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At least 343 records · Page 19
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

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

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

60 APPLIED LIFE SCIENCES↗
DOE OSTI2026

Integrating three plan evaluation approaches for coordinated heat resilience in cities across the Arizona urban corridor

Increasing heat poses a growing threat to cities worldwide due to both climate change and the urban heat island effect. While heat planning and governance are still emergent, research suggests that silos and conflicts within cities' networks of plans often impede heat resilience. Integrated heat resilience planning, therefore, requires a systematic and comprehensive analysis of the silos and conflicts relevant to heat resilience within networks of plans. This study is the first to combine three complementary plan evaluation methods to assess how cities' networks of plans address heat resilience. We applied 1) plan cross-referencing, 2) Plan Quality Evaluation for Heat Resilience, and 3) Plan Integration for Resilience Scorecard™ (PIRS™) for Heat to 19 plans from seven Arizona cities. We find similarities and differences in how these cities' networks of plans address heat hazards. The plans have consistently high-quality participation and coordination principles but lack details on vulnerability and climate change uncertainty, suggesting a need to move beyond immediate heat risks. We also identify opportunities to diversify policy mechanisms, spatially target high heat risk areas, and enhance the connection between planning efforts. These results validate that plan elements are interlinked and the importance of integrative plan development processes to improve heat resilience.

Extreme heat↗
DOE OSTI2018

A novel IMRT planning study by using the fixed-jaw method in the treatment of peripheral lung cancer with mediastinal lymph node metastasis

Intensity-modulated radiotherapy (IMRT) is an important technology in cancer radiotherapy. In the current planning system, such as in the Pinnacle{sup 3} system, jaw positions are automatically set to cover all target volumes, and many medical centers in developing countries are not equipped with linear accelerators with a jaw tracing function. As solitary lesions are often located in patients, the resulting radiation leakage and transmission increase the dose exposure in surrounding critical organs, although blocked by multileaf collimator (MLC) leaves. We therefore designed a method to manually fix jaw positions, which further reduces doses. We particularly focused on the patients of peripheral lung cancer combined with mediastinal lymph node metastasis, as our medical center mainly targets lung cancer. We designed 2 treatment plans for each patient with the same optimization parameters, i.e., the plan of automatically chosen jaw positions (jaw auto-chosen plan) and the plan of fixed-jaw positions (fixed-jaw plan). In the latter plan, jaws were manually fixed for tumors in lung and in mediastinal lymph node metastases, respectively. We found that both plans met the clinical requirements, and the D{sub 2}, D{sub 98}, conformation number (CN), and homogeneity index (HI) for planning target volume (PTV) had no significant differences between the 2 plans. Importantly, the machine units (MUs) for fixed-jaw plans were 50%~60% more than routine jaw auto-chosen plans, whereas the V{sub 5}, V{sub 10}, V{sub 20}, V{sub 30}, and the mean dose in the total lung and the ipsilateral lung were less than the routine jaw auto-chosen plans. Dose-volume values D{sub 1} for the spinal cord and D{sub 2}, V{sub 40}, V{sub 60} for the heart existed no significant differences for 2 plans. In the fixed-jaw method, the total lung TLV{sub 5}-â–³V{sub ab} and TLV{sub 10}-â–³V{sub ab} values had a moderate positive correlation with the lung radiation leakage and the transmission area reduction. We concluded that the fixed-jaw plan is superior to the routine jaw auto-chosen plan in reducing the radiation exposure of surrounding critical organs, which will benefit the IMRT application.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Photon optimizer (PO) vs progressive resolution optimizer (PRO): a conformality- and complexity-based comparison for intensity-modulated arc therapy plans

This study aimed to provide guidance on the advantages and limitations of a new optimizer, “photon optimizer” (PO), when compared with its predecessor, “progressive resolution optimizer” (PRO), for intensity-modulated arc therapy (IMAT) plans. Eleven study plans that included a cohort of prostate, head and neck, and brain treatment sites were optimized using both PRO and PO algorithms. A plan template using the same objectives for the same number of iterations was used for each optimized plan to obtain hypothetical treatment plans that would be comparable with a clinical plan. Analysis was performed using plan conformity-based parameters such as target volume coverage factor, conformation number and homogeneity indices, and plan complexity assessment parameters such as small aperture score, modulation indices, and monitor unit variation with arc angle for prostate, brain and head, and neck IMAT treatment plans. Plan conformality analysis demonstrated that conformation numbers, target volume coverage factors, and homogeneity indices produced by the 2 optimizers were comparable for most anatomic sites. IMAT treatment plans produced using the PRO optimizer were found to be less complex than plans produced using the PO optimizer, in terms of multileaf collimator (MLC) leaf position variability and modulation complexity scores. Similarly, the PRO optimizer was shown to produce treatment plans that used fewer monitor units (and generally fewer monitor unit per degree of arc rotation) than PO optimizer. This study demonstrated that the PO optimizer can produce IMAT treatment plans with a similar degree of dose conformity to the target volume and generally improved organ at risk sparing, compared with the PRO optimizer. Better coverage to organs at risk produced by plans optimized using PO was observed to have higher MLC variability and monitor units. Therefore, careful evaluation of treatment plan conformity and complexity before assessing its deliverability is recommended when implementing the routine use of PO optimizer.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2012

The dosimetric impact of inversely optimized arc radiotherapy plan modulation for real-time dynamic MLC tracking delivery

Purpose: Real-time dynamic multileaf collimator (MLC) tracking for management of intrafraction tumor motion can be challenging for highly modulated beams, as the leaves need to travel far to adjust for target motion perpendicular to the leaf travel direction. The plan modulation can be reduced by using a leaf position constraint (LPC) that reduces the difference in the position of adjacent MLC leaves in the plan. The purpose of this study was to investigate the impact of the LPC on the quality of inversely optimized arc radiotherapy plans and the effect of the MLC motion pattern on the dosimetric accuracy of MLC tracking delivery. Specifically, the possibility of predicting the accuracy of MLC tracking delivery based on the plan modulation was investigated. Methods: Inversely optimized arc radiotherapy plans were created on CT-data of three lung cancer patients. For each case, five plans with a single 358 deg. arc were generated with LPC priorities of 0 (no LPC), 0.25, 0.5, 0.75, and 1 (highest possible LPC), respectively. All the plans had a prescribed dose of 2 Gy x 30, used 6 MV, a maximum dose rate of 600 MU/min and a collimator angle of 45 deg. or 315 deg. To quantify the plan modulation, an average adjacent leaf distance (ALD) was calculated by averaging the mean adjacent leaf distance for each control point. The linear relationship between the plan quality [i.e., the calculated dose distributions and the number of monitor units (MU)] and the LPC was investigated, and the linear regression coefficient as well as a two tailed confidence level of 95% was used in the evaluation. The effect of the plan modulation on the performance of MLC tracking was tested by delivering the plans to a cylindrical diode array phantom moving with sinusoidal motion in the superior-inferior direction with a peak-to-peak displacement of 2 cm and a cycle time of 6 s. The delivery was adjusted to the target motion using MLC tracking, guided in real-time by an infrared optical system. The dosimetric results were evaluated using gamma index evaluation with static target measurements as reference. Results: The plan quality parameters did not depend significantly on the LPC (p {>=} 0.066), whereas the ALD depended significantly on the LPC (p < 0.001). The gamma index failure rate depended significantly on the ALD, weighted to the percentage of the beam delivered in each control point of the plan (ALD{sub w}) when MLC tracking was used (p < 0.001), but not for delivery without MLC tracking (p {>=} 0.342). The gamma index failure rate with the criteria of 2% and 2 mm was decreased from > 33.9% without MLC tracking to <31.4% (LPC 0) and <2.2% (LPC 1) with MLC tracking. Conclusions: The results indicate that the dosimetric robustness of MLC tracking delivery of an inversely optimized arc radiotherapy plan can be improved by incorporating leaf position constraints in the objective function without otherwise affecting the plan quality. The dosimetric robustness may be estimated prior to delivery by evaluating the ALD{sub w} of the plan.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-T-213: Initial Experience with VMAT Plan and Delivery Verification Using a DICOM-RT Framework and Linac Delivery Log Files

Purpose: Mobius3D/MobiusFX (M3D/MFX), a commercial DICOM-RT based plan and delivery verification system, was used to compare calculated and delivered volumetric modulated arc therapy (VMAT) dose distributions using TrueBeam delivery log files (TrajectoryLogs). Methods: M3D/MFX utilizes measured linac commissioning data to generate institution specific beam models for evaluating planned and delivered dose distributions. 30 RapidArc prostate plans and 30 head and neck SmartArc plans were used in this study. For every plan, CT images, contoured structure sets, RT-plan, and RT-dose files were exported to M3D, which recalculated the patients’ planning CT dose distributions using a collapsed-cone-convolutionsuperposition algorithm. MFX utilized the acquired TrajectoryLogs to compute patients’ delivered dose distributions based on actual treatment delivery parameters. The agreement between computed and delivered dose distributions was evaluated utilizing a (3%, 3mm) global 3D-gamma analysis and dose-volume histogram changes for targets and organs at risk. Results: Excellent 3D-gamma agreements were observed for all VMAT plans. On average, for computed and delivered RapidArc and SmartArc plans the gamma passing rates were (99.0%±1.4%) and (96.8%±1.8%), respectively. The average difference for primary target prescription dose percent-coverage between calculated and delivered plans was (− 0.09%±2.52%) for RapidArc and (−2.71%±4.62%) for SmartArc cases. Similarly, the planning target mean dose differences were (1.38%±0.96%) for RapidArc and (1.17%±0.72%) for SmartArc plans. For the prostate plans, the calculated and delivered variations of the maximum dose for a 2cc volume for bladder and rectum were (1.32%±1.26%) and (0.65%±1.44%), respectively. The spinal-cord 2cc maximum dose differences of (3.26%±1.68%) were observed for the SmartArc plans. Conclusions: Clinical quality assurance practice based on linac treatment log files for verification of delivered 3D dose distributions in the patients’ geometries represents a paradigm shift from dose measurements in a phantom. This approach captures treatment planning beam modeling differences as well as the linac uncertainties during treatment delivery of the plan.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-115: Analysis of Patient Specific QA for VMAT by Disease Site and Planning-Delivery System Using the ScandiDos Delta4 Phantom

Purpose: To evaluate patient specific quality assurance (PSQA) for the delivery of volumetric modulated arc therapy (VMAT) by disease site. To compare planning-delivery system (PDS) PSQA pass rates in a dual vendor institution. Methods: PSQA is performed for VMAT plans using a ScandiDos Delta4 phantom. Verification plans are calculated using Varian Eclipse and Elekta Monaco treatment planning systems (TPS) for patients treated using Varian Truebeam and Elekta linear accelerators respectively. Individual arcs are delivered to the Delta4 phantoms and assessed using the gamma index pass criterion(3% Dose Deviation(DD%), 3mm Distance to Agreement(DTA),10% dose threshold and 90% gamma index). Results: A total of 287 VMAT plans and 680 arcs were analyzed. The passing rates for VMAT QA plans were 95% and 98% for head/neck and pelvis/prostate plans respectively, and 100% for chest/abdomen, spine, lung Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery(SRS) plans. Average gamma indices were: (99 ± 2) % for pelvis/prostate, chest/abdomen and lung SBRT plans, (97 ± 4) % for head and neck plans and (98 ± 3) % for spine plans. The average DD% and DTA pass rates ranged from 82% to 90% and 98% to 99% respectively for plans in different disease sites. Paired t-test analysis (two tails) indicated no significant differences in the gamma indices between plans delivered using different PDS; the P values were: 0.08, 0.45, and 0.94 for lung SBRT, head/neck and pelvis/prostate plans respectively. The statistical power for comparing PDS in different disease sites with an alpha of 0.05 is 1. Conclusion: The Gamma indices based on 3% DD%, 3 mm DTA and 10% dose threshold for the VMAT QA plans in all disease sites were well above 90%, suggesting the possibility of using a more stringent PSQA criterion. No significant differences were observed in the QA of VMAT plans delivered using different PDS.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-520: Dosimetric Comparison of Radiation Treatment Plans for Whole Breast Irradiation Between 3D Conformal in Prone and Supine Positions Vs. VMAT and IMRT in Supine Positions

Purpose: The target volume for Whole Breast Irradiation (WBI) is dictated by location of tumor mass, breast tissue distribution, and involvement of lymph nodes. Dose coverage and Organs at Risk (OARs) sparing can be difficult to achieve in patients with unfavorable thoracic geometries. For these cases, inverse-planned and 3D-conformal prone treatments can be alternatives to traditional supine 3D-conformal plans. A dosimetric comparison can determine which of these techniques achieve optimal target coverage while sparing OARs. Methods: This study included simulation datasets for 8 patients, 5 of whom were simulated in both supine and prone positions. Positioning devices included breast boards and Vaclok bags for the supine position, and prone breast boards for the prone position. WBI 3-D conformal plans were created for patients simulated in both positions. Additional VMAT and IMRT WBI plans were made for all patients in the supine position. Results: Prone and supine 3D conformal plans had comparable PTV coverage. Prone 3D conformal plans received a significant 50% decrease to V20, V10, V5 and V30% for the ipsilateral lung in contrast to the supine plans. The heart also experienced a 10% decrease in maximum dose in the prone position, and V20, V10, V5 and V2 had significantly lower values than the supine plan. Supine IMRT and VMAT breast plans obtained comparable PTV coverage. The heart experienced a 10% decrease in maximum dose with inverse modulated plans when compared to the supine 3D conformal plan, while V20, V10, V5 and V2 showed higher values with inverse modulated plans than with supine 3D conformal plans. Conclusion: Prone 3D-conformal, and supine inverse planned treatments were generally superior in sparing OARs to supine plans with comparable PTV coverage. IMRT and VMAT plans offer sparing of OARs from high dose regions with an increase of irradiated volume in the low dose regions.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2002

Lessons Learned In Developing Multiple Distributed Planning Systems for the International Space Station

The planning processes for the International Space Station (ISS) Program are quite complex. Detailed mission planning for ISS on-orbit operations is a distributed function. Pieces of the on-orbit plan are developed by multiple planning organizations, located around the world, based on their respective expertise and responsibilities. The "pieces" are then integrated to yield the final detailed plan that will be executed onboard the ISS. Previous space programs have not distributed the planning and scheduling functions to this extent. Major ISS planning organizations are currently located in the United States (at both the NASA Johnson Space Center (JSC) and NASA Marshall Space Flight Center (MSFC)), in Russia, in Europe, and in Japan. Software systems have been developed by each of these planning organizations to support their assigned planning and scheduling functions. Although there is some cooperative development and sharing of key software components, each planning system has been tailored to meet the unique requirements and operational environment of the facility in which it operates. However, all the systems must operate in a coordinated fashion in order to effectively and efficiently produce a single integrated plan of ISS operations, in accordance with the established planning processes. This paper addresses lessons learned during the development of these multiple distributed planning systems, from the perspective of the developer of one of the software systems. The lessons focus on the coordination required to allow the multiple systems to operate together, rather than on the problems associated with the development of any particular system. Included in the paper is a discussion of typical problems faced during the development and coordination process, such as incompatible development schedules, difficulties in defining system interfaces, technical coordination and funding for shared tools, continually evolving planning concepts/requirements, programmatic and budget issues, and external influences. Techniques that mitigated some of these problems will also be addressed, along with recommendations for any future programs involving the development of multiple planning and scheduling systems. Many of these lessons learned are not unique to the area of planning and scheduling systems, so may be applied to other distributed ground systems that must operate in concert to successfully support space mission operations.

Maxwell, Theresa G.↗
NASA NTRS2002

Lessons Learned in Developing Multiple Distributed Planning Systems for the International Space Station

The planning processes for the International Space Station (ISS) Program are quite complex. Detailed mission planning for ISS on-orbit operations is a distributed function. Pieces of the on-orbit plan are developed by multiple planning organizations, located around the world, based on their respective expertise and responsibilities. The pieces are then integrated to yield the final detailed plan that will be executed onboard the ISS. Previous space programs have not distributed the planning and scheduling functions to this extent. Major ISS planning organizations are currently located in the United States (at both the NASA Johnson Space Center (JSC) and NASA Marshall Space Flight Center (MSFC)), in Russia, in Europe, and in Japan. Software systems have been developed by each of these planning organizations to support their assigned planning and scheduling functions. Although there is some cooperative development and sharing of key software components, each planning system has been tailored to meet the unique requirements and operational environment of the facility in which it operates. However, all the systems must operate in a coordinated fashion in order to effectively and efficiently produce a single integrated plan of ISS operations, in accordance with the established planning processes. This paper addresses lessons learned during the development of these multiple distributed planning systems, from the perspective of the developer of one of the software systems. The lessons focus on the coordination required to allow the multiple systems to operate together, rather than on the problems associated with the development of any particular system. Included in the paper is a discussion of typical problems faced during the development and coordination process, such as incompatible development schedules, difficulties in defining system interfaces, technical coordination and funding for shared tools, continually evolving planning concepts/requirements, programmatic and budget issues, and external influences. Techniques that mitigated some of these problems will also be addressed, along with recommendations for any future programs involving the development of multiple planning and scheduling systems. Many of these lessons learned are not unique to the area of planning and scheduling systems, so may be applied to other distributed ground systems that must operate in concert to successfully support space mission operations.

Maxwell, Theresa G.↗
NASA NTRS2021

Concept of Operations for OSIRIS-REx Optical Navigation Image Planning

Optical navigation (OpNav) is a critical subsystem of the OSIRIS-REx asteroid sample return mission, which operated in the vicinity of near-Earth asteroid (101955) Bennu from August 2018 through April 2021. A substantial amount of mission resources across multiple subsystems and institutions is required to ensure that the OpNav data are successfully acquired. The KinetX OpNav team, part of the Flight Dynamics System (FDS), is responsible for performing required analysis to develop the OpNav operations plans; requesting, reviewing and verifying the plans; and ultimately using the image data for critical navigation operations. The FDS team, responsible for the mission navigation, is operated by KinetX Aerospace with management and operations support from NASA’s Goddard Space Flight Center. The Science Processing and Operations Center (SPOC), located at the University of Arizona’s Lunar and Planetary Laboratory, is responsible for generating the planning products for all science and most OpNav data. These plans are integrated into the spacecraft sequences, tested, and commanded by the Mission Support Area (MSA) at Lockheed Martin Space. To ensure mission-critical navigation image data are successfully acquired, the plan is developed through a waterfall of planning cycles over the course of 3 months prior to onboard plan execution. During the initial strategic planning for a mission phase, detailed analysis is performed by the OpNav team to conceptualize the concept of operations (ConOps) for image data collection. This phase OpNav Narrative is included along with other strategic planning documents for the key ground segment stakeholders to review and provide feedback. The detailed OpNav plans get defined in the tactical planning cycle, which spans 8 to 3 weeks before the week-long integrated sequence is executed on-board the spacecraft. During the tactical cycle, the initial OpNav Request is submitted along with the science requests, kicking off development of the science and OpNav plans. Once the initial plan is drafted, interfaces are exercised so that the plan can be reviewed and iterated, if necessary. A rigorous schedule is followed by the planning teams during the implementation cycle, spanning the last 18 days before uplink, to ensure all the necessary integration, testing, and reviewing can occur on time. The development of the OpNav planning ConOps, including responsibilities, interfaces, timelines, and procedures, took extensive collaboration across mission elements and institutions. The process was robust throughout the 137 weeks of continuous Optical Navigation Operations at Bennu, which concluded on April 9th, 2021.

Coralie D. Adam↗
DOE OSTI2015

Drilling, Completion, and Data Collection Plans An Assessment of Geological Carbon Sequestration Options in the Illinois Basin: Phase III

Executive Summary The Illinois Basin – Decatur Project (IBDP) is managed by the Midwest Geological Sequestration Consortium (MGSC) and is led by the Illinois State Geological Survey (ISGS) at the University of Illinois. The project site is located on the Archer Daniels Midland Company (ADM) property in Decatur, Illinois, and is a fully integrated carbon capture and storage (CCS) project that uses CO₂ captured from the ethanol-producing fermentation process at the ADM corn-processing plant (Finley et. al., 2013). IBDP has a goal of injecting one million tonnes of CO₂ into the basal sands of the Mt. Simon Sandstone over a three-year period. This is a multifaceted project, and this report details the planning and results of the drilling, completions, well testing, log data acquisition, and the Health, Safety, and Environment (HSE) aspects of the project. Three deep wells were planned for the IBDP: • The injection well: Injection Well #1 (CCS1); • The monitoring well (both in-zone and above seal): Verification Well #1 (VW1); and • The geophone monitoring well: Geophysical Monitoring Well #1 (GM1). The detailed plans for these wells are attached to the appendices of this document. The wells were drilled successfully with little deviation from the original plans. The biggest change from the plan to execution was the need to adjust for larger-than-expected loss of circulation in the Potosi section of the Knox Formation. The completions reports also attached to this document detail the well constructions as they were actually built. Injectivity testing was carried out, and the perforating plans were adjusted based on the results. Additional perforations and acidizing were performed as a result of the injectivity testing. The testing plans are detailed in this report along with the actual testing results. The injectivity testing results were used in the modeling and simulation efforts. Detailed HSE plans were developed and implemented during the planning and execution phases of the project. The implementation included an HSE Bridging Document, which served to unify the HSE policies of the project partners and key subcontractors. The HSE plan and actual HSE results are presented in this document. There were no recordable HSE incidents during the project. A detailed logging program was developed based on project needs. The log data were acquired in accordance with the plan, and both the plan and log results are presented in this report. Log data were heavily utilized by the research staff, modelers, reservoir engineers, and for technical and permitting efforts. 5 Several key lessons were learned during the project: • Safety in operations and execution is paramount and is only achieved through proper planning and behavior control. The certainty of this was reinforced through implementation of this lesson and the resultant flawless HSE performance during the project. • Losses of drilling fluid circulation were larger than anticipated within the Potosi Formation. Circulation was only recovered through cementing the loss zones. • When possible, minimizing complexity in permit requirements and well designs is preferable. • The size of the wells were outside of the standard experience and expertise typical within the basin, and therefore required substantial planning and ramp-up of contractors and partners to meet project objectives. • With multiple stakeholders and research partners, establishing objectives and requirements early and adhering to change request procedures throughout the project are critical to manage competing data and sampling objectives that may be detrimental to overall progress. The well construction and completion operations were successfully executed, with all wells built in a manner that achieved excellent wellbore integrity. Log planning involved a number of stakeholders and technical specialists. Data collection from logging, coring, and testing was excellent. Time and effort spent with the associated contractors and suppliers to develop a well plan beyond normal scope proved highly successful, resulting in a well-construction and completion project that surpassed expectations. The world-class HSE results also demonstrate the commitment of all stakeholders in the project. The details follow in the body of this document

01 COAL, LIGNITE, AND PEAT↗
DOE OSTI2014

Clinical Implementation of an Online Adaptive Plan-of-the-Day Protocol for Nonrigid Motion Management in Locally Advanced Cervical Cancer IMRT

Purpose: To evaluate the clinical implementation of an online adaptive plan-of-the-day protocol for nonrigid target motion management in locally advanced cervical cancer intensity modulated radiation therapy (IMRT). Methods and Materials: Each of the 64 patients had four markers implanted in the vaginal fornix to verify the position of the cervix during treatment. Full and empty bladder computed tomography (CT) scans were acquired prior to treatment to build a bladder volume-dependent cervix-uterus motion model for establishment of the plan library. In the first phase of clinical implementation, the library consisted of one IMRT plan based on a single model-predicted internal target volume (mpITV), covering the target for the whole pretreatment observed bladder volume range, and a 3D conformal radiation therapy (3DCRT) motion-robust backup plan based on the same mpITV. The planning target volume (PTV) combined the ITV and nodal clinical target volume (CTV), expanded with a 1-cm margin. In the second phase, for patients showing >2.5-cm bladder-induced cervix-uterus motion during planning, two IMRT plans were constructed, based on mpITVs for empty-to-half-full and half-full-to-full bladder. In both phases, a daily cone beam CT (CBCT) scan was acquired to first position the patient based on bony anatomy and nodal targets and then select the appropriate plan. Daily post-treatment CBCT was used to verify plan selection. Results: Twenty-four and 40 patients were included in the first and second phase, respectively. In the second phase, 11 patients had two IMRT plans. Overall, an IMRT plan was used in 82.4% of fractions. The main reasons for selecting the motion-robust backup plan were uterus outside the PTV (27.5%) and markers outside their margin (21.3%). In patients with two IMRT plans, the half-full-to-full bladder plan was selected on average in 45% of the first 12 fractions, which was reduced to 35% in the last treatment fractions. Conclusions: The implemented online adaptive plan-of-the-day protocol for locally advanced cervical cancer enables (almost) daily tissue-sparing IMRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a {sup 60}Co Magnetic Resonance Image Guidance Radiation Therapy System

Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating {sup 60}Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create {sup 60}Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The {sup 60}Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All {sup 60}Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for {sup 60}Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all {sup 60}Co plan OARs were within clinical tolerances. Conclusions: A commercial {sup 60}Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Independent calculation-based verification of IMRT plans using a 3D dose-calculation engine

Independent monitor unit verification of intensity-modulated radiation therapy (IMRT) plans requires detailed 3-dimensional (3D) dose verification. The aim of this study was to investigate using a 3D dose engine in a second commercial treatment planning system (TPS) for this task, facilitated by in-house software. Our department has XiO and Pinnacle TPSs, both with IMRT planning capability and modeled for an Elekta-Synergy 6 MV photon beam. These systems allow the transfer of computed tomography (CT) data and RT structures between them but do not allow IMRT plans to be transferred. To provide this connectivity, an in-house computer programme was developed to convert radiation therapy prescription (RTP) files as generated by many planning systems into either XiO or Pinnacle IMRT file formats. Utilization of the technique and software was assessed by transferring 14 IMRT plans from XiO and Pinnacle onto the other system and performing 3D dose verification. The accuracy of the conversion process was checked by comparing the 3D dose matrices and dose volume histograms (DVHs) of structures for the recalculated plan on the same system. The developed software successfully transferred IMRT plans generated by 1 planning system into the other. Comparison of planning target volume (TV) DVHs for the original and recalculated plans showed good agreement; a maximum difference of 2% in mean dose, − 2.5% in D95, and 2.9% in V95 was observed. Similarly, a DVH comparison of organs at risk showed a maximum difference of +7.7% between the original and recalculated plans for structures in both high- and medium-dose regions. However, for structures in low-dose regions (less than 15% of prescription dose) a difference in mean dose up to +21.1% was observed between XiO and Pinnacle calculations. A dose matrix comparison of original and recalculated plans in XiO and Pinnacle TPSs was performed using gamma analysis with 3%/3 mm criteria. The mean and standard deviation of pixels passing gamma tolerance for XiO-generated IMRT plans was 96.1 ± 1.3, 96.6 ± 1.2, and 96.0 ± 1.5 in axial, coronal, and sagittal planes respectively. Corresponding results for Pinnacle-generated IMRT plans were 97.1 ± 1.5, 96.4 ± 1.2, and 96.5 ± 1.3 in axial, coronal, and sagittal planes respectively.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Multicriteria optimization informed VMAT planning

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Advantages and limitations of navigation-based multicriteria optimization (MCO) for localized prostate cancer IMRT planning

Efficacy of inverse planning is becoming increasingly important for advanced radiotherapy techniques. This study’s aims were to validate multicriteria optimization (MCO) in RayStation (v2.4, RaySearch Laboratories, Sweden) against standard intensity-modulated radiation therapy (IMRT) optimization in Oncentra (v4.1, Nucletron BV, the Netherlands) and characterize dose differences due to conversion of navigated MCO plans into deliverable multileaf collimator apertures. Step-and-shoot IMRT plans were created for 10 patients with localized prostate cancer using both standard optimization and MCO. Acceptable standard IMRT plans with minimal average rectal dose were chosen for comparison with deliverable MCO plans. The trade-off was, for the MCO plans, managed through a user interface that permits continuous navigation between fluence-based plans. Navigated MCO plans were made deliverable at incremental steps along a trajectory between maximal target homogeneity and maximal rectal sparing. Dosimetric differences between navigated and deliverable MCO plans were also quantified. MCO plans, chosen as acceptable under navigated and deliverable conditions resulted in similar rectal sparing compared with standard optimization (33.7 ± 1.8 Gy vs 35.5 ± 4.2 Gy, p = 0.117). The dose differences between navigated and deliverable MCO plans increased as higher priority was placed on rectal avoidance. If the best possible deliverable MCO was chosen, a significant reduction in rectal dose was observed in comparison with standard optimization (30.6 ± 1.4 Gy vs 35.5 ± 4.2 Gy, p = 0.047). Improvements were, however, to some extent, at the expense of less conformal dose distributions, which resulted in significantly higher doses to the bladder for 2 of the 3 tolerance levels. In conclusion, similar IMRT plans can be created for patients with prostate cancer using MCO compared with standard optimization. Limitations exist within MCO regarding conversion of navigated plans to deliverable apertures, particularly for plans that emphasize avoidance of critical structures. Minimizing these differences would result in better quality treatments for patients with prostate cancer who were treated with radiotherapy using MCO plans.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2017

Functional image-guided stereotactic body radiation therapy planning for patients with hepatocellular carcinoma

The aim of the current planning study is to evaluate the ability of gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI)–guided stereotactic body radiation therapy (SBRT) planning by using intensity-modulated radiation therapy (IMRT) techniques in sparing the functional liver tissues during SBRT for hepatocellular carcinoma. In this study, 20 patients with hepatocellular carcinoma were enrolled. Functional liver tissues were defined according to quantitative liver-spleen contrast ratios ≥ 1.5 on a hepatobiliary phase scan. Functional images were fused with the planning computed tomography (CT) images; the following 2 SBRT plans were designed using a “step-and-shoot” static IMRT technique for each patient: (1) an anatomical SBRT plan optimization based on the total liver; and (2) a functional SBRT plan based on the functional liver. The total prescribed dose was 48 gray (Gy) in 4 fractions. Dosimetric parameters, including dose to 95% of the planning target volume (PTV D{sub 95%}), percentages of total and functional liver volumes, which received doses from 5 to 30 Gy (V5 to V30 and fV5 to fV30), and mean doses to total and functional liver (MLD and fMLD, respectively) of the 2 plans were compared. Compared with anatomical plans, functional image-guided SBRT plans reduced MLD (mean: plan A, 5.5 Gy; and plan F, 5.1 Gy; p < 0.0001) and fMLD (mean: plan A, 5.4 Gy; and plan F, 4.9 Gy; p < 0.0001), as well as V5 to V30 and fV5 to fV30. No differences were noted in PTV coverage and nonhepatic organs at risk (OARs) doses. In conclusion, EOB-MRI–guided SBRT planning using the IMRT technique may preserve functional liver tissues in patients with hepatocellular carcinoma (HCC).

61 RADIATION PROTECTION AND DOSIMETRY↗