntjens 2005, Reynaert 2007, Verhaegen and Seuntjens 2008), and confirms the high level of interest in Monte Carlo technology for radiotherapy treatment planning. The 13 articles selected for this special section (following Physics in Medicine and Biology's usual rigorous peer-review procedure) give a good picture of the high quality of the work presented at MCTP2009. The book of abstracts can be downloaded from http://www.mctp2009.org. I wish to thank the IOP Medical Physics and Computational Physics Groups for their financial support, Elekta Ltd and Dosisoft for sponsoring MCTP2009, and leading manufacturers such as BrainLab, Nucletron and Varian for showcasing their latest MC-based radiotherapy solutions during a dedicated technical session. I am also very grateful to the eight invited speakers who kindly accepted to give keynote

  11. Methods for Cf-252 cervix cancer therapy and treatment planning for GYN malignancies in Lexington

    SciTech Connect

    Coffey, C.W.; Yoneda, J.; Beach, J.L.; Maruyama, Y.

    1986-01-01

    This paper presents the clinical physics methods and treatment planning techniques used in both the external beam and brachytherapy treatment of GYN malignancies in the Radiotherapy Department of the University of Kentucky Medical Center. Specific description of the departmental implant suite and brachytherapy procedures are included. The optimization of brachytherapy applicator placement, source arrangement, and normal and tumor total dose and dose distributions are presented. Quality assurance protocols for teletherapy and brachytherapy and patient and staff safety procedures with Cf-252 are discussed.

  12. Experimental and Monte Carlo evaluation of Eclipse treatment planning system for effects on dose distribution of the hip prostheses

    SciTech Connect

    Çatlı, Serap; Tanır, Güneş

    2013-10-01

    The present study aimed to investigate the effects of titanium, titanium alloy, and stainless steel hip prostheses on dose distribution based on the Monte Carlo simulation method, as well as the accuracy of the Eclipse treatment planning system (TPS) at 6 and 18 MV photon energies. In the present study the pencil beam convolution (PBC) method implemented in the Eclipse TPS was compared to the Monte Carlo method and ionization chamber measurements. The present findings show that if high-Z material is used in prosthesis, large dose changes can occur due to scattering. The variance in dose observed in the present study was dependent on material type, density, and atomic number, as well as photon energy; as photon energy increased back scattering decreased. The dose perturbation effect of hip prostheses was significant and could not be predicted accurately by the PBC method for hip prostheses. The findings show that for accurate dose calculation the Monte Carlo-based TPS should be used in patients with hip prostheses.

  13. Boosting runtime-performance of photon pencil beam algorithms for radiotherapy treatment planning.

    PubMed

    Siggel, M; Ziegenhein, P; Nill, S; Oelfke, U

    2012-10-01

    Pencil beam algorithms are still considered as standard photon dose calculation methods in Radiotherapy treatment planning for many clinical applications. Despite their established role in radiotherapy planning their performance and clinical applicability has to be continuously adapted to evolving complex treatment techniques such as adaptive radiation therapy (ART). We herewith report on a new highly efficient version of a well-established pencil beam convolution algorithm which relies purely on measured input data. A method was developed that improves raytracing efficiency by exploiting the capability of modern CPU architecture for a runtime reduction. Since most of the current desktop computers provide more than one calculation unit we used symmetric multiprocessing extensively to parallelize the workload and thus decreasing the algorithmic runtime. To maximize the advantage of code parallelization, we present two implementation strategies - one for the dose calculation in inverse planning software, and one for traditional forward planning. As a result, we could achieve on a 16-core personal computer with AMD processors a superlinear speedup factor of approx. 18 for calculating the dose distribution of typical forward IMRT treatment plans. PMID:22071169

  14. Numbers of Beauty: An Innovative Aesthetic Analysis for Orthognathic Surgery Treatment Planning.

    PubMed

    Marianetti, Tito Matteo; Gasparini, Giulio; Midulla, Giulia; Grippaudo, Cristina; Deli, Roberto; Cervelli, Daniele; Pelo, Sandro; Moro, Alessandro

    2016-01-01

    The aim of this study was to validate a new aesthetic analysis and establish the sagittal position of the maxilla on an ideal group of reference. We want to demonstrate the usefulness of these findings in the treatment planning of patients undergoing orthognathic surgery. We took a reference group of 81 Italian women participating in a national beauty contest in 2011 on which we performed Arnett's soft tissues cephalometric analysis and our new "Vertical Planning Line" analysis. We used the ideal values to elaborate the surgical treatment planning of a second group of 60 consecutive female patients affected by skeletal class III malocclusion. Finally we compared both pre- and postoperative pictures with the reference values of the ideal group. The ideal group of reference does not perfectly fit in Arnett's proposed norms. From the descriptive statistical comparison of the patients' values before and after orthognathic surgery with the reference values we observed how all parameters considered got closer to the ideal population. We consider our "Vertical Planning Line" a useful help for orthodontist and surgeon in the treatment planning of patients with skeletal malocclusions, in combination with the clinical facial examination and the classical cephalometric analysis of bone structures. PMID:27110566

  15. Numbers of Beauty: An Innovative Aesthetic Analysis for Orthognathic Surgery Treatment Planning

    PubMed Central

    Marianetti, Tito Matteo; Gasparini, Giulio; Midulla, Giulia; Grippaudo, Cristina; Deli, Roberto; Cervelli, Daniele; Pelo, Sandro; Moro, Alessandro

    2016-01-01

    The aim of this study was to validate a new aesthetic analysis and establish the sagittal position of the maxilla on an ideal group of reference. We want to demonstrate the usefulness of these findings in the treatment planning of patients undergoing orthognathic surgery. We took a reference group of 81 Italian women participating in a national beauty contest in 2011 on which we performed Arnett's soft tissues cephalometric analysis and our new “Vertical Planning Line” analysis. We used the ideal values to elaborate the surgical treatment planning of a second group of 60 consecutive female patients affected by skeletal class III malocclusion. Finally we compared both pre- and postoperative pictures with the reference values of the ideal group. The ideal group of reference does not perfectly fit in Arnett's proposed norms. From the descriptive statistical comparison of the patients' values before and after orthognathic surgery with the reference values we observed how all parameters considered got closer to the ideal population. We consider our “Vertical Planning Line” a useful help for orthodontist and surgeon in the treatment planning of patients with skeletal malocclusions, in combination with the clinical facial examination and the classical cephalometric analysis of bone structures. PMID:27110566

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

    SciTech Connect

    Harding, R.; Trnková, P.; Lomax, A. J.; Weston, S. J.; Lilley, J.; Thompson, C. M.; Cosgrove, V. P.; Short, S. C.; Loughrey, C.; Thwaites, D. I.

    2014-11-01

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

  17. Advances in 4D Treatment Planning for Scanned Particle Beam Therapy — Report of Dedicated Workshops

    PubMed Central

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

    2014-01-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue. PMID:24354749

  18. An investigation on the use of removal-diffusion theory for BNCT treatment planning: a method for determining proper removal-diffusion parameters.

    PubMed

    Albertson, B J; Blue, T E; Niemkiewicz, J

    2001-09-01

    This paper outlines a method for determining proper removal-diffusion parameters to be used in removal-diffusion theory calculations for the purpose of BNCT treatment planning. Additionally, this paper demonstrates that, given the proper choice of removal-diffusion parameters, removal-diffusion theory may provide an accurate calculation technique for determining absorbed dose distributions for the purpose of BNCT treatment planning. For a four-group, one-dimensional calculation in water, this method was used to determine values for the neutron scattering cross sections, neutron removal cross sections, neutron diffusion coefficients, and extrapolation distances. These values were then used in a one-dimensional DIF3D calculation. The results of the DIF3D calculation showed a maximum deviation of 2.5% from a MCNP calculation performed for the same geometry. PMID:11585220

  19. Simultaneous {sup 68}Ga-DOTATOC-PET/MRI for IMRT Treatment Planning for Meningioma: First Experience

    SciTech Connect

    Thorwarth, Daniela; Henke, Guido; Mueller, Arndt-Christian; Reimold, Matthias; Beyer, Thomas; Boss, Andreas; Kolb, Armin; Pichler, Bernd; Pfannenberg, Christina

    2011-09-01

    Purpose: To evaluate intensity-modulated radiotherapy (IMRT) treatment planning based on simultaneous positron-emission tomography and magnetic resonance imaging (PET/MRI) of meningioma. Methods and Materials: A meningioma patient was examined prior to radiotherapy with dedicated planning computed tomography (CT), MRI, PET/CT with gallium-68-labeled DOTATOC ({sup 68}Ga-DOTATOC), and simultaneous {sup 68}Ga-DOTATOC-PET/MRI. The first gross target volume (GTV) was defined based on a combination of separate MR and {sup 68}Ga-DOTATOC-PET/CT imaging (GTV{sub PET/CT+MR}). Then, the simultaneous PET/MR images were used to delineate a second GTV (GTV{sub PET/MR}) by following exactly the same delineation strategy. After an isotropic expansion of those volumes by a 4-mm safety margin, the resulting planning target volumes (PTVs) were compared by calculating the intersection volume and the relative complements. A cross-evaluation of IMRT plans was performed, where the treatment plan created for the PTV{sub PET/CT+MR} was applied to the PET/MR-based PTV{sub PET/MR}. Results: Generally, target volumes for IMRT treatment planning did not differ between MRI plus {sup 68}Ga-DOTATOC-PET/CT and simultaneous PET/MR imaging. Only in certain regions of the GTV were differences observed. The overall volume of the PET/MR-based PTV was approximately the same as that obtained from PET/CT data. A small region of infiltrative tumor growth next to the main tumor mass was better visualized with combined PET/MR due to smaller PET voxel sizes and improved recovery. An IMRT treatment plan was optimized for the PTV{sub PET/CT+MR}. The evaluation of this plan with respect to the PTV{sub PET/MR} showed parts of the target volume that would not have received the full radiation dose after delineation of the tumor, based on simultaneous PET/MR. Conclusion: This case showed that differences in target volumes delineated on the basis of separate MR and PET/CT and simultan