Positron emission tomography imaging approaches for external beam radiation therapies: current status and future developments

PubMed Central

Price, P M; Green, M M

2011-01-01

In an era in which it is possible to deliver radiation with high precision, there is a heightened need for enhanced imaging capabilities to improve tumour localisation for diagnostic, planning and delivery purposes. This is necessary to increase the accuracy and overall efficacy of all types of external beam radiotherapy (RT), including particle therapies. Positron emission tomography (PET) has the potential to fulfil this need by imaging fundamental aspects of tumour biology. The key areas in which PET may support the RT process include improving disease diagnosis and staging; assisting tumour volume delineation; defining tumour phenotype or biological tumour volume; assessment of treatment response; and in-beam monitoring of radiation dosimetry. The role of PET and its current developmental status in these key areas are overviewed in this review, highlighting the advantages and drawbacks. PMID:21427180

SU-F-J-108: TMR Correction Factor Based Online Adaptive Radiotherapy for Stereotactic Radiosurgery (SRS) of L-Spine Tumors Using Cone Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghaffar, I; Balik, S; Zhuang, T

Purpose: To investigate the feasibility of using TMR ratio correction factors for a fast online adaptive plan to compensate for anatomical changes in stereotactic radiosurgery (SRS) of L-spine tumors. Methods: Three coplanar treatment plans were made for 11 patients: Uniform (9 IMRT beams equally distributed around the patient); Posterior (IMRT with 9 posterior beams every 20 degree) and VMAT (2 360° arcs). For each patient, the external body and bowel gas were contoured on the planning CT and pre-treatment CBCT. After registering CBCT and the planning CT by aligning to the tumor, the CBCT contours were transferred to the planningmore » CT. To estimate the actual delivered dose while considering patient’s anatomy of the treatment day, a hybrid CT was created by overriding densities in planning CT using the differences between CT and CBCT external and bowel gas contours. Correction factors (CF) were calculated using the effective depth information obtained from the planning system using the hybrid CT: CF = TMR (delivery)/TMR (planning). The adaptive plan was generated by multiplying the planned Monitor Units with the CFs. Results: The mean absolute difference (MAD) in V16Gy of the target between planned and estimated delivery with and without TMR correction was 0.8 ± 0.7% vs. 2.4 ± 1.3% for Uniform and 1.0 ± 0.9% vs. 2.6 ± 1.3% for VMAT plans(p<0.05), respectively. For V12Gy of cauda-equina with and without TMR correction, MAD was 0.24 ± 0.19% vs. 1.2 ± 1.02% for Uniform and 0.23 ± 0.20% vs. 0.78 ± 0.79% for VMAT plans(p<0.05), respectively. The differences between adaptive and original plans were not significant for posterior plans. Conclusion: The online adaptive strategy using TMR ratios and pre-treatment CBCT information was feasible strategy to compensate for anatomical changes for the patients treated for L-spine tumors, particularly for equally spaced IMRT and VMAT plans.« less

[Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

PubMed

Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

2013-01-01

To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γ<1). These parameters should be independent of the film analysis software. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Retrospective evaluation of pediatric cranio-spinal axis irradiation plans with the Hi-ART tomotherapy system.

PubMed

Penagaricano, José A; Yan, Yulong; Corry, Peter; Moros, Eduardo; Ratanatharathorn, Vaneerat

2007-08-01

Helical tomotherapy (HT) can be used for the delivery of cranio-spinal axis irradiation (CSAI) without the need for beam matching of conventional linac-based external beam irradiation. The aim of this study is to retrospectively evaluate HT plans used for treatment in nine patients treated with CSAI. Helical tomotherapy cranio-spinal axis irradiation (HT-CSAI) plans were created for each patient. Average length along the cranio-spinal axis of the PTV was 65.6 cm with a range between 53 and 74 cm. Treatment planning optimization and plan evaluation parameters were obtained from the HT planning station for each of the nine patients. PTV coverage by the 95% isodose surface ranged between 98.0 to 100.0% for all nine patients. The clinically acceptable dose variation within the PTV or tolerance range was between 0.7 and 2.5% for all nine patients. Doses to the organs at risk were clinically acceptable. An increasing length along the longitudinal axis of the PTV did not consistently increase the beam-on time indicating that using a larger jaw width had a greater impact on treatment time. With a larger jaw width it is possible to substantially reduce the normalized beam-on treatment time without compromising plan quality and sparing of organs at risk. By using a larger jaw width or lower modulation factor or both, normalized beam-on times were decreased by up to 61% as compared to the other evaluated treatment plans. From the nine cases reported in this study the minimum beam-on time was achieved with a jaw width of 5.0 cm, pitch of 0.287 and a modulation factor of 2.0. Large and long cylindrical volumes can be effectively treated with helical tomotherapy with both clinically acceptable dose distribution and beam-on time.

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

NASA Astrophysics Data System (ADS)

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

2005-03-01

The aim of this project is to extend accurate and patient-specific treatment planning to new treatment modalities, such as molecular targeted radiation therapy, incorporating previously crafted and proven Monte Carlo and deterministic computation methods. A flexible software environment is being created that allows planning radiation treatment for these new modalities and combining different forms of radiation treatment with consideration of biological effects. The system uses common input interfaces, medical image sets for definition of patient geometry and dose reporting protocols. Previously, the Idaho National Engineering and Environmental Laboratory (INEEL), Montana State University (MSU) and Lawrence Livermore National Laboratory (LLNL) had accrued experience in the development and application of Monte Carlo based, three-dimensional, computational dosimetry and treatment planning tools for radiotherapy in several specialized areas. In particular, INEEL and MSU have developed computational dosimetry systems for neutron radiotherapy and neutron capture therapy, while LLNL has developed the PEREGRINE computational system for external beam photon-electron therapy. Building on that experience, the INEEL and MSU are developing the MINERVA (modality inclusive environment for radiotherapeutic variable analysis) software system as a general framework for computational dosimetry and treatment planning for a variety of emerging forms of radiotherapy. In collaboration with this development, LLNL has extended its PEREGRINE code to accommodate internal sources for molecular targeted radiotherapy (MTR), and has interfaced it with the plugin architecture of MINERVA. Results from the extended PEREGRINE code have been compared to published data from other codes, and found to be in general agreement (EGS4—2%, MCNP—10%) (Descalle et al 2003 Cancer Biother. Radiopharm. 18 71-9). The code is currently being benchmarked against experimental data. The interpatient variability of the drug pharmacokinetics in MTR can only be properly accounted for by image-based, patient-specific treatment planning, as has been common in external beam radiation therapy for many years. MINERVA offers 3D Monte Carlo-based MTR treatment planning as its first integrated operational capability. The new MINERVA system will ultimately incorporate capabilities for a comprehensive list of radiation therapies. In progress are modules for external beam photon-electron therapy and boron neutron capture therapy (BNCT). Brachytherapy and proton therapy are planned. Through the open application programming interface (API), other groups can add their own modules and share them with the community.

Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paulson, Eric S., E-mail: epaulson@mcw.edu; Erickson, Beth; Schultz, Chris

Purpose: The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP. Methods: A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP ofmore » brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI-optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off-resonance and gradient nonlinearity-induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams. Results: The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast-to-noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off-resonance and gradient nonlinearity induced geometric distortions. Conclusions: The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In their experience, these strategies provide robust, high fidelity, high contrast MR images suitable for external beam RTP.« less

Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report.

PubMed

Giannelli, Flavio; Chiola, Ilaria; Belgioia, Liliana; Garelli, Stefania; Pastorino, Alice; Marcenaro, Michela; Mammoliti, Serafina; Costantini, Sergio; Bizzarri, Nicolò; Vellone, Valerio; Barra, Salvina; Corvò, Renzo

2017-12-01

Hidradenocarcinoma (HC) is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB), followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 - PTV1), 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node), and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes). Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1), and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2). D 90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects.

SU-F-T-151: Measurement Evaluation of Skin Dose in Scanning Proton Beam Therapy for Breast Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, J; Nichols, E; Strauss, D

Purpose: To measure the skin dose and compare it with the calculated dose from a treatment planning system (TPS) for breast cancer treatment using scanning proton beam therapy (SPBT). Methods: A single en-face-beam SPBT plan was generated by a commercial TPS for two breast cancer patients. The treatment volumes were the entire breasts (218 cc and 1500 cc) prescribed to 50.4 Gy (RBE) in 28 fractions. A range shifter of 5 cm water equivalent thickness was used. The organ at risk (skin) was defined to be 5 mm thick from the surface. The skin doses were measured in water withmore » an ADCL calibrated parallel plate (PP) chamber. The measured data were compared with the values calculated in the TPS. Skin dose calculations can be subject to uncertainties created by the definition of the external contour and the limitations of the correction based algorithms, such as proton convolution superposition. Hence, the external contours were expanded by 0, 3 mm and 1 cm to include additional pixels for dose calculation. In addition, to examine the effects of the cloth gown on the skin dose, the skin dose measurements were conducted with and without gown. Results: On average the measured skin dose was 4% higher than the calculated values. At deeper depths, the measured and calculated doses were in better agreement (< 2%). Large discrepancy occur for the dose calculated without external expansion due to volume averaging. The addition of the gown only increased the measured skin dose by 0.4%. Conclusion: The implemented TPS underestimated the skin dose for breast treatments. Superficial dose calculation without external expansion would result in large errors for SPBT for breast cancer.« less

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

PubMed

Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma

2017-03-01

External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Open-source software for collision detection in external beam radiation therapy

NASA Astrophysics Data System (ADS)

Suriyakumar, Vinith M.; Xu, Renee; Pinter, Csaba; Fichtinger, Gabor

2017-03-01

PURPOSE: Collision detection for external beam radiation therapy (RT) is important for eliminating the need for dryruns that aim to ensure patient safety. Commercial treatment planning systems (TPS) offer this feature but they are expensive and proprietary. Cobalt-60 RT machines are a viable solution to RT practice in low-budget scenarios. However, such clinics are hesitant to invest in these machines due to a lack of affordable treatment planning software. We propose the creation of an open-source room's eye view visualization module with automated collision detection as part of the development of an open-source TPS. METHODS: An openly accessible linac 3D geometry model is sliced into the different components of the treatment machine. The model's movements are based on the International Electrotechnical Commission standard. Automated collision detection is implemented between the treatment machine's components. RESULTS: The room's eye view module was built in C++ as part of SlicerRT, an RT research toolkit built on 3D Slicer. The module was tested using head and neck and prostate RT plans. These tests verified that the module accurately modeled the movements of the treatment machine and radiation beam. Automated collision detection was verified using tests where geometric parameters of the machine's components were changed, demonstrating accurate collision detection. CONCLUSION: Room's eye view visualization and automated collision detection are essential in a Cobalt-60 treatment planning system. Development of these features will advance the creation of an open-source TPS that will potentially help increase the feasibility of adopting Cobalt-60 RT.

Galactic Cosmic Ray Simulator at the NASA Space Radiation Laboratory

NASA Technical Reports Server (NTRS)

Norbury, John W.; Slaba, Tony C.; Rusek, Adam

2015-01-01

The external Galactic Cosmic Ray (GCR) spectrum is significantly modified when it passes through spacecraft shielding and astronauts. One approach for simulating the GCR space radiation environment is to attempt to reproduce the unmodified, external GCR spectrum at a ground based accelerator. A possibly better approach would use the modified, shielded tissue spectrum, to select accelerator beams impinging on biological targets. NASA plans for implementation of a GCR simulator at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory will be discussed.

Monte Carlo-based parametrization of the lateral dose spread for clinical treatment planning of scanned proton and carbon ion beams.

PubMed

Parodi, Katia; Mairani, Andrea; Sommerer, Florian

2013-07-01

Ion beam therapy using state-of-the-art pencil-beam scanning offers unprecedented tumour-dose conformality with superior sparing of healthy tissue and critical organs compared to conventional radiation modalities for external treatment of deep-seated tumours. For inverse plan optimization, the commonly employed analytical treatment-planning systems (TPSs) have to meet reasonable compromises in the accuracy of the pencil-beam modelling to ensure good performances in clinically tolerable execution times. In particular, the complex lateral spreading of ion beams in air and in the traversed tissue is typically approximated with ideal Gaussian-shaped distributions, enabling straightforward superimposition of several scattering contributions. This work presents the double Gaussian parametrization of scanned proton and carbon ion beams in water that has been introduced in an upgraded version of the worldwide first commercial ion TPS for clinical use at the Heidelberg Ion Beam Therapy Center (HIT). First, the Monte Carlo results obtained from a detailed implementation of the HIT beamline have been validated against available experimental data. Then, for generating the TPS lateral parametrization, radial beam broadening has been calculated in a water target placed at a representative position after scattering in the beamline elements and air for 20 initial beam energies for each ion species. The simulated profiles were finally fitted with an idealized double Gaussian distribution that did not perfectly describe the nature of the data, thus requiring a careful choice of the fitting conditions. The obtained parametrization is in clinical use not only at the HIT center, but also at the Centro Nazionale di Adroterapia Oncologica.

Monte Carlo-based parametrization of the lateral dose spread for clinical treatment planning of scanned proton and carbon ion beams

PubMed Central

Parodi, Katia; Mairani, Andrea; Sommerer, Florian

2013-01-01

Ion beam therapy using state-of-the-art pencil-beam scanning offers unprecedented tumour-dose conformality with superior sparing of healthy tissue and critical organs compared to conventional radiation modalities for external treatment of deep-seated tumours. For inverse plan optimization, the commonly employed analytical treatment-planning systems (TPSs) have to meet reasonable compromises in the accuracy of the pencil-beam modelling to ensure good performances in clinically tolerable execution times. In particular, the complex lateral spreading of ion beams in air and in the traversed tissue is typically approximated with ideal Gaussian-shaped distributions, enabling straightforward superimposition of several scattering contributions. This work presents the double Gaussian parametrization of scanned proton and carbon ion beams in water that has been introduced in an upgraded version of the worldwide first commercial ion TPS for clinical use at the Heidelberg Ion Beam Therapy Center (HIT). First, the Monte Carlo results obtained from a detailed implementation of the HIT beamline have been validated against available experimental data. Then, for generating the TPS lateral parametrization, radial beam broadening has been calculated in a water target placed at a representative position after scattering in the beamline elements and air for 20 initial beam energies for each ion species. The simulated profiles were finally fitted with an idealized double Gaussian distribution that did not perfectly describe the nature of the data, thus requiring a careful choice of the fitting conditions. The obtained parametrization is in clinical use not only at the HIT center, but also at the Centro Nazionale di Adroterapia Oncologica. PMID:23824133

SU-E-T-605: Performance Evaluation of MLC Leaf-Sequencing Algorithms in Head-And-Neck IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jing, J; Lin, H; Chow, J

2015-06-15

Purpose: To investigate the efficiency of three multileaf collimator (MLC) leaf-sequencing algorithms proposed by Galvin et al, Chen et al and Siochi et al using external beam treatment plans for head-and-neck intensity modulated radiation therapy (IMRT). Methods: IMRT plans for head-and-neck were created using the CORVUS treatment planning system. The plans were optimized and the fluence maps for all photon beams determined. Three different MLC leaf-sequencing algorithms based on Galvin et al, Chen et al and Siochi et al were used to calculate the final photon segmental fields and their monitor units in delivery. For comparison purpose, the maximum intensitymore » of fluence map was kept constant in different plans. The number of beam segments and total number of monitor units were calculated for the three algorithms. Results: From results of number of beam segments and total number of monitor units, we found that algorithm of Galvin et al had the largest number of monitor unit which was about 70% larger than the other two algorithms. Moreover, both algorithms of Galvin et al and Siochi et al have relatively lower number of beam segment compared to Chen et al. Although values of number of beam segment and total number of monitor unit calculated by different algorithms varied with the head-and-neck plans, it can be seen that algorithms of Galvin et al and Siochi et al performed well with a lower number of beam segment, though algorithm of Galvin et al had a larger total number of monitor units than Siochi et al. Conclusion: Although performance of the leaf-sequencing algorithm varied with different IMRT plans having different fluence maps, an evaluation is possible based on the calculated number of beam segment and monitor unit. In this study, algorithm by Siochi et al was found to be more efficient in the head-and-neck IMRT. The Project Sponsored by the Fundamental Research Funds for the Central Universities (J2014HGXJ0094) and the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry.« less

Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report

PubMed Central

Giannelli, Flavio; Chiola, Ilaria; Garelli, Stefania; Pastorino, Alice; Marcenaro, Michela; Mammoliti, Serafina; Costantini, Sergio; Bizzarri, Nicolò; Vellone, Valerio; Barra, Salvina; Corvò, Renzo

2017-01-01

Hidradenocarcinoma (HC) is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB), followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 – PTV1), 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node), and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes). Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1), and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2). D90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects. PMID:29441103

A TCP model for external beam treatment of intermediate-risk prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walsh, Sean; Putten, Wil van der

2013-03-15

Purpose: Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes. Methods: A fully heterogeneous population averaged tumor control probability model was fit to clinical outcome data for hyper, standard, and hypofractionated treatments. The tumor control probability model was then employed to predict the clinical outcome of extreme hypofractionation regimes, as utilized in stereotactic body radiotherapy. Results: The tumor control probability model achieves an excellent level of fit, R{sup 2} value of 0.93 and a root meanmore » squared error of 1.31%, to the clinical outcome data for hyper, standard, and hypofractionated treatments using realistic values for biological input parameters. Residuals Less-Than-Or-Slanted-Equal-To 1.0% are produced by the tumor control probability model when compared to clinical outcome data for stereotactic body radiotherapy. Conclusions: The authors conclude that this tumor control probability model, used with the optimized radiosensitivity values obtained from the fit, is an appropriate mechanistic model for the analysis and evaluation of external beam RT plans with regard to tumor control for these clinical conditions.« less

25. Photocopy of engineering drawing (original drawing located in LBNL ...

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

25. Photocopy of engineering drawing (original drawing located in LBNL Building 90F Architecture and Engineering As-Built Collection). February 18, 1969. 4B51BK001. EXTERNAL PROTRON BEAM HALL. B51B FIRST FLOOR PLAN. - University of California Radiation Laboratory, Bevatron, 1 Cyclotron Road, Berkeley, Alameda County, CA

TSR: A storage and cooling ring for HIE-ISOLDE

NASA Astrophysics Data System (ADS)

Butler, P. A.; Blaum, K.; Davinson, T.; Flanagan, K.; Freeman, S. J.; Grieser, M.; Lazarus, I. H.; Litvinov, Yu. A.; Lotay, G.; Page, R. D.; Raabe, R.; Siesling, E.; Wenander, F.; Woods, P. J.

2016-06-01

It is planned to install the heavy-ion, low-energy ring TSR, currently at the Max-Planck-Institute for Nuclear Physics in Heidelberg, at the HIE-ISOLDE facility in CERN, Geneva. Such a facility will provide a capability for experiments with stored, cooled secondary beams that is rich and varied, spanning from studies of nuclear ground-state properties and reaction studies of astrophysical relevance, to investigations with highly-charged ions and pure isomeric beams. In addition to experiments performed using beams recirculating within the ring, the cooled beams can be extracted and exploited by external spectrometers for high-precision measurements. The capabilities of the ring facility as well as some physics cases will be presented, together with a brief report on the status of the project.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mao, W; Hrycushko, B; Yan, Y

Purpose: Traditional external beam radiotherapy for cervical cancer requires setup by external skin marks. In order to improve treatment accuracy and reduce planning margin for more conformal therapy, it is essential to monitor tumor positions interfractionally and intrafractionally. We demonstrate feasibility of monitoring cervical tumor motion online using EPID imaging from Beam’s Eye View. Methods: Prior to treatment, 1∼2 cylindrical radio opaque markers were implanted into inferior aspect of cervix tumor. During external beam treatments on a Varian 2100C by 4-field 3D plans, treatment beam images were acquired continuously by an EPID. A Matlab program was developed to locate internalmore » markers on MV images. Based on 2D marker positions obtained from different treatment fields, their 3D positions were estimated for every treatment fraction. Results: There were 398 images acquired during different treatment fractions of three cervical cancer patients. Markers were successfully located on every frame of image at an analysis speed of about 1 second per frame. Intrafraction motions were evaluated by comparing marker positions relative to the position on the first frame of image. The maximum intrafraction motion of the markers was 1.6 mm. Interfraction motions were evaluated by comparing 3D marker positions at different treatment fractions. The maximum interfraction motion was up to 10 mm. Careful comparison found that this is due to patient positioning since the bony structures shifted with the markers. Conclusion: This method provides a cost-free and simple solution for online tumor tracking for cervical cancer treatment since it is feasible to acquire and export EPID images with fast analysis in real time. This method does not need any extra equipment or deliver extra dose to patients. The online tumor motion information will be very useful to reduce planning margins and improve treatment accuracy, which is particularly important for SBRT treatment with long delivery time.« less

Differences in Radiation Dosimetry and Anorectal Function Testing Imply That Anorectal Symptoms May Arise From Different Anatomic Substrates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smeenk, Robert Jan, E-mail: r.smeenk@rther.umcn.nl; Hopman, Wim P.M.; Hoffmann, Aswin L.

2012-01-01

Purpose: To explore the influence of functional changes and dosimetric parameters on specific incontinence-related anorectal complaints after prostate external beam radiotherapy and to estimate dose-effect relations for the anal wall and rectal wall. Methods and Materials: Sixty patients, irradiated for localized prostate cancer, underwent anorectal manometry and barostat measurements to evaluate anal pressures, rectal capacity, and rectal sensory functions. In addition, 30 untreated men were analyzed as a control group. In 36 irradiated patients, the anal wall and rectal wall were retrospectively delineated on planning computed tomography scans, and dosimetric parameters were retrieved from the treatment plans. Functional and dosimetricmore » parameters were compared between patients with and without complaints, focusing on urgency, incontinence, and frequency. Results: After external beam radiotherapy, reduced anal pressures and tolerated rectal volumes were observed, irrespective of complaints. Patients with urgency and/or incontinence showed significantly lower anal resting pressures (mean 38 and 39 vs. 49 and 50 mm Hg) and lower tolerated rectal pressures (mean 28 and 28 vs. 33 and 34 mm Hg), compared to patients without these complaints. In patients with frequency, almost all rectal parameters were reduced. Several dosimetric parameters to the anal wall and rectal wall were predictive for urgency (e.g., anal D{sub mean}>38Gy), whereas some anal wall parameters correlated to incontinence and no dose-effect relation for frequency was found. Conclusions: Anorectal function deteriorates after external beam radiotherapy. Different incontinence-related complaints show specific anorectal dysfunctions, suggesting different anatomic and pathophysiologic substrates: urgency and incontinence seem to originate from both anal wall and rectal wall, whereas frequency seems associated with rectal wall dysfunction. Also, dose-effect relations differed between these complaints. This implies that anal wall and rectal wall should be considered separate organs in radiotherapy planning.« less

Technological advances in radiotherapy for cervical cancer.

PubMed

Walsh, Lorraine; Morgia, Marita; Fyles, Anthony; Milosevic, Michael

2011-09-01

To discuss the important technological advances that have taken place in the planning and delivery of both external beam radiotherapy and brachytherapy for patients with locally advanced cervical cancer, and the implications for improved clinical outcomes. Technological advances in external beam radiation treatment and brachytherapy for patients with cervical cancer allow more precise targeting of tumour and relative sparing of surrounding normal organs and tissues. Early evidence is emerging to indicate that these advances will translate into improvements in tumour control and reduced side effects. However, there are patient, tumour and treatment-related factors that can detract from these benefits. Foremost among these is complex, unpredictable and sometimes dramatic internal tumour and normal organ motion during treatment. The focus of current research and clinical development is on tracking internal anatomic change in individual patients and adapting treatment plans as required to assure that optimal tumour coverage and normal tissue sparing is maintained at all times. The success of this approach will depend on clear definitions of target volumes, high resolution daily soft tissue imaging, and new software tools for rapid contouring, treatment planning and quality assurance. Radiation treatment of locally advanced cervical cancer is evolving rapidly, driven by advances in technology, towards more individualized patient care that has the potential to substantially improve clinical outcomes.

SU-E-J-32: Dosimetric Evaluation Based On Pre-Treatment Cone Beam CT for Spine Stereotactic Body Radiotherapy: Does Region of Interest Focus Matter?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Magnelli, A; Xia, P

2015-06-15

Purpose: Spine stereotactic body radiotherapy requires very conformal dose distributions and precise delivery. Prior to treatment, a KV cone-beam CT (KV-CBCT) is registered to the planning CT to provide image-guided positional corrections, which depend on selection of the region of interest (ROI) because of imperfect patient positioning and anatomical deformation. Our objective is to determine the dosimetric impact of ROI selections. Methods: Twelve patients were selected for this study with the treatment regions varied from C-spine to T-spine. For each patient, the KV-CBCT was registered to the planning CT three times using distinct ROIs: one encompassing the entire patient, amore » large ROI containing large bony anatomy, and a small target-focused ROI. Each registered CBCT volume, saved as an aligned dataset, was then sent to the planning system. The treated plan was applied to each dataset and dose was recalculated. The tumor dose coverage (percentage of target volume receiving prescription dose), maximum point dose to 0.03 cc of the spinal cord, and dose to 10% of the spinal cord volume (V10) for each alignment were compared to the original plan. Results: The average magnitude of tumor coverage deviation was 3.9%±5.8% with external contour, 1.5%±1.1% with large ROI, 1.3%±1.1% with small ROI. Spinal cord V10 deviation from plan was 6.6%±6.6% with external contour, 3.5%±3.1% with large ROI, and 1.2%±1.0% with small ROI. Spinal cord max point dose deviation from plan was: 12.2%±13.3% with external contour, 8.5%±8.4% with large ROI, and 3.7%±2.8% with small ROI. Conclusion: A small ROI focused on the target results in the smallest deviation from planned dose to target and cord although rotations at large distances from the targets were observed. It is recommended that image fusion during CBCT focus narrowly on the target volume to minimize dosimetric error. Improvement in patient setups may further reduce residual errors.« less

Off-line commissioning of EBIS and plans for its integration into ATLAS and CARIBU.

PubMed

Ostroumov, P N; Barcikowski, A; Dickerson, C A; Mustapha, B; Perry, A; Sharamentov, S I; Vondrasek, R C; Zinkann, G

2016-02-01

An Electron Beam Ion Source Charge Breeder (EBIS-CB) has been developed at Argonne to breed radioactive beams from the CAlifornium Rare Isotope Breeder Upgrade (CARIBU) facility at Argonne Tandem Linac Accelerator System (ATLAS). The EBIS-CB will replace the existing ECR charge breeder to increase the intensity and significantly improve the purity of reaccelerated radioactive ion beams. The CARIBU EBIS-CB has been successfully commissioned offline with an external singly charged cesium ion source. The performance of the EBIS fully meets the specifications to breed rare isotope beams delivered from CARIBU. The EBIS is being relocated and integrated into ATLAS and CARIBU. A long electrostatic beam transport system including two 180° bends in the vertical plane has been designed. The commissioning of the EBIS and the beam transport system in their permanent location will start at the end of this year.

Off-line commissioning of EBIS and plans for its integration into ATLAS and CARIBU

NASA Astrophysics Data System (ADS)

Ostroumov, P. N.; Barcikowski, A.; Dickerson, C. A.; Mustapha, B.; Perry, A.; Sharamentov, S. I.; Vondrasek, R. C.; Zinkann, G.

2016-02-01

An Electron Beam Ion Source Charge Breeder (EBIS-CB) has been developed at Argonne to breed radioactive beams from the CAlifornium Rare Isotope Breeder Upgrade (CARIBU) facility at Argonne Tandem Linac Accelerator System (ATLAS). The EBIS-CB will replace the existing ECR charge breeder to increase the intensity and significantly improve the purity of reaccelerated radioactive ion beams. The CARIBU EBIS-CB has been successfully commissioned offline with an external singly charged cesium ion source. The performance of the EBIS fully meets the specifications to breed rare isotope beams delivered from CARIBU. The EBIS is being relocated and integrated into ATLAS and CARIBU. A long electrostatic beam transport system including two 180° bends in the vertical plane has been designed. The commissioning of the EBIS and the beam transport system in their permanent location will start at the end of this year.

Methods and computer readable medium for improved radiotherapy dosimetry planning

DOEpatents

Wessol, Daniel E.; Frandsen, Michael W.; Wheeler, Floyd J.; Nigg, David W.

2005-11-15

Methods and computer readable media are disclosed for ultimately developing a dosimetry plan for a treatment volume irradiated during radiation therapy with a radiation source concentrated internally within a patient or incident from an external beam. The dosimetry plan is available in near "real-time" because of the novel geometric model construction of the treatment volume which in turn allows for rapid calculations to be performed for simulated movements of particles along particle tracks therethrough. The particles are exemplary representations of alpha, beta or gamma emissions emanating from an internal radiation source during various radiotherapies, such as brachytherapy or targeted radionuclide therapy, or they are exemplary representations of high-energy photons, electrons, protons or other ionizing particles incident on the treatment volume from an external source. In a preferred embodiment, a medical image of a treatment volume irradiated during radiotherapy having a plurality of pixels of information is obtained.

WE-F-16A-05: Use of 3D-Printers to Create a Tissue Equivalent 3D-Bolus for External Beam Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burleson, S; Baker, J; Hsia, A

2014-06-15

Purpose: The purpose of this project is to demonstrate that a non-expensive 3D-printer can be used to manufacture a 3D-bolus for external beam therapy. The printed bolus then can be modeled in our treatment planning system to ensure accurate dose delivery to the patient. Methods: We developed a simple method to manufacture a patient-specific custom 3Dbolus. The bolus is designed using Eclipse Treatment Planning System, contoured onto the patients CT images. The bolus file is exported from Eclipse to 3D-printer software, and then printed using a 3D printer. Various tests were completed to determine the properties of the printing material.more » Percent depth dose curves in this material were measured with electron and photon beams for comparison to other materials. In order to test the validity of the 3D printed bolus for treatment planning, a custom bolus was printed and tested on the Rando phantom using film for a dose plane comparison. We compared the dose plane measured on the film to the same dose plane exported from our treatment planning system using Film QA software. The gamma-dose distribution tool was used in our film analysis. Results: We compared point measurements throughout the dose plane and were able to achieve greater than 95% passing rate at 3% dose difference and 3 mm distance to agreement, which is our departments acceptable gamma pixel parameters. Conclusion: The printed 3D bolus has proven to be accurately modeled in our treatment planning system, it is more conformal to the patient surface and more durable than other bolus currently used (wax, superflab etc.). It is also more convenient and less costly than comparable bolus from milling machine companies.« less

Beam shaping assembly of a D-T neutron source for BNCT and its dosimetry simulation in deeply-seated tumor

NASA Astrophysics Data System (ADS)

Faghihi, F.; Khalili, S.

2013-08-01

This article involves two aims for BNCT. First case includes a beam shaping assembly estimation for a D-T neutron source to find epi-thermal neutrons which are the goal in the BNCT. Second issue is the percent depth dose calculation in the adult Snyder head phantom. Monte-Carlo simulations and verification of a suggested beam shaping assembly (including internal neutron multiplier, moderator, filter, external neutron multiplier, collimator, and reflector dimensions) for thermalizing a D-T neutron source as well as increasing neutron flux are carried out and our results are given herein. Finally, we have simulated its corresponding doses for treatment planning of a deeply-seated tumor.

Feasibility and Initial Dosimetric Findings for a Randomized Trial Using Dose-Painted Multiparametric Magnetic Resonance Imaging–Defined Targets in Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bossart, Elizabeth L., E-mail: EBossart@med.miami.edu; Stoyanova, Radka; Sandler, Kiri

2016-06-01

Purpose: To compare dosimetric characteristics with multiparametric magnetic resonance imaging–identified imaging tumor volume (gross tumor volume, GTV), prostate clinical target volume and planning target volume, and organs at risk (OARs) for 2 treatment techniques representing 2 arms of an institutional phase 3 randomized trial of hypofractionated external beam image guided highly targeted radiation therapy. Methods and Materials: Group 1 (n=20) patients were treated before the trial inception with the standard dose prescription. Each patient had an additional treatment plan generated per the experimental arm. A total of 40 treatment plans were compared (20 plans for each technique). Group 2 (n=15)more » consists of patients currently accrued to the hypofractionated external beam image guided highly targeted radiation therapy trial. Plans were created as per the treatment arm, with additional plans for 5 of the group 2 experimental arm with a 3-mm expansion in the imaging GTV. Results: For all plans in both patient groups, planning target volume coverage ranged from 95% to 100%; GTV coverage of 89.3 Gy for the experimental treatment plans ranged from 95.2% to 99.8%. For both groups 1 and 2, the percent volumes of rectum/anus and bladder receiving 40 Gy, 65 Gy, and 80 Gy were smaller in the experimental plans than in the standard plans. The percent volume at 1 Gy per fraction and 1.625 Gy per fraction were compared between the standard and the experimental arms, and these were found to be equivalent. Conclusions: The dose per fraction to the OARs can be made equal even when giving a large simultaneous integrated boost to the GTV. The data suggest that a GTV margin may be added without significant dose effects on the OARs.« less

L-Boronophenylalanine-Mediated Boron Neutron Capture Therapy for Malignant Glioma Progressing After External Beam Radiation Therapy: A Phase I Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kankaanranta, Leena; Seppaelae, Tiina; Koivunoro, Hanna

Purpose: To investigate the safety of boronophenylalanine-mediated boron neutron capture therapy (BNCT) in the treatment of malignant gliomas that progress after surgery and conventional external beam radiation therapy. Methods and Materials: Adult patients who had histologically confirmed malignant glioma that had progressed after surgery and external beam radiotherapy were eligible for this Phase I study, provided that >6 months had elapsed from the last date of radiation therapy. The first 10 patients received a fixed dose, 290 mg/kg, of L-boronophenylalanine-fructose (L-BPA-F) as a 2-hour infusion before neutron irradiation, and the remaining patients were treated with escalating doses of L-BPA-F, eithermore » 350 mg/kg, 400 mg/kg, or 450 mg/kg, using 3 patients on each dose level. Adverse effects were assessed using National Cancer Institute Common Toxicity Criteria version 2.0. Results: Twenty-two patients entered the study. Twenty subjects had glioblastoma, and 2 patients had anaplastic astrocytoma, and the median cumulative dose of prior external beam radiotherapy was 59.4 Gy. The maximally tolerated L-BPA-F dose was reached at the 450 mg/kg level, where 4 of 6 patients treated had a grade 3 adverse event. Patients who were given >290 mg/kg of L-BPA-F received a higher estimated average planning target volume dose than those who received 290 mg/kg (median, 36 vs. 31 Gy [W, i.e., a weighted dose]; p = 0.018). The median survival time following BNCT was 7 months. Conclusions: BNCT administered with an L-BPA-F dose of up to 400 mg/kg as a 2-hour infusion is feasible in the treatment of malignant gliomas that recur after conventional radiation therapy.« less

SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hoffman, D; Chung, E; Hess, C

2015-06-15

Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patientmore » treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream from the patient. Both systems demonstrate substantial utility for online treatment verification and QA of photon external beam radiotherapy.« less

Dosimetric impact of tumor bed delineation variability based on 4DCT scan for external-beam partial breast irradiation.

PubMed

Guo, Bing; Li, Jianbin; Wang, Wei; Li, Fengxiang; Guo, Yanluan; Li, Yankang; Liu, Tonghai

2015-01-01

This study sought to evaluate the dosimetric impact of tumor bed delineation variability (based on clips, seroma or both clips and seroma) during external-beam partial breast irradiation (EB-PBI) planned utilizing four-dimensional computed tomography (4DCT) scans. 4DCT scans of 20 patients with a seroma clarity score (SCS) 3~5 and ≥5 surgical clips were included in this study. The combined volume of the tumor bed formed using clips, seroma, or both clips and seroma on the 10 phases of 4DCT was defined as the internal gross target volume (termed IGTVC, IGTVS and IGTVC+S, respectively). A 1.5-cm margin was added by defining the planning target volume (termed PTVC, PTVS and PTVC+S, respectively). Three treatment plans were established using the 4DCT images (termed EB-PBIC, EB-PBIS, EB-PBIC+S, respectively). The results showed that the volume of IGTVC+S was significantly larger than that of IGTVCand IGTVS. Similarly, the volume of PTVC+S was markedly larger than that of PTVC and PTVS. However, the PTV coverage for EB-PBIC+S was similar to that of EB-PBIC and EB-PBIS, and there were no significant differences in the homogeneity index or conformity index between the three treatment plans (P=0.878, 0.086). The EB-PBIS plan resulted in the lowest ipsilateral normal breast and ipsilateral lung doses compared with the EB-PBIC and EB-PBIC+S plans. To conclude, the volume variability delineated based on clips, seroma or both clips and seroma resulted in dosimetric variability for organs at risk, but did not show a marked influence on the dosimetric distribution.

Dosimetric impact of tumor bed delineation variability based on 4DCT scan for external-beam partial breast irradiation

PubMed Central

Guo, Bing; Li, Jianbin; Wang, Wei; Li, Fengxiang; Guo, Yanluan; Li, Yankang; Liu, Tonghai

2015-01-01

This study sought to evaluate the dosimetric impact of tumor bed delineation variability (based on clips, seroma or both clips and seroma) during external-beam partial breast irradiation (EB-PBI) planned utilizing four-dimensional computed tomography (4DCT) scans. 4DCT scans of 20 patients with a seroma clarity score (SCS) 3~5 and ≥5 surgical clips were included in this study. The combined volume of the tumor bed formed using clips, seroma, or both clips and seroma on the 10 phases of 4DCT was defined as the internal gross target volume (termed IGTVC, IGTVS and IGTVC+S, respectively). A 1.5-cm margin was added by defining the planning target volume (termed PTVC, PTVS and PTVC+S, respectively). Three treatment plans were established using the 4DCT images (termed EB-PBIC, EB-PBIS, EB-PBIC+S, respectively). The results showed that the volume of IGTVC+S was significantly larger than that of IGTVCand IGTVS. Similarly, the volume of PTVC+S was markedly larger than that of PTVC and PTVS. However, the PTV coverage for EB-PBIC+S was similar to that of EB-PBIC and EB-PBIS, and there were no significant differences in the homogeneity index or conformity index between the three treatment plans (P=0.878, 0.086). The EB-PBIS plan resulted in the lowest ipsilateral normal breast and ipsilateral lung doses compared with the EB-PBIC and EB-PBIC+S plans. To conclude, the volume variability delineated based on clips, seroma or both clips and seroma resulted in dosimetric variability for organs at risk, but did not show a marked influence on the dosimetric distribution. PMID:26885108

Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Tzung-Chi, E-mail: tzungchi.huang@mail.cmu.edu.tw; Department of Biomedical Informatics, Asia University, Taichung City, Taiwan; Chou, Kuei-Ting

2015-10-01

The high mobility of the bladder and the rectum causes uncertainty in radiation doses prescribed to patients with prostate cancer who undergo radiotherapy (RT) multifraction treatments. The purpose of this study was to estimate the dose received by the bladder, rectum, and prostate from multifraction treatments using daily cone-beam computed tomography (CBCT). Overall, 28 patients with prostate cancer who planned to receive radiation treatments were enrolled in the study. The acquired CBCT before the treatment delivery was registered with the planning CT to map the dose distribution used in the treatment plan for estimating the received dose during clinical treatment.more » For all 28 patients with 112 data sets, the mean percentage differences (± standard deviation) in the volume and radiation dose were 44% (± 41) and 18% (± 17) for the bladder, 20% (± 21) and 2% (± 2) for the prostate, and 36% (± 29) and 22% (± 15) for the rectum, respectively. Substantial differences between the volumes and radiation dose and those specified in treatment plans were observed. Besides the use of image-guided RT to improve patient setup accuracy, further consideration of large changes in bladder and rectum volumes is strongly suggested when using external beam radiation for prostate cancer.« less

SU-F-T-527: A Novel Dynamic Multileaf Collimator Leaf-Sequencing Algorithm in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jing, J; Lin, H; Chow, J

Purpose: A novel leaf-sequencing algorithm is developed for generating arbitrary beam intensity profiles in discrete levels using dynamic multileaf collimator (MLC). The efficiency of this dynamic MLC leaf-sequencing method was evaluated using external beam treatment plans delivered by intensity modulated radiation therapy technique. Methods: To qualify and validate this algorithm, integral test for the beam segment of MLC generated by the CORVUS treatment planning system was performed with clinical intensity map experiments. The treatment plans were optimized and the fluence maps for all photon beams were determined. This algorithm started with the algebraic expression for the area under the beammore » profile. The coefficients in the expression can be transformed into the specifications for the leaf-setting sequence. The leaf optimization procedure was then applied and analyzed for clinical relevant intensity profiles in cancer treatment. Results: The macrophysical effect of this method can be described by volumetric plan evaluation tools such as dose-volume histograms (DVHs). The DVH results are in good agreement compared to those from the CORVUS treatment planning system. Conclusion: We developed a dynamic MLC method to examine the stability of leaf speed including effects of acceleration and deceleration of leaf motion in order to make sure the stability of leaf speed did not affect the intensity profile generated. It was found that the mechanical requirements were better satisfied using this method. The Project is sponsored by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry.« less

Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study.

PubMed

Nicolaisen, Marianne; Müller, Stig; Patel, Hitendra R H; Hanssen, Tove Aminda

2014-12-01

To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. A cross-sectional survey design was used. The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Long-term quality of life effects should be considered when planning follow-up and information for men after radical prostate cancer treatment. Structured and organised information/education may increase preparedness for symptoms and bother after the treatment, improve symptom management strategies and result in improved quality of life. © 2014 John Wiley & Sons Ltd.

Treatment planning systems dosimetry auditing project in Portugal.

PubMed

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

2014-02-01

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Camingue, Pamela; Christian, Rochelle; Ng, Davin

The purpose of this study was to compare 4 different external beam radiation therapy treatment techniques for the treatment of T1-2, N0, M0 glottic cancers: traditional lateral beams with wedges (3D), 5-field intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and proton therapy. Treatment plans in each technique were created for 10 patients using consistent planning parameters. The photon treatment plans were optimized using Philips Pinnacle{sub 3} v.9 and the IMRT and VMAT plans used the Direct Machine Parameter Optimization algorithm. The proton treatment plans were optimized using Varian Eclipse Proton v.8.9. The prescription used for each plan wasmore » 63 Gy in 28 fractions. The contours for spinal cord, right carotid artery, left carotid artery, and normal tissue were created with respect to the patient's bony anatomy so that proper comparisons of doses could be made with respect to volume. An example of the different isodose distributions will be shown. The data collection for comparison purposes includes: clinical treatment volume coverage, dose to spinal cord, dose to carotid arteries, and dose to normal tissue. Data comparisons will be displayed graphically showing the maximum, mean, median, and ranges of doses.« less

SU-E-T-09: A Clinical Implementation and Optimized Dosimetry Study of Freiberg Flap Skin Surface Treatment in High Dose Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Syh, J; Patel, B

Purpose: This case study was designated to confirm the optimized plan was used to treat skin surface of left leg in three stages. 1. To evaluate dose distribution and plan quality by alternating of the source loading catheters pattern in flexible Freiberg Flap skin surface (FFSS) applicator. 2. To investigate any impact on Dose Volume Histogram (DVH) of large superficial surface target volume coverage. 3. To compare the dose distribution if it was treated with electron beam. Methods: The Freiburg Flap is a flexible mesh style surface mold for skin radiation or intraoperative surface treatments. The Freiburg Flap consists ofmore » multiple spheres that are attached to each other, holding and guiding up to 18 treatment catheters. The Freiburg Flap also ensures a constant distance of 5mm from the treatment catheter to the surface. Three treatment trials with individual planning optimization were employed: 18 channels, 9 channels of FF and 6 MeV electron beam. The comparisons were highlighted in target coverage, dose conformity and dose sparing of surrounding tissues. Results: The first 18 channels brachytherapy plan was generated with 18 catheters inside the skin-wrapped up flap (Figure 1A). A second 9 catheters plan was generated associated with the same calculation points which were assigned to match prescription for target coverage as 18 catheters plan (Figure 1B). The optimized inverse plan was employed to reduce the dose to adjacent structures such as tibia or fibula. The comparison of DVH’s was depicted on Figure 2. External beam of electron RT plan was depicted in Figure 3. Overcall comparisons among these three were illustrated in Conclusion: The 9-channel Freiburg flap flexible skin applicator offers a reasonably acceptable plan without compromising the coverage. Electron beam was discouraged to use to treat curved skin surface because of low target coverage and high dose in adjacent tissues.« less

Assessment of three-dimensional setup errors in image-guided pelvic radiotherapy for uterine and cervical cancer using kilovoltage cone-beam computed tomography and its effect on planning target volume margins.

PubMed

Patni, Nidhi; Burela, Nagarjuna; Pasricha, Rajesh; Goyal, Jaishree; Soni, Tej Prakash; Kumar, T Senthil; Natarajan, T

2017-01-01

To achieve the best possible therapeutic ratio using high-precision techniques (image-guided radiation therapy/volumetric modulated arc therapy [IGRT/VMAT]) of external beam radiation therapy in cases of carcinoma cervix using kilovoltage cone-beam computed tomography (kV-CBCT). One hundred and five patients of gynecological malignancies who were treated with IGRT (IGRT/VMAT) were included in the study. CBCT was done once a week for intensity-modulated radiation therapy and daily in IGRT/VMAT. These images were registered with the planning CT scan images and translational errors were applied and recorded. In all, 2078 CBCT images were studied. The margins of planning target volume were calculated from the variations in the setup. The setup variation was 5.8, 10.3, and 5.6 mm in anteroposterior, superoinferior, and mediolateral direction. This allowed adequate dose delivery to the clinical target volume and the sparing of organ at risks. Daily kV-CBCT is a satisfactory method of accurate patient positioning in treating gynecological cancers with high-precision techniques. This resulted in avoiding geographic miss.

On charged particle equilibrium violation in external photon fields.

PubMed

Bouchard, Hugo; Seuntjens, Jan; Palmans, Hugo

2012-03-01

In a recent paper by Bouchard et al. [Med. Phys. 36(10), 4654-4663 (2009)], a theoretical model of quality correction factors for idealistic so-called plan-class specific reference (PCSR) fields was proposed. The reasoning was founded on the definition of PCSR fields made earlier by Alfonso et al. [Med. Phys. 35(11), 5179-5186 (2008)], requiring the beam to achieve charged particle equilibrium (CPE), in a time-averaged sense, in the reference medium. The relation obtained by Bouchard et al. was derived using Fano's theorem (1954) which states that if CPE is established in a given medium, the dose is independent of point-to-point density variations. A potential misconception on the achievability of the condition required by Fano (1954) might be responsible for false practical conclusions, both in the definition of PCSR fields as well as the theoretical model of quality correction factor. In this paper, the practical achievability of CPE in external beams is treated in detail. The fact that this condition is not achievable in single or composite deliveries is illustrated by an intuitive method and is also formally demonstrated. Fano's theorem is not applicable in external beam radiation dosimetry without (virtually) removing attenuation effects, and therefore, the relation conditionally defined by Bouchard et al. (2009) cannot be valid in practice. A definition of PCSR fields in the recent formalism for nonstandard beams proposed by Alfonso et al. (2008) should be modified, revising the criterion of CPE condition. The authors propose reconsidering the terminology used to describe standard and nonstandard beams. The authors argue that quality correction factors of intensity modulated radiation therapy PCSR fields (i.e., k(Q(pcsr),Q) (f(pcsr),f(ref) )) could be unity under ideal conditions, but it is concluded that further investigation is necessary to confirm that hypothesis.

SU-F-T-94: Plan2pdf - a Software Tool for Automatic Plan Report for Philips Pinnacle TPS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, C

Purpose: To implement an automatic electronic PDF plan reporting tool for Philips Pinnacle treatment planning system (TPS) Methods: An electronic treatment plan reporting software is developed by us to enable fully automatic PDF report from Pinnacle TPS to external EMR programs such as MOSAIQ. The tool is named “plan2pdf”. plan2pdf is implemented using Pinnacle scripts, Java and UNIX shell scripts, without any external program needed. plan2pdf supports full auto-mode and manual mode reporting. In full auto-mode, with a single mouse click, plan2pdf will generate a detailed Pinnacle plan report in PDF format, which includes customizable cover page, Pinnacle plan summary,more » orthogonal views through each plan POI and maximum dose point, DRR for each beam, serial transverse views captured throughout the dose grid at a user specified interval, DVH and scorecard windows. The final PDF report is also automatically bookmarked for each section above for convenient plan review. The final PDF report can either be saved on a user specified folder on Pinnacle, or it can be automatically exported to an EMR import folder via a user configured FTP service. In manual capture mode, plan2pdf allows users to capture any Pinnacle plan by full screen, individual window or rectangular ROI drawn on screen. Furthermore, to avoid possible patients’ plan mix-up during auto-mode reporting, a user conflict check feature is included in plan2pdf: it prompts user to wait if another patient is being exported by plan2pdf by another user. Results: plan2pdf is tested extensively and successfully at our institution consists of 5 centers, 15 dosimetrists and 10 physicists, running Pinnacle version 9.10 on Enterprise servers. Conclusion: plan2pdf provides a highly efficient, user friendly and clinical proven platform for all Philips Pinnacle users, to generate a detailed plan report in PDF format for external EMR systems.« less

Non-rigid CT/CBCT to CBCT registration for online external beam radiotherapy guidance

NASA Astrophysics Data System (ADS)

Zachiu, Cornel; de Senneville, Baudouin Denis; Tijssen, Rob H. N.; Kotte, Alexis N. T. J.; Houweling, Antonetta C.; Kerkmeijer, Linda G. W.; Lagendijk, Jan J. W.; Moonen, Chrit T. W.; Ries, Mario

2018-01-01

Image-guided external beam radiotherapy (EBRT) allows radiation dose deposition with a high degree of accuracy and precision. Guidance is usually achieved by estimating the displacements, via image registration, between cone beam computed tomography (CBCT) and computed tomography (CT) images acquired at different stages of the therapy. The resulting displacements are then used to reposition the patient such that the location of the tumor at the time of treatment matches its position during planning. Moreover, ongoing research aims to use CBCT-CT image registration for online plan adaptation. However, CBCT images are usually acquired using a small number of x-ray projections and/or low beam intensities. This often leads to the images being subject to low contrast, low signal-to-noise ratio and artifacts, which ends-up hampering the image registration process. Previous studies addressed this by integrating additional image processing steps into the registration procedure. However, these steps are usually designed for particular image acquisition schemes, therefore limiting their use on a case-by-case basis. In the current study we address CT to CBCT and CBCT to CBCT registration by the means of the recently proposed EVolution registration algorithm. Contrary to previous approaches, EVolution does not require the integration of additional image processing steps in the registration scheme. Moreover, the algorithm requires a low number of input parameters, is easily parallelizable and provides an elastic deformation on a point-by-point basis. Results have shown that relative to a pure CT-based registration, the intrinsic artifacts present in typical CBCT images only have a sub-millimeter impact on the accuracy and precision of the estimated deformation. In addition, the algorithm has low computational requirements, which are compatible with online image-based guidance of EBRT treatments.

External Beam Radiation Therapy for Cancer

Cancer.gov

External beam radiation therapy is used to treat many types of cancer. it is a local treatment, where a machine aims radiation at your cancer. Learn more about different types of external beam radiation therapy, and what to expect if you're receiving treatment.

Physics at COSY-Juelich

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stroeher, Hans

2011-10-21

COSY, a storage and cooler synchrotron, which is fed by an injector cyclotron, is operated at Forschungszentrum Juelich (Germany). It provides phase space cooled polarized or unpolarized beams of protons and deuterons with momenta between 0.3 and 3.7 GeV/c for internal experiments and to external target stations. The major experimental facilities, used for the ongoing physics program, are ANKE and WASA (internal) and TOF (external). A new internal target station to investigate polarization build-up by spin-filtering (PAX) has recently been commissioned. COSY is the machine for hadron spin physics on a world-wide scale, which is also used for tests inmore » conjunction with plans to build a dedicated storage ring for electric dipole moment (EDM) measurements of proton, deuteron and {sup 3}He. In this contribution recent results as well as future plans are summarized.« less

Radiobiological concepts for treatment planning of schemes that combines external beam radiotherapy and systemic targeted radiotherapy

NASA Astrophysics Data System (ADS)

Fabián Calderón Marín, Carlos; González González, Joaquín Jorge; Laguardia, Rodolfo Alfonso

2017-09-01

The combination of radiotherapy modalities with external bundles and systemic radiotherapy (CIERT) could be a reliable alternative for patients with multiple lesions or those where treatment planning maybe difficult because organ(s)-at-risk (OARs) constraints. Radiobiological models should have the capacity for predicting the biological irradiation response considering the differences in the temporal pattern of dose delivering in both modalities. Two CIERT scenarios were studied: sequential combination in which one modality is executed following the other one and concurrent combination when both modalities are running simultaneously. Expressions are provided for calculation of the dose-response magnitudes Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP). General results on radiobiological modeling using the linear-quadratic (LQ) model are also discussed. Inter-subject variation of radiosensitivity and volume irradiation effect in CIERT are studied. OARs should be under control during the planning in concurrent CIERT treatment as the administered activity is increased. The formulation presented here may be used for biological evaluation of prescriptions and biological treatment planning of CIERT schemes in clinical situation.

Proton Therapy Facility Planning From a Clinical and Operational Model.

PubMed

Das, Indra J; Moskvin, Vadim P; Zhao, Qingya; Cheng, Chee-Wai; Johnstone, Peter A

2015-10-01

This paper provides a model for planning a new proton therapy center based on clinical data, referral pattern, beam utilization and technical considerations. The patient-specific data for the depth of targets from skin in each beam angle were reviewed at our center providing megavoltage photon external beam and proton beam therapy respectively. Further, data on insurance providers, disease sites, treatment depths, snout size and the beam angle utilization from the patients treated at our proton facility were collected and analyzed for their utilization and their impact on the facility cost. The most common disease sites treated at our center are head and neck, brain, sarcoma and pediatric malignancies. From this analysis, it is shown that the tumor depth from skin surface has a bimodal distribution (peak at 12 and 26 cm) that has significant impact on the maximum proton energy, requiring the energy in the range of 130-230 MeV. The choice of beam angles also showed a distinct pattern: mainly at 90° and 270°; this indicates that the number of gantries may be minimized. Snout usage data showed that 70% of the patients are treated with 10 cm snouts. The cost of proton beam therapy depends largely on the type of machine, maximum beam energy and the choice of gantry versus fixed beam line. Our study indicates that for a 4-room center, only two gantry rooms could be needed at the present pattern of the patient cohorts, thus significantly reducing the initial capital cost. In the USA, 95% and 100% of patients can be treated with 200 and 230 MeV proton beam respectively. Use of multi-leaf collimators and pencil beam scanning may further reduce the operational cost of the facility. © The Author(s) 2014.

4D dose calculation and delivery with interplay effects between respiratory motion and uniform scanning proton beam

NASA Astrophysics Data System (ADS)

Zhao, Qingya

2011-12-01

Proton radiotherapy has advantages to deliver accurate high conformal radiation dose to the tumor while sparing the surrounding healthy tissue and critical structures. However, the treatment effectiveness is degraded greatly due to patient free breathing during treatment delivery. Motion compensation for proton radiotherapy is especially challenging as proton beam is more sensitive to the density change along the beam path. Tumor respiratory motion during treatment delivery will affect the proton dose distribution and the selection of optimized parameters for treatment planning, which has not been fully addressed yet in the existing approaches for proton dose calculation. The purpose of this dissertation is to develop an approach for more accurate dose delivery to a moving tumor in proton radiotherapy, i.e., 4D proton dose calculation and delivery, for the uniform scanning proton beam. A three-step approach has been carried out to achieve this goal. First, a solution for the proton output factor calculation which will convert the prescribed dose to machine deliverable monitor unit for proton dose delivery has been proposed and implemented. The novel sector integration method is accurate and time saving, which considers the various beam scanning patterns and treatment field parameters, such as aperture shape, aperture size, measuring position, beam range, and beam modulation. Second, tumor respiratory motion behavior has been statistically characterized and the results have been applied to advanced image guided radiation treatment. Different statistical analysis and correlation discovery approaches have been investigated. The internal / external motion correlation patterns have been simulated, analyzed, and applied in a new hybrid gated treatment to improve the target coverage. Third, a dose calculation method has been developed for 4D proton treatment planning which integrates the interplay effects of tumor respiratory motion patterns and proton beam delivery mechanism. These three steps provide an innovative integrated framework for accurate 4D proton dose calculation and treatment planning for a moving tumor, which extends the functionalities of existing 3D planning systems. In short, this dissertation work addresses a few important problems for effective proton radiotherapy to a moving target. The outcomes of the dissertation are very useful for motion compensation with advanced image guided proton treatment.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Chuanben; Fei, Zhaodong; Chen, Lisha

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

Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vance, Sean M.; Stenmark, Matthew H.; Blas, Kevin

2012-07-01

Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75-79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6-12), median PCV was 10%more » (interquartile range, 2.5-25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log-rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.« less

Modelling second malignancy risks from low dose rate and high dose rate brachytherapy as monotherapy for localised prostate cancer.

PubMed

Murray, Louise; Mason, Joshua; Henry, Ann M; Hoskin, Peter; Siebert, Frank-Andre; Venselaar, Jack; Bownes, Peter

2016-08-01

To estimate the risks of radiation-induced rectal and bladder cancers following low dose rate (LDR) and high dose rate (HDR) brachytherapy as monotherapy for localised prostate cancer and compare to external beam radiotherapy techniques. LDR and HDR brachytherapy monotherapy plans were generated for three prostate CT datasets. Second cancer risks were assessed using Schneider's concept of organ equivalent dose. LDR risks were assessed according to a mechanistic model and a bell-shaped model. HDR risks were assessed according to a bell-shaped model. Relative risks and excess absolute risks were estimated and compared to external beam techniques. Excess absolute risks of second rectal or bladder cancer were low for both LDR (irrespective of the model used for calculation) and HDR techniques. Average excess absolute risks of rectal cancer for LDR brachytherapy according to the mechanistic model were 0.71 per 10,000 person-years (PY) and 0.84 per 10,000 PY respectively, and according to the bell-shaped model, were 0.47 and 0.78 per 10,000 PY respectively. For HDR, the average excess absolute risks for second rectal and bladder cancers were 0.74 and 1.62 per 10,000 PY respectively. The absolute differences between techniques were very low and clinically irrelevant. Compared to external beam prostate radiotherapy techniques, LDR and HDR brachytherapy resulted in the lowest risks of second rectal and bladder cancer. This study shows both LDR and HDR brachytherapy monotherapy result in low estimated risks of radiation-induced rectal and bladder cancer. LDR resulted in lower bladder cancer risks than HDR, and lower or similar risks of rectal cancer. In absolute terms these differences between techniques were very small. Compared to external beam techniques, second rectal and bladder cancer risks were lowest for brachytherapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dose enhancement in radiotherapy of small lung tumors using inline magnetic fields: A Monte Carlo based planning study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oborn, B. M., E-mail: brad.oborn@gmail.com; Ge, Y.; Hardcastle, N.

2016-01-15

Purpose: To report on significant dose enhancement effects caused by magnetic fields aligned parallel to 6 MV photon beam radiotherapy of small lung tumors. Findings are applicable to future inline MRI-guided radiotherapy systems. Methods: A total of eight clinical lung tumor cases were recalculated using Monte Carlo methods, and external magnetic fields of 0.5, 1.0, and 3 T were included to observe the impact on dose to the planning target volume (PTV) and gross tumor volume (GTV). Three plans were 6 MV 3D-CRT plans while 6 were 6 MV IMRT. The GTV’s ranged from 0.8 to 16 cm{sup 3}, whilemore » the PTV’s ranged from 1 to 59 cm{sup 3}. In addition, the dose changes in a 30 cm diameter cylindrical water phantom were investigated for small beams. The central 20 cm of this phantom contained either water or lung density insert. Results: For single beams, an inline magnetic field of 1 T has a small impact in lung dose distributions by reducing the lateral scatter of secondary electrons, resulting in a small dose increase along the beam. Superposition of multiple small beams leads to significant dose enhancements. Clinically, this process occurs in the lung tissue typically surrounding the GTV, resulting in increases to the D{sub 98%} (PTV). Two isolated tumors with very small PTVs (3 and 6 cm{sup 3}) showed increases in D{sub 98%} of 23% and 22%. Larger PTVs of 13, 26, and 59 cm{sup 3} had increases of 9%, 6%, and 4%, describing a natural fall-off in enhancement with increasing PTV size. However, three PTVs bounded to the lung wall showed no significant increase, due to lack of dose enhancement in the denser PTV volume. In general, at 0.5 T, the GTV mean dose enhancement is around 60% lower than that at 1 T, while at 3 T, it is 5%–60% higher than 1 T. Conclusions: Monte Carlo methods have described significant and predictable dose enhancement effects in small lung tumor plans for 6 MV radiotherapy when an external inline magnetic field is included. Results of this study indicate that future clinical inline MRI-guided radiotherapy systems will be able to deliver a dosimetrically superior treatment to small (PTV < 15 cm{sup 3}), isolated lung tumors over non-MRI-Linac systems. This increased efficacy coincides with the reimbursement in the United States of lung CT screening and the likely rapid growth in the number of patients with small lung tumors to be treated with radiotherapy.« less

Conventional external beam radiotherapy for central nervous system malignancies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Halperin, E.C.; Burger, P.C.

1985-11-01

Fractionated external beam photon radiotherapy is an important component of the clinical management of malignant disease of the central nervous system. The practicing neurologist or neurosurgeon frequently relies on the consultative and treatment skills of a radiotherapist. This article provides a review for the nonradiotherapist of the place of conventional external beam radiotherapy in neuro-oncology. 23 references.

In-air RBS measurements at the LAMFI external beam setup

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silva, T. F.; Added, N.; Moro, M. V.

2014-11-11

This work describes new developments in the external beam setup of the Laboratory of Material Analysis with Ion Beams of the University of São Paulo (LAMFI-USP). This setup was designed to be a versatile analytical station to analyze a broad range of samples. In recent developments, we seek the external beam Rutherford Backscattering Spectroscopy (RBS) analysis to complement the Particle Induced X-ray Emission (PIXE) measurements. This work presents the initial results of the external beam RBS analysis as well as recent developments to improve the energy resolution RBS measurements, in particular tests to seek for sources of resolution degradation. Thesemore » aspects are discussed and preliminary results of in-air RBS analysis of some test samples are presented.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, X; Wang, J; Hu, W

Purpose: The Varian RapidPlan™ is a commercial knowledge-based optimization process which uses a set of clinically used treatment plans to train a model that can predict individualized dose-volume objectives. The purpose of this study is to evaluate the performance of RapidPlan to generate intensity modulated radiation therapy (IMRT) plans for cervical cancer. Methods: Totally 70 IMRT plans for cervical cancer with varying clinical and physiological indications were enrolled in this study. These patients were all previously treated in our institution. There were two prescription levels usually used in our institution: 45Gy/25 fractions and 50.4Gy/28 fractions. 50 of these plans weremore » selected to train the RapidPlan model for predicting dose-volume constraints. After model training, this model was validated with 10 plans from training pool(internal validation) and additional other 20 new plans(external validation). All plans used for the validation were re-optimized with the original beam configuration and the generated priorities from RapidPlan were manually adjusted to ensure that re-optimized DVH located in the range of the model prediction. DVH quantitative analysis was performed to compare the RapidPlan generated and the original manual optimized plans. Results: For all the validation cases, RapidPlan based plans (RapidPlan) showed similar or superior results compared to the manual optimized ones. RapidPlan increased the result of D98% and homogeneity in both two validations. For organs at risk, the RapidPlan decreased mean doses of bladder by 1.25Gy/1.13Gy (internal/external validation) on average, with p=0.12/p<0.01. The mean dose of rectum and bowel were also decreased by an average of 2.64Gy/0.83Gy and 0.66Gy/1.05Gy,with p<0.01/ p<0.01and p=0.04/<0.01 for the internal/external validation, respectively. Conclusion: The RapidPlan model based cervical cancer plans shows ability to systematically improve the IMRT plan quality. It suggests that RapidPlan has great potential to make the treatment planning process more efficient.« less

Dose painting to treat single-lobe prostate cancer with hypofractionated high-dose radiation using targeted external beam radiation: Is it feasible?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amini, Arya; Westerly, David C.; Waxweiler, Timothy V.

Targeted focal therapy strategies for treating single-lobe prostate cancer are under investigation. In this planning study, we investigate the feasibility of treating a portion of the prostate to full-dose external beam radiation with reduced dose to the opposite lobe, compared with full-dose radiation delivered to the entire gland using hypofractionated radiation. For 10 consecutive patients with low- to intermediate-risk prostate cancer, 2 hypofractionated, single-arc volumetric-modulated arc therapy (VMAT) plans were designed. The first plan (standard hypofractionation regimen [STD]) included the entire prostate gland, treated to 70 Gy delivered in 28 fractions. The second dose painting plan (DP) encompassed the involvedmore » lobe treated to 70 Gy delivered in 28 fractions, whereas the opposing, uninvolved lobe received 50.4 Gy in 28 fractions. Mean dose to the opposing neurovascular bundle (NVB) was considerably lower for DP vs STD, with a mean dose of 53.9 vs 72.3 Gy (p < 0.001). Mean penile bulb dose was 18.6 Gy for DP vs 19.2 Gy for STD (p = 0.880). Mean rectal dose was 21.0 Gy for DP vs 22.8 Gy for STD (p = 0.356). Rectum V{sub 70} (the volume receiving ≥70 Gy) was 2.01% for DP vs 2.74% for STD (p = 0.328). Bladder V{sub 70} was 1.69% for DP vs 2.78% for STD (p = 0.232). Planning target volume (PTV) maximum dose points were 76.5 and 76.3 Gy for DP and STD, respectively (p = 0.760). This study demonstrates the feasibility of using VMAT for partial-lobe prostate radiation in patients with prostate cancer involving 1 lobe. Partial-lobe prostate plans appeared to spare adjacent critical structures including the opposite NVB.« less

SU-E-J-244: Development and Validation of a Knowledge Based Planning Model for External Beam Radiation Therapy of Locally Advanced Non-Small Cell Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Z; Kennedy, A; Larsen, E

2015-06-15

Purpose: The study aims to develop and validate a knowledge based planning (KBP) model for external beam radiation therapy of locally advanced non-small cell lung cancer (LA-NSCLC). Methods: RapidPlan™ technology was used to develop a lung KBP model. Plans from 65 patients with LA-NSCLC were used to train the model. 25 patients were treated with VMAT, and the other patients were treated with IMRT. Organs-at-risk (OARs) included right lung, left lung, heart, esophagus, and spinal cord. DVH and geometric distribution DVH were extracted from the treated plans. The model was trained using principal component analysis and step-wise multiple regression. Boxmore » plot and regression plot tools were used to identify geometric outliers and dosimetry outliers and help fine-tune the model. The validation was performed by (a) comparing predicted DVH boundaries to actual DVHs of 63 patients and (b) using an independent set of treatment planning data. Results: 63 out of 65 plans were included in the final KBP model with PTV volume ranging from 102.5cc to 1450.2cc. Total treatment dose prescription varied from 50Gy to 70Gy based on institutional guidelines. One patient was excluded due to geometric outlier where 2.18cc of spinal cord was included in PTV. The other patient was excluded due to dosimetric outlier where the dose sparing to spinal cord was heavily enforced in the clinical plan. Target volume, OAR volume, OAR overlap volume percentage to target, and OAR out-of-field volume were included in the trained model. Lungs and heart had two principal component scores of GEDVH, whereas spinal cord and esophagus had three in the final model. Predicted DVH band (mean ±1 standard deviation) represented 66.2±3.6% of all DVHs. Conclusion: A KBP model was developed and validated for radiotherapy of LA-NSCLC in a commercial treatment planning system. The clinical implementation may improve the consistency of IMRT/VMAT planning.« less

Evidence for the use PET for radiation therapy planning in patients with cervical cancer: a systematic review.

PubMed

Salem, A; Salem, A F; Al-Ibraheem, A; Lataifeh, I; Almousa, A; Jaradat, I

2011-01-01

In recent years, the role of positron emission tomography (PET) in the staging and management of gynecological cancers has been increasing. The aim of this study was to systematically review the role of PET in radiotherapy planning and brachytherapy treatment optimization in patients with cervical cancer. Systematic literature review. Systematic review of relevant literature addressing the utilization of PET and/or PET-computed tomography (CT) in external-beam radiotherapy planning and brachytherapy treatment optimization. We performed an extensive PubMed database search on 20 April 2011. Nineteen studies, including 759 patients, formed the basis of this systematic review. PET/ PET-CT is the most sensitive imaging modality for detecting nodal metastases in patients with cervical cancer and has been shown to impact external-beam radiotherapy planning by modifying the treatment field and customizing the radiation dose. This particularly applies to detection of previously uncovered para-aortic and inguinal nodal metastases. Furthermore, PET/ PET-CT guided intensity-modulated radiation therapy (IMRT) allows delivery of higher doses of radiation to the primary tumor, if brachytherapy is unsuitable, and to grossly involved nodal disease while minimizing treatment-related toxicity. PET/ PET-CT based brachytherapy optimization allows improved tumor-volume dose distribution and detailed 3D dosimetric evaluation of risk organs. Sequential PET/ PET-CT imaging performed during the course of brachytherapy form the basis of “adaptive” brachytherapy in cervical cancer. This review demonstrates the effectiveness of pretreatment PET/ PET-CT in cervical cancer patients treated by radiotherapy. Further prospective studies are required to define the group of patients who would benefit the most from this procedure.

Novel Parameter Predicting Grade 2 Rectal Bleeding After Iodine-125 Prostate Brachytherapy Combined With External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shiraishi, Yutaka, E-mail: shiraishi@rad.med.keio.ac.jp; Hanada, Takashi; Ohashi, Toshio

2013-09-01

Purpose: To propose a novel parameter predicting rectal bleeding on the basis of generalized equivalent uniform doses (gEUD) after {sup 125}I prostate brachytherapy combined with external beam radiation therapy and to assess the predictive value of this parameter. Methods and Materials: To account for differences among radiation treatment modalities and fractionation schedules, rectal dose–volume histograms (DVHs) of 369 patients with localized prostate cancer undergoing combined therapy retrieved from corresponding treatment planning systems were converted to equivalent dose-based DVHs. The gEUDs for the rectum were calculated from these converted DVHs. The total gEUD (gEUD{sub sum}) was determined by a summation ofmore » the brachytherapy and external-beam radiation therapy components. Results: Thirty-eight patients (10.3%) developed grade 2+ rectal bleeding. The grade 2+ rectal bleeding rate increased as the gEUD{sub sum} increased: 2.0% (2 of 102 patients) for <70 Gy, 10.3% (15 of 145 patients) for 70-80 Gy, 15.8% (12 of 76 patients) for 80-90 Gy, and 19.6% (9 of 46 patients) for >90 Gy (P=.002). Multivariate analysis identified age (P=.024) and gEUD{sub sum} (P=.000) as risk factors for grade 2+ rectal bleeding. Conclusions: Our results demonstrate gEUD to be a potential predictive factor for grade 2+ late rectal bleeding after combined therapy for prostate cancer.« less

Telerobotic system concept for real-time soft-tissue imaging during radiotherapy beam delivery.

PubMed

Schlosser, Jeffrey; Salisbury, Kenneth; Hristov, Dimitre

2010-12-01

The curative potential of external beam radiation therapy is critically dependent on having the ability to accurately aim radiation beams at intended targets while avoiding surrounding healthy tissues. However, existing technologies are incapable of real-time, volumetric, soft-tissue imaging during radiation beam delivery, when accurate target tracking is most critical. The authors address this challenge in the development and evaluation of a novel, minimally interfering, telerobotic ultrasound (U.S.) imaging system that can be integrated with existing medical linear accelerators (LINACs) for therapy guidance. A customized human-safe robotic manipulator was designed and built to control the pressure and pitch of an abdominal U.S. transducer while avoiding LINAC gantry collisions. A haptic device was integrated to remotely control the robotic manipulator motion and U.S. image acquisition outside the LINAC room. The ability of the system to continuously maintain high quality prostate images was evaluated in volunteers over extended time periods. Treatment feasibility was assessed by comparing a clinically deployed prostate treatment plan to an alternative plan in which beam directions were restricted to sectors that did not interfere with the transabdominal U.S. transducer. To demonstrate imaging capability concurrent with delivery, robot performance and U.S. target tracking in a phantom were tested with a 15 MV radiation beam active. Remote image acquisition and maintenance of image quality with the haptic interface was successfully demonstrated over 10 min periods in representative treatment setups of volunteers. Furthermore, the robot's ability to maintain a constant probe force and desired pitch angle was unaffected by the LINAC beam. For a representative prostate patient, the dose-volume histogram (DVH) for a plan with restricted sectors remained virtually identical to the DVH of a clinically deployed plan. With reduced margins, as would be enabled by real-time imaging, gross tumor volume coverage was identical while notable reductions of bladder and rectal volumes exposed to large doses were possible. The quality of U.S. images obtained during beam operation was not appreciably degraded by radiofrequency interference and 2D tracking of a phantom object in U.S. images obtained with the beam on/off yielded no significant differences. Remotely controlled robotic U.S. imaging is feasible in the radiotherapy environment and for the first time may offer real-time volumetric soft-tissue guidance concurrent with radiotherapy delivery.

Ef: Software for Nonrelativistic Beam Simulation by Particle-in-Cell Algorithm

NASA Astrophysics Data System (ADS)

Boytsov, A. Yu.; Bulychev, A. A.

2018-04-01

Understanding of particle dynamics is crucial in construction of electron guns, ion sources and other types of nonrelativistic beam devices. Apart from external guiding and focusing systems, a prominent role in evolution of such low-energy beams is played by particle-particle interaction. Numerical simulations taking into account these effects are typically accomplished by a well-known particle-in-cell method. In practice, for convenient work a simulation program should not only implement this method, but also support parallelization, provide integration with CAD systems and allow access to details of the simulation algorithm. To address the formulated requirements, development of a new open source code - Ef - has been started. It's current features and main functionality are presented. Comparison with several analytical models demonstrates good agreement between the numerical results and the theory. Further development plans are discussed.

Decreasing Temporal Lobe Dose With Five-Field Intensity-Modulated Radiotherapy for Treatment of Pituitary Macroadenomas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parhar, Preeti K.; Duckworth, Tamara; Shah, Parinda

2010-10-01

Purpose: To compare temporal lobe dose delivered by three pituitary macroadenoma irradiation techniques: three-field three-dimensional conformal radiotherapy (3D-CRT), three-field intensity-modulated radiotherapy (3F IMRT), and a proposed novel alternative of five-field IMRT (5F IMRT). Methods and Materials: Computed tomography-based external beam radiotherapy planning was performed for 15 pituitary macroadenoma patients treated at New York University between 2002 and 2007 using: 3D-CRT (two lateral, one midline superior anterior oblique [SAO] beams), 3F IMRT (same beam angles), and 5F IMRT (same beam angles with additional right SAO and left SAO beams). Prescription dose was 45 Gy. Target volumes were: gross tumor volume (GTV)more » = macroadenoma, clinical target volume (CTV) = GTV, and planning target volume = CTV + 0.5 cm. Structure contouring was performed by two radiation oncologists guided by an expert neuroradiologist. Results: Five-field IMRT yielded significantly decreased temporal lobe dose delivery compared with 3D-CRT and 3F IMRT. Temporal lobe sparing with 5F IMRT was most pronounced at intermediate doses: mean V25Gy (% of total temporal lobe volume receiving {>=}25 Gy) of 13% vs. 28% vs. 29% for right temporal lobe and 14% vs. 29% vs. 30% for left temporal lobe for 5F IMRT, 3D-CRT, and 3F IMRT, respectively (p < 10{sup -7} for 5F IMRT vs. 3D-CRT and 5F IMRT vs. 3F IMRT). Five-field IMRT plans did not compromise target coverage, exceed normal tissue dose constraints, or increase estimated brain integral dose. Conclusions: Five-field IMRT irradiation technique results in a statistically significant decrease in the dose to the temporal lobes and may thus help prevent neurocognitive sequelae in irradiated pituitary macroadenoma patients.« less

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

PubMed Central

2012-01-01

Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. Results The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. Conclusions The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable. PMID:22971539

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

PubMed

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

2012-09-12

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

Regression and statistical shape model based substitute CT generation for MRI alone external beam radiation therapy from standard clinical MRI sequences.

PubMed

Ghose, Soumya; Greer, Peter B; Sun, Jidi; Pichler, Peter; Rivest-Henault, David; Mitra, Jhimli; Richardson, Haylea; Wratten, Chris; Martin, Jarad; Arm, Jameen; Best, Leah; Dowling, Jason A

2017-10-27

In MR only radiation therapy planning, generation of the tissue specific HU map directly from the MRI would eliminate the need of CT image acquisition and may improve radiation therapy planning. The aim of this work is to generate and validate substitute CT (sCT) scans generated from standard T2 weighted MR pelvic scans in prostate radiation therapy dose planning. A Siemens Skyra 3T MRI scanner with laser bridge, flat couch and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole pelvis MRI (1.6 mm 3D isotropic T2w SPACE sequence) was acquired. Patients received a routine planning CT scan. Co-registered whole pelvis CT and T2w MRI pairs were used as training images. Advanced tissue specific non-linear regression models to predict HU for the fat, muscle, bladder and air were created from co-registered CT-MRI image pairs. On a test case T2w MRI, the bones and bladder were automatically segmented using a novel statistical shape and appearance model, while other soft tissues were separated using an Expectation-Maximization based clustering model. The CT bone in the training database that was most 'similar' to the segmented bone was then transformed with deformable registration to create the sCT component of the test case T2w MRI bone tissue. Predictions for the bone, air and soft tissue from the separate regression models were successively combined to generate a whole pelvis sCT. The change in monitor units between the sCT-based plans relative to the gold standard CT plan for the same IMRT dose plan was found to be [Formula: see text] (mean  ±  standard deviation) for 39 patients. The 3D Gamma pass rate was [Formula: see text] (2 mm/2%). The novel hybrid model is computationally efficient, generating an sCT in 20 min from standard T2w images for prostate cancer radiation therapy dose planning and DRR generation.

Regression and statistical shape model based substitute CT generation for MRI alone external beam radiation therapy from standard clinical MRI sequences

NASA Astrophysics Data System (ADS)

Ghose, Soumya; Greer, Peter B.; Sun, Jidi; Pichler, Peter; Rivest-Henault, David; Mitra, Jhimli; Richardson, Haylea; Wratten, Chris; Martin, Jarad; Arm, Jameen; Best, Leah; Dowling, Jason A.

2017-11-01

In MR only radiation therapy planning, generation of the tissue specific HU map directly from the MRI would eliminate the need of CT image acquisition and may improve radiation therapy planning. The aim of this work is to generate and validate substitute CT (sCT) scans generated from standard T2 weighted MR pelvic scans in prostate radiation therapy dose planning. A Siemens Skyra 3T MRI scanner with laser bridge, flat couch and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole pelvis MRI (1.6 mm 3D isotropic T2w SPACE sequence) was acquired. Patients received a routine planning CT scan. Co-registered whole pelvis CT and T2w MRI pairs were used as training images. Advanced tissue specific non-linear regression models to predict HU for the fat, muscle, bladder and air were created from co-registered CT-MRI image pairs. On a test case T2w MRI, the bones and bladder were automatically segmented using a novel statistical shape and appearance model, while other soft tissues were separated using an Expectation-Maximization based clustering model. The CT bone in the training database that was most ‘similar’ to the segmented bone was then transformed with deformable registration to create the sCT component of the test case T2w MRI bone tissue. Predictions for the bone, air and soft tissue from the separate regression models were successively combined to generate a whole pelvis sCT. The change in monitor units between the sCT-based plans relative to the gold standard CT plan for the same IMRT dose plan was found to be 0.3%+/-0.9% (mean  ±  standard deviation) for 39 patients. The 3D Gamma pass rate was 99.8+/-0.00 (2 mm/2%). The novel hybrid model is computationally efficient, generating an sCT in 20 min from standard T2w images for prostate cancer radiation therapy dose planning and DRR generation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Magallanes, L., E-mail: lorena.magallanes@med.uni-heidelberg.de; Rinaldi, I., E-mail: ilaria.rinaldi@med.uni-heidelberg.de; Brons, S., E-mail: stephan.brons@med.uni-heidelberg.de

External beam radiotherapy techniques have the common aim to maximize the radiation dose to the target while sparing the surrounding healthy tissues. The inverted and finite depth-dose profile of ion beams (Bragg peak) allows for precise dose delivery and conformai dose distribution. Furthermore, increased radiobiological effectiveness of ions enhances the capability to battle radioresistant tumors. Ion beam therapy requires a precise determination of the ion range, which is particularly sensitive to range uncertainties. Therefore, novel imaging techniques are currently investigated as a tool to improve the quality of ion beam treatments. Approaches already clinically available or under development are basedmore » on the detection of secondary particles emitted as a result of nuclear reactions (e.g., positron-annihilation or prompt gammas, charged particles) or transmitted high energy primary ion beams. Transmission imaging techniques make use of the beams exiting the patient, which have higher initial energy and lower fluence than the therapeutic ones. At the Heidelberg Ion Beam Therapy Center, actively scanned energetic proton and carbon ion beams provide an ideal environment for the investigation of ion-based radiography and tomography. This contribution presents the rationale of ion beam therapy, focusing on the role of ion-based transmission imaging methods towards the reduction of range uncertainties and potential improvement of treatment planning.« less

SU-E-T-250: New IMRT Sequencing Strategy: Towards Intra-Fraction Plan Adaptation for the MR-Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kontaxis, C; Bol, G; Lagendijk, J

2014-06-01

Purpose: To develop a new sequencer for IMRT planning that during treatment makes the inclusion of external factors possible and by doing so accounts for intra-fraction anatomy changes. Given a real-time imaging modality that will provide the updated patient anatomy during delivery, this sequencer is able to take these changes into account during the calculation of subsequent segments. Methods: Pencil beams are generated for each beam angle of the treatment and a fluence optimization is performed. The pencil beams, together with the patient anatomy and the above optimal fluence form the input of our algorithm. During each iteration the followingmore » steps are performed: A fluence optimization is done and each beam's fluence is then split to discrete intensity levels. Deliverable segments are calculated for each one of these. Each segment's area multiplied by its intensity describes its efficiency. The most efficient segment among all beams is then chosen to deliver a part of the calculated fluence and the dose that will be delivered by this segment is calculated. This delivered dose is then subtracted from the remaining dose. This loop is repeated until 90% of the dose has been delivered and a final segment weight optimization is performed to reach full convergence. Results: This algorithm was tested in several prostate cases yielding results that meet all clinical constraints. Quality assurance was performed on Delta4 and film phantoms for one of these prostate cases and received clinical acceptance after passing both gamma analyses with the 3%/3mm criteria. Conclusion: A new sequencing algorithm was developed to facilitate the needs of intensity modulated treatment. The first results on static anatomy confirm that it can calculate clinical plans equivalent to those of the commercially available planning systems. We are now working towards 100% dose convergence which will allow us to handle anatomy deformations. This work is financially supported by Elekta AB, Stockholm, Sweden.« less

Radiotherapy in poor risk patients with stage I cancer of the endometrium: results of not giving external beam radiotherapy.

PubMed

DeCruze, B; Guthrie, D

1999-01-01

Poor prognosis (poorly differentiated and/or deep myometrial invasion) Stage I endometrial cancer can have a relapse rate as high as 50%. Traditionally, most clinical oncologists treat these patients with external beam radiotherapy after surgery but there is no evidence to show that this improves survival. The retrospective study looks at the results of not giving external beam radiotherapy in 25 consecutive patients and compares the results with a group of 13 consecutive patients who did have such treatment. The two groups were comparable with regard to age, degree of differentiation and degree of invasion. Survival was comparable in the two groups. There is no evidence of any obvious decrease in survival from withholding external beam radiotherapy, but this was not a prospective randomized controlled trial. This study illustrates that it is essential that the Medical Research Council ASTEC trial should be supported because this will determine the true place of external beam radiotherapy in such patients.

Carbon-Ion Pencil Beam Scanning Treatment With Gated Markerless Tumor Tracking: An Analysis of Positional Accuracy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mori, Shinichiro, E-mail: shinshin@nirs.go.jp; Karube, Masataka; Shirai, Toshiyuki

Purpose: Having implemented amplitude-based respiratory gating for scanned carbon-ion beam therapy, we sought to evaluate its effect on positional accuracy and throughput. Methods and Materials: A total of 10 patients with tumors of the lung and liver participated in the first clinical trials at our center. Treatment planning was conducted with 4-dimensional computed tomography (4DCT) under free-breathing conditions. The planning target volume (PTV) was calculated by adding a 2- to 3-mm setup margin outside the clinical target volume (CTV) within the gating window. The treatment beam was on when the CTV was within the PTV. Tumor position was detected inmore » real time with a markerless tumor tracking system using paired x-ray fluoroscopic imaging units. Results: The patient setup error (mean ± SD) was 1.1 ± 1.2 mm/0.6 ± 0.4°. The mean internal gating accuracy (95% confidence interval [CI]) was 0.5 mm. If external gating had been applied to this treatment, the mean gating accuracy (95% CI) would have been 4.1 mm. The fluoroscopic radiation doses (mean ± SD) were 23.7 ± 21.8 mGy per beam and less than 487.5 mGy total throughout the treatment course. The setup, preparation, and irradiation times (mean ± SD) were 8.9 ± 8.2 min, 9.5 ± 4.6 min, and 4.0 ± 2.4 min, respectively. The treatment room occupation time was 36.7 ± 67.5 min. Conclusions: Internal gating had a much higher accuracy than external gating. By the addition of a setup margin of 2 to 3 mm, internal gating positional error was less than 2.2 mm at 95% CI.« less

Predictive parameters for selection of electronic tissue compensation radiotherapy in early-stage breast cancer patients after breast-conserving surgery.

PubMed

Song, Yanbo; Zhang, Miao; Gan, Lu; Chen, Xiaopin; Zhang, Tao; Yue, Ning J; Goyal, Sharad; Haffty, Bruce; Ren, Guosheng

2016-05-31

Electronic tissue compensation (eComp) is an external beam planning technique allowing user to manually generate dynamic beam fluence to produce more uniform or modulated dose distribution. In this study, we compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and eComp for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing doses to lung, heart, and skin. Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS) to explore any correlations and planning method selection. It was found that to keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost.

Sample holder with optical features

DOEpatents

Milas, Mirko; Zhu, Yimei; Rameau, Jonathan David

2013-07-30

A sample holder for holding a sample to be observed for research purposes, particularly in a transmission electron microscope (TEM), generally includes an external alignment part for directing a light beam in a predetermined beam direction, a sample holder body in optical communication with the external alignment part and a sample support member disposed at a distal end of the sample holder body opposite the external alignment part for holding a sample to be analyzed. The sample holder body defines an internal conduit for the light beam and the sample support member includes a light beam positioner for directing the light beam between the sample holder body and the sample held by the sample support member.

Transmission electron microscope sample holder with optical features

DOEpatents

Milas, Mirko [Port Jefferson, NY; Zhu, Yimei [Stony Brook, NY; Rameau, Jonathan David [Coram, NY

2012-03-27

A sample holder for holding a sample to be observed for research purposes, particularly in a transmission electron microscope (TEM), generally includes an external alignment part for directing a light beam in a predetermined beam direction, a sample holder body in optical communication with the external alignment part and a sample support member disposed at a distal end of the sample holder body opposite the external alignment part for holding a sample to be analyzed. The sample holder body defines an internal conduit for the light beam and the sample support member includes a light beam positioner for directing the light beam between the sample holder body and the sample held by the sample support member.

Clinical Ion Beam Applications: Basic Properties, Application, Quality Control, Planning

NASA Astrophysics Data System (ADS)

Kraft, Gerhard

2009-03-01

Heavy-ion therapy using beam scanning and biological dose optimization is a novel technique of high-precision external radiotherapy. It yields a better perspective for tumor cure of radio-resistant tumors. However, heavy-ion therapy is not a general solution for all types of tumors. As compared to conventional radiotherapy, heavy-ion radiotherapy has the advantages of higher tumor dose, improved sparing of normal tissue in the entrance channel, a more precise concentration of the dose in the target volume with steeper gradients to the normal tissue, and a higher radiobiological effectiveness for tumors which are radio-resistant in conventional therapy. These properties make it possible to treat radio-resistant tumors with great success, including those in close vicinity to critical organs.

Quantication and analysis of respiratory motion from 4D MRI

NASA Astrophysics Data System (ADS)

Aizzuddin Abd Rahni, Ashrani; Lewis, Emma; Wells, Kevin

2014-11-01

It is well known that respiratory motion affects image acquisition and also external beam radiotherapy (EBRT) treatment planning and delivery. However often the existing approaches for respiratory motion management are based on a generic view of respiratory motion such as the general movement of organ, tissue or fiducials. This paper thus aims to present a more in depth analysis of respiratory motion based on 4D MRI for further integration into motion correction in image acquisition or image based EBRT. Internal and external motion was first analysed separately, on a per-organ basis for internal motion. Principal component analysis (PCA) was then performed on the internal and external motion vectors separately and the relationship between the two PCA spaces was analysed. The motion extracted from 4D MRI on general was found to be consistent with what has been reported in literature.

Catching errors with patient-specific pretreatment machine log file analysis.

PubMed

Rangaraj, Dharanipathy; Zhu, Mingyao; Yang, Deshan; Palaniswaamy, Geethpriya; Yaddanapudi, Sridhar; Wooten, Omar H; Brame, Scott; Mutic, Sasa

2013-01-01

A robust, efficient, and reliable quality assurance (QA) process is highly desired for modern external beam radiation therapy treatments. Here, we report the results of a semiautomatic, pretreatment, patient-specific QA process based on dynamic machine log file analysis clinically implemented for intensity modulated radiation therapy (IMRT) treatments delivered by high energy linear accelerators (Varian 2100/2300 EX, Trilogy, iX-D, Varian Medical Systems Inc, Palo Alto, CA). The multileaf collimator machine (MLC) log files are called Dynalog by Varian. Using an in-house developed computer program called "Dynalog QA," we automatically compare the beam delivery parameters in the log files that are generated during pretreatment point dose verification measurements, with the treatment plan to determine any discrepancies in IMRT deliveries. Fluence maps are constructed and compared between the delivered and planned beams. Since clinical introduction in June 2009, 912 machine log file analyses QA were performed by the end of 2010. Among these, 14 errors causing dosimetric deviation were detected and required further investigation and intervention. These errors were the result of human operating mistakes, flawed treatment planning, and data modification during plan file transfer. Minor errors were also reported in 174 other log file analyses, some of which stemmed from false positives and unreliable results; the origins of these are discussed herein. It has been demonstrated that the machine log file analysis is a robust, efficient, and reliable QA process capable of detecting errors originating from human mistakes, flawed planning, and data transfer problems. The possibility of detecting these errors is low using point and planar dosimetric measurements. Copyright © 2013 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Contralateral Breast Dose After Whole-Breast Irradiation: An Analysis by Treatment Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Terence M.; Moran, Jean M., E-mail: jmmoran@med.umich.edu; Hsu, Shu-Hui

2012-04-01

Purpose: To investigate the contralateral breast dose (CBD) across a continuum of breast-conservation therapy techniques. Methods and Materials: An anthropomorphic phantom was CT-simulated, and six treatment plans were generated: open tangents, tangents with an external wedge on the lateral beam, tangents with lateral and medial external wedges, a simple segment plan (three segments per tangent), a complex segmental intensity-modulated radiotherapy (IMRT) plan (five segments per tangent), and a beamlet IMRT plan (>100 segments). For all techniques, the breast on the phantom was irradiated to 5000 cGy. Contralateral breast dose was measured at a uniform depth at the center and eachmore » quadrant using thermoluminescent detectors. Results: Contralateral breast dose varied with position and was 50 {+-} 7.3 cGy in the inner half, 24 {+-} 4.1 cGy at the center, and 16 {+-} 2.2 cGy in the outer half for the open tangential plan. Compared with an average dose of 31 cGy across all points for the open field, the average doses were simple segment 32 cGy (range, 99-105% compared with open technique), complex segment 34 cGy (range, 103-117% compared with open technique), beamlet IMRT 34 cGy (range, 103-124% compared with open technique), lateral wedge only 46 cGy (range, 133-175% compared with open technique), and medial and lateral wedge 96 cGy (range, 282-370% compared with open technique). Conclusions: Single or dual wedge techniques resulted in the highest CBD increases compared with open tangents. To obtain the desired homogeneity to the treated breast while minimizing CBD, segmental and IMRT techniques should be encouraged over external physical compensators.« less

Propagation characteristics of a focused laser beam in a strontium barium niobate photorefractive crystal under reverse external electric field.

PubMed

Guo, Q L; Liang, B L; Wang, Y; Deng, G Y; Jiang, Y H; Zhang, S H; Fu, G S; Simmonds, P J

2014-10-01

The propagation characteristics of a focused laser beam in a SBN:75 photorefractive crystal strongly depend on the signal-to-background intensity ratio (R=I_s/I_b) under reverse external electric field. In the range 20>R>0.05, the laser beam shows enhanced self-defocusing behavior with increasing external electric field, while it shows self-focusing in the range 0.03>R>0.01. Spatial solitons are observed under a suitable reverse external electric field for R=0.025. A theoretical model is proposed to explain the experimental observations, which suggest a new type of soliton formation due to "enhancement" not "screening" of the external electrical field.

Effect of electron beam cooling on transversal and longitudinal emittance of an external proton beam

NASA Astrophysics Data System (ADS)

Kilian, K.; Machner, H.; Magiera, A.; Prasuhn, D.; von Rossen, P.; Siudak, R.; Stein, H. J.; Stockhorst, H.

2018-02-01

Benefits of electron cooling to the quality of extracted ion beams from storage rings are discussed. The transversal emittances of an external proton beam with and without electron cooling at injection energy are measured with the GEM detector assembly. While the horizontal emittance remains the vertical emittance shrinks by the cooling process. The longitudinal momentum variance is also reduced by cooling.

Radiation dermatitis caused by a bolus effect from an abdominal compression device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Connor, Michael; Wei, Randy L.; Yu, Suhong

American Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up betweenmore » the device, a lower-density alternative device, and an open field. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The total dose was 50.4 Gy delivered over 40 elapsed days. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The original treatment plan did not include a contour of the device. Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. In conclusion, replanning with the device contoured revealed the bolus effect. The skin dose increased from 27 to 36 Gy. planned target volume (PTV) coverage at 45 Gy was reduced to 76.5% from 95.8%. The second VMAT treatment plan with an anterior avoidance sector and more oblique beam angles maintained PTV coverage and spared the anterior wall, however at the expense of substantially increased dose to lung. This case report provides an important reminder of the bolus effect from external devices such as abdominal compression. Special consideration must be given to contour and/or avoiding beam entrance to the device, and to the use of such devices in patients who may have heightened radiosensitivity, such as those who are human immunodeficiency virus (HIV)–positive.« less

SU-E-T-125: Dosimetric Comparison of Intensity Modulated Radiation Therapy Using Robotic Versus Traditional Linac Platform in Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayes, T; Rella, J; Yang, J

Purpose: Recent development of an MLC for robotic external beam radiotherapy has the potential of new clinical application in conventionally fractionated radiation therapy. This study offers a dosimetric comparison of IMRT plans using Cyberknife with MLC versus conventional linac plans. Methods: Ten prostate cancer patients treated on a traditional linac with IMRT to 7920cGy at 180cGy/fraction were randomly selected. GTVs were defined as prostate plus proximal seminal vesicles. PTVs were defined as GTV+8mm in all directions except 5mm posteriorly. Conventional IMRT planning was performed on Philips Pinnacle and delivered on a standard linac with CBCT and 10mm collimator leaf width.more » For each case a Cyberknife plan was created using Accuray Multiplan with same CT data set, contours, and dose constraints. All dosimetric data was transferred to third party software for independent computation of contour volumes and DVH. Delivery efficiency was evaluated using total MU, treatment time, number of beams, and number of segments. Results: Evaluation criteria including percent target coverage, homogeneity index, and conformity index were found to be comparable. All dose constraints from QUANTEC were found to be statistically similar except rectum V50Gy and bladder V65Gy. Average rectum V50Gy was lower for robotic IMRT (30.07%±6.57) versus traditional (34.73%±3.62, p=0.0130). Average bladder V65Gy was lower for robotic (17.87%±12.74) versus traditional (21.03%±11.93, p=0.0405). Linac plans utilized 9 coplanar beams, 48.9±3.8 segments, and 19381±2399MU. Robotic plans utilized 38.4±9.0 non-coplanar beams, 85.5±21.0 segments and 42554.71±16381.54 MU. The average treatment was 15.02±0.60 minutes for traditional versus 20.90±2.51 for robotic. Conclusion: The robotic IMRT plans were comparable to the traditional IMRT plans in meeting the target volume dose objectives. Critical structure dose constraints were largely comparable although statistically significant differences were found in favor of the robotic platform in terms of rectum V50Gy and bladder V65Gy at a cost of 25% longer treatment time.« less

Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis.

PubMed

Blake, P; Swart, Ann Marie; Orton, J; Kitchener, H; Whelan, T; Lukka, H; Eisenhauer, E; Bacon, M; Tu, D; Parmar, M K B; Amos, C; Murray, C; Qian, W

2009-01-10

Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40-46 Gy in 20-25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1.05 (95% CI 0.75-1.48; p=0.77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1.04; 95% CI 0.84-1.29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years was 6.1%. Adjuvant external beam radiotherapy cannot be recommended as part of routine treatment for women with intermediate-risk or high-risk early-stage endometrial cancer with the aim of improving survival. The absolute benefit of external beam radiotherapy in preventing isolated local recurrence is small and is not without toxicity.

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

PubMed

Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The Missing Pieces in Reporting of Randomized Controlled Trials of External Beam Radiation Therapy Dose Escalation for Prostate Cancer.

PubMed

Zaorsky, Nicholas G; Egleston, Brian L; Horwitz, Eric M; Dicker, Adam P; Nguyen, Paul L; Showalter, Timothy N; Den, Robert B

2016-08-01

Randomized controlled trials (RCTs) are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and for assessing the cost-effectiveness of a treatment. For many patients, cancer is a chronic illness; RCTs evaluating treatments for indolent cancers must evolve to facilitate medical decision-making, as "concrete" patient outcomes (eg, survival) will likely be excellent independent of the intervention, and detecting a difference between trial arms may be impossible. In this commentary, we articulate 9 recommendations that we hope future clinical trialists and funding agencies (including those under the National Cancer Institute) will take into consideration when planning RCTs to help guide subsequent interpretation of results and clinical decision making, based on RCTs of external beam radiation therapy dose escalation for the most common indolent cancer in men, that is, prostate cancer. We recommend routinely reporting: (1) race; (2) medical comorbidities; (3) psychiatric comorbidities; (4) insurance status; (5) education; (6) marital status; (7) income; (8) sexual orientation; and (9) facility-related characteristics (eg, number of centers involved, type of facilities, yearly hospital volumes). We discuss how these factors independently affect patient outcomes and toxicities; future clinicians and governing organizations should consider this information to plan RCTs accordingly (to maximize patient accrual and total n), select appropriate endpoints (eg, toxicity, quality of life, sexual function), actively monitor RCTs, and report results so as to identify the optimal treatment among subpopulations.

Clinical outcomes from an innovative protocol using serial ultrasound imaging and a single MR image to guide brachytherapy for locally advanced cervix cancer.

PubMed

van Dyk, Sylvia; Narayan, Kailash; Bernshaw, David; Kondalsamy-Chennakesavan, Srinivas; Khaw, Pearly; Lin, Ming Yin; Schneider, Michal

The aim of this study was to report clinical outcomes in a series of patients who underwent serial ultrasound and a single MRI to plan and verify intracavitary brachytherapy. Data for patients who were referred for curative intent radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) Stage 1-1V cervix cancer between January 2007 and March 2012 were analyzed. All patients received external beam radiotherapy with concurrent chemotherapy and sequential high-dose rate brachytherapy. Brachytherapy was planned and verified using serial ultrasound imaging and a single MRI. Data from 191 patients were available for analyses. The median (range) followup time was 5.08 (0.25-8.25) years. Five-year local control, failure-free survival, cancer-specific survival, and overall survival were 86%, 57.3%, 70% and 63%, respectively. Mean (standard deviation) combined external beam radiotherapy and brachytherapy target doses, equivalent to doses in 2 Gy fractions were 80.4 Gy10 (3.89), median (range) 80 (49-96) Gy10. Grade 3 or greater gastrointestinal, genitourinary, or vaginal late toxicity occurred in 3%, 1.6%, and 2% of patients, respectively. Survival, patterns of failure, and late complication rates were similar to published series of MRI/CT-based brachytherapy practices. This large study demonstrates that favorable treatment outcomes can be obtained using a pragmatic and innovative combination of ultrasound and MR imaging. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

MO-A-201-01: A Cliff’s Notes Version of Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kruse, J.

Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatchesmore » between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ from standard x-ray approaches, due to equipment design or the desire to maximize efficiency within a high-cost proton therapy treatment room. Differences between x-ray and proton therapy delivery will be described. Learning Objectives: Understand how CT HU are calibrated to provide proton stopping power, and the sources of uncertainty in this process. Understand why a PTV is not suitable for proton therapy, and how robust treatment planning and evaluation are used to mitigate uncertainties. Understand the source and implications of variable RBE in proton therapy Learn about proton specific challenges and approaches in beam delivery and image guidance Jon Kruse has a research grant from Varian Medical Systems related to proton therapy treatment plannning.; J. Kruse, Jon Kruse has a research grant with Varian Medical Systems related to proton therapy planning.« less

MO-A-201-00: A Cliff’s Notes Version of Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Proton therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of proton therapy is identical to x-ray based external beam radiotherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and proton based practices. Unlike in x-ray therapy, proton dose calculations use CT Hounsfield Units (HU) to determine proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatchesmore » between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for proton therapy. Robust treatment planning and evaluation are critical in proton therapy, and will be discussed in this course. Predicting the biological effect of a proton dose distribution within a patient is also a complex undertaking. The proton therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in proton therapy and describe how this is incorporated into current proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of proton therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered protons or x-rays. Image guidance techniques in proton therapy may also differ from standard x-ray approaches, due to equipment design or the desire to maximize efficiency within a high-cost proton therapy treatment room. Differences between x-ray and proton therapy delivery will be described. Learning Objectives: Understand how CT HU are calibrated to provide proton stopping power, and the sources of uncertainty in this process. Understand why a PTV is not suitable for proton therapy, and how robust treatment planning and evaluation are used to mitigate uncertainties. Understand the source and implications of variable RBE in proton therapy Learn about proton specific challenges and approaches in beam delivery and image guidance Jon Kruse has a research grant from Varian Medical Systems related to proton therapy treatment plannning.; J. Kruse, Jon Kruse has a research grant with Varian Medical Systems related to proton therapy planning.« less

A CW radiofrequency ion source for production of negative hydrogen ion beams for cyclotrons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalvas, T.; Tarvainen, O.; Komppula, J.

2015-04-08

A CW 13.56 MHz radiofrequency-driven ion source RADIS for production of H{sup −} and D{sup −} beams is under development for replacing the filament-driven ion source of the MCC30/15 cyclotron. The RF ion source has a 16-pole multicusp plasma chamber, an electromagnet-based magnetic filter and an external planar spiral RF antenna behind an AlN window. The extraction is a 5-electrode system with an adjustable puller electrode voltage for optimizing the beam formation, a water-cooled electron dump electrode and an accelerating einzel lens. At 2650 W of RF power, the source produces 1 mA of H{sup −} (2.6 mA/cm{sup 2}), which is the intensity neededmore » at injection for production of 200 µA H{sup +} with the filament-driven ion source. A simple pepperpot device has been developed for characterizing the beam emittance. Plans for improving the power efficiency with the use of a new permanent magnet front plate is discussed.« less

Corrosion of 15th and early 16th century stained glass from the monastery of Batalha studied with external ion beam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vilarigues, M., E-mail: mgv@fct.unl.pt; Redol, P.; Monastery of Batalha, P-2440

2011-02-15

This paper reports the study of corrosion in two stained glass panels from the south aisle of Sta. Maria da Vitoria monastery, at Batalha (Portugal), one depicting the Last Supper (dated from 1508), and the other one showing a saint (c. 1450). These panels exhibit extensive corrosion with darkening phenomena that are an impediment to their correct visualization, a source of major concern both to conservators and curators. By using external micro-beam Particle Induced X-ray Emission (PIXE) and Particle Induced Gamma Emission (PIGE) spectrometry, the elemental compositions of large fragments were obtained, enabling the selection of representative corroded areas, frommore » which elemental distribution maps were produced by scanning. Calcium and potassium rich structures were found - at the surface and inside cavities in the glass - that were identified as oxalates and carbonates, by Raman microscopy and micro-FTIR. The dark spots present in the glass surfaces were found to be Zn and Pb rich. These findings indicate that the corrosion observed was due not only to reactions with atmospheric water and CO{sub 2} but also with the oxalic acid secreted by micro-organisms. Furthermore, it did not result from reactions with atmospheric SO{sub 2} or acid rain. The information obtained is relevant for a better understanding of the corrosion processes and products formed on the surface of these panels and therefore for the proper planning of much needed adequate conservation-restoration actions and appropriate display conditions. - Research Highlights: {yields} Corrosion and darkening of stained glasses is of concern to conservators and curators. {yields} A multi-technique approach is of relevance to study stained glass corrosion. {yields} External beam PIXE-PIGE provide valuable insight on stained glass corrosion.« less

SU-E-J-155: Utilizing Varian TrueBeam Developer Mode for the Quantification of Mechanical Limits and the Simulation of 4D Respiratory Motion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moseley, D; Dave, M

Purpose: Use Varian TrueBeam Developer mode to quantify the mechanical limits of the couch and to simulate 4D respiratory motion. Methods: An in-house MATLAB based GUI was created to make the BEAM XML files. The couch was moved in a triangular wave in the S/I direction with varying amplitudes (1mm, 5mm, 10mm, and 50mm) and periods (3s, 6s, and 9s). The periods were determined by specifying the speed. The theoretical positions were compared to the values recorded by the machine at 50 Hz. HD videos were taken for certain tests as external validation. 4D Respiratory motion was simulated by anmore » A/P MV beam being delivered while the couch moved in an elliptical manner. The ellipse had a major axis of 2 cm (S/I) and a minor axis of 1 cm (A/P). Results: The path planned by the TrueBeam deviated from the theoretical triangular form as the speed increased. Deviations were noticed starting at a speed of 3.33 cm/s (50mm amplitude, 6s period). The greatest deviation occurred in the 50mm- 3s sequence with a correlation value of −0.13 and a 27% time increase; the plan essentially became out of phase. Excluding these two, the plans had correlation values of 0.99. The elliptical sequence effectively simulated a respiratory pattern with a period of 6s. The period could be controlled by changing the speeds or the dose rate. Conclusion: The work first shows the quantification of the mechanical limits of the couch and the speeds at which the proposed plans begin to deviate. These limits must be kept in mind when programming other couch sequences. The methodology can be used to quantify the limits of other axes. Furthermore, the work shows the possibility of creating 4D respiratory simulations without using specialized phantoms or motion-platforms. This can be further developed to program patient-specific breathing patterns.« less

Comparison of PDR brachytherapy and external beam radiation therapy in the case of breast cancer

NASA Astrophysics Data System (ADS)

Teymournia, L.; Berger, D.; Kauer-Dorner, D.; Poljanc, K.; Seitz, W.; Aiginger, H.; Kirisits, C.

2009-04-01

Pulsed dose rate brachytherapy (PDR) was compared to external beam radiation therapy (EBRT) in the case of breast cancer. The benefits were figured out by evaluation of dosimetric parameters and calculating the normal tissue complication probability (NTCP). PDR plans were set up for five randomly chosen left-sided breast cancer patients delivering a total dose of 50.4 Gy to the target (dose rate 0.8 Gy h-1). For EBRT five left-sided breast cancer patients were planned using 3D-conformal tangential photon beams with a prescribed total dose of 50 Gy (2 Gy/fraction) to the total breast volume. For plan ranking and NTCP calculation the physical dose was first converted into the biologically effective dose (BED) and then into the normalized total dose (NTD) using the linear quadratic model with an α/β ratio of 3 Gy. In PDR the relative effectiveness (RE) was calculated for each dose bin of the differential dose volume histogram to get the BED. NTCPs were calculated for the ipsilateral lung and the heart as contoured on CT slices based on the Lyman model and the Kutcher reduction scheme. Dosimetric parameters as Vth (percentage of the total volume exceeding a threshold dose) and Jackson's fdam (fraction of the organ damaged) were also used to figure out the benefits. The comparison of calculated NTCPs in PDR and EBRT showed no difference between these two modalities. All values were below 0.01%. fdam derived from EBRT was always higher (mean value 8.95% versus 1.21% for the lung). The mean V10 and V20 of the lung related to BED were 6.32% and 1.72% for PDR versus 11.72% and 9.59% for EBRT. When using dosimetric parameters as Vth and fdam, PDR was mostly superior to EBRT in respect of sparing normal tissues. NTCP calculation as a single method of modality ranking showed a lack of information, especially when normal tissue was exposed to low radiation doses.

An external milli-beam for archaeometric applications on the AGLAE IBA facility of the Louvre museum

NASA Astrophysics Data System (ADS)

Calligaro, T.; Dran, J.-C.; Hamon, H.; Moignard, B.; Salomon, J.

1998-03-01

External beam lines have been built on numerous IBA facilities for the analysis of works of art to avoid sampling and vacuum potentially detrimental to the integrity of such precious objects. On the other hand, growing interest lies on microprobe systems which provide a high lateral resolution but which usually work under vacuum. Until recently, the AGLAE facility was equipped with separate external beam and microprobe lines. The need of a better spatial resolution in the external beam mode has led us to combine them into a single system which exhibits numerous advantages and allows the analysis of small heterogeneities like inclusions in gemstones or tiny components of composite samples. The triplet of quadrupole lenses bought from Oxford is used to focus the beam. By using a 0.75 μm thick Al foil as the exit window, blowing a helium flow around the beam spot and reducing the window-sample distance below 3 mm, a beam size of about 30 μm can be reached. The experimental setup includes two Si(Li), a HPGe and a Si surface barrier detectors for the simultaneous implementation of PIXE, NRA and RBS. The full description of this device is given as well as a few applications to highlight its capability.

Development and Commissioning of an External Beam Facility in the Union College Ion Beam Analysis Laboratory

NASA Astrophysics Data System (ADS)

Yoskowitz, Joshua; Clark, Morgan; Labrake, Scott; Vineyard, Michael

2015-10-01

We have developed an external beam facility for the 1.1-MV tandem Pelletron accelerator in the Union College Ion Beam Analysis Laboratory. The beam is extracted from an aluminum pipe through a 1 / 4 ' ' diameter window with a 7.5- μm thick Kapton foil. This external beam facility allows us to perform ion beam analysis on samples that cannot be put under vacuum, including wet samples and samples too large to fit into the scattering chamber. We have commissioned the new facility by performing proton induced X-ray emission (PIXE) analysis of several samples of environmental interest. These include samples of artificial turf, running tracks, and a human tooth with an amalgam filling. A 1.7-MeV external proton beam was incident on the samples positioned 2 cm from the window. The resulting X-rays were measured using a silicon drift detector and were analyzed using GUPIX software to determine the concentrations of elements in the samples. The results on the human tooth indicate that while significant concentrations of Hg, Ag, and Sn are present in the amalgam filling, only trace amounts of Hg appear to have leached into the tooth. The artificial turf and running tracks show rather large concentrations of a broad range of elements and trace amounts of Pb in the turf infill.

Marker-less respiratory motion modeling using the Microsoft Kinect for Windows

NASA Astrophysics Data System (ADS)

Tahavori, F.; Alnowami, M.; Wells, K.

2014-03-01

Patient respiratory motion is a major problem during external beam radiotherapy of the thoracic and abdominal regions due to the associated organ and target motion. In addition, such motion introduces uncertainty in both radiotherapy planning and delivery and may potentially vary between the planning and delivery sessions. The aim of this work is to examine subject-specific external respiratory motion and its associated drift from an assumed average cycle which is the basis for many respiratory motion compensated applications including radiotherapy treatment planning and delivery. External respiratory motion data were acquired from a group of 20 volunteers using a marker-less 3D depth camera, Kinect for Windows. The anterior surface encompassing thoracic and abdominal regions were subject to principal component analysis (PCA) to investigate dominant variations. The first principal component typically describes more than 70% of the motion data variance in the thoracic and abdominal surfaces. Across all of the subjects used in this study, 58% of subjects demonstrate largely abdominal breathing and 33% exhibited largely thoracic dominated breathing. In most cases there is observable drift in respiratory motion during the 300s capture period, which is visually demonstrated using Kernel Density Estimation. This study demonstrates that for this cohort of apparently healthy volunteers, there is significant respiratory motion drift in most cases, in terms of amplitude and relative displacement between the thoracic and abdominal respiratory components. This has implications for the development of effective motion compensation methodology.

In vivo dosimetry with TLD in conservative treatment of breast cancer patients treated with the EORTC protocol 22881.

PubMed

Hamers, H P; Johansson, K A; Venselaar, J L; de Brouwer, P; Hansson, U; Moudi, C

1993-01-01

Two anthropomorphic phantom breasts and six patients with breast carcinoma were irradiated according the prescriptions of the EORTC protocol 22881 on the conservative management of breast carcinoma by tumorectomy and radiotherapy. During the implantation procedure for an iridium-192 boost, three tubes were implanted, enabling the measurement with TLD rods of the dose within the breasts of the phantom and the patients during one fraction of the external x-ray therapy and during the interstitial therapy. Measured doses were compared with calculated values from a 2-D dose planning system. In general a fair agreement was found between the measured and calculated doses in points within the breast for the external beam therapy as well as for the interstitial treatment.

External-cavity beam combining of 4-channel quantum cascade lasers

NASA Astrophysics Data System (ADS)

Zhao, Yue; Zhang, Jin-Chuan; Zhou, Yu-Hong; Jia, Zhi-Wei; Zhuo, Ning; Zhai, Shen-Qiang; Wang, Li-Jun; Liu, Jun-Qi; Liu, Shu-Man; Liu, Feng-Qi; Wang, Zhan-Guo

2017-09-01

We demonstrate an external-cavity (EC) beam combining of 4-channel quantum cascade lasers (QCLs) with an output coupler which makes different QCL beams propagating coaxially. A beam combining efficiency of 35% (up to 75% near threshold) is obtained with a beam quality M2 of 5.5. A peak power of 0.64 W is achieved at a wavelength of 4.7 μm. The differences of spot characteristic between coupled and uncoupled are also showed in this letter. The QCLs in this EC system do not have heat crosstalk so that the system can be used for high power beam combining of QCLs.

Proton therapy in the clinic.

PubMed

DeLaney, Thomas F

2011-01-01

The clinical advantage for proton radiotherapy over photon approaches is the marked reduction in integral dose to the patient, due to the absence of exit dose beyond the proton Bragg peak. The integral dose with protons is approximately 60% lower than that with any external beam photon technique. Pediatric patients, because of their developing normal tissues and anticipated length of remaining life, are likely to have the maximum clinical gain with the use of protons. Proton therapy may also allow treatment of some adult tumors to much more effective doses, because of normal tissue sparing distal to the tumor. Currently, the most commonly available proton treatment technology uses 3D conformal approaches based on (a) distal range modulation, (b) passive scattering of the proton beam in its x- and y-axes, and (c) lateral beam-shaping. It is anticipated that magnetic pencil beam scanning will become the dominant mode of proton delivery in the future, which will lower neutron scatter associated with passively scattered beam lines, reduce the need for expensive beam-shaping devices, and allow intensity-modulated proton radiotherapy. Proton treatment plans are more sensitive to variations in tumor size and normal tissue changes over the course of treatment than photon plans, and it is expected that adaptive radiation therapy will be increasingly important for proton therapy as well. While impressive treatment results have been reported with protons, their cost is higher than for photon IMRT. Hence, protons should ideally be employed for anatomic sites and tumors not well treated with photons. While protons appear cost-effective for pediatric tumors, their cost-effectiveness for treatment of some adult tumors, such as prostate cancer, is uncertain. Comparative studies have been proposed or are in progress to more rigorously assess their value for a variety of sites. The utility of proton therapy will be enhanced by technological developments that reduce its cost. Combinations of 3D protons with IMRT photons may offer improved treatment plans at lower cost than pure proton plans. Hypofractionation with proton therapy appears to be safe and cost-effective for many tumor sites, such as for selected liver, lung and pancreas cancers, and may yield significant reduction in the cost of a therapy course. Together, these offer practical strategies for expanding the clinical availability of proton therapy. Copyright © 2011 S. Karger AG, Basel.

SU-F-T-352: Development of a Knowledge Based Automatic Lung IMRT Planning Algorithm with Non-Coplanar Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, W; Wu, Q; Yuan, L

Purpose: To improve the robustness of a knowledge based automatic lung IMRT planning method and to further validate the reliability of this algorithm by utilizing for the planning of clinical cases with non-coplanar beams. Methods: A lung IMRT planning method which automatically determines both plan optimization objectives and beam configurations with non-coplanar beams has been reported previously. A beam efficiency index map is constructed to guide beam angle selection in this algorithm. This index takes into account both the dose contributions from individual beams and the combined effect of multiple beams which is represented by a beam separation score. Wemore » studied the effect of this beam separation score on plan quality and determined the optimal weight for this score.14 clinical plans were re-planned with the knowledge-based algorithm. Significant dosimetric metrics for the PTV and OARs in the automatic plans are compared with those in the clinical plans by the two-sample t-test. In addition, a composite dosimetric quality index was defined to obtain the relationship between the plan quality and the beam separation score. Results: On average, we observed more than 15% reduction on conformity index and homogeneity index for PTV and V{sub 40}, V{sub 60} for heart while an 8% and 3% increase on V{sub 5}, V{sub 20} for lungs, respectively. The variation curve of the composite index as a function of angle spread score shows that 0.6 is the best value for the weight of the beam separation score. Conclusion: Optimal value for beam angle spread score in automatic lung IMRT planning is obtained. With this value, model can result in statistically the “best” achievable plans. This method can potentially improve the quality and planning efficiency for IMRT plans with no-coplanar angles.« less

Lithium formate EPR dosimetry for verifications of planned dose distributions prior to intensity-modulated radiation therapy.

PubMed

Gustafsson, H; Lund, E; Olsson, S

2008-09-07

The objective of the present investigation was to evaluate lithium formate electron paramagnetic resonance (EPR) dosimetry for measurement of dose distributions in phantoms prior to intensity-modulated radiation therapy (IMRT). Lithium formate monohydrate tablets were carefully prepared, and blind tests were performed in clinically relevant situations in order to determine the precision and accuracy of the method. Further experiments confirmed that within the accuracy of the current method, the dosimeter response was independent of beam energies and dose rates used for IMRT treatments. The method was applied to IMRT treatment plans, and the dose determinations were compared to ionization chamber measurements. The experiments showed that absorbed doses above 3 Gy could be measured with an uncertainty of less than 2.5% of the dose (coverage factor kappa = 1.96). Measurement time was about 15 min using a well-calibrated dosimeter batch. The conclusion drawn from the investigation was that lithium formate EPR dosimetry is a promising new tool for absorbed dose measurements in external beam radiation therapy, especially for doses above 3 Gy.

Lithium formate EPR dosimetry for verifications of planned dose distributions prior to intensity-modulated radiation therapy

NASA Astrophysics Data System (ADS)

Gustafsson, H.; Lund, E.; Olsson, S.

2008-09-01

The objective of the present investigation was to evaluate lithium formate electron paramagnetic resonance (EPR) dosimetry for measurement of dose distributions in phantoms prior to intensity-modulated radiation therapy (IMRT). Lithium formate monohydrate tablets were carefully prepared, and blind tests were performed in clinically relevant situations in order to determine the precision and accuracy of the method. Further experiments confirmed that within the accuracy of the current method, the dosimeter response was independent of beam energies and dose rates used for IMRT treatments. The method was applied to IMRT treatment plans, and the dose determinations were compared to ionization chamber measurements. The experiments showed that absorbed doses above 3 Gy could be measured with an uncertainty of less than 2.5% of the dose (coverage factor k = 1.96). Measurement time was about 15 min using a well-calibrated dosimeter batch. The conclusion drawn from the investigation was that lithium formate EPR dosimetry is a promising new tool for absorbed dose measurements in external beam radiation therapy, especially for doses above 3 Gy.

SU-E-T-618: Dosimetric Comparison of Manual and Beam Angle Optimization of Gantry Angles in IMRT for Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, X; Sun, T; Liu, T

2014-06-01

Purpose: To evaluate the dosimetric characteristics of intensity-modulated radiotherapy (IMRT) treatment plan with beam angle optimization. Methods: Ten post-operation patients with cervical cancer were included in this analysis. Two IMRT plans using seven beams were designed in each patient. A standard coplanar equi-space beam angles were used in the first plan (plan 1), whereas the selection of beam angle was optimized by beam angle optimization algorithm in Varian Eclipse treatment planning system for the same number of beams in the second plan (plan 2). Two plans were designed for each patient with the same dose-volume constraints and prescription dose. Allmore » plans were normalized to the mean dose to PTV. The dose distribution in the target, the dose to the organs at risk and total MU were compared. Results: For conformity and homogeneity in PTV, no statistically differences were observed in the two plans. For the mean dose in bladder, plan 2 were significantly lower than plan 1(p<0.05). No statistically significant differences were observed between two plans for the mean doses in rectum, left and right femur heads. Compared with plan1, the average monitor units reduced 16% in plan 2. Conclusion: The IMRT plan based on beam angle optimization for cervical cancer could reduce the dose delivered to bladder and also reduce MU. Therefore there were some dosimetric advantages in the IMRT plan with beam angle optimization for cervical cancer.« less

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

PubMed

Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Santanam, Lakshmi; Blodgett, Kurt; Curran, Bruce H; Engelsman, Martijn; Feng, Wenzheng; Mechalakos, Jim; Pavord, Dan; Simon, Tom; Sutlieff, Steven; Zhu, X Ronald

2010-12-04

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.

Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis

PubMed Central

2009-01-01

Summary Background Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. Methods Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40–46 Gy in 20–25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). Findings After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1·05 (95% CI 0·75–1·48; p=0·77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1·04; 95% CI 0·84–1·29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years was 6·1%. Interpretation Adjuvant external beam radiotherapy cannot be recommended as part of routine treatment for women with intermediate-risk or high-risk early-stage endometrial cancer with the aim of improving survival. The absolute benefit of external beam radiotherapy in preventing isolated local recurrence is small and is not without toxicity. Funding Medical Research Council, National Cancer Research Network, National Cancer Institute of Canada, with funds from the Canadian Cancer Society. PMID:19070891

Development of an external beam nuclear microprobe on the Aglae facility of the Louvre museum

NASA Astrophysics Data System (ADS)

Calligaro, T.; Dran, J.-C.; Ioannidou, E.; Moignard, B.; Pichon, L.; Salomon, J.

2000-03-01

The external beam line of our facility has been recently equipped with the focusing system previously mounted on a classical nuclear microprobe. When using a 0.1 μm thick Si 3N 4 foil for the exit window and flowing helium on the sample under analysis, a beam spot as small as 10 μm is attainable at a distance of 3 mm from the window. Elemental micromapping is performed by mechanical scanning. An electronic device has been designed which allows XY scanning by moving the sample under the beam by steps down to 0.1 μm. Beam monitoring is carried out by means of the weak X-ray signal emitted by the exit foil and detected by a specially designed Si(Li) detector cooled by Peltier effect. The characteristics of external beams of protons and alpha particles are evaluated by means of resonance scanning and elemental mapping of a grid. An example of application is presented, dealing with elemental micro-mapping of inclusions in gemstones.

Urethra sparing - potential of combined Nickel-Titanium stent and intensity modulated radiation therapy in prostate cancer.

PubMed

Thomsen, Jakob Borup; Arp, Dennis Tideman; Carl, Jesper

2012-05-01

To investigate a novel method for sparing urethra in external beam radiotherapy of prostate cancer and to evaluate the efficacy of such a treatment in terms of tumour control using a mathematical model. This theoretical study includes 20 patients previously treated for prostate cancer using external beam radiotherapy. All patients had a Nickel-Titanium (Ni-Ti) stent inserted into the prostate part of urethra. The stent has been used during the treatment course as an internal marker for patient positioning prior to treatment. In this study the stent is used for delineating urethra while intensity modulated radiotherapy was used for lowering dose to urethra. Evaluation of the dose plans were performed using a tumour control probability model based on the concept of uniform equivalent dose. The feasibility of the urethra dose reduction method is validated and a reduction of about 17% is shown to be possible. Calculations suggest a nearly preserved tumour control probability. A new concept for urethra dose reduction is presented. The method relies on the use of a Ni-Ti stent as a fiducial marker combined with intensity modulated radiotherapy. Theoretical calculations suggest preserved tumour control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

In regard to "Tran A, Zhang J, Woods K, Yu V, Nguyen D, Gustafson G, Rosen L, Sheng K. Treatment planning comparison of IMPT, VMAT and 4π radiotherapy for prostate cases. Radiation oncology. 2017 Jan 11; 12(1):10".

PubMed

Sarkar, Biplab

2018-04-12

This article describe the three dimensional geometrical incompetency of the term "4π radiotherapy"; frequently used in radiation oncology to establish the superiority (or rather complexity) of particular kind of external beam delivery technique. It was claimed by several researchers, to obtain 4π c solid angle at target centre created by the tele-therapy delivery machine in three dimensional Euclidian space. However with the present design of linear accelerator (or any other tele-therapy machine) it is not possible to achieve more than 2π c with the allowed boundary condition of 0 ≤ Gnatry position≤π c and [Formula: see text]≤Couch Position≤[Formula: see text] .This article describes why it is not possible to achieve a 4π c solid angle at any point in three dimensional Euclidian spaces. This article also recommends not to use the terminology "4π radiotherapy" for describing any external beam technique or its complexity as this term is geometrically wrong.

Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donovan, E. M.; James, H.; Bonora, M.

2012-10-15

Purpose: To compare organ specific cancer incidence risks for standard and complex external beam radiotherapy (including cone beam CT verification) following breast conservation surgery for early breast cancer.Method: Doses from breast radiotherapy and kilovoltage cone beam CT (CBCT) exposures were obtained from thermoluminescent dosimeter measurements in an anthropomorphic phantom in which the positions of radiosensitive organs were delineated. Five treatment deliveries were investigated: (i) conventional tangential field whole breast radiotherapy (WBRT), (ii) noncoplanar conformal delivery applicable to accelerated partial beast irradiation (APBI), (iii) two-volume simultaneous integrated boost (SIB) treatment, (iv) forward planned three-volume SIB, and (v) inverse-planned three volume SIB.more » Conformal and intensity modulated radiotherapy methods were used to plan the complex treatments. Techniques spanned the range from simple methods appropriate for patient cohorts with a low cancer recurrence risk to complex plans relevant to cohorts with high recurrence risk. Delineated organs at risk included brain, salivary glands, thyroid, contralateral breast, left and right lung, esophagus, stomach, liver, colon, and bladder. Biological Effects of Ionizing Radiation (BEIR) VII cancer incidence models were applied to the measured mean organ doses to determine lifetime attributable risk (LAR) for ages at exposure from 35 to 80 yr according to radiotherapy techniques, and included dose from the CBCT imaging. Results: All LAR decreased with age at exposure and were lowest for brain, thyroid, liver, and bladder (<0.1%). There was little dependence of LAR on radiotherapy technique for these organs and for colon and stomach. LAR values for the lungs for the three SIB techniques were two to three times those from WBRT and APBI. Uncertainties in the LAR models outweigh any differences in lung LAR between the SIB methods. Constraints in the planning of the SIB methods ensured that contralateral breast doses and LAR were comparable to WBRT, despite their added complexity. The smaller irradiated volume of the ABPI plan contributed to a halving of LAR for contralateral breast compared with the other plan types. Daily image guided radiotherapy (IGRT) for a left breast protocol using kilovoltage CBCT contributed <10% to LAR for the majority of organs, and did not exceed 22% of total organ dose. Conclusions: Phantom measurements and calculations of LAR from the BEIR VII models predict that complex breast radiotherapy techniques do not increase the theoretical risk of second cancer incidence for organs distant from the treated breast, or the contralateral breast where appropriate plan constraints are applied. Complex SIB treatments are predicted to increase the risk of second cancer incidence in the lungs compared to standard whole breast radiotherapy; this is outweighed by the threefold reduction in 5 yr local recurrence risk for patients of high risk of recurrence, and young age, from the use of radiotherapy. APBI may have a favorable impact on risk of second cancer in the contralateral breast and lung for older patients at low risk of recurrence. Intensive use of IGRTincreased the estimated values of LAR but these are dominated by the effect of the dose from the radiotherapy, and any increase in LAR from IGRT is much lower than the models' uncertainties.« less

Noncoplanar Beam Angle Class Solutions to Replace Time-Consuming Patient-Specific Beam Angle Optimization in Robotic Prostate Stereotactic Body Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rossi, Linda, E-mail: l.rossi@erasmusmc.nl; Breedveld, Sebastiaan; Aluwini, Shafak

Purpose: To investigate development of a recipe for the creation of a beam angle class solution (CS) for noncoplanar prostate stereotactic body radiation therapy to replace time-consuming individualized beam angle selection (iBAS) without significant loss in plan quality, using the in-house “Erasmus-iCycle” optimizer for fully automated beam profile optimization and iBAS. Methods and Materials: For 30 patients, Erasmus-iCycle was first used to generate 15-, 20-, and 25-beam iBAS plans for a CyberKnife equipped with a multileaf collimator. With these plans, 6 recipes for creation of beam angle CSs were investigated. Plans of 10 patients were used to create CSs based on themore » recipes, and the other 20 to independently test them. For these tests, Erasmus-iCycle was also used to generate intensity modulated radiation therapy plans for the fixed CS beam setups. Results: Of the tested recipes for CS creation, only 1 resulted in 15-, 20-, and 25-beam noncoplanar CSs without plan deterioration compared with iBAS. For the patient group, mean differences in rectum D{sub 1cc}, V{sub 60GyEq}, V{sub 40GyEq}, and D{sub mean} between 25-beam CS plans and 25-beam plans generated with iBAS were 0.2 ± 0.4 Gy, 0.1% ± 0.2%, 0.2% ± 0.3%, and 0.1 ± 0.2 Gy, respectively. Differences between 15- and 20-beam CS and iBAS plans were also negligible. Plan quality for CS plans relative to iBAS plans was also preserved when narrower planning target volume margins were arranged and when planning target volume dose inhomogeneity was decreased. Using a CS instead of iBAS reduced the computation time by a factor of 14 to 25, mainly depending on beam number, without loss in plan quality. Conclusions: A recipe for creation of robust beam angle CSs for robotic prostate stereotactic body radiation therapy has been developed. Compared with iBAS, computation times decreased by a factor 14 to 25. The use of a CS may avoid long planning times without losses in plan quality.« less

Scaling the spectral beam combining channel by multiple diode laser stacks in an external cavity

NASA Astrophysics Data System (ADS)

Meng, Huicheng; Ruan, Xu; Du, Weichuan; Wang, Zhao; Lei, Fuchuan; Yu, Junhong; Tan, Hao

2017-04-01

Spectral beam combining of a broad area diode laser is a promising technique for direct diode laser applications. We present an experimental study of three mini-bar stacks in an external cavity on spectral beam combining in conjunction with spatial beam combining. At the pump current of 70 A, a CW output power of 579 W, spectral bandwidth of 18.8 nm and electro-optical conversion efficiency of 47% are achieved. The measured M 2 values of spectral beam combining are 18.4 and 14.7 for the fast and the slow axis, respectively. The brightness of the spectral beam combining output is 232 MW · cm-2 · sr-1.

Endobiliary Stent Position Changes during External-beam Radiotherapy

PubMed Central

Chu, Kwun-Ye; Eccles, Cynthia L.; Brunner, Thomas B.

2015-01-01

Purpose Endobiliary stents can be used as surrogates for pancreatic localization when using cone-beam computed tomography (CBCT) during external-beam radiotherapy (EBRT). This work reports on interfraction stent position changes during EBRT for locally advanced pancreatic cancer (LAPC). Materials and Methods Six patients with endobiliary stents who underwent EBRT for LAPC were assessed. Measurements from the most superior aspect of the stent (sup stent) and the most inferior aspect of the stent (inf stent) to the most inferior, posterior aspect of the L1 vertebra central spinous process were determined from daily treatment CBCTs and compared with those determined from the planning computed tomography (CT) scan. Changes in stent-L1 measurements were interpreted as changes in relative stent position. Results Three patients showed mean interfraction stent position changes of ≥1 cm when treatment measurements were compared with planning measurements. The sup stent for patient A moved to the right (2.66 ± 2.77 cm) and inferiorly (3.0 ± 3.12 cm), and the inf stent moved to the right (1.92 ± 2.02 cm) inferiorly (3.23 ± 3.34 cm) and posteriorly (1.41 ± 1.43 cm). The inf stent for patient B moved superiorly (2.23 ± 0.49 cm) and posteriorly (1.72 ± 0.59 cm). The sup and inf stent for patient F moved inferiorly (0.98 ± 0.35 cm and 1.21 ± 0.38 cm, respectively). The remaining three patients C, D, and E showed interfraction position changes of <1 cm. Conclusion Endobiliary stent migration and deformation were observed in a small subset of patients. Further investigation is required before confirming their use as surrogates for LAPC target localization during image-guided EBRT. PMID:26090069

Postoperative irradiation of carcinoma of the head of the pancreas area: Short-time tolerance and results to precision high-dose technique in 18 patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, T.D.; Bugat, R.; Combes, P.F.

1982-07-01

During the period from January 1977-August 1979, 18 patients with biopsy-proven pancreas duct or ampullary adenocarcinoma with no distant or liver metastases underwent external beam radiation therapy following laparotomy. With the use of a 25 MEV photon beam and a four field ''box'' technique, the dose delivered to the target volume identified with radio-opaque clips at laparotomy was 6000 rad in six weeks, while largely sparing the spinal cord, kidney, liver and gut. All patients subjected to low fat, gluten free diet completed treatment as planned without any acute reaction. Three patients developed delayed pancreatic insufficiency. According to actuarial survivalmore » analysis and low morbidity such an approach may lead to increased survival in patients with pancreatic cancer.« less

Current and prospective safety issues at the HFBR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tichler, P.R.

The Brookhaven High Flux Beam Reactor (HFBR) was designed primarily to produce external neutron beams for experimental research. It is cooled, moderated and reflected by heavy water and uses MTR-ETR type fuel elements containing enriched uranium. The reactor power when operation began in 19965 was 40 MW, was raised to 60 MW in 1982 after a number of plant modifications, and operated at that level until 1989. Since that time safety questions have been raised which resulted in extended shutdowns and a reduction in operating power to 30 MW. This paper will discuss the principle safety issues, plans for theirmore » resolution and return to 60 MW operation. In addition, radiation embrittlement of the reactor vessel and thermal shield and its affect on the life of the facility will be briefly discussed.« less

Current and prospective safety issues at the HFBR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tichler, P.R.

The Brookhaven high-flux beam reactor (HFBR) was designed primarily to produce external neutron beams for experimental research. It is cooled, moderated, and reflected by heavy water and uses materials test reactor and engineering test reactor type of fuel elements containing enriched uranium. The reactor power when operation began in 1965 was 40 MW, was raised to 60 MW in 1982 after a number of plant modifications, and operated at that level until 1989. Since that time, safety questions have been raised that resulted in extended shutdowns and a reduction in operating power to 30 MW. This paper discusses the principalmore » safety issues and plans for their resolution and return to 60-MW operation. In addition, radiation embrittlement of the reactor vessel and thermal shield and its effect on the life of the facility are briefly discussed.« less

What to Know about External Beam Radiation Therapy

MedlinePlus

... Radiation Therapy: What To Know About External Beam Radiation Therapy Before treatment starts: You will meet with a doctor or ... and show the therapist where to aim the radiation. When you go for treatment: ■ Don’t have powder, deodorant, Band-Aids ® , or ...

Electro-optic harmonic conversion to switch a laser beam out of a cavity

DOEpatents

Haas, Roger A.; Henesian, Mark A.

1987-01-01

The invention is a switch to permit a laser beam to escape a laser cavity through the use of an externally applied electric field across a harmonic conversion crystal. Amplification takes place in the laser cavity, and then the laser beam is switched out by the laser light being harmonically converted with dichroic or polarization sensitive elements present to alter the optical path of the harmonically converted laser light. Modulation of the laser beam can also be accomplished by varying the external electric field.

The Patient Burden of Bladder Outlet Obstruction after Prostate Cancer Treatment.

PubMed

Liberman, Daniel; Jarosek, Stephanie; Virnig, Beth A; Chu, Haitao; Elliott, Sean P

2016-05-01

Bladder outlet obstruction after prostate cancer therapy imposes a significant burden on health and quality of life in men. Our objective was to describe the burden of bladder outlet obstruction after prostate cancer therapy by detailing the type of procedures performed and how often those procedures were repeated in men with recurrent bladder outlet obstruction. Using SEER (Surveillance, Epidemiology and End Results)-Medicare linked data from 1992 to 2007 with followup through 2009 we identified 12,676 men who underwent at least 1 bladder outlet obstruction procedure after prostate cancer therapy, including external beam radiotherapy in 3,994, brachytherapy in 1,485, brachytherapy plus external beam radiotherapy in 1,847, radical prostatectomy in 4,736, radical prostatectomy plus external beam radiotherapy in 369 and cryotherapy in 245. Histogram, incidence rates and Cox proportional hazards models with repeat events analysis were done to describe the burden of repeat bladder outlet obstruction treatments stratified by prostate cancer therapy type. We describe the type of bladder outlet obstruction surgery grouped by level of invasiveness. At a median followup of 8.8 years 44.6% of men underwent 2 or more bladder outlet obstruction procedures. Compared to men who underwent radical prostatectomy those treated with brachytherapy and brachytherapy plus external beam radiotherapy were at increased adjusted risk for repeat bladder outlet obstruction treatment (HR 1.2 and 1.32, respectively, each p <0.05). After stricture incision the men treated with radical prostatectomy or radical prostatectomy plus external beam radiotherapy were most likely to undergo dilation at a rate of 34.7% to 35.0%. Stricture resection/ablation was more common after brachytherapy, external beam radiotherapy or brachytherapy plus external beam radiotherapy at a rate of 28.9% to 41.2%. Almost half of the men with bladder outlet obstruction after prostate cancer therapy undergo more than 1 procedure. Furthermore men with bladder outlet obstruction after radiotherapy undergo more invasive endoscopic therapies and are at higher risk for multiple treatments than men with bladder outlet obstruction after radical prostatectomy. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Beam profiles measured with thermoluminescent dosimeters

NASA Technical Reports Server (NTRS)

Lucks, H.; Marcowitz, S. M.; Wheeler, R. W.

1969-01-01

Beam profilometer, using thermoluminescent dosimeters, gives a quantitative and qualitative representation of the focus of an external protron beam of a synchrotron. The total number of particles in the beam, particle distribution, and the shape of the beam are determined.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Noel, Camille E.; Gutti, VeeraRajesh; Bosch, Walter

Purpose: To quantify the potential impact of the Integrating the Healthcare Enterprise–Radiation Oncology Quality Assurance with Plan Veto (QAPV) on patient safety of external beam radiation therapy (RT) operations. Methods and Materials: An institutional database of events (errors and near-misses) was used to evaluate the ability of QAPV to prevent clinically observed events. We analyzed reported events that were related to Digital Imaging and Communications in Medicine RT plan parameter inconsistencies between the intended treatment (on the treatment planning system) and the delivered treatment (on the treatment machine). Critical Digital Imaging and Communications in Medicine RT plan parameters were identified.more » Each event was scored for importance using the Failure Mode and Effects Analysis methodology. Potential error occurrence (frequency) was derived according to the collected event data, along with the potential event severity, and the probability of detection with and without the theoretical implementation of the QAPV plan comparison check. Failure Mode and Effects Analysis Risk Priority Numbers (RPNs) with and without QAPV were compared to quantify the potential benefit of clinical implementation of QAPV. Results: The implementation of QAPV could reduce the RPN values for 15 of 22 (71%) of evaluated parameters, with an overall average reduction in RPN of 68 (range, 0-216). For the 6 high-risk parameters (>200), the average reduction in RPN value was 163 (range, 108-216). The RPN value reduction for the intermediate-risk (200 > RPN > 100) parameters was (0-140). With QAPV, the largest RPN value for “Beam Meterset” was reduced from 324 to 108. The maximum reduction in RPN value was for Beam Meterset (216, 66.7%), whereas the maximum percentage reduction was for Cumulative Meterset Weight (80, 88.9%). Conclusion: This analysis quantifies the value of the Integrating the Healthcare Enterprise–Radiation Oncology QAPV implementation in clinical workflow. We demonstrate that although QAPV does not provide a comprehensive solution for error prevention in RT, it can have a significant impact on a subset of the most severe clinically observed events.« less

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

PubMed

Parodi, Katia

2015-12-01

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oborn, B; Ge, Y; Hardcastle, N

Purpose: To report on significant dose enhancement effects caused by magnetic fields aligned parallel to 6MV photon beam radiotherapy of small lung tumors. Findings are applicable to future inline MRI-guided radiotherapy systems. Methods: 9 clinical lung plans were recalculated using Monte Carlo methods and external inline (parallel to the beam direction) magnetic fields of 0.5 T, 1.0 T and 3 T were included. Three plans were 6MV 3D-CRT and six were 6MV IMRT. The GTV’s ranged from 0.8 cc to 73 cc, while the PTV ranged from 1 cc to 180 cc. Results: The inline magnetic field has a moderatemore » impact in lung dose distributions by reducing the lateral scatter of secondary electrons and causing a small local dose increase. Superposition of multiple small beams acts to superimpose the small dose increases and can lead to significant dose enhancements, especially when the GTV is low density. Two plans with very small, low mean density GTV’s (<1 cc, ρ(mean)<0.35g/cc) showed uniform increases of 16% and 23% at 1 T throughout the PTV. Three plans with moderate mean density PTV’s (3–13 cc, ρ(mean)=0.58–0.67 g/cc) showed 6% mean dose enhancement at 1 T in the PTV, however not uniform throughout the GTV/PTV. Replanning would benefit these cases. The remaining 5 plans had large dense GTV’s (∼ 1 g/cc) and so only a minimal (<2%) enhancement was seen. In general the mean dose enhancement at 0.5 T was 60% less than 1 T, while 5–50% higher at 3 T. Conclusions: A paradigm shift in the efficacy of small lung tumor radiotherapy is predicted with future inline MRI-linac systems. This will be achieved by carefully taking advantage of the reduction of lateral electronic disequilibrium withing lung tissue that is induced naturally inside strong inline magnetic fields.« less

Biological effective dose for comparison and combination of external beam and low-dose rate interstitial brachytherapy prostate cancer treatment plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jani, Ashesh B.; Hand, Christopher M.; Lujan, Anthony E.

2004-03-31

We report a methodology for comparing and combining dose information from external beam radiotherapy (EBRT) and interstitial brachytherapy (IB) components of prostate cancer treatment using the biological effective dose (BED). On a prototype early-stage prostate cancer patient treated with EBRT and low-dose rate I-125 brachytherapy, a 3-dimensional dose distribution was calculated for each of the EBRT and IB portions of treatment. For each component of treatment, the BED was calculated on a point-by-point basis to produce a BED distribution. These individual BED distributions could then be summed for combined therapies. BED dose-volume histograms (DVHs) of the prostate, urethra, rectum, andmore » bladder were produced and compared for various combinations of EBRT and IB. Transformation to BED enabled computation of the relative contribution of each modality to the prostate dose, as the relative weighting of EBRT and IB was varied. The BED-DVHs of the prostate and urethra demonstrated dramatically increased inhomogeneity with the introduction of even a small component of IB. However, increasing the IB portion relative to the EBRT component resulted in lower dose to the surrounding normal structures, as evidenced by the BED-DVHs of the bladder and rectum. Conformal EBRT and low-dose rate IB conventional dose distributions were successfully transformed to the common 'language' of BED distributions for comparison and for merging prostate cancer radiation treatment plans. The results of this analysis can assist physicians in quantitatively determining the best combination and weighting of radiation treatment modalities for individual patients.« less

Variation in Adherence to External Beam Radiotherapy Quality Measures Among Elderly Men With Localized Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bekelman, Justin E.; Zelefsky, Michael J.; Jang, Thomas L.

2007-12-01

Purpose: To characterize the variation in adherence to quality measures of external beam radiotherapy (EBRT) for localized prostate cancer and its relation to patient and provider characteristics in a population-based, representative sample of U.S. men. Methods and Materials: We evaluated EBRT quality measures proposed by a RAND expert panel of physicians among men aged {>=}65 years diagnosed between 2000 and 2002 with localized prostate cancer and treated with primary EBRT using data from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare program. We assessed the adherence to five EBRT quality measures that were amenable to analysis using SEER-Medicare data: (1)more » use of conformal RT planning; (2) use of high-energy (>10-MV) photons; (3) use of custom immobilization; (4) completion of two follow-up visits with a radiation oncologist in the year after therapy; and (5) radiation oncologist board certification. Results: Of the 11,674 patients, 85% had received conformal RT planning, 75% had received high-energy photons, and 97% had received custom immobilization. One-third of patients had completed two follow-up visits with a radiation oncologist, although 91% had at least one visit with a urologist or radiation oncologist. Most patients (85%) had been treated by a board-certified radiation oncologist. Conclusions: The overall high adherence to EBRT quality measures masked substantial variation in geography, socioeconomic status in the area of residence, and teaching affiliation of the RT facility. Future research should examine the reasons for the variations in these measures and whether the variation is associated with important clinical outcomes.« less

[Description of latest generation equipment in external radiotherapy].

PubMed

Pellejero, S; Lozares, S; Mañeru, F

2009-01-01

Both the planning systems and the form of administering radiotherapy have changed radically since the introduction of 3D planning. At present treatment planning based on computerised axial tomography (CAT) images is standard practice in radiotherapy services. In recent years lineal accelerators for medical use have incorporated technology capable of administering intensity modulated radiation beams (IMRT). With this mode distributions of conformed doses are generated that adjust to the three dimensional form of the white volume, providing appropriate coverage and a lower dose to nearby risk organs. The use of IMRT is rapidly spreading amongst radiotherapy centres throughout the world. This growing use of IMRT has focused attention on the need for greater control of the geometric uncertainties in positioning the patient and control of internal movements. To this end, both flat and volumetric image systems have been incorporated into the treatment equipment, making image-guided radiotherapy (IGRT) possible. This article offers a brief description of the latest advances included in the planning and administration of radiotherapy treatment.

Fast wavelength tuning techniques for external cavity lasers

DOEpatents

Wysocki, Gerard [Princeton, NJ; Tittel, Frank K [Houston, TX

2011-01-11

An apparatus comprising a laser source configured to emit a light beam along a first path, an optical beam steering component configured to steer the light beam from the first path to a second path at an angle to the first path, and a diffraction grating configured to reflect back at least a portion of the light beam along the second path, wherein the angle determines an external cavity length. Included is an apparatus comprising a laser source configured to emit a light beam along a first path, a beam steering component configured to redirect the light beam to a second path at an angle to the first path, wherein the optical beam steering component is configured to change the angle at a rate of at least about one Kilohertz, and a diffraction grating configured to reflect back at least a portion of the light beam along the second path.

External beam pixe programs at the University of California, Davis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eldred, R.A.

A PIXE system in which large or delicate samples are excited by a low-current external proton beam is described. This system has been used to analyze historical printed books and manuscripts, as well as a large variety of archeological artifacts. The steps used to protect the sample from unnecessary beam current are examined. A recent thorough study of the first volume of the Gutenberg 42-line Bible is described in some detail.

The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant glioma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsao, May N.; Mehta, Minesh P.; Whelan, Timothy J.

2005-09-01

Purpose: To systematically review the evidence for the use of stereotactic radiosurgery or stereotactic fractionated radiation therapy in adult patients with malignant glioma. Methods: Key clinical questions to be addressed in this evidence-based review were identified. Outcomes considered were overall survival, quality of life or symptom control, brain tumor control or response and toxicity. MEDLINE (1990-2004 June Week 2), CANCERLIT (1990-2003), CINAHL (1990-2004 June Week 2), EMBASE (1990-2004 Week 25), and the Cochrane library (2004 issue 2) databases were searched using OVID. In addition, the Physician Data Query clinical trials database, the proceedings of the American Society of Clinical Oncologymore » (1997-2004), ASTRO (1997-2004), and the European Society of Therapeutic Radiology and Oncology (ESTRO) (1997-2003) were searched. Data from the literature search were reviewed and tabulated. This process included an assessment of the level of evidence. Results: For patients with newly diagnosed malignant glioma, radiosurgery as boost therapy with conventional external beam radiation was examined in one randomized trial, five prospective cohort studies, and seven retrospective series. There is Level I evidence that the use of radiosurgery boost followed by external beam radiotherapy and carmustine (BCNU) does not confer benefit with respect to overall survival, quality of life, or patterns of failure as compared with external beam radiotherapy and BCNU. There is Level I-III evidence of toxicity associated with radiosurgery boost as compared with external beam radiotherapy alone. The results of the prospective and retrospective studies may be influenced by selection bias. Radiosurgery used as salvage for recurrent or progressive malignant glioma after conventional external beam radiotherapy failure was reported in zero randomized trials, three prospective cohort studies, and five retrospective series. The available data are sparse and insufficient to make absolute recommendations. Stereotactic fractionated radiation therapy has been reported as boost therapy with external beam radiotherapy for patients with newly diagnosed malignant glioma in only three prospective studies. As primary therapy alone without conventional external beam radiotherapy for newly diagnosed malignant glioma patients, stereotactic fractionated radiation therapy has been reported in only one prospective study. There were only three prospective series and two retrospective studies reported for patients with recurrent or progressive malignant glioma. Conclusions: For patients with malignant glioma, there is Level I-III evidence that the use of radiosurgery boost followed by external beam radiotherapy and BCNU does not confer benefit in terms of overall survival, local brain control, or quality of life as compared with external beam radiotherapy and BCNU. The use of radiosurgery boost is associated with increased toxicity. For patients with malignant glioma, there is insufficient evidence regarding the benefits/harms of using radiosurgery at the time progression or recurrence. There is also insufficient evidence regarding the benefits/harms in the use of stereotactic fractionated radiation therapy for patients with newly diagnosed or progressive/recurrent malignant glioma.« less

Cloud-based design of high average power traveling wave linacs

NASA Astrophysics Data System (ADS)

Kutsaev, S. V.; Eidelman, Y.; Bruhwiler, D. L.; Moeller, P.; Nagler, R.; Barbe Welzel, J.

2017-12-01

The design of industrial high average power traveling wave linacs must accurately consider some specific effects. For example, acceleration of high current beam reduces power flow in the accelerating waveguide. Space charge may influence the stability of longitudinal or transverse beam dynamics. Accurate treatment of beam loading is central to the design of high-power TW accelerators, and it is especially difficult to model in the meter-scale region where the electrons are nonrelativistic. Currently, there are two types of available codes: tracking codes (e.g. PARMELA or ASTRA) that cannot solve self-consistent problems, and particle-in-cell codes (e.g. Magic 3D or CST Particle Studio) that can model the physics correctly but are very time-consuming and resource-demanding. Hellweg is a special tool for quick and accurate electron dynamics simulation in traveling wave accelerating structures. The underlying theory of this software is based on the differential equations of motion. The effects considered in this code include beam loading, space charge forces, and external magnetic fields. We present the current capabilities of the code, provide benchmarking results, and discuss future plans. We also describe the browser-based GUI for executing Hellweg in the cloud.

Analysis of errors detected in external beam audit dosimetry program at Mexican radiotherapy centers

NASA Astrophysics Data System (ADS)

Álvarez-Romero, José T.; Tovar-Muñoz, Víctor M.

2012-10-01

Presented and analyzed are the causes of deviation observed in the pilot postal dosimetry audit program to verify the absorbed dose to water Dw in external beams of teletherapy 60Co and/or linear accelerators in Mexican radiotherapy centers, during the years 2007-2011.

SU-E-T-153: Burst-Mode Modulated Arc Therapy with Flattening-Filter-Free Beams Versus Flattening-Filtered Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kainz, K; Lawton, C; Li, X

2015-06-15

Purpose: To compare the dosimetry and delivery of burst-mode modulated arc radiotherapy using flattening-filter-free (FFF) and flattening-filtered (FF) beams. Methods: Burst-mode modulated arc therapy (mARC, Siemens) plans were generated for six prostate cases with FFF and FF beam models, using the Elekta Monaco v. 5.00 planning system. One 360-degree arc was used for five cases, and for one case two 360-degree coplanar arcs were used. The maximum number of optimization points (OPs) per arc was set to 91, and OPs with less than 4 MU were disregarded. All plans were delivered on the Siemens Artiste linear accelerator with 6MV FFmore » (300 MU/min) and comparable-energy FFF (2000 MU/min, labeled as 7UF) beams. Results: For all cases studied, the plans with FFF beams exhibited DVHs for the PTV, rectum, and bladder that were nearly identical to those for the plans with FF beams. The FFF plan yielded reduced dose to the right femoral head for 5 cases, and lower mean dose to the left femoral head for 4 cases. For all but the two-arc case, the FFF and FF plans resulted in an identical number of segments. The total number of MUs was slightly lower for the FF plans for five cases. The total delivery time per fraction was substantially lower for the FFF plans, ranging from 25 to 50 percent among all cases, as compared to the FF plans. Conclusion: For mARC plans, FFF and FF beams provided comparable PTV coverage and rectum and bladder sparing. For the femoral heads, the mean dose was slightly lower in most cases when using the FFF beam. Although the flat beam plans typically required slightly fewer MUs, FFF beams required substantially less time to deliver a plan of similar quality. This work was supported by Siemens Medical Solutions and the MCW Cancer Center Fotsch Foundation.« less

SU-E-T-230: Creating a Large Number of Focused Beams with Variable Patient Head Tilt to Improve Dose Fall-Off for Brain Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiu, J; Ma, L

2015-06-15

Purpose: To develop a treatment delivery and planning strategy by increasing the number of beams to minimize dose to brain tissue surrounding a target, while maximizing dose coverage to the target. Methods: We analyzed 14 different treatment plans via Leksell PFX and 4C. For standardization, single tumor cases were chosen. Original treatment plans were compared with two optimized plans. The number of beams was increased in treatment plans by varying tilt angles of the patient head, while maintaining original isocenter and the beam positions in the x-, y- and z-axes, collimator size, and beam blocking. PFX optimized plans increased beammore » numbers with three pre-set tilt angles, 70, 90, 110, and 4C optimized plans increased beam numbers with tilt angles increasing arbitrarily from range of 30 to 150 degrees. Optimized treatment plans were compared dosimetrically with original treatment plans. Results: Comparing total normal tissue isodose volumes between original and optimized plans, the low-level percentage isodose volumes decreased in all plans. Despite the addition of multiple beams up to a factor of 25, beam-on times for 1 tilt angle versus 3 or more tilt angles were comparable (<1 min.). In 64% (9/14) of the studied cases, the volume percentage decrease by >5%, with the highest value reaching 19%. The addition of more tilt angles correlates to a greater decrease in normal brain irradiated volume. Selectivity and coverage for original and optimized plans remained comparable. Conclusion: Adding large number of additional focused beams with variable patient head tilt shows improvement for dose fall-off for brain radiosurgery. The study demonstrates technical feasibility of adding beams to decrease target volume.« less

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators.

PubMed

Constantin, Dragoş E; Fahrig, Rebecca; Keall, Paul J

2011-07-01

Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approach in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29n-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the inline configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72n and 2.01 n-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34n and 0.35n-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field.

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators

PubMed Central

Constantin, Dragoş E.; Fahrig, Rebecca; Keall, Paul J.

2011-01-01

Purpose: Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Methods: Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approach in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. Results: For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29π-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the in-line configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72π and 2.01π-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34π and 0.35π-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. Conclusions: 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field. PMID:21859019

Delivery confirmation of bolus electron conformal therapy combined with intensity modulated x-ray therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kavanaugh, James A.; Hogstrom, Kenneth R.; Fontenot, Jonas P.

2013-02-15

Purpose: The purpose of this study was to demonstrate that a bolus electron conformal therapy (ECT) dose plan and a mixed beam plan, composed of an intensity modulated x-ray therapy (IMXT) dose plan optimized on top of the bolus ECT plan, can be accurately delivered. Methods: Calculated dose distributions were compared with measured dose distributions for parotid and chest wall (CW) bolus ECT and mixed beam plans, each simulated in a cylindrical polystyrene phantom that allowed film dose measurements. Bolus ECT plans were created for both parotid and CW PTVs (planning target volumes) using 20 and 16 MeV beams, respectively,more » whose 90% dose surface conformed to the PTV. Mixed beam plans consisted of an IMXT dose plan optimized on top of the bolus ECT dose plan. The bolus ECT, IMXT, and mixed beam dose distributions were measured using radiographic films in five transverse and one sagittal planes for a total of 36 measurement conditions. Corrections for film dose response, effects of edge-on photon irradiation, and effects of irregular phantom optical properties on the Cerenkov component of the film signal resulted in high precision measurements. Data set consistency was verified by agreement of depth dose at the intersections of the sagittal plane with the five measured transverse planes. For these same depth doses, results for the mixed beam plan agreed with the sum of the individual depth doses for the bolus ECT and IMXT plans. The six mean measured planar dose distributions were compared with those calculated by the treatment planning system for all modalities. Dose agreement was assessed using the 4% dose difference and 0.2 cm distance to agreement. Results: For the combined high-dose region and low-dose region, pass rates for the parotid and CW plans were 98.7% and 96.2%, respectively, for the bolus ECT plans and 97.9% and 97.4%, respectively, for the mixed beam plans. For the high-dose gradient region, pass rates for the parotid and CW plans were 93.1% and 94.62%, respectively, for the bolus ECT plans and 89.2% and 95.1%, respectively, for the mixed beam plans. For all regions, pass rates for the parotid and CW plans were 98.8% and 97.3%, respectively, for the bolus ECT plans and 97.5% and 95.9%, respectively, for the mixed beam plans. For the IMXT component of the mixed beam plans, pass rates for the parotid and CW plans were 93.7% and 95.8%. Conclusions: Bolus ECT and mixed beam therapy dose delivery to the phantom were more accurate than IMXT delivery, adding confidence to the use of planning, fabrication, and delivery for bolus ECT tools either alone or as part of mixed beam therapy. The methodology reported in this work could serve as a basis for future standardization of the commissioning of bolus ECT or mixed beam therapy. When applying this technology to patients, it is recommended that an electron dose algorithm more accurate than the pencil beam algorithm, e.g., a Monte Carlo algorithm or analytical transport such as the pencil beam redefinition algorithm, be used for planning to ensure the desired accuracy.« less

The Electrical Structure of Discharges Modified by Electron Beams

NASA Astrophysics Data System (ADS)

Haas, F. A.; Braithwaite, N. St. J.

1997-10-01

Injection of an electron beam into a low pressure plasma modifies both the electrical structure and the distributions of charged particle energies. The electrical structure is investigated here in a one-dimensional model by representing the discharge as two collisionless sheaths with a monenergetic electron beam, linked by a quasi-neutral collisional region. The latter is modelled by fluid equations in which the beam current decreases with position. Since the electrodes are connected by an external conductor this implies through Kirchoff's laws that the thermal electron current must correspondingly increase with position. Given the boundary conditions and beam input at the first electrode then the rest of the system is uniquely described. The model reveals the dependence of the sheath potentials at the emitting and absorbing surfaces on the beam current. The model is relevant to externally injected beams and to electron beams originating from secondary processes on surfaces exposed to the plasma.

Improvements to the internal and external antenna H(-) ion sources at the Spallation Neutron Source.

PubMed

Welton, R F; Dudnikov, V G; Han, B X; Murray, S N; Pennisi, T R; Pillar, C; Santana, M; Stockli, M P; Turvey, M W

2014-02-01

The Spallation Neutron Source (SNS), a large scale neutron production facility, routinely operates with 30-40 mA peak current in the linac. Recent measurements have shown that our RF-driven internal antenna, Cs-enhanced, multi-cusp ion sources injects ∼55 mA of H(-) beam current (∼1 ms, 60 Hz) at 65-kV into a Radio Frequency Quadrupole (RFQ) accelerator through a closely coupled electrostatic Low-Energy Beam Transport system. Over the last several years a decrease in RFQ transmission and issues with internal antennas has stimulated source development at the SNS both for the internal and external antenna ion sources. This report discusses progress in improving internal antenna reliability, H(-) yield improvements which resulted from modifications to the outlet aperture assembly (applicable to both internal and external antenna sources) and studies made of the long standing problem of beam persistence with the external antenna source. The current status of the external antenna ion source will also be presented.

First experimental-based characterization of oxygen ion beam depth dose distributions at the Heidelberg Ion-Beam Therapy Center

NASA Astrophysics Data System (ADS)

Kurz, C.; Mairani, A.; Parodi, K.

2012-08-01

Over the last decades, the application of proton and heavy-ion beams to external beam radiotherapy has rapidly increased. Due to the favourable lateral and depth dose profile, the superposition of narrow ion pencil beams may enable a highly conformal dose delivery to the tumour, with better sparing of the surrounding healthy tissue in comparison to conventional radiation therapy with photons. To fully exploit the promised clinical advantages of ion beams, an accurate planning of the patient treatments is required. The clinical treatment planning system (TPS) at the Heidelberg Ion-Beam Therapy Center (HIT) is based on a fast performing analytical algorithm for dose calculation, relying, among others, on laterally integrated depth dose distributions (DDDs) simulated with the FLUKA Monte Carlo (MC) code. Important input parameters of these simulations need to be derived from a comparison of the simulated DDDs with measurements. In this work, the first measurements of 16O ion DDDs at HIT are presented with a focus on the determined Bragg peak positions and the understanding of factors influencing the shape of the distributions. The measurements are compared to different simulation approaches aiming to reproduce the acquired data at best. A simplified geometrical model is first used to optimize important input parameters, not known a priori, in the simulations. This method is then compared to a more realistic, but also more time-consuming simulation approach better accounting for the experimental set-up and the measuring process. The results of this work contributed to a pre-clinical oxygen ion beam database, which is currently used by a research TPS for corresponding radio-biological cell experiments. A future extension to a clinical database used by the clinical TPS at HIT is foreseen. As a side effect, the performed investigations showed that the typical water equivalent calibration approach of experimental data acquired with water column systems leads to slight deviations between the experimentally determined and the real Bragg peak positions. For improved accuracy, the energy dependence of the stopping power, and herewith the water equivalent thickness, of the material downstream of the water tank should be considered in the analysis of measured data.

Beam-specific planning volumes for scattered-proton lung radiotherapy

NASA Astrophysics Data System (ADS)

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

2014-08-01

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

A novel probabilistic approach to generating PTV with partial voxel contributions

NASA Astrophysics Data System (ADS)

Tsang, H. S.; Kamerling, C. P.; Ziegenhein, P.; Nill, S.; Oelfke, U.

2017-06-01

Radiotherapy treatment planning for use with high-energy photon beams currently employs a binary approach in defining the planning target volume (PTV). We propose a margin concept that takes the beam directions into account, generating beam-dependent PTVs (bdPTVs) on a beam-by-beam basis. The resulting degree of overlaps between the bdPTVs are used within the optimisation process; the optimiser effectively considers the same voxel to be both target and organ at risk (OAR) with fractional contributions. We investigate the impact of this novel approach when applied to prostate radiotherapy treatments, and compare treatment plans generated using beam dependent margins to conventional margins. Five prostate patients were used in this planning study, and plans using beam dependent margins improved the sparing of high doses to target-surrounding OARs, though a trade-off in delivering additional low dose to the OARs can be observed. Plans using beam dependent margins are observed to have a slightly reduced target coverage. Nevertheless, all plans are able to satisfy 90% population coverage with the target receiving at least 95% of the prescribed dose to D98% .

Generation of synthetic CT using multi-scale and dual-contrast patches for brain MRI-only external beam radiotherapy.

PubMed

Aouadi, Souha; Vasic, Ana; Paloor, Satheesh; Torfeh, Tarraf; McGarry, Maeve; Petric, Primoz; Riyas, Mohamed; Hammoud, Rabih; Al-Hammadi, Noora

2017-10-01

To create a synthetic CT (sCT) from conventional brain MRI using a patch-based method for MRI-only radiotherapy planning and verification. Conventional T1 and T2-weighted MRI and CT datasets from 13 patients who underwent brain radiotherapy were included in a retrospective study whereas 6 patients were tested prospectively. A new contribution to the Non-local Means Patch-Based Method (NMPBM) framework was done with the use of novel multi-scale and dual-contrast patches. Furthermore, the training dataset was improved by pre-selecting the closest database patients to the target patient for computation time/accuracy balance. sCT and derived DRRs were assessed visually and quantitatively. VMAT planning was performed on CT and sCT for hypothetical PTVs in homogeneous and heterogeneous regions. Dosimetric analysis was done by comparing Dose Volume Histogram (DVH) parameters of PTVs and organs at risk (OARs). Positional accuracy of MRI-only image-guided radiation therapy based on CBCT or kV images was evaluated. The retrospective (respectively prospective) evaluation of the proposed Multi-scale and Dual-contrast Patch-Based Method (MDPBM) gave a mean absolute error MAE=99.69±11.07HU (98.95±8.35HU), and a Dice in bones DI bone =83±0.03 (0.82±0.03). Good agreement with conventional planning techniques was obtained; the highest percentage of DVH metric deviations was 0.43% (0.53%) for PTVs and 0.59% (0.75%) for OARs. The accuracy of sCT/CBCT or DRR sCT /kV images registration parameters was <2mm and <2°. Improvements with MDPBM, compared to NMPBM, were significant. We presented a novel method for sCT generation from T1 and T2-weighted MRI potentially suitable for MRI-only external beam radiotherapy in brain sites. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Assessment of uncertainties in radiation-induced cancer risk predictions at clinically relevant doses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nguyen, J.; Moteabbed, M.; Paganetti, H., E-mail: hpaganetti@mgh.harvard.edu

2015-01-15

Purpose: Theoretical dose–response models offer the possibility to assess second cancer induction risks after external beam therapy. The parameters used in these models are determined with limited data from epidemiological studies. Risk estimations are thus associated with considerable uncertainties. This study aims at illustrating uncertainties when predicting the risk for organ-specific second cancers in the primary radiation field illustrated by choosing selected treatment plans for brain cancer patients. Methods: A widely used risk model was considered in this study. The uncertainties of the model parameters were estimated with reported data of second cancer incidences for various organs. Standard error propagationmore » was then subsequently applied to assess the uncertainty in the risk model. Next, second cancer risks of five pediatric patients treated for cancer in the head and neck regions were calculated. For each case, treatment plans for proton and photon therapy were designed to estimate the uncertainties (a) in the lifetime attributable risk (LAR) for a given treatment modality and (b) when comparing risks of two different treatment modalities. Results: Uncertainties in excess of 100% of the risk were found for almost all organs considered. When applied to treatment plans, the calculated LAR values have uncertainties of the same magnitude. A comparison between cancer risks of different treatment modalities, however, does allow statistically significant conclusions. In the studied cases, the patient averaged LAR ratio of proton and photon treatments was 0.35, 0.56, and 0.59 for brain carcinoma, brain sarcoma, and bone sarcoma, respectively. Their corresponding uncertainties were estimated to be potentially below 5%, depending on uncertainties in dosimetry. Conclusions: The uncertainty in the dose–response curve in cancer risk models makes it currently impractical to predict the risk for an individual external beam treatment. On the other hand, the ratio of absolute risks between two modalities is less sensitive to the uncertainties in the risk model and can provide statistically significant estimates.« less

Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction.

PubMed

Giantsoudi, Drosoula; De Man, Bruno; Verburg, Joost; Trofimov, Alexei; Jin, Yannan; Wang, Ge; Gjesteby, Lars; Paganetti, Harald

2017-04-21

A significant and increasing number of patients receiving radiation therapy present with metal objects close to, or even within, the treatment area, resulting in artifacts in computed tomography (CT) imaging, which is the most commonly used imaging method for treatment planning in radiation therapy. In the presence of metal implants, such as dental fillings in treatment of head-and-neck tumors, spinal stabilization implants in spinal or paraspinal treatment or hip replacements in prostate cancer treatments, the extreme photon absorption by the metal object leads to prominent image artifacts. Although current CT scanners include a series of correction steps for beam hardening, scattered radiation and noisy measurements, when metal implants exist within or close to the treatment area, these corrections do not suffice. CT metal artifacts affect negatively the treatment planning of radiation therapy either by causing difficulties to delineate the target volume or by reducing the dose calculation accuracy. Various metal artifact reduction (MAR) methods have been explored in terms of improvement of organ delineation and dose calculation in radiation therapy treatment planning, depending on the type of radiation treatment and location of the metal implant and treatment site. Including a brief description of the available CT MAR methods that have been applied in radiation therapy, this article attempts to provide a comprehensive review on the dosimetric effect of the presence of CT metal artifacts in treatment planning, as reported in the literature, and the potential improvement suggested by different MAR approaches. The impact of artifacts on the treatment planning and delivery accuracy is discussed in the context of different modalities, such as photon external beam, brachytherapy and particle therapy, as well as by type and location of metal implants.

Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction

NASA Astrophysics Data System (ADS)

Giantsoudi, Drosoula; De Man, Bruno; Verburg, Joost; Trofimov, Alexei; Jin, Yannan; Wang, Ge; Gjesteby, Lars; Paganetti, Harald

2017-04-01

A significant and increasing number of patients receiving radiation therapy present with metal objects close to, or even within, the treatment area, resulting in artifacts in computed tomography (CT) imaging, which is the most commonly used imaging method for treatment planning in radiation therapy. In the presence of metal implants, such as dental fillings in treatment of head-and-neck tumors, spinal stabilization implants in spinal or paraspinal treatment or hip replacements in prostate cancer treatments, the extreme photon absorption by the metal object leads to prominent image artifacts. Although current CT scanners include a series of correction steps for beam hardening, scattered radiation and noisy measurements, when metal implants exist within or close to the treatment area, these corrections do not suffice. CT metal artifacts affect negatively the treatment planning of radiation therapy either by causing difficulties to delineate the target volume or by reducing the dose calculation accuracy. Various metal artifact reduction (MAR) methods have been explored in terms of improvement of organ delineation and dose calculation in radiation therapy treatment planning, depending on the type of radiation treatment and location of the metal implant and treatment site. Including a brief description of the available CT MAR methods that have been applied in radiation therapy, this article attempts to provide a comprehensive review on the dosimetric effect of the presence of CT metal artifacts in treatment planning, as reported in the literature, and the potential improvement suggested by different MAR approaches. The impact of artifacts on the treatment planning and delivery accuracy is discussed in the context of different modalities, such as photon external beam, brachytherapy and particle therapy, as well as by type and location of metal implants.

Image guided radiation therapy applications for head and neck, prostate, and breast cancers using 3D ultrasound imaging and Monte Carlo dose calculations

NASA Astrophysics Data System (ADS)

Fraser, Danielle

In radiation therapy an uncertainty in the delivered dose always exists because anatomic changes are unpredictable and patient specific. Image guided radiation therapy (IGRT) relies on imaging in the treatment room to monitor the tumour and surrounding tissue to ensure their prescribed position in the radiation beam. The goal of this thesis was to determine the dosimetric impact on the misaligned radiation therapy target for three cancer sites due to common setup errors; organ motion, tumour tissue deformation, changes in body habitus, and treatment planning errors. For this purpose, a novel 3D ultrasound system (Restitu, Resonant Medical, Inc.) was used to acquire a reference image of the target in the computed tomography simulation room at the time of treatment planning, to acquire daily images in the treatment room at the time of treatment delivery, and to compare the daily images to the reference image. The measured differences in position and volume between daily and reference geometries were incorporated into Monte Carlo (MC) dose calculations. The EGSnrc (National Research Council, Canada) family of codes was used to model Varian linear accelerators and patient specific beam parameters, as well as to estimate the dose to the target and organs at risk under several different scenarios. After validating the necessity of MC dose calculations in the pelvic region, the impact of interfraction prostate motion, and subsequent patient realignment under the treatment beams, on the delivered dose was investigated. For 32 patients it is demonstrated that using 3D conformal radiation therapy techniques and a 7 mm margin, the prescribed dose to the prostate, rectum, and bladder is recovered within 0.5% of that planned when patient setup is corrected for prostate motion, despite the beams interacting with a new external surface and internal tissue boundaries. In collaboration with the manufacturer, the ultrasound system was adapted from transabdominal imaging to neck imaging. Two case studies of nasopharyngeal cancer are discussed. The deformation of disease-positive cervical lymph nodes was monitored throughout treatment. Node volumes shrunk to 17% of the initial volume, moved up 1.3 cm, and received up to a 12% lower dose than that prescribed. It is shown that difficulties in imaging soft tissue in the neck region are circumvented with ultrasound imaging, and after dosimetric verification it is argued that adaptive replanning may be more beneficial than patient realignment when intensity modulated radiation therapy techniques are used. Some of the largest dose delivery errors were found in external electron beam treatments for breast cancer patients who underwent breast conserving surgery. Inaccuracies in conventional treatment planning resulted in substantial target dose discrepancies of up to 88%. When patient setup errors, interfraction tumour bed motion, and tissue remodeling were considered, inadequate target coverage was exacerbated. This thesis quantifies the dose discrepancy between that prescribed and that delivered. I delve into detail for common IGRT treatment sites, and illuminate problems that have not received much attention for less common IGRT treatment sites.

iCycle: Integrated, multicriterial beam angle, and profile optimization for generation of coplanar and noncoplanar IMRT plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Breedveld, Sebastiaan; Storchi, Pascal R. M.; Voet, Peter W. J.

2012-02-15

Purpose: To introduce iCycle, a novel algorithm for integrated, multicriterial optimization of beam angles, and intensity modulated radiotherapy (IMRT) profiles. Methods: A multicriterial plan optimization with iCycle is based on a prescription called wish-list, containing hard constraints and objectives with ascribed priorities. Priorities are ordinal parameters used for relative importance ranking of the objectives. The higher an objective priority is, the higher the probability that the corresponding objective will be met. Beam directions are selected from an input set of candidate directions. Input sets can be restricted, e.g., to allow only generation of coplanar plans, or to avoid collisions betweenmore » patient/couch and the gantry in a noncoplanar setup. Obtaining clinically feasible calculation times was an important design criterium for development of iCycle. This could be realized by sequentially adding beams to the treatment plan in an iterative procedure. Each iteration loop starts with selection of the optimal direction to be added. Then, a Pareto-optimal IMRT plan is generated for the (fixed) beam setup that includes all so far selected directions, using a previously published algorithm for multicriterial optimization of fluence profiles for a fixed beam arrangement Breedveld et al.[Phys. Med. Biol. 54, 7199-7209 (2009)]. To select the next direction, each not yet selected candidate direction is temporarily added to the plan and an optimization problem, derived from the Lagrangian obtained from the just performed optimization for establishing the Pareto-optimal plan, is solved. For each patient, a single one-beam, two-beam, three-beam, etc. Pareto-optimal plan is generated until addition of beams does no longer result in significant plan quality improvement. Plan generation with iCycle is fully automated. Results: Performance and characteristics of iCycle are demonstrated by generating plans for a maxillary sinus case, a cervical cancer patient, and a liver patient treated with SBRT. Plans generated with beam angle optimization did better meet the clinical goals than equiangular or manually selected configurations. For the maxillary sinus and liver cases, significant improvements for noncoplanar setups were seen. The cervix case showed that also in IMRT with coplanar setups, beam angle optimization with iCycle may improve plan quality. Computation times for coplanar plans were around 1-2 h and for noncoplanar plans 4-7 h, depending on the number of beams and the complexity of the site. Conclusions: Integrated beam angle and profile optimization with iCycle may result in significant improvements in treatment plan quality. Due to automation, the plan generation workload is minimal. Clinical application has started.« less

Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck.

PubMed

Yan, M; Lovelock, D; Hunt, M; Mechalakos, J; Hu, Y; Pham, H; Jackson, A

2013-12-01

To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or -0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1-2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39-16.8) cGy, or 10.1 (0.8-32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%-9.06%) and 10.2% (0.7%-63.6%), respectively. Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup, the standard deviation of setup error reduced by 31%, 42%, and 54% in RL, AP, and SI direction, respectively, and consequently, the uncertainty of the mean dose to cochlea reduced more than 50%. The authors estimate that the effects of these uncertainties on the probability of hearing loss for an individual patient could be as large as 10%.

Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck

PubMed Central

Yan, M.; Lovelock, D.; Hunt, M.; Mechalakos, J.; Hu, Y.; Pham, H.; Jackson, A.

2013-01-01

Purpose: To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Methods: Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. Results: The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or −0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1–2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39–16.8) cGy, or 10.1 (0.8–32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%–9.06%) and 10.2% (0.7%–63.6%), respectively. Conclusions: Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup, the standard deviation of setup error reduced by 31%, 42%, and 54% in RL, AP, and SI direction, respectively, and consequently, the uncertainty of the mean dose to cochlea reduced more than 50%. The authors estimate that the effects of these uncertainties on the probability of hearing loss for an individual patient could be as large as 10%. PMID:24320510

Energy optimization in gold nanoparticle enhanced radiation therapy.

PubMed

Sung, Wonmo; Schuemann, Jan

2018-06-25

Gold nanoparticles (GNPs) have been demonstrated as radiation dose enhancing agents. Kilovoltage external photon beams have been shown to yield the largest enhancement due to the high interaction probability with gold. While orthovoltage irradiations are feasible and promising, they suffer from a reduced tissue penetrating power. This study quantifies the effect of varying photon beam energies on various beam arrangements, body, tumor, and cellular GNP uptake geometries. Cell survival was modeled based on our previously developed GNP-local effect model with radial doses calculated using the TOPAS-nBio Monte Carlo code. Cell survival curves calculated for tumor sites with GNPs were used to calculate the relative biological effectiveness (RBE)-weighted dose. In order to evaluate the plan quality, the ratio of the mean dose between the tumor and normal tissue for 50-250 kVp beams with GNPs was compared to the standard of care using 6 MV photon beams without GNPs for breast and brain tumors. For breast using a single photon beam, kV  +  GNP was found to yield up to 2.73 times higher mean RBE-weighted dose to the tumor than two tangential megavoltage beams while delivering the same dose to healthy tissue. For irradiation of brain tumors using multiple photon beams, the GNP dose enhancement was found to be effective for energies above 50 keV. A small tumor at shallow depths was found to be the most effective treatment conditions for GNP enhanced radiation therapy. GNP uptake distributions in the cell (with or without nuclear uptake) and the beam arrangement were found to be important factors in determining the optimal photon beam energy.

SU-F-J-11: Radiobiologically Optimized Patient Localization During Prostate External Beam Localization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Y; Gardner, S; Liu, C

2016-06-15

Purpose: To present a novel positioning strategy which optimizes radiation delivery with radiobiological response knowledge, and to evaluate its application during prostate external beam radiotherapy. Methods: Ten patients with low or intermediate risk prostate cancer were evaluated retrospectively in this IRB-approved study. For each patient, a VMAT plan was generated on the planning CT (PCT) to deliver 78 Gy in 39 fractions with PTV = prostate + 7 mm margin, except for 5mm in the posterior direction. Five representative pretreatment CBCT images were selected for each patient, and prostate, rectum, and bladder were delineated on all CBCT images. Each CBCTmore » was auto-registered to the corresponding PCT. Starting from this auto-matched position (AM-position), a search for optimal treatment position was performed utilizing a score function based on radiobiological and dosimetric indices (D98-DTV, NTCP-rectum, and NTCP-bladder) for the daily target volume (DTV), rectum, and bladder. DTV was defined as prostate + 4 mm margin to account for intra-fraction motion as well as contouring variability on CBCT. We termed the optimal treatment position the radiobiologically optimized couch shift position (ROCS-position). Results: The indices, averaged over the 10 patients’ treatment plans, were (mean±SD): 77.7±0.2 Gy (D98-PTV), 12.3±2.7% (NTCP-rectum), and 53.2±11.2% (NTCP-bladder). The corresponding values calculated on all 50 CBCT images at the AM-positions were 72.9±11.3 Gy (D98-DTV), 15.8±6.4% (NTCP-rectum), and 53.0±21.1% (NTCP-bladder), respectively. In comparison, calculated on CBCT at the ROCS-positions, the indices were 77.0±2.1 Gy (D98-DTV), 12.1±5.7% (NTCP-rectum), and 60.7±16.4% (NTCP-bladder). Compared to autoregistration, ROCS-optimization recovered dose coverage to target volume and lowered the risk to rectum. Moreover, NTCPrectum for one patient remained high after ROCS-optimization and therefore could potentially benefit from adaptive planning. Conclusion: These encouraging results illustrate the potential utility of applying radiobiologically optimized correction for online image-guided radiotherapy of prostate patients.« less

SU-E-T-130: Are Proton Gantries Needed? An Analysis of 4332 Patient Proton Gantry Treatment Plans From the Past 10 Years

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, S; Lu, H; Flanz, J

2015-06-15

Purpose: To ascertain the necessity of a proton gantry, as compared to the feasibility of using a horizontal fixed proton beam-line for treatment with advanced technology. Methods: To calculate the percentage of patients that can be treated with a horizontal fixed beam-line instead of a gantry, we analyze the distributions of beam orientations of our proton gantry patients treated over the past 10 years. We identify three horizontal fixed beam geometries (FIXED, BEND and MOVE) with the patient in lying and/or sitting positions. The FIXED geometry includes only table/chair rotations and translations. In BEND, the beam can be bent up/downmore » for up to 20 degrees. MOVE allows for patient head/body angle adjustment. Based on the analysis, we select eight patients whose plan involves beams which are still challenging to achieve with a horizontal fixed beam. These beams are removed in the pencil beam scanning (PBS) plan optimized for the fixed beam-line (PBS-fix). We generate non-coplanar PBS-gantry plans for comparison, and perform a robustness analysis. Results: The percentage of patients with head-and-neck/brain tumors that can be treated with horizontal fixed beam is 44% in FIXED, 70% in 20-degrees BEND, and 100% in 90-degrees MOVE. For torso regions, 99% of the patients can be treated in 20-degree BEND. The target coverage is more homogeneous with PBS-fix plans compared to the clinical scattering treatment plans. The PBS-fix plans reduce the mean dose to organs-at-risk by a factor of 1.1–28.5. PBS-gantry plans are as good as PBS-fix plans, sometimes marginally better. Conclusion: The majority of the beam orientations can be realized with a horizontal fixed beam-line. Challenging non-coplanar beams can be eliminated with PBS delivery. Clinical implementation of the proposed fixed beam-line requires use of robotic patient positioning, further developments in immobilization, and image guidance. However, our results suggest that fixed beam-lines can be as effective as gantries.« less

The drift chamber array at the external target facility in HIRFL-CSR

NASA Astrophysics Data System (ADS)

Sun, Y. Z.; Sun, Z. Y.; Wang, S. T.; Duan, L. M.; Sun, Y.; Yan, D.; Tang, S. W.; Yang, H. R.; Lu, C. G.; Ma, P.; Yu, Y. H.; Zhang, X. H.; Yue, K.; Fang, F.; Su, H.

2018-06-01

A drift chamber array at the External Target Facility in HIRFL-CSR has been constructed for three-dimensional particle tracking in high-energy radioactive ion beam experiments. The design, readout, track reconstruction program and calibration procedures for the detector are described. The drift chamber array was tested in a 311 AMeV 40Ar beam experiment. The detector performance based on the measurements of the beam test is presented. A spatial resolution of 230 μm is achieved.

Monte Carlo characterization of materials for prosthetic implants and dosimetric validation of Pinnacle 3 TPS

NASA Astrophysics Data System (ADS)

Palleri, Francesca; Baruffaldi, Fabio; Angelini, Anna Lisa; Ferri, Andrea; Spezi, Emiliano

2008-12-01

In external beam radiotherapy the calculation of dose distribution for patients with hip prostheses is critical. Metallic implants not only degrade the image quality but also perturb the dose distribution. Conventional treatment planning systems do not accurately account for high-Z prosthetic implants heterogeneities, especially at interfaces. The materials studied in this work have been chosen on the basis of a statistical investigation on the hip prostheses implanted in 70 medical centres. The first aim of this study is a systematic characterization of materials used for hip prostheses, and it has been provided by BEAMnrc Monte Carlo code. The second aim is to evaluate the capabilities of a specific treatment planning system, Pinnacle 3, when dealing with dose calculations in presence of metals, also close to the regions of high-Z gradients. In both cases it has been carried out an accurate comparison versus experimental measurements for two clinical photon beam energies (6 MV and 18 MV) and for two experimental sets-up: metallic cylinders inserted in a water phantom and in a specifically built PMMA slab. Our results show an agreement within 2% between experiments and MC simulations. TPS calculations agree with experiments within 3%.

Quality Assurance with Plan Veto: reincarnation of a record and verify system and its potential value.

PubMed

Noel, Camille E; Gutti, Veerarajesh; Bosch, Walter; Mutic, Sasa; Ford, Eric; Terezakis, Stephanie; Santanam, Lakshmi

2014-04-01

To quantify the potential impact of the Integrating the Healthcare Enterprise-Radiation Oncology Quality Assurance with Plan Veto (QAPV) on patient safety of external beam radiation therapy (RT) operations. An institutional database of events (errors and near-misses) was used to evaluate the ability of QAPV to prevent clinically observed events. We analyzed reported events that were related to Digital Imaging and Communications in Medicine RT plan parameter inconsistencies between the intended treatment (on the treatment planning system) and the delivered treatment (on the treatment machine). Critical Digital Imaging and Communications in Medicine RT plan parameters were identified. Each event was scored for importance using the Failure Mode and Effects Analysis methodology. Potential error occurrence (frequency) was derived according to the collected event data, along with the potential event severity, and the probability of detection with and without the theoretical implementation of the QAPV plan comparison check. Failure Mode and Effects Analysis Risk Priority Numbers (RPNs) with and without QAPV were compared to quantify the potential benefit of clinical implementation of QAPV. The implementation of QAPV could reduce the RPN values for 15 of 22 (71%) of evaluated parameters, with an overall average reduction in RPN of 68 (range, 0-216). For the 6 high-risk parameters (>200), the average reduction in RPN value was 163 (range, 108-216). The RPN value reduction for the intermediate-risk (200 > RPN > 100) parameters was (0-140). With QAPV, the largest RPN value for "Beam Meterset" was reduced from 324 to 108. The maximum reduction in RPN value was for Beam Meterset (216, 66.7%), whereas the maximum percentage reduction was for Cumulative Meterset Weight (80, 88.9%). This analysis quantifies the value of the Integrating the Healthcare Enterprise-Radiation Oncology QAPV implementation in clinical workflow. We demonstrate that although QAPV does not provide a comprehensive solution for error prevention in RT, it can have a significant impact on a subset of the most severe clinically observed events. Copyright © 2014 Elsevier Inc. All rights reserved.

SU-F-BRD-08: Guaranteed Epsilon-Optimal Treatment Plans with Minimum Number of Beams for SBRT Using RayStation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yarmand, H; Winey, B; Craft, D

2014-06-15

Purpose: To efficiently find quality-guaranteed treatment plans with the minimum number of beams for stereotactic body radiation therapy using RayStation. Methods: For a pre-specified pool of candidate beams we use RayStation (a treatment planning software for clinical use) to identify the deliverable plan which uses all the beams with the minimum dose to organs at risk (OARs) and dose to the tumor and other structures in specified ranges. Then use the dose matrix information for the generated apertures from RayStation to solve a linear program to find the ideal plan with the same objective and constraints allowing use of allmore » beams. Finally we solve a mixed integer programming formulation of the beam angle optimization problem (BAO) with the objective of minimizing the number of beams while remaining in a predetermined epsilon-optimality of the ideal plan with respect to the dose to OARs. Since the treatment plan optimization is a multicriteria optimization problem, the planner can exploit the multicriteria optimization capability of RayStation to navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing quality. For the numerical experiments two liver cases and one lung case with 33 non-coplanar beams are considered. Results: The ideal plan uses an impractically large number of beams. The proposed technique reduces the number of beams to the range of practical application (5 to 9 beams) while remaining in the epsilon-optimal range of 1% to 5% optimality gap. Conclusion: The proposed method can be integrated into a general algorithm for fast navigation of the ideal dose distribution Pareto surface and finding the treatment plan with the minimum number of beams, which corresponds to the delivery time, in epsilon-optimality range of the desired ideal plan. The project was supported by the Federal Share of program income earned by Massachusetts General Hospital on C06 CA059267, Proton Therapy Research and Treatment Center and partially by RaySearch Laboratories.« less

SU-E-T-215: Comparison of VMAT-SABR Treatment Plans with Flattened Filter (FF) Beam and Flattening Filter-Free (FFF) Beam for Localized Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, J; Kim, J; Kang, S

2015-06-15

Purpose: The purpose of this study is to access VMAT-SABR plan using flattening filter (FF) and flattening filter-free (FFF) beam, and compare the verification results for all pretreatment plans. Methods: SABR plans for 20 prostate patients were optimized in the Eclipse treatment planning system. A prescription dose was 42.7 Gy/7 fractions. Four SABR plans for each patient were calculated using Acuros XB algorithm with both FF and FFF beams of 6- and 10-MV. The dose-volume histograms (DVH) and technical parameters were recorded and compared. A pretreatment verification was performed and the gamma analysis was used to quantify the agreement betweenmore » calculations and measurements. Results: For each patient, the DVHs are closely similar for plans of four different beams. There are small differences showed in dose distributions and corresponding DVHs when comparing the each plan related to the same patient. Sparing on bladder and rectum was slightly better on plans with 10-MV FF and FFF than with 6-MV FF and FFF, but this difference was negligible. However, there was no significance in the other OARs. The mean agreement of 3%/3mm criteria was higher than 97% in all plans. The mean MUs and deliver time employed was 1701±101 and 3.02±0.17 min for 6-MV FF, 1870±116 and 1.69±0.08 min for 6-MV FFF, 1471±86 and 2.68±0.14 min for 10-MV FF, and 1619±101 and 0.98±0.04 min for 10-MV FFF, respectively. Conclusion: Dose distributions on prostate SABR plans using FFF beams were similar to those generated by FF beams. However, the use of FFF beam offers a clear benefit in delivery time when compared to FF beam. Verification of pretreatment also represented the acceptable and comparable results in all plans using FF beam as well as FFF beam. Therefore, this study suggests that the use of FFF beam is feasible and efficient technique for prostate SABR.« less

Current external beam radiation therapy quality assurance guidance: does it meet the challenges of emerging image-guided technologies?

PubMed

Palta, Jatinder R; Liu, Chihray; Li, Jonathan G

2008-01-01

The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this "one-size-fits-all" prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.

PubMed

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-05

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of the complete beam search space. This challenging optimization problem with the complete beam search space is effectively handled by the proposed SVD acceleration.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy

NASA Astrophysics Data System (ADS)

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-01

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of the complete beam search space. This challenging optimization problem with the complete beam search space is effectively handled by the proposed SVD acceleration.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fitzgerald, Emma, E-mail: emmafitz1390@gmail.com; Miles, Wesley; Fenton, Paul

2014-09-15

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

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

PubMed Central

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

2014-01-01

Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues. The patient was prescribed a dose of 60 Gy to the planning target volume (PTV) with 1.0 cm bolus over the ventral surface of each limb. The beam arrangement consisted of six treatment fields that avoided entry and exit through the contralateral limb. The treatment plans met the International Commission on Radiation Units and Measurements (ICRU) guidelines and produced highly conformal dosimetric results. Skin toxicity was measured against the National Cancer Institute: Common Terminology Criteria for Adverse Events (NCI: CTCAE) version 3. A well-tolerated treatment was delivered with excellent results given the initial extent of the disease. This case study has demonstrated the feasibility and effectiveness of IMRT for skin cancers as an alternative to surgery and traditional superficial radiation therapy, utilising a complex PTV of the extremities for patients with similar presentations. PMID:26229657

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

2013-07-15

Purpose: To compare IMRT planning strategies for prostate cancer patients with metal hip prostheses.Methods: All plans were generated fully automatically (i.e., no human trial-and-error interactions) using iCycle, the authors' in-house developed algorithm for multicriterial selection of beam angles and optimization of fluence profiles, allowing objective comparison of planning strategies. For 18 prostate cancer patients (eight with bilateral hip prostheses, ten with a right-sided unilateral prosthesis), two planning strategies were evaluated: (i) full exclusion of beams containing beamlets that would deliver dose to the target after passing a prosthesis (IMRT{sub remove}) and (ii) exclusion of those beamlets only (IMRT{sub cut}). Plansmore » with optimized coplanar and noncoplanar beam arrangements were generated. Differences in PTV coverage and sparing of organs at risk (OARs) were quantified. The impact of beam number on plan quality was evaluated.Results: Especially for patients with bilateral hip prostheses, IMRT{sub cut} significantly improved rectum and bladder sparing compared to IMRT{sub remove}. For 9-beam coplanar plans, rectum V{sub 60Gy} reduced by 17.5%{+-} 15.0% (maximum 37.4%, p= 0.036) and rectum D{sub mean} by 9.4%{+-} 7.8% (maximum 19.8%, p= 0.036). Further improvements in OAR sparing were achievable by using noncoplanar beam setups, reducing rectum V{sub 60Gy} by another 4.6%{+-} 4.9% (p= 0.012) for noncoplanar 9-beam IMRT{sub cut} plans. Large reductions in rectum dose delivery were also observed when increasing the number of beam directions in the plans. For bilateral implants, the rectum V{sub 60Gy} was 37.3%{+-} 12.1% for coplanar 7-beam plans and reduced on average by 13.5% (maximum 30.1%, p= 0.012) for 15 directions.Conclusions: iCycle was able to automatically generate high quality plans for prostate cancer patients with prostheses. Excluding only beamlets that passed through the prostheses (IMRT{sub cut} strategy) significantly improved OAR sparing. Noncoplanar beam arrangements and, to a larger extent, increasing the number of treatment beams further improved plan quality.« less

A two‐point scheme for optimal breast IMRT treatment planning

PubMed Central

2013-01-01

We propose an approach to determining optimal beam weights in breast/chest wall IMRT treatment plans. The goal is to decrease breathing effect and to maximize skin dose if the skin is included in the target or, otherwise, to minimize the skin dose. Two points in the target are utilized to calculate the optimal weights. The optimal plan (i.e., the plan with optimal beam weights) consists of high energy unblocked beams, low energy unblocked beams, and IMRT beams. Six breast and five chest wall cases were retrospectively planned with this scheme in Eclipse, including one breast case where CTV was contoured by the physician. Compared with 3D CRT plans composed of unblocked and field‐in‐field beams, the optimal plans demonstrated comparable or better dose uniformity, homogeneity, and conformity to the target, especially at beam junction when supraclavicular nodes are involved. Compared with nonoptimal plans (i.e., plans with nonoptimized weights), the optimal plans had better dose distributions at shallow depths close to the skin, especially in cases where breathing effect was taken into account. This was verified with experiments using a MapCHECK device attached to a motion simulation table (to mimic motion caused by breathing). PACS number: 87.55 de PMID:24257291

On finding the analytic dependencies of the external field potential on the control function when optimizing the beam dynamics

NASA Astrophysics Data System (ADS)

Ovsyannikov, A. D.; Kozynchenko, S. A.; Kozynchenko, V. A.

2017-12-01

When developing a particle accelerator for generating the high-precision beams, the injection system design is of importance, because it largely determines the output characteristics of the beam. At the present paper we consider the injection systems consisting of electrodes with given potentials. The design of such systems requires carrying out simulation of beam dynamics in the electrostatic fields. For external field simulation we use the new approach, proposed by A.D. Ovsyannikov, which is based on analytical approximations, or finite difference method, taking into account the real geometry of the injection system. The software designed for solving the problems of beam dynamics simulation and optimization in the injection system for non-relativistic beams has been developed. Both beam dynamics and electric field simulations in the injection system which use analytical approach and finite difference method have been made and the results presented in this paper.

Image Guidance in External Beam Accelerated Partial Breast Irradiation: Comparison of Surrogates for the Lumpectomy Cavity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hasan, Yasmin; Kim, Leonard; Martinez, Alvaro

Purpose: To compare localization of the lumpectomy cavity by using breast surface matching vs. clips for image-guided external beam accelerated partial breast irradiation. Methods and Materials: Twenty-seven patients with breast cancer with two computed tomography (CT) scans each had three CT registrations performed: (1) to bony anatomy, (2) to the center of mass (COM) of surgical clips, and (3) to the breast surface. The cavity COM was defined in both the initial and second CT scans after each type of registration, and distances between COMs ({delta}COM{sub Bone}, {delta}COM{sub Clips}, and {delta}COM{sub Surface}) were determined. Smaller {delta}COMs were interpreted as bettermore » localizations. Correlation coefficients were calculated for {delta}COM vs. several variables. Results: The {delta}COM{sub Bone} (mean, 7 {+-} 2 [SD] mm) increased with breast volume (r = 0.4; p = 0.02) and distance from the chest wall (r = 0.5; p = 0.003). Relative to bony registration, clip registration provided better localization ({delta}COM{sub Clips} < {delta}COM{sub Bone}) in 25 of 27 cases. Breast surface matching improved cavity localization ({delta}COM{sub Surface} < {delta}COM{sub Bone}) in 19 of 27 cases. Mean improvements ({delta}COM{sub Bone} - {delta}COM{sub ClipsorSurface}) were 4 {+-} 3 and 2 {+-} 4 mm, respectively. In terms of percentage of improvement ([{delta}COM{sub Bone} - {delta}COM{sub ClipsorSurface}]/{delta}COM{sub Bone}), only surface matching showed a correlation with breast volume. Clip localization outperformed surface registration for cavities located superior to the breast COM. Conclusions: Use of either breast surface or surgical clips as surrogates for the cavity results in improved localization in most patients compared with bony registration and may allow smaller planning target volume margins for external beam accelerated partial breast irradiation. Compared with surface registration, clip registration may be less sensitive to anatomic characteristics and therefore more broadly applicable.« less

Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dupin, Charles, E-mail: c.dupin@bordeaux.unicancer.fr; Lang, Philippe; Dessard-Diana, Bernadette

2014-06-01

Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm{sup 3} (range, 0.9-243 cm{sup 3}) and 116 cm{sup 3} (range, 24-731 cm{sup 3}), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories ofmore » paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas.« less

Stereotactic ultrasound for target volume definition in a patient with prostate cancer and bilateral total hip replacement.

PubMed

Boda-Heggemann, Judit; Haneder, Stefan; Ehmann, Michael; Sihono, Dwi Seno Kuncoro; Wertz, Hansjörg; Mai, Sabine; Kegel, Stefan; Heitmann, Sigrun; von Swietochowski, Sandra; Lohr, Frank; Wenz, Frederik

2015-01-01

Target-volume definition for prostate cancer in patients with bilateral metal total hip replacements (THRs) is a challenge because of metal artifacts in the planning computed tomography (CT) scans. Magnetic resonance imaging (MRI) can be used for matching and prostate delineation; however, at a spatial and temporal distance from the planning CT, identical rectal and vesical filling is difficult to achieve. In addition, MRI may also be impaired by metal artifacts, even resulting in spatial image distortion. Here, we present a method to define prostate target volumes based on ultrasound images acquired during CT simulation and online-matched to the CT data set directly at the planning CT. A 78-year-old patient with cT2cNxM0 prostate cancer with bilateral metal THRs was referred to external beam radiation therapy. T2-weighted MRI was performed on the day of the planning CT with preparation according to a protocol for reproducible bladder and rectal filling. The planning CT was obtained with the immediate acquisition of a 3-dimensional ultrasound data set with a dedicated stereotactic ultrasound system for online intermodality image matching referenced to the isocenter by ceiling-mounted infrared cameras. MRI (offline) and ultrasound images (online) were thus both matched to the CT images for planning. Daily image guided radiation therapy (IGRT) was performed with transabdominal ultrasound and compared with cone beam CT. Because of variations in bladder and rectal filling and metal-induced image distortion in MRI, soft-tissue-based matching of the MRI to CT was not sufficient for unequivocal prostate target definition. Ultrasound-based images could be matched, and prostate, seminal vesicles, and target volumes were reliably defined. Daily IGRT could be successfully completed with transabdominal ultrasound with good accordance between cone beam CT and ultrasound. For prostate cancer patients with bilateral THRs causing artifacts in planning CTs, ultrasound referenced to the isocenter of the CT simulator and acquired with intermodal online coregistration directly at the planning CT is a fast and easy method to reliably delineate the prostate and target volumes and for daily IGRT. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Effectiveness of virtual reality simulation software in radiotherapy treatment planning involving non-coplanar beams with partial breast irradiation as a model.

PubMed

Glaser, S; Warfel, B; Price, J; Sinacore, J; Albuquerque, K

2012-10-01

Virtual reality simulation software (VRS - FocalSim Version 4.40 with VRS prototype, Computerized Medical Systems, St. Louis, MO) is a new radiation dose planning tool that allows for 3D visualization of the patient and the machine couch (treatment table) in relationship to the linear accelerator. This allows the radiation treatment planner to have a "room's-eye-view" and enhances the process of virtual simulation. The aim of this study was to compare VRS to a standard planning program (XiO - Version 4.50, Computerized Medical Systems, St. Louis, MO) in regards to the time it took to use each program, the angles chosen in each, and to determine if there was a dosimetric benefit to using VRS. Ten patients who had undergone left-sided lumpectomies were chosen to have treatment plans generated. A partial breast irradiation (PBI) treatment plan by external beam radiation therapy (EBRT) was generated for each patient using two different methods. In the first method the full plan was generated using XiO software. In the second method beam angles were chosen using the VRS software, those angles were transferred to XiO, and the remaining part of the plan was completed using XiO (since VRS does not allow dose calculations). On average, using VRS to choose angles took about 10 minutes longer than XiO. None of the five gantry angles differed significantly between the two programs, but four of the five couch angles did. Dose-volume histogram (DVH) data showed a significantly better conformality index, and trends toward decreased hot spots and increased coverage of the planed treatment volume (PTV) when using VRS. However, when angels were chosen in VRS a greater volume of the ipsilateral breast received a low dose of radiation (between 3% and 50% of the prescribed dose) (VRS = 23.06%, XiO = 19.57%, p < 0.0005). A significant advantage that VRS provided over XiO was the ability to detect potential collisions prior to actual treatment of the patient in three of the ten patients studied. The potential to save time with VRS by not having to redo plans because of a collision increases clinic efficiency.

Dosimetric validation of the Acuros XB Advanced Dose Calculation algorithm: fundamental characterization in water

NASA Astrophysics Data System (ADS)

Fogliata, Antonella; Nicolini, Giorgia; Clivio, Alessandro; Vanetti, Eugenio; Mancosu, Pietro; Cozzi, Luca

2011-05-01

This corrigendum intends to clarify some important points that were not clearly or properly addressed in the original paper, and for which the authors apologize. The original description of the first Acuros algorithm is from the developers, published in Physics in Medicine and Biology by Vassiliev et al (2010) in the paper entitled 'Validation of a new grid-based Boltzmann equation solver for dose calculation in radiotherapy with photon beams'. The main equations describing the algorithm reported in our paper, implemented as the 'Acuros XB Advanced Dose Calculation Algorithm' in the Varian Eclipse treatment planning system, were originally described (for the original Acuros algorithm) in the above mentioned paper by Vassiliev et al. The intention of our description in our paper was to give readers an overview of the algorithm, not pretending to have authorship of the algorithm itself (used as implemented in the planning system). Unfortunately our paper was not clear, particularly in not allocating full credit to the work published by Vassiliev et al on the original Acuros algorithm. Moreover, it is important to clarify that we have not adapted any existing algorithm, but have used the Acuros XB implementation in the Eclipse planning system from Varian. In particular, the original text of our paper should have been as follows: On page 1880 the sentence 'A prototype LBTE solver, called Attila (Wareing et al 2001), was also applied to external photon beam dose calculations (Gifford et al 2006, Vassiliev et al 2008, 2010). Acuros XB builds upon many of the methods in Attila, but represents a ground-up rewrite of the solver where the methods were adapted especially for external photon beam dose calculations' should be corrected to 'A prototype LBTE solver, called Attila (Wareing et al 2001), was also applied to external photon beam dose calculations (Gifford et al 2006, Vassiliev et al 2008). A new algorithm called Acuros, developed by the Transpire Inc. group, was built upon many of the methods in Attila, but represents a ground-up rewrite of the solver where the methods were especially adapted for external photon beam dose calculations, and described in Vassiliev et al (2010). Acuros XB is the Varian implementation of the original Acuros algorithm in the Eclipse planning system'. On page 1881, the sentence 'Monte Carlo and explicit LBTE solution, with sufficient refinement, will converge on the same solution. However, both methods produce errors (inaccuracies). In explicit LBTE solution methods, errors are primarily systematic, and result from discretization of the solution variables in space, angle, and energy. In both Monte Carlo and explicit LBTE solvers, a trade-off exists between speed and accuracy: reduced computational time may be achieved when less stringent accuracy criteria are specified, and vice versa' should cite the reference Vassiliev et al (2010). On page 1882, the beginning of the sub-paragraph The radiation transport model should start with 'The following description of the Acuros XB algorithm is as outlined by Vassiliev et al (2010) and reports the main steps of the radiation transport model as implemented in Eclipse'. The authors apologize for this lack of clarity in our published paper, and trust that this corrigendum gives full credit to Vassiliev et al in their earlier paper, with respect to previous work on the Acuros algorithm. However we wish to note that the entire contents of the data and results published in our paper are original and the work of the listed authors. References Gifford K A, Horton J L Jr, Wareing T A, Failla G and Mourtada F 2006 Comparison of a finite-element multigroup discrete-ordinates code with Monte Carlo for radiotherapy calculations Phys. Med. Biol. 51 2253-65 Vassiliev O N, Wareing T A, Davis I M, McGhee J, Barnett D, Horton J L, Gifford K, Failla G, Titt U and Mourtada F 2008 Feasibility of a multigroup deterministic solution method for three-dimensional radiotherapy dose calculations Int. J. Radiat. Oncol. Biol. Phys. 72 220-7 Vassiliev O N, Wareing T A, McGhee J, Failla G, Salehpour M R and Mourtada F 2010 Validation of a new grid based Boltzmann equation solver for dose calculation in radiotherapy with photon beams Phys. Med. Biol. 55 581-98 Wareing T A, McGhee J M, Morel J E and Pautz S D 2001 Discontinuous finite element Sn methods on three-dimensional unstructured grids Nucl. Sci. Eng. 138 256-68

Simulation of the development and interaction of instabilities in a relativistic electron beam under variation of the beam wall thickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Badarin, A. A.; Kurkin, S. A.; Koronovskii, A. A.

The development and interaction of Bursian and diocotron instabilities in an annular relativistic electron beam propagating in a cylindrical drift chamber are investigated analytically and numerically as functions of the beam wall thickness and the magnitude of the external uniform magnetic field. It is found that the interaction of instabilities results in the formation of a virtual cathode with a complicated rotating helical structure and several reflection regions (electron bunches) in the azimuthal direction. It is shown that the number of electron bunches in the azimuthal direction increases with decreasing beam wall thickness and depends in a complicated manner onmore » the magnitude of the external magnetic field.« less

Quasi-plane-hypothesis of strain coordination for RC beams seismically strengthened with externally-bonded or near-surface mounted fiber reinforced plastic

NASA Astrophysics Data System (ADS)

Ren, Zhenhua; Zeng, Xiantao; Liu, Hanlong; Zhou, Fengjun

2013-03-01

The application of fiber reinforced plastic (FRP), including carbon FRP and glass FRP, for structural repair and strengthening has grown due to their numerous advantages over conventional materials such as externally bonded reinforcement (EBR) and near-surface mounted (NSM) strengthening techniques. This paper summarizes the results from 21 reinforced concrete beams strengthened with different methods, including externally-bonded and near-surface mounted FRP, to study the strain coordination of the FRP and steel rebar of the RC beam. Since there is relative slipping between the RC beam and the FRP, the strain of the FRP and steel rebar of the RC beam satisfy the quasi-plane-hypothesis; that is, the strain of the longitudinal fiber that parallels the neutral axis of the plated beam within the scope of the effective height ( h 0) of the cross section is in direct proportion to the distance from the fiber to the neutral axis. The strain of the FRP and steel rebar satisfies the equation: ɛ FRP= βɛ steel, and the value of β is equal to 1.1-1.3 according to the test results.

The use of cognitive-behavioral treatment including hypnosis for claustrophobia in cancer patients.

PubMed

Steggles, S

1999-04-01

Two case studies are reported to illustrate the use of a comprehensive cognitive-behavioral approach to treat claustrophobia in cancer patients undergoing external beam radiation therapy. Hypnosis was an essential component of the cognitive-behavioral approach. Both patients responded favorably to the psychological intervention and completed the required external beam radiation therapy.

Hole-cyclotron instability in semiconductor quantum plasmas

NASA Astrophysics Data System (ADS)

Areeb, F.; Rasheed, A.; Jamil, M.; Siddique, M.; Sumera, P.

2018-01-01

The excitation of electrostatic hole-cyclotron waves generated by an externally injected electron beam in semiconductor plasmas is examined using a quantum hydrodynamic model. The quantum effects such as tunneling potential, Fermi degenerate pressure, and exchange-correlation potential are taken care of. The growth rate of the wave is analyzed on varying the parameters normalized by hole-plasma frequency, like the angle θ between propagation vector and B0∥z ̂ , speed of the externally injected electron beam v0∥k , thermal temperature of the electron beam τ, external magnetic field B0∥z ̂ that modifies the hole-cyclotron frequency, and finally, the semiconductor electron number density. The instability of the hole-cyclotron wave seeks its applications in semiconductor devices.

Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment

NASA Astrophysics Data System (ADS)

Kim, Yon-Lae; Chung, Jin-Beom; Kim, Jae-Sung; Lee, Jeong-Woo; Kim, Jin-Young; Kang, Sang-Won; Suh, Tae-Suk

2015-11-01

The purpose of this study was to test the feasibility of clinical usage of a flattening-filter-free (FFF) beam for treatment with lung stereotactic ablative radiotherapy (SABR). Ten patients were treated with SABR and a 6-MV FFF beam for this study. All plans using volumetric modulated arc therapy (VMAT) were optimized in the Eclipse treatment planning system (TPS) by using the Acuros XB (AXB) dose calculation algorithm and were delivered by using a Varian TrueBeam ™ linear accelerator equipped with a high-definition (HD) multi-leaf collimator. The prescription dose used was 48 Gy in 4 fractions. In order to compare the plan using a conventional 6-MV flattening-filter (FF) beam, the SABR plan was recalculated under the condition of the same beam settings used in the plan employing the 6-MV FFF beam. All dose distributions were calculated by using Acuros XB (AXB, version 11) and a 2.5-mm isotropic dose grid. The cumulative dosevolume histograms (DVH) for the planning target volume (PTV) and all organs at risk (OARs) were analyzed. Technical parameters, such as total monitor units (MUs) and the delivery time, were also recorded and assessed. All plans for target volumes met the planning objectives for the PTV ( i.e., V95% > 95%) and the maximum dose ( i.e., Dmax < 110%) revealing adequate target coverage for the 6-MV FF and FFF beams. Differences in DVH for target volumes (PTV and clinical target volume (CTV)) and OARs on the lung SABR plans from the interchange of the treatment beams were small, but showed a marked reduction (52.97%) in the treatment delivery time. The SABR plan with a FFF beam required a larger number of MUs than the plan with the FF beam, and the mean difference in MUs was 4.65%. This study demonstrated that the use of the FFF beam for lung SABR plan provided better treatment efficiency relative to 6-MV FF beam. This strategy should be particularly beneficial for high dose conformity to the lung and decreased intra-fraction movements because of the shorter treatment delivery time. Future studies are necessary to assess the clinical outcome and the toxicity.

SU-F-T-429: Craniospinal Irradiation by VMAT Technique: Impact of FFF Beam and High Resolution MLC On Plan Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ganesh, T; Sarkar, B; Munshi, A

2016-06-15

Purpose: Objective of this study was to evaluate the impact of using flattening filter free (FFF) beam with 0.5 cm multileaf collimator (MLC) leaves over conventional flattened beam with 1 cm leaf width MLC on the treatment plan quality in cranio-spinal irradiation (CSI). Methods: For five medulloblastoma cases (3 males and 2 females), who were previously treated by volumetric modulated arc therapy (VMAT) technique using conventional flattened beam shaped by 1 cm width MLC leaves, four test plans were generated and compared against the delivered plan. These retrospective plans consisted of four different combinations of flattened and FFF beams frommore » Elekta’s Agility treatment head with 0.5 cm width MLC leaves. Sparing of organs at risks (OAR) in terms of dose to 5%, 50%, 75% and 90% volumes, mean and maximum dose were evaluated. Results: All plans satisfied the planning objective of covering 95% of PTV by at least 95% of prescription dose. Marginal variation of dose spillage was observed between different VMAT plans at very low dose range (1–5 Gy). Variation in dose statistics for PTVs and OARs were within 1% or 1 Gy. Amongst the five plans, the plan with flattened beam with 1 cm MLC had the highest number of MUs, 2.13 times higher than the plan with Agility MLC with FFF beam that had the least number of MUs. No statistically significant difference (p≥0.05) was observed between the reference plan and the retrospectively generated plans in terms of PTV coverage, cold spot, hot spot and organ at risk doses. Conclusion: In the treatment of CSI cases by VMAT technique, FFF beams and/or finer width MLC did not exhibit advantage over the flattened beams or wider MLC in terms of plan quality except for reduction in MUs.« less

Portal imaging based definition of the planning target volume during pelvic irradiation for gynecological malignancies.

PubMed

Mock, U; Dieckmann, K; Wolff, U; Knocke, T H; Pötter, R

1999-08-01

Geometrical accuracy in patient positioning can vary substantially during external radiotherapy. This study estimated the set-up accuracy during pelvic irradiation for gynecological malignancies for determination of safety margins (planning target volume, PTV). Based on electronic portal imaging devices (EPID), 25 patients undergoing 4-field pelvic irradiation for gynecological malignancies were analyzed with regard to set-up accuracy during the treatment course. Regularly performed EPID images were used in order to systematically assess the systematic and random component of set-up displacements. Anatomical matching of verification and simulation images was followed by measuring corresponding distances between the central axis and anatomical features. Data analysis of set-up errors referred to the x-, y-,and z-axes. Additionally, cumulative frequencies were evaluated. A total of 50 simulation films and 313 verification images were analyzed. For the anterior-posterior (AP) beam direction mean deviations along the x- and z-axes were 1.5 mm and -1.9 mm, respectively. Moreover, random errors of 4.8 mm (x-axis) and 3.0 mm (z-axis) were determined. Concerning the latero-lateral treatment fields, the systematic errors along the two axes were calculated to 2.9 mm (y-axis) and -2.0 mm (z-axis) and random errors of 3.8 mm and 3.5 mm were found, respectively. The cumulative frequency of misalignments < or =5 mm showed values of 75% (AP fields) and 72% (latero-lateral fields). With regard to cumulative frequencies < or =10 mm quantification revealed values of 97% for both beam directions. During external pelvic irradiation therapy for gynecological malignancies, EPID images on a regular basis revealed acceptable set-up inaccuracies. Safety margins (PTV) of 1 cm appear to be sufficient, accounting for more than 95% of all deviations.

SU-F-T-225: Is It Time to Have Pre-Configured Therapeutic Beams Available in Commercial Treatment Planning Systems?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, G

Purpose: Commissioning radiation beams requires considerable effort to obtain the beam data for beam configuration in a commercial treatment planning system. With the advances in technology, the manufacturer of accelerators now has the ability to adjust radiation beam parameters to meet pre-determined specifications with high precision. This study aims to illustrate the feasibility of making pre-configured radiation beams available in commercial treatment planning systems. Methods: In recent years, Varian has made a set of measured beam data from the TrueBeam accelerator available to users. Although the beam data are provided as “suggestive data” without warranty, the commissioned data measured bymore » users have been shown to be in excellent agreement with the data set provided when the beams from the installed Linacs were adjusted to meet the beam specifications. An unofficial survey among Varian Linac TrueBeam users shows that the suggestive data set has been used with validation by users in some clinics. This indicates that radiation beams from a specified Linac can be standardized and pre-configured in a treatment planning system. Results: Two newly installed Varian TrueBeam accelerators at two different centers were examined in which one set of commissioned beam data was obtained from measurements performed by an independent physics consulting company and the other was measured by local physicists in the department. All beams from both accelerators were tuned to meet the manufacturer’s specifications. Discrepancies of less than 1% were found between the commissioned beam data from both accelerators and the suggestive data set provided by Varian. Conclusion: It may be feasible that radiation beams can be pre-configured in commercial treatment planning systems. The radiation beam users will perform the beam validation and end-to-end tests instead of configuring beams. This framework can increase both the efficiency and the accuracy in commercial radiation treatment planning systems.« less

Metasurface external cavity laser

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, Luyao, E-mail: luyaoxu.ee@ucla.edu; Curwen, Christopher A.; Williams, Benjamin S.

2015-11-30

A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

SU-G-TeP4-12: Individual Beam QA for a Robotic Radiosurgery System Using a Scintillator Cone

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGuinness, C; Descovich, M; Sudhyadhom, A

2016-06-15

Purpose: The targeting accuracy of the Cyberknife system is measured by end-to-end tests delivering multiple isocentric beams to a point in space. While the targeting accuracy of two representative beams can be determined by a Winston-Lutz-type test, no test is available today to determine the targeting accuracy of each clinical beam. We used a scintillator cone to measure the accuracy of each individual beam. Methods: The XRV-124 from Logos Systems Int’l is a scintillator cone with an imaging system that is able to measure individual beam vectors and a resulting error between planned and measured beam coordinates. We measured themore » targeting accuracy of isocentric and non-isocentric beams for a number of test cases using the Iris and the fixed collimator. The average difference between plan and measured beam position was 0.8–1.2mm across the collimator sizes and plans considered here. The max error for a single beam was 2.5mm for the isocentric plans, and 1.67mm for the non-isocentric plans. The standard deviation of the differences was 0.5mm or less. Conclusion: The CyberKnife System is specified to have an overall targeting accuracy for static targets of less than 0.95mm. In E2E tests using the XRV124 system we measure average beam accuracy between 0.8 to 1.23mm, with maximum of 2.5mm. We plan to investigate correlations between beam position error and robot position, and to quantify the effect of beam position errors on patient specific plans. Martina Descovich has received research support and speaker honoraria from Accuray.« less

A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy

PubMed Central

Wilson, Lydia J; Newhauser, Wayne D

2015-01-01

State-of-the-art radiotherapy treatment planning systems provide reliable estimates of the therapeutic radiation but are known to underestimate or neglect the stray radiation exposures. Most commonly, stray radiation exposures are reconstructed using empirical formulas or lookup tables. The purpose of this study was to develop the basic physics of a model capable of calculating the total absorbed dose both inside and outside of the therapeutic radiation beam for external beam photon therapy. The model was developed using measurements of total absorbed dose in a water-box phantom from a 6 MV medical linear accelerator to calculate dose profiles in both the in-plane and cross-plane direction for a variety of square field sizes and depths in water. The water-box phantom facilitated development of the basic physical aspects of the model. RMS discrepancies between measured and calculated total absorbed dose values in water were less than 9.3% for all fields studied. Computation times for 10 million dose points within a homogeneous phantom were approximately 4 minutes. These results suggest that the basic physics of the model are sufficiently simple, fast, and accurate to serve as a foundation for a variety of clinical and research applications, some of which may require that the model be extended or simplified based on the needs of the user. A potentially important advantage of a physics-based approach is that the model is more readily adaptable to a wide variety of treatment units and treatment techniques than with empirical models. PMID:26040833

A simple and fast physics-based analytical method to calculate therapeutic and stray doses from external beam, megavoltage x-ray therapy.

PubMed

Jagetic, Lydia J; Newhauser, Wayne D

2015-06-21

State-of-the-art radiotherapy treatment planning systems provide reliable estimates of the therapeutic radiation but are known to underestimate or neglect the stray radiation exposures. Most commonly, stray radiation exposures are reconstructed using empirical formulas or lookup tables. The purpose of this study was to develop the basic physics of a model capable of calculating the total absorbed dose both inside and outside of the therapeutic radiation beam for external beam photon therapy. The model was developed using measurements of total absorbed dose in a water-box phantom from a 6 MV medical linear accelerator to calculate dose profiles in both the in-plane and cross-plane direction for a variety of square field sizes and depths in water. The water-box phantom facilitated development of the basic physical aspects of the model. RMS discrepancies between measured and calculated total absorbed dose values in water were less than 9.3% for all fields studied. Computation times for 10 million dose points within a homogeneous phantom were approximately 4 min. These results suggest that the basic physics of the model are sufficiently simple, fast, and accurate to serve as a foundation for a variety of clinical and research applications, some of which may require that the model be extended or simplified based on the needs of the user. A potentially important advantage of a physics-based approach is that the model is more readily adaptable to a wide variety of treatment units and treatment techniques than with empirical models.

Intrafractional dose variation and beam configuration in carbon ion radiotherapy for esophageal cancer.

PubMed

Haefner, M F; Sterzing, F; Krug, D; Koerber, S A; Jaekel, O; Debus, J; Haertig, M M

2016-11-15

In carbon ion radiotherapy (CIR) for esophageal cancer, organ and target motion is a major challenge for treatment planning due to potential range deviations. This study intends to analyze the impact of intrafractional variations on dosimetric parameters and to identify favourable settings for robust treatment plans. We contoured esophageal boost volumes in different organ localizations for four patients and calculated CIR-plans with 13 different beam geometries on a free-breathing CT. Forward calculation of these plans was performed on 4D-CT datasets representing seven different phases of the breathing cycle. Plan quality was assessed for each patient and beam configuration. Target volume coverage was adequate for all settings in the baseline CIR-plans (V 95  > 98% for two-beam geometries, > 94% for one-beam geometries), but reduced on 4D-CT plans (V 95 range 50-95%). Sparing of the organs at risk (OAR) was adequate, but range deviations during the breathing cycle partly caused critical, maximum doses to spinal cord up to 3.5x higher than expected. There was at least one beam configuration for each patient with appropriate plan quality. Despite intrafractional motion, CIR for esophageal cancer is possible with robust treatment plans when an individually optimized beam setup is selected depending on tumor size and localization.

Strengthening Performance of PALF-Epoxy Composite Plate on Reinforced Concrete Beams

NASA Astrophysics Data System (ADS)

Chin, Siew C.; Tong, Foo S.; Doh, Shu I.; Gimbun, Jolius; Ong, Huey R.; Serigar, Januar P.

2018-03-01

This paper presents the effective strengthening potential of pineapple leaves fiber (PALF)-epoxy composite plate on reinforced concrete (RC) beam. At first the PALF is treated with alkali (NaOH) and its morphology is observed via scanning electron microscope (SEM). The composite plates made of PALF and epoxy with fiber loading ranging from 0.1 to 0.4 v/v was tested for its flexural behaviour. The composite was then used for external RC beam strengthening. The structural properties of RC beams were evaluated and all the beams were tested under four-point bending. It was found that the flexural strength increased as the fiber volume ratio increases. The maximum flexural strength (301.94 MPa) was obtained at the fiber volume ratio of 40%. The beam strengthened with PALF-epoxy composite plate has a 7% higher beam capacity compared to the control beam. Cracks formed at the edge of the plate of PALF-strengthened beams resulted in diagonal cracking. Result from this work shows that the PALF-epoxy composite plate has the potential to be used as external strengthening material for RC beam.

Generation of a pulsed low-energy electron beam using the channel spark device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Elgarhy, M. A. I., E-mail: elgarhy@azhar.edu.eg; Hassaballa, S. E.; Rashed, U. M.

2015-12-15

For the generation of low-energy electron beam, the design and characteristics of channel spark discharge (CSD) operating at a low voltage are presented in this paper. The discharge voltage, discharge current, X-ray emissions, and electron beam current were experimentally determined. The effects of the applied voltage, working gas pressure, and external capacitance on the CSD and beam parameters were measured. At an applied voltage of 11 kV, an oxygen gas pressure of 25 mTorr, and an external capacitance of 16.45 nF, the maximum measured current was 900 A. The discharge current increased with the increase in the pressure and capacitance,more » while its periodic time decreased with the increase in the pressure. Two types of the discharge were identified and recorded: the hollow cathode discharge and the conduction discharge. A Faraday cup was used to measure the beam current. The maximum measured beam current was 120 A, and the beam signal exhibited two peaks. The increase in both the external capacitance and the applied discharge voltage increased the maximum electron beam current. The electron-beam pulse time decreased with the increase in the gas pressure at a constant voltage and increased with the decrease in the applied discharge voltage. At an applied voltage of 11 kV and an oxygen gas pressure of 15 mTorr, the maximum beam energy was 2.8 keV. The X-ray signal intensity decreased with the increase in the gas pressure and increased with the increase in the capacitance.« less

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Constantin, Dragos E.; Fahrig, Rebecca; Keall, Paul J.

Purpose: Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Methods: Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approachmore » in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. Results: For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29{pi}-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the in-line configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72{pi} and 2.01{pi}-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34{pi} and 0.35{pi}-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. Conclusions: 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field.« less

Multi-frequency klystron designed for high efficiency

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jensen, Aaron

A multi-frequency klystron has an electron gun which generates a beam, a circuit of bunch-align-collect (BAC) tuned cavities that bunch the beam and amplify an RF signal, a collector where the beam is collected and dumped, and a standard output cavity and waveguide coupled to a window to output RF power at a fundamental mode to an external load. In addition, the klystron has additional bunch-align-collect (BAC) cavities tuned to a higher harmonic frequency, and a harmonic output cavity and waveguide coupled via a window to an additional external load.

MO-A-BRB-03: Integration Issues in Electronic Charting for External Beam Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sutlief, S.

2015-06-15

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

A comprehensive comparison of IMRT and VMAT plan quality for prostate cancer treatment

PubMed Central

QUAN, ENZHUO M.; LI, XIAOQIANG; LI, YUPENG; WANG, XIAOCHUN; KUDCHADKER, RAJAT J.; JOHNSON, JENNIFER L.; KUBAN, DEBORAH A.; LEE, ANDREW K.; ZHANG, XIAODONG

2013-01-01

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 8-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 8-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 8-beam IMRT plans, but the delivery time was still less than 3 minutes. 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. PMID:22704703

SU-F-T-522: Dosimetric Study of Junction Dose in Double Isocenter Flatten and Flatten Filter Free IMRT and VMAT Plan Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samuvel, K; Yadav, G; Bhushan, M

2016-06-15

Purpose: To quantify the dosimetric accuracy of junction dose in double isocenter flattened and flatten filter free(FFF) intensity modulated radiation therapy(IMRT) and volumetric modulated arc therapy(VMAT) plan delivery using pelvis phantom. Methods: Five large field pelvis patients were selected for this study. Double isocenter IMRT and VMAT treatment plans were generated in Eclipse Treatment planning System (V.11.0) using 6MV FB and FFF beams. For all the plans same distance 17.0cm was kept between one isocenter to another isocenter. IMRT Plans were made with 7 coplanar fields and VMAT plans were made with full double arcs. Dose calculation was performed usingmore » AAA algorithms with dose grid size of 0.25 cm. Verification plans were calculated on Scanditronix Wellhofer pelvis slab phantom. Measurement point was selected and calculated, where two isocenter plan fields are overlapping, this measurement point was kept at distance 8.5cm from both isocenter. The plans were delivered using Varian TrueBeamTM machine on pelvis slab phantom. Point dose measurements was carried out using CC13 ion chamber volume of 0.13cm3. Results: The measured junction point dose are compared with TPS calculated dose. The mean difference observed was 4.5%, 6.0%, 4.0% and 7.0% for IMRT-FB,IMRT-FFF, VMAT-FB and VMAT-FFF respectively. The measured dose results shows closer agreement with calculated dose in Flatten beam planning in both IMRT and VMAT, whereas in FFF beam plan dose difference are more compared with flatten beam plan. Conclusion: Dosimetry accuracy of Large Field junction dose difference was found less in Flatten beam compared with FFF beam plan delivery. Even though more dosimetric studies are required to analyse junction dose for FFF beam planning using multiple point dose measurements and fluence map verification in field junction area.« less

Early-stage central lung cancer and volumetric modulated arc therapy: a dosimetric case study with literature review.

PubMed

Valakh, Vladimir; Chan, Philip; D'Adamo, Karen; Micaily, Bizhan

2013-10-01

In the present article we review on the use of Volumetric Modulated Arc Therapy (VMAT) for a small lung nodule that was centrally located in close proximity to the mediastinal structures. An inoperable patient with central, clinical stage IA adenocarcinoma of the right lung was treated with external-beam radiation therapy of 52.5 Gy in 15 factions. A single 360° coplanar arc VMAT plan (360-VMAT) was used for treatment and compared to step-and-shoot Intensity Modulation Radiotherapy (IMRT) and a single 180° ipsilateral partial arc VMAT plan (180-VMAT). Planning Target Volume (PTV) coverage was not different, and 360-VMAT had the highest dose homogeneity. Both 360-VMAT and 180-VMAT reduced esophageal dose compared to IMRT. While IMRT had the lowest lung dose, all 3 plans achieved acceptable sparing of the lung. 180-VMAT had the highest dose conformity. Both 360-VMAT and 180-VMAT improved esophageal sparing compared to IMRT. Use of VMAT in early-stage, centrally located NSCLC is a promising treatment approach and merits additional investigation.

MO-H-19A-01: FEATURED PRESENTATION - Treatment Planning Tool for Radiotherapy with Very High-Energy Electron Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bazalova, M; Qu, B; Palma, B

2014-06-15

Purpose: To develop a tool for treatment planning optimization for fast radiotherapy delivered with very high-energy electron beams (VHEE) and to compare VHEE plans to state-of-the-art plans for challenging pelvis and H'N cases. Methods: Treatment planning for radiotherapy delivered with VHEE scanning pencil beams was performed by integrating EGSnrc Monte Carlo (MC) dose calculations with spot scanning optimization run in a research version of RayStation. A Matlab GUI for MC beamlet generation was developed, in which treatment parameters such as the pencil beam size and spacing, energy and number of beams can be selected. Treatment planning study for H'N andmore » pelvis cases was performed and the effect of treatment parameters on the delivered dose distributions was evaluated and compared to the clinical treatment plans. The pelvis case with a 691cm3 PTV was treated with 2-arc 15MV VMAT and the H'N case with four PTVs with total volume of 531cm3 was treated with 4-arc 6MV VMAT. Results: Most studied VHEE plans outperformed VMAT plans. The best pelvis 80MeV VHEE plan with 25 beams resulted in 12% body dose sparing and 8% sparing to the bowel and right femur compared to the VMAT plan. The 100MeV plan was superior to the 150MeV plan. Mixing 100 and 150MeV improved dose sparing to the bladder by 7% compared to either plan. Plans with 16 and 36 beams did not significantly affect the dose distributions compared to 25 beam plans. The best H'N 100MeV VHEE plan decreased mean doses to the brainstem, chiasm, and both globes by 10-42% compared to the VMAT plan. Conclusion: The pelvis and H'N cases suggested that sixteen 100MeV beams might be sufficient specifications of a novel VHEE treatment machine. However, optimum machine parameters will be determined with the presented VHEE treatment-planning tool for a large number of clinical cases. BW Loo and P Maxim received research support from RaySearch Laboratories. E Hynning and B Hardemark are employees of RaySearch Laboratories.« less

PET imaging for treatment verification of ion therapy: Implementation and experience at GSI Darmstadt and MGH Boston

NASA Astrophysics Data System (ADS)

Parodi, Katia; Bortfeld, Thomas; Enghardt, Wolfgang; Fiedler, Fine; Knopf, Antje; Paganetti, Harald; Pawelke, Jörg; Shakirin, Georgy; Shih, Helen

2008-06-01

Ion beams offer the possibility of improved conformation of the dose delivered to the tumor with better sparing of surrounding tissue and critical structures in comparison to conventional photon and electron external radiation treatment modalities. Full clinical exploitation of this advantage can benefit from in vivo confirmation of the actual beam delivery and, in particular, of the ion range in the patient. During irradiation, positron emitters like 15O (half-life T1/2≈2 min) and 11C ( T1/2≈20 min) are formed in nuclear interactions between the ions and the tissue. Detection of this transient radioactivity via positron emission tomography (PET) and comparison with the expectation based on the prescribed beam application may serve as an in vivo, non-invasive range validation method of the whole treatment planning and delivery chain. For technical implementation, PET imaging during irradiation (in-beam) requires the development of customized, limited angle detectors with data acquisition synchronized with the beam delivery. Alternatively, commercial PET or PET/CT scanners in close proximity to the treatment site enable detection of the residual activation from long-lived emitters shortly after treatment (offline). This paper reviews two clinical examples using a dedicated in-beam PET scanner for verification of carbon ion therapy at GSI Darmstadt, Germany, as well as a commercial offline PET/CT tomograph for post-radiation imaging of proton treatments at Massachusetts General Hospital, Boston, USA. Challenges as well as pros and cons of the two imaging approaches in dependence of the different ion type and beam delivery system are discussed.

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology.

PubMed

Shahbazi-Gahrouei, Daryoush; Saeb, Mohsen; Monadi, Shahram; Jabbari, Iraj

2017-01-01

Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany). Seven test cases were performed using semi CIRS phantom. In homogeneous regions and simple plans for both energies, there was a good agreement between measured and treatment planning system calculated dose. Their relative error was found to be between 0.8% and 3% which is acceptable for audit, but in nonhomogeneous organs, such as lung, a few errors were observed. In complex treatment plans, when wedge or shield in the way of energy is used, the error was in the accepted criteria. In complex beam plans, the difference between measured and calculated dose was found to be 2%-3%. All differences were obtained between 0.4% and 1%. A good consistency was observed for the same type of energy in the homogeneous and nonhomogeneous phantom for the three-dimensional conformal field with a wedge, shield, asymmetric using the TiGRT treatment planning software in studied center. The results revealed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy was globally within acceptable standards with no major causes for concern.

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology

PubMed Central

Shahbazi-Gahrouei, Daryoush; Saeb, Mohsen; Monadi, Shahram; Jabbari, Iraj

2017-01-01

Background: Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Materials and Methods: Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany). Seven test cases were performed using semi CIRS phantom. Results: In homogeneous regions and simple plans for both energies, there was a good agreement between measured and treatment planning system calculated dose. Their relative error was found to be between 0.8% and 3% which is acceptable for audit, but in nonhomogeneous organs, such as lung, a few errors were observed. In complex treatment plans, when wedge or shield in the way of energy is used, the error was in the accepted criteria. In complex beam plans, the difference between measured and calculated dose was found to be 2%–3%. All differences were obtained between 0.4% and 1%. Conclusions: A good consistency was observed for the same type of energy in the homogeneous and nonhomogeneous phantom for the three-dimensional conformal field with a wedge, shield, asymmetric using the TiGRT treatment planning software in studied center. The results revealed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy was globally within acceptable standards with no major causes for concern. PMID:28989910

SU-F-BRD-10: Lung IMRT Planning Using Standardized Beam Bouquet Templates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yuan, L; Wu, Q J.; Yin, F

2014-06-15

Purpose: We investigate the feasibility of choosing from a small set of standardized templates of beam bouquets (i.e., entire beam configuration settings) for lung IMRT planning to improve planning efficiency and quality consistency, and also to facilitate automated planning. Methods: A set of beam bouquet templates is determined by learning from the beam angle settings in 60 clinical lung IMRT plans. A k-medoids cluster analysis method is used to classify the beam angle configuration into clusters. The value of the average silhouette width is used to determine the ideal number of clusters. The beam arrangements in each medoid of themore » resulting clusters are taken as the standardized beam bouquet for the cluster, with the corresponding case taken as the reference case. The resulting set of beam bouquet templates was used to re-plan 20 cases randomly selected from the database and the dosimetric quality of the plans was evaluated against the corresponding clinical plans by a paired t-test. The template for each test case was manually selected by a planner based on the match between the test and reference cases. Results: The dosimetric parameters (mean±S.D. in percentage of prescription dose) of the plans using 6 beam bouquet templates and those of the clinical plans, respectively, and the p-values (in parenthesis) are: lung Dmean: 18.8±7.0, 19.2±7.0 (0.28), esophagus Dmean: 32.0±16.3, 34.4±17.9 (0.01), heart Dmean: 19.2±16.5, 19.4±16.6 (0.74), spinal cord D2%: 47.7±18.8, 52.0±20.3 (0.01), PTV dose homogeneity (D2%-D99%): 17.1±15.4, 20.7±12.2 (0.03).The esophagus Dmean, cord D02 and PTV dose homogeneity are statistically better in the plans using the standardized templates, but the improvements (<5%) may not be clinically significant. The other dosimetric parameters are not statistically different. Conclusion: It's feasible to use a small number of standardized beam bouquet templates (e.g. 6) to generate plans with quality comparable to that of clinical plans. Partially supported by NIH/NCI under grant #R21CA161389 and a master research grant by Varian Medical System.« less

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 optimization algorithms are demonstrated. We investigated the clinical significance of MERT on spinal irradiation, breast boost irradiation, and a head and neck sarcoma cancer site using several parameters to analyze the treatment plans. Finally, we investigated the idea of mixed beam photon and electron treatment planning. Photon optimization treatment planning tools were included within the MERT planning toolkit for the purpose of mixed beam optimization. In conclusion, this thesis work has resulted in the development of an advanced framework for photon and electron Monte Carlo treatment planning studies and the development of an inverse planning system for photon, electron or mixed beam radiotherapy (MBRT). The justification and validation of this work is found within the results of the planning studies, which have demonstrated dosimetric advantages to using MERT or MBRT in comparison to clinical treatment alternatives.

Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl; Spadola, Sara; Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna

Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differencesmore » in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30 patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an enhanced risk for the development of contralateral breast cancer.« less

Integral radiation dose to normal structures with conformal external beam radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aoyama, Hidefumi; Westerly, David Clark; Mackie, Thomas Rockwell

2006-03-01

Background: This study was designed to evaluate the integral dose (ID) received by normal tissue from intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Twenty-five radiation treatment plans including IMRT using a conventional linac with both 6 MV (6MV-IMRT) and 20 MV (20MV-IMRT), as well as three-dimensional conformal radiotherapy (3DCRT) using 6 MV (6MV-3DCRT) and 20 MV (20MV-3DCRT) and IMRT using tomotherapy (6MV) (Tomo-IMRT), were created for 5 patients with localized prostate cancer. The ID (mean dose x tissue volume) received by normal tissue (NTID) was calculated from dose-volume histograms. Results: The 6MV-IMRT resulted in 5.0% lower NTID thanmore » 6MV-3DCRT; 20 MV beam plans resulted in 7.7%-11.2% lower NTID than 6MV-3DCRT. Tomo-IMRT NTID was comparable to 6MV-IMRT. Compared with 6MV-3DCRT, 6MV-IMRT reduced IDs to the rectal wall and penile bulb by 6.1% and 2.7%, respectively. Tomo-IMRT further reduced these IDs by 11.9% and 16.5%, respectively. The 20 MV did not reduce IDs to those structures. Conclusions: The difference in NTID between 3DCRT and IMRT is small. The 20 MV plans somewhat reduced NTID compared with 6 MV plans. The advantage of tomotherapy over conventional IMRT and 3DCRT for localized prostate cancer was demonstrated in regard to dose sparing of rectal wall and penile bulb while slightly decreasing NTID as compared with 6MV-3DCRT.« less

Beam commissioning and measurements validating the beam model in a new TPS that converts helical tomotherapy plans to step-and-shoot IMRT plans.

PubMed

Petersson, Kristoffer; Ceberg, Crister; Engström, Per; Knöös, Tommy

2011-01-01

A new type of treatment planning system called SHAREPLAN has been studied, which enables the transfer of treatment plans generated for helical tomotherapy delivery to plans that can be delivered on C-arm linacs. The purpose is to ensure continuous patient treatment during periods of unscheduled downtime for the TomoTherapy unit, particularly in clinics without a backup unit. The purpose of this work was to verify that the plans generated in this novel planning system are deliverable and accurate. The work consists primarily of beam commissioning, verification of the beam model, and measurements verifying that generated plans are deliverable with sufficient accuracy. The beam commissioning process involves input of general geometric properties of the modeled linac, profiles and depth dose curves for a specific photon nominal energy (6 MV), and the automated modeling of other beam properties. Some manual tuning of the beam model is required. To evaluate its accuracy, the confidence limit concept [J. Venselaar et al., "Tolerances for the accuracy of photon beam dose calculations of treatment planning systems," Radiother. Oncol. 60, 191-201 (2001)] was used, which is a method supported by ESTRO. Measurements were conducted with a 2D diode array at the commissioned linac as a final check of the beam model and to evaluate whether the generated plans were deliverable and accurate. The comparison and evaluation of calculated data points and measured data according to the method applied confirmed the accuracy of the beam model. The profiles had a confidence limit of 1.1% and the depth dose curves had a confidence limit of 1.7%, both of which were well below the tolerance limit of 2%. Plan specific QC measurements and evaluation verified that different plans generated in the TPS were deliverable with sufficient accuracy at the commissioned linac, as none of the 160 beams for the 20 different plans evaluated had a fraction of approved data points below 90%, the local clinical approval criterion for delivery QA measurements. This study is a validation of the new TPS as it verifies that the generated plans are deliverable at a commissioned linac with adequate accuracy. A thorough investigation of the treatment plan quality will require a separate study. The TPS is proving to be a useful and time-saving complement, especially for clinics having a single unit for helical delivery among its conventional linacs.

The effect of anterior proton beams in the setting of a prostate-rectum spacer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Christodouleas, John P., E-mail: christojo@uphs.upenn.edu; Tang, Shikui; Susil, Robert C.

2013-10-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangementmore » anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.« less

The effect of anterior proton beams in the setting of a prostate-rectum spacer

PubMed Central

Christodouleas, John P.; Tang, Shikui; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y.; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; DeWeese, Theodore L.; Lu, Hsiao-Ming; Both, Stefan

2014-01-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS. PMID:23578497

Optical properties of monolayer polystyrene microspheres driven by a direct current

NASA Astrophysics Data System (ADS)

Jiao, Xinbing; Pan, Qian; Zhao, Xinwei; Hao, Ruirui; Bai, Xue

2018-04-01

Polystyrene microspheres (PSMs) with diameters of 5 μm and 10 μm are prepared on garnet by a self-assembly method. The pressure generated by quartz sheet/PSM/garnet/graphite is measured by a resistance strain sensor as a function of the external direct current (DC) voltage. The surface morphology of the PSMs are observed by optical microscopy. The polarization properties of the linearly and circularly polarized laser beams with a wavelength of 1550 nm reflected from the different PSMs are researched by a Thorlabs PAX 5710 IR3 Polarization Analyzing System as a function of the external DC voltage. The results show that the PSMs with different sizes can be damaged when the external pressure exceeds its critical value of 3.0 MPa, but the critical DC voltages are different. The optical polarization properties of the circularly polarized laser beam can be changed with the external DC voltage, whereas the linearly polarized laser beam cannot be changed.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces

NASA Astrophysics Data System (ADS)

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian; Cremer, Johannes; Chasovskikh, Egor; Signorell, Ruth

2015-04-01

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance for the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces.

PubMed

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian; Cremer, Johannes; Chasovskikh, Egor; Signorell, Ruth

2015-04-21

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance for the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.

Improving treatment plan evaluation with automation.

PubMed

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

2016-11-08

The goal of this work is to evaluate the effectiveness of Plan-Checker Tool (PCT) which was created to improve first-time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the phys-ics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was suc-cessfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. © 2016 The Authors.

Knowledge-based computer systems for radiotherapy planning.

PubMed

Kalet, I J; Paluszynski, W

1990-08-01

Radiation therapy is one of the first areas of clinical medicine to utilize computers in support of routine clinical decision making. The role of the computer has evolved from simple dose calculations to elaborate interactive graphic three-dimensional simulations. These simulations can combine external irradiation from megavoltage photons, electrons, and particle beams with interstitial and intracavitary sources. With the flexibility and power of modern radiotherapy equipment and the ability of computer programs that simulate anything the machinery can do, we now face a challenge to utilize this capability to design more effective radiation treatments. How can we manage the increased complexity of sophisticated treatment planning? A promising approach will be to use artificial intelligence techniques to systematize our present knowledge about design of treatment plans, and to provide a framework for developing new treatment strategies. Far from replacing the physician, physicist, or dosimetrist, artificial intelligence-based software tools can assist the treatment planning team in producing more powerful and effective treatment plans. Research in progress using knowledge-based (AI) programming in treatment planning already has indicated the usefulness of such concepts as rule-based reasoning, hierarchical organization of knowledge, and reasoning from prototypes. Problems to be solved include how to handle continuously varying parameters and how to evaluate plans in order to direct improvements.

Using component technology to facilitate external software reuse in ground-based planning systems

NASA Technical Reports Server (NTRS)

Chase, A.

2003-01-01

APGEN (Activity Plan GENerator - 314), a multi-mission planning tool, must interface with external software to vest serve its users. AP-GEN's original method for incorporating external software, the User-Defined library mechanism, has been very successful in allowing APGEN users access to external software functionality.

Co-registration of cone beam CT and planning CT in head and neck IMRT dose estimation: a feasible adaptive radiotherapy strategy

PubMed Central

Yip, C; Thomas, C; Michaelidou, A; James, D; Lynn, R; Lei, M

2014-01-01

Objective: To investigate if cone beam CT (CBCT) can be used to estimate the delivered dose in head and neck intensity-modulated radiotherapy (IMRT). Methods: 15 patients (10 without replan and 5 with replan) were identified retrospectively. Weekly CBCT was co-registered with original planning CT. Original high-dose clinical target volume (CTV1), low-dose CTV (CTV2), brainstem, spinal cord, parotids and external body contours were copied to each CBCT and modified to account for anatomical changes. Corresponding planning target volumes (PTVs) and planning organ-at-risk volumes were created. The original plan was applied and calculated using modified per-treatment volumes on the original CT. Percentage volumetric, cumulative (planned dose delivered prior to CBCT + adaptive dose delivered after CBCT) and actual delivered (summation of weekly adaptive doses) dosimetric differences between each per-treatment and original plan were calculated. Results: There was greater volumetric change in the parotids with an average weekly difference of between −4.1% and −27.0% compared with the CTVs/PTVs (−1.8% to −5.0%). The average weekly cumulative dosimetric differences were as follows: CTV/PTV (range, −3.0% to 2.2%), ipsilateral parotid volume receiving ≥26 Gy (V26) (range, 0.5–3.2%) and contralateral V26 (range, 1.9–6.3%). In patients who required replan, the average volumetric reductions were greater: CTV1 (−2.5%), CTV2 (−6.9%), PTV1 (−4.7%), PTV2 (−11.5%), ipsilateral (−10.4%) and contralateral parotids (−12.1%), but did not result in significant dosimetric changes. Conclusion: The dosimetric changes during head and neck simultaneous integrated boost IMRT do not necessitate adaptive radiotherapy in most patients. Advances in knowledge: Our study shows that CBCT could be used for dose estimation during head and neck IMRT. PMID:24288402

SU-F-T-338: Flattening Filter Free Photon Beams Can Achieve the Same Plan Quality as Conventional Flattened Beams for Prostate Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolar, M; Szwedowski, R; Greskovich, J

Purpose: Some modern linear accelerators are equipped with one low energy flat beam and two flattening filter free (FFF) beams at high and low energies. The purpose of this study is to investigate whether the high energy FFF beam can produce the same plan quality as the conventional low energy flat beam, using a volumetric modulated arc (VMAT) technique for prostate patients. Methods: Ten prostate cancer patients were selected with a prescription of 78Gy. For each patient, three plans were created: (a) double arc flat 6MV plan used clinically; (b) double arc 10MV FFF plan; (c) single arc 10MV FFFmore » plan. Each plan was prescribed so that at least 95% of the PTV received the prescription dose. The following dosimetric endpoints were evaluated: volume receiving 78Gy (V78) of the CTV and PTV, PTV conformality index (CI, ratio of prescription isodose volume to the PTV volume), bladder volume receiving 70Gy (V70) and 60Gy (V60), rectum volume receiving 70Gy (V70) and 50Gy (V50), dose to 10cc of the rectum, and volume of both femoral heads receiving 50Gy (V50). Total monitor units for each plan were recorded. Results: No significant difference was found for all dosimetric endpoints between all plans (p>0.05). Compared to the 6MV plans, monitor units were higher with the double arc 10MV FFF plans and lower with the single arc 10MV FFF plans, 29% and 4% respectively. Conclusion: Both single arc and double arc 10MV FFF VMAT can achieve equivalent plan quality as 6MV flat beam double arc treatment plans. With the gantry speed restriction, a high dose rate of 2400MU/min may allow the optimizer to use more MUs than actually needed. Single arc 10MV FFF VMAT plans are a reasonable alternative to double arc 6MV flat beam VMAT plans.« less

Spot scanning proton therapy minimizes neutron dose in the setting of radiation therapy administered during pregnancy.

PubMed

Wang, Xin; Poenisch, Falk; Sahoo, Narayan; Zhu, Ronald X; Lii, MingFwu; Gillin, Michael T; Li, Jing; Grosshans, David

2016-09-08

This is a real case study to minimize the neutron dose equivalent (H) to a fetus using spot scanning proton beams with favorable beam energies and angles. Minimum neutron dose exposure to the fetus was achieved with iterative planning under the guidance of neutron H measurement. Two highly conformal treatment plans, each with three spot scanning beams, were planned to treat a 25-year-old pregnant female with aggressive recurrent chordoma of the base of skull who elected not to proceed with termination. Each plan was scheduled for delivery every other day for robust target coverage. Neutron H to the fetus was measured using a REM500 neutron survey meter placed at the fetus position of a patient simulating phantom. 4.1 and 44.1 μSv/fraction were measured for the two initial plans. A vertex beam with higher energy and the fetal position closer to its central axis was the cause for the plan that produced an order higher neutron H. Replacing the vertex beam with a lateral beam reduced neutron H to be comparable with the other plan. For a prescription of 70 Gy in 35 fractions, the total neutron H to the fetus was estimated to be 0.35 mSv based on final measurement in single fraction. In comparison, the passive scattering proton plan and photon plan had an estimation of 26 and 70 mSv, respectively, for this case. While radiation therapy in pregnant patients should be avoided if at all possible, our work demonstrated spot scanning beam limited the total neutron H to the fetus an order lower than the suggested 5 mSv regulation threshold. It is far superior than passive scattering beam and careful beam selection with lower energy and keeping fetus further away from beam axis are essential in minimizing the fetus neutron exposure. © 2016 The Authors.

Photovoltaic spatial solitons affected by a resistor in the external circuit

NASA Astrophysics Data System (ADS)

Wang, Xiao Sheng; She, Wei Long

2002-09-01

We have found that the FWHM of one-dimensional photovoltaic spatial soliton is modified by the space-charge field in the crystal, which can be controlled by a resistor in the external circuit. In this case, the photovoltaic contribution of a background beam is taken into account. In a crystal with a positive perturbation of refractive index, the FWHM of dark soliton decreases with the resistance of the resistor, while the FWHM of bright soliton increases with the resistance. Furthermore, when R (the ratio of the effective Glass constant of a signal beam over a background beam) is higher than 1, we can switch a dark soliton to a bright soliton by decreasing the resistance or vice versa. During such process, both the wavelengths and the intensities of the signal beam and the background beam are kept unchanged.

External audits of electron beams using mailed TLD dosimetry: preliminary results.

PubMed

Gomola, I; Van Dam, J; Isern-Verdum, J; Verstraete, J; Reymen, R; Dutreix, A; Davis, B; Huyskens, D

2001-02-01

A feasibility study has been performed to investigate the possibility of using mailed thermoluminescence dosimetry (TLD) for external audits of clinical electron beams in Europe. In the frame of the EC Network Project for Quality Assurance in Radiotherapy, instruction sheets and mailing procedures have been defined for mailed TLD dosimetry using the dedicated holder developed by a panel of experts of the International Atomic Energy Agency (IAEA). Three hundred and thirty electron beam set-ups have been checked in the reference centres and some local centres of the EC Network Project and in addition through the centres participating to the EORTC Radiotherapy Group trial 22922. The mean ratio of measured dose to stated dose is 0.2% and the standard deviation of measured dose to stated dose is 3.2%. In seven beam set-ups, deviations greater than 10% were observed (max. 66%), showing the usefulness of these checks. The results of this feasibility study (instruction sheets, mailing procedures, holder) are presently endorsed by the EQUAL-ESTRO structure in order to offer in the future to all ESTRO members the possibility to request external audits of clinical electron beams.

Effect of External Post-tensioning in Retrofitting of RC Beams

NASA Astrophysics Data System (ADS)

Manisekar, R.

2018-05-01

There are large number of existing concrete bridges in distressed condition in India and other countries, and they need retrofitting solutions. External post-tensioning is a prime technique for bridge retrofitting. It is being applied for retrofitting of bridges in India and other countries. Although the technique is becoming popular in retrofitting, various issues regarding performance of post-retrofitting behaviour need to be studied in detail. RC beam specimens of rectangular section were distressed by means of cracks to a certain limit, and were retrofitted by external post-tensioning. Retrofitted specimens were tested to fail to study the post-retrofitting behaviour. Retrofitting has increased the ultimate load carrying capacity by 81% with reference to the control beam, and recovered the deflection. This paper intends to report the results of the experimental investigations, and conclusions.

In vivo dosimetry for external photon treatments of head and neck cancers by diodes and TLDS.

PubMed

Tung, C J; Wang, H C; Lo, S H; Wu, J M; Wang, C J

2004-01-01

In vivo dosimetry was implemented for treatments of head and neck cancers in the large fields. Diode and thermoluminescence dosemeter (TLD) measurements were carried out for the linear accelerators of 6 MV photon beams. ESTRO in vivo dosimetry protocols were followed in the determination of midline doses from measurements of entrance and exit doses. Of the fields monitored by diodes, the maximum absolute deviation of measured midline doses from planned target doses was 8%, with the mean value and the standard deviation of -1.0 and 2.7%. If planned target doses were calculated using radiological water equivalent thicknesses rather than patient geometric thicknesses, the maximum absolute deviation dropped to 4%, with the mean and the standard deviation of 0.7 and 1.8%. For in vivo dosimetry monitored by TLDs, the shift in mean dose remained small but the statistical precision became poor.

SU-E-T-110: An Investigation On Monitor Unit Threshold and Effects On IMPT Delivery in Proton Pencil Beam Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Ding, X; Syh, J

2015-06-15

Purpose: An approved proton pencil beam scanning (PBS) treatment plan might not be able to deliver because of existed extremely low monitor unit per beam spot. A dual hybrid plan with higher efficiency of higher spot monitor unit and the efficacy of less number of energy layers were searched and optimized. The range of monitor unit threshold setting was investigated and the plan quality was evaluated by target dose conformity. Methods: Certain limitations and requirements need to be checks and tested before a nominal proton PBS treatment plan can be delivered. The plan needs to be met the machine characterization,more » specification in record and verification to deliver the beams. Minimal threshold of monitor unit, e.g. 0.02, per spot was set to filter the low counts and plan was re-computed. Further MU threshold increment was tested in sequence without sacrificing the plan quality. The number of energy layer was also alternated due to elimination of low count layer(s). Results: Minimal MU/spot threshold, spot spacing in each energy layer and total number of energy layer and the MU weighting of beam spots of each beam were evaluated. Plan optimization between increases of the spot MU (efficiency) and less energy layers of delivery (efficacy) was adjusted. 5% weighting limit of total monitor unit per beam was feasible. Scarce spreading of beam spots was not discouraging as long as target dose conformity within 3% criteria. Conclusion: Each spot size is equivalent to the relative dose in the beam delivery system. The energy layer is associated with the depth of the targeting tumor. Our work is crucial to maintain the best possible quality plan. To keep integrity of all intrinsic elements such as spot size, spot number, layer number and the carried weighting of spots in each layer is important in this study.« less

SU-E-T-577: Commissioning of a Deterministic Algorithm for External Photon Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, T; Finlay, J; Mesina, C

Purpose: We report commissioning results for a deterministic algorithm for external photon beam treatment planning. A deterministic algorithm solves the radiation transport equations directly using a finite difference method, thus improve the accuracy of dose calculation, particularly under heterogeneous conditions with results similar to that of Monte Carlo (MC) simulation. Methods: Commissioning data for photon energies 6 – 15 MV includes the percentage depth dose (PDD) measured at SSD = 90 cm and output ratio in water (Spc), both normalized to 10 cm depth, for field sizes between 2 and 40 cm and depths between 0 and 40 cm. Off-axismore » ratio (OAR) for the same set of field sizes was used at 5 depths (dmax, 5, 10, 20, 30 cm). The final model was compared with the commissioning data as well as additional benchmark data. The benchmark data includes dose per MU determined for 17 points for SSD between 80 and 110 cm, depth between 5 and 20 cm, and lateral offset of up to 16.5 cm. Relative comparisons were made in a heterogeneous phantom made of cork and solid water. Results: Compared to the commissioning beam data, the agreement are generally better than 2% with large errors (up to 13%) observed in the buildup regions of the FDD and penumbra regions of the OAR profiles. The overall mean standard deviation is 0.04% when all data are taken into account. Compared to the benchmark data, the agreements are generally better than 2%. Relative comparison in heterogeneous phantom is in general better than 4%. Conclusion: A commercial deterministic algorithm was commissioned for megavoltage photon beams. In a homogeneous medium, the agreement between the algorithm and measurement at the benchmark points is generally better than 2%. The dose accuracy for a deterministic algorithm is better than a convolution algorithm in heterogeneous medium.« less

Experiment study on RC frame retrofitted by the external structure

NASA Astrophysics Data System (ADS)

Liu, Chunyang; Shi, Junji; Hiroshi, Kuramoto; Taguchi, Takashi; Kamiya, Takashi

2016-09-01

A new retrofitting method is proposed herein for reinforced concrete (RC) structures through attachment of an external structure. The external structure consists of a fiber concrete encased steel frame, connection slab and transverse beams. The external structure is connected to the existing structure through a connection slab and transverse beams. Pseudostatic experiments were carried out on one unretrofitted specimen and three retrofitted frame specimens. The characteristics, including failure mode, crack pattern, hysteresis loops behavior, relationship of strain and displacement of the concrete slab, are demonstrated. The results show that the load carrying capacity is obviously increased, and the extension length of the slab and the number of columns within the external frame are important influence factors on the working performance of the existing structure. In addition, the displacement difference between the existing structure and the outer structure was caused mainly by three factors: shear deformation of the slab, extraction of transverse beams, and drift of the conjunction part between the slab and the existing frame. Furthermore, the total deformation determined by the first two factors accounted for approximately 80% of the damage, therefore these factors should be carefully considered in engineering practice to enhance the effects of this new retrofitting method.

SU-E-T-327: The Update of a XML Composing Tool for TrueBeam Developer Mode

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, Y; Mao, W; Jiang, S

2014-06-01

Purpose: To introduce a major upgrade of a novel XML beam composing tool to scientists and engineers who strive to translate certain capabilities of TrueBeam Developer Mode to future clinical benefits of radiation therapy. Methods: TrueBeam Developer Mode provides the users with a test bed for unconventional plans utilizing certain unique features not accessible at the clinical mode. To access the full set of capabilities, a XML beam definition file accommodating all parameters including kV/MV imaging triggers in the plan can be locally loaded at this mode, however it is difficult and laborious to compose one in a text editor.more » In this study, a stand-along interactive XML beam composing application, TrueBeam TeachMod, was developed on Windows platforms to assist users in making their unique plans in a WYSWYG manner. A conventional plan can be imported in a DICOM RT object as the start of the beam editing process in which trajectories of all axes of a TrueBeam machine can be modified to the intended values at any control point. TeachMod also includes libraries of predefined imaging and treatment procedures to further expedite the process. Results: The TeachMod application is a major of the TeachMod module within DICOManTX. It fully supports TrueBeam 2.0. Trajectories of all axes including all MLC leaves can be graphically rendered and edited as needed. The time for XML beam composing has been reduced to a negligible amount regardless the complexity of the plan. A good understanding of XML language and TrueBeam schema is not required though preferred. Conclusion: Creating XML beams manually in a text editor will be a lengthy error-prone process for sophisticated plans. A XML beam composing tool is highly desirable for R and D activities. It will bridge the gap between scopes of TrueBeam capabilities and their clinical application potentials.« less

On Interactions of Oscillation Modes for a Weakly Non-Linear Undamped Elastic Beam with AN External Force

NASA Astrophysics Data System (ADS)

BOERTJENS, G. J.; VAN HORSSEN, W. T.

2000-08-01

In this paper an initial-boundary value problem for the vertical displacement of a weakly non-linear elastic beam with an harmonic excitation in the horizontal direction at the ends of the beam is studied. The initial-boundary value problem can be regarded as a simple model describing oscillations of flexible structures like suspension bridges or iced overhead transmission lines. Using a two-time-scales perturbation method an approximation of the solution of the initial-boundary value problem is constructed. Interactions between different oscillation modes of the beam are studied. It is shown that for certain external excitations, depending on the phase of an oscillation mode, the amplitude of specific oscillation modes changes.

Calculations of dose distributions using a neural network model

NASA Astrophysics Data System (ADS)

Mathieu, R.; Martin, E.; Gschwind, R.; Makovicka, L.; Contassot-Vivier, S.; Bahi, J.

2005-03-01

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journées Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

Calculations of dose distributions using a neural network model.

PubMed

Mathieu, R; Martin, E; Gschwind, R; Makovicka, L; Contassot-Vivier, S; Bahi, J

2005-03-07

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journees Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

SU-E-T-457: Impact of Interfractional Variations On Anterior Vs. Lateral-Field Proton Therapy of Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moteabbed, M; Trofimov, A; Sharp, G C

2015-06-15

Purpose: To investigate the effects of interfractional anatomy and setup variations on plans with anterior-oblique vs. lateral beams for prostate cancer pencil beam scanning (PBS) and passive scattered (PS) proton therapy. Methods: Six patients with low/intermediate risk prostate cancer treated with PS proton therapy at our institution were selected. All patients underwent weekly verification CT scans. Implanted fiducials were used for localization, and endorectal balloons for prostate immobilization. New PBS plans with lateral beams, as well as PBS and PS plans with anterior-oblique beams (±35 deg) were created. PBS plans used two different spot sizes: ∼10mm (large) and ∼5mm (medium)more » sigma at 25cm range and optimized as single-field-uniform-dose with ∼8% non-uniformity. No range uncertainty margins were applied in PBS plans to maximize rectal sparing. Field-specific apertures were used when planning with large spots to sharpen the penumbrae. The planned dose was recomputed on each weekly CT with fiducials aligned to the simulation CT, scaled and accumulated via deformable image registration. Results: The dose volume analysis showed that although difference between planned and accumulated dose remains negligible for plans with conventional lateral beams using both PS and PBS, this is not the case for plans with anterior beams. The target coverage in anterior plans was largely degraded due to the variations in the beam path length and the absence of range margins. The average prostate D95 was reduced by 7.5/15.9% (using PS/PBS) after accumulation for anterior plans, compared with 0/0.4% for lateral plans. The average mean dose in organs-at-risk decreased by 1% for lateral and 2% for anterior plans, similarly for PS and PBS. Spot size did not affect the dose changes. Conclusion: Prostate plans using anterior beams may undergo clinically relevant interfractional dose degradation. Corrective strategies guided by in-vivo range measurements should be studied before clinical application of this technique.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bazalova-Carter, Magdalena; Qu, Bradley; Palma, Bianey

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 graphicalmore » 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 plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI{sub 100} = 1.09 and CI{sub 50} = 4.07) were better than VMAT conformity indices (CI{sub 100} = 1.30 and CI{sub 50} = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI{sub 100} and CI{sub 50} conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI{sub 100} and CI{sub 50} conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans.« less

High dose chemoradiation for unresectable hilar cholangiocarcinomas using intensity modulated external beam radiotherapy: a single tertiary care centre experience

PubMed Central

Mehta, Shaesta; Kalyani, Nikhil; Chaudhari, Suresh; Dharia, Tejas; Shetty, Nitin; Chopra, Supriya; Goel, Mahesh; Kulkarni, Suyash; Shrivastava, Shyam Kishore

2017-01-01

Background We present results of patients diagnosed with unresectable hilar cholangiocarcinomas treated with high dose radiotherapy and concurrent chemotherapy. Methods From Aug 2005 to Dec 2012, 68 consecutive patients were treated. Fifty patients (group 1) presenting to us with obstructive jaundice were planned for endobiliary brachytherapy (EBBT 14 Gy) followed external beam radiotherapy (EBRT 45 Gy). Twenty-two patients (group 2) who had previously undergone biliary drainage underwent EBRT (57 Gy). All patients received injection Gemcitabine 300 mg/m2/weekly along with EBRT. Results Twenty-nine patients in group 1 and 22 patients in group 2 completed the treatment. Twenty-six (55%) patients achieved complete radiological response, 16 (64%) belonging to group 1 and 8 (44%) of group 2 (P=0.05). The median overall survival (MOS) was 17.5 and 16 months for group 1 and 2 respectively (P=0.07). The 1- and 2-year survival was 63%, and 18% for group I and 61% and 22% for group II respectively. The MOS was 5 months and 1 year survival was 14% for patients receiving EBBT only. MOS was significantly better after complete response (P=0.001). Conclusions Intensity modulated radiotherapy (IMRT) modulated high dose radiotherapy used either alone or with brachytherapy demonstrates potential to prolonged overall survival in unresectable hilar cholangiocarcinomas. PMID:28280622

In vivo dosimetry in external beam radiotherapy.

PubMed

Mijnheer, Ben; Beddar, Sam; Izewska, Joanna; Reft, Chester

2013-07-01

In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20∕20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

SU-F-T-207: Does the Greater Flexibility of Pencil Beam Scanning Reduce the Need for a Proton Gantry?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, S; Depauw, N; Flanz, J

2016-06-15

Purpose: Gantry-less proton treatment facility could lower the capital cost of proton therapy. This study investigates the dosimetric feasibility of using only coplanar pencil beam scanning (PBS) beams for those patients who had beam angles that would not have been deliverable without the gantry. Those coplanar beams are implemented on gantry-less horizontal beam-line with patients in sitting or standing positions. Methods: We have selected ten patients (seven head-and-neck, one thoracic, one abdominal and one pelvic case) with clinically delivered double scattering (DS) or PBS treatment plans with beam angles that were challenging to achieve without a gantry. After removing thesemore » beams angles, PBS plans were optimized for gantry-less intensity modulated proton therapy (IMPT) or single field optimization (SFO) with multi-criteria optimization (MCO). For head-and-neck patients who were treated by DS, we generated PBS plans with non-coplanar beams for comparison. Dose-volume-histograms (DVHs), target homogeneity index (HI), mean dose, D-2 and D-98 were reported. Robustness analysis was performed with ±2.5 mm setup errors and ±3.5% range uncertainties for three head-and-neck patients. Results: PBS-gantry-less plans provided more homogenous target coverage and significant improvements on organs-at-risk (OARs) sparing, compared to passive scattering treatments with a gantry. The PBS gantry-less treatments reduced the HI for target coverage by 1.3% to 47.2%, except for a suprasellar patient and a liver patient. The PBS-gantry-less plans reduced the D-mean of OARs by 3.6% to 67.4%. The PBS-gantry plans had similar target coverage and only marginal improvements on OAR sparing as compared to the PBS-gantry-less plans. These two PBS plans also had similar robustness relative to range uncertainties and setup errors. Conclusion: The gantry-less plans have with less mean dose to OARs and more homogeneous target coverage. Although the PBS-gantry plans have slightly improved target coverage and OARs sparing, the overall benefit of having a gantry to provide non-coplanar beams is debatable.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, E; Yuan, F; Templeton, A

Purpose: The ultimate goal of radiotherapy treatment planning is to find a treatment that will yield a high tumor-control-probability(TCP) with an acceptable normal-tissue-complication probability(NTCP). Yet most treatment planning today is not based upon optimization of TCPs and NTCPs, but rather upon meeting physical dose and volume constraints defined by the planner. We design treatment plans that optimize TCP directly and contrast them with the clinical dose-based plans. PET image is incorporated to evaluate gain in TCP for dose escalation. Methods: We build a nonlinear mixed integer programming optimization model that maximizes TCP directly while satisfying the dose requirements on themore » targeted organ and healthy tissues. The solution strategy first fits the TCP function with a piecewise-linear approximation, then solves the problem that maximizes the piecewise linear approximation of TCP, and finally performs a local neighborhood search to improve the TCP value. To gauge the feasibility, characteristics, and potential benefit of PET-image guided dose escalation, initial validation consists of fifteen cervical cancer HDR patient cases. These patients have all received prior 45Gy of external radiation dose. For both escalated strategies, we consider 35Gy PTV-dose, and two variations (37Gy-boost to BTV vs 40Gy-boost) to PET-image-pockets. Results: TCP for standard clinical plans range from 59.4% - 63.6%. TCP for dose-based PET-guided escalated-dose-plan ranges from 63.8%–98.6% for all patients; whereas TCP-optimized plans achieves over 91% for all patients. There is marginal difference in TCP among those with 37Gy-boosted vs 40Gy-boosted. There is no increase in rectum and bladder dose among all plans. Conclusion: Optimizing TCP directly results in highly conformed treatment plans. The TCP-optimized plan is individualized based on the biological PET-image of the patients. The TCP-optimization framework is generalizable and has been applied successfully to other external-beam delivery modalities. A clinical trial is on-going to gauge the clinical significance. Partially supported by the National Science Foundation.« less

[Benchmark experiment to verify radiation transport calculations for dosimetry in radiation therapy].

PubMed

Renner, Franziska

2016-09-01

Monte Carlo simulations are regarded as the most accurate method of solving complex problems in the field of dosimetry and radiation transport. In (external) radiation therapy they are increasingly used for the calculation of dose distributions during treatment planning. In comparison to other algorithms for the calculation of dose distributions, Monte Carlo methods have the capability of improving the accuracy of dose calculations - especially under complex circumstances (e.g. consideration of inhomogeneities). However, there is a lack of knowledge of how accurate the results of Monte Carlo calculations are on an absolute basis. A practical verification of the calculations can be performed by direct comparison with the results of a benchmark experiment. This work presents such a benchmark experiment and compares its results (with detailed consideration of measurement uncertainty) with the results of Monte Carlo calculations using the well-established Monte Carlo code EGSnrc. The experiment was designed to have parallels to external beam radiation therapy with respect to the type and energy of the radiation, the materials used and the kind of dose measurement. Because the properties of the beam have to be well known in order to compare the results of the experiment and the simulation on an absolute basis, the benchmark experiment was performed using the research electron accelerator of the Physikalisch-Technische Bundesanstalt (PTB), whose beam was accurately characterized in advance. The benchmark experiment and the corresponding Monte Carlo simulations were carried out for two different types of ionization chambers and the results were compared. Considering the uncertainty, which is about 0.7 % for the experimental values and about 1.0 % for the Monte Carlo simulation, the results of the simulation and the experiment coincide. Copyright © 2015. Published by Elsevier GmbH.

The Manuel Lujan, Jr. Neutron Scattering Center, LANSCE experiment reports: 1990 Run Cycle

DOE Office of Scientific and Technical Information (OSTI.GOV)

DiStravolo, M.A.

1991-10-01

This year was the third in which LANSCE ran a formal user program. A call for proposals was issued before the scheduled run cycles, and experiment proposals were submitted by scientists from universities, industry, and other research facilities around the world. An external program advisory committee, which LANSCE shares with the Intense Pulsed Neutron Source (IPNS), Argonne National Laboratory examined the proposals and made recommendations. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and anmore » associated Proton Storage Ring (PSR), which can alter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each six-month LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. One hundred thirty-four proposals were submitted for unclassified research and twelve proposals for research of a programmatic nature to the Laboratory. Our definition of beam availability is when the proton current from the PSR exceeds 50% of the planned value. The PSR ran at 65{mu}A current (average) at 20 Hz for most of 1990. All of the scheduled experiments were performed and experiments in support of the LANSCE research program were accomplished during the discretionary periods.« less

Target margins in radiotherapy of prostate cancer

PubMed Central

Bauman, Glenn

2016-01-01

We reviewed the literature on the use of margins in radiotherapy of patients with prostate cancer, focusing on different options for image guidance (IG) and technical issues. The search in PubMed database was limited to include studies that involved external beam radiotherapy of the intact prostate. Post-prostatectomy studies, brachytherapy and particle therapy were excluded. Each article was characterized according to the IG strategy used: positioning on external marks using room lasers, bone anatomy and soft tissue match, usage of fiducial markers, electromagnetic tracking and adapted delivery. A lack of uniformity in margin selection among institutions was evident from the review. In general, introduction of pre- and in-treatment IG was associated with smaller planning target volume (PTV) margins, but there was a lack of definitive experimental/clinical studies providing robust information on selection of exact PTV values. In addition, there is a lack of comparative research regarding the cost–benefit ratio of the different strategies: insertion of fiducial markers or electromagnetic transponders facilitates prostate gland localization but at a price of invasive procedure; frequent pre-treatment imaging increases patient in-room time, dose and labour; online plan adaptation should improve radiation delivery accuracy but requires fast and precise computation. Finally, optimal protocols for quality assurance procedures need to be established. PMID:27377353

A new small-footprint external-beam PIXE facility for cultural heritage applications using pulsed proton beams

NASA Astrophysics Data System (ADS)

Vadrucci, M.; Bazzano, G.; Borgognoni, F.; Chiari, M.; Mazzinghi, A.; Picardi, L.; Ronsivalle, C.; Ruberto, C.; Taccetti, F.

2017-09-01

In the framework of the COBRA project, elemental analyses of cultural heritage objects based on the particle induced X-ray emission (PIXE) are planned in a collaboration between the APAM laboratory of ENEA-Frascati and the LABEC laboratory of INFN in Florence. With this aim a 3-7 MeV pulsed proton beam, driven by the injector of the protontherapy accelerator under construction for the TOP-IMPLART project, will be used to demonstrate the feasibility of the technique with a small-footprint pulsed accelerator to Italian small and medium enterprises interested in the composition analysis of ancient artifacts. The experimental set-up for PIXE analysis on the TOP-IMPLART machine consists of a modified assembly of the vertical beam line usually dedicated to radiobiology experiments: the beam produced by the injector (RFQ + DTL, a PL7 ACCSYSHITACHI model) is bent to 90° by a magnet, is collimated by a 300 μm aperture inserted in the end nozzle and extracted into ambient pressure by an exit window consisting of a Upilex foil 7.5 μm thick. The beam is pulsed with a variable pulse duration of 20-100 μs and a repetition rate variable from 10 to 100 Hz. The X-ray detection system is based on a Ketek Silicon Drift Detector (SDD) with 7 mm2 active area and 450 μm thickness, with a thin Beryllium entrance window (8 μm). The results of the calibration of this new PIXE set-up using thick target standards and of the analysis of the preliminary measurements on pigments are presented.

SU-F-T-345: Quasi-Dead Beams: Clinical Relevance and Implications for Automatic Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Price, R; Veltchev, I; Lin, T

Purpose: Beam direction selection for fixed-beam IMRT planning is typically a manual process. Severe dose-volume limits on critical structures in the thorax often result in atypical selection of beam directions as compared to other body sites. This work demonstrates the potential consequences as well as clinical relevance. Methods: 21 thoracic cases treated with 5–7 beam directions, 6 cases including non-coplanar arrangements, with fractional doses of 150–411cGy were analyzed. Endpoints included per-beam modulation scaling factor (MSF), variation from equal weighting, and delivery QA passing rate. Results: During analysis of patient-specific delivery QA a sub-standard passing rate was found for a singlemore » 5-field plan (90.48% of pixels evaluated passing 3% dose, 3mm DTA). During investigation it was found that a single beam demonstrated a MSF of 34.7 and contributed only 2.7% to the mean dose of the target. In addition, the variation from equal weighting for this beam was 17.3% absolute resulting in another beam with a MSF of 4.6 contributing 41.9% to the mean dose to the target; a variation of 21.9% from equal weighting. The average MSF for the remaining 20 cases was 4.0 (SD 1.8) with an average absolute deviation of 2.8% from equal weighting (SD 3.1%). Conclusion: Optimization in commercial treatment planning systems typically results in relatively equally weighted beams. Extreme variation from this can result in excessively high MSFs (very small segments) and potential decreases in agreement between planned and delivered dose distributions. In addition, the resultant beam may contribute minimal dose to the target (quasi-dead beam); a byproduct being increased treatment time and associated localization uncertainties. Potential ramifications exist for automatic planning algorithms should they allow for user-defined beam directions. Additionally, these quasi-dead beams may be embedded in the libraries for model-based systems potentially resulting in inefficient and less accurate deliveries.« less

Study on shear strengthening of RC continuous T-beams using different layers of CFRP strips

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alferjani, M. B. S.; Samad, A. A. Abdul; Mohamad, Noridah

2015-05-15

Carbon fiber reinforced polymer (CFRP) laminates are externally bonded to reinforced concrete (RC) members to provide additional strength such as flexural, shear, etc. However, this paper presents the results of an experimental investigation for enhancing the shear capacity of reinforced concrete (RC) continuous T- beams using different layers of CFRP wrapping schemes. A total of three concrete beams were tested and various sheet configurations and layouts were studied to determine their effects on ultimate shear strength and shear capacity of the beams. One beam was kept as control beams, while other beams were strengthened with externally bonded CFRP strips withmore » three side bonding and one or two layers of CFRP strips. From the test results, it was found that all schemes were found to be effective in enhancing the shear strength of RC beams. It was observed that the strength increases with the number of sheet layers provided the most effective strengthening for RC continuous T- beam. Beam strengthened using this scheme showed 23.21% increase in shear capacity as compared to the control beam. Two prediction models available in literature were used for computing the contribution of CFRP strips and compared with the experimental results.« less

Influence of thermal deformation in cavity mirrors on beam propagation characteristics of high-power slab lasers

NASA Astrophysics Data System (ADS)

Wang, Zhen; Xiao, Longsheng; Wang, Wei; Wu, Chao; Tang, Xiahui

2018-01-01

Owing to their good diffusion cooling and low sensitivity to misalignment, slab-shape negative-branch unstable-waveguide resonators are widely used for high-power lasers in industry. As the output beam of the resonator is astigmatic, an external beam shaping system is required. However, the transverse dimension of the cavity mirrors in the resonator is large. For a long-time operation, the heating of cavity mirrors can be non-uniform. This results in micro-deformation and a change in the radius of curvature of the cavity mirrors, and leads to an output beam of an offset optical axis of the resonator. It was found that a change in the radius of curvature of 0.1% (1 mm) caused by thermal deformation generates a transverse displacement of 1.65 mm at the spatial filter of the external beam shaping system, and an output power loss of more than 80%. This can potentially burn out the spatial filter. In order to analyze the effect of the offset optical axis of the beam on the external optical path, we analyzed the transverse displacement and rotational misalignments of the spatial filter. For instance, if the transverse displacement was 0.3 mm, the loss in the output power was 9.6% and a sidelobe appeared in the unstable direction. If the angle of rotation was 5°, the loss in the output power was 2%, and the poles were in the direction of the waveguide. Based on these results, by adjusting the bending mirror, the deviation angle of the output beam of the resonator cavity was corrected, in order to obtain maximum output power and optimal beam quality. Finally, the propagation characteristics of the corrected output beam were analyzed.

Dosimetric quality assurance of highly conformal external beam treatments: from 2D phantom comparisons to 4D patient dose reconstruction

NASA Astrophysics Data System (ADS)

Feygelman, V.; Nelms, B.

2013-06-01

As IMRT technology continues to evolve, so do the dosimetric QA methods. A historical review of those is presented, starting with longstanding techniques such as film and ion chamber in a phantom and progressing towards 3D and 4D dose reconstruction in the patient. Regarding patient-specific QA, we envision that the currently prevalent limited comparison of dose distributions in the phantom by γ-analysis will be eventually replaced by clinically meaningful patient dose analyses with improved sensitivity and specificity. In a larger sense, we envision a future of QA built upon lessons from the rich history of "quality" as a science and philosophy. This future will aim to improve quality (and ultimately reduce cost) via advanced commissioning processes that succeed in detecting and rooting out systematic errors upstream of patient treatment, thus reducing our reliance on, and the resource burden associated with, per-beam/per-plan inspection.

A method for depth-dose distribution measurements in tissue irradiated by a proton beam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gambarini, G.; Birattari, C.; Bartolo, D. de

1994-12-31

The use of protons and heavy ions for the treatment of malignant and non-malignant disease has aroused a growing interest in the last decade. The notable advantage of heavy charged particles over photons in external beam radiotherapy lies in the possibility of irradiating a small localized region within the body, keeping a low value for the entrance dose. Owing to this high disuniformity of energy deposition, an essential requirement for treatment planning is a precise evaluation of the spatial distribution of absorbed dose. The proposed method for depth-dose distribution measurements utilizes a chemical dosimeter (ferrous sulphate solution plus sulfuric acidmore » and eventually xylenol orange) incorporated in a gelatine, whose role is the maintenance of spatial information. Ionizing radiation causes a variation in some parameters of the system such as the proton relaxation rates in the solution (measurable by NMR analysis) or the optical absorption of the gel in the visible spectrum (measurable by spectrophotometry).« less

Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. Report of the AAPM Radiation Therapy Committee Task Group 63.

PubMed

Reft, Chester; Alecu, Rodica; Das, Indra J; Gerbi, Bruce J; Keall, Paul; Lief, Eugene; Mijnheer, Ben J; Papanikolaou, Nikos; Sibata, Claudio; Van Dyk, Jake

2003-06-01

This document is the report of a task group of the Radiation Therapy Committee of the AAPM and has been prepared primarily to advise hospital physicists involved in external beam treatment of patients with pelvic malignancies who have high atomic number (Z) hip prostheses. The purpose of the report is to make the radiation oncology community aware of the problems arising from the presence of these devices in the radiation beam, to quantify the dose perturbations they cause, and, finally, to provide recommendations for treatment planning and delivery. Some of the data and recommendations are also applicable to patients having implanted high-Z prosthetic devices such as pins, humeral head replacements. The scientific understanding and methodology of clinical dosimetry for these situations is still incomplete. This report is intended to reflect the current state of scientific understanding and technical methodology in clinical dosimetry for radiation oncology patients with high-Z hip prostheses.

Scattered radiation from dental metallic crowns in head and neck radiotherapy.

PubMed

Shimozato, T; Igarashi, Y; Itoh, Y; Yamamoto, N; Okudaira, K; Tabushi, K; Obata, Y; Komori, M; Naganawa, S; Ueda, M

2011-09-07

We aimed to estimate the scattered radiation from dental metallic crowns during head and neck radiotherapy by irradiating a jaw phantom with external photon beams. The phantom was composed of a dental metallic plate and hydroxyapatite embedded in polymethyl methacrylate. We used radiochromic film measurement and Monte Carlo simulation to calculate the radiation dose and dose distribution inside the phantom. To estimate dose variations in scattered radiation under different clinical situations, we altered the incident energy, field size, plate thickness, plate depth and plate material. The simulation results indicated that the dose at the incident side of the metallic dental plate was approximately 140% of that without the plate. The differences between dose distributions calculated with the radiation treatment-planning system (TPS) algorithms and the data simulation, except around the dental metallic plate, were 3% for a 4 MV photon beam. Therefore, we should carefully consider the dose distribution around dental metallic crowns determined by a TPS.

Scattered radiation from dental metallic crowns in head and neck radiotherapy

NASA Astrophysics Data System (ADS)

Shimozato, T.; Igarashi, Y.; Itoh, Y.; Yamamoto, N.; Okudaira, K.; Tabushi, K.; Obata, Y.; Komori, M.; Naganawa, S.; Ueda, M.

2011-09-01

We aimed to estimate the scattered radiation from dental metallic crowns during head and neck radiotherapy by irradiating a jaw phantom with external photon beams. The phantom was composed of a dental metallic plate and hydroxyapatite embedded in polymethyl methacrylate. We used radiochromic film measurement and Monte Carlo simulation to calculate the radiation dose and dose distribution inside the phantom. To estimate dose variations in scattered radiation under different clinical situations, we altered the incident energy, field size, plate thickness, plate depth and plate material. The simulation results indicated that the dose at the incident side of the metallic dental plate was approximately 140% of that without the plate. The differences between dose distributions calculated with the radiation treatment-planning system (TPS) algorithms and the data simulation, except around the dental metallic plate, were 3% for a 4 MV photon beam. Therefore, we should carefully consider the dose distribution around dental metallic crowns determined by a TPS.

Contouring and Constraining Bowel on a Full-Bladder Computed Tomography Scan May Not Reflect Treatment Bowel Position and Dose Certainty in Gynecologic External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yaparpalvi, Ravindra, E-mail: ryaparpa@montefiore.org; Mehta, Keyur J.; Bernstein, Michael B.

Purpose: To evaluate, in a gynecologic cancer setting, changes in bowel position, dose-volume parameters, and biological indices that arise between full-bladder (FB) and empty-bladder (EB) treatment situations; and to evaluate, using cone beam computed tomography (CT), the validity of FB treatment presumption. Methods and Materials: Seventeen gynecologic cancer patients were retrospectively analyzed. Empty-bladder and FB CTs were obtained. Full-bladder CTs were used for planning and dose optimization. Patients were given FB instructions for treatment. For the study purpose, bowel was contoured on the EB CTs for all patients. Bowel position and volume changes between FB and EB states were determined.more » Full-bladder plans were applied on EB CTs for determining bowel dose-volume changes in EB state. Biological indices (generalized equivalent uniform dose and normal tissue complication probability) were calculated and compared between FB and EB. Weekly cone beam CT data were available in 6 patients to assess bladder volume at treatment. Results: Average (±SD) planned bladder volume was 299.7 ± 68.5 cm{sup 3}. Median bowel shift in the craniocaudal direction between FB and EB was 12.5 mm (range, 3-30 mm), and corresponding increase in exposed bowel volume was 151.3 cm{sup 3} (range, 74.3-251.4 cm{sup 3}). Absolute bowel volumes receiving 45 Gy were higher for EB compared with FB (mean 328.0 ± 174.8 vs 176.0 ± 87.5 cm{sup 3}; P=.0038). Bowel normal tissue complication probability increased 1.5× to 23.5× when FB planned treatments were applied in the EB state. For the study, the mean percentage value of relative bladder volume at treatment was 32%. Conclusions: Full-bladder planning does not necessarily translate into FB treatments, with a patient tendency toward EB. Given the uncertainty in daily control over bladder volume for treatment, we strongly recommend a “planning-at-risk volume bowel” (PRV{sub B}owel) concept to account for bowel motion between FB and EB that can be tailored for the individual patient.« less

SU-E-J-127: Implementation of An Online Replanning Tool for VMAT Using Flattening Filter-Free Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ates, O; Ahunbay, E; Li, X

2015-06-15

Purpose: This is to report the implementation of an online replanning tool based on segment aperture morphing (SAM) for VMAT with flattening filter free (FFF) beams. Methods: Previously reported SAM algorithm modified to accommodate VMAT with FFF beams was implemented in a tool that was interfaced with a treatment planning system (Monaco, Elekta). The tool allows (1) to output the beam parameters of the original VMAT plan from Monaco, and (2) to input the apertures generated from the SAM algorithm into Monaco for the dose calculation on daily CT/CBCT/MRI in the following steps:(1) Quickly generating target contour based on themore » image of the day, using an auto-segmentation tool (ADMIRE, Elekta) with manual editing if necessary; (2) Morphing apertures based on the SAM in the original VMAT plan to account for the interfractional change of the target from the planning to the daily images; (3) Calculating dose distribution for new apertures with the same numbers of MU as in the original plan; (4) Transferring the new plan into a record & verify system (MOSAIQ, Elekta); (5) Performing a pre-delivery QA based on software; (6) Delivering the adaptive plan for the fraction.This workflow was implemented on a 16-CPU (2.6 GHz dual-core) hardware with GPU and was tested for sample cases of prostate, pancreas and lung tumors. Results: The online replanning process can be completed within 10 minutes. The adaptive plans generally have improved the plan quality when compared to the IGRT repositioning plans. The adaptive plans with FFF beams have better normal tissue sparing as compared with those of FF beams. Conclusion: The online replanning tool based on SAM can quickly generate adaptive VMAT plans using FFF beams with improved plan quality than those from the IGRT repositioning plans based on daily CT/CBCT/MRI and can be used clinically. This research was supported by Elekta Inc. (Crawley, UK)« less

The Resistive-Wall Instability in Multipulse Linear Induction Accelerators

DOE PAGES

Ekdahl, Carl

2017-05-01

The resistive-wall instability results from the Lorentz force on the beam due to the beam image charge and current. If the beam pipe is perfectly conducting, the electric force due to the image charge attracts the beam to the pipe wall, and the magnetic force due to the image current repels the beam from the wall. For a relativistic beam, these forces almost cancel, leaving a slight attractive force, which is easily overcome by external magnetic focusing. However, if the beam pipe is not perfectly conducting, the magnetic field due to the image current decays on a magnetic-diffusion time scale.more » If the beam pulse is longer than the magnetic diffusion time, the repulsion of the beam tail will be weaker than the repulsion of the beam head. In the absence of an external focusing force, this causes a head-to-tail sweep of the beam toward the wall. This instability is usually thought to be a concern only for long-pulse relativistic electron beams. However, with the advent of multipulse, high current linear induction accelerators, the possibility of pulse-to-pulse coupling of this instability should be investigated. Lastly, we have explored pulse-to-pulse coupling using the linear accelerator model for Dual Axis Radiography for Hydrodynamic Testing beam dynamics code, and we present the results of this paper.« less

The Resistive-Wall Instability in Multipulse Linear Induction Accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ekdahl, Carl

The resistive-wall instability results from the Lorentz force on the beam due to the beam image charge and current. If the beam pipe is perfectly conducting, the electric force due to the image charge attracts the beam to the pipe wall, and the magnetic force due to the image current repels the beam from the wall. For a relativistic beam, these forces almost cancel, leaving a slight attractive force, which is easily overcome by external magnetic focusing. However, if the beam pipe is not perfectly conducting, the magnetic field due to the image current decays on a magnetic-diffusion time scale.more » If the beam pulse is longer than the magnetic diffusion time, the repulsion of the beam tail will be weaker than the repulsion of the beam head. In the absence of an external focusing force, this causes a head-to-tail sweep of the beam toward the wall. This instability is usually thought to be a concern only for long-pulse relativistic electron beams. However, with the advent of multipulse, high current linear induction accelerators, the possibility of pulse-to-pulse coupling of this instability should be investigated. Lastly, we have explored pulse-to-pulse coupling using the linear accelerator model for Dual Axis Radiography for Hydrodynamic Testing beam dynamics code, and we present the results of this paper.« less

Electron intensity modulation for mixed-beam radiation therapy with an x-ray multi-leaf collimator

NASA Astrophysics Data System (ADS)

Weinberg, Rebecca

The current standard treatment for head and neck cancer at our institution uses intensity-modulated x-ray therapy (IMRT), which improves target coverage and sparing of critical structures by delivering complex fluence patterns from a variety of beam directions to conform dose distributions to the shape of the target volume. The standard treatment for breast patients is field-in-field forward-planned IMRT, with initial tangential fields and additional reduced-weight tangents with blocking to minimize hot spots. For these treatment sites, the addition of electrons has the potential of improving target coverage and sparing of critical structures due to rapid dose falloff with depth and reduced exit dose. In this work, the use of mixed-beam therapy (MBT), i.e., combined intensity-modulated electron and x-ray beams using the x-ray multi-leaf collimator (MLC), was explored. The hypothesis of this study was that addition of intensity-modulated electron beams to existing clinical IMRT plans would produce MBT plans that were superior to the original IMRT plans for at least 50% of selected head and neck and 50% of breast cases. Dose calculations for electron beams collimated by the MLC were performed with Monte Carlo methods. An automation system was created to facilitate communication between the dose calculation engine and the treatment planning system. Energy and intensity modulation of the electron beams was accomplished by dividing the electron beams into 2x2-cm2 beamlets, which were then beam-weight optimized along with intensity-modulated x-ray beams. Treatment plans were optimized to obtain equivalent target dose coverage, and then compared with the original treatment plans. MBT treatment plans were evaluated by participating physicians with respect to target coverage, normal structure dose, and overall plan quality in comparison with original clinical plans. The physician evaluations did not support the hypothesis for either site, with MBT selected as superior in 1 out of the 15 head and neck cases (p=1) and 6 out of 18 breast cases (p=0.95). While MBT was not shown to be superior to IMRT, reductions were observed in doses to critical structures distal to the target along the electron beam direction and to non-target tissues, at the expense of target coverage and dose homogeneity.

The external scanning proton microprobe of Firenze: A comprehensive description

NASA Astrophysics Data System (ADS)

Giuntini, L.; Massi, M.; Calusi, S.

2007-06-01

An external proton scanning microbeam setup is installed on the -30° line of the new 3 MV tandem accelerator in Firenze; the most relevant features of the line, such as detection setup for IBA measurements, target viewing system, beam diagnostic and transport are described here. With our facility we can work with a beam spot on sample better than 10 μm full-width half-maximum (FWHM) and an intensity of some nanoamperes. Standard beam exit windows are silicon nitride (Si 3N 4) TEM membranes, 100 nm thick and 0.5×0.5 mm 2 wide; we also successfully performed measurements using membranes 1×1 mm 2 wide, 100 nm thick, and 2×2 mm 2 wide, 200 and 500 nm thick. Exploiting the yield of Si X-rays produced by the beam in the exit window as an indirect measurement of the charge, a beam charge monitor system was implemented. The analytical capabilities of the microbeam have been extended by integrating a two-detector PIXE setup with BS and PIGE detectors; the external scanning proton microprobe in Firenze is thus a powerful instrument to fully characterize samples by ion beam analysis, through the simultaneous collection of PIXE, PIGE and BS elemental maps. Its characteristics can make it often competitive with traditional in vacuum microbeam for measurements of thick targets.

Simultaneous integrated boost therapy of carcinoma of the hypopharynx/larynx with and without flattening filter - a treatment planning and dosimetry study.

PubMed

Dobler, Barbara; Obermeier, Tina; Hautmann, Matthias G; Khemissi, Amine; Koelbl, Oliver

2017-07-05

The aim of this study was to investigate if the flattening filter free (FFF) irradiation mode of a linear accelerator (linac) is advantageous as compared to the flat beam (FF) irradiation mode in intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) for carcinoma of the hypopharynx / larynx. Four treatment plans were created for each of 10 patients for an Elekta Synergy linac with Agility collimating device, a dual arc VMAT and a nine field step and shoot IMRT each with and without flattening filter. Plan quality was compared considering target coverage and dose to the organs at risk. All plans were verified by a 2D-ionization-chamber-array and delivery times were compared. Peripheral point doses were determined as a measure of second cancer risk. The Wilcoxon test was used for statistical analysis with a significance level of 0.05. Plan quality was similar for all four treatment plans without statistically significant differences of clinical relevance. The clinical goals were met in all plans for the PTV-SIB (V 95%  > 95%), the spinal cord (D 1ccm  < 45 Gy) and the brain stem (D 1ccm  < 48 Gy). For the parotids, the goal of D 50%  < 30 Gy was met in 70% and 60% of the plans for the left and right parotid respectively, and the V 95% of the SIB reached an average of 94%. Delivery times were similar for FF and FFF and significantly decreased by around 70% for VMAT as compared to IMRT. Peripheral doses were significantly reduced by 18% in FFF mode as compared to FF and by 26% for VMAT as compared to IMRT. Lowest peripheral doses were found for VMAT FFF, followed by VMAT FF. The FFF mode of a linear accelerator is advantageous for the treatment of hypopharynx/larynx carcinoma only with respect to reduction of second cancer induction in peripheral organs for the combination of Elekta Synergy linacs and Oncentra® External Beam v4.5 treatment planning system. This might be of interest in a therapy with curative intent.

[Comparison of SIB-IMRT treatment plans for upper esophageal carcinoma].

PubMed

Fu, Wei-hua; Wang, Lv-hua; Zhou, Zong-mei; Dai, Jian-rong; Hu, Yi-min

2003-06-01

To implement simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT) plans for upper esophageal carcinoma and investigate the dose profiles of tumor and electively treated region and the dose to organs at risk (OARs). SIB-IMRT plans were designed for two patients with upper esophageal carcinoma. Two target volumes were predefined: PTV1, the target volume of the primary lesion, which was given to 67.2 Gy, and PTV2, the target volume of electively treated region, which was given to 50.4 Gy. With the same dose-volume constraints, but different beams arrangements (3, 5, 7, or 9 equispaced coplanar beams), four plans were generated. Indices, including dose distribution, dose volume histogram (DVH) and conformity index, were used for comparison of these plans. The plan with three intensity-modulated beams could produce good dose distribution for the two target volumes. The dose conformity to targets and the dose to OARs were improved as the beam number increased. The dose distributions in targets changed little when the beam number increased from 7 to 9. Five to seven intensity-modulated beams can produce desirable dose distributions for simultaneous integrated boost (SIB) treatment for upper esophageal carcinoma. The primary tumor can get higher equivalent dose by SIB treatments. It is easier and more efficient to design plans with equispaced coplanar beams. The efficacy of SIB-IMRT remains to be determined by the clinical outcome.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces

DOE Office of Scientific and Technical Information (OSTI.GOV)

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance formore » the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.« less

SU-F-J-197: A Novel Intra-Beam Range Detection and Adaptation Strategy for Particle Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, M; Jiang, S; Shao, Y

2016-06-15

Purpose: In-vivo range detection/verification is crucial in particle therapy for effective and safe delivery. The state-of-art techniques are not sufficient for in-vivo on-line range verification due to conflicts among patient dose, signal statistics and imaging time. We propose a novel intra-beam range detection and adaptation strategy for particle therapy. Methods: This strategy uses the planned mid-range spots as probing beams without adding extra radiation to patients. Such choice of probing beams ensures the Bragg peaks to remain inside the tumor even with significant range variation from the plan. It offers sufficient signal statistics for in-beam positron emission tomography (PET) duemore » to high positron activity of therapeutic dose. The probing beam signal can be acquired and reconstructed using in-beam PET that allows for delineation of the Bragg peaks and detection of range shift with ease of detection enabled by single-layered spots. If the detected range shift is within a pre-defined tolerance, the remaining spots will be delivered as the original plan. Otherwise, a fast re-optimization using range-shifted beamlets and accounting for the probing beam dose is applied to consider the tradeoffs posed by the online anatomy. Simulated planning and delivery studies were used to demonstrate the effectiveness of the proposed techniques. Results: Simulations with online range variations due to shifts of various foreign objects into the beam path showed successful delineation of the Bragg peaks as a result of delivering probing beams. Without on-line delivery adaptation, dose distribution was significantly distorted. In contrast, delivery adaptation incorporating detected range shift recovered well the planned dose. Conclusion: The proposed intra-beam range detection and adaptation utilizing the planned mid-range spots as probing beams, which illuminate the beam range with strong and accurate PET signals, is a safe, practical, yet effective approach to address range uncertainty issues in particle therapy.« less

Liquid metal ion source assembly for external ion injection into an electron string ion source (ESIS)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Segal, M. J., E-mail: mattiti@gmail.com; University of Cape Town, Rondebosch, Cape Town 7700; Bark, R. A.

An assembly for a commercial Ga{sup +} liquid metal ion source in combination with an ion transportation and focusing system, a pulse high-voltage quadrupole deflector, and a beam diagnostics system has been constructed in the framework of the iThemba LABS (Cape Town, South Africa)—JINR (Dubna, Russia) collaboration. First, results on Ga{sup +} ion beam commissioning will be presented. Outlook of further experiments for measurements of charge breeding efficiency in the electron string ion source with the use of external injection of Ga{sup +} and Au{sup +} ion beams will be reported as well.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, S; Suh, T; Chung, J

Purpose: The purpose of this study is to evaluate the dosimetric and radiobiological impact of Acuros XB (AXB) and Anisotropic Analytic Algorithm (AAA) dose calculation algorithms on prostate stereotactic body radiation therapy plans with both conventional flattened (FF) and flattening-filter free (FFF) modes. Methods: For thirteen patients with prostate cancer, SBRT planning was performed using 10-MV photon beam with FF and FFF modes. The total dose prescribed to the PTV was 42.7 Gy in 7 fractions. All plans were initially calculated using AAA algorithm in Eclipse treatment planning system (11.0.34), and then were re-calculated using AXB with the same MUsmore » and MLC files. The four types of plans for different algorithms and beam energies were compared in terms of homogeneity and conformity. To evaluate the radiobiological impact, the tumor control probability (TCP) and normal tissue complication probability (NTCP) calculations were performed. Results: For PTV, both calculation algorithms and beam modes lead to comparable homogeneity and conformity. However, the averaged TCP values in AXB plans were always lower than in AAA plans with an average difference of 5.3% and 6.1% for 10-MV FFF and FF beam, respectively. In addition, the averaged NTCP values for organs at risk (OARs) were comparable. Conclusion: This study showed that prostate SBRT plan were comparable dosimetric results with different dose calculation algorithms as well as delivery beam modes. For biological results, even though NTCP values for both calculation algorithms and beam modes were similar, AXB plans produced slightly lower TCP compared to the AAA plans.« less

Moment redistribution in continuous reinforced concrete beams strengthened with carbon-fiber-reinforced polymer laminates

NASA Astrophysics Data System (ADS)

Aiello, M. A.; Valente, L.; Rizzo, A.

2007-09-01

The results of tests on continuous steel-fiber-reinforced concrete (RC) beams, with and without an external strengthening, are presented. The internal flexural steel reinforcement was designed so that to allow steel yielding before the collapse of the beams. To prevent the shear failure, steel stirrups were used. The tests also included two nonstrengthened control beams; the other specimens were strengthened with different configurations of externally bonded carbon-fiber-reinforced polymer (CFRP) laminates. In order to prevent the premature failure from delamination of the CFRP strengthening, a wrapping was also applied. The experimental results obtained show that it is possible to achieve a sufficient degree of moment redistribution if the strengthening configuration is chosen properly, confirming the results provided by two simple numerical models.

Space Construction Automated Fabrication Experiment Definition Study. (SCAFEDS), part 3. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1979-01-01

A range of tasks focused on a baseline system concept is discussed. A beam builder concept developed to produce a triangular beam is discussed. Beam elements used laminated graphite and glass composite strip material with external surface coatings are described.

A fast optimization approach for treatment planning of volumetric modulated arc therapy.

PubMed

Yan, Hui; Dai, Jian-Rong; Li, Ye-Xiong

2018-05-30

Volumetric modulated arc therapy (VMAT) is widely used in clinical practice. It not only significantly reduces treatment time, but also produces high-quality treatment plans. Current optimization approaches heavily rely on stochastic algorithms which are time-consuming and less repeatable. In this study, a novel approach is proposed to provide a high-efficient optimization algorithm for VMAT treatment planning. A progressive sampling strategy is employed for beam arrangement of VMAT planning. The initial beams with equal-space are added to the plan in a coarse sampling resolution. Fluence-map optimization and leaf-sequencing are performed for these beams. Then, the coefficients of fluence-maps optimization algorithm are adjusted according to the known fluence maps of these beams. In the next round the sampling resolution is doubled and more beams are added. This process continues until the total number of beams arrived. The performance of VMAT optimization algorithm was evaluated using three clinical cases and compared to those of a commercial planning system. The dosimetric quality of VMAT plans is equal to or better than the corresponding IMRT plans for three clinical cases. The maximum dose to critical organs is reduced considerably for VMAT plans comparing to those of IMRT plans, especially in the head and neck case. The total number of segments and monitor units are reduced for VMAT plans. For three clinical cases, VMAT optimization takes < 5 min accomplished using proposed approach and is 3-4 times less than that of the commercial system. The proposed VMAT optimization algorithm is able to produce high-quality VMAT plans efficiently and consistently. It presents a new way to accelerate current optimization process of VMAT planning.

TH-E-BRE-04: An Online Replanning Algorithm for VMAT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahunbay, E; Li, X; Moreau, M

2014-06-15

Purpose: To develop a fast replanning algorithm based on segment aperture morphing (SAM) for online replanning of volumetric modulated arc therapy (VMAT) with flattening filtered (FF) and flattening filter free (FFF) beams. Methods: A software tool was developed to interface with a VMAT planning system ((Monaco, Elekta), enabling the output of detailed beam/machine parameters of original VMAT plans generated based on planning CTs for FF or FFF beams. A SAM algorithm, previously developed for fixed-beam IMRT, was modified to allow the algorithm to correct for interfractional variations (e.g., setup error, organ motion and deformation) by morphing apertures based on themore » geometric relationship between the beam's eye view of the anatomy from the planning CT and that from the daily CT for each control point. The algorithm was tested using daily CTs acquired using an in-room CT during daily IGRT for representative prostate cancer cases along with their planning CTs. The algorithm allows for restricted MLC leaf travel distance between control points of the VMAT delivery to prevent SAM from increasing leaf travel, and therefore treatment delivery time. Results: The VMAT plans adapted to the daily CT by SAM were found to improve the dosimetry relative to the IGRT repositioning plans for both FF and FFF beams. For the adaptive plans, the changes in leaf travel distance between control points were < 1cm for 80% of the control points with no restriction. When restricted to the original plans' maximum travel distance, the dosimetric effect was minimal. The adaptive plans were delivered successfully with similar delivery times as the original plans. The execution of the SAM algorithm was < 10 seconds. Conclusion: The SAM algorithm can quickly generate deliverable online-adaptive VMAT plans based on the anatomy of the day for both FF and FFF beams.« less

Guaranteed epsilon-optimal treatment plans with the minimum number of beams for stereotactic body radiation therapy

NASA Astrophysics Data System (ADS)

Yarmand, Hamed; Winey, Brian; Craft, David

2013-09-01

Stereotactic body radiation therapy (SBRT) is characterized by delivering a high amount of dose in a short period of time. In SBRT the dose is delivered using open fields (e.g., beam’s-eye-view) known as ‘apertures’. Mathematical methods can be used for optimizing treatment planning for delivery of sufficient dose to the cancerous cells while keeping the dose to surrounding organs at risk (OARs) minimal. Two important elements of a treatment plan are quality and delivery time. Quality of a plan is measured based on the target coverage and dose to OARs. Delivery time heavily depends on the number of beams used in the plan as the setup times for different beam directions constitute a large portion of the delivery time. Therefore the ideal plan, in which all potential beams can be used, will be associated with a long impractical delivery time. We use the dose to OARs in the ideal plan to find the plan with the minimum number of beams which is guaranteed to be epsilon-optimal (i.e., a predetermined maximum deviation from the ideal plan is guaranteed). Since the treatment plan optimization is inherently a multi-criteria-optimization problem, the planner can navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing epsilon-optimality. We use mixed integer programming (MIP) for optimization. To reduce the computation time for the resultant MIP, we use two heuristics: a beam elimination scheme and a family of heuristic cuts, known as ‘neighbor cuts’, based on the concept of ‘adjacent beams’. We show the effectiveness of the proposed technique on two clinical cases, a liver and a lung case. Based on our technique we propose an algorithm for fast generation of epsilon-optimal plans.

Method for energy recovery of spent ERL beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marhauser, Frank; Hannon, Fay; Rimmer, Robert

A method for recovering energy from spent energy recovered linac (ERL) beams. The method includes adding a plurality of passive decelerating cavities at the beam dump of the ERL, adding one or more coupling waveguides between the passive decelerating cavities, setting an adequate external Q (Qext) to adjust to the beam loading situation, and extracting the RF energy through the coupling waveguides.

Prefabricated Roof Beams for Hardened Shelters

DTIC Science & Technology

1993-08-01

beam with a composite concrete slab. Based on the results of the concept evaluation, a test program was designed and conducted to validate the steel...ultimaw, strength. The results of these tests showed that the design procedure accurately predicts the response of the ste,-confined concrete composite...BENDING OF EXTERNALLY REINFORCED CONCRETE BEAMS ........ 67 TABLE 9. SINGLE POINT LOAD BEAM TEST RESULTS

Automatic Substitute Computed Tomography Generation and Contouring for Magnetic Resonance Imaging (MRI)-Alone External Beam Radiation Therapy From Standard MRI Sequences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dowling, Jason A., E-mail: jason.dowling@csiro.au; University of Newcastle, Callaghan, New South Wales; Sun, Jidi

Purpose: To validate automatic substitute computed tomography CT (sCT) scans generated from standard T2-weighted (T2w) magnetic resonance (MR) pelvic scans for MR-Sim prostate treatment planning. Patients and Methods: A Siemens Skyra 3T MR imaging (MRI) scanner with laser bridge, flat couch, and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole-pelvis MRI scan (1.6 mm 3-dimensional isotropic T2w SPACE [Sampling Perfection with Application optimized Contrasts using different flip angle Evolution] sequence) was acquired. Three additional small field of view scans were acquired: T2w, T2*w, and T1wmore » flip angle 80° for gold fiducials. Patients received a routine planning CT scan. Manual contouring of the prostate, rectum, bladder, and bones was performed independently on the CT and MR scans. Three experienced observers contoured each organ on MRI, allowing interobserver quantification. To generate a training database, each patient CT scan was coregistered to their whole-pelvis T2w using symmetric rigid registration and structure-guided deformable registration. A new multi-atlas local weighted voting method was used to generate automatic contours and sCT results. Results: The mean error in Hounsfield units between the sCT and corresponding patient CT (within the body contour) was 0.6 ± 14.7 (mean ± 1 SD), with a mean absolute error of 40.5 ± 8.2 Hounsfield units. Automatic contouring results were very close to the expert interobserver level (Dice similarity coefficient): prostate 0.80 ± 0.08, bladder 0.86 ± 0.12, rectum 0.84 ± 0.06, bones 0.91 ± 0.03, and body 1.00 ± 0.003. The change in monitor units between the sCT-based plans relative to the gold standard CT plan for the same dose prescription was found to be 0.3% ± 0.8%. The 3-dimensional γ pass rate was 1.00 ± 0.00 (2 mm/2%). Conclusions: The MR-Sim setup and automatic sCT generation methods using standard MR sequences generates realistic contours and electron densities for prostate cancer radiation therapy dose planning and digitally reconstructed radiograph generation.« less

FusionArc optimization: a hybrid volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) planning strategy.

PubMed

Matuszak, Martha M; Steers, Jennifer M; Long, Troy; McShan, Daniel L; Fraass, Benedick A; Romeijn, H Edwin; Ten Haken, Randall K

2013-07-01

To introduce a hybrid volumetric modulated arc therapy/intensity modulated radiation therapy (VMAT/IMRT) optimization strategy called FusionArc that combines the delivery efficiency of single-arc VMAT with the potentially desirable intensity modulation possible with IMRT. A beamlet-based inverse planning system was enhanced to combine the advantages of VMAT and IMRT into one comprehensive technique. In the hybrid strategy, baseline single-arc VMAT plans are optimized and then the current cost function gradients with respect to the beamlets are used to define a metric for predicting which beam angles would benefit from further intensity modulation. Beams with the highest metric values (called the gradient factor) are converted from VMAT apertures to IMRT fluence, and the optimization proceeds with the mixed variable set until convergence or until additional beams are selected for conversion. One phantom and two clinical cases were used to validate the gradient factor and characterize the FusionArc strategy. Comparisons were made between standard IMRT, single-arc VMAT, and FusionArc plans with one to five IMRT∕hybrid beams. The gradient factor was found to be highly predictive of the VMAT angles that would benefit plan quality the most from beam modulation. Over the three cases studied, a FusionArc plan with three converted beams achieved superior dosimetric quality with reductions in final cost ranging from 26.4% to 48.1% compared to single-arc VMAT. Additionally, the three beam FusionArc plans required 22.4%-43.7% fewer MU∕Gy than a seven beam IMRT plan. While the FusionArc plans with five converted beams offer larger reductions in final cost--32.9%-55.2% compared to single-arc VMAT--the decrease in MU∕Gy compared to IMRT was noticeably smaller at 12.2%-18.5%, when compared to IMRT. A hybrid VMAT∕IMRT strategy was implemented to find a high quality compromise between gantry-angle and intensity-based degrees of freedom. This optimization method will allow patients to be simultaneously planned for dosimetric quality and delivery efficiency without switching between delivery techniques. Example phantom and clinical cases suggest that the conversion of only three VMAT segments to modulated beams may result in a good combination of quality and efficiency.

Carcinoma of the cervix, stage III. Results of radiation therapy.

PubMed

Montana, G S; Fowler, W C; Varia, M A; Walton, L A; Mack, Y; Shemanski, L

1986-01-01

From April 1969 through December 1980, 203 patients with Stage III epidermoid carcinoma of the cervix were treated with radiation therapy with curative intent. The disease-free survival at 2, 5, and 10 years was 50%, 33%, and 27%, respectively. The survival was better for patients with Stage IIIB disease than for those with Stage IIIA disease. Eighty-eight patients were treated with external beam therapy only, and 115 received external beam and brachytherapy. The disease-free survival was better for the combination therapy group initially, but this difference was not sustained beyond 5 years. One hundred eight patients experienced recurrence within the irradiated field, for a locoregional recurrence rate of 53%. Twenty-seven patients had complications (13%). The complications were mild in 13 patients, moderate in 4 patients, and severe in 10 patients. A study was made of the relationship of the dose to Point A and the occurrence of complications. Similar analyses were made of the bladder and rectal doses and the subsequent occurrence of urinary and intestinal complications. In these analyses, the mean dose to Point A and the critical organs was higher for the groups of patients with complications than for those patients without complications. This relationship was also observed when the patients were stratified for treatment with either external beam plus brachytherapy or external beam therapy alone.

Fraction-variant beam orientation optimization for non-coplanar IMRT

NASA Astrophysics Data System (ADS)

O'Connor, Daniel; Yu, Victoria; Nguyen, Dan; Ruan, Dan; Sheng, Ke

2018-02-01

Conventional beam orientation optimization (BOO) algorithms for IMRT assume that the same set of beam angles is used for all treatment fractions. In this paper we present a BOO formulation based on group sparsity that simultaneously optimizes non-coplanar beam angles for all fractions, yielding a fraction-variant (FV) treatment plan. Beam angles are selected by solving a multi-fraction fluence map optimization problem involving 500-700 candidate beams per fraction, with an additional group sparsity term that encourages most candidate beams to be inactive. The optimization problem is solved using the fast iterative shrinkage-thresholding algorithm. Our FV BOO algorithm is used to create five-fraction treatment plans for digital phantom, prostate, and lung cases as well as a 30-fraction plan for a head and neck case. A homogeneous PTV dose coverage is maintained in all fractions. The treatment plans are compared with fraction-invariant plans that use a fixed set of beam angles for all fractions. The FV plans reduced OAR mean dose and D 2 values on average by 3.3% and 3.8% of the prescription dose, respectively. Notably, mean OAR dose was reduced by 14.3% of prescription dose (rectum), 11.6% (penile bulb), 10.7% (seminal vesicle), 5.5% (right femur), 3.5% (bladder), 4.0% (normal left lung), 15.5% (cochleas), and 5.2% (chiasm). D 2 was reduced by 14.9% of prescription dose (right femur), 8.2% (penile bulb), 12.7% (proximal bronchus), 4.1% (normal left lung), 15.2% (cochleas), 10.1% (orbits), 9.1% (chiasm), 8.7% (brainstem), and 7.1% (parotids). Meanwhile, PTV homogeneity defined as D 95/D 5 improved from .92 to .95 (digital phantom), from .95 to .98 (prostate case), and from .94 to .97 (lung case), and remained constant for the head and neck case. Moreover, the FV plans are dosimetrically similar to conventional plans that use twice as many beams per fraction. Thus, FV BOO offers the potential to reduce delivery time for non-coplanar IMRT.

SU-F-P-28: A Method of Maximize the Noncoplanar Beam Orientations and Assure the Beam Delivery Clearance for Stereotactic Body Radiation Therapy (SBRT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, J

2016-06-15

Purpose: Develop a method to maximize the noncoplanar beam orientations and assure the beam delivery clearance for SBRT, therefore, optimize the dose conformality to the target, increase the dose sparing to the critical normal organs and reduce the hot spots in the body. Methods: A SBRT body frame (Elekta, Stockholm, Sweden) was used for patient immobilization and target localization. The SBRT body frame has CT fiducials on its side frames. After patient’s CT scan, the radiation treatment isocenter was defined and its coordinators referring to the body frame was calculated in the radiation treatment planning process. Meanwhile, initial beam orientationsmore » were designed based on the patient target and critical organ anatomy. The body frame was put on the linear accelerator couch and positioned to the calculated isocenter. Initially designed beam orientations were manually measured by tuning the body frame position on the couch, the gantry and couch angles. The finalized beam orientations were put into the treatment planning for dosimetric calculations. Results: Without patient presence, an optimal set of beam orientations were designed and validated. The radiation treatment plan was optimized and guaranteed for delivery clearance. Conclusion: The developed method is beneficial and effective in SBRT treatment planning for individual patient. It first allows maximizing the achievable noncoplanar beam orientation space, therefore, optimize the treatment plan for specific patient. It eliminates the risk that a plan needs to be modified due to the gantry and couch collision during patient setup.« less

Beam orientation optimization for intensity-modulated radiation therapy using mixed integer programming

NASA Astrophysics Data System (ADS)

Yang, Ruijie; Dai, Jianrong; Yang, Yong; Hu, Yimin

2006-08-01

The purpose of this study is to extend an algorithm proposed for beam orientation optimization in classical conformal radiotherapy to intensity-modulated radiation therapy (IMRT) and to evaluate the algorithm's performance in IMRT scenarios. In addition, the effect of the candidate pool of beam orientations, in terms of beam orientation resolution and starting orientation, on the optimized beam configuration, plan quality and optimization time is also explored. The algorithm is based on the technique of mixed integer linear programming in which binary and positive float variables are employed to represent candidates for beam orientation and beamlet weights in beam intensity maps. Both beam orientations and beam intensity maps are simultaneously optimized in the algorithm with a deterministic method. Several different clinical cases were used to test the algorithm and the results show that both target coverage and critical structures sparing were significantly improved for the plans with optimized beam orientations compared to those with equi-spaced beam orientations. The calculation time was less than an hour for the cases with 36 binary variables on a PC with a Pentium IV 2.66 GHz processor. It is also found that decreasing beam orientation resolution to 10° greatly reduced the size of the candidate pool of beam orientations without significant influence on the optimized beam configuration and plan quality, while selecting different starting orientations had large influence. Our study demonstrates that the algorithm can be applied to IMRT scenarios, and better beam orientation configurations can be obtained using this algorithm. Furthermore, the optimization efficiency can be greatly increased through proper selection of beam orientation resolution and starting beam orientation while guaranteeing the optimized beam configurations and plan quality.

Report of the AAPM Task Group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning.

PubMed

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

2007-12-01

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 experimental verification of MC dose algorithms. As the MC method is an emerging technology, this report is not meant to be prescriptive. Rather, it is intended as a preliminary report to review the tenets of the MC method and to provide the framework upon which to build a comprehensive program for commissioning and routine quality assurance of MC-based treatment planning systems.

TU-D-201-03: Results of a Survey On the Implementation of the TG-51 Protocol and Associated Addendum On Reference Dosimetry of External Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, G; Muir, B; Culberson, W

Purpose: The working group on the review and extension of the TG-51 protocol (WGTG51) collected data from American Association of Physicists in Medicine (AAPM) members with respect to their current TG-51 and associated addendum usage in the interest of considering future protocol addenda and guidance on reference dosimetry best practices. This study reports an overview of this survey on dosimetry of external beams. Methods: Fourteen survey questions were developed by WGTG51 and released in November 2015. The questions collected information on reference dosimetry, beam quality specification, and ancillary calibration equipment. Results: Of the 190 submissions completed worldwide (U.S. 70%), 83%more » were AAPM members. Of the respondents, 33.5% implemented the TG-51 addendum, with the maximum calibration difference for any photon beam, with respect to the original TG-51 protocol, being <1% for 97.4% of responses. One major finding is that 81.8% of respondents used the same cylindrical ionization chamber for photon and electron dosimetry, implying that many clinics are foregoing the use of parallel-plate chambers. Other evidence suggests equivalent dosimetric results can be obtained with both cylindrical and parallel-plate chambers in electron beams. This, combined with users comfort with cylindrical chambers for electrons will likely impact recommendations put forward in an upcoming electron beam addendum to the TG-51 protocol. Data collected on ancillary equipment showed 58.2% (45.0%) of the thermometers (barometers) in use for beam calibration had NIST traceable calibration certificates, but 48.4% (42.7%) were never recalibrated. Conclusion: This survey provides a snapshot of TG-51 external beam reference dosimetry practice in radiotherapy centers. Findings demonstrate the rapid take-up of the TG-51 photon beam addendum and raise issues for the WGTG51 to focus on going forward, including guidelines on ancillary equipment and the choice of chamber for electron beam dosimetry.« less

A modular approach to intensity-modulated arc therapy optimization with noncoplanar trajectories

NASA Astrophysics Data System (ADS)

Papp, Dávid; Bortfeld, Thomas; Unkelbach, Jan

2015-07-01

Utilizing noncoplanar beam angles in volumetric modulated arc therapy (VMAT) has the potential to combine the benefits of arc therapy, such as short treatment times, with the benefits of noncoplanar intensity modulated radiotherapy (IMRT) plans, such as improved organ sparing. Recently, vendors introduced treatment machines that allow for simultaneous couch and gantry motion during beam delivery to make noncoplanar VMAT treatments possible. Our aim is to provide a reliable optimization method for noncoplanar isocentric arc therapy plan optimization. The proposed solution is modular in the sense that it can incorporate different existing beam angle selection and coplanar arc therapy optimization methods. Treatment planning is performed in three steps. First, a number of promising noncoplanar beam directions are selected using an iterative beam selection heuristic; these beams serve as anchor points of the arc therapy trajectory. In the second step, continuous gantry/couch angle trajectories are optimized using a simple combinatorial optimization model to define a beam trajectory that efficiently visits each of the anchor points. Treatment time is controlled by limiting the time the beam needs to trace the prescribed trajectory. In the third and final step, an optimal arc therapy plan is found along the prescribed beam trajectory. In principle any existing arc therapy optimization method could be incorporated into this step; for this work we use a sliding window VMAT algorithm. The approach is demonstrated using two particularly challenging cases. The first one is a lung SBRT patient whose planning goals could not be satisfied with fewer than nine noncoplanar IMRT fields when the patient was treated in the clinic. The second one is a brain tumor patient, where the target volume overlaps with the optic nerves and the chiasm and it is directly adjacent to the brainstem. Both cases illustrate that the large number of angles utilized by isocentric noncoplanar VMAT plans can help improve dose conformity, homogeneity, and organ sparing simultaneously using the same beam trajectory length and delivery time as a coplanar VMAT plan.

The effect of statistical noise on IMRT plan quality and convergence for MC-based and MC-correction-based optimized treatment plans.

PubMed

Siebers, Jeffrey V

2008-04-04

Monte Carlo (MC) is rarely used for IMRT plan optimization outside of research centres due to the extensive computational resources or long computation times required to complete the process. Time can be reduced by degrading the statistical precision of the MC dose calculation used within the optimization loop. However, this eventually introduces optimization convergence errors (OCEs). This study determines the statistical noise levels tolerated during MC-IMRT optimization under the condition that the optimized plan has OCEs <100 cGy (1.5% of the prescription dose) for MC-optimized IMRT treatment plans.Seven-field prostate IMRT treatment plans for 10 prostate patients are used in this study. Pre-optimization is performed for deliverable beams with a pencil-beam (PB) dose algorithm. Further deliverable-based optimization proceeds using: (1) MC-based optimization, where dose is recomputed with MC after each intensity update or (2) a once-corrected (OC) MC-hybrid optimization, where a MC dose computation defines beam-by-beam dose correction matrices that are used during a PB-based optimization. Optimizations are performed with nominal per beam MC statistical precisions of 2, 5, 8, 10, 15, and 20%. Following optimizer convergence, beams are re-computed with MC using 2% per beam nominal statistical precision and the 2 PTV and 10 OAR dose indices used in the optimization objective function are tallied. For both the MC-optimization and OC-optimization methods, statistical equivalence tests found that OCEs are less than 1.5% of the prescription dose for plans optimized with nominal statistical uncertainties of up to 10% per beam. The achieved statistical uncertainty in the patient for the 10% per beam simulations from the combination of the 7 beams is ~3% with respect to maximum dose for voxels with D>0.5D(max). The MC dose computation time for the OC-optimization is only 6.2 minutes on a single 3 Ghz processor with results clinically equivalent to high precision MC computations.

SU-E-T-504: Intensity-Modulated Radiosurgery Treatments Derived by Optimizing Delivery of Sphere Packing Treatment Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hermansen, M; Bova, F; John, T St.

2015-06-15

Purpose To minimize the number of monitor units required to deliver a sphere packing stereotactic radiosurgery (SRS) plan by eliminating overlaps of individual beam projections. Methods An algorithm was written in C{sup ++} to calculate SRS treatment doses using sphere packing. Three fixed beams were used to approximate each arc in a typical SRS treatment plan. For cases involving multiple isocenters, at each gantry and table angle position beams directed to individual spheres overlap to produce regions of high dose, resulting in intensity modulated beams. These high dose regions were dampened by post-processing of the combined beam profile. The post-processmore » dampening involves removing the excess overlapping fluence from all but the highest contributing beam. The dampened beam profiles at each table and gantry angle position were then summed to produce the new total dose distribution. Results Delivery times for even the most complex multiple sphere plans can be reduced to consistent times of about 20 to 30 minutes. The total MUs required to deliver the plan can also be reduced by as much as 85% of the original plan’s MUs. Conclusion Regions of high dose are removed. Dampening overlapping radiation fluence can produce the new beam profiles that have more uniform dose distributions using less MUs. This results in a treatment that requires significantly fewer intensity values than traditional IMRT or VAMT planning.« less

Poster — Thur Eve — 31: Dosimetric Effect of Respiratory Motion on RapidArc Lung SBRT Treatment Delivered by TrueBeam Linear Accelerator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, Runqing; Zhan, Lixin; Osei, Ernest

2014-08-15

Volumetric modulated arc therapy (VMAT) allows fast delivery of stereotactic radiotherapy. However, the discrepancies between the calculated and delivered dose distributions due to respiratory motion and dynamic multileaf collimators (MLCs) interplay are not avoidable. The purpose of this study is to investigate RapidArc lung SBRT treatment delivered by the flattening filter-free (FFF) beam and flattened beam with Varian TrueBeam machine. CIRS Dynamic Thorax Phantom with in-house made lung tumor insertion was CT scanned both in free breathing and 4DCT. 4DCT was used to determine the internal target volume. The free breathing CT scan was used for treatment planning. A 5more » mm margin was given to ITV to generate a planning target volume. Varian Eclipse treatment planning was used to generate RapidArc plans based on the 6 MV flattened beam and 6MV FFF beam. The prescription dose was 48 Gy in 4 fractions. At least 95% of PTV was covered by the prescribed dose. The RapidArc plans with 6 MV flattened beam and 6MV FFF beam were delivered with Varian TrueBeam machine. The dosimetric measurements were performed with Gafchromic XR-RV3 film, which was placed in the lung tumor insertion. The interplay between the dynamic MLC-based delivery of VMAT and the respiratory motion of the tumor degraded target coverage and created undesired hot or cold dose spots inside the lung tumor. Lung SBRT RapidArc treatments delivered by the FFF beam of TrueBeam linear accelerator is superior to the flattened beam. Further investigation will be performed by Monte Carlo simulation.« less

Congenital Auricular Malformations: Description of Anomalies and Syndromes.

PubMed

Bartel-Friedrich, Sylva

2015-12-01

Half of the malformations in the ear, nose, and throat region affect the ear. Malformations of the external ear (pinna or auricle with external auditory canal [EAC]) are collectively termed microtia. Microtia is a congenital anomaly that ranges in severity from mild structural abnormalities to complete absence of the external ear (anotia). Microtia occurs more frequently in males (∼2 or 3:1), is predominantly unilateral (∼70-90%), and more often involves the right ear (∼60%). The reported prevalence varies geographically from 0.83 to 17.4 per 10,000 births. Microtia may be genetic (with family history, spontaneous mutations) or acquired. Malformations of the external ear can also involve the middle ear and/or inner ear. Microtia may be an isolated birth defect, but associated anomalies or syndromes are described in 20 to 60% of cases, depending on study design. These generally fit within the oculo-auriculo-vertebral spectrum; defects are located most frequently in the facial skeleton, facial soft tissues, heart, and vertebral column, or comprise a syndrome (e.g., Treacher Collins syndrome). Diagnostic investigation of microtia includes clinical examination, audiologic testing, genetic analysis and, especially in higher grade malformations with EAC deformities, computed tomography (CT) or cone-beam CT for the planning of surgery and rehabilitation procedures, including implantation of hearing aids. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of VMAT and IMRT strategies for cervical cancer patients using automated planning.

PubMed

Sharfo, Abdul Wahab M; Voet, Peter W J; Breedveld, Sebastiaan; Mens, Jan Willem M; Hoogeman, Mischa S; Heijmen, Ben J M

2015-03-01

In a published study on cervical cancer, 5-beam IMRT was inferior to single arc VMAT. Here we compare 9, 12, and 20 beam IMRT with single and dual arc VMAT. For each of 10 patients, automated plan generation with the in-house Erasmus-iCycle optimizer was used to assist an expert planner in generating the five plans with the clinical TPS. For each patient, all plans were clinically acceptable with a high and similar PTV coverage. OAR sparing increased when going from 9 to 12 to 20 IMRT beams, and from single to dual arc VMAT. For all patients, 12 and 20 beam IMRT were superior to single and dual arc VMAT, with substantial variations in gain among the study patients. As expected, delivery of VMAT plans was significantly faster than delivery of IMRT plans. Often reported increased plan quality for VMAT compared to IMRT has not been observed for cervical cancer. Twenty and 12 beam IMRT plans had a higher quality than single and dual arc VMAT. For individual patients, the optimal delivery technique depends on a complex trade-off between plan quality and treatment time that may change with introduction of faster delivery systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Electron beam collimation with a photon MLC for standard electron treatments

NASA Astrophysics Data System (ADS)

Mueller, S.; Fix, M. K.; Henzen, D.; Frei, D.; Frauchiger, D.; Loessl, K.; Stampanoni, M. F. M.; Manser, P.

2018-01-01

Standard electron treatments are currently still performed using standard or molded patient-specific cut-outs placed in the electron applicator. Replacing cut-outs and electron applicators with a photon multileaf collimator (pMLC) for electron beam collimation would make standard electron treatments more efficient and would facilitate advanced treatment techniques like modulated electron radiotherapy (MERT) and mixed beam radiotherapy (MBRT). In this work, a multiple source Monte Carlo beam model for pMLC shaped electron beams commissioned at a source-to-surface distance (SSD) of 70 cm is extended for SSDs of up to 100 cm and validated for several Varian treatment units with field sizes typically used for standard electron treatments. Measurements and dose calculations agree generally within 3% of the maximal dose or 2 mm distance to agreement. To evaluate the dosimetric consequences of using pMLC collimated electron beams for standard electron treatments, pMLC-based and cut-out-based treatment plans are created for a left and a right breast boost, a sternum, a testis and a parotid gland case. The treatment plans consist of a single electron field, either alone (1E) or in combination with two 3D conformal tangential photon fields (1E2X). For each case, a pMLC plan with similar treatment plan quality in terms of dose homogeneity to the target and absolute mean dose values to the organs at risk (OARs) compared to a cut-out plan is found. The absolute mean dose to an OAR is slightly increased for pMLC-based compared to cut-out-based 1E plans if the OAR is located laterally close to the target with respect to beam direction, or if a 6 MeV electron beam is used at an extended SSD. In conclusion, treatment plans using cut-out collimation can be replaced by plans of similar treatment plan quality using pMLC collimation with accurately calculated dose distributions.

Design concept for improved photo-scan tube

NASA Technical Reports Server (NTRS)

Malling, L. R.

1967-01-01

Conceptual photo-scan tube avoids complexity of internal beam scanning and beam-current adjustment by optical scan readout. It differs from a conventional image orthicon in its use of an external oscilloscope tube.

Dynamic assessment of reinforced concrete beams repaired with externally bonded FRP sheets

NASA Astrophysics Data System (ADS)

Bonfiglioli, B.; Pascale, G.

2006-01-01

This research deals with RC beams strengthened with FRP. An experimental research is presented which is aimed at evaluating the capability of an experimental modal analysis to assess the stiffness decrease due to damage, as well as the stiffness recovery due to strengthening. Ten beams were tested. All of them were subjected to loading cycles with increasing load levels in order to induce cracking of different severity in them. The beams were then retrofitted by externally bonded FRP sheets. Three types of composites were used. The number of layers was varied, too. Modal tests were carried out after each loading-unloading cycle. The modal frequencies and damping ratios were determined for the first four vibration modes. The results obtained indicate that an experimental modal analysis can give useful information on the severity of damage and the effectiveness of strengthening.

Adverse Events Involving Radiation Oncology Medical Devices: Comprehensive Analysis of US Food and Drug Administration Data, 1991 to 2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Connor, Michael J.; Department of Radiation Oncology, University of California Irvine School of Medicine, Irvine, California; Marshall, Deborah C.

Purpose: Radiation oncology relies on rapidly evolving technology and highly complex processes. The US Food and Drug Administration collects reports of adverse events related to medical devices. We sought to characterize all events involving radiation oncology devices (RODs) from the US Food and Drug Administration's postmarket surveillance Manufacturer and User Facility Device Experience (MAUDE) database, comparing these with non–radiation oncology devices. Methods and Materials: MAUDE data on RODs from 1991 to 2015 were sorted into 4 product categories (external beam, brachytherapy, planning systems, and simulation systems) and 5 device problem categories (software, mechanical, electrical, user error, and dose delivery impact).more » Outcomes included whether the device was evaluated by the manufacturer, adverse event type, remedial action, problem code, device age, and time since 510(k) approval. Descriptive statistics were performed with linear regression of time-series data. Results for RODs were compared with those for other devices by the Pearson χ{sup 2} test for categorical data and 2-sample Kolmogorov-Smirnov test for distributions. Results: There were 4234 ROD and 4,985,698 other device adverse event reports. Adverse event reports increased over time, and events involving RODs peaked in 2011. Most ROD reports involved external beam therapy (50.8%), followed by brachytherapy (24.9%) and treatment planning systems (21.6%). The top problem types were software (30.4%), mechanical (20.9%), and user error (20.4%). RODs differed significantly from other devices in each outcome (P<.001). RODs were more likely to be evaluated by the manufacturer after an event (46.9% vs 33.0%) but less likely to be recalled (10.5% vs 37.9%) (P<.001). Device age and time since 510(k) approval were shorter among RODs (P<.001). Conclusions: Compared with other devices, RODs may experience adverse events sooner after manufacture and market approval. Close postmarket surveillance, improved software design, and manufacturer–user training may help mitigate these events.« less

Medical Device Recalls in Radiation Oncology: Analysis of US Food and Drug Administration Data, 2002-2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Connor, Michael J.; University of California Irvine School of Medicine, Irvine, California; Tringale, Kathryn

Purpose: To analyze all recalls involving radiation oncology devices (RODs) from the US Food and Drug Administration (FDA)'s recall database, comparing these with non–radiation oncology device recalls to identify discipline-specific trends that may inform improvements in device safety. Methods and Materials: Recall data on RODs from 2002 to 2015 were sorted into 4 product categories (external beam, brachytherapy, planning systems, and simulation systems). Outcomes included determined cause of recall, recall class (severity), quantity in commerce, time until recall termination (date FDA determines recall is complete), and time since 510(k) approval. Descriptive statistics were performed with linear regression of time-series data. Resultsmore » for RODs were compared with those for other devices by Pearson χ{sup 2} test for categorical data and 2-sample Kolmogorov-Smirnov test for distributions. Results: There were 502 ROD recalls and 9534 other class II device recalls during 2002 to 2015. Most recalls were for external beam devices (66.7%) and planning systems (22.9%), and recall events peaked in 2011. Radiation oncology devices differed significantly from other devices in all recall outcomes (P≤.04). Recall cause was commonly software related (49% vs 10% for other devices). Recall severity was more often moderate among RODs (97.6% vs 87.2%) instead of severe (0.2% vs 4.4%; P<.001). Time from 510(k) market approval to recall was shorter among RODs (P<.001) and progressively shortened over time. Radiation oncology devices had fewer recalled devices in commerce than other devices (P<.001). Conclusions: Compared with other class II devices, RODs experience recalls sooner after market approval and are trending sooner still. Most of these recalls were moderate in severity, and software issues are prevalent. Comprehensive analysis of recall data can identify areas for device improvement, such as better system design among RODs.« less

Conventional and conformal technique of external beam radiotherapy in locally advanced cervical cancer: Dose distribution, tumor response, and side effects

NASA Astrophysics Data System (ADS)

Mutrikah, N.; Winarno, H.; Amalia, T.; Djakaria, M.

2017-08-01

The objective of this study was to compare conventional and conformal techniques of external beam radiotherapy (EBRT) in terms of the dose distribution, tumor response, and side effects in the treatment of locally advanced cervical cancer patients. A retrospective cohort study was conducted on cervical cancer patients who underwent EBRT before brachytherapy in the Radiotherapy Department of Cipto Mangunkusumo Hospital. The prescribed dose distribution, tumor response, and acute side effects of EBRT using conventional and conformal techniques were investigated. In total, 51 patients who underwent EBRT using conventional techniques (25 cases using Cobalt-60 and 26 cases using a linear accelerator (LINAC)) and 29 patients who underwent EBRT using conformal techniques were included in the study. The distribution of the prescribed dose in the target had an impact on the patient’s final response to EBRT. The complete response rate of patients to conformal techniques was significantly greater (58%) than that of patients to conventional techniques (42%). No severe acute local side effects were seen in any of the patients (Radiation Therapy Oncology Group (RTOG) grades 3-4). The distribution of the dose and volume to the gastrointestinal tract affected the proportion of mild acute side effects (RTOG grades 1-2). The urinary bladder was significantly greater using conventional techniques (Cobalt-60/LINAC) than using conformal techniques at 72% and 78% compared to 28% and 22%, respectively. The use of conformal techniques in pelvic radiation therapy is suggested in radiotherapy centers with CT simulators and 3D Radiotherapy Treatment Planning Systems (RTPSs) to decrease some uncertainties in radiotherapy planning. The use of AP/PA pelvic radiation techniques with Cobalt-60 should be limited in body thicknesses equal to or less than 18 cm. When using conformal techniques, delineation should be applied in the small bowel, as it is considered a critical organ according to RTOG consensus guidelines.

Surrogate-driven deformable motion model for organ motion tracking in particle radiation therapy

NASA Astrophysics Data System (ADS)

Fassi, Aurora; Seregni, Matteo; Riboldi, Marco; Cerveri, Pietro; Sarrut, David; Battista Ivaldi, Giovanni; Tabarelli de Fatis, Paola; Liotta, Marco; Baroni, Guido

2015-02-01

The aim of this study is the development and experimental testing of a tumor tracking method for particle radiation therapy, providing the daily respiratory dynamics of the patient’s thoraco-abdominal anatomy as a function of an external surface surrogate combined with an a priori motion model. The proposed tracking approach is based on a patient-specific breathing motion model, estimated from the four-dimensional (4D) planning computed tomography (CT) through deformable image registration. The model is adapted to the interfraction baseline variations in the patient’s anatomical configuration. The driving amplitude and phase parameters are obtained intrafractionally from a respiratory surrogate signal derived from the external surface displacement. The developed technique was assessed on a dataset of seven lung cancer patients, who underwent two repeated 4D CT scans. The first 4D CT was used to build the respiratory motion model, which was tested on the second scan. The geometric accuracy in localizing lung lesions, mediated over all breathing phases, ranged between 0.6 and 1.7 mm across all patients. Errors in tracking the surrounding organs at risk, such as lungs, trachea and esophagus, were lower than 1.3 mm on average. The median absolute variation in water equivalent path length (WEL) within the target volume did not exceed 1.9 mm-WEL for simulated particle beams. A significant improvement was achieved compared with error compensation based on standard rigid alignment. The present work can be regarded as a feasibility study for the potential extension of tumor tracking techniques in particle treatments. Differently from current tracking methods applied in conventional radiotherapy, the proposed approach allows for the dynamic localization of all anatomical structures scanned in the planning CT, thus providing complete information on density and WEL variations required for particle beam range adaptation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brualla, Lorenzo, E-mail: lorenzo.brualla@uni-due.de; Zaragoza, Francisco J.; Sempau, Josep

Purpose: External beam radiotherapy is the only conservative curative approach for Stage I non-Hodgkin lymphomas of the conjunctiva. The target volume is geometrically complex because it includes the eyeball and lid conjunctiva. Furthermore, the target volume is adjacent to radiosensitive structures, including the lens, lacrimal glands, cornea, retina, and papilla. The radiotherapy planning and optimization requires accurate calculation of the dose in these anatomical structures that are much smaller than the structures traditionally considered in radiotherapy. Neither conventional treatment planning systems nor dosimetric measurements can reliably determine the dose distribution in these small irradiated volumes. Methods and Materials: The Montemore » Carlo simulations of a Varian Clinac 2100 C/D and human eye were performed using the PENELOPE and PENEASYLINAC codes. Dose distributions and dose volume histograms were calculated for the bulbar conjunctiva, cornea, lens, retina, papilla, lacrimal gland, and anterior and posterior hemispheres. Results: The simulated results allow choosing the most adequate treatment setup configuration, which is an electron beam energy of 6 MeV with additional bolus and collimation by a cerrobend block with a central cylindrical hole of 3.0 cm diameter and central cylindrical rod of 1.0 cm diameter. Conclusions: Monte Carlo simulation is a useful method to calculate the minute dose distribution in ocular tissue and to optimize the electron irradiation technique in highly critical structures. Using a voxelized eye phantom based on patient computed tomography images, the dose distribution can be estimated with a standard statistical uncertainty of less than 2.4% in 3 min using a computing cluster with 30 cores, which makes this planning technique clinically relevant.« less

External-beam irradiation of carcinoma of the penis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sagerman, R.H.; Yu, W.S.; Chung, C.T.

1984-07-01

Twenty-four patients with biopsy-proved squamous-cell carcinoma of the penis underwent external-beam radiation therapy between 1966 and 1980. Fifteen were treated for the primary tumor and 9 for metastatic inguinal lymphadenopathy; no patient received prophylactic nodal irradiation. Seven out of 9 tumors in stage I, 2/3 in stage II, and 1/3 in stage IV were controlled for three years. Control of fixed, inoperable groin nodes was poor, and none of these patients survived beyond 1 1/2 years.

Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

DTIC Science & Technology

2014-10-01

Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing 5a. CONTRACT NUMBER...in the fifth quarter of the award. 15. SUBJECT TERMS Fracture healing , bone healing , endochondral ossification, intramembranous ossification...of radiation on the two pathways of bone healing and propose an optimal method of surgical fracture repair for managing malignant osteoporotic

High Contrast Internal and External Coronagraph Masks Produced by Various Techniques

NASA Technical Reports Server (NTRS)

Balasubramanian, Kunjithapatha; Wilson, Daniel; White, Victor; Muller, Richard; Dickie, Matthew; Yee, Karl; Ruiz, Ronald; Shaklan, Stuart; Cady, Eric; Kern, Brian;

SU-F-T-188: A Robust Treatment Planning Technique for Proton Pencil Beam Scanning Cranial Spinal Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, M; Mehta, M; Badiyan, S

2016-06-15

Purpose: To propose a proton pencil beam scanning (PBS) cranial spinal irradiation (CSI) treatment planning technique robust against patient roll, isocenter offset and proton range uncertainty. Method: Proton PBS plans were created (Eclipse V11) for three previously treated CSI patients to 36 Gy (1.8 Gy/fractions). The target volume was separated into three regions: brain, upper spine and lower spine. One posterior-anterior (PA) beam was used for each spine region, and two posterior-oblique beams (15° apart from PA direction, denoted as 2PO-15) for the brain region. For comparison, another plan using one PA beam for the brain target (denoted as 1PA)more » was created. Using the same optimization objectives, 98% CTV was optimized to receive the prescription dose. To evaluate plan robustness against patient roll, the gantry angle was increased by 3° and dose was recalculated without changing the proton spot weights. On the re-calculated plan, doses were then calculated using 12 scenarios that are combinations of isocenter shift (±3mm in X, Y, and Z directions) and proton range variation (±3.5%). The worst-case-scenario (WCS) brain CTV dosimetric metrics were compared to the nominal plan. Results: For both beam arrangements, the brain field(s) and upper-spine field overlap in the T2–T5 region depending on patient anatomy. The maximum monitor unit per spot were 48.7%, 47.2%, and 40.0% higher for 1PA plans than 2PO-15 plans for the three patients. The 2PO-15 plans have better dose conformity. At the same level of CTV coverage, the 2PO-15 plans have lower maximum dose and higher minimum dose to the CTV. The 2PO-15 plans also showed lower WCS maximum dose to CTV, while the WCS minimum dose to CTV were comparable between the two techniques. Conclusion: Our method of using two posterior-oblique beams for brain target provides improved dose conformity and homogeneity, and plan robustness including patient roll.« less

SU-G-TeP2-03: Comparison of Standard Dosimetry Protocol in Japan and AAPM TG-51 Addendum in Order to Establish Optimal Dosimetry for FFF Beam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matsunaga, T; Adachi, Y; Hayashi, N

Purpose: Japan Standard Dosimetry of Absorbed dose to water in external beam radiotherapy (JSDP12) is widely used to measure radiation dose in radiotherapy. However, JSDP12 does not take flattening-filter-free (FFF) beam into consideration. In addition, JSDP12 applied TPR20,10 for dose quality index for photon beam. The purpose of this study is to compare JSDP12 with AAPM TG-51 addendum in order to establish optimal dosimetry procedure for FFF beam. Method: We evaluated the ion-recombination factor (ks) and the correction factor of radial beam profile (Prp) in FFF beam dosimetry. The ks was introduced by 2 voltages method and verified by Jaffe’smore » plot. The Prp was given by both film measurement and calculation of treatment planning system, and compared them. Next, we compared the dose quality indexes (kQ) between TPR20,10 method and PDD(10)x method. Finally we considered optimal dosimetry protocol for FFF photon beam using JSDP12 with referring TG-51 addendum protocols. The FFF photon beams of 6 MV (6X-FFF) and 10 MV (10X-FFF) from TrueBeam were investigated in this study. Results: The ks for 6X-FFF and 10X-FFF beams were 1.005 and 1.010, respectively. The Prp of 0.6 cc ionization chamber for 6X-FFF and 10X-FFF beams (Film, TPS) were (1.004, 1.008) and (1.005, 1.008), respectively. The kQ for 6X-FFF and 10X-FFF beams (JSDP12, TG-51 addendum) were (0.9950, 0.9947) and (0.9851, 0.9845), respectively. The most effective factor for uncertainty in FFF photon beam measurement was Prp for JSDP12 formalism. Total dosimetric differences between JSDP12 and TG-51 addendum for 6X-FFF and 10X-FFF were -0.47% and -0.73%, respectively. Conclusion: The total dosimetric difference between JSDP12 and TG-51 addendum was within 1%. The introduction of kQ given by JSDP is feasible for FFF photon beam dosimetry. However, we think Prp should be considered for optimal dosimetry procedure even if JSDP12 is used for FFF photon beam dosimetry.« less

Developing a mailed phantom to implement a local QA program in Egypt radiotherapy centers

NASA Astrophysics Data System (ADS)

Soliman, H. A.; Aletreby, M.

2016-07-01

In this work, a simple method that differs from the IAEA/WHO Thermoluminescent dosimeters (TLD) postal quality assurance (QA) program is developed. A small perspex; polymethyl methacrylate (PMMA), phantom measured 50 mm × 50 mm × 50 mm is constructed to be used for absorbed dose verification of high-energy photon beams in some major radiotherapy centers in Egypt. The phantom weighted only 140.7 g with two buildup covers weighted 14.8 and 43.19 g for the Cobalt-60 and the 6-MV X-ray beams, respectively. This phantom is aimed for use in the future's external audit/QA services in Egypt for the first time. TLD-700 chips are used for testing and investigating a convenient and national dosimetry QA program. Although the used methodology is comparable to previously introduced but new system; it has smaller size, less weight, and different more available material. Comparison with the previous similar designs is introduced. Theoretical calculations were done by the commercial Eclipse treatment planning system, implementing the pencil beam convolution algorithm to verify the accuracy of the experimental calculation of the dose conversion factor of water to the perspex phantom. The new constructed small phantom and methodology was applied in 10 participating radiotherapy centers. The absorbed dose was verified under the reference conditions for both 60Co and 6-MV high-energy photon beams. The checked beams were within the 5% limit except for four photon beams. There was an agreement of 0.2% between our experimental data and those previously published confirming the validity of the applied method in verifying radiotherapy absorbed dose.

High energy micro electron beam generation using chirped laser pulse in the presence of an axial magnetic field

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akou, H., E-mail: h.akou@nit.ac.ir; Hamedi, M.

2015-10-15

In this paper, the generation of high-quality and high-energy micro electron beam in vacuum by a chirped Gaussian laser pulse in the presence of an axial magnetic field is numerically investigated. The features of energy and angular spectra, emittances, and position distribution of electron beam are compared in two cases, i.e., in the presence and absence of an external magnetic field. The electron beam is accelerated with higher energy and qualified in spatial distribution in the presence of the magnetic field. The presence of an axial magnetic field improves electron beam spatial quality as well as its gained energy throughmore » keeping the electron motion parallel to the direction of propagation for longer distances. It has been found that a 64 μm electron bunch with about MeV initial energy becomes a 20 μm electron beam with high energy of the order of GeV, after interacting with a laser pulse in the presence of an external magnetic field.« less

A simulation-based study on the influence of beam hardening in X-ray computed tomography for dimensional metrology.

PubMed

Lifton, Joseph J; Malcolm, Andrew A; McBride, John W

2015-01-01

X-ray computed tomography (CT) is a radiographic scanning technique for visualising cross-sectional images of an object non-destructively. From these cross-sectional images it is possible to evaluate internal dimensional features of a workpiece which may otherwise be inaccessible to tactile and optical instruments. Beam hardening is a physical process that degrades the quality of CT images and has previously been suggested to influence dimensional measurements. Using a validated simulation tool, the influence of spectrum pre-filtration and beam hardening correction are evaluated for internal and external dimensional measurements. Beam hardening is shown to influence internal and external dimensions in opposition, and to have a greater influence on outer dimensions compared to inner dimensions. The results suggest the combination of spectrum pre-filtration and a local gradient-based surface determination method are able to greatly reduce the influence of beam hardening in X-ray CT for dimensional metrology.

Diagnosis and treatment of a dermal malignant melanoma in an African lion (Panthera leo).

PubMed

Steeil, James C; Schumacher, Juergen; Baine, Katherine; Ramsay, Edward C; Sura, Patricia; Hodshon, Rebecca; Donnell, Robert L; Lee, Nathan D

2013-09-01

A 13-yr-old intact male African lion (Panthera leo) presented with a 4-mo history of left maxillary lip swelling. On physical examination, a 10-cm-diameter, ulcerated, round, firm, and pigmented mass at the level of the left maxillary canine tooth was noticed. All other organ systems examined were within normal limits. Multiple biopsies of the mass were collected and fixed in 10% neutral buffered formalin. Histopathologic evaluation of the biopsies revealed a malignant dermal melanoma. Hematologic and plasma biochemical parameters were within normal reference ranges. Thoracic radiographs taken 3 days following initial presentation showed no evidence of metastasis of the tumor. Computed tomography of the skull and neck was performed to evaluate local tumor invasion and to plan for hypofractionated radiation therapy. Therapy included four weekly treatments of 8 gray external-beam hypofractionated radiation and four bimonthly immunotherapy treatments. Following this treatment regime, the tumor size was reduced by 50%, and surgical excision was performed. No major side effects associated with radiation or immunotherapy were seen. Six months after diagnosis, hematologic and plasma biochemical parameters were within normal limits, thoracic radiographs showed no evidence of metastasis, and the lion showed no clinical signs of disease. The lion will continue to receive immunotherapy every 6 mo for the rest of its life. To the authors' knowledge, this is the first report of a successful treatment of a malignant dermal melanoma with external-beam hypofractionated radiation, immunotherapy, and surgical excision in an African lion.

Radiation therapy and esophageal cancer.

PubMed

Shridhar, Ravi; Almhanna, Khaldoun; Meredith, Kenneth L; Biagioli, Matthew C; Chuong, Michael D; Cruz, Alex; Hoffe, Sarah E

2013-04-01

Squamous cell carcinoma and adenocarcinoma account for more than 90% of all esophageal cancer cases. Although the incidence of squamous cell carcinoma has declined, the incidence of adenocarcinoma has risen due to increases in obesity and gastroesophageal reflux disease. The authors examine the role of radiation therapy alone (external beam and brachytherapy) for the management of esophageal cancer or combined with other modalities. The impact on staging and appropriate stratification of patients referred for curative vs palliative intent with modalities is reviewed. The authors also explore the role of emerging radiation technologies. Current data show that neoadjuvant chemoradiotherapy followed by surgical resection is the accepted standard of care, with 3-year overall survival rates ranging from 30% to 60%. The benefit of adjuvant radiation therapy is limited to patients with node-positive cancer. The survival benefit of surgical resection after chemoradiotherapy remains controversial. External beam radiation therapy alone results in few long-term survivors and is considered palliative at best. Radiation dose-escalation has failed to improve local control or survival. Brachytherapy can provide better long-term palliation of dysphagia than metal stent placement. Although three-dimensional conformal treatment planning is the accepted standard, the roles of IMRT and proton therapy are evolving and potentially reduce adverse events due to better sparing of normal tissue. Future directions will evaluate the benefit of induction chemotherapy followed by chemoradiotherapy, the role of surgery in locally advanced disease, and the identification of responders prior to treatment based on microarray analysis.

Improving treatment plan evaluation with automation

PubMed Central

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

2016-01-01

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

Histological changes in the human prostate after radiotherapy and salvage high intensity focused ultrasound

PubMed Central

Chalasani, Venu; Martinez, Carlos H.; Williams, Andrew K.; Kwan, Kevin; Chin, Joseph L.

2010-01-01

The histological changes (both macroscopic and microscopic) in the prostate following the combination of external beam radiotherapy and salvage high intensity focused ultrasound (HIFU) have not been previously described. This article describes the case of a 65-year-old male who presented with recurrent localized prostate cancer after undergoing external beam radiotherapy for low-risk prostate cancer. He was treated with salvage HIFU, and 4 weeks later presented with symptoms and signs consistent with a prostatorectal fistula. During a period of conservative management, his serum prostate-specific antigen levels started rising after having reached a nadir. A radical cystoprostatectomy and repair of fistula were performed after conservative management failed. Histological changes of dense fibrosis were noted in the region where the prostate should have been located. A literature review of the histological findings in the prostate after HIFU is discussed in this article, as well as the available evidence for the management of patients with local failure after the combination of external beam radiotherapy and salvage HIFU. PMID:20694085

Patient safety in external beam radiotherapy, results of the ACCIRAD project: Recommendations for radiotherapy institutions and national authorities on assessing risks and analysing adverse error-events and near misses.

PubMed

Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Skrobala, Agnieszka; Valero, Marc; Jarvinen, Hannu

2018-05-02

The ACCIRAD project, commissioned by the European Commission (EC) to develop guidelines for risk analysis of accidental and unintended exposures in external beam radiotherapy (EBRT), was completed in the year 2014. In 2015, the "General guidelines on risk management in external beam radiotherapy" were published as EC report Radiation Protection (RP)-181. The present document is the third and final report of the findings from the ACCIRAD project. The main aim of this paper is to describe the key features of the risk management process and to provide general guidelines for radiotherapy departments and national authorities on risk assessment and analysis of adverse error-events and near misses. The recommendations provided here and in EC report RP-181 are aimed at promoting the harmonisation of risk management systems across Europe, improving patient safety, and enabling more reliable inter-country comparisons. Copyright © 2018 Elsevier B.V. All rights reserved.

Treatment planning for heavy ion radiotherapy: clinical implementation and application.

PubMed

Jäkel, O; Krämer, M; Karger, C P; Debus, J

2001-04-01

The clinical implementation and application of a novel treatment planning system (TPS) for scanned ion beams is described, which is in clinical use for carbon ion treatments at the German heavy ion facility (GSI). All treatment plans are evaluated on the basis of biologically effective dose distributions. For therapy control, in-beam positron emission tomography (PET) and an online monitoring system for the beam intensity and position are used. The absence of a gantry restricts the treatment plans to horizontal beams. Most of the treatment plans consist of two nearly opposing lateral fields or sometimes orthogonal fields. In only a very few cases a single beam was used. For patients with very complex target volumes lateral and even distal field patching techniques were applied. Additional improvements can be achieved when the patient's head is fixed in a tilted position, in order to achieve sparing of the organs at risk. In order to test the stability of dose distributions in the case of patient misalignments we routinely simulate the effects of misalignments for patients with critical structures next to the target volume. The uncertainties in the range calculation are taken into account by a margin around the target volume of typically 2-3 mm, which can, however, be extended if the simulation demonstrates larger deviations. The novel TPS developed for scanned ion beams was introduced into clinical routine in December 1997 and was used for the treatment planning of 63 patients with head and neck tumours until July 2000. Planning strategies and methods were developed for this tumour location that facilitate the treatment of a larger number of patients with the scanned heavy ion beam in a clinical setting. Further developments aim towards a simultaneous optimization of the treatment field intensities and more effective procedures for the patient set-up. The results demonstrate that ion beams can be integrated into a clinical environment for treatment planning and delivery.

Cervix regression and motion during the course of external beam chemoradiation for cervical cancer.

PubMed

Beadle, Beth M; Jhingran, Anuja; Salehpour, Mohammad; Sam, Marianne; Iyer, Revathy B; Eifel, Patricia J

2009-01-01

To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer. Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group. Mean cervical volumes before and after 45 Gy of external beam irradiation were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively. Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures.

Automatic online adaptive radiation therapy techniques for targets with significant shape change: a feasibility study.

PubMed

Court, Laurence E; Tishler, Roy B; Petit, Joshua; Cormack, Robert; Chin, Lee

2006-05-21

This work looks at the feasibility of an online adaptive radiation therapy concept that would detect the daily position and shape of the patient, and would then correct the daily treatment to account for any changes compared with planning position. In particular, it looks at the possibility of developing algorithms to correct for large complicated shape change. For co-planar beams, the dose in an axial plane is approximately associated with the positions of a single multi-leaf collimator (MLC) pair. We start with a primary plan, and automatically generate several secondary plans with gantry angles offset by regular increments. MLC sequences for each plan are calculated keeping monitor units (MUs) and number of segments constant for a given beam (fluences are different). Bulk registration (3D) of planning and daily CT images gives global shifts. Slice-by-slice (2D) registration gives local shifts and rotations about the longitudinal axis for each axial slice. The daily MLC sequence is then created for each axial slice/MLC leaf pair combination, by taking the MLC positions from the pre-calculated plan with the nearest rotation, and shifting using a beam's-eye-view calculation to account for local linear shifts. A planning study was carried out using two head and neck region MR images of a healthy volunteer which were contoured to simulate a base-of-tongue treatment: one with the head straight (used to simulate the planning image) and the other with the head tilted to the left (the daily image). Head and neck treatment was chosen to evaluate this technique because of its challenging nature, with varying internal and external contours, and multiple degrees of freedom. Shape change was significant: on a slice-by-slice basis, local rotations in the daily image varied from 2 to 31 degrees, and local shifts ranged from -0.2 to 0.5 cm and -0.4 to 0.0 cm in right-left and posterior-anterior directions, respectively. The adapted treatment gave reasonable target coverage (100%, 90% and 80% of the base-of-tongue, left nodes and right nodes, respectively, receiving the daily prescription dose), and kept the daily cord dose below the limit used in the original plan (65%, equivalent to 46 Gy over 35 fractions). Most of the loss of coverage was due to one shoulder being raised more superior relative to the other shoulder compared with the plan. This type of skew-like motion is not accounted for by the proposed ART technique. In conclusion, this technique has potential to correct for fairly extreme daily changes in patient setup, but some control of the daily position would still be necessary. Importantly, it was possible to combine treatments from different plans (MLC sequences) to correct for position and shape change.

An experimentally based analytical model for the shear capacity of FRP-strengthened reinforced concrete beams

NASA Astrophysics Data System (ADS)

Pellegrino, C.; Modena, C.

2008-05-01

This paper deals with the shear strengthening of Reinforced Concrete (RC) flexural members with externally bonded Fiber-Reinforced Polymers (FRPs). The interaction between an external FRP and an internal transverse steel reinforcement is not considered in actual code recommendations, but it strongly influences the efficiency of the shear strengthening rehabilitation technique and, as a consequence, the computation of interacting contributions to the nominal shear strength of beams. This circumstance is also discussed on the basis of the results of an experimental investigation of rectangular RC beams strengthened in shear with "U-jacketed" carbon FRP sheets. Based on experimental results of the present and other investigations, a new analytical model for describing the shear capacity of RC beams strengthened according to the most common schemes (side-bonded and "U-jacketed"), taking into account the interaction between steel and FRP shear strength contributions, is proposed.

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.

TH-EF-BRB-05: 4pi Non-Coplanar IMRT Beam Angle Selection by Convex Optimization with Group Sparsity Penalty

DOE Office of Scientific and Technical Information (OSTI.GOV)

O’Connor, D; Nguyen, D; Voronenko, Y

Purpose: Integrated beam orientation and fluence map optimization is expected to be the foundation of robust automated planning but existing heuristic methods do not promise global optimality. We aim to develop a new method for beam angle selection in 4π non-coplanar IMRT systems based on solving (globally) a single convex optimization problem, and to demonstrate the effectiveness of the method by comparison with a state of the art column generation method for 4π beam angle selection. Methods: The beam angle selection problem is formulated as a large scale convex fluence map optimization problem with an additional group sparsity term thatmore » encourages most candidate beams to be inactive. The optimization problem is solved using an accelerated first-order method, the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). The beam angle selection and fluence map optimization algorithm is used to create non-coplanar 4π treatment plans for several cases (including head and neck, lung, and prostate cases) and the resulting treatment plans are compared with 4π treatment plans created using the column generation algorithm. Results: In our experiments the treatment plans created using the group sparsity method meet or exceed the dosimetric quality of plans created using the column generation algorithm, which was shown superior to clinical plans. Moreover, the group sparsity approach converges in about 3 minutes in these cases, as compared with runtimes of a few hours for the column generation method. Conclusion: This work demonstrates the first non-greedy approach to non-coplanar beam angle selection, based on convex optimization, for 4π IMRT systems. The method given here improves both treatment plan quality and runtime as compared with a state of the art column generation algorithm. When the group sparsity term is set to zero, we obtain an excellent method for fluence map optimization, useful when beam angles have already been selected. NIH R43CA183390, NIH R01CA188300, Varian Medical Systems; Part of this research took place while D. O’Connor was a summer intern at RefleXion Medical.« less

SU-E-T-216: Comparison of Volumetrically Modulated Arc Therapy Treatment Using Flattening Filter Free Beams Vs. Flattened Beams for Partial Brain Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, S; Roa, D; Hanna, N

2015-06-15

Purpose: Flattening Filter Free (FFF) beams offer the potential for higher dose rates, short treatment time, and lower out of field dose. Therefore, the aim of this study was to investigate the dosimetric effects and out of field dose of Volumetric Modulated Arc Therapy (VMAT) plans using FFF vs Flattening Filtering (FF) beams for partial brain irradiation. Methods: Ten brain patients treated with a 6FF beam from a Truebeam STX were analyzed retrospectively for this study. These plans (46Gy at 2 Gy per fraction) were re-optimized for 6FFF beams using the same dose constraints as the original plans. PTV coverage,more » PTV Dmax, total MUs, and mean dose to organs-at-risk (OAR) were evaluated. In addition, the out-of-field dose for 6FF and 6FFF plans for one patient was measured on an anthropomorphic phantom. TLDs were placed inside (central axis) and outside (surface) the phantom at distances ranging from 0.5 cm to 17 cm from the field edge. Paired T-test was used for statistical analysis. Results: PTV coverage and PTV Dmax were comparable for the FF and FFF plans with 95.9% versus 95.6% and 111.2% versus 111.9%, respectively. Mean dose to the OARs were 3.7% less for FFF than FF plans (p<0.0001). Total MUs were, on average, 12.5% greater for FFF than FF plans with 481±55 MU (FFF) versus 429±50 MU (FF), p=0.0003. On average, the measured out of field dose was 24% less for FFF compared to FF, p<0.0001. A similar beam-on time was observed for the FFF and FF treatment. Conclusion: It is beneficial to use 6FFF beams for regular fractionated brain VMAT treatments. VMAT treatment plans using FFF beams can achieve comparable PTV coverage but with more OAR sparing. The out of field dose is significant less with mean reduction of 24%.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Islam, M; Ahmad, S; Jin, H

Purpose: The out-of-beam dose is important for understanding the peripheral dose in radiation therapy. In proton radiotherapy, the study of out-of-beam dose is scarce and the treatment planning system (TPS) based on pencil beam algorithm cannot accurately predict the out-of-beam dose. This study investigates the out-of-beam dose for the single-room Mevion S250 double scattering proton therapy system using experimentally measured and treatment planning software generated data. The results are compared with those reported for conventional photon beam therapy. However, this study does not incorporate the neutron contribution in the scattered dose. Methods: A total of seven proton treatment plans weremore » generated using Varian Eclipse TPS for three different sites (brain, lung, and pelvis) in an anthropomorphic phantom. Three field sizes of 5×5, 10×10, and 20×20 cm{sup 2} (lung only) with typical clinical range (13.3–22.8 g/cm{sup 2}) and modulation widths (5.3–14.0 g/cm{sup 2}) were used. A single beam was employed in each treatment plan to deliver a dose of 181.8 cGy (200.0 cGy (RBE)) to the selected target. The out-of-beam dose was measured at 2.0, 5.0, 10.0, and 15.0 cm from the beam edge in the phantom using a thimble chamber (PTW TN31010). Results: The out-of-beam dose generally increased with field size, range, and volume irradiated. For all the plans, the scattered dose sharply fell off with distance. At 2.0 cm, the out-of-beam dose ranged from 0.35% to 2.16% of the delivered dose; however, the dose was clinically negligible (<0.3%) at a distance of 5.0 cm and greater. In photon therapy, the slightly greater out-of-beam dose was reported (TG36; 4%, 2%, and 1% for 2.0, 5.0, and 10.0 cm, respectively, using 6 MV beam). Conclusion: The measured out-of-beam dose in proton therapy excluding neutron contribution was observed higher than the TPS calculated dose and comparable to that of photon beam therapy.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ju, N; Chen, C; Gans, S

Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan usingmore » bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm{sup 3} of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.« less

Robust Proton Pencil Beam Scanning Treatment Planning for Rectal Cancer Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blanco Kiely, Janid Patricia, E-mail: jkiely@sas.upenn.edu; White, Benjamin M.

2016-05-01

Purpose: To investigate, in a treatment plan design and robustness study, whether proton pencil beam scanning (PBS) has the potential to offer advantages, relative to interfraction uncertainties, over photon volumetric modulated arc therapy (VMAT) in a locally advanced rectal cancer patient population. Methods and Materials: Ten patients received a planning CT scan, followed by an average of 4 weekly offline CT verification CT scans, which were rigidly co-registered to the planning CT. Clinical PBS plans were generated on the planning CT, using a single-field uniform-dose technique with single-posterior and parallel-opposed (LAT) fields geometries. The VMAT plans were generated on the planningmore » CT using 2 6-MV, 220° coplanar arcs. Clinical plans were forward-calculated on verification CTs to assess robustness relative to anatomic changes. Setup errors were assessed by forward-calculating clinical plans with a ±5-mm (left–right, anterior–posterior, superior–inferior) isocenter shift on the planning CT. Differences in clinical target volume and organ at risk dose–volume histogram (DHV) indicators between plans were tested for significance using an appropriate Wilcoxon test (P<.05). Results: Dosimetrically, PBS plans were statistically different from VMAT plans, showing greater organ at risk sparing. However, the bladder was statistically identical among LAT and VMAT plans. The clinical target volume coverage was statistically identical among all plans. The robustness test found that all DVH indicators for PBS and VMAT plans were robust, except the LAT's genitalia (V5, V35). The verification CT plans showed that all DVH indicators were robust. Conclusions: Pencil beam scanning plans were found to be as robust as VMAT plans relative to interfractional changes during treatment when posterior beam angles and appropriate range margins are used. Pencil beam scanning dosimetric gains in the bowel (V15, V20) over VMAT suggest that using PBS to treat rectal cancer may reduce radiation treatment–related toxicity.« less

SU-E-T-24: A Simple Correction-Based Method for Independent Monitor Unit (MU) Verification in Monte Carlo (MC) Lung SBRT Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pokhrel, D; Badkul, R; Jiang, H

2014-06-01

Purpose: Lung-SBRT uses hypo-fractionated dose in small non-IMRT fields with tissue-heterogeneity corrected plans. An independent MU verification is mandatory for safe and effective delivery of the treatment plan. This report compares planned MU obtained from iPlan-XVM-Calgorithm against spreadsheet-based hand-calculation using most commonly used simple TMR-based method. Methods: Treatment plans of 15 patients who underwent for MC-based lung-SBRT to 50Gy in 5 fractions for PTV V100%=95% were studied. ITV was delineated on MIP images based on 4D-CT scans. PTVs(ITV+5mm margins) ranged from 10.1- 106.5cc(average=48.6cc). MC-SBRT plans were generated using a combination of non-coplanar conformal arcs/beams using iPlan XVM-Calgorithm (BrainLAB iPlan ver.4.1.2)more » for Novalis-TX consisting of micro-MLCs and 6MV-SRS (1000MU/min) beam. These plans were re-computed using heterogeneity-corrected Pencil-Beam (PB-hete) algorithm without changing any beam parameters, such as MLCs/MUs. Dose-ratio: PB-hete/MC gave beam-by-beam inhomogeneity-correction-factors (ICFs):Individual Correction. For independent-2nd-check, MC-MUs were verified using TMR-based hand-calculation and obtained an average ICF:Average Correction, whereas TMR-based hand-calculation systematically underestimated MC-MUs by ∼5%. Also, first 10 MC-plans were verified with an ion-chamber measurement using homogenous phantom. Results: For both beams/arcs, mean PB-hete dose was systematically overestimated by 5.5±2.6% and mean hand-calculated MU systematic underestimated by 5.5±2.5% compared to XVMC. With individual correction, mean hand-calculated MUs matched with XVMC by - 0.3±1.4%/0.4±1.4 for beams/arcs, respectively. After average 5% correction, hand-calculated MUs matched with XVMC by 0.5±2.5%/0.6±2.0% for beams/arcs, respectively. Smaller dependence on tumor volume(TV)/field size(FS) was also observed. Ion-chamber measurement was within ±3.0%. Conclusion: PB-hete overestimates dose to lung tumor relative to XVMC. XVMC-algorithm is much more-complex and accurate with tissues-heterogeneities. Measurement at machine is time consuming and need extra resources; also direct measurement of dose for heterogeneous treatment plans is not clinically practiced, yet. This simple correction-based method was very helpful for independent-2nd-check of MC-lung-SBRT plans and routinely used in our clinic. A look-up table can be generated to include TV/FS dependence in ICFs.« less

Dosimetric and radiobiological comparison of Forward Tangent Intensity Modulated Radiation Therapy (FT-IMRT) and Volumetric Modulated Arc Therapy (VMAT) for early stage whole breast cancer

NASA Astrophysics Data System (ADS)

Moshiri Sedeh, Nader

Intensity Modulated Radiation Therapy (IMRT) is a well-known type of external beam radiation therapy. The advancement in technology has had an inevitable influence in radiation oncology as well that has led to a newer and faster dose delivery technique called Volumetric Modulated Arc Therapy (VMAT). Since the presence of the VMAT modality in clinics in the late 2000, there have been many studies in order to compare the results of the VMAT modality with the current popular modality IMRT for various tumor sites in the body such as brain, prostate, head and neck, cervix and anal carcinoma. This is the first study to compare VMAT with IMRT for breast cancer. The results show that the RapidArc technique in Eclipse version 11 does not improve all aspects of the treatment plans for the breast cases automatically and easily, but it needs to be manipulated by extra techniques to create acceptable plans thus further research is needed.

The influence of bone density on the radiotherapy of cervix cancer

NASA Astrophysics Data System (ADS)

Soares, M. R.; Souza, D. N.

2011-10-01

Until the 1970s the irradiated region of a patient undergoing external beam radiotherapy was considered a homogeneous volume and a regular surface, with physical characteristics similar to water. With the improvement of medical imaging equipment, it has become possible to conduct planning in radiotherapy treatment that considers the heterogeneities and irregularities of a patient's anatomy. Consequently, such technological resources have brought greater accuracy to radiotherapy. In this study, we determined the variation in the average amount of absorbed dose on the target volume and at the point of prescription treatment by comparing the doses which were calculated in a planning system considering the patient both as a homogeneous, and as a heterogeneous medium. The results showed that when we take into account the volume of the upper vagina and cervix, and consider the pelvis as a heterogeneous medium, the calculated dose was under-estimated at some points in the studied volume with respect to the dose when this region was considered homogeneous.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palma, B; Bazalova, M; Qu, B

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

Proton Beam Therapy

NASA Astrophysics Data System (ADS)

Paganetti, Harald

2017-01-01

Cancer therapy is a multi-modality approach including surgery, systemic or targeted chemotherapy, radiation (external beam or radionuclide), and immunotherapy. Radiation is typically administered using external beam photon therapy. Proton therapy has been around for more than 60 years but was restricted to research laboratories until the 1990s. Since then clinical proton therapy has been growing rapidly with currently more than 50 facilities worldwide. The interest in proton therapy stems from the physical properties of protons allowing for advanced dose sculpting around the target and sparing of healthy tissue. This review first evaluates the basics of proton therapy physics and technology and then outlines some of the current physical, biological, and clinical challenges. Solving these will ultimately determine whether proton therapy will continue on its path to becoming mainstream.

Green high-power tunable external-cavity GaN diode laser at 515  nm.

PubMed

Chi, Mingjun; Jensen, Ole Bjarlin; Petersen, Paul Michael

2016-09-15

A 480 mW green tunable diode laser system is demonstrated for the first time to our knowledge. The laser system is based on a GaN broad-area diode laser and Littrow external-cavity feedback. The green laser system is operated in two modes by switching the polarization direction of the laser beam incident on the grating. When the laser beam is p-polarized, an output power of 50 mW with a tunable range of 9.2 nm is achieved. When the laser beam is s-polarized, an output power of 480 mW with a tunable range of 2.1 nm is obtained. This constitutes the highest output power from a tunable green diode laser system.

21. c, 1915 Historic plan, standard 2 beam girder bridge. ...

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

21. c, 1915 Historic plan, standard 2 beam girder bridge. United Construction Company, Albany, New York. Generic plan typical of Prescott Bridge. Source: New Hampshire Department of Transportation - Prescott Bridge, Spanning Lamprey River on Prescott Road, Raymond, Rockingham County, NH

Clinical experience with planning, quality assurance, and delivery of burst‐mode modulated arc therapy

PubMed Central

Prah, Douglas; Ahunbay, Ergun; Li, X. Allen

2016-01-01

“Burst‐mode” modulated arc therapy (hereafter referred to as “mARC”) is a form of volumetric‐modulated arc therapy characterized by variable gantry rotation speed, static MLCs while the radiation beam is on, and MLC repositioning while the beam is off. We present our clinical experience with the planning techniques and plan quality assurance measurements of mARC delivery. Clinical mARC plans for five representative cases (prostate, low‐dose‐rate brain, brain with partial‐arc vertex fields, pancreas, and liver SBRT) were generated using a Monte Carlo–based treatment planning system. A conventional‐dose‐rate flat 6 MV and a high‐dose‐rate non‐flat 7 MV beam are available for planning and delivery. mARC plans for intact‐prostate cases can typically be created using one 360° arc, and treatment times per fraction seldom exceed 6 min using the flat beam; using the nonflat beam results in slightly higher MU per fraction, but also in delivery times less than 4 min and with reduced mean dose to distal organs at risk. mARC also has utility in low‐dose‐rate brain irradiation; mARC fields can be designed which deliver a uniform 20 cGy dose to the PTV in approximately 3‐minute intervals, making it a viable alternative to conventional 3D CRT. For brain cases using noncoplanar arcs, delivery time is approximately six min using the nonflat beam. For pancreas cases using the nonflat beam, two overlapping 360° arcs are required, and delivery times are approximately 10 min. For liver SBRT, the time to deliver 800 cGy per fraction is at least 12 min. Plan QA measurements indicate that the mARC delivery is consistent with the plan calculation for all cases. mARC has been incorporated into routine practice within our clinic; currently, on average approximately 15 patients per day are treated using mARC; and with the exception of LDR brain cases, all are treated using the nonflat beam. PACS number(s): 87.55.D‐, 87.55.K‐, 87.53.Ay. 87.56.N‐ PMID:27685123

Commissioning of intensity modulated neutron radiotherapy (IMNRT).

PubMed

Burmeister, Jay; Spink, Robyn; Liang, Liang; Bossenberger, Todd; Halford, Robert; Brandon, John; Delauter, Jonathan; Snyder, Michael

2013-02-01

Intensity modulated neutron radiotherapy (IMNRT) has been developed using inhouse treatment planning and delivery systems at the Karmanos Cancer Center∕Wayne State University Fast Neutron Therapy facility. The process of commissioning IMNRT for clinical use is presented here. Results of commissioning tests are provided including validation measurements using representative patient plans as well as those from the TG-119 test suite. IMNRT plans were created using the Varian Eclipse optimization algorithm and an inhouse planning system for calculation of neutron dose distributions. Tissue equivalent ionization chambers and an ionization chamber array were used for point dose and planar dose distribution comparisons with calculated values. Validation plans were delivered to water and virtual water phantoms using TG-119 measurement points and evaluation techniques. Photon and neutron doses were evaluated both inside and outside the target volume for a typical IMNRT plan to determine effects of intensity modulation on the photon dose component. Monitor unit linearity and effects of beam current and gantry angle on output were investigated, and an independent validation of neutron dosimetry was obtained. While IMNRT plan quality is superior to conventional fast neutron therapy plans for clinical sites such as prostate and head and neck, it is inferior to photon IMRT for most TG-119 planning goals, particularly for complex cases. This results significantly from current limitations on the number of segments. Measured and calculated doses for 11 representative plans (six prostate∕five head and neck) agreed to within -0.8 ± 1.4% and 5.0 ± 6.0% within and outside the target, respectively. Nearly all (22∕24) ion chamber point measurements in the two phantom arrangements were within the respective confidence intervals for the quantity [(measured-planned)∕prescription dose] derived in TG-119. Mean differences for all measurements were 0.5% (max = 7.0%) and 1.4% (max = 4.1%) in water and virtual water, respectively. The mean gamma pass rate for all cases was 92.8% (min = 88.6%). These pass rates are lower than typically achieved with photon IMRT, warranting development of a planar dosimetry system designed specifically for IMNRT and∕or the improvement of neutron beam modeling in the penumbral region. The fractional photon dose component did not change significantly in a typical IMNRT plan versus a conventional fast neutron therapy plan, and IMNRT delivery is not expected to significantly alter the RBE. All other commissioning results were considered satisfactory for clinical implementation of IMNRT, including the external neutron dose validation, which agreed with the predicted neutron dose to within 1%. IMNRT has been successfully commissioned for clinical use. While current plan quality is inferior to photon IMRT, it is superior to conventional fast neutron therapy. Ion chamber validation results for IMNRT commissioning are also comparable to those typically achieved with photon IMRT. Gamma pass rates for planar dose distributions are lower than typically observed for photon IMRT but may be improved with improved planar dosimetry equipment and beam modeling techniques. In the meantime, patient-specific quality assurance measurements should rely more heavily on point dose measurements with tissue equivalent ionization chambers. No significant technical impediments are anticipated in the clinical implementation of IMNRT as described here.

SU-F-T-336: A Quick Auto-Planning (QAP) Method for Patient Intensity Modulated Radiotherapy (IMRT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peng, J; Zhang, Z; Wang, J

2016-06-15

Purpose: The aim of this study is to develop a quick auto-planning system that permits fast patient IMRT planning with conformal dose to the target without manual field alignment and time-consuming dose distribution optimization. Methods: The planning target volume (PTV) of the source and the target patient were projected to the iso-center plane in certain beameye- view directions to derive the 2D projected shapes. Assuming the target interior was isotropic for each beam direction boundary analysis under polar coordinate was performed to map the source shape boundary to the target shape boundary to derive the source-to-target shape mapping function. Themore » derived shape mapping function was used to morph the source beam aperture to the target beam aperture over all segments in each beam direction. The target beam weights were re-calculated to deliver the same dose to the reference point (iso-center) as the source beam did in the source plan. The approach was tested on two rectum patients (one source patient and one target patient). Results: The IMRT planning time by QAP was 5 seconds on a laptop computer. The dose volume histograms and the dose distribution showed the target patient had the similar PTV dose coverage and OAR dose sparing with the source patient. Conclusion: The QAP system can instantly and automatically finish the IMRT planning without dose optimization.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nunes, R. P.; Rizzato, F. B.

This work analyzes the transversal dynamics of an inhomogeneous and mismatched charged particle beam. The beam is azimuthally symmetric, initially cold, and evolves in a linear channel permeated by an external constant magnetic field. Based on a Lagrangian approach, a low-dimensional model for the description of the beam dynamics has been obtained. The small set of nonlinear dynamical equations provided results that are in reasonable agreement with that ones observed in full self-consistent N-particle beam numerical simulations.

Early laser operations at the Large Binocular Telescope Observatory

NASA Astrophysics Data System (ADS)

Rahmer, Gustavo; Lefebvre, Michael; Christou, Julian; Raab, Walfried; Rabien, Sebastian; Ziegleder, Julian; Borelli, José L.; Gässler, Wolfgang

2014-08-01

ARGOS is the GLAO (Ground-Layer Adaptive Optics) Rayleigh-based LGS (Laser Guide Star) facility for the Large Binocular Telescope Observatory (LBTO). It is dedicated for observations with LUCI1 and LUCI2, LBTO's pair of NIR imagers and multi-object spectrographs. The system projects three laser beams from the back of each of the two secondary mirror units, which create two constellations circumscribed on circles of 2 arcmin radius with 120 degree spacing. Each of the six Nd:YAG lasers provides a beam of green (532nm) pulses at a rate of 10kHz with a power of 14W to 18W. We achieved first on-sky propagation on the night of November 5, 2013, and commissioning of the full system will take place during 2014. We present the initial results of laser operations at the observatory, including safety procedures and the required coordination with external agencies (FAA, Space Command, and Military Airspace Manager). We also describe our operational procedures and report on our experiences with aircraft spotters. Future plans for safer and more efficient aircraft monitoring and detection are discussed.

The continued development of the Spallation Neutron Source external antenna H- ion sourcea)

NASA Astrophysics Data System (ADS)

Welton, R. F.; Carmichael, J.; Desai, N. J.; Fuga, R.; Goulding, R. H.; Han, B.; Kang, Y.; Lee, S. W.; Murray, S. N.; Pennisi, T.; Potter, K. G.; Santana, M.; Stockli, M. P.

2010-02-01

The U.S. Spallation Neutron Source (SNS) is an accelerator-based, pulsed neutron-scattering facility, currently in the process of ramping up neutron production. In order to ensure that the SNS will meet its operational commitments as well as provide for future facility upgrades with high reliability, we are developing a rf-driven, H- ion source based on a water-cooled, ceramic aluminum nitride (AlN) plasma chamber. To date, early versions of this source have delivered up to 42 mA to the SNS front end and unanalyzed beam currents up to ˜100 mA (60 Hz, 1 ms) to the ion source test stand. This source was operated on the SNS accelerator from February to April 2009 and produced ˜35 mA (beam current required by the ramp up plan) with availability of ˜97%. During this run several ion source failures identified reliability issues, which must be addressed before the source re-enters production: plasma ignition, antenna lifetime, magnet cooling, and cooling jacket integrity. This report discusses these issues, details proposed engineering solutions, and notes progress to date.

A dose optimization method for electron radiotherapy using randomized aperture beams

NASA Astrophysics Data System (ADS)

Engel, Konrad; Gauer, Tobias

2009-09-01

The present paper describes the entire optimization process of creating a radiotherapy treatment plan for advanced electron irradiation. Special emphasis is devoted to the selection of beam incidence angles and beam energies as well as to the choice of appropriate subfields generated by a refined version of intensity segmentation and a novel random aperture approach. The algorithms have been implemented in a stand-alone programme using dose calculations from a commercial treatment planning system. For this study, the treatment planning system Pinnacle from Philips has been used and connected to the optimization programme using an ASCII interface. Dose calculations in Pinnacle were performed by Monte Carlo simulations for a remote-controlled electron multileaf collimator (MLC) from Euromechanics. As a result, treatment plans for breast cancer patients could be significantly improved when using randomly generated aperture beams. The combination of beams generated through segmentation and randomization achieved the best results in terms of target coverage and sparing of critical organs. The treatment plans could be further improved by use of a field reduction algorithm. Without a relevant loss in dose distribution, the total number of MLC fields and monitor units could be reduced by up to 20%. In conclusion, using randomized aperture beams is a promising new approach in radiotherapy and exhibits potential for further improvements in dose optimization through a combination of randomized electron and photon aperture beams.

Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

DTIC Science & Technology

2015-10-01

stiffness, or a partial snap with lower yield force and stiffness (Figure 4). Three dimensional micro CT analysis around fracture Figure 3. (a-b... fractures with plate fixation on both sides and irradiation on the left while the contralateral limb serves as a non-radiated internal control. The...AWARD NUMBER: W81XWH-13-1-0430 TITLE: Optimal Treatment of Malignant Long Bone Fracture : Influence of Method of Repair and External Beam

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

PubMed

Inaniwa, T; Kanematsu, N

2015-01-07

In scanned carbon-ion (C-ion) radiotherapy, some primary C-ions undergo nuclear reactions before reaching the target and the resulting particles deliver doses to regions at a significant distance from the central axis of the beam. The effects of these particles on physical dose distribution are accounted for in treatment planning by representing the transverse profile of the scanned C-ion beam as the superposition of three Gaussian distributions. In the calculation of biological dose distribution, however, the radiation quality of the scanned C-ion beam has been assumed to be uniform over its cross-section, taking the average value over the plane at a given depth (monochrome model). Since these particles, which have relatively low radiation quality, spread widely compared to the primary C-ions, the radiation quality of the beam should vary with radial distance from the central beam axis. To represent its transverse distribution, we propose a trichrome beam model in which primary C-ions, heavy fragments with atomic number Z ≥ 3, and light fragments with Z ≤ 2 are assigned to the first, second, and third Gaussian components, respectively. Assuming a realistic beam-delivery system, we performed computer simulations using Geant4 Monte Carlo code for analytical beam modeling of the monochrome and trichrome models. The analytical beam models were integrated into a treatment planning system for scanned C-ion radiotherapy. A target volume of 20  ×  20  ×  40 mm(3) was defined within a water phantom. A uniform biological dose of 2.65 Gy (RBE) was planned for the target with the two beam models based on the microdosimetric kinetic model (MKM). The plans were recalculated with Geant4, and the recalculated biological dose distributions were compared with the planned distributions. The mean target dose of the recalculated distribution with the monochrome model was 2.72 Gy (RBE), while the dose with the trichrome model was 2.64 Gy (RBE). The monochrome model 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.

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

In scanned carbon-ion (C-ion) radiotherapy, some primary C-ions undergo nuclear reactions before reaching the target and the resulting particles deliver doses to regions at a significant distance from the central axis of the beam. The effects of these particles on physical dose distribution are accounted for in treatment planning by representing the transverse profile of the scanned C-ion beam as the superposition of three Gaussian distributions. In the calculation of biological dose distribution, however, the radiation quality of the scanned C-ion beam has been assumed to be uniform over its cross-section, taking the average value over the plane at a given depth (monochrome model). Since these particles, which have relatively low radiation quality, spread widely compared to the primary C-ions, the radiation quality of the beam should vary with radial distance from the central beam axis. To represent its transverse distribution, we propose a trichrome beam model in which primary C-ions, heavy fragments with atomic number Z ≥ 3, and light fragments with Z ≤ 2 are assigned to the first, second, and third Gaussian components, respectively. Assuming a realistic beam-delivery system, we performed computer simulations using Geant4 Monte Carlo code for analytical beam modeling of the monochrome and trichrome models. The analytical beam models were integrated into a treatment planning system for scanned C-ion radiotherapy. A target volume of 20  ×  20  ×  40 mm3 was defined within a water phantom. A uniform biological dose of 2.65 Gy (RBE) was planned for the target with the two beam models based on the microdosimetric kinetic model (MKM). The plans were recalculated with Geant4, and the recalculated biological dose distributions were compared with the planned distributions. The mean target dose of the recalculated distribution with the monochrome model was 2.72 Gy (RBE), while the dose with the trichrome model was 2.64 Gy (RBE). The monochrome model 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.

Effect of contrast agent administration on consequences of dosimetry and biology in radiotherapy planning

NASA Astrophysics Data System (ADS)

Lo, Ching-Jung; Yang, Pei-Ying; Chao, Tsi-Chian; Tu, Shu-Ju

2015-06-01

In the treatment planning of radiation therapy, patients may be administrated with contrast media in CT scanning to assist physicians for accurate delineation of the target or organs. However, contrast media are not used in patients during the treatment delivery. In particular, contrast media contain materials with high atomic numbers and dosimetric variations may occur between scenarios where contrast media are present in treatment planning and absent in treatment delivery. In this study we evaluate the effect of contrast media on the dosimetry and biological consequence. An analytical phantom based on AAPM TG 119 and five sets of CT images from clinical patients are included. Different techniques of treatment planning are considered, including 1-field AP, 2-field AP+PA, 4-field box, 7-field IMRT, and RapidArc. RapidArc is a recent technique of volumetric modulated arc therapy and is used in our study of contrast media in clinical scenarios. The effect of RapidArc on dosimetry and biological consequence for administration of contrast media in radiotherapy is not discussed previously in literature. It is shown that dose difference is reduced as the number of external beams is increased, suggesting RapidArc may be favored to be used in the treatment planning enhanced by contrast media. Linear trend lines are fitted for assessment of percent dose differences in the planning target volume versus concentrations of contrast media between plans where contrast media are present and absent, respectively.

SU-F-T-197: Investigating Optimal Oblique-Beam Arrangement for Bilateral Metallic Prosthesis Prostate Cancer in Pencil Beam Scanning Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rana, S; Tesfamicael, B; Park, S

Purpose: The main purpose of this study is to investigate the optimum oblique-beam arrangement for bilateral metallic prosthesis prostate cancer treatment in pencil beam scanning (PBS) proton therapy. Methods: A computed tomography dataset of bilateral metallic prosthesis prostate cancer case was selected for this retrospective study. A total of four beams (rightanterior- oblique [RAO], left-anterior-oblique [LAO], left-posterior-oblique [LPO], and right-posterior-oblique [RPO]) were selected for treatment planning. PBS plans were generated using multi-field-optimization technique for a total dose of 79.2 Gy[RBE] to be delivered in 44 fractions. Specifically, five different PBS plans were generated based on 2.5% ± 2 mm rangemore » uncertainty using five different beam arrangements (i)LAO+RAO+LPO+RPO, (ii)LAO+RAO, (iii)LPO+RPO, (iv)RAO+LPO, and (v)LAO+RPO. Each PBS plan was optimized by applying identical dose-volume constraints to the PTV, rectum, and bladder. Treatment plans were then compared based on the dose-volume histograms results. Results: The PTV coverage was found to be greater than 99% in all five plans. The homogeneity index (HI) was found to be almost identical (range, 0.03–0.04). The PTV mean dose was found to be comparable (range, 81.0–81.1 Gy[RBE]). For the rectum, the lowest mean dose (8.0 Gy[RBE]) and highest mean dose (31.1 Gy[RBE]) were found in RAO+LAO plan and LPO+RPO plan, respectively. LAO+RAO plan produced the most favorable dosimetric results of the rectum in the medium-dose region (V50) and high-dose region (V70). For the bladder, the lowest (5.0 Gy[RBE]) and highest mean dose (10.3 Gy[RBE]) were found in LPO+RPO plan and RAO+LAO plan, respectively. Other dosimetric results (V50 and V70) of the bladder were slightly better in LPO+RPO plan than in other plans. Conclusion: Dosimetric findings from this study suggest that two anterior-oblique proton beams arrangement (LAO+RAO) is a more favorable option with the possibility of reducing rectal dose significantly while maintaining comparable target coverage and acceptable bladder dose.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qu, H; Yu, N; Qi, P

Purpose: In commercial secondary dose calculation system, an average effective depth is used to calculate the Monitor Units for an arc beam from the volumetric modulated arc (VMAT) plans. Typically, an arithmetic mean of the effective depths (AMED) of a VMAT arc beam is used, which may result in large MU discrepancy from that of the primary treatment planning system. This study is to demonstrate the use of a dose weighted mean effective depth (DWED) can improve accuracy of MU calculation for the secondary MU verification. Methods: In-house scripts were written in the primary treatment planning system (TPS) to firstmore » convert a VMAT arc beam to a series of static step & shoot beams (every 4 degree). The computed dose and effective depth of each static beam were then used to obtain the dose weighted mean effective depth (DWED) for the VMAT beam. The DWED was used for the secondary MU calculation for VMAT plans. Six lung SBRT VMAT plans, eight head and neck VMAT plans and ten prostate VMAT plans that had > 5% MU deviations (failed MU verification) using the AMED method were recalculated with the DWED. For comparison, same number VMAT plans that had < 5% MU deviations (passed MU verification) using AMED method were also reevaluated with the dose weighted mean effective depth method. Results: For MU verification passed plans, the mean and standard deviation of MU differences between the TPS and the secondary calculation program were 2.2%±1.5% for the AMED and 2.1%±1.7% for the DMED method. For the failed plans, the mean and standard deviation of MU differences of TPS to the secondary calculation program were 9.9%±4.7% and 4.7%±2.6, respectively. Conclusion: The dose weighted mean effective depth improved MU calculation accuracy which can be used for the pre-treatment MU verification of VMAT plans.« less

SU-E-T-375: Passive Scattering to Pencil-Beam-Scanning Comparison for Medulloblastoma Proton Therapy: LET Distributions and Radiobiological Implications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Giantsoudi, D; MacDonald, S; Paganetti, H

2014-06-01

Purpose: To compare the linear energy transfer (LET) distributions between passive scattering and pencil beam scanning proton radiation therapy techniques for medulloblastoma patients and study the potential radiobiological implications. Methods: A group of medulloblastoma patients, previously treated with passive scattering (PS) proton craniospinal irradiation followed by prosterior fossa or involved field boost, were selected from the patient database of our institution. Using the beam geometry and planning computed tomography (CT) image sets of the original treatment plans, pencil beam scanning (PBS) treatment plans were generated for the cranial treatment for each patient, with average beam spot size of 8mm (sigmamore » in air at isocenter). 3-dimensional dose and LET distributions were calculated by Monte Carlo methods (TOPAS) both for the original passive scattering and new pencil beam scanning treatment plans. LET volume histograms were calculated for the target and OARs and compared for the two delivery methods. Variable RBE weighted dose distributions and volume histograms were also calculated using a variable dose and LET-based model. Results: Better dose conformity was achieved with PBS planning compared to PS, leading to increased dose coverage for the boost target area and decreased average dose to the structures adjacent to it and critical structures outside the whole brain treatment field. LET values for the target were lower for PBS plans. Elevated LET values for OARs close to the boosted target areas were noticed, due to end of range of proton beams falling inside these structures, resulting in higher RBE weighted dose for these structures compared to the clinical RBE value of 1.1. Conclusion: Transitioning from passive scattering to pencil beam scanning proton radiation treatment can be dosimetrically beneficial for medulloblastoma patients. LET–guided treatment planning could contribute to better decision making for these cases, especially for critical structures at close proximity to the boosted target area.« less

TH-CD-202-12: Online Inter-Beam Replanning Based On Real-Time Dose Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamerling, CP; Fast, MF; Ziegenhein, P

Purpose: This work provides a proof-of-concept study for online replanning during treatment delivery for step-and-shoot prostate SBRT, based on real-time dose reconstruction. Online replanning is expected to improve the trade-off between target coverage and organ-at-risk dose in the presence of intra-fractional motion. Methods: We have implemented an online replanning workflow on top of our previously reported real-time dose reconstruction software which connects to an Elekta research linac. The treatment planning system DynaPlan was extended to (1) re-optimize and sequence treatment plans (in clockwise beam order) before each beam, based on actual delivered dose, in a timeframe limited by the gantrymore » rotation between subsequent beams, and (2) send the respective segments to the delivery control software DynaTrack which starts/continues treatment immediately.To investigate the impact of a reduced safety margin, we have created and delivered (on a linac emulator) a conventional CTV+5/3mm (I) and a reduced CTV+1mm margin (II) treatment plan for a prostate patient. We have assessed CTV coverage with and without inter-beam replanning, all exposed to a gradual target shift of 0–5mm in posterior and inferior direction from start until the end of delivery. Results: For the reconstructed conventional plan (I), D98 for CTV was 100% of D98 of the planned dose. For the reconstructed margin-reduced plan (II), D98 for CTV was 95% of the planned D98 without replanning, but could be recovered to 99% by replanning for each beam. Plan (II) with replanning resulted in a decrease for bladder V90% by 88% and an increase to rectum V90% by 9% compared to the conventional plan (I). Dose calculation/accumulation was performed in <15ms per MLC aperture, replanning in <15s per beam. Conclusion: We have shown that online inter-beam replanning is technically feasible and potentially allows for a margin reduction. Future investigation considering motion-robust replanning optimization parameters is in progress. We acknowledge support of the MLC research from Elekta AB. This work is supported by Cancer Research UK under Programme C33589/A19908. Research at ICR is also supported by Cancer Research UK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR.« less

Polymeric Materials

DTIC Science & Technology

2009-06-01

funding have been established, including membership at the BNLS X27C Beam Line, two visiting ASEE Summer faculty, two EOARD programs, two CINT...complement these efforts, collaborative programs with external funding have been established, including membership at the BNLS X27C Beam Line, one visiting

Dosimetric comparison between conventional and conformal radiotherapy for carcinoma cervix: Are we treating the right volumes?

PubMed Central

Goswami, Jyotirup; Patra, Niladri B.; Sarkar, Biplab; Basu, Ayan; Pal, Santanu

2013-01-01

Background and Purpose: Conventional portals, based on bony anatomy, for external beam radiotherapy for cervical cancer have been repeatedly demonstrated as inadequate. Conversely, with image-based conformal radiotherapy, better target coverage may be offset by the greater toxicities and poorer compliance associated with treating larger volumes. This study was meant to dosimetrically compare conformal and conventional radiotherapy. Materials and Methods: Five patients of carcinoma cervix underwent planning CT scan with IV contrast and targets, and organs at risk (OAR) were contoured. Two sets of plans-conventional and conformal were generated for each patient. Field sizes were recorded, and dose volume histograms of both sets of plans were generated and compared on the basis of target coverage and OAR sparing. Results: Target coverage was significantly improved with conformal plans though field sizes required were significantly larger. On the other hand, dose homogeneity was not significantly improved. Doses to the OARs (rectum, urinary bladder, and small bowel) were not significantly different across the 2 arms. Conclusion: Three-dimensional conformal radiotherapy gives significantly better target coverage, which may translate into better local control and survival. On the other hand, it also requires significantly larger field sizes though doses to the OARs are not significantly increased. PMID:24455584

SU-E-T-274: Radiation Therapy with Very High-Energy Electron (VHEE) Beams in the Presence of Metal Implants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jensen, C; Palma, B; Qu, B

2014-06-01

Purpose: To evaluate the effect of metal implants on treatment plans for radiation therapy with very high-energy electron (VHEE) beams. Methods: The DOSXYZnrc/BEAMnrc Monte Carlo (MC) codes were used to simulate 50–150MeV VHEE beam dose deposition and its effects on steel and titanium (Ti) heterogeneities in a water phantom. Heterogeneities of thicknesses ranging from 0.5cm to 2cm were placed at 10cm depth. MC was also used to calculate electron and photon spectra generated by the VHEE beams' interaction with metal heterogeneities. The original VMAT patient dose calculation was planned in Eclipse. Patient dose calculations with MC-generated beamlets were planned usingmore » a Matlab GUI and research version of RayStation. VHEE MC treatment planning was performed on water-only geometry and water with segmented prostheses (steel and Ti) geometries with 100MeV and 150MeV beams. Results: 100MeV PDD 5cm behind steel/Ti heterogeneity was 51% less than in the water-only phantom. For some cases, dose enhancement lateral to the borders of the phantom increased the dose by up to 22% in steel and 18% in Ti heterogeneities. The dose immediately behind steel heterogeneity decreased by an average of 6%, although for 150MeV, the steel heterogeneity created a 23% increase in dose directly behind it. The average dose immediately behind Ti heterogeneities increased 10%. The prostate VHEE plans resulted in mean dose decrease to the bowel (20%), bladder (7%), and the urethra (5%) compared to the 15MV VMAT plan. The average dose to the body with prosthetic implants was 5% higher than to the body without implants. Conclusion: Based on MC simulations, metallic implants introduce dose perturbations to VHEE beams from lateral scatter and backscatter. However, when performing clinical planning on a prostate case, the use of multiple beams and inverse planning still produces VHEE plans that are dosimetrically superior to photon VMAT plans. BW Loo and P Maxim received research support from RaySearch laboratories; B Hardemark and E Hynning are employees of RaySearch.« less

SU-F-T-404: Dosimetric Advantages of Flattening Free Beams to Prone Accelerated Partial Breast Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Galavis, P; Barbee, D; Jozsef, G

2016-06-15

Purpose: Prone accelerated partial breast irradiation (APBI) results in dose reduction to the heart and lung. Flattening filter free beams (FFF) reduce out of field dose due to the reduced scatter from the removal of the flattening filter and reduce the buildup region. The aim of this work is to evaluate the dosimetric advantages of FFF beams to prone APBI target coverage and reduction in dose to organs at risk. Methods: Fifteen clinical prone APBI cases using flattened photon beams were retrospectively re-planned in Eclipse-TPS using FFF beams. FFF plans were designed to provide equivalent target coverage with similar hotspotsmore » using the same field arrangements, resulting in comparable target DVHs. Both plans were transferred to a prone breast phantom and delivered on Varian-Edge-Linac. GafChromic-film was placed in the coronal plane of the phantom, partially overlapping the treatment field and extending into OARs to compare dose profiles from both plans. Results: FFF plans were comparable to the clinical plans with maximum doses of (108.3±2.3)% and (109.2±2.4)% and mean doses of (104.5±1.0)% and (104.6±1.2)%, respectively. Similar mean dose doses to the heart and contralateral lungs were observed from both plans, whereas the mean dose to the contra-lateral breast was (2.79±1.18) cGy and (2.86±1.40) cGy for FFF and clinical plans respectively. However for both plans the error between calculated and measured doses at 4 cm from the field edge was 10%. Conclusion: The results showed that FFF beams in prone APBI provide dosimetrically equivalent target coverage and improved coverage in superficial target due to softer energy spectra. Film analysis showed that the TPS underestimates dose outside field edges for both cases. The FFF measured plans showed less dose outside the beam that might reduce the probability of secondary cancers in the contralateral breast.« less

Proton therapy posterior beam approach with pencil beam scanning for esophageal cancer : Clinical outcome, dosimetry, and feasibility.

PubMed

Zeng, Yue-Can; Vyas, Shilpa; Dang, Quang; Schultz, Lindsay; Bowen, Stephen R; Shankaran, Veena; Farjah, Farhood; Oelschlager, Brant K; Apisarnthanarax, Smith; Zeng, Jing

2016-12-01

The aim of this study is to present the dosimetry, feasibility, and preliminary clinical results of a novel pencil beam scanning (PBS) posterior beam technique of proton treatment for esophageal cancer in the setting of trimodality therapy. From February 2014 to June 2015, 13 patients with locally advanced esophageal cancer (T3-4N0-2M0; 11 adenocarcinoma, 2 squamous cell carcinoma) were treated with trimodality therapy (neoadjuvant chemoradiation followed by esophagectomy). Eight patients were treated with uniform scanning (US) and 5 patients were treated with a single posterior-anterior (PA) beam PBS technique with volumetric rescanning for motion mitigation. Comparison planning with PBS was performed using three plans: AP/PA beam arrangement; PA plus left posterior oblique (LPO) beams, and a single PA beam. Patient outcomes, including pathologic response and toxicity, were evaluated. All 13 patients completed chemoradiation to 50.4 Gy (relative biological effectiveness, RBE) and 12 patients underwent surgery. All 12 surgical patients had an R0 resection and pathologic complete response was seen in 25 %. Compared with AP/PA plans, PA plans have a lower mean heart (14.10 vs. 24.49 Gy, P < 0.01), mean stomach (22.95 vs. 31.33 Gy, P = 0.038), and mean liver dose (3.79 vs. 5.75 Gy, P = 0.004). Compared to the PA/LPO plan, the PA plan reduced the lung dose: mean lung dose (4.96 vs. 7.15 Gy, P = 0.020) and percentage volume of lung receiving 20 Gy (V 20 ; 10 vs. 17 %, P < 0.01). Proton therapy with a single PA beam PBS technique for preoperative treatment of esophageal cancer appears safe and feasible.

Acceleration and stability of a high-current ion beam in induction fields

NASA Astrophysics Data System (ADS)

Karas', V. I.; Manuilenko, O. V.; Tarakanov, V. P.; Federovskaya, O. V.

2013-03-01

A one-dimensional nonlinear analytic theory of the filamentation instability of a high-current ion beam is formulated. The results of 2.5-dimensional numerical particle-in-cell simulations of acceleration and stability of an annular compensated ion beam (CIB) in a linear induction particle accelerator are presented. It is shown that additional transverse injection of electron beams in magnetically insulated gaps (cusps) improves the quality of the ion-beam distribution function and provides uniform beam acceleration along the accelerator. The CIB filamentation instability in both the presence and the absence of an external magnetic field is considered.

Shear Strengthening of RC Deep Beam Using Externally Bonded GFRP Fabrics

NASA Astrophysics Data System (ADS)

Kumari, A.; Patel, S. S.; Nayak, A. N.

2018-06-01

This work presents the experimental investigation of RC deep beams wrapped with externally bonded Glass Fibre Reinforced Polymer (GFRP) fabrics in order to study the Load versus deflection behavior, cracking pattern, failure modes and ultimate shear strength. A total number of five deep beams have been casted, which is designed with conventional steel reinforcement as per IS: 456 (Indian standard plain and reinforced concrete—code for practice, Bureau of Indian Standards, New Delhi, 2000). The spans to depth ratio for all RC deep beams have been kept less than 2 as per the above specification. Out of five RC deep beams, one without retrofitting serves as a reference beam and the rest four have been wrapped with GFRP fabrics in multiple layers and tested with two point loading condition. The first cracking load, ultimate load and the shear contribution of GFRP to the deep beams have been observed. A critical discussion is made with respect to the enhancement of the strength, behaviour and performance of retrofitted deep beams in comparison to the deep beam without GFRP in order to explore the potential use of GFRP for strengthening the RC deep beams. Test results have demonstrated that the deep beams retrofitted with GFRP shows a slower development of the diagonal cracks and improves shear carrying capacity of the RC deep beam. A comparative study of the experimental results with the theoretical ones predicted by various researchers available in the literatures has also been presented. It is observed that the ultimate load of the beams retrofitted with GFRP fabrics increases with increase of number of GFRP layers up to a specific number of layers, i.e. 3 layers, beyond which it decreases.

Shear Strengthening of RC Deep Beam Using Externally Bonded GFRP Fabrics

NASA Astrophysics Data System (ADS)

Kumari, A.; Patel, S. S.; Nayak, A. N.

2018-02-01

This work presents the experimental investigation of RC deep beams wrapped with externally bonded Glass Fibre Reinforced Polymer (GFRP) fabrics in order to study the Load versus deflection behavior, cracking pattern, failure modes and ultimate shear strength. A total number of five deep beams have been casted, which is designed with conventional steel reinforcement as per IS: 456 (Indian standard plain and reinforced concrete—code for practice, Bureau of Indian Standards, New Delhi, 2000). The spans to depth ratio for all RC deep beams have been kept less than 2 as per the above specification. Out of five RC deep beams, one without retrofitting serves as a reference beam and the rest four have been wrapped with GFRP fabrics in multiple layers and tested with two point loading condition. The first cracking load, ultimate load and the shear contribution of GFRP to the deep beams have been observed. A critical discussion is made with respect to the enhancement of the strength, behaviour and performance of retrofitted deep beams in comparison to the deep beam without GFRP in order to explore the potential use of GFRP for strengthening the RC deep beams. Test results have demonstrated that the deep beams retrofitted with GFRP shows a slower development of the diagonal cracks and improves shear carrying capacity of the RC deep beam. A comparative study of the experimental results with the theoretical ones predicted by various researchers available in the literatures has also been presented. It is observed that the ultimate load of the beams retrofitted with GFRP fabrics increases with increase of number of GFRP layers up to a specific number of layers, i.e. 3 layers, beyond which it decreases.

Longitudinal density modulation and energy conversion in intense beams.

PubMed

Harris, J R; Neumann, J G; Tian, K; O'Shea, P G

2007-08-01

Density modulation of charged particle beams may occur as a consequence of deliberate action, or may occur inadvertently because of imperfections in the particle source or acceleration method. In the case of intense beams, where space charge and external focusing govern the beam dynamics, density modulation may, under some circumstances, be converted to velocity modulation, with a corresponding conversion of potential energy to kinetic energy. Whether this will occur depends on the properties of the beam and the initial modulation. This paper describes the evolution of discrete and continuous density modulations on intense beams and discusses three recent experiments related to the dynamics of density-modulated electron beams.

Betatron radiation based diagnostics for plasma wakefield accelerated electron beams at the SPARC_LAB test facility

NASA Astrophysics Data System (ADS)

Shpakov, V.; Anania, M. P.; Biagioni, A.; Chiadroni, E.; Cianchi, A.; Curcio, A.; Dabagov, S.; Ferrario, M.; Filippi, F.; Marocchino, A.; Paroli, B.; Pompili, R.; Rossi, A. R.; Zigler, A.

2016-09-01

Recent progress with wake-field acceleration has shown a great potential in providing high gradient acceleration fields, while the quality of the beams remains relatively poor. Precise knowledge of the beam size at the exit from the plasma and matching conditions for the externally injected beams are the key for improvement of beam quality. Betatron radiation emitted by the beam during acceleration in the plasma is a powerful tool for the transverse beam size measurement, being also non-intercepting. In this work we report on the technical solutions chosen at SPARC_LAB for such diagnostics tool, along with expected parameters of betatron radiation.

SU-E-T-186: Cloud-Based Quality Assurance Application for Linear Accelerator Commissioning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rogers, J

2015-06-15

Purpose: To identify anomalies and safety issues during data collection and modeling for treatment planning systems Methods: A cloud-based quality assurance system (AQUIRE - Automated QUalIty REassurance) has been developed to allow the uploading and analysis of beam data aquired during the treatment planning system commissioning process. In addition to comparing and aggregating measured data, tools have also been developed to extract dose from the treatment planning system for end-to-end testing. A gamma index is perfomed on the data to give a dose difference and distance-to-agreement for validation that a beam model is generating plans consistent with the beam datamore » collection. Results: Over 20 linear accelerators have been commissioning using this platform, and a variety of errors and potential saftey issues have been caught through the validation process. For example, the gamma index of 2% dose, 2mm DTA is quite sufficient to see curves not corrected for effective point of measurement. Also, data imported into the database is analyzed against an aggregate of similar linear accelerators to show data points that are outliers. The resulting curves in the database exhibit a very small standard deviation and imply that a preconfigured beam model based on aggregated linear accelerators will be sufficient in most cases. Conclusion: With the use of this new platform for beam data commissioning, errors in beam data collection and treatment planning system modeling are greatly reduced. With the reduction in errors during acquisition, the resulting beam models are quite similar, suggesting that a common beam model may be possible in the future. Development is ongoing to create routine quality assurance tools to compare back to the beam data acquired during commissioning. I am a medical physicist for Alzyen Medical Physics, and perform commissioning services.« less

TU-H-BRC-03: Evaluation of Very High-Energy Electron (VHEE) Beams in Comparison to VMAT and PBS Treatment Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schueler, E; Loo, B; Maxim, P

2016-06-15

Purpose: The aim of this study was to evaluate the performance of very high-energy electron (VHEE) beams in comparison to clinically delivered treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PBS) technology. Methods: Three clinical cases were selected (prostate, lung, and pediatric CNS). The VHEE plans were calculated in the Monte Carlo EGSnrc code and pencil beam doses were calculated using the DOSxyznrc MC code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PBS were optimized in a research version of RayStation using an in house build script in ordermore » to minimize operator bias between the different techniques. Results: For the prostate cancer case, the PBS plan showed lower mean organ at risk (OAR) doses compared to the other modalities. An exception was the femoral heads, due to the lateral beam arrangements. The VMAT plan showed lower mean doses to the rectum and the bladder compared to the 100 MeV VHEE plan. The lung cancer case showed minor differences between the three modalities. However, the PBS plan showed a lower contralateral lung dose. The pediatric CNS case showed a better conformity and lower spinal cord dose for the 100 MeV VHEE plan. For all cases, the 200 MeV VHEE plans were found to be similar to or better than the 100 MeV VHEE plans. Conclusion: The present study showed that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses can be achieved. Funding: DoD, Award#:W81XWH-13-1-0165, Weston Havens Foundation, Bio-X (Stanford University), the Office of the Dean of the Medical School, the Office of the Provost (Stanford University), and the Swedish Childhood Cancer Foundation. BL and PM are founders of TibaRay,Inc. BL and PM have received research grants from Varian and RaySearch Laboratory.« less

Comparing four volumetric modulated arc therapy beam arrangements for the treatment of early-stage prostate cancer

PubMed Central

Elith, Craig A; Dempsey, Shane E; Warren-Forward, Helen M

2014-01-01

Introduction This study compared four different volumetric modulated arc therapy (VMAT) beam arrangements for the treatment of early-stage prostate cancer examining plan quality and the impact on a radiotherapy department's resources. Methods Twenty prostate cases were retrospectively planned using four VMAT beam arrangements (1) a partial arc (PA), (2) one arc (1A), (3) one arc plus a partial arc (1A + PA) and (4) two arcs (2A). The quality of the dose distributions generated were compared by examining the overall plan quality, the homogeneity and conformity to the planning target volume (PTV), the number of monitor units and the dose delivered to the organs at risk. Departmental resources were considered by recording the planning time and beam delivery time. Results Each technique produced a plan of similar quality that was considered adequate for treatment; though some differences were noted. The 1A, 1A + PA and 2A plans demonstrated a better conformity to the PTV which correlated to improved sparing of the rectum in the 60–70 Gy range for the 1A + PA and 2A techniques. The time needed to generate the plans was different for each technique ranging from 13.1 min for 1A + PA to 17.8 min for 1A. The PA beam delivery time was fastest with a mean time of 0.9 min. Beam-on times then increased with an increase in the number of arcs up to an average of 2.2 min for the 2A technique. Conclusion Which VMAT technique is best suited for clinical implementation for the treatment of prostate cancer may be dictated by the individual patient and the availability of departmental resources. PMID:26229643

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation.

PubMed

Jaberi, Ramin; Siavashpour, Zahra; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-12-01

Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in 'organs-applicators', while maintaining target dose at the original level. There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients' plans to be able to serve as a clinical tool.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stathakis, S; Defoor, D; Saenz, D

Purpose: Stereotactic radiosurgery (SRS) outcomes are related to the delivered dose to the target and to surrounding tissue. We have commissioned a Monte Carlo based dose calculation algorithm to recalculated the delivered dose planned using pencil beam calculation dose engine. Methods: Twenty consecutive previously treated patients have been selected for this study. All plans were generated using the iPlan treatment planning system (TPS) and calculated using the pencil beam algorithm. Each patient plan consisted of 1 to 3 targets and treated using dynamically conformal arcs or intensity modulated beams. Multi-target treatments were delivered using multiple isocenters, one for each target.more » These plans were recalculated for the purpose of this study using a single isocenter. The CT image sets along with the plan, doses and structures were DICOM exported to Monaco TPS and the dose was recalculated using the same voxel resolution and monitor units. Benchmark data was also generated prior to patient calculations to assess the accuracy of the two TPS against measurements using a micro ionization chamber in solid water. Results: Good agreement, within −0.4% for Monaco and +2.2% for iPlan were observed for measurements in water phantom. Doses in patient geometry revealed up to 9.6% differences for single target plans and 9.3% for multiple-target-multiple-isocenter plans. The average dose differences for multi-target-single-isocenter plans were approximately 1.4%. Similar differences were observed for the OARs and integral dose. Conclusion: Accuracy of the beam is crucial for the dose calculation especially in the case of small fields such as those used in SRS treatments. A superior dose calculation algorithm such as Monte Carlo, with properly commissioned beam models, which is unaffected by the lack of electronic equilibrium should be preferred for the calculation of small fields to improve accuracy.« less

Intensity-modulated radiotherapy (IMRT) for carcinoma of the maxillary sinus: A comparison of IMRT planning systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, Raef S.; Ove, Roger; Duan, Jun

2006-10-01

The treatment of maxillary sinus carcinoma with forward planning can be technically difficult when the neck also requires radiotherapy. This difficulty arises because of the need to spare the contralateral face while treating the bilateral neck. There is considerable potential for error in clinical setup and treatment delivery. We evaluated intensity-modulated radiotherapy (IMRT) as an improvement on forward planning, and compared several inverse planning IMRT platforms. A composite dose-volume histogram (DVH) was generated from a complex forward planned case. We compared the results with those generated by sliding window fixed field dynamic multileaf collimator (MLC) IMRT, using sets of coplanarmore » beams. All setups included an anterior posterior (AP) beam, and 3-, 5-, 7-, and 9-field configurations were evaluated. The dose prescription and objective function priorities were invariant. We also evaluated 2 commercial tomotherapy IMRT delivery platforms. DVH results from all of the IMRT approaches compared favorably with the forward plan. Results for the various inverse planning approaches varied considerably across platforms, despite an attempt to prescribe the therapy similarly. The improvement seen with the addition of beams in the fixed beam sliding window case was modest. IMRT is an effective means of delivering radiotherapy reliably in the complex setting of maxillary sinus carcinoma with neck irradiation. Differences in objective function definition and optimization algorithms can lead to unexpected differences in the final dose distribution, and our evaluation suggests that these factors are more significant than the beam arrangement or number of beams.« less

Realistic respiratory motion margins for external beam partial breast irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conroy, Leigh; Quirk, Sarah; Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4

Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dosemore » profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was described. It was found that the currently used respiratory margin of 5 mm in partial breast irradiation may be overly conservative for many 3DCRT PBI patients. Amplitude alone was found to be insufficient to determine patient-specific margins: individual respiratory trace shape and baseline drift both contributed to the dosimetric target coverage. With respiratory coaching, individualized respiratory margins smaller than the full extent of motion could reduce planning target volumes while ensuring adequate coverage under respiratory motion.« less

Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

PubMed

Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P < .001). Time spent on safety reviews remained the same (20% of the allocated interval), but the peer review component increased. The Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

SU-F-T-242: A Method for Collision Avoidance in External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buzurovic, I; Cormack, R

2016-06-15

Purpose: We proposed a method for collision avoidance (CA) in external beam radiation therapy (EBRT). The method encompasses the analysis of all positions of the moving components of the beam delivery system such as the treatment table and gantry, including patient specific information obtained from the CT images. This method eliminates the need for time-consuming dry-runs prior to the actual treatments. Methods: The QA procedure for EBRT requires that the collision should be checked prior to treatment. We developed a system capable of a rigorous computer simulation of all moving components including positions of the couch and gantry during themore » delivery, position of the patients, and imaging equipment. By running this treatment simulation it is possible to quantify and graphically represent all positions and corresponding trajectories of all points of the moving parts during the treatment delivery. The development of the workflow for implementation of the CA includes several steps: a) derivation of combined dynamic equation of motion of the EBRT delivery systems, b) developing the simulation model capable of drawing the motion trajectories of the specific points, c) developing the interface between the model and the treatment plan parameters such as couch and gantry parameters for each field. Results: The patient CT images were registered to the treatment couch so the patient dimensions were included into the simulation. The treatment field parameters were structured in the xml-file which was used as the input into the dynamic equations. The trajectories of the moving components were plotted on the same graph using the dynamic equations. If the trajectories intersect that was the signal that collision exists. Conclusion: This CA method was proved to be effective in the simulation of treatment delivery. The proper implementation of this system can potentially improve the QA program and increase the efficacy in the clinical setup.« less

External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

PubMed Central

Melchert, Corinna; Kovács, György

2016-01-01

Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

Adaptive radiation therapy for postprostatectomy patients using real-time electromagnetic target motion tracking during external beam radiation therapy.

PubMed

Zhu, Mingyao; Bharat, Shyam; Michalski, Jeff M; Gay, Hiram A; Hou, Wei-Hsien; Parikh, Parag J

2013-03-15

Using real-time electromagnetic (EM) transponder tracking data recorded by the Calypso 4D Localization System, we report inter- and intrafractional target motion of the prostate bed, describe a strategy to evaluate treatment adequacy in postprostatectomy patients receiving intensity modulated radiation therapy (IMRT), and propose an adaptive workflow. Tracking data recorded by Calypso EM transponders was analyzed for postprostatectomy patients that underwent step-and-shoot IMRT. Rigid target motion parameters during beam delivery were calculated from recorded transponder positions in 16 patients with rigid transponder geometry. The delivered doses to the clinical target volume (CTV) were estimated from the planned dose matrix and the target motion for the first 3, 5, 10, and all fractions. Treatment adequacy was determined by comparing the delivered minimum dose (Dmin) with the planned Dmin to the CTV. Treatments were considered adequate if the delivered CTV Dmin is at least 95% of the planned CTV Dmin. Translational target motion was minimal for all 16 patients (mean: 0.02 cm; range: -0.12 cm to 0.07 cm). Rotational motion was patient-specific, and maximum pitch, yaw, and roll were 12.2, 4.1, and 10.5°, respectively. We observed inadequate treatments in 5 patients. In these treatments, we observed greater target rotations along with large distances between the CTV centroid and transponder centroid. The treatment adequacy from the initial 10 fractions successfully predicted the overall adequacy in 4 of 5 inadequate treatments and 10 of 11 adequate treatments. Target rotational motion could cause underdosage to partial volume of the postprostatectomy targets. Our adaptive treatment strategy is applicable to post-prostatectomy patients receiving IMRT to evaluate and improve radiation therapy delivery. Copyright © 2013 Elsevier Inc. All rights reserved.

Dosimetry audit simulation of treatment planning system in multicenters radiotherapy

NASA Astrophysics Data System (ADS)

Kasmuri, S.; Pawiro, S. A.

2017-07-01

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

Sentinel Lymph Node Biopsy: Quantification of Lymphedema Risk Reduction

DTIC Science & Technology

2006-10-01

dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J Radiat Oncol Biol Phys...techniques based on conventional photon beams, intensity modulated photon beams and proton beams for therapy of intact breast. Radiother Oncol. Feb...Harris JR. Three-dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J

Do technological advances in linear accelerators improve dosimetric outcomes in stereotaxy? A head-on comparison of seven linear accelerators using volumetric modulated arc therapy-based stereotactic planning.

PubMed

Sarkar, B; Pradhan, A; Munshi, A

2016-01-01

Linear accelerator (Linac) based stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) using volumetric modulated arc therapy (VMAT) has been used for treating small intracranial lesions. Recent development in the Linacs such as inbuilt micro multileaf collimator (MLC) and flattening filter free (FFF) beam are intended to provide a better dose conformity and faster delivery when using VMAT technique. This study was aimed to compare the dosimetric outcomes and monitor units (MUs) of the stereotactic treatment plans for different commercially available MLC models and beam profiles. Ten patients having 12 planning target volume (PTV)/gross target volume's (GTVs) who received the SRS/SRT treatment in our clinic using Axesse Linac (considered reference arm gold standard) were considered for this study. The test arms comprised of plans using Elekta Agility with FFF, Elekta Agility with the plane beam, Elekta APEX, Varian Millennium 120, Varian Millennium 120HD, and Elekta Synergy in Monaco treatment planning system. Planning constraints and calculation grid spacing were not altered in the test plans. To objectively evaluate the efficacy of MLC-beam model, the resultant dosimetric outcomes were subtracted from the reference arm parameters. V95%, V100%, V105%, D1%, maximum dose, and mean dose of PTV/GTV showed a maximum inter MLC - beam model variation of 1.5% and 2% for PTV and GTV, respectively. Average PTV conformity index and heterogeneity index shows a variation in the range 0.56-0.63 and 1.08-1.11, respectively. Mean dose difference (excluding Axesse) for all organs varied between 1.1 cGy and 74.8 cGy (mean dose = 6.1 cGy standard deviation [SD] = 26.9 cGy) and 1.7 cGy-194.5 cGy (mean dose 16.1 cGy SD = 57.2 cGy) for single and multiple fraction, respectively. The dosimetry of VMAT-based SRS/SRT treatment plan had minimal dependence on MLC and beam model variations. All tested MLC and beam model could fulfil the desired PTV coverage and organs at risk dose constraints. The only notable difference was the halving of the MU for FFF beam as compared to the plane beam. This has the potential to reduce the total patient on couch time by 15% (approximately 2 min).

Assessing the Dosimetric Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy.

PubMed

Paradis, Eric; Cao, Yue; Lawrence, Theodore S; Tsien, Christina; Feng, Mary; Vineberg, Karen; Balter, James M

2015-12-01

The purpose of this study was to assess the dosimetric accuracy of synthetic CT (MRCT) volumes generated from magnetic resonance imaging (MRI) data for focal brain radiation therapy. A study was conducted in 12 patients with gliomas who underwent both MR and CT imaging as part of their simulation for external beam treatment planning. MRCT volumes were generated from MR images. Patients' clinical treatment planning directives were used to create 12 individual volumetric modulated arc therapy (VMAT) plans, which were then optimized 10 times on each of their respective CT and MRCT-derived electron density maps. Dose metrics derived from optimization criteria, as well as monitor units and gamma analyses, were evaluated to quantify differences between the imaging modalities. Mean differences between planning target volume (PTV) doses on MRCT and CT plans across all patients were 0.0% (range: -0.1 to 0.2%) for D(95%); 0.0% (-0.7 to 0.6%) for D(5%); and -0.2% (-1.0 to 0.2%) for D(max). MRCT plans showed no significant changes in monitor units (-0.4%) compared to CT plans. Organs at risk (OARs) had average D(max) differences of 0.0 Gy (-2.2 to 1.9 Gy) over 85 structures across all 12 patients, with no significant differences when calculated doses approached planning constraints. Focal brain VMAT plans optimized on MRCT images show excellent dosimetric agreement with standard CT-optimized plans. PTVs show equivalent coverage, and OARs do not show any overdose. These results indicate that MRI-derived synthetic CT volumes can be used to support treatment planning of most patients treated for intracranial lesions. Copyright © 2015 Elsevier Inc. All rights reserved.

Accelerated Partial Breast Irradiation: What is Dosimetric Effect of Advanced Technology Approaches?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moran, Jean M.; Ben-David, Merav A.; Marsh, Robin B.

2009-09-01

Purpose: The present treatment planning study compared whole breast radiotherapy (WBRT) to accelerated partial breast irradiation (APBI) for different external beam techniques and geometries (e.g., free breathing [FB] and deep inspiration breath hold [DIBH]). Methods and Materials: After approval by our institutional review board, a treatment planning study was performed of 10 patients with left-sided Stage 0-I breast cancer enrolled in a Phase I-II study of APBI using intensity-modulated radiotherapy (IMRT). After lumpectomy, patients underwent planning computed tomography scans during FB and using an active breathing control device at DIBH. For the FB geometry, standard WBRT and three-dimensional conformal radiotherapymore » (3D-CRT) APBI plans were created. For the DIBH geometry with active breathing control, WBRT, 3D-CRT, and IMRT APBI plans were created. Results: All APBI techniques had excellent planning target volume coverage. The maximal planning target volume dose was reduced from 116% of the prescription dose to 108% with the IMRT(DIBH) APBI plan. The maximal heart dose was >30 Gy for the WBRT techniques, 8.2 Gy for 3D-CRT(FB), and <5.0 Gy for 3D-CRT(DIBH) and IMRT(DIBH) techniques. The mean left anterior descending artery dose was significantly reduced from 11.4 Gy with WBRT(FB) to 4.2 with WBRT(DIBH) and <2.0 Gy with all APBI techniques. Conclusion: Although planning target volume coverage was acceptable with all techniques, the plans using the DIBH geometry resulted in a marked reduction in the normal tissue dose compared with WBRT planned in the absence of cardiac blocking. Additional study is needed to determine whether these techniques result in clinical benefits.« less

Assessing the Dosimetric Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paradis, Eric, E-mail: eparadis@umich.edu; Cao, Yue; Department of Radiology, University of Michigan Hospital and Health Systems, Ann Arbor, Michigan

2015-12-01

Purpose: The purpose of this study was to assess the dosimetric accuracy of synthetic CT (MRCT) volumes generated from magnetic resonance imaging (MRI) data for focal brain radiation therapy. Methods and Materials: A study was conducted in 12 patients with gliomas who underwent both MR and CT imaging as part of their simulation for external beam treatment planning. MRCT volumes were generated from MR images. Patients' clinical treatment planning directives were used to create 12 individual volumetric modulated arc therapy (VMAT) plans, which were then optimized 10 times on each of their respective CT and MRCT-derived electron density maps. Dosemore » metrics derived from optimization criteria, as well as monitor units and gamma analyses, were evaluated to quantify differences between the imaging modalities. Results: Mean differences between planning target volume (PTV) doses on MRCT and CT plans across all patients were 0.0% (range: −0.1 to 0.2%) for D{sub 95%}; 0.0% (−0.7 to 0.6%) for D{sub 5%}; and −0.2% (−1.0 to 0.2%) for D{sub max}. MRCT plans showed no significant changes in monitor units (−0.4%) compared to CT plans. Organs at risk (OARs) had average D{sub max} differences of 0.0 Gy (−2.2 to 1.9 Gy) over 85 structures across all 12 patients, with no significant differences when calculated doses approached planning constraints. Conclusions: Focal brain VMAT plans optimized on MRCT images show excellent dosimetric agreement with standard CT-optimized plans. PTVs show equivalent coverage, and OARs do not show any overdose. These results indicate that MRI-derived synthetic CT volumes can be used to support treatment planning of most patients treated for intracranial lesions.« less

26 CFR 54.9815-2719T - Internal claims and appeals and external review processes (temporary).

Code of Federal Regulations, 2012 CFR

2012-04-01

... external review processes for group health plans and health insurance issuers that are not grandfathered...) In general. A group health plan and a health insurance issuer offering group health insurance...). (2) Requirements for group health plans and group health insurance issuers. A group health plan and a...

26 CFR 54.9815-2719T - Internal claims and appeals and external review processes (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... external review processes for group health plans and health insurance issuers that are not grandfathered...) In general. A group health plan and a health insurance issuer offering group health insurance...). (2) Requirements for group health plans and group health insurance issuers. A group health plan and a...

26 CFR 54.9815-2719T - Internal claims and appeals and external review processes (temporary).

Code of Federal Regulations, 2014 CFR

2014-04-01

... external review processes for group health plans and health insurance issuers that are not grandfathered...) In general. A group health plan and a health insurance issuer offering group health insurance...). (2) Requirements for group health plans and group health insurance issuers. A group health plan and a...

26 CFR 54.9815-2719T - Internal claims and appeals and external review processes (temporary).

Code of Federal Regulations, 2013 CFR

2013-04-01

... external review processes for group health plans and health insurance issuers that are not grandfathered...) In general. A group health plan and a health insurance issuer offering group health insurance...). (2) Requirements for group health plans and group health insurance issuers. A group health plan and a...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mechalakos, J.

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

Generation of a cylindrically symmetric, polarized laser beam with narrow linewidth and fine tunability

NASA Astrophysics Data System (ADS)

Hirayama, Toru; Kozawa, Yuichi; Nakamura, Takahiro; Sato, Shunichi

2006-12-01

We demonstrated a generation of cylindrically symmetric, polarized laser beams with narrow linewidth and fine tunability. Since an LP11 mode beam in an optical fiber is a superposition of an HE21 (hybrid) mode beam and a TE01 or TM01 mode beam, firstly, a higher order transverse (TEM01 or TEM10) mode laser beam with narrow linewidth and fine tunability was generated from an external cavity diode laser (ECDL) in conjunction with a phase adjustment plate. Then the beam generated was passed in a two mode optical fiber. A doughnut shaped laser beam with the cylindrically symmetric polarization (a radially or azimuthally polarized beam) was obtained by properly adding stress-induced birefringence in the optical fiber.

Monte Carlo simulation for scanning technique with scattering foil free electron beam: A proof of concept study

PubMed Central

Sung, Wonmo; Park, Jong In; Kim, Jung-in; Carlson, Joel; Ye, Sung-Joon

2017-01-01

This study investigated the potential of a newly proposed scattering foil free (SFF) electron beam scanning technique for the treatment of skin cancer on the irregular patient surfaces using Monte Carlo (MC) simulation. After benchmarking of the MC simulations, we removed the scattering foil to generate SFF electron beams. Cylindrical and spherical phantoms with 1 cm boluses were generated and the target volume was defined from the surface to 5 mm depth. The SFF scanning technique with 6 MeV electrons was simulated using those phantoms. For comparison, volumetric modulated arc therapy (VMAT) plans were also generated with two full arcs and 6 MV photon beams. When the scanning resolution resulted in a larger separation between beams than the field size, the plan qualities were worsened. In the cylindrical phantom with a radius of 10 cm, the conformity indices, homogeneity indices and body mean doses of the SFF plans (scanning resolution = 1°) vs. VMAT plans were 1.04 vs. 1.54, 1.10 vs. 1.12 and 5 Gy vs. 14 Gy, respectively. Those of the spherical phantom were 1.04 vs. 1.83, 1.08 vs. 1.09 and 7 Gy vs. 26 Gy, respectively. The proposed SFF plans showed superior dose distributions compared to the VMAT plans. PMID:28493940

Monte Carlo simulation for scanning technique with scattering foil free electron beam: A proof of concept study.

PubMed

Sung, Wonmo; Park, Jong In; Kim, Jung-In; Carlson, Joel; Ye, Sung-Joon; Park, Jong Min

2017-01-01

This study investigated the potential of a newly proposed scattering foil free (SFF) electron beam scanning technique for the treatment of skin cancer on the irregular patient surfaces using Monte Carlo (MC) simulation. After benchmarking of the MC simulations, we removed the scattering foil to generate SFF electron beams. Cylindrical and spherical phantoms with 1 cm boluses were generated and the target volume was defined from the surface to 5 mm depth. The SFF scanning technique with 6 MeV electrons was simulated using those phantoms. For comparison, volumetric modulated arc therapy (VMAT) plans were also generated with two full arcs and 6 MV photon beams. When the scanning resolution resulted in a larger separation between beams than the field size, the plan qualities were worsened. In the cylindrical phantom with a radius of 10 cm, the conformity indices, homogeneity indices and body mean doses of the SFF plans (scanning resolution = 1°) vs. VMAT plans were 1.04 vs. 1.54, 1.10 vs. 1.12 and 5 Gy vs. 14 Gy, respectively. Those of the spherical phantom were 1.04 vs. 1.83, 1.08 vs. 1.09 and 7 Gy vs. 26 Gy, respectively. The proposed SFF plans showed superior dose distributions compared to the VMAT plans.

SU-E-T-568: Improving Normal Brain Sparing with Increasing Number of Arc Beams for Volume Modulated Arc Beam Radiosurgery of Multiple Brain Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hossain, S; Hildebrand, K; Ahmad, S

Purpose: Intensity modulated arc beams have been newly reported for treating multiple brain metastases. The purpose of this study was to determine the variations in the normal brain doses with increasing number of arc beams for multiple brain metastases treatments via the TrueBeam Rapidarc system (Varian Oncology, Palo Alto, CA). Methods: A patient case with 12 metastatic brain lesions previously treated on the Leksell Gamma Knife Perfexion (GK) was used for the study. All lesions and organs at risk were contoured by a senior radiation oncologist and treatment plans for a subset of 3, 6, 9 and all 12 targetsmore » were developed for the TrueBeam Rapidarc system via 3 to 7 intensity modulated arc-beams with each target covered by at least 99% of the prescribed dose of 20 Gy. The peripheral normal brain isodose volumes as well as the total beam-on time were analyzed with increasing number of arc beams for these targets. Results: All intensisty modulated arc-beam plans produced efficient treatment delivery with the beam-on time averaging 0.6–1.5 min per lesion at an output of 1200 MU/min. With increasing number of arc beams, the peripheral normal brain isodose volumes such as the 12-Gy isodose line enclosed normal brain tissue volumes were on average decreased by 6%, 11%, 18%, and 28% for the 3-, 6-, 9-, 12-target treatment plans respectively. The lowest normal brain isodose volumes were consistently found for the 7-arc treatment plans for all the cases. Conclusion: With nearly identical beam-on times, the peripheral normal brain dose was notably decreased when the total number of intensity modulated arc beams was increased when treating multiple brain metastases. Dr Sahgal and Dr Ma are currently serving on the board of international society of stereotactic radiosurgery.« less

Technical Note: A fast online adaptive replanning method for VMAT using flattening filter free beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ates, Ozgur; Ahunbay, Ergun E.; Li, X. Allen, E-mail: ali@mcw.edu

Purpose: To develop a fast replanning algorithm based on segment aperture morphing (SAM) for online replanning of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams. Methods: A software tool was developed to interface with a VMAT research planning system, which enables the input and output of beam and machine parameters of VMAT plans. The SAM algorithm was used to modify multileaf collimator positions for each segment aperture based on the changes of the target from the planning (CT/MR) to daily image [CT/CBCT/magnetic resonance imaging (MRI)]. The leaf travel distance was controlled for large shifts to prevent themore » increase of VMAT delivery time. The SAM algorithm was tested for 11 patient cases including prostate, pancreatic, and lung cancers. For each daily image set, three types of VMAT plans, image-guided radiation therapy (IGRT) repositioning, SAM adaptive, and full-scope reoptimization plans, were generated and compared. Results: The SAM adaptive plans were found to have improved the plan quality in target and/or critical organs when compared to the IGRT repositioning plans and were comparable to the reoptimization plans based on the data of planning target volume (PTV)-V100 (volume covered by 100% of prescription dose). For the cases studied, the average PTV-V100 was 98.85% ± 1.13%, 97.61% ± 1.45%, and 92.84% ± 1.61% with FFF beams for the reoptimization, SAM adaptive, and repositioning plans, respectively. The execution of the SAM algorithm takes less than 10 s using 16-CPU (2.6 GHz dual core) hardware. Conclusions: The SAM algorithm can generate adaptive VMAT plans using FFF beams with comparable plan qualities as those from the full-scope reoptimization plans based on daily CT/CBCT/MRI and can be used for online replanning to address interfractional variations.« less

Integrated Electro-optical Laser-Beam Scanners

NASA Technical Reports Server (NTRS)

Boord, Warren T.

1990-01-01

Scanners using solid-state devices compact, consume little power, and have no moving parts. Integrated electro-optical laser scanner, in conjunction with external lens, points outgoing beam of light in any number of different directions, depending on number of upper electrodes. Offers beam-deflection angles larger than those of acousto-optic scanners. Proposed for such diverse applications as nonimpact laser printing, color imaging, ranging, barcode reading, and robotic vision.

Microdosimetric investigation at the therapeutic proton beam facility of CATANA.

PubMed

De Nardo, L; Moro, D; Colautti, P; Conte, V; Tornielli, G; Cuttone, G

2004-01-01

Proton beams (62 Mev) are used by the Laboratori Nazionali del Sud of the Italian Institute of Nuclear Physics to treat eye melanoma tumours at the therapeutic facility called CATANA. A cylindrical slim tissue-equivalent proportional counter (TEPC) of 2.7 mm external diameter has been used to compare the radiation quality of two spread-out Bragg peaks (SOBP) at the CATANA proton beam.

Phase Space Generation for Proton and Carbon Ion Beams for External Users' Applications at the Heidelberg Ion Therapy Center.

PubMed

Tessonnier, Thomas; Marcelos, Tiago; Mairani, Andrea; Brons, Stephan; Parodi, Katia

2015-01-01

In the field of radiation therapy, accurate and robust dose calculation is required. For this purpose, precise modeling of the irradiation system and reliable computational platforms are needed. At the Heidelberg Ion Therapy Center (HIT), the beamline has been already modeled in the FLUKA Monte Carlo (MC) code. However, this model was kept confidential for disclosure reasons and was not available for any external team. The main goal of this study was to create efficiently phase space (PS) files for proton and carbon ion beams, for all energies and foci available at HIT. PSs are representing the characteristics of each particle recorded (charge, mass, energy, coordinates, direction cosines, generation) at a certain position along the beam path. In order to achieve this goal, keeping a reasonable data size but maintaining the requested accuracy for the calculation, we developed a new approach of beam PS generation with the MC code FLUKA. The generated PSs were obtained using an infinitely narrow beam and recording the desired quantities after the last element of the beamline, with a discrimination of primaries or secondaries. In this way, a unique PS can be used for each energy to accommodate the different foci by combining the narrow-beam scenario with a random sampling of its theoretical Gaussian beam in vacuum. PS can also reproduce the different patterns from the delivery system, when properly combined with the beam scanning information. MC simulations using PS have been compared to simulations, including the full beamline geometry and have been found in very good agreement for several cases (depth dose distributions, lateral dose profiles), with relative dose differences below 0.5%. This approach has also been compared with measured data of ion beams with different energies and foci, resulting in a very satisfactory agreement. Hence, the proposed approach was able to fulfill the different requirements and has demonstrated its capability for application to clinical treatment fields. It also offers a powerful tool to perform investigations on the contribution of primary and secondary particles produced in the beamline. These PSs are already made available to external teams upon request, to support interpretation of their measurements.

SU-F-J-145: MRI-Guided Interventional Boost Radiotherapy for Rectal Cancer: Investigating the Feasibility of Adapting the Anatomy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kleijnen, J J E; Couwenberg, A M; Asselen, B van

Purpose: The recent development of an MRI-linac allows adaptation of treatments to the anatomy of the moment. This anatomy, in turn, could be altered into a more favorable situation for radiotherapy purposes. The purpose of this study is to investigate the potential dosimetric benefits of manipulating rectal anatomy in MRI-guided interventional external-beam radiotherapy for rectal cancer. Methods: For this retrospective analysis, four patients (1M/3F) diagnosed with rectal cancer were included. These underwent MR-imaging using sonography transmission gel as endorectal contrast at time of diagnosis and standard, non-contrast, MR-imaging prior to radiotherapy planning. In the contrast scan, the rectum is inflatedmore » by the inserted contrast gel, thereby potentially increasing the distance between tumor and the organs-at-risk (OAR). Both anatomies were delineated and 7- beam IMRT-plans were calculated for both situations (RT-standard and RT-inflated), using in-house developed treatment planning software. Each plan was aimed to deliver 15Gy to the planning target volume (PTV; tumor+3mm margin) with a D99>95% and Dmax<120% of the planned dose. The D2cc dose to the OAR were then compared for both situations. Results: At equal (or better) target coverage, we found a mean reduction in D2cc of 4.1Gy/237% [range 2.6Gy–6.3Gy/70%–621%] for the bladder and of 2.0Gy/145% [range −0.7Gy–7.9Gy/−73%–442%] for the small-bowel, for the RT-inflated compared to the RT-standard plans. For the three female patients, a reduction in D2cc of 5.2Gy/191% [range 3.2Gy–9.2Gy/44%–475%] for the gynecological organs was found. We found all D2cc doses to be better for the RT-inflated plans, except for one patient for whom the bladder D2cc dose was slightly increased. Conclusion: Reduction of OAR dose by manipulation of anatomy is feasible. Inflation of the rectum results in more distance between OAR and PTV. This leads to a substantial reduction in dose to OAR at equal or better target coverage.« less

Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalet, Alan M., E-mail: amkalet@uw.edu; Seattle Cancer Care Alliance, Seattle, Washington; Richardson, Hannah L.

The purpose of this study was to evaluate the dosimetric and practical effects of the Monaco treatment planning system “max arcs-per-beam” optimization parameter in pelvic radiotherapy treatments. We selected for this study a total of 17 previously treated patients with a range of pelvic disease sites including prostate (9), bladder (1), uterus (3), rectum (3), and cervix (1). For each patient, 2 plans were generated, one using an arc-per-beam setting of “1” and another with an arc-per-beam setting of “2” using the volumes and constraints established from the initial clinical treatments. All constraints and dose coverage objects were kept themore » same between plans, and all plans were normalized to 99.7% to ensure 100% of the planning target volume (PTV) received 95% of the prescription dose. Plans were evaluated for PTV conformity, homogeneity, number of monitor units, number of control points, and overall plan acceptability. Treatment delivery time, patient-specific quality assurance procedures, and the impact on clinical workflow were also assessed. We found that for complex-shaped target volumes (small central volumes with extending arms to cover nodal regions), the use of 2 arc-per-beam (2APB) parameter setting achieved significantly lower average dose-volume histogram values for the rectum V{sub 20} (p = 0.0012) and bladder V{sub 30} (p = 0.0036) while meeting the high dose target constraints. For simple PTV shapes, we found reduced monitor units (13.47%, p = 0.0009) and control points (8.77%, p = 0.0004) using 2APB planning. In addition, we found a beam delivery time reduction of approximately 25%. In summary, the dosimetric benefit, although moderate, was improved over a 1APB setting for complex PTV, and equivalent in other cases. The overall reduced delivery time suggests that the use of mulitple arcs per beam could lead to reduced patient-on-table time, increased clinical throughput, and reduced medical physics quality assurance effort.« less

Comparison of dosimetric and radiobiological parameters on plans for prostate stereotactic body radiotherapy using an endorectal balloon for different dose-calculation algorithms and delivery-beam modes

NASA Astrophysics Data System (ADS)

Kang, Sang-Won; Suh, Tae-Suk; Chung, Jin-Beom; Eom, Keun-Yong; Song, Changhoon; Kim, In-Ah; Kim, Jae-Sung; Lee, Jeong-Woo; Cho, Woong

2017-02-01

The purpose of this study was to evaluate the impact of dosimetric and radiobiological parameters on treatment plans by using different dose-calculation algorithms and delivery-beam modes for prostate stereotactic body radiation therapy using an endorectal balloon. For 20 patients with prostate cancer, stereotactic body radiation therapy (SBRT) plans were generated by using a 10-MV photon beam with flattening filter (FF) and flattening-filter-free (FFF) modes. The total treatment dose prescribed was 42.7 Gy in 7 fractions to cover at least 95% of the planning target volume (PTV) with 95% of the prescribed dose. The dose computation was initially performed using an anisotropic analytical algorithm (AAA) in the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA) and was then re-calculated using Acuros XB (AXB V. 11.0.34) with the same monitor units and multileaf collimator files. The dosimetric and the radiobiological parameters for the PTV and organs at risk (OARs) were analyzed from the dose-volume histogram. An obvious difference in dosimetric parameters between the AAA and the AXB plans was observed in the PTV and rectum. Doses to the PTV, excluding the maximum dose, were always higher in the AAA plans than in the AXB plans. However, doses to the other OARs were similar in both algorithm plans. In addition, no difference was observed in the dosimetric parameters for different delivery-beam modes when using the same algorithm to generate plans. As a result of the dosimetric parameters, the radiobiological parameters for the two algorithm plans presented an apparent difference in the PTV and the rectum. The average tumor control probability of the AAA plans was higher than that of the AXB plans. The average normal tissue complication probability (NTCP) to rectum was lower in the AXB plans than in the AAA plans. The AAA and the AXB plans yielded very similar NTCPs for the other OARs. In plans using the same algorithms, the NTCPs for delivery-beam modes showed no differences. This study demonstrated that the dosimetric and the radiobiological parameters for the PTV and the rectum affected the dose-calculation algorithms for prostate SBRT using an endorectal balloon. However, the dosimetric and the radiobiological parameters in the AAA and the AXB plans for other OARs were similar. Furthermore, difference between the dosimetric and the radiobiological parameters for different delivery-beam modes were not found when the same algorithm was used to generate the treatment plan.

Accelerator/Experiment Operations - FY 2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Czarapata, P.

2015-10-01

This Technical Memorandum summarizes the Fermilab accelerator and experiment operations for FY 2015. It is one of a series of annual publications intended to gather information in one place. In this case, the information concerns the FY 2015 NOvA, MINOS+ and MINERvA experiments using the Main Injector Neutrino Beam (NuMI), the activities in the SciBooNE Hall using the Booster Neutrino Beam (BNB), and the SeaQuest experiment and Meson Test Beam (MTest) activities in the 120 GeV external Switchyard beam (SY120).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zheng, Y; Chang, A; Liu, Y

Purpose: Electron beams are commonly used for boost radiation following whole breast irradiation (WBI) to improve the in-breast local control. Proton beams have a finite range and a sharper distal dose falloff compared to electron beams, thus potentially sparing more heart and lung in breast treatment. The purpose of the study is to compare protons with electrons for boost breast treatment in terms of target coverage and normal tissue sparing. Methods: Six breast cancer patients were included in this study. All women received WBI to 45–50 Gy, followed by a 10–16.2 Gy boost with standard fractionation. If proton beams weremore » used for the boost treatment, an electron plan was retrospectively generated for comparison using the same CT set and structures, and vice versa if electron beams were used for treatment. Proton plans were generated using the treatment planning system (TPS) with two to three uniform scanning proton beams. Electron plans were generated using the Pinnacle TPS with one single en face beam. Dose-volume histograms (DVH) were calculated and compared between proton and electron boost plans. Results: Proton plans show a similar boost target coverage, similar skin dose, and much better heart and lung sparing. For an example patient, V95% for PTV was 99.98% and skin (5 mm shell) received a max dose close to the prescription dose for both protons and electrons; however, V2 and V5 for the ipsilateral lung and heart were 37.5%, 17.9% and 19.9%, 4.9% respectively for electrons, but were essentially 0 for protons. Conclusions: This dosimetric comparison demonstrates that while both proton therapy and electron therapy provided similar coverage and skin dose, proton therapy could largely reduce the dose to lung and heart, thus leading to potential less side effects.« less

Impact of Concurrent Androgen Deprivation on Fiducial Marker Migration in External-beam Radiation Therapy for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tiberi, David A.; Carrier, Jean-Francois; Beauchemin, Marie-Claude

2012-09-01

Purpose: To determine the extent of gold fiducial marker (FM) migration in patients treated for prostate cancer with concurrent androgen deprivation and external-beam radiation therapy (EBRT). Methods and Materials: Three or 4 gold FMs were implanted in 37 patients with prostate adenocarcinoma receiving androgen deprivation therapy (ADT) in conjunction with 70-78 Gy. Androgen deprivation therapy was started a median of 3.9 months before EBRT (range, 0.3-12.5 months). To establish the extent of FM migration, the distance between each FM was calculated for 5-8 treatments once per week throughout the EBRT course. For each treatment, the distance between FMs was comparedmore » with the distance from the digitally reconstructed radiographs generated from the planning CT. A total of 281 treatments were analyzed. Results: The average daily migration was 0.8 {+-} 0.3 mm, with distances ranging from 0.2 mm-2.6 mm. Two of the 281 assessed treatments (0.7%) showed migrations >2 mm. No correlation between FM migration and patient weight or time delay between ADT and start of EBRT was found. There was no correlation between the extent of FM migration and prostate volume. Conclusion: This is the largest report of implanted FM migration in patients receiving concomitant ADT. Only 0.7% of the 281 treatments studied had significant marker migrations (>2 mm) throughout the course of EBRT. Consequently, the use of implanted FMs in these patients enables accurate monitoring of prostate gland position during treatment.« less

Equivalence of Gyn GEC-ESTRO guidelines for image guided cervical brachytherapy with EUD-based dose prescription

PubMed Central

2013-01-01

Background To establish a generalized equivalent uniform dose (gEUD) -based prescription method for Image Guided Brachytherapy (IGBT) that reproduces the Gyn GEC-ESTRO WG (GGE) prescription for cervix carcinoma patients on CT images with limited soft tissue resolution. Methods The equivalence of two IGBT planning approaches was investigated in 20 patients who received external beam radiotherapy (EBT) and 5 concomitant high dose rate IGBT treatments. The GGE planning strategy based on dose to the most exposed 2 cm3 (D2cc) was used to derive criteria for the gEUD-based planning of the bladder and rectum. The safety of gEUD constraints in terms of GGE criteria was tested by maximizing dose to the gEUD constraints for individual fractions. Results The gEUD constraints of 3.55 Gy for the rectum and 5.19 Gy for the bladder were derived. Rectum and bladder gEUD-maximized plans resulted in D2cc averages very similar to the initial GGE criteria. Average D2ccs and EUDs from the full treatment course were comparable for the two techniques within both sets of normal tissue constraints. The same was found for the tumor doses. Conclusions The derived gEUD criteria for normal organs result in GGE-equivalent IGBT treatment plans. The gEUD-based planning considers the entire dose distribution of organs in contrast to a single dose-volume-histogram point. PMID:24225184

Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alvarez R, J T; Tovar M, V M

2008-08-11

A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven {sup 60}Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D{sub W} = 2 Gy{center_dot}c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gymore » in terms of absorbed dose to water D{sub W} for {sup 60}Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foster, R; Ding, C; Jiang, S

Purpose Spine SRS/SAbR treatment plans typically require very steep dose gradients to meet spinal cord constraints and it is crucial that the dose distribution be accurate. However, these plans are typically calculated on helical free-breathing CT scans, which often contain motion artifacts. While the spine itself doesn’t exhibit very much intra-fraction motion, tissues around the spine, particularly the liver, do move with respiration. We investigated the dosimetric effect of liver motion on dose distributions calculated on helical free-breathing CT scans for spine SAbR delivered to the T and L spine. Methods We took 5 spine SAbR plans and used densitymore » overrides to simulate an average reconstruction CT image set, which would more closely represent the patient anatomy during treatment. The value used for the density override was 0.66 g/cc. All patients were planned using our standard beam arrangement, which consists of 13 coplanar step and shoot IMRT beams. The original plan was recalculated with the same MU on the “average” scan and target coverage and spinal cord dose were compared to the original plan. Results The average changes in minimum PTV dose, PTV coverage, max cord dose and volume of cord receiving 10 Gy were 0.6%, 0.8%, 0.3% and 4.4% (0.012 cc), respectively. Conclusion SAbR spine plans are surprisingly robust relative to surrounding organ motion due to respiration. Motion artifacts in helical planning CT scans do not cause clinically significant differences when these plans are re-calculated on pseudo-average CT reconstructions. This is likely due to the beam arrangement used because only three beams pass through the liver and only one beam passes completely through the density override. The effect of the respiratory motion on VMAT plans for spine SAbR is being evaluated.« less

Trace element fingerprinting of jewellery rubies by external beam PIXE

NASA Astrophysics Data System (ADS)

Calligaro, T.; Poirot, J.-P.; Querré, G.

1999-04-01

External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies : one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional gemological observations.

A novel surrogate to identify anatomical changes during radiotherapy of head and neck cancer patients.

PubMed

Gros, Sébastien A A; Xu, William; Roeske, John C; Choi, Mehe; Emami, Bahman; Surucu, Murat

2017-03-01

To develop a novel method to monitor external anatomical changes in head and neck cancer patients in order to triage possible adaptive radiotherapy needs. The presented approach aims to provide information on internal anatomical changes based on variations observed in external anatomy. Setup Cone Beam Computed Tomography (CBCT) images are processed to produce an accurate external contour of the patient's skin. After registering the CBCTs to the reference planning CT, the external contours from each CBCT are transferred to the initial - first week - CBCT. Contour radii, defined as the distances between an external contour and the isocenter projection in each CBCT slice, are calculated for each scan over the full 360 degrees. The changes in external anatomy are then quantified by the difference in radial distance between the external contours of any secondary CBCT relative to the initial CBCT. Finally, the radial difference is displayed in cylindrical coordinates as a 2D intensity map to highlight regions of interests with significant changes. Weekly CBCT scans from 15 head and neck patients were retrospectively analyzed to demonstrate the utility of this approach as a proof of principle. External changes suggested by the 2D radial difference map of an example patient after 23 fractions were then correlated with the changes in the gross tumor volumes and organs at risks. The resulting dosimetric effects were evaluated. An interactive standalone software application has been developed to facilitate the generation and the interpretation of the 2D intensity map. The 2D radial difference maps provided qualitative and quantitative information, such as the location and the magnitude of external contour changes and the rate at which these deviations occur. Out of the 15 patients, 10 presented clear evidence of general external volume shrinkage due to weight loss, and nine patients had at least one site of local shrinkage. Only two patients showed no signs of anatomical change during their entire treatment course. For the example patient, the mean (±σ) radial difference was 6.7 (±3.0) mm for the left parotid and 7.3 (±2.5) mm for the right parotid. The mean dose to the left and right parotids increased from 20.1 Gy to 30 Gy and from 16.3 Gy to 29.6 Gy, respectively. This novel method provides an efficient tool to visualize 3D external anatomical changes on a single 2D map. It quickly pinpoints the location of differences in anatomy during the course of radiotherapy, which can help physicians determine if a treatment plan needs to be adapted. The interactive graphic user interface developed in this study will be evaluated in an adaptive radiotherapy workflow for head and neck patients in a future prospective trial. © 2016 American Association of Physicists in Medicine.

Adjuvant radiotherapy for stage I endometrial cancer.

PubMed

Kong, A; Johnson, N; Cornes, P; Simera, I; Collingwood, M; Williams, C; Kitchener, H

2007-04-18

The role of adjuvant radiotherapy (both pelvic external beam radiotherapy and vaginal intracavity brachytherapy) in stage I endometrial cancer following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) remains unclear. To assess the efficacy of adjuvant radiotherapy following surgery for stage I endometrial cancer. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CancerLit, Physician Data Query (PDQ) of National Cancer Institute. Handsearching was also carried out where appropriate. Randomised controlled trials (RCTs) which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer were included. Quality of the studies was assessed and data collected using a predefined data collection form. The primary endpoint was overall survival. Secondary endpoints were locoregional recurrence, distant recurrence and endometrial cancer death. Data on quality of life (QOL) and morbidity were also collected. A meta-analysis on included trials was performed using the Cochrane Collaboration Review Manager Software 4.2. The meta-analysis was performed on four trials (1770 patients). The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 (95% confidence interval (CI) 0.17 to 0.44, p < 0.00001), which is a 72% reduction in the risk of pelvic relapse (95% CI 56% to 83%) and an absolute risk reduction of 6% (95% CI of 4 to 8%). The number needed to treat (NNT) to prevent one locoregional recurrence is 16.7 patients (95% CI 12.5 to 25). The reduction in the risk of locoregional recurrence did not translate into either a reduction in the risk of distant recurrence or death from all causes or endometrial cancer death. A subgroup analysis of women with multiple high risk factors (including stage 1c and grade 3) showed a trend toward the reduction in the risk of death from all causes and endometrial cancer death in patients who underwent adjuvant external beam radiotherapy. Patients with stage I endometrial carcinoma have different risks of local and distant recurrence depending on the presence of risk factors including stage 1c, grade 3, lymphovascular space invasion and age. Though external beam pelvic radiotherapy reduced locoregional recurrence by 72%, there is no evidence to suggest that it reduced the risk of death. In patients with multiple high risk factors, including stage 1c and grade 3, there was a trend towards a survival benefit and adjuvant external beam radiotherapy may be justified. For patients with only one risk factor, grade 3 or stage 1c, no definite conclusion can be made and data from ongoing studies ( ASTEC; Lukka) are awaited. External beam radiotherapy carries a risk of toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.

Fast radioactive seed localization in intraoperative cone beam CT for low-dose-rate prostate brachytherapy

NASA Astrophysics Data System (ADS)

Hu, Yu-chi; Xiong, Jian-ping; Cohan, Gilad; Zaider, Marco; Mageras, Gig; Zelefsky, Michael

2013-03-01

A fast knowledge-based radioactive seed localization method for brachytherapy was developed to automatically localize radioactive seeds in an intraoperative volumetric cone beam CT (CBCT) so that corrections, if needed, can be made during prostate implant surgery. A transrectal ultrasound (TRUS) scan is acquired for intraoperative treatment planning. Planned seed positions are transferred to intraoperative CBCT following TRUS-to-CBCT registration using a reference CBCT scan of the TRUS probe as a template, in which the probe and its external fiducial markers are pre-segmented and their positions in TRUS are known. The transferred planned seeds and probe serve as an atlas to reduce the search space in CBCT. Candidate seed voxels are identified based on image intensity. Regions are grown from candidate voxels and overlay regions are merged. Region volume and intensity variance is checked against known seed volume and intensity profile. Regions meeting the above criteria are flagged as detected seeds; otherwise they are flagged as likely seeds and sorted by a score that is based on volume, intensity profile and distance to the closest planned seed. A graphical interface allows users to review and accept or reject likely seeds. Likely seeds with approximately twice the seed volume are automatically split. Five clinical cases are tested. Without any manual correction in seed detection, the method performed the localization in 5 seconds (excluding registration time) for a CBCT scan with 512×512×192 voxels. The average precision rate per case is 99% and the recall rate is 96% for a total of 416 seeds. All false negative seeds are found with 15 in likely seeds and 1 included in a detected seed. With the new method, updating of calculations of dose distribution during the procedure is possible and thus facilitating evaluation and improvement of treatment quality.

In vivo real-time rectal wall dosimetry for prostate radiotherapy

PubMed Central

Hardcastle, Nicholas; Cutajar, Dean L.; Metcalfe, Peter E.; Lerch, Michael L. F.; Perevertaylo, Vladimir L.; Tomé, Wolfgang A.; Rosenfeld, Anatoly B.

2010-01-01

Rectal balloons are used in external beam prostate radiotherapy to provide reproducible anatomy and rectal dose reductions. This is an investigation into the combination of a MOSFET radiation detector with a rectal balloon for real time in vivo rectal wall dosimetry. The MOSFET used in the study is a radiation detector that provides a water equivalent depth of measurement of 70μm. Two MOSFETs were combined in a face-to-face orientation. The reproducibility, sensitivity and angular dependence were measured for the dual MOSFET in a 6MV photon beam. The dual MOSFET was combined with a rectal balloon and irradiated with hypothetical prostate treatments in a phantom. The anterior rectal wall dose was measured in real time and compared with the planning system calculated dose. The dual MOSFET showed angular dependence within ± 2.5% in the azimuth and +2.5%/-4% in the polar axes. When compared with an ion chamber measurement in a phantom, the dual MOSFET agreed within 2.5% for a range of radiation path lengths and incident angles. The dual MOSFET had reproducible sensitivity for fraction sizes of 2-10Gy. For the hypothetical prostate treatments the measured anterior rectal wall dose was 2.6% and 3.2% lower than the calculated dose for 3DCRT and IMRT plans. This was expected due to limitations of the dose calculation method used at the balloon cavity interface. A dual MOSFET combined with a commercial rectal balloon was shown to provide reproducible measurements of the anterior rectal wall dose in real time. The measured anterior rectal wall dose agreed with the expected dose from the treatment plan for 3DCRT and IMRT plans. The dual MOSFET could be read out in real time during the irradiation, providing capability for real time dose monitoring of the rectal wall dose during treatment. PMID:20571209

Variation in costs of cone beam CT examinations among healthcare systems.

PubMed

Christell, H; Birch, S; Hedesiu, M; Horner, K; Ivanauskaité, D; Nackaerts, O; Rohlin, M; Lindh, C

2012-10-01

To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients' and accompanying persons' time, "out of pocket" costs for examination fee and visits). The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range €148 000-227 000). Variation in indirect costs were mainly owing to examination fees (range €0-102.02). Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances.

The comparison of 5-field conformal radiotherapy techniques for the treatment of prostate cancer: The best for femoral head sparing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zare, Mahkameh; Lashkari, Marzieh, E-mail: m-lashkari@sina.tums.ac.ir; Ghalehtaki, Reza

2016-01-01

External radiotherapy is a standard treatment procedure for localized prostate cancer. Given the relatively high long term survival treatment complications have been brought in center of attention. In this planning study, between 2012 and 2014, CT simulation data of 90 consecutive high-risk prostate cancer patients were collected. In the first phase, all were planned for whole pelvis irradiation up to 46Gy in 23 daily fractions. In the second phase, only the prostate gland was the target of radiation. Next, the subjects were divided randomly into three groups and each received a unique 5field conformal radiation plan including Plan A (Gantrymore » angle: 0, 60, 120, 240, and 300), Plan B (Gantry angles: 0, 90, 120, 240, and 270) and Plan C (Gantry angles: 0, 60, 90, 270, and 300). The total dose was 70Gy. For each patient, the rectum, bladder, and both femoral heads were contoured as the at risk organs (OAR). From dose volume histograms, the proportional dose of PTV V100, the bladder and rectum V80 and V90 and femoral head V50 and V100 were calculated in all subjects and compared across plans. A statistically significant difference in the femoral head V50 and V100 was found between our studied 5field plans so that in Plan A (beam angles: 0, 60, 120, 240 and 300) less dose was received by both heads of femur. This study suggests that 5 field treatment planning including an anterior, two anterior oblique and two posterior oblique portals to be more proper for 3D conformal radiotherapy in order to spare femoral head with acceptable PTV coverage, and bladder and rectal doses.« less

Fermilab’s Accelerator Complex: Current Status, Upgrades and Outlook

DOE Office of Scientific and Technical Information (OSTI.GOV)

Convery, M. E.

We report on the status of the Fermilab accelerator complex, including recent performance, upgrades in progress, and plans for the future. Beam delivery to the neutrino experiments surpassed our goals for the past year. The Proton Improvement Plan is well underway with successful 15 Hz beam operation. Beam power of 700 kW to the NOvA experiment was demonstrated and will be routine in the next year. We are also preparing the Muon Campus to commission beam to the g-2 experiment.

TU-F-CAMPUS-J-01: Dosimetric Effects of HU Changes During the Course of Proton Therapy for Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teng, C; Yin, L; Ainsley, C

2015-06-15

Purpose: To characterize the changes in Hounsfield unit (HU) in lung radiotherapy with proton beams during the course of treatment and to study the effect on the proton plan dose distribution. Methods: Twenty consecutive patients with non-small cell lung cancer treated with proton radiotherapy who underwent multiple CT scans including the planning CT and weekly verification CTs were studied. HU histograms were computed for irradiated lung volumes in beam paths for all scans using the same treatment plan. Histograms for un-irradiated lung volume were used as control to characterize inter-scan variations. HU statistics were calculated for both irradiated and un-irradiatedmore » lung volumes for each patient scan. Further, multiple CT scans based on the same planning CT were generated by replacing the HU of the lung based on the verification CT scans HU values. Using the same beam arrangement, we created plans for each of the altered CT scans to study the dosimetric effect using the dose volume histogram. Results: Lung HU decreased for irradiated lung volume during the course of radiotherapy. The magnitude of this change increased with total irradiation dose. On average, HU changed by −53.8 in the irradiated volume. This change resulted in less than 0.5mm of beam overshoot in tissue for every 1cm beam traversed in the irradiated lung. The dose modification is about +3% for the lung, and less than +1% for the primary tumor. Conclusion: HU of the lung decrease throughout the course of radiation therapy. This change results in a beam overshoot (e.g. 3mm for 6cm of lung traversed) and causes a small dose modification in the overall plan. However, this overshoot does not affect the quality of plans since the margins used in planning, based on proton range uncertainty, are greater. HU needs to change by 150 units before re-planning is warranted.« less

Multicentre validation of IMRT pre-treatment verification: comparison of in-house and external audit.

PubMed

Jornet, Núria; Carrasco, Pablo; Beltrán, Mercè; Calvo, Juan Francisco; Escudé, Lluís; Hernández, Victor; Quera, Jaume; Sáez, Jordi

2014-09-01

We performed a multicentre intercomparison of IMRT optimisation and dose planning and IMRT pre-treatment verification methods and results. The aims were to check consistency between dose plans and to validate whether in-house pre-treatment verification results agreed with those of an external audit. Participating centres used two mock cases (prostate and head and neck) for the intercomparison and audit. Compliance to dosimetric goals and total number of MU per plan were collected. A simple quality index to compare the different plans was proposed. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit. While for the prostate case, all centres fulfilled the dosimetric goals and plan quality was homogeneous, that was not the case for the head and neck case. The number of MU did not correlate with the plan quality index. Pre-treatment verifications results of the external audit did not agree with those of the in-house measurements for two centres: being within tolerance for in-house measurements and unacceptable for the audit or the other way round. Although all plans fulfilled dosimetric constraints, plan quality is highly dependent on the planner expertise. External audits are an excellent tool to detect errors in IMRT implementation and cannot be replaced by intercomparison using results obtained by centres. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

In vivo TLD dose measurements in catheter-based high-dose-rate brachytherapy.

PubMed

Adlienė, Diana; Jakštas, Karolis; Urbonavičius, Benas Gabrielis

2015-07-01

Routine in vivo dosimetry is well established in external beam radiotherapy; however, it is restricted mainly to detection of gross errors in high-dose-rate (HDR) brachytherapy due to complicated measurements in the field of steep dose gradients in the vicinity of radioactive source and high uncertainties. The results of in vivo dose measurements using TLD 100 mini rods and TLD 'pin worms' in catheter-based HDR brachytherapy are provided in this paper alongside with their comparison with corresponding dose values obtained using calculation algorithm of the treatment planning system. Possibility to perform independent verification of treatment delivery in HDR brachytherapy using TLDs is discussed. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Targets for production of the medical radioisotopes with alpha and proton or deuteron beams

NASA Astrophysics Data System (ADS)

Stolarz, Anna; Kowalska, J. A.; Jastrzebski, J.; Choiński, J.; Sitarz, M.; Szkliniarz, K.; Trzcińska, A.; Zipper, W.

2018-05-01

The research quantities of some medical radioisotopes were produced in reactions induced by 32 MeV internal alpha beam (211At, Sc isotopes), 16 MeV and 28 MeV proton beams (Sc isotopes) and 8 MeV deuteron beam (Sc isotopes). The frame-less targets used for irradiation with internal alpha beam were prepared from elemental (Bi for 211At) and compound (CaCO3 for Sc radioisotopes) materials. The CaCO3 powder targets were also used for production of Sc radioisotopes with proton or deuteron external beams. Methods developed for preparation of the targets suitable for the irradiating beam type are described in this work.

Integrated beam orientation and scanning-spot optimization in intensity-modulated proton therapy for brain and unilateral head and neck tumors.

PubMed

Gu, Wenbo; O'Connor, Daniel; Nguyen, Dan; Yu, Victoria Y; Ruan, Dan; Dong, Lei; Sheng, Ke

2018-04-01

Intensity-Modulated Proton Therapy (IMPT) is the state-of-the-art method of delivering proton radiotherapy. Previous research has been mainly focused on optimization of scanning spots with manually selected beam angles. Due to the computational complexity, the potential benefit of simultaneously optimizing beam orientations and spot pattern could not be realized. In this study, we developed a novel integrated beam orientation optimization (BOO) and scanning-spot optimization algorithm for intensity-modulated proton therapy (IMPT). A brain chordoma and three unilateral head-and-neck patients with a maximal target size of 112.49 cm 3 were included in this study. A total number of 1162 noncoplanar candidate beams evenly distributed across 4π steradians were included in the optimization. For each candidate beam, the pencil-beam doses of all scanning spots covering the PTV and a margin were calculated. The beam angle selection and spot intensity optimization problem was formulated to include three terms: a dose fidelity term to penalize the deviation of PTV and OAR doses from ideal dose distribution; an L1-norm sparsity term to reduce the number of active spots and improve delivery efficiency; a group sparsity term to control the number of active beams between 2 and 4. For the group sparsity term, convex L2,1-norm and nonconvex L2,1/2-norm were tested. For the dose fidelity term, both quadratic function and linearized equivalent uniform dose (LEUD) cost function were implemented. The optimization problem was solved using the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA). The IMPT BOO method was tested on three head-and-neck patients and one skull base chordoma patient. The results were compared with IMPT plans created using column generation selected beams or manually selected beams. The L2,1-norm plan selected spatially aggregated beams, indicating potential degeneracy using this norm. L2,1/2-norm was able to select spatially separated beams and achieve smaller deviation from the ideal dose. In the L2,1/2-norm plans, the [mean dose, maximum dose] of OAR were reduced by an average of [2.38%, 4.24%] and[2.32%, 3.76%] of the prescription dose for the quadratic and LEUD cost function, respectively, compared with the IMPT plan using manual beam selection while maintaining the same PTV coverage. The L2,1/2 group sparsity plans were dosimetrically superior to the column generation plans as well. Besides beam orientation selection, spot sparsification was observed. Generally, with the quadratic cost function, 30%~60% spots in the selected beams remained active. With the LEUD cost function, the percentages of active spots were in the range of 35%~85%.The BOO-IMPT run time was approximately 20 min. This work shows the first IMPT approach integrating noncoplanar BOO and scanning-spot optimization in a single mathematical framework. This method is computationally efficient, dosimetrically superior and produces delivery-friendly IMPT plans. © 2018 American Association of Physicists in Medicine.

Prototype electron lens set-up for the Tevatron beam-beam compensation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, C.; Saewert, G.; Santucci, J.

1999-05-17

A prototype "electron lens" for the Tevatron beam-beam compensation project is commissioned at Fermilab. We de-scribe the set-up, report results of the first tests of the elec-tron beam, and discuss future plans.

High-resolution fluence verification for treatment plan specific QA in ion beam radiotherapy

NASA Astrophysics Data System (ADS)

Martišíková, Mária; Brons, Stephan; Hesse, Bernd M.; Jäkel, Oliver

2013-03-01

Ion beam radiotherapy exploits the finite range of ion beams and the increased dose deposition of ions toward the end of their range in material. This results in high dose conformation to the target region, which can be further increased using scanning ion beams. The standard method for patient-plan verification in ion beam therapy is ionization chamber dosimetry. The spatial resolution of this method is given by the distance between the chambers (typically 1 cm). However, steep dose gradients created by scanning ion beams call for more information and improved spatial resolution. Here we propose a clinically applicable method, supplementary to standard patient-plan verification. It is based on ion fluence measurements in the entrance region with high spatial resolution in the plane perpendicular to the beam, separately for each energy slice. In this paper the usability of the RID256 L amorphous silicon flat-panel detector for the measurements proposed is demonstrated for carbon ion beams. The detector provides sufficient spatial resolution for this kind of measurement (pixel pitch 0.8 mm). The experiments were performed at the Heidelberg Ion-Beam Therapy Center in Germany. This facility is equipped with a synchrotron capable of accelerating ions from protons up to oxygen to energies between 48 and 430 MeV u-1. Beam application is based on beam scanning technology. The measured signal corresponding to single energy slices was translated to ion fluence on a pixel-by-pixel basis, using calibration, which is dependent on energy and ion type. To quantify the agreement of the fluence distributions measured with those planned, a gamma-index criterion was used. In the patient field investigated excellent agreement was found between the two distributions. At least 95% of the slices contained more than 96% of points agreeing with our criteria. Due to the high spatial resolution, this method is especially valuable for measurements of strongly inhomogeneous fluence distributions like those in intensity-modulated treatment plans or plans including dose painting. Since no water phantom is needed to perform measurements, the flat-panel detector investigated has high potential for use with gantries. Before the method can be used in the clinical routine, it has to be sufficiently tested for each detector-facility combination.

Predicting fatigue service life extension of RC bridges with externally bonded CFRP repairs.

DOT National Transportation Integrated Search

2015-12-01

This paper presents the results of an experimental study on the fatigue performance of RC beams : strengthened with different externally bonded CFRP systems. Seven specimens were fabricated; three had : no CFRP; the remaining four had one of two CFRP...

SU-F-T-648: Sharpening Dose Fall-Off Via Beam Number Enhancements For Stereotactic Brain Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiu, J; Braunstein, S; McDermott, M

Purpose: Sharp dose fall-off is the hallmark of brain radiosurgery to deliver a high dose of radiation to the target while minimizing dose to normal brain tissue. In this study, we developed a technique for the purpose of enhancing the peripheral dose gradient by magnifying the total number of beams focused toward each isocenter via patient head tilt and simultaneous beam intensity modulations. Methods: Computer scripting for the proposed beam number enhancement (BNE) technique was developed. The technique was tested and then implemented on a clinical treatment planning system for a dedicated brain radiosurgical system (GK Perfexion, Elekta Oncology). Tomore » study technical feasibility and dosimetric advantages of the technique, we compared treatment planning quality and delivery efficiency for 20 radiosurgical cases previously treated at our institution. These cases included relatively complex treatments such as acoustic schwannoma, meningioma, brain metastasis and mesial temporal lobe epilepsy. Results: The BNE treatment plans were found to produce nearly identical target volume coverage (absolute value < 0.5%, P > 0.2) and dose conformity (BNE CI= 1.41±0.15 versus 1.41±0.20, P>0.9) as the original treatment plans. The total beam-on time for theBNE treatment plans were comparable (within 1.0 min or 1.8%) with those of the original treatment plans for all the cases. However, BNE treatment plans significantly improved the mean gradient index (BNE GI = 2.9±0.3 versus original GI =3.0±0.3 p<0.0001) and low-level isodose volumes, e.g. 20-50% prescribed isodose volumes, by 2.0% to 5.0% (p<0.02). Furthermore, with 4 to 5-fold increase in the total number of beams, the GI decreased by as much as 20% or 0.5 in absolute values. Conclusion: BNE via head tilt and simultaneous beam intensity modulation is an effective and efficient technique that physically sharpens the peripheral dose gradient for brain radiosurgery.« less

Adaptation, Commissioning, and Evaluation of a 3D Treatment Planning System for High-Resolution Small-Animal Irradiation

PubMed Central

Jeong, Jeho; Chen, Qing; Febo, Robert; Yang, Jie; Pham, Hai; Xiong, Jian-Ping; Zanzonico, Pat B.; Deasy, Joseph O.; Humm, John L.; Mageras, Gig S.

2016-01-01

Although spatially precise systems are now available for small-animal irradiations, there are currently limited software tools available for treatment planning for such irradiations. We report on the adaptation, commissioning, and evaluation of a 3-dimensional treatment planning system for use with a small-animal irradiation system. The 225-kV X-ray beam of the X-RAD 225Cx microirradiator (Precision X-Ray) was commissioned using both ion-chamber and radiochromic film for 10 different collimators ranging in field size from 1 mm in diameter to 40 × 40 mm2. A clinical 3-dimensional treatment planning system (Metropolis) developed at our institution was adapted to small-animal irradiation by making it compatible with the dimensions of mice and rats, modeling the microirradiator beam orientations and collimators, and incorporating the measured beam data for dose calculation. Dose calculations in Metropolis were verified by comparison with measurements in phantoms. Treatment plans for irradiation of a tumor-bearing mouse were generated with both the Metropolis and the vendor-supplied software. The calculated beam-on times and the plan evaluation tools were compared. The dose rate at the central axis ranges from 74 to 365 cGy/min depending on the collimator size. Doses calculated with Metropolis agreed with phantom measurements within 3% for all collimators. The beam-on times calculated by Metropolis and the vendor-supplied software agreed within 1% at the isocenter. The modified 3-dimensional treatment planning system provides better visualization of the relationship between the X-ray beams and the small-animal anatomy as well as more complete dosimetric information on target tissues and organs at risk. It thereby enhances the potential of image-guided microirradiator systems for evaluation of dose–response relationships and for preclinical experimentation generally. PMID:25948321

A new metric for assessing IMRT modulation complexity and plan deliverability.

PubMed

McNiven, Andrea L; Sharpe, Michael B; Purdie, Thomas G

2010-02-01

To evaluate the utility of a new complexity metric, the modulation complexity score (MCS), in the treatment planning and quality assurance processes and to evaluate the relationship of the metric with deliverability. A multisite (breast, rectum, prostate, prostate bed, lung, and head and neck) and site-specific (lung) dosimetric evaluation has been completed. The MCS was calculated for each beam and the overall treatment plan. A 2D diode array (MapCHECK, Sun Nuclear, Melbourne, FL) was used to acquire measurements for each beam. The measured and planned dose (PINNACLE3, Phillips, Madison, WI) was evaluated using different percent differences and distance to agreement (DTA) criteria (3%/ 3 mm and 2%/ 1 mm) and the relationship between the dosimetric results and complexity (as measured by the MCS or simple beam parameters) assessed. For the multisite analysis (243 plans total), the mean MCS scores for each treatment site were breast (0.92), rectum (0.858), prostate (0.837), prostate bed (0.652), lung (0.631), and head and neck (0.356). The MCS allowed for compilation of treatment site-specific statistics, which is useful for comparing different techniques, as well as for comparison of individual treatment plans with the typical complexity levels. For the six plans selected for dosimetry, the average diode percent pass rate was 98.7% (minimum of 96%) for 3%/3 mm evaluation criteria. The average difference in absolute dose measurement between the planned and measured dose was 1.7 cGy. The detailed lung analysis also showed excellent agreement between the measured and planned dose, as all beams had a diode percentage pass rate for 3%/3 mm criteria of greater than 95.9%, with an average pass rate of 99.0%. The average absolute maximum dose difference for the lung plans was 0.7 cGy. There was no direct correlation between the MCS and simple beam parameters which could be used as a surrogate for complexity level (i.e., number of segments or MU). An evaluation criterion of 2%/ 1 mm reliably allowed for the identification of beams that are dosimetrically robust. In this study we defined a robust beam or plan as one that maintained a diode percentage pass rate greater than 90% at 2%/ 1 mm, indicating delivery that was deemed accurate when compared to the planned dose, even under stricter evaluation criterion. MCS and MU threshold criteria were determined by defining a required specificity of 1.0. A MCS threshold of 0.8 allowed for identification of robust deliverability with a sensitivity of 0.36. In contrast, MU had a lower sensitivity of 0.23 for a threshold of 50 MU. The MCS allows for a quantitative assessment of plan complexity, on a fixed scale, that can be applied to all treatment sites and can provide more information related to dose delivery than simple beam parameters. This could prove useful throughout the entire treatment planning and QA process.

WE-G-16A-01: Evolution of Radiation Treatment Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rothenberg, L; Mohan, R; Van Dyk, J

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 ofmore » 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 delineation, assignment of dose requirements, consideration of uncertainties, selection of beam configurations and shaping of beams, and calculations, optimization and evaluation of dose distributions. This will be followed by three presentations covering the evolution of treatment planning, which parallels the evolution of computers, availability of advanced volumetric imaging and the development of novel technologies such as dynamic multi-leaf collimators and online image guidance. This evolution will be divided over three distinct periods - prior to 1970's, the 2D era; from 1980 to the mid-1990's, the 3D era; and from the mid 1990's to today, the IMRT era. When the World was Flat: The Two-Dimensional Radiation Therapy Era” - Jacob Van Dyk In the 2D era, anatomy was defined with the aid of solder wires, special contouring devices and projection x-rays. Dose distributions were calculated manually from single field, flat surface isodoses on transparencies. Precalculated atlases of generic dose distributions were produced by the International Atomic Energy Agency. Massive time-shared main frames and mini-computers were used to compute doses at individual points or dose distributions in a single plane. Beam shapes were generally rectangular, with wedges, missing tissue compensators and occasional blocks to shield critical structures. Dose calculations were measurement-based or they used primary and scatter calculations based on scatter-air ratio methodologies. Dose distributions were displayed on line printers as alpha-numeric character maps or isodose patterns made with pen plotters. More than Pretty Pictures: 3D Treatment Planning and Conformal Therapy - Benedick A. Fraass The introduction of computed tomography allowed the delineation of anatomy three-dimensionally and, supported partly by contracts from the National Cancer Institute, made possible the introduction and clinical use of 3D treatment planning, leading to development and use of 3D conformal therapy in the 1980's. 3D computer graphics and 3D anatomical structure definitions made possible Beam's Eye View (BEV) displays, making conformal beam shaping and much more sophisticated beam arrangements possible. These conformal plans significantly improved target dose coverage as well as normal tissue sparing. The use of dose volume histograms, gross/clinical/planning target volumes, MRI and PET imaging, multileaf collimators, and computer-controlled treatment delivery made sophisticated planning approaches practical. The significant improvements in dose distributions and analysis achievable with 3D conformal therapy made possible formal dose escalation and normal tissue tolerance clinical studies that set new and improved expectations for improved local control and decreasing complications in many clinical sites. From the Art to the State of the Art: Inverse Planning and IMRT - Thomas R. Bortfeld While the potential of intensity modulation was recognized in the mid- 1980's, intensity-modulated radiotherapy (IMRT) did not become a reality until the mid-1990's. Broad beams of photons could be sub-divided into narrow beamlets whose intensities could be determined using sophisticated optimization algorithms to appropriately balance tumor dose with normal tissue sparing. The development of dynamic multi-leaf collimators (on conventional linear accelerators as well as in helical delivery devices) enabled the efficient delivery of IMRT. The evolution of IMRT planning is continuing in the form of Volumetric Modulated Arc Therapy (VMAT) and through advanced optimization tools, such as multi-criteria optimization, automated IMRT planning, and robust optimization to protect dose distributions against uncertainties. IMRT also facilitates “dose painting” in which different sub-volumes of the target are prescribed different doses. Clearly, these advancements are being made possible by the increasing power and lower cost of computers and developments in other fields such as imaging and operations research. Summary - Radhe Mohan The history does not end here. The advancement of treatment planning is expected to continue, leading to further automation and improvements in conformality and robustness of dose distributions, particularly in the area of particle therapy. Radiobiological modeling will gain emphasis as part of the planning process. Learning Objectives: The scope of changes in technology and the capabilities of radiation treatment planning The impact of these changes in the quality of treatment plans and optimality of dose distributions The impact of development in other fields (imaging, computers, operations research, etc.) on the evolution of radiation treatment planning.« less

SU-F-T-563: Delivered Dose Reconstruction of Moving Targets for Gated Volumetric Modulated Arc Therapy (VMAT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, H; Cho, S; Jeong, C

2016-06-15

Purpose: Actual delivered dose of moving tumors treated with gated volumetric arc therapy (VMAT) may significantly differ from the planned dose assuming static target. In this study, we developed a method which reconstructs actual delivered dose distribution of moving target by taking into account both tumor motion and dynamic beam delivery of gated VMAT, and applied to abdominal tumors. Methods: Fifteen dual-arc VMAT plans (Eclipse, Varian Medical Systems) for 5 lung, 5 pancreatic, and 5 liver cancer patients treated with gated VMAT stereotactic body radiotherapy (SBRT) were studied. For reconstruction of the delivered dose distribution, we divided each original arcmore » beam into control-point-wise sub-beams, and applied beam isocenter shifting to each sub-beam to reflect the tumor motion. The tumor positions as a function of beam delivery were estimated by synchronizing the beam delivery with the respiratory signal which acquired during treatment. For this purpose, an in-house program (MATLAB, Mathworks) was developed to convert the original DICOM plan data into motion-involved treatment plan. The motion-involved DICOM plan was imported into Eclipse for dose calculation. The reconstructed delivered dose was compared to the plan dose using the dose coverage of gross tumor volume (GTV) and dose distribution of organs at risk (OAR). Results: The mean GTV dose coverage difference between the reconstructed delivered dose and the plan dose was 0.2 % in lung and pancreas cases, and no difference in liver cases. Mean D1000cc of ipsilateral lungs was reduced (0.8 ± 1.4cGy). Conclusion: We successfully developed a method of delivered dose reconstruction taking into account both respiratory tumor motion and dynamic beam delivery, and applied it to abdominal tumors treated with gated VAMT. No significant deterioration of delivered dose distribution indicates that interplay effect would be minimal even in the case of gated SBRT. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015038710)« less

Flexural behaviour of RCC beams with externally bonded FRP

NASA Astrophysics Data System (ADS)

Vignesh, S. Arun; Sumathi, A.; Saravana Raja Mohan, K.

2017-07-01

The increasing use of carbon and glass fibre reinforced polymer (FRP) sheets for strengthening existing reinforced concrete beams has generated considerable interest in understanding the behavior of the FRP sheets when subjected to bending. The study on flexure includes various parameters like percentage of increase in strength of the member due to the externally bonded Fiber reinforced polymer, examining the crack patterns, reasons of debonding of the fibre from the structure, scaling, convenience of using the fibres, cost effectiveness etc. The present work aims to study experimentally about the reasons behind the failure due to flexure of an EB-FRP concrete beam by studying the various parameters. Deflection control may become as important as flexural strength for the design of FRPreinforced concrete structures. A numerical model is created using FEM software and the results are compared with that of the experiment.

An Apparatus For Student Projects Using External-Beam PIXE And PIGE

NASA Astrophysics Data System (ADS)

Correll, Francis D.; Edsall, Douglas W.; DePooter, Katherine A.; Maskell, Nicholas D.; Vanhoy, Jeffrey R.

2011-06-01

We recently installed a simple endstation at the Naval Academy Tandem Accelerator Laboratory to support student projects using external-beam PIXE and PIGE. It consists of a short, graphite-lined beamline extension with a thin window, an interlocked box that surrounds the target, detectors for x- and gamma rays, provision for flooding the target with helium gas, easily changed x-ray absorbers, and a compact video camera for monitoring the position of the beam spot. We used this system to measure the elemental composition of colonial-era architectural materials, principally bricks and mortar, from James Madison's Montpelier, the reconstructed Virginia estate of the fourth President of the United States. We describe the design and construction of the system, relate some of our experiences using it, and present some preliminary data from our investigations.

Bremsstrahlung Diode Performance on Mercury MIV A

DTIC Science & Technology

2005-06-01

generator, experiments are performed utilizing both carbon (C) and tantalum (Ta) converters. An array of CaF2 thermoluminescent dosimeters ( TLDs ...an Al cylinder of 4-mm wall thickness; this thickness is sufficient to isolate the TLDs from externally produced Compton electrons . The measured PD...production of Mercury, a series of large-area electron -beam (e-beam) diode experiments are performed in which the e-beam is deposited onto either a

Technologies for delivery of proton and ion beams for radiotherapy

NASA Astrophysics Data System (ADS)

Owen, Hywel; Holder, David; Alonso, Jose; Mackay, Ranald

2014-05-01

Recent developments for the delivery of proton and ion beam therapy have been significant, and a number of technological solutions now exist for the creation and utilisation of these particles for the treatment of cancer. In this paper we review the historical development of particle accelerators used for external beam radiotherapy and discuss the more recent progress towards more capable and cost-effective sources of particles.

Flexural strength using Steel Plate, Carbon Fiber Reinforced Polymer (CFRP) and Glass Fiber Reinforced Polymer (GFRP) on reinforced concrete beam in building technology

NASA Astrophysics Data System (ADS)

Tarigan, Johannes; Patra, Fadel Muhammad; Sitorus, Torang

2018-03-01

Reinforced concrete structures are very commonly used in buildings because they are cheaper than the steel structures. But in reality, many concrete structures are damaged, so there are several ways to overcome this problem, by providing reinforcement with Fiber Reinforced Polymer (FRP) and reinforcement with steel plates. Each type of reinforcements has its advantages and disadvantages. In this study, researchers discuss the comparison between flexural strength of reinforced concrete beam using steel plates and Fiber Reinforced Polymer (FRP). In this case, the researchers use Carbon Fiber Reinforced Polymer (CFRP) and Glass Fiber Reinforced Polymer (GFRP) as external reinforcements. The dimension of the beams is 15 x 25 cm with the length of 320 cm. Based on the analytical results, the strength of the beam with CFRP is 1.991 times its initial, GFRP is 1.877 times while with the steel plate is 1.646 times. Based on test results, the strength of the beam with CFRP is 1.444 times its initial, GFRP is 1.333 times while the steel plate is 1.167 times. Based on these test results, the authors conclude that beam with CFRP is the best choice for external reinforcement in building technology than the others.

Fabrication of a self-sensing electroactive polymer bimorph actuator based on polyvinylidene fluoride and its electrostrictive terpolymer

NASA Astrophysics Data System (ADS)

Engel, Leeya; Van Volkinburg, Kyle R.; Ben-David, Moti; Washington, Gregory N.; Krylov, Slava; Shacham-Diamand, Yosi

2016-04-01

In this paper, we report on the fabrication of a self-sensing electroactive polymer cantilevered bimorph beam actuator and its frequency response. Tip deflections of the beam, induced by applying an AC signal across ferroelectric relaxor polyvinylidene fluoride-trifluoroethylene chlorotrifluoroethylene (P(VDF-TrFE-CTFE)), reached a magnitude of 350μm under a field of ~55MV/m and were recorded externally using a laser Doppler vibrometer (LDV). Deflections were determined simultaneously by applying a sensing model to the voltage measured across the bimorph's integrated layer of piezoelectric polymer polyvinylidene fluoride (PVDF). The sensing model treats the structure as a simple Euler- Bernoulli cantilevered beam with two distributed active elements represented through the use of generalized functions and offers a method through which real time tip deflection can be measured without the need for external visualization. When not being used as a sensing element, the PVDF layer can provide an additional means for actuation of the beam via the converse piezoelectric effect, resulting in bidirectional control of the beam's deflections. Integration of flexible sensing elements together with modeling of the electroactive polymer beam can benefit the developing field of polymer microactuators which have applications in soft robotics as "smart" prosthetics/implants, haptic displays, tools for less invasive surgery, and sensing.

4D CT-based Treatment Planning for Intensity-Modulated Radiation Therapy and Proton Therapy for Distal Esophagus Cancer

PubMed Central

Zhang, Xiaodong; Zhao, Kuai-Le; Guerrero, Thomas M.; McGuire, Sean E.; Yaremko, Brian; Komaki, Ritsuko; Cox, James D.; Hui, Zhouguang; Li, Yupeng; Newhauser, Wayne D.; Mohan, Radhe; Liao, Zhongxing

2008-01-01

Purpose To compare three-dimensional (3D) and 4D computed tomography (CT)– based treatment plans for proton therapy or intensity-modulated radiation therapy (IMRT) for esophageal cancer in terms of doses to the lung, heart, and spinal cord and variations in target coverage and normal tissue sparing. Materials and Methods IMRT and proton plans for 15 patients with distal esophageal cancer were designed from the 3D average CT scans and then recalculated on 10 4D CT data sets. Dosimetric data were compared for tumor coverage and normal tissue sparing. Results Compared with IMRT, median lung volumes exposed to 5,10, and 20 Gy and mean lung dose were reduced by 35.6%, 20.5%,5.8%, and 5.1 Gy for a two-beam proton plan and by 17.4%,8.4%,5%, and 2.9 Gy for a three-beam proton plan. The greater lung sparing in the two-beam proton plan was achieved at the expense of less conformity to the target (conformity index CI=1.99) and greater irradiation of the heart (heart-V40=41.8%) compared with the IMRT plan(CI=1.55, heart-V40=35.7%) or the three-beam proton plan (CI=1.46, heart-V40=27.7%). Target coverage differed by more than 2% between the 3D and 4D plans for patients with substantial diaphragm motion in the three-beam proton and IMRT plans. The difference in spinal cord maximum dose between 3D and 4D plans could exceed 5 Gy for the proton plans partly owing to variations in stomach gas-filling. Conclusions Proton therapy provided significantly better sparing of lung than did IMRT. Diaphragm motion and stomach gas-filling must be considered in evaluating target coverage and cord doses. PMID:18722278

Four-dimensional computed tomography-based treatment planning for intensity-modulated radiation therapy and proton therapy for distal esophageal cancer.

PubMed

Zhang, Xiaodong; Zhao, Kuai-le; Guerrero, Thomas M; McGuire, Sean E; Yaremko, Brian; Komaki, Ritsuko; Cox, James D; Hui, Zhouguang; Li, Yupeng; Newhauser, Wayne D; Mohan, Radhe; Liao, Zhongxing

2008-09-01

To compare three-dimensional (3D) and four-dimensional (4D) computed tomography (CT)-based treatment plans for proton therapy or intensity-modulated radiation therapy (IMRT) for esophageal cancer in terms of doses to the lung, heart, and spinal cord and variations in target coverage and normal tissue sparing. The IMRT and proton plans for 15 patients with distal esophageal cancer were designed from the 3D average CT scans and then recalculated on 10 4D CT data sets. Dosimetric data were compared for tumor coverage and normal tissue sparing. Compared with IMRT, median lung volumes exposed to 5, 10, and 20 Gy and mean lung dose were reduced by 35.6%, 20.5%, 5.8%, and 5.1 Gy for a two-beam proton plan and by 17.4%, 8.4%, 5%, and 2.9 Gy for a three-beam proton plan. The greater lung sparing in the two-beam proton plan was achieved at the expense of less conformity to the target (conformity index [CI], 1.99) and greater irradiation of the heart (heart-V40, 41.8%) compared with the IMRT plan(CI, 1.55, heart-V40, 35.7%) or the three-beam proton plan (CI, 1.46, heart-V40, 27.7%). Target coverage differed by more than 2% between the 3D and 4D plans for patients with substantial diaphragm motion in the three-beam proton and IMRT plans. The difference in spinal cord maximum dose between 3D and 4D plans could exceed 5 Gy for the proton plans partly owing to variations in stomach gas filling. Proton therapy provided significantly better sparing of lung than did IMRT. Diaphragm motion and stomach gas-filling must be considered in evaluating target coverage and cord doses.

SU-F-T-494: A Multi-Institutional Study of Independent Dose Verification Using Golden Beam Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Itano, M; Yamazaki, T; Tachibana, R

Purpose: In general, beam data of individual linac is measured for independent dose verification software program and the verification is performed as a secondary check. In this study, independent dose verification using golden beam data was compared to that using individual linac’s beam data. Methods: Six institutions were participated and three different beam data were prepared. The one was individual measured data (Original Beam Data, OBD) .The others were generated by all measurements from same linac model (Model-GBD) and all linac models (All-GBD). The three different beam data were registered to the independent verification software program for each institute. Subsequently,more » patient’s plans in eight sites (brain, head and neck, lung, esophagus, breast, abdomen, pelvis and bone) were analyzed using the verification program to compare doses calculated using the three different beam data. Results: 1116 plans were collected from six institutes. Compared to using the OBD, the results shows the variation using the Model-GBD based calculation and the All-GBD was 0.0 ± 0.3% and 0.0 ± 0.6%, respectively. The maximum variations were 1.2% and 2.3%, respectively. The plans with the variation over 1% shows the reference points were located away from the central axis with/without physical wedge. Conclusion: The confidence limit (2SD) using the Model-GBD and the All-GBD was within 0.6% and 1.2%, respectively. Thus, the use of golden beam data may be feasible for independent verification. In addition to it, the verification using golden beam data provide quality assurance of planning from the view of audit. This research is partially supported by Japan Agency for Medical Research and Development(AMED)« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sole, Claudio V., E-mail: cvsole@uc.cl; School of Medicine, Complutense University, Madrid; Service of Radiation Oncology, Instituto de Radiomedicina, Santiago

Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up ofmore » 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial to confirm these results.« less

Monte Carlo modeling of HD120 multileaf collimator on Varian TrueBeam linear accelerator for verification of 6X and 6X FFF VMAT SABR treatment plans

PubMed Central

Gete, Ermias; Duzenli, Cheryl; Teke, Tony

2014-01-01

A Monte Carlo (MC) validation of the vendor‐supplied Varian TrueBeam 6 MV flattened (6X) phase‐space file and the first implementation of the Siebers‐Keall MC MLC model as applied to the HD120 MLC (for 6X flat and 6X flattening filterfree (6X FFF) beams) are described. The MC model is validated in the context of VMAT patient‐specific quality assurance. The Monte Carlo commissioning process involves: 1) validating the calculated open‐field percentage depth doses (PDDs), profiles, and output factors (OF), 2) adapting the Siebers‐Keall MLC model to match the new HD120‐MLC geometry and material composition, 3) determining the absolute dose conversion factor for the MC calculation, and 4) validating this entire linac/MLC in the context of dose calculation verification for clinical VMAT plans. MC PDDs for the 6X beams agree with the measured data to within 2.0% for field sizes ranging from 2 × 2 to 40 × 40 cm2. Measured and MC profiles show agreement in the 50% field width and the 80%‐20% penumbra region to within 1.3 mm for all square field sizes. MC OFs for the 2 to 40 cm2 square fields agree with measurement to within 1.6%. Verification of VMAT SABR lung, liver, and vertebra plans demonstrate that measured and MC ion chamber doses agree within 0.6% for the 6X beam and within 2.0% for the 6X FFF beam. A 3D gamma factor analysis demonstrates that for the 6X beam, > 99% of voxels meet the pass criteria (3%/3 mm). For the 6X FFF beam, > 94% of voxels meet this criteria. The TrueBeam accelerator delivering 6X and 6X FFF beams with the HD120 MLC can be modeled in Monte Carlo to provide an independent 3D dose calculation for clinical VMAT plans. This quality assurance tool has been used clinically to verify over 140 6X and 16 6X FFF TrueBeam treatment plans. PACS number: 87.55.K‐ PMID:24892341

Universal field matching in craniospinal irradiation by a background-dose gradient-optimized method.

PubMed

Traneus, Erik; Bizzocchi, Nicola; Fellin, Francesco; Rombi, Barbara; Farace, Paolo

2018-01-01

The gradient-optimized methods are overcoming the traditional feathering methods to plan field junctions in craniospinal irradiation. In this note, a new gradient-optimized technique, based on the use of a background dose, is described. Treatment planning was performed by RayStation (RaySearch Laboratories, Stockholm, Sweden) on the CT scans of a pediatric patient. Both proton (by pencil beam scanning) and photon (by volumetric modulated arc therapy) treatments were planned with three isocenters. An 'in silico' ideal background dose was created first to cover the upper-spinal target and to produce a perfect dose gradient along the upper and lower junction regions. Using it as background, the cranial and the lower-spinal beams were planned by inverse optimization to obtain dose coverage of their relevant targets and of the junction volumes. Finally, the upper-spinal beam was inversely planned after removal of the background dose and with the previously optimized beams switched on. In both proton and photon plans, the optimized cranial and the lower-spinal beams produced a perfect linear gradient in the junction regions, complementary to that produced by the optimized upper-spinal beam. The final dose distributions showed a homogeneous coverage of the targets. Our simple technique allowed to obtain high-quality gradients in the junction region. Such technique universally works for photons as well as protons and could be applicable to the TPSs that allow to manage a background dose. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Photon Beaming in External Compton models

NASA Astrophysics Data System (ADS)

Hutter, Anne; Spanier, Felix

In attempt to model blazar emission spectra, External Compton models have been employed to fit the observed data. In these models photons from the accretion disk or the CMB are upscat-tered via the Compton effect by the electrons and contribute to the emission. In previous works the resulting scattered photon angular distribution has been calculated for ultrarelativistic elec-trons. This work aims to extend the result to the case of mildly relativistic electrons. Hence, the beaming pattern produced by a relativistic moving blob consisting of isotropic distributed electrons, which scatter photons of an isotropic external radiation is calculated numerically. The isotropic photon density distribution in the blob frame is Lorentz-transformed into the rest frame of the electron and results in an anisotropic distribution with a preferred direction where it is upscattered by the electrons. The photon density distribution is determined and transformed back into the blob frame. As the photons in the rest frame of the electrons are dis-tributed anisotropically the scattering does not reproduce this anisotropic distribution. When transforming back into the blob frame the resulting photon distribution won't be isotropic. Approximations have shown that the resulting photon distribution is boosted more strongly than a distribution assumed to be isotropic in the rest frame of the electrons. Hence, in order to obtain the beaming caused by external Compton it is of particular interest to derive a more exact approximation of the resulting photon angular distribution.

Short-term Androgen-Deprivation Therapy Improves Prostate Cancer-Specific Mortality in Intermediate-Risk Prostate Cancer Patients Undergoing Dose-Escalated External Beam Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zumsteg, Zachary S.; Spratt, Daniel E.; Pei, Xin

2013-03-15

Purpose: We investigated the benefit of short-term androgen-deprivation therapy (ADT) in patients with intermediate-risk prostate cancer (PC) receiving dose-escalated external beam radiation therapy. Methods and Materials: The present retrospective study comprised 710 intermediate-risk PC patients receiving external beam radiation therapy with doses of ≥81 Gy at a single institution from 1992 to 2005, including 357 patients receiving neoadjuvant and concurrent ADT. Prostate-specific antigen recurrence-free survival (PSA-RFS) and distant metastasis (DM) were compared using the Kaplan-Meier method and Cox proportional hazards models. PC-specific mortality (PCSM) was assessed using competing-risks analysis. Results: The median follow-up was 7.9 years. Despite being more likelymore » to have higher PSA levels, Gleason score 4 + 3 = 7, multiple National Comprehensive Cancer Network intermediate-risk factors, and older age (P≤.001 for all comparisons), patients receiving ADT had improved PSA-RFS (hazard ratio [HR], 0.598; 95% confidence interval [CI], 0.435-0.841; P=.003), DM (HR, 0.424; 95% CI, 0.219-0.819; P=.011), and PCSM (HR, 0.380; 95% CI, 0.157-0.921; P=.032) on univariate analysis. Using multivariate analysis, ADT was an even stronger predictor of improved PSA-RFS (adjusted HR [AHR], 0.516; 95% CI, 0.360-0.739; P<.001), DM (AHR, 0.347; 95% CI, 0.176-0.685; P=.002), and PCSM (AHR, 0.297; 95% CI, 0.128-0.685; P=.004). Gleason score 4 + 3 = 7 and ≥50% positive biopsy cores were other independent predictors of PCSM. Conclusions: Short-term ADT improves PSA-RFS, DM, and PCSM in patients with intermediate-risk PC undergoing dose-escalated external beam radiation therapy.« less

External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barraclough, Lisa Helen; Swindell, Ric; Livsey, Jacqueline E.

2008-07-01

Purpose: To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials: Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results: Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, andmore » IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received {>=}60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion: An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT.« less

External Beam Radiotherapy for Prostate Cancer Patients on Anticoagulation Therapy: How Significant is the Bleeding Toxicity?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choe, Kevin S.; Jani, Ashesh B.; Liauw, Stanley L., E-mail: sliauw@radonc.uchicago.ed

Purpose: To characterize the bleeding toxicity associated with external beam radiotherapy for prostate cancer patients receiving anticoagulation (AC) therapy. Methods and Materials: The study cohort consisted of 568 patients with adenocarcinoma of the prostate who were treated with definitive external beam radiotherapy. Of these men, 79 were receiving AC therapy with either warfarin or clopidogrel. All patients were treated with three-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Bleeding complications were recorded during treatment and subsequent follow-up visits. Results: With a median follow-up of 48 months, the 4-year actuarial risk of Grade 3 or worse bleeding toxicity was 15.5% for those receivingmore » AC therapy compared with 3.6% among those not receiving AC (p < .0001). On multivariate analysis, AC therapy was the only significant factor associated with Grade 3 or worse bleeding (p < .0001). For patients taking AC therapy, the crude rate of bleeding was 39.2%. Multivariate analysis within the AC group demonstrated that a higher radiotherapy dose (p = .0408), intensity-modulated radiotherapy (p = 0.0136), and previous transurethral resection of the prostate (p = .0001) were associated with Grade 2 or worse bleeding toxicity. Androgen deprivation therapy was protective against bleeding, with borderline significance (p = 0.0599). Dose-volume histogram analysis revealed that Grade 3 or worse bleeding was minimized if the percentage of the rectum receiving >=70 Gy was <10% or the rectum receiving >=50 Gy was <50%. Conclusion: Patients taking AC therapy have a substantial risk of bleeding toxicity from external beam radiotherapy. In this setting, dose escalation or intensity-modulated radiotherapy should be used judiciously. With adherence to strict dose-volume histogram criteria and minimizing hotspots, the risk of severe bleeding might be reduced.« less

Accelerated partial breast irradiation with external beam radiotherapy : First results of the German phase 2 trial.

PubMed

Ott, Oliver J; Strnad, Vratislav; Stillkrieg, Wilhelm; Uter, Wolfgang; Beckmann, Matthias W; Fietkau, Rainer

2017-01-01

To evaluate the feasibility and efficacy of external beam three-dimensional (3D) conformal accelerated partial breast irradiation (APBI) for selected patients with early breast cancer. Between 2011 and 2016, 72 patients were recruited for this prospective phase 2 trial. Patients were eligible for APBI if they had histologically confirmed breast cancer or pure ductal carcinoma in situ (DCIS), a tumor diameter ≤3 cm, clear resection margins ≥2 mm, no axillary lymph node involvement, no distant metastases, tumor bed clips, and were aged ≥50 years. Patients were excluded if mammography showed a multicentric invasive growth pattern, or if they had residual diffuse microcalcifications postoperatively, an extensive intraductal component, or vessel invasion. Patients received 3D conformal external beam APBI with a total dose of 38 Gy in 10 fractions in 1-2 weeks. The trial had been registered at the German Clinical Trials Register, DRKS-ID: DRKS00004417. Median follow-up was 25.5 months (range 1-61 months). Local control was maintained in 71 of 72 patients. The 3‑year local recurrence rate was 2.1% (95% confidence interval, CI: 0-6.1%). Early toxicity (grade 1 radiodermatitis) was seen in 34.7% (25/72). Late side effects ≥ grade 3 did not occur. Cosmetic results were rated as excellent/good in 96.7% (59/61). APBI with external beam radiotherapy techniques is feasible with low toxicity and, according to the results of the present and other studies, on the way to becoming a standard treatment option for a selected subgroup of patients.

Minimal-effort planning of active alignment processes for beam-shaping optics

NASA Astrophysics Data System (ADS)

Haag, Sebastian; Schranner, Matthias; Müller, Tobias; Zontar, Daniel; Schlette, Christian; Losch, Daniel; Brecher, Christian; Roßmann, Jürgen

2015-03-01

In science and industry, the alignment of beam-shaping optics is usually a manual procedure. Many industrial applications utilizing beam-shaping optical systems require more scalable production solutions and therefore effort has been invested in research regarding the automation of optics assembly. In previous works, the authors and other researchers have proven the feasibility of automated alignment of beam-shaping optics such as collimation lenses or homogenization optics. Nevertheless, the planning efforts as well as additional knowledge from the fields of automation and control required for such alignment processes are immense. This paper presents a novel approach of planning active alignment processes of beam-shaping optics with the focus of minimizing the planning efforts for active alignment. The approach utilizes optical simulation and the genetic programming paradigm from computer science for automatically extracting features from a simulated data basis with a high correlation coefficient regarding the individual degrees of freedom of alignment. The strategy is capable of finding active alignment strategies that can be executed by an automated assembly system. The paper presents a tool making the algorithm available to end-users and it discusses the results of planning the active alignment of the well-known assembly of a fast-axis collimator. The paper concludes with an outlook on the transferability to other use cases such as application specific intensity distributions which will benefit from reduced planning efforts.

Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time.

PubMed

Wild, Esther; Bangert, Mark; Nill, Simeon; Oelfke, Uwe

2015-05-01

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. 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. 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 treatment plan quality. The authors' study reconfirms the dosimetric benefits of noncoplanar irradiation of nasopharyngeal tumors. Both SnS using optimized noncoplanar beam ensembles and VMAT using an optimized, arbitrary, noncoplanar trajectory enabled dose reductions in organs at risk compared to coplanar SnS and VMAT. Using great circles or simple couch rotations to implement noncoplanar VMAT, however, was not sufficient to yield meaningful improvements in treatment plan quality. The authors estimate that noncoplanar VMAT using arbitrary optimized irradiation trajectories comes at an increased delivery time compared to coplanar VMAT yet at a decreased delivery time compared to noncoplanar SnS IMRT.

Simulations using patient data to evaluate systematic errors that may occur in 4D treatment planning: a proof of concept study.

PubMed

St James, Sara; Seco, Joao; Mishra, Pankaj; Lewis, John H

2013-09-01

The purpose of this work is to present a framework to evaluate the accuracy of four-dimensional treatment planning in external beam radiation therapy using measured patient data and digital phantoms. To accomplish this, 4D digital phantoms of two model patients were created using measured patient lung tumor positions. These phantoms were used to simulate a four-dimensional computed tomography image set, which in turn was used to create a 4D Monte Carlo (4DMC) treatment plan. The 4DMC plan was evaluated by simulating the delivery of the treatment plan over approximately 5 min of tumor motion measured from the same patient on a different day. Unique phantoms accounting for the patient position (tumor position and thorax position) at 2 s intervals were used to represent the model patients on the day of treatment delivery and the delivered dose to the tumor was determined using Monte Carlo simulations. For Patient 1, the tumor was adequately covered with 95.2% of the tumor receiving the prescribed dose. For Patient 2, the tumor was not adequately covered and only 74.3% of the tumor received the prescribed dose. This study presents a framework to evaluate 4D treatment planning methods and demonstrates a potential limitation of 4D treatment planning methods. When systematic errors are present, including when the imaging study used for treatment planning does not represent all potential tumor locations during therapy, the treatment planning methods may not adequately predict the dose to the tumor. This is the first example of a simulation study based on patient tumor trajectories where systematic errors that occur due to an inaccurate estimate of tumor motion are evaluated.

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2011 CFR

2011-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2012 CFR

2012-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2013 CFR

2013-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2014 CFR

2014-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

Strategic Planning Techniques: Matching External Assessment with Internal Audit.

ERIC Educational Resources Information Center

Groff, Warren H.

The literature on strategic planning, and the capabilities of Massachusetts system of public postsecondary education were assessed, as part of a 1981 leadership seminar. Teams from all public postsecondary education institutions in the state reviewed the basic concepts of strategic planning; critically analyzed the environment external to their…

Modification and validation of an analytical source model for external beam radiotherapy Monte Carlo dose calculations.

PubMed

Davidson, Scott E; Cui, Jing; Kry, Stephen; Deasy, Joseph O; Ibbott, Geoffrey S; Vicic, Milos; White, R Allen; Followill, David S

2016-08-01

A dose calculation tool, which combines the accuracy of the dose planning method (DPM) Monte Carlo code and the versatility of a practical analytical multisource model, which was previously reported has been improved and validated for the Varian 6 and 10 MV linear accelerators (linacs). The calculation tool can be used to calculate doses in advanced clinical application studies. One shortcoming of current clinical trials that report dose from patient plans is the lack of a standardized dose calculation methodology. Because commercial treatment planning systems (TPSs) have their own dose calculation algorithms and the clinical trial participant who uses these systems is responsible for commissioning the beam model, variation exists in the reported calculated dose distributions. Today's modern linac is manufactured to tight specifications so that variability within a linac model is quite low. The expectation is that a single dose calculation tool for a specific linac model can be used to accurately recalculate dose from patient plans that have been submitted to the clinical trial community from any institution. The calculation tool would provide for a more meaningful outcome analysis. The analytical source model was described by a primary point source, a secondary extra-focal source, and a contaminant electron source. Off-axis energy softening and fluence effects were also included. The additions of hyperbolic functions have been incorporated into the model to correct for the changes in output and in electron contamination with field size. A multileaf collimator (MLC) model is included to facilitate phantom and patient dose calculations. An offset to the MLC leaf positions was used to correct for the rudimentary assumed primary point source. Dose calculations of the depth dose and profiles for field sizes 4 × 4 to 40 × 40 cm agree with measurement within 2% of the maximum dose or 2 mm distance to agreement (DTA) for 95% of the data points tested. The model was capable of predicting the depth of the maximum dose within 1 mm. Anthropomorphic phantom benchmark testing of modulated and patterned MLCs treatment plans showed agreement to measurement within 3% in target regions using thermoluminescent dosimeters (TLD). Using radiochromic film normalized to TLD, a gamma criteria of 3% of maximum dose and 2 mm DTA was applied with a pass rate of least 85% in the high dose, high gradient, and low dose regions. Finally, recalculations of patient plans using DPM showed good agreement relative to a commercial TPS when comparing dose volume histograms and 2D dose distributions. A unique analytical source model coupled to the dose planning method Monte Carlo dose calculation code has been modified and validated using basic beam data and anthropomorphic phantom measurement. While this tool can be applied in general use for a particular linac model, specifically it was developed to provide a singular methodology to independently assess treatment plan dose distributions from those clinical institutions participating in National Cancer Institute trials.

Teaching treatment planning for protons with educational open-source software: experience with FoCa and matRad.

PubMed

Sanchez-Parcerisa, Daniel; Udías, Jose

2018-05-12

Open-source, MATLAB-based treatment planning systems FoCa and matRAD were used in a pilot project for training prospective medical physicists and postgraduate physics students in treatment planning and beam modeling techniques for proton therapy. In the four exercises designed, students learnt how proton pencil beams are modeled and how dose is calculated in three-dimensional voxelized geometries, how pencil beam scanning plans (PBS) are constructed, the rationale behind the choice of spot spacing in patient plans, and the dosimetric differences between photon IMRT and proton PBS plans. Sixty students of two courses participated in the pilot project, with over 90% of satisfactory rating from student surveys. The pilot experience will certainly be continued. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Secondary radiation measurements for particle therapy applications: charged particles produced by 4He and 12C ion beams in a PMMA target at large angle

NASA Astrophysics Data System (ADS)

Rucinski, A.; Battistoni, G.; Collamati, F.; De Lucia, E.; Faccini, R.; Frallicciardi, P. M.; Mancini-Terracciano, C.; Marafini, M.; Mattei, I.; Muraro, S.; Paramatti, R.; Piersanti, L.; Pinci, D.; Russomando, A.; Sarti, A.; Sciubba, A.; Solfaroli Camillocci, E.; Toppi, M.; Traini, G.; Voena, C.; Patera, V.

2018-03-01

Proton and carbon ion beams are used in the clinical practice for external radiotherapy treatments achieving, for selected indications, promising and superior clinical results with respect to x-ray based radiotherapy. Other ions, like \

Multicentre knowledge sharing and planning/dose audit on flattening filter free beams for SBRT lung

NASA Astrophysics Data System (ADS)

Hansen, C. R.; Sykes, J. R.; Barber, J.; West, K.; Bromley, R.; Szymura, K.; Fisher, S.; Sim, J.; Bailey, M.; Chrystal, D.; Deshpande, S.; Franji, I.; Nielsen, T. B.; Brink, C.; Thwaites, D. I.

2015-01-01

When implementing new technology into clinical practice, there will always be a need for large knowledge gain. The aim of this study was twofold, (I) audit the treatment planning and dose delivery of Flattening Filter Free (FFF) beam technology for Stereotactic Body Radiation Therapy (SBRT) of lung tumours across a range of treatment planning systems compared to the conventional Flatting Filter (FF) beams, (II) investigate how sharing knowledge between centres of different experience can improve plan quality. All vendor/treatment planning system (TPS) combinations investigated were able to produce acceptable treatment plans and the dose accuracy was clinically acceptable for all plans. By sharing knowledge between the different centres, the minor protocol violations (MPV) could be significantly reduced, from an average of 1.9 MPV per plan to 0.6 after such sharing of treatment planning knowledge. In particular, for the centres with less SBRT and/or volumetric- modulated arc therapy (VMAT) experience the MPV average per plan improved. All vendor/TPS combinations were also able to successfully deliver the FF and FFF SBRT VMAT plans. The plan quality and dose accuracy were found to be clinically acceptable.

Continuous wavelength tunable laser source with optimum positioning of pivot axis for grating

DOEpatents

Pushkarsky, Michael; Amone, David F.

2010-06-08

A laser source (10) for generating a continuously wavelength tunable light (12) includes a gain media (16), an optical output coupler (36F), a cavity collimator (38A), a diffraction grating (30), a grating beam (54), and a beam attacher (56). The diffraction grating (30) is spaced apart from the cavity collimator (38A) and the grating (30) cooperates with the optical output coupler (36F) to define an external cavity (32). The grating (30) includes a grating face surface (42A) that is in a grating plane (42B). The beam attacher (56) retains the grating beam (54) and allows the grating beam (54) and the grating (30) to effectively pivot about a pivot axis (33) that is located approximately at an intersection of a pivot plane (50) and the grating plane (42B). As provided herein, the diffraction grating (30) can be pivoted about the unique pivot axis (33) to move the diffraction grating (30) relative to the gain media (16) to continuously tune the lasing frequency of the external cavity (32) and the wavelength of the output light (12) so that the output light (12) is mode hop free.

Impact of field number and beam angle on functional image-guided lung cancer radiotherapy planning

NASA Astrophysics Data System (ADS)

Tahir, Bilal A.; Bragg, Chris M.; Wild, Jim M.; Swinscoe, James A.; Lawless, Sarah E.; Hart, Kerry A.; Hatton, Matthew Q.; Ireland, Rob H.

2017-09-01

To investigate the effect of beam angles and field number on functionally-guided intensity modulated radiotherapy (IMRT) normal lung avoidance treatment plans that incorporate hyperpolarised helium-3 magnetic resonance imaging (3He MRI) ventilation data. Eight non-small cell lung cancer patients had pre-treatment 3He MRI that was registered to inspiration breath-hold radiotherapy planning computed tomography. IMRT plans that minimised the volume of total lung receiving  ⩾20 Gy (V20) were compared with plans that minimised 3He MRI defined functional lung receiving  ⩾20 Gy (fV20). Coplanar IMRT plans using 5-field manually optimised beam angles and 9-field equidistant plans were also evaluated. For each pair of plans, the Wilcoxon signed ranks test was used to compare fV20 and the percentage of planning target volume (PTV) receiving 90% of the prescription dose (PTV90). Incorporation of 3He MRI led to median reductions in fV20 of 1.3% (range: 0.2-9.3% p  =  0.04) and 0.2% (range: 0 to 4.1%; p  =  0.012) for 5- and 9-field arrangements, respectively. There was no clinically significant difference in target coverage. Functionally-guided IMRT plans incorporating hyperpolarised 3He MRI information can reduce the dose received by ventilated lung without comprising PTV coverage. The effect was greater for optimised beam angles rather than uniformly spaced fields.

External tank project new technology plan. [development of space shuttle external tank system

NASA Technical Reports Server (NTRS)

1973-01-01

A production plan for the space shuttle external tank configuration is presented. The subjects discussed are: (1) the thermal protection system, (2) thermal coating application techniques, (3) manufacturing and tooling, (4) propulsion system configurations and components, (5) low temperature rotating and sliding joint seals, (6) lightning protection, and (7) nondestructive testing technology.

Ion beams in radiotherapy - from tracks to treatment planning

NASA Astrophysics Data System (ADS)

Krämer, M.; Scifoni, E.; Wälzlein, C.; Durante, M.

2012-07-01

Several dozen clinical sites around the world apply beams of fast light ions for radiotherapeutical purposes. Thus there is a vested interest in the various physical and radiobiological processes governing the interaction of ion beams with matter, specifically living systems. We discuss the various modelling steps which lead from basic interactions to the application in actual patient treatment planning. The nano- and microscopic scale is covered by sample calculations with our TRAX code. On the macroscopic scale we feature the TRiP98 treatment planning system, which was clinically used in GSI's radiotherapy pilot project.

Very high-energy electron (VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.

PubMed

Schüler, Emil; Eriksson, Kjell; Hynning, Elin; Hancock, Steven L; Hiniker, Susan M; Bazalova-Carter, Magdalena; Wong, Tony; Le, Quynh-Thu; Loo, Billy W; Maxim, Peter G

2017-06-01

The aim of this study was to evaluate the performance of very high-energy electron beams (VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer (HNC)). The VHEE beams were calculated in the EGSnrc/DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk (OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing. © 2017 American Association of Physicists in Medicine.

Optical eye tracking system for real-time noninvasive tumor localization in external beam radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Via, Riccardo, E-mail: riccardo.via@polimi.it; Fassi, Aurora; Fattori, Giovanni

Purpose: External beam radiotherapy currently represents an important therapeutic strategy for the treatment of intraocular tumors. Accurate target localization and efficient compensation of involuntary eye movements are crucial to avoid deviations in dose distribution with respect to the treatment plan. This paper describes an eye tracking system (ETS) based on noninvasive infrared video imaging. The system was designed for capturing the tridimensional (3D) ocular motion and provides an on-line estimation of intraocular lesions position based on a priori knowledge coming from volumetric imaging. Methods: Eye tracking is performed by localizing cornea and pupil centers on stereo images captured by twomore » calibrated video cameras, exploiting eye reflections produced by infrared illumination. Additionally, torsional eye movements are detected by template matching in the iris region of eye images. This information allows estimating the 3D position and orientation of the eye by means of an eye local reference system. By combining ETS measurements with volumetric imaging for treatment planning [computed tomography (CT) and magnetic resonance (MR)], one is able to map the position of the lesion to be treated in local eye coordinates, thus enabling real-time tumor referencing during treatment setup and irradiation. Experimental tests on an eye phantom and seven healthy subjects were performed to assess ETS tracking accuracy. Results: Measurements on phantom showed an overall median accuracy within 0.16 mm and 0.40° for translations and rotations, respectively. Torsional movements were affected by 0.28° median uncertainty. On healthy subjects, the gaze direction error ranged between 0.19° and 0.82° at a median working distance of 29 cm. The median processing time of the eye tracking algorithm was 18.60 ms, thus allowing eye monitoring up to 50 Hz. Conclusions: A noninvasive ETS prototype was designed to perform real-time target localization and eye movement monitoring during ocular radiotherapy treatments. The device aims at improving state-of-the-art invasive procedures based on surgical implantation of radiopaque clips and repeated acquisition of X-ray images, with expected positive effects on treatment quality and patient outcome.« less

Quality of Life After Whole Pelvic Versus Prostate-Only External Beam Radiotherapy for Prostate Cancer: A Matched-Pair Comparison

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pinkawa, Michael, E-mail: mpinkawa@ukaachen.de; Piroth, Marc D.; Holy, Richard

Purpose: Comparison of health-related quality of life after whole pelvic (WPRT) and prostate-only (PORT) external beam radiotherapy for prostate cancer. Methods and Materials: A group of 120 patients (60 in each group) was surveyed prospectively before radiation therapy (RT) (time A), at the last day of RT (time B), at a median time of 2 months (time C) and >1 year after RT (time D) using a validated questionnaire (Expanded Prostate Cancer Index Composite). All patients were treated with 1.8- to 2.0-Gy fractions up to 70.2 to 72.0 Gy with or without WPRT up to 45 to 46 Gy. Pairsmore » were matched according to the following criteria: age {+-} 5years, planning target volume {+-} 10 cc (considering planning target volume without pelvic nodes for WPRT patients), urinary/bowel/sexual function score before RT {+-} 10, and use of antiandrogens. Results: With the exception of prognostic risk factors, both groups were well balanced with respect to baseline characteristics. No significant differences were found with regard to urinary and sexual score changes. Mean bladder function scores reached baseline levels in both patient subgroups after RT. However, bowel function scores decreased significantly more for patients after WPRT than in those receiving PORT at all times (p < 0.01, respectively). Significant differences were found for most items in the bowel domain in the acute phase. At time D, patients after WPRT reported rectal urgency (>once a day in 15% vs. 3%; p = 0.03), bloody stools ({>=}half the time in 7% vs. 0%; p = 0.04) and frequent bowel movements (>two on a typical day in 32% vs. 7%; p < 0.01) more often than did patients after PORT. Conclusion: In comparison to PORT, WPRT (larger bladder and rectum volumes in medium dose levels, but similar volumes in high dose levels) was associated with decreased bowel quality of life in the acute and chronic phases after treatment but remained without adverse long-term urinary effects.« less

Optical eye tracking system for real-time noninvasive tumor localization in external beam radiotherapy.

PubMed

Via, Riccardo; Fassi, Aurora; Fattori, Giovanni; Fontana, Giulia; Pella, Andrea; Tagaste, Barbara; Riboldi, Marco; Ciocca, Mario; Orecchia, Roberto; Baroni, Guido

2015-05-01

External beam radiotherapy currently represents an important therapeutic strategy for the treatment of intraocular tumors. Accurate target localization and efficient compensation of involuntary eye movements are crucial to avoid deviations in dose distribution with respect to the treatment plan. This paper describes an eye tracking system (ETS) based on noninvasive infrared video imaging. The system was designed for capturing the tridimensional (3D) ocular motion and provides an on-line estimation of intraocular lesions position based on a priori knowledge coming from volumetric imaging. Eye tracking is performed by localizing cornea and pupil centers on stereo images captured by two calibrated video cameras, exploiting eye reflections produced by infrared illumination. Additionally, torsional eye movements are detected by template matching in the iris region of eye images. This information allows estimating the 3D position and orientation of the eye by means of an eye local reference system. By combining ETS measurements with volumetric imaging for treatment planning [computed tomography (CT) and magnetic resonance (MR)], one is able to map the position of the lesion to be treated in local eye coordinates, thus enabling real-time tumor referencing during treatment setup and irradiation. Experimental tests on an eye phantom and seven healthy subjects were performed to assess ETS tracking accuracy. Measurements on phantom showed an overall median accuracy within 0.16 mm and 0.40° for translations and rotations, respectively. Torsional movements were affected by 0.28° median uncertainty. On healthy subjects, the gaze direction error ranged between 0.19° and 0.82° at a median working distance of 29 cm. The median processing time of the eye tracking algorithm was 18.60 ms, thus allowing eye monitoring up to 50 Hz. A noninvasive ETS prototype was designed to perform real-time target localization and eye movement monitoring during ocular radiotherapy treatments. The device aims at improving state-of-the-art invasive procedures based on surgical implantation of radiopaque clips and repeated acquisition of X-ray images, with expected positive effects on treatment quality and patient outcome.

SU-E-T-55: Biological Equivalent Dose (BED) Comparison Between Permanent Interstitial Brachytherapy and Conventional External Beam Radiotherapy for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, X; Rahimian, J; Cosmatos, H

2014-06-01

Purpose: The goal of this research is to calculate and compare the Biological Equivalent Dose (BED) between permanent prostate Iodine-125 implant brachytherapy as monotherapy with the BED of conventional external beam radiation therapy (EBRT). Methods: A retrospective study of 605 patients treated with Iodine-125 seed implant was performed in which physician A treated 274 patients and physician B treated 331 patients. All the Brachytherapy treatment plans were created using VariSeed 8 planning system. The Iodine-125 seed source activities and loading patterns varied slightly between the two physicians. The prescription dose is 145 Gy to PTV for each patient. The BEDmore » and Tumor Control Probability (TCP) were calculated based on the TG 137 formulas. The BED for conventional EBRT of the prostate given in our institution in 2Gy per fraction for 38 fractions was calculated and compared. Results: Physician A treated 274 patients with an average BED of 123.92±0.87 Gy and an average TCP of 99.20%; Physician B treated 331 patients with an average BED of 124.87±1.12 Gy and an average TCP of 99.30%. There are no statistically significant differences (T-Test) between the BED and TCP values calculated for these two group patients.The BED of the patients undergoing conventional EBRT is calculated to be 126.92Gy. The BED of the patients treated with permanent implant brachytherapy and EBRT are comparable. Our BED and TCP values are higher than the reported values by TG 137 due to higher Iodine-125 seed activity used in our institution. Conclusion: We calculated the BED,a surrogate of the biological response to a permanent prostate brachytherapy using TG 137 formulas and recommendation. The TCP of better than 99% is calculated for these patients. A clinical outcome study of these patients correlating the BED and TCP values with PSA and Gleason Levels as well as patient survival is warranted.« less

Assessing radiation exposure of the left anterior descending artery, heart and lung in patients with left breast cancer: A dosimetric comparison between multicatheter accelerated partial breast irradiation and whole breast external beam radiotherapy.

PubMed

Chan, Tabitha Y; Tan, Poh Wee; Tan, Chek Wee; Tang, Johann I

2015-12-01

This study aims to quantify dosimetric reduction to the left anterior descending (LAD) artery, heart and lung when comparing whole breast external beam radiotherapy (WBEBRT) with multicatheter accelerated partial breast irradiation (MCABPI) for early stage left breast cancer. Planning CT data sets of 15 patients with left breast cancer receiving multicatheter brachytherapy post breast conserving surgery were used to create two independent treatment plans - WBEBRT prescribed to 50 Gy/25 fractions and MCABPI prescribed to 34 Gy/10 fractions. Dose parameters for (i) LAD artery, (ii) heart, and (iii) ipsilateral lung were calculated and compared between the two treatment modalities. After adjusting for Equivalent Dose in 2 Gy fractions(EQD2), and comparing MCAPBI with WBEBRT, the largest dose reduction was for the LAD artery whose mean dose differed by a factor of 7.7, followed by the ipsilateral lung and heart with a factor of 4.6 and 2.6 respectively. Compared to WBEBRT, the mean MCAPBI LAD was significantly lower compared to WBEBRT (6.0 Gy vs 45.9 Gy; p<0.01). Mean MCAPBI heart D(0.1cc) (representing the dose received by the most highly exposed 0.1 cc of the risk organ, i.e. the dose peak) was significantly lower (16.3 Gy vs 50.6 Gy; p<0.01). Likewise, the mean heart dose (MHD) was significantly lower (2.3 Gy vs 6.0 Gy; p<0.01). Peak dose and mean lung dose (MLD) for ipsilateral lung was also lower for MCAPBI compared to WBEBRT (Peak dose: 22.2 Gy vs 52.0 Gy; p<0.01; MLD: 2.3 Gy vs 10.7 Gy; p<0.01). Compared to WBEBRT, MCAPBI showed a significant reduction in radiation dose for the LAD, heart and lung. This may translate into better cardiac and pulmonary toxicities for patients undergoing MCAPBI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of a mixed beam therapy for post-mastectomy breast cancer patients: bolus electron conformal therapy combined with intensity modulated photon radiotherapy and volumetric modulated photon arc therapy.

PubMed

Zhang, Rui; Heins, David; Sanders, Mary; Guo, Beibei; Hogstrom, Kenneth

2018-05-10

The purpose of this study was to assess the potential benefits and limitations of a mixed beam therapy, which combined bolus electron conformal therapy (BECT) with intensity modulated photon radiotherapy (IMRT) and volumetric modulated photon arc therapy (VMAT), for left-sided post-mastectomy breast cancer patients. Mixed beam treatment plans were produced for nine post-mastectomy radiotherapy (PMRT) patients previously treated at our clinic with VMAT alone. The mixed beam plans consisted of 40 Gy to the chest wall area using BECT, 40 Gy to the supraclavicular area using parallel opposed IMRT, and 10 Gy to the total planning target volume (PTV) by optimizing VMAT on top of the BECT+IMRT dose distribution. The treatment plans were created in a commercial treatment planning system (TPS), and all plans were evaluated based on PTV coverage, dose homogeneity index (DHI), conformity index (CI), dose to organs at risk (OARs), normal tissue complication probability (NTCP), and secondary cancer complication probability (SCCP). The standard VMAT alone planning technique was used as the reference for comparison. Both techniques produced clinically acceptable PMRT plans but with a few significant differences: VMAT showed significantly better CI (0.70 vs. 0.53, p < 0.001) and DHI (0.12 vs. 0.20, p < 0.001) over mixed beam therapy. For normal tissues, mixed beam therapy showed better OAR sparing and significantly reduced NTCP for cardiac mortality (0.23% vs. 0.80%, p = 0.01) and SCCP for contralateral breast (1.7% vs. 3.1% based on linear model, and 1.2% vs. 1.9% based on linear-exponential model, p < 0.001 in both cases), but showed significantly higher mean (50.8 Gy vs. 49.3 Gy, p < 0.001) and maximum skin doses (59.7 Gy vs. 53.3 Gy, p < 0.001) compared with VMAT. Patients with more tissue (minimum distance between the distal PTV surface and lung approximately > 0.5 cm and volume of tissue between the distal PTV surface and heart or lung approximately > 250 cm 3 ) between distal PTV surface and lung may benefit the most from mixed beam therapy. This work has demonstrated that mixed beam therapy (BECT+IMRT : VMAT = 4 : 1) produces clinically acceptable plans having reduced OAR doses and risks of side effects compared with VMAT. Even though VMAT alone produces more homogenous and conformal dose distributions, mixed beam therapy remains as a viable option for treating post-mastectomy patients, possibly leading to reduced normal tissue complications. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Submillimeter Schottky Diodes with Electron Beam Lithography.

DTIC Science & Technology

1979-12-01

Timer 2: external clock, oneshot , 0’ sixteen bit counting modes are .,selected, no data is entered; interrupts are disabled. Timer 3: external clock and...CLOCK, ONESHOT MODE, NO INTERRUPTS, 00031* 16 BIT COUNTING MODE, OUTPUT IS EN- 00032 * ABLED; NO DATA IS ENTERED, 00033 00034 * TIMER3: EXT CLOCK

Dosimetric comparison of peripheral NSCLC SBRT using Acuros XB and AAA calculation algorithms.

PubMed

Ong, Chloe C H; Ang, Khong Wei; Soh, Roger C X; Tin, Kah Ming; Yap, Jerome H H; Lee, James C L; Bragg, Christopher M

2017-01-01

There is a concern for dose calculation in highly heterogenous environments such as the thorax region. This study compares the quality of treatment plans of peripheral non-small cell lung cancer (NSCLC) stereotactic body radiation therapy (SBRT) using 2 calculation algorithms, namely, Eclipse Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB), for 3-dimensional conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT). Four-dimensional computed tomography (4DCT) data from 20 anonymized patients were studied using Varian Eclipse planning system, AXB, and AAA version 10.0.28. A 3DCRT plan and a VMAT plan were generated using AAA and AXB with constant plan parameters for each patient. The prescription and dose constraints were benchmarked against Radiation Therapy Oncology Group (RTOG) 0915 protocol. Planning parameters of the plan were compared statistically using Mann-Whitney U tests. Results showed that 3DCRT and VMAT plans have a lower target coverage up to 8% when calculated using AXB as compared with AAA. The conformity index (CI) for AXB plans was 4.7% lower than AAA plans, but was closer to unity, which indicated better target conformity. AXB produced plans with global maximum doses which were, on average, 2% hotter than AAA plans. Both 3DCRT and VMAT plans were able to achieve D95%. VMAT plans were shown to be more conformal (CI = 1.01) and were at least 3.2% and 1.5% lower in terms of PTV maximum and mean dose, respectively. There was no statistically significant difference for doses received by organs at risk (OARs) regardless of calculation algorithms and treatment techniques. In general, the difference in tissue modeling for AXB and AAA algorithm is responsible for the dose distribution between the AXB and the AAA algorithms. The AXB VMAT plans could be used to benefit patients receiving peripheral NSCLC SBRT. Copyright © 2017 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Longitudinal Fracture Analysis of a Two-Dimensional Functionally Graded Beam

NASA Astrophysics Data System (ADS)

Rizov, V.

2017-11-01

Longitudinal fracture in a two-dimensional functionally graded beam is analyzed. The modulus of elasticity varies continuously in the beam cross-section. The beam is clamped in its right-hand end. The external loading consists of one longitudinal force applied at the free end of the lower crack arm. The longitudinal crack is located in the beam mid-plane. The fracture is studied in terms of the strain energy release rate. The solution derived is used to elucidate the effects of material gradients along the height as well as along the width of the beam cross-section on the fracture behaviour. The results obtained indicate that the fracture in two-dimensional functionally graded beams can be regulated efficiently by employing appropriate material gradients.

CW 50W/M2 = 10.9 diode laser source by spectral beam combining based on a transmission grating.

PubMed

Zhang, Jun; Peng, Hangyu; Fu, Xihong; Liu, Yun; Qin, Li; Miao, Guoqing; Wang, Lijun

2013-02-11

An external cavity structure based on the -1st transmission grating is introduced to spectral beam combining a 970 nm diode laser bar. A CW output power of 50.8 W, an electro-optical conversion efficiency of 45%, a spectral beam combining efficiency of 90.2% and a holistic M(2) value of 10.9 are achieved. This shows a way for a diode laser source with several KW power and diffraction-limited beam quality at the same time.

Experimental and numerical investigation on laser-assisted bending of pre-loaded metal plate

NASA Astrophysics Data System (ADS)

Nowak, Zdzisław; Nowak, Marcin; Widłaszewski, Jacek; Kurp, Piotr

2018-01-01

The laser forming technique has an important disadvantage, which is the limitation of plastic deformation generated by a single laser beam pass. To increase the plastic deformation it is possible to apply external forces in the laser forming process. In this paper, we investigate the influence of external pre-loads on the laser bending of steel plate. The pre-loads investigated generate bending towards the laser beam. The thermal, elastic-plastic analysis is performed using the commercial nonlinear finite element analysis package ABAQUS. The focus of the paper is to identify how this pattern of the pre-load influence the final bend angle of the plate.

MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Richardson, S.

2015-06-15

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

The success of primary chemotherapy for group D heritable retinoblastoma.

PubMed

Cohen, V M L; Kingston, J; Hungerford, J L

2009-07-01

To report the ocular survival and event-free survival following primary multiagent chemotherapy for group D, heritable bilateral retinoblastoma (RB). The RB database was used to identify children with heritable, bilateral RB treated with primary chemotherapy (six cycles of vincristine, etoposide and carboplatin). Only Group D eyes with more than 12 months' follow-up were analysed. The timing, number and type of salvage treatments were recorded. Kaplan-Meier estimates for the ocular survival and event-free survival (percentage of eyes that avoided external beam radiotherapy and/or enucleation) were performed as a function of time. Of 18 group D eyes, two (11%) were treated successfully with chemotherapy alone, nine (50%) underwent successful salvage treatment, and seven (39%) were enucleated. The median time from completing chemotherapy to enucleation was 9 months (range 4 to 25 months). Ocular survival was 67% at 2 years. External beam radiotherapy proved successful salvage treatment in five of nine eyes, so the event-free survival was 34% at 2 years. Multiagent chemotherapy alone is rarely sufficient for the preservation of group D eyes. External beam radiotherapy and plaque radiotherapy remain important salvage treatments for advanced, heritable retinoblastoma.

Fast neutron detection at near-core location of a research reactor with a SiC detector

NASA Astrophysics Data System (ADS)

Wang, Lei; Jarrell, Josh; Xue, Sha; Tan, Chuting; Blue, Thomas; Cao, Lei R.

2018-04-01

The measurable charged-particle produced from the fast neutron interactions with the Si and C nucleuses can make a wide bandgap silicon carbide (SiC) sensor intrinsically sensitive to neutrons. The 4H-SiC Schottky detectors have been fabricated and tested at up to 500 °C, presenting only a slightly degraded energy resolution. The response spectrum of the SiC detectors were also obtained by exposing the detectors to external neutron beam irradiation and at a near-core location where gamma-ray field is intense. The fast neutron flux of these two locations are ∼ 4 . 8 × 104cm-2 ṡs-1 and ∼ 2 . 2 × 107cm-2 ṡs-1, respectively. At the external beam location, a Si detector was irradiated side-by-side with SiC detector to disjoin the neutron response from Si atoms. The contribution of gamma ray, neutron scattering, and charged-particles producing reactions in the SiC was discussed. The fast neutron detection efficiencies were determined to be 6 . 43 × 10-4 for the external fast neutron beam irradiation and 6 . 13 × 10-6 for the near-core fast neutron irradiation.

Linear induction accelerators made from pulse-line cavities with external pulse injection.

PubMed

Smith, I

1979-06-01

Two types of linear induction accelerator have been reported previously. In one, unidirectional voltage pulses are generated outside the accelerator and injected into the accelerator cavity modules, which contain ferromagnetic material to reduce energy losses in the form of currents induced, in parallel with the beam, in the cavity structure. In the other type, the accelerator cavity modules are themselves pulse-forming lines with energy storage and switches; parallel current losses are made zero by the use of circuits that generate bidirectional acceleration waveforms with a zero voltage-time integral. In a third type of design described here, the cavities are externally driven, and 100% efficient coupling of energy to the beam is obtained by designing the external pulse generators to produce bidirectional voltage waveforms with zero voltage-time integral. A design for such a pulse generator is described that is itself one hundred percent efficient and which is well suited to existing pulse power techniques. Two accelerator cavity designs are described that can couple the pulse from such a generator to the beam; one of these designs provides voltage doubling. Comparison is made between the accelerating gradients that can be obtained with this and the preceding types of induction accelerator.

29 CFR 2590.715-2719 - Internal claims and appeals and external review processes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GROUP HEALTH PLANS RULES AND REGULATIONS FOR GROUP HEALTH... and appeals and external review processes for group health plans and health insurance issuers that are..., 2010. (b) Internal claims and appeals process—(1) In general. A group health plan and a health...

29 CFR 2590.715-2719 - Internal claims and appeals and external review processes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GROUP HEALTH PLANS RULES AND REGULATIONS FOR GROUP HEALTH... and appeals and external review processes for group health plans and health insurance issuers that are..., 2010. (b) Internal claims and appeals process—(1) In general. A group health plan and a health...

29 CFR 2590.715-2719 - Internal claims and appeals and external review processes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GROUP HEALTH PLANS RULES AND REGULATIONS FOR GROUP HEALTH... and appeals and external review processes for group health plans and health insurance issuers that are..., 2010. (b) Internal claims and appeals process—(1) In general. A group health plan and a health...

Succession Planning in a Two-Year Technical College System

ERIC Educational Resources Information Center

Neefe, Diane Osterhaus

2009-01-01

The study explores the organizational characteristics of strategic planning, succession planning and career management and the processes impact on the hiring location of academic leaders from within the college, external to the college but within the system, and external to the system. The study was conducted in the 16 college Wisconsin…

Dosimetric Improvements with a Novel Breast Stereotactic Radiotherapy Device for Delivery of Preoperative Partial-Breast Irradiation.

PubMed

Snider, James W; Mutaf, Yildirim; Nichols, Elizabeth; Hall, Andrea; Vadnais, Patrick; Regine, William F; Feigenberg, Steven J

2017-01-01

Partial-breast irradiation (PBI) with external-beam radiotherapy has produced higher than expected rates of fair-to-poor cosmesis. Worsened outcomes have been correlated with larger volumes of breast tissue exposed to radiation. A novel breast-specific stereotactic radiotherapy (BSRT) device (BSRTD) has been developed at our institution and has shown promise in delivering highly conformal dose distributions. We compared normal tissue sparing with this device with that achieved with intensity-modulated radiation therapy (IMRT)-PBI. Fifteen women previously treated with breast conservation therapy were enrolled on an institutional review board-approved protocol. Each of them underwent CT simulation in the prone position using the BSRTD-specific immobilization system. Simulated postoperative and preoperative treatment volumes were generated based on surgical bed/clip position. Blinded planners generated IMRT-PBI plans and BSRT plans for each set of volumes. These plans were compared based on clinically validated markers for cosmetic outcome and toxicity using a Wilcoxon rank-sum test. The BSRT plans consistently reduced the volumes receiving each of several dose levels (Vx) to breast tissue, the chest wall, the lung, the heart, and the skin in both preoperative and postoperative settings (p < 0.05). Preoperative BSRT yielded particularly dramatic improvements. The novel BSRTD has demonstrated significant dosimetric benefits over IMRT-PBI. Further investigation is currently proceeding through initial clinical trials. © 2016 S. Karger AG, Basel.

Performance of Al2O3:C optically stimulated luminescence dosimeters for clinical radiation therapy applications.

PubMed

Hu, B; Wang, Y; Zealey, W

2009-12-01

A commercial Optical Stimulated Luminescence (OSL) dosimetry system developed by Landauer was tested to analyse the possibility of using OSL dosimetry for external beam radiotherapy planning checks. Experiments were performed to determine signal sensitivity, dose response range, beam type/energy dependency, reproducibility and linearity. Optical annealing processes to test OSL material reusability were also studied. In each case the measurements were converted into absorbed dose. The experimental results show that OSL dosimetry provides a wide dose response range, good linearity and reproducibility for the doses up to 800cGy. The OSL output is linear with dose up to 600cGy range showing a maximum deviation from linearity of 2.0% for the doses above 600cGy. The standard deviation in response of 20 dosimeters was 3.0%. After optical annealing using incandescent light, the readout intensity decreased by approximately 98% in the first 30 minutes. The readout intensity, I, decreased after repeated optical annealing as a power law, given by I infinity t (-1.3). This study concludes that OSL dosimetry can provide an alternative dosimetry technique for use in in-vivo dosimetry if rigorous measurement protocols are established.

Optimization of combined electron and photon beams for breast cancer

NASA Astrophysics Data System (ADS)

Xiong, W.; Li, J.; Chen, L.; Price, R. A.; Freedman, G.; Ding, M.; Qin, L.; Yang, J.; Ma, C.-M.

2004-05-01

Recently, intensity-modulated radiation therapy and modulated electron radiotherapy have gathered a growing interest for the treatment of breast and head and neck tumours. In this work, we carried out a study to combine electron and photon beams to achieve differential dose distributions for multiple target volumes simultaneously. A Monte Carlo based treatment planning system was investigated, which consists of a set of software tools to perform accurate dose calculation, treatment optimization, leaf sequencing and plan analysis. We compared breast treatment plans generated using this home-grown optimization and dose calculation software for different treatment techniques. Five different planning techniques have been developed for this study based on a standard photon beam whole breast treatment and an electron beam tumour bed cone down. Technique 1 includes two 6 MV tangential wedged photon beams followed by an anterior boost electron field. Technique 2 includes two 6 MV tangential intensity-modulated photon beams and the same boost electron field. Technique 3 optimizes two intensity-modulated photon beams based on a boost electron field. Technique 4 optimizes two intensity-modulated photon beams and the weight of the boost electron field. Technique 5 combines two intensity-modulated photon beams with an intensity-modulated electron field. Our results show that technique 2 can reduce hot spots both in the breast and the tumour bed compared to technique 1 (dose inhomogeneity is reduced from 34% to 28% for the target). Techniques 3, 4 and 5 can deliver a more homogeneous dose distribution to the target (with dose inhomogeneities for the target of 22%, 20% and 9%, respectively). In many cases techniques 3, 4 and 5 can reduce the dose to the lung and heart. It is concluded that combined photon and electron beam therapy may be advantageous for treating breast cancer compared to conventional treatment techniques using tangential wedged photon beams followed by a boost electron field.

Pseudomorphic In(y)Ga(1-y)As/GaAs/Al(x)Ga(1-x)As single quantum well surface-emitting lasers with integrated 45 deg beam deflectors

NASA Technical Reports Server (NTRS)

Kim, Jae-Hoon; Larsson, Anders; Lee, Luke P.

1991-01-01

The paper reports on the first demonstration of pseudomorphic InGaAs single quantum well surface-emitting lasers (SELs), with etched vertical mirrors and integrated 45-deg beam deflectors fabricated by ion beam etching. 100-micron-wide broad-area SELs exhibited a threshold current of 320 mA, a total power of 126 mW, and a total external differential quantum efficiency of 0.09 W/A for a 500-micron-long cavity. The perpendicular far-field pattern of broad-area SELs showed a full width at half maximum of about 20 deg. Lasers with various types of cavities fabricated from the same wafer were compared. Broad-area edge-emitting lasers had a threshold current of 200 mA, a total power of 700 mW, and a total external differential quantum efficiency of 0.52 W/A.

Observation of divergent-beam X-ray diffraction from a crystal of diamond using synchrotron radiation.

PubMed

Glazer, A M; Collins, S P; Zekria, D; Liu, J; Golshan, M

2004-03-01

In 1947 Kathleen Lonsdale conducted a series of experiments on X-ray diffraction using a divergent beam external to a crystal sample. Unlike the Kossel technique, where divergent X-rays are excited by the presence of fluorescing atoms within the crystal, the use of an external divergent source made it possible to study non-fluorescing crystals. The resulting photographs not only illustrated the complexity of X-ray diffraction from crystals in a truly beautiful way, but also demonstrated unprecedented experimental precision. This long-forgotten work is repeated here using a synchrotron radiation source and, once again, considerable merit is found in Lonsdale's technique. The results of this experiment suggest that, through the use of modern 'third-generation' synchrotron sources, divergent-beam diffraction could soon enjoy a renaissance for high-precision lattice-parameter determination and the study of crystal perfection.

EDITORIAL: Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012)

NASA Astrophysics Data System (ADS)

Spezi, Emiliano; Leal, Antonio

2013-04-01

The Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) was held from 15-18 May, 2012 in Seville, Spain. The event was organized by the Universidad de Sevilla with the support of the European Workgroup on Monte Carlo Treatment Planning (EWG-MCTP). MCTP2012 followed two successful meetings, one held in Ghent (Belgium) in 2006 (Reynaert 2007) and one in Cardiff (UK) in 2009 (Spezi 2010). The recurrence of these workshops together with successful events held in parallel by McGill University in Montreal (Seuntjens et al 2012), show consolidated interest from the scientific community in Monte Carlo (MC) treatment planning. The workshop was attended by a total of 90 participants, mainly coming from a medical physics background. A total of 48 oral presentations and 15 posters were delivered in specific scientific sessions including dosimetry, code development, imaging, modelling of photon and electron radiation transport, external beam radiation therapy, nuclear medicine, brachitherapy and hadrontherapy. A copy of the programme is available on the workshop's website (www.mctp2012.com). In this special section of Physics in Medicine and Biology we report six papers that were selected following the journal's rigorous peer review procedure. These papers actually provide a good cross section of the areas of application of MC in treatment planning that were discussed at MCTP2012. Czarnecki and Zink (2013) and Wagner et al (2013) present the results of their work in small field dosimetry. Czarnecki and Zink (2013) studied field size and detector dependent correction factors for diodes and ion chambers within a clinical 6MV photon beam generated by a Siemens linear accelerator. Their modelling work based on the BEAMnrc/EGSnrc codes and experimental measurements revealed that unshielded diodes were the best choice for small field dosimetry because of their independence from the electron beam spot size and correction factor close to unity. Wagner et al (2013) investigated the recombination effect on liquid ionization chambers for stereotactic radiotherapy, a field of increasing importance in external beam radiotherapy. They modelled both radiation source (Cyberknife unit) and detector with the BEAMnrc/EGSnrc codes and quantified the dependence of the response of this type of detectors on factors such as the volume effect and the electrode. They also recommended that these dependences be accounted for in measurements involving small fields. In the field of external beam radiotherapy, Chakarova et al (2013) showed how total body irradiation (TBI) could be improved by simulating patient treatments with MC. In particular, BEAMnrc/EGSnrc based simulations highlighted the importance of optimizing individual compensators for TBI treatments. In the same area of application, Mairani et al (2013) reported on a new tool for treatment planning in proton therapy based on the FLUKA MC code. The software, used to model both proton therapy beam and patient anatomy, supports single-field and multiple-field optimization and can be used to optimize physical and relative biological effectiveness (RBE)-weighted dose distribution, using both constant and variable RBE models. In the field of nuclear medicine Marcatili et al (2013) presented RAYDOSE, a Geant4-based code specifically developed for applications in molecular radiotherapy (MRT). RAYDOSE has been designed to work in MRT trials using sequential positron emission tomography (PET) or single-photon emission tomography (SPECT) imaging to model patient specific time-dependent metabolic uptake and to calculate the total 3D dose distribution. The code was validated through experimental measurements in homogeneous and heterogeneous phantoms. Finally, in the field of code development Miras et al (2013) reported on CloudMC, a Windows Azure-based application for the parallelization of MC calculations in a dynamic cluster environment. Although the performance of CloudMC has been tested with the PENELOPE MC code, the authors report that software has been designed in a way that it should be independent of the type of MC code, provided that simulation meets a number of operational criteria. We wish to thank Elekta/CMS Inc., the University of Seville, the Junta of Andalusia and the European Regional Development Fund for their financial support. We would like also to acknowledge the members of EWG-MCTP for their help in peer-reviewing all the abstracts, and all the invited speakers who kindly agreed to deliver keynote presentations in their area of expertise. A final word of thanks to our colleagues who worked on the reviewing process of the papers selected for this special section and to the IOP Publishing staff who made it possible. MCTP2012 was accredited by the European Federation of Organisations for Medical Physics as a CPD event for medical physicists. Emiliano Spezi and Antonio Leal Guest Editors References Chakarova R, Müntzing K, Krantz M, E Hedin E and Hertzman S 2013 Monte Carlo optimization of total body irradiation in a phantom and patient geometry Phys. Med. Biol. 58 2461-69 Czarnecki D and Zink K 2013 Monte Carlo calculated correction factors for diodes and ion chambers in small photon fields Phys. Med. Biol. 58 2431-44 Mairani A, Böhlen T T, Schiavi A, Tessonnier T, Molinelli S, Brons S, Battistoni G, Parodi K and Patera V 2013 A Monte Carlo-based treatment planning tool for proton therapy Phys. Med. Biol. 58 2471-90 Marcatili S, Pettinato C, Daniels S, Lewis G, Edwards P, Fanti S and Spezi E 2013 Development and validation of RAYDOSE: a Geant4 based application for molecular radiotherapy Phys. Med. Biol. 58 2491-508 Miras H, Jiménez R, Miras C and Gomà C 2013 CloudMC: A cloud computing application for Monte Carlo simulation Phys. Med. Biol. 58 N125-33 Reynaert N 2007 First European Workshop on Monte Carlo Treatment Planning J. Phys.: Conf. Ser. 74 011001 Seuntjens J, Beaulieu L, El Naqa I and Després P 2012 Special section: Selected papers from the Fourth International Workshop on Recent Advances in Monte Carlo Techniques for Radiation Therapy Phys. Med. Biol. 57 (11) E01 Spezi E 2010 Special section: Selected papers from the Second European Workshop on Monte Carlo Treatment Planning (MCTP2009) Phys. Med. Biol. 55 (16) E01 Wagner A, Crop F, Lacornerie T, Vandevelde F and Reynaert N 2013 Use of a liquid ionization chamber for stereotactic radiotherapy dosimetry Phys. Med. Biol. 58 2445-59

Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martin, Jeffrey M.; Handorf, Elizabeth A.; Price, Robert A.

A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 receivedmore » a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality.« less

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

PubMed Central

Jaberi, Ramin; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-01-01

Purpose Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool. PMID:29441094

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

PubMed

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

2013-03-21

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 equallyspaced 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.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Y; Giebeler, A; Mascia, A

Purpose: To quantitatively evaluate dosimetric consequence of spot size variations and validate beam-matching criteria for commissioning a pencil beam model for multiple treatment rooms. Methods: A planning study was first conducted by simulating spot size variations to systematically evaluate dosimetric impact of spot size variations in selected cases, which was used to establish the in-air spot size tolerance for beam matching specifications. A beam model in treatment planning system was created using in-air spot profiles acquired in one treatment room. These spot profiles were also acquired from another treatment room for assessing the actual spot size variations between the twomore » treatment rooms. We created twenty five test plans with targets of different sizes at different depths, and performed dose measurement along the entrance, proximal and distal target regions. The absolute doses at those locations were measured using ionization chambers at both treatment rooms, and were compared against the calculated doses by the beam model. Fifteen additional patient plans were also measured and included in our validation. Results: The beam model is relatively insensitive to spot size variations. With an average of less than 15% measured in-air spot size variations between two treatment rooms, the average dose difference was −0.15% with a standard deviation of 0.40% for 55 measurement points within target region; but the differences increased to 1.4%±1.1% in the entrance regions, which are more affected by in-air spot size variations. Overall, our single-room based beam model in the treatment planning system agreed with measurements in both rooms < 0.5% within the target region. For fifteen patient cases, the agreement was within 1%. Conclusion: We have demonstrated that dosimetrically equivalent machines can be established when in-air spot size variations are within 15% between the two treatment rooms.« less

Evaluation of the dosimetric impact of applying flattening filter-free beams in intensity-modulated radiotherapy for early-stage upper thoracic carcinoma of oesophagus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Wuzhe; Lin, Zhixiong; Yang, Zhining

2015-06-15

Flattening filter-free (FFF) radiation beams have recently become clinically available on modern linear accelerators in radiation therapy. This study aimed to evaluate the dosimetric impact of using FFF beams in intensity-modulated radiotherapy (IMRT) for early-stage upper thoracic oesophageal cancer. Eleven patients with primary stage upper thoracic oesophageal cancer were recruited. For each patient, two IMRT plans were computed using conventional beams (Con-P) and FFF beams (FFF-P), respectively. Both plans employed a five-beam arrangement and were prescribed with 64 Gy to (planning target volume) PTV1 and 54 Gy to PTV2 in 32 fractions using 6 MV photons. The dose parameters ofmore » the target volumes and organs at risks (OARs), and treatment parameters including the monitor units (MU) and treatment time (TT) for Con-P and FFF-P were recorded and compared. The mean D{sub 5} of PTV1 and PTV2 were higher in FFF-P than Con-P by 0.4 Gy and 0.3 Gy, respectively. For the OARs, all the dose parameters did not show significant difference between the two plans except the mean V{sub 5} and V{sub 10} of the lung in which the FFF-P was lower (46.7% vs. 47.3% and 39.1% vs. 39.6%, respectively). FFF-P required 54% more MU but 18.4% less irradiation time when compared to Con-P. The target volume and OARs dose distributions between the two plans were comparable. However, FFF-P was more effective in sparing the lung from low dose and reduced the mean TT compared with Con-P. Long-term clinical studies are suggested to evaluate the radiobiological effects of FFF beams.« less

Neurovascular bundle–sparing radiotherapy for prostate cancer using MRI-CT registration: A dosimetric feasibility study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cassidy, R.J., E-mail: richardjcassidy@emory.edu; Yang, X.; Liu, T.

Purpose: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of “NVB-sparing” prostate radiotherapy while still delivering adequate dose to the prostate. Methods: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dosemore » of 79.2 Gy were evaluated. Pelvic MRI and simulation computed tomography scans were registered using dedicated software to allow for bilateral NVB target delineation on T2-weighted MRI. A volumetric modulated arc therapy plan was generated using the NVB bilaterally with 2 mm margin as an organ to spare and compared to the patient’s previously delivered plan. Dose-volume histogram endpoints for NVB, rectum, bladder, and planning target volume 79.2 were compared between the 2 plans using a 2-tailed paired t-test. Results: The V70 for the NVB was significantly lower on the NVB-sparing plan (p <0.01), while rectum and bladder endpoints were similar. Target V100% was similar but V{sub 105%} was higher for the NVB-sparing plans (p <0.01). Conclusions: “NVB-sparing” radiotherapy is dosimetrically feasible using CT-MRI registration, and for volumetric modulated arc therapy technology — target coverage is acceptable without increased dose to other normal structures, but with higher target dose inhomogeneity. The clinical impact of “NVB-sparing” radiotherapy is currently under study at our institution.« less

Off-axis spectral beam combining of Bragg reflection waveguide photonic crystal diode lasers

NASA Astrophysics Data System (ADS)

Sun, Fangyuan; Wang, Lijie; Zhao, Yufei; Hou, Guanyu; Shu, Shili; Zhang, Jun; Peng, Hangyu; Tian, Sicong; Tong, Cunzhu; Wang, Lijun

2018-06-01

The spectral beam combining (SBC) of Bragg reflection waveguide photonic crystal (BRW-PC) diode lasers was studied for the first time. An off-axis feedback system was constructed using a stripe mirror and a spatial filter to control beam quality in the external cavity. It was found that the BRW-PC diode lasers with a low divergence and a circular beam provided a simplified and cost-effective SBC. The off-axis feedback broke the beam quality limit of a single element, and an M 2 factor of 3.8 times lower than that of a single emitter in the slow axis was demonstrated.

High-power continuous-wave tunable 544- and 272-nm beams based on a diode-oscillator fiber-amplifier for calcium spectroscopy

NASA Astrophysics Data System (ADS)

Ko, Kwang-Hoon; Kim, Yonghee; Park, Hyunmin; Cha, Yong-Ho; Kim, Taek-Soo; Lee, Lim; Lim, Gwon; Han, Jaemin; Ko, Kwang-Hee; Jeong, Do-Young

2015-08-01

Continuous-wave single-frequency tunable 544- and 272-nm beams have been demonstrated by the second- and fourth-harmonic conversions of a 1088-nm fundamental beam from a diode-oscillator fiber-amplifier. The single-pass second-harmonic generation with a MgO-doped periodically poled stoichiometric LiTaO3 crystal and the external-cavity frequency-doubling technique with a bulk BBO crystal were employed to achieve an approximately 6-W 544-nm beam and a 1.5-W 272-nm beam, respectively. We characterized the second- and fourth-harmonic generations and discussed their applications to calcium spectroscopy.

Phase-locking of annular-combination CO2 laser

NASA Astrophysics Data System (ADS)

Qi, Tingxiang; Chen, Mei; Zhang, Rongzhu; Xiao, Qianyi

2015-07-01

A new annular-combination resonator structure adopting the external-injection phase-locking technology is presented theoretically for that the beam quality of stable annular resonator is not satisfying. The phase-locking principle and feasibility are characterized by energy density of injection beam and coupling coefficient. Based on the diffraction theory, output mode of the resonator with phase-locking is deduced and simulated. Results also confirm that injection beam have a good control effect on output mode. The intensity distributions of output beam are studied briefly and indicate that this new resonator which is adaptable to annular gain media can produce high-power laser beam with high quality.

Coherent phonon optics in a chip with an electrically controlled active device.

PubMed

Poyser, Caroline L; Akimov, Andrey V; Campion, Richard P; Kent, Anthony J

2015-02-05

Phonon optics concerns operations with high-frequency acoustic waves in solid media in a similar way to how traditional optics operates with the light beams (i.e. photons). Phonon optics experiments with coherent terahertz and sub-terahertz phonons promise a revolution in various technical applications related to high-frequency acoustics, imaging, and heat transport. Previously, phonon optics used passive methods for manipulations with propagating phonon beams that did not enable their external control. Here we fabricate a phononic chip, which includes a generator of coherent monochromatic phonons with frequency 378 GHz, a sensitive coherent phonon detector, and an active layer: a doped semiconductor superlattice, with electrical contacts, inserted into the phonon propagation path. In the experiments, we demonstrate the modulation of the coherent phonon flux by an external electrical bias applied to the active layer. Phonon optics using external control broadens the spectrum of prospective applications of phononics on the nanometer scale.

Automatic external filling for the ion source gas bottle of a Van de Graaff accelerator

NASA Astrophysics Data System (ADS)

Strivay, D.; Bastin, T.; Dehove, C.; Dumont, P. D.; Marchal, A.; Garnir, H.; Weber, G.

1997-09-01

We describe a fully automatic system we developed to fill, from an external gas bottle, the ion source terminal gas storage bottle of a 2 MV Van de Graaff accelerator without depressing the 25 bar insulating gas. The system is based on a programmable automate ordering electropneumatical valves. The only manual operation is the connection of the external gas cylinder. The time needed for a gas change is reduced to typically 15 min (depending on the residual pressure wished for the gas removed from the terminal bottle). To check this system we study the ionic composition of the ion beam delivered by our accelerator after different gas changes. The switching magnet of our accelerator was used to analyse the ionic composition of the accelerated beams in order to verify the degree of elimination of the previous gases in the system.

Guidelines on the implementation of diode in vivo dosimetry programs for photon and electron external beam therapy.

PubMed

Alecu, R; Loomis, T; Alecu, J; Ochran, T

1999-01-01

Semiconductor diodes offer many advantages for clinical dosimetry: high sensitivity, real-time readout, simple instrumentation, robustness and air pressure independence. The feasibility and usefulness of in vivo dosimetry with diodes has been shown by numerous publications, but very few, if any, refer to the utilization of diodes in electron beam dosimetry. The purpose of this paper is to present our methods for implementing an effective IVD program for external beam therapy with photons and electrons and to evaluate a new type of diodes. Methods of deciding on reasonable action levels along with calibration procedures, established according to the type of measurements intended to be performed and the action limits, are discussed. Correction factors to account for nonreference clinical conditions for new types of diodes (designed for photon and electron beams) are presented and compared with those required by older models commercially available. The possibilities and limitations of each type of diode are presented, emphasizing the importance of using the appropriate diode for each task and energy range.

Proton therapy of prostate cancer by anterior-oblique beams: implications of setup and anatomy variations

NASA Astrophysics Data System (ADS)

Moteabbed, M.; Trofimov, A.; Sharp, G. C.; Wang, Y.; Zietman, A. L.; Efstathiou, J. A.; Lu, H.-M.

2017-03-01

Proton therapy of prostate by anterior beams could offer an attractive option for treating patients with hip prosthesis and limiting the high-dose exposure to the rectum. We investigated the impact of setup and anatomy variations on the anterior-oblique (AO) proton plan dose, and strategies to manage these effects via range verification and adaptive delivery. Ten patients treated by bilateral (BL) passive-scattering proton therapy (79.2 Gy in 44 fractions) who underwent weekly verification CT scans were selected. Plans with AO beams were additionally created. To isolate the effect of daily variations, initial AO plans did not include range uncertainty margins. The use of fixed planning margins and adaptive range adjustments to manage these effects was investigated. For each case, the planned dose was recalculated on weekly CTs, and accumulated on the simulation CT using deformable registration to approximate the delivered dose. Planned and accumulated doses were compared for each scenario to quantify dose deviations induced by variations. The possibility of estimating the necessary range adjustments before each treatment was explored by simulating the procedure of a diode-based in vivo range verification technique, which would potentially be used clinically. The average planned rectum, penile bulb and femoral heads mean doses were smaller for initial AO compared to BL plans (by 8.3, 16.1 and 25.9 Gy, respectively). After considering interfractional variations in AO plans, the target coverage was substantially reduced. The maximum reduction of V 79.2/D 95/D mean/EUD for AO (without distal margins) (25.3%/10.7/1.6/4.9 Gy, respectively) was considerably larger than BL plans. The loss of coverage was mainly related to changes in water equivalent path length of the prostate after fiducial-based setup, caused by discrepancies in patient anterior surface and bony-anatomy alignment. Target coverage was recovered partially when using fixed planning margins, and fully when applying adaptive range adjustments. The accumulated organs-at-risk dose for AO beams after range adjustment demonstrated full sparing of femoral heads and superior sparing of penile bulb and rectum compared to the conventional BL cases. Our study indicates that using AO beams makes prostate treatment more susceptible to target underdose induced by interfractional variations. Adaptive range verification/adjustment may facilitate the use of anterior beam approaches, and ensure adequate target coverage in every fraction of the treatment.

State-of-the-art on cone beam CT imaging for preoperative planning of implant placement.

PubMed

Guerrero, Maria Eugenia; Jacobs, Reinhilde; Loubele, Miet; Schutyser, Filip; Suetens, Paul; van Steenberghe, Daniel

2006-03-01

Orofacial diagnostic imaging has grown dramatically in recent years. As the use of endosseous implants has revolutionized oral rehabilitation, a specialized technique has become available for the preoperative planning of oral implant placement: cone beam computed tomography (CT). This imaging technology provides 3D and cross-sectional views of the jaws. It is obvious that this hardware is not in the same class as CT machines in cost, size, weight, complexity, and radiation dose. It is thus considered to be the examination of choice when making a risk-benefit assessment. The present review deals with imaging modalities available for preoperative planning purposes with a specific focus on the use of the cone beam CT and software for planning of oral implant surgery. It is apparent that cone beam CT is the medium of the future, thus, many changes will be performed to improve these. Any adaptation of the future systems should go hand in hand with a further dose optimalization.

THE LINAC LASER NOTCHER FOR THE FERMILAB BOOSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, David E,; Duel, Kevin; Gardner, Matthew

2016-09-27

In synchrotron machines, the beam extraction is accomplished by a combination of septa and kicker magnets which deflect the beam from an accelerator into another. Ideally the kicker field must rise/fall in between the beam bunches. However, in reality, an intentional beam-free time region (aka "notch") is created on the beam pulse to assure that the beam can be extracted with minimal losses. In the case of the Fermilab Booster, the notch is created in the ring near injection energy by the use of fast kickers which deposit the beam in a shielded collimation region within the accelerator tunnel. Withmore » increasing beam power it is desirable to create this notch at the lowest possible energy to minimize activation. The Fermilab Proton Improvement Plan (PIP) initiated an R&D project to build a laser system to create the notch within a linac beam pulse at 750 keV. This talk will describe the concept for the laser notcher and discuss our current status, commissioning results, and future plans.« less

The development and role of megavoltage cone beam computerized tomography in radiation oncology

NASA Astrophysics Data System (ADS)

Morin, Olivier

External beam radiation therapy has now the ability to deliver doses that conform tightly to a tumor volume. The steep dose gradients planned in these treatments make it increasingly important to reproduce the patient position and anatomy at each treatment fraction. For this reason, considerable research now focuses on in-room three-dimensional imaging. This thesis describes the first clinical megavoltage cone beam computed tomography (MVCBCT) system, which utilizes a conventional linear accelerator equipped with an amorphous silicon flat panel detector. The document covers the system development and investigation of its clinical applications over the last 4-5 years. The physical performance of the system was evaluated and optimized for soft-tissue contrast resolution leading to recommendations of imaging protocols to use for specific clinical applications and body sites. MVCBCT images can resolve differences of 5% in electron density for a mean dose of 9 cGy. Hence, the image quality of this system is sufficient to differentiate some soft-tissue structures. The absolute positioning accuracy with MVCBCT is better than 1 mm. The accuracy of isodose lines calculated using MVCBCT images of head and neck patients is within 3% and 3 mm. The system shows excellent stability in image quality, CT# calibration, radiation exposure and absolute positioning over a period of 8 months. A procedure for MVCBCT quality assurance was developed. In our clinic, MVCBCT has been used to detect non rigid spinal cord distortions, to position a patient with a paraspinous tumor close to metallic hardware, to position prostate cancer patients using gold markers or soft-tissue landmarks, to monitor head and neck anatomical changes and their dosimetric consequences, and to complement the convention CT for treatment planning in presence of metallic implants. MVCBCT imaging is changing the clinical practice of our department by increasingly revealing patient-specific errors. New verification protocols are being developed to minimize those errors thus moving the practice of radiation therapy one step closer to personalized medicine.

Corrosion of steel members strengthenened with carbon fiber reinforced polymer sheets

NASA Astrophysics Data System (ADS)

Bumadian, Ibrahim

Due to many years of service at several cases of exposure at various environments there are many of steel bridges which are in need of rehabilitation. The infrastructure needs upgrading, repair or maintenance, and also strengthening, but by using an alternative as retrofits methods. The alternative retrofit method, which used fiber reinforced polymer (FRP) composite materials which their strength materials comes largely from the fiber such as carbon, glass, and aramid fiber. Of the most important materials used in the rehabilitation of infrastructure is a composite material newly developed in bonded externally carbon fiber and polymer (CFRP) sheets, which has achieved remarkable success in the rehabilitation and upgrading of structural members. This technique has many disadvantages one of them is galvanic corrosion. This study presents the effect of galvanic corrosion on the interfacial strength between carbon fiber reinforced polymer (CFRP) sheets and a steel substrate. A total of 35 double-lap joint specimens and 19 beams specimens are prepared and exposed to an aggressive service environment in conjunction with an electrical potential method accelerating corrosion damage. Six test categories are planned at a typical exposure interval of 12 hours, including five specimens per category for double-lap joint specimens. And six test categories are planned at a typical exposure interval of 12 hours, including three specimens per category for Beam section specimens. In addition one beam section specimen is control. The degree of corrosion is measured. Fourier transform infrared (FTIR) reflectance spectroscopy has been used to monitor and confirm the proposed corrosion mechanisms on the surface of CFRP. In this study we are using FTIR-spectroscopic measurement systems in the mid infrared (MIR) wavelength region (4000 - 400) cm-1 to monitor characteristic spectral features. Upon completion of corrosion processes, all specimens are monotonically loaded until failure occurs to measure their residual capacity. A relationship between the level of galvanic corrosion and the failure characteristics of steel-composite interface is established.

SU-F-T-501: Dosimetric Comparison of Single Arc-Per-Beam and Two Arc-Per-Beam VMAT Optimization in the Monaco Treatment Planning System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalet, A; Cao, N; Meyer, J

Purpose: The purpose of this study was to evaluate the dosimetric and practical effects of the Monaco treatment planning system “max arcs-per-beam” optimization parameter in pelvic radiotherapy treatments. Methods: A total of 17 previously treated patients were selected for this study with a range of pelvic disease site including prostate(9), bladder(1), uterus(3), rectum(3), and cervix(1). For each patient, two plans were generated, one using a arc-per-beam setting of ‘1’ and another with setting of ‘2’. The setting allows the optimizer to add a gantry direction change, creating multiple arc passes per beam sequence. Volumes and constraints established from the initialmore » clinical treatments were used for planning. All constraints and dose coverage objects were kept the same between plans, and all plans were normalized to 99.7% to ensure 100% of the PTV received 95% of the prescription dose. We evaluated the PTV conformity index, homogeneity index, total monitor units, number of control points, and various dose volume histogram (DVH) points for statistical comparison (alpha=0.05). Results: We found for the 10 complex shaped target volumes (small central volumes with extending bilateral ‘arms’ to cover nodal regions) that the use of 2 arcs-per-beam achieved significantly lower average DVH values for the bladder V20 (p=0.036) and rectum V30 (p=0.001) while still meeting the high dose target constraints. DVH values for the simpler, more spherical PTVs were not found significantly different. Additionally, we found a beam delivery time reduction of approximately 25%. Conclusion: In summary, the dosimetric benefit, while moderate, was improved over a 1 arc-per-beam setting for complex PTVs, and equivalent in other cases. The overall reduced delivery time suggests that the use of multiple arcs-per-beam could lead to reduced patient on table time, increased clinical throughput, and reduced medical physics quality assurance effort.« less

Dosimetry quality audit of high energy photon beams in greek radiotherapy centers.

PubMed

Hourdakis, Constantine J; Boziari, A

2008-04-01

Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002--2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside +/-3% and 31% outside +/-5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and discussed in details. This quality audit proved to be a useful tool for the improvement of quality in radiotherapy. It succeeded to disseminate the IAEA TRS-398 protocol in nearly all radiotherapy centers achieving homogenization and consistency of dosimetry within the country. Also, it detected discrepancies in dosimetry and provided guidance and recommendations to eliminate sources of errors. Finally, it proved that quality assurance programs, periodic quality control tests, maintenance and service play an important role for achieving accuracy and safe operation in radiotherapy.

Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wild, Esther, E-mail: e.wild@dkfz.de; Bangert, Mark; Nill, Simeon

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 directionsmore » 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 treatment plan quality. Conclusions: The authors’ study reconfirms the dosimetric benefits of noncoplanar irradiation of nasopharyngeal tumors. Both SnS using optimized noncoplanar beam ensembles and VMAT using an optimized, arbitrary, noncoplanar trajectory enabled dose reductions in organs at risk compared to coplanar SnS and VMAT. Using great circles or simple couch rotations to implement noncoplanar VMAT, however, was not sufficient to yield meaningful improvements in treatment plan quality. The authors estimate that noncoplanar VMAT using arbitrary optimized irradiation trajectories comes at an increased delivery time compared to coplanar VMAT yet at a decreased delivery time compared to noncoplanar SnS IMRT.« less

SU-F-T-643: Feasibility of Performing Patient Specific VMAT QA On Single Linac for Plans Treated in Beam-Matched Elekta Agility Linacs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leung, R; Lee, V; Cheung, S

2016-06-15

Purpose: The increasing application of VMAT demands a more efficient workflow and QA solution. This study aims to investigate the feasibility of performing VMAT QA measurements on one linac for plans treated on other beam-matched Elekta Agility linacs. Methods: A single model was used to create 24 clinically approved VMAT plans (12 head-and-neck and 12 prostate using 6MV and 10MV respectively) on Pinnacle v9.10 (Philips, Einhoven, Netherlands). All head-and-neck plans were delivered on three beam-matched machines while all prostate cases were delivered on two beam-matched 10MV Agility machines. All plans were delivered onto PTW Octavius 4D phantom with 1500 detectormore » array (PTW, Freiburg, Germany). Reconstructed volume doses were then compared with the Pinnacle reference plans in Verisoft 6.1 under 3%/3mm gamma criteria at local dose. Plans were considered clinically acceptable if >90% of the voxels passing the gamma criteria. Results: All measurements were passed (3D gamma passing rate >90%) and the result shows that the mean difference of 3D gamma of 12 head-and-neck cases is 1.2% with standard deviation of 0.6%. While for prostate cases, the mean difference of 3D gamma is 0.9% with standard deviation of 0.7%. Maximum difference of 3D gamma of all measurements between beam-matched machines is less than 2.5%. The differences of passing rates between different machines were statistically insignificant (p>0.05). Conclusion. The result suggests that ther Conclusion: The result suggests that there exists a 3D gamma threshold, in our case 92.5%, above which the VMAT QA performed in any one of beam-matched machine will also pass in another one. Therefore, VMAT QA efficiency may be increased and phantom set up time can be saved by implementing such method. A constant performance across all beam matched machines must be maintained to make this QA approach feasible.« less

SU-E-T-190: First Integration of Steriotactic Radiotherapy Planning System Iplan with Elekta Linear Accelerator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biplab, S; Soumya, R; Paul, S

2014-06-01

Purpose: For the first time in the world, BrainLAB has integrated its iPlan treatment planning system for clinical use with Elekta linear accelerator (Axesse with a Beam Modulator). The purpose of this study was to compare the calculated and measured doses with different chambers to establish the calculation accuracy of iPlan system. Methods: The iPlan has both Pencil beam (PB) and Monte Carlo (MC) calculation algorithms. Beam data include depth doses, profiles and output measurements for different field sizes. Collected data was verified by vendor and beam modelling was done. Further QA tests were carried out in our clinic. Dosemore » calculation accuracy verified point, volumetric dose measurement using ion chambers of different volumes (0.01cc and 0.125cc). Planner dose verification was done using diode array. Plans were generated in iPlan and irradiated in Elekta Axesse linear accelerator. Results: Dose calculation accuracies verified using ion chamber for 6 and 10 MV beam were 3.5+/-0.33(PB), 1.7%+/-0.7(MC) and 3.9%+/-0.6(PB), 3.4%+/-0.6(MC) respectively. Using a pin point chamber, dose calculation accuracy for 6MV and 10MV was 3.8%+/-0.06(PB), 1.21%+/-0.2(MC) and 4.2%+/-0.6(PB), 3.1%+/-0.7(MC) respectively. The calculated planar dose distribution for 10.4×10.4 cm2 was verified using a diode array and the gamma analysis for 2%-2mm criteria yielded pass rates of 88 %(PB) and 98.8%(MC) respectively. 3mm-3% yields 100% passing for both MC and PB algorithm. Conclusion: Dose calculation accuracy was found to be within acceptable limits for MC for 6MV beam. PB for both beams and MC for 10 MV beam were found to be outside acceptable limits. The output measurements were done twice for conformation. The lower gamma matching was attributed to meager number of measured profiles (only two profiles for PB) and coarse measurement resolution for diagonal profile measurement (5mm). Based on these measurements we concluded that 6 MV MC algorithm is suitable for patient treatment.« less

Steady states of a diode with counterstreaming electron and positron beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ender, A. Ya.; Kuznetsov, V. I., E-mail: victor.kuznetsov@mail.ioffe.ru; Gruzdev, A. A.

2016-10-15

Steady states of a plasma layer with counterstreaming beams of oppositely charged particles moving without collisions in a self-consistent electric field are analyzed. The study is aimed at clarifying the mechanism of generation and reconstruction of pulsar radiation. Such a layer also models the processes occurring in Knudsen plasma diodes with counterstreaming electron and ion beams. The steady-state solutions are exhaustively classified. The existence of several solutions at the same external parameters is established.

The formation of an ion beam in a vacuum neutron tube

NASA Astrophysics Data System (ADS)

Agafonov, A. V.; Tarakanov, V. P.

2014-09-01

The formation of a deuteron beam in a diode with a plasma emitter that is integrated into the structure of a vacuum neutron tube is considered. Computations are carried out for plasma with given time dependences of parameters (density, relative concentration, and expansion velocity) at the inlet to an accelerating gap. It is shown that it is possible to increase the ion-beam current possible by sectioning the diode at the given external parameters.

Steady states of a diode with counterstreaming electron and positron beams

NASA Astrophysics Data System (ADS)

Ender, A. Ya.; Kuznetsov, V. I.; Gruzdev, A. A.

2016-10-01

Steady states of a plasma layer with counterstreaming beams of oppositely charged particles moving without collisions in a self-consistent electric field are analyzed. The study is aimed at clarifying the mechanism of generation and reconstruction of pulsar radiation. Such a layer also models the processes occurring in Knudsen plasma diodes with counterstreaming electron and ion beams. The steady-state solutions are exhaustively classified. The existence of several solutions at the same external parameters is established.

Electrostatically frequency tunable micro-beam-based piezoelectric fluid flow energy harvester

NASA Astrophysics Data System (ADS)

Rezaee, Mousa; Sharafkhani, Naser

2017-07-01

This research investigates the dynamic behavior of a sandwich micro-beam based piezoelectric energy harvester with electrostatically adjustable resonance frequency. The system consists of a cantilever micro-beam immersed in a fluid domain and is subjected to the simultaneous action of cross fluid flow and nonlinear electrostatic force. Two parallel piezoelectric laminates are extended along the length of the micro-beam and connected to an external electric circuit which generates an output power as a result of the micro-beam oscillations. The fluid-coupled structure is modeled using Euler-Bernoulli beam theory and the equivalent force terms for the fluid flow. Fluid induced forces comprise the added inertia force which is evaluated using equivalent added mass and the drag and lift forces which are evaluated using relative velocity and Van der Pol equation. In addition to flow velocity and fluid density, the influence of several design parameters such as external electrical resistance, piezo layer position, and dc voltage on the generated power are investigated by using Galerkin and step by step linearization method. It is shown that for given flowing fluid parameters, i.e., density and velocity, one can adjust the applied dc voltage to tune resonance frequency so that the lock-in phenomenon with steady large amplitude oscillations happens, also by adjusting the harvester parameters including the mechanical and electrical ones, the maximal output power of the harvester becomes possible.

Directionality of nose-emitted echolocation calls from bats without a nose leaf (Plecotus auritus).

PubMed

Jakobsen, Lasse; Hallam, John; Moss, Cynthia F; Hedenström, Anders

2018-02-13

All echolocating bats and whales measured to date emit a directional bio-sonar beam that affords them a number of advantages over an omni-directional beam, i.e. reduced clutter, increased source level and inherent directional information. In this study, we investigated the importance of directional sound emission for navigation through echolocation by measuring the sonar beam of brown long-eared bats, Plecotus auritus Plecotus auritus emits sound through the nostrils but has no external appendages to readily facilitate a directional sound emission as found in most nose emitters. The study shows that P. auritus , despite lacking an external focusing apparatus, emits a directional echolocation beam (directivity index=13 dB) and that the beam is more directional vertically (-6 dB angle at 22 deg) than horizontally (-6 dB angle at 35 deg). Using a simple numerical model, we found that the recorded emission pattern is achievable if P. auritus emits sound through the nostrils as well as the mouth. The study thus supports the hypothesis that a directional echolocation beam is important for perception through echolocation and we propose that animals with similarly non-directional emitter characteristics may facilitate a directional sound emission by emitting sound through both the nostrils and the mouth. © 2018. Published by The Company of Biologists Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, V; Nguyen, D; Tran, A

Purpose: To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non-coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing. Methods: A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routingmore » through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients. Results: Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion. Conclusion: The mathematical modeling utilized in 4π is accurate to create and guide highly complex non-coplanar IMRT treatments that consistently and significantly outperform human-operator-created plans. Deliverability of such plans is clinically demonstrated. This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE-1144087.« less