Results for “Implementation” — Page 21

DOE OSTI2025

Implementation and Demonstration of the Digital Twin Certification System Remote Operations Framework

Microreactors are one promising advanced-reactor concept being pursued by the nuclear industry. They are distinguished by a relatively low power output of 20 MWth or less. These microreactors are intended for deployment in applications where conventional small-capacity power solutions, such as diesel generators, are either economically unfeasible or logistically challenging. Such applications include providing electric power and/or heat for remote communities, mining sites, defense installations, and humanitarian and disaster-relief missions. An important feature for the successful deployment of microreactors is their capability to be operated remotely. This capability can significantly reduce staffing costs by eliminating the need for licensed operators to be physically present at each reactor site. Instead, operators can be centralized in a single remote operations center placed in an economically advantageous location, thereby optimizing resources by consolidating expertise and enhancing operational efficiency. However, the implementation of a remote operation system for nuclear reactors raises new concerns regarding the security, reliability, and resilience of such a system. One way in which remote operations can be supported in a manner that maintains system security, reliability, and resilience is through the use of digital twins in a novel framework designed to verify and validate sensor data and commands communicated between the remote operations center and reactor. This framework, known as the Digital Twin Certification System (DTCS), has previously been proposed as an operations architecture that can bring security and resiliency levels of remote nuclear-reactor operations to a level acceptable for commercial deployment. This paper moves the proposed DTCS architecture from concept to reality by presenting the implementation and testing of the system. The rationale and implementation of the DTCS using tools such as DeepLynx and Apache Airflow, is covered in-depth. This is followed by a demonstration of the DTCS by applying the implemented system architecture to the Single Primary Heat Extraction and Removal Emulator, a small-scale non-nuclear test bed that emulates thermal behavior of a microreactor. The demonstration includes both normal and abnormal operating scenarios to highlight how the DTCS can increase the security, reliability, and resilience of a remote operations system.

22 - GENERAL STUDIES OF NUCLEAR REACTORS↗

DOE OSTI2025

Implementation and Demonstration of the Digital Twin Certification System Remote Operations Framework

Microreactors are one promising advanced-reactor concept being pursued by the nuclear industry. They are distinguished by a relatively low power output of 20 MWth or less. These microreactors are intended for deployment in applications where conventional small-capacity power solutions, such as diesel generators, are either economically unfeasible or logistically challenging. Such applications include providing electric power and/or heat for remote communities, mining sites, defense installations, and humanitarian and disaster-relief missions. An important feature for the successful deployment of microreactors is their capability to be operated remotely. This capability can significantly reduce staffing costs by eliminating the need for licensed operators to be physically present at each reactor site. Instead, operators can be centralized in a single remote operations center placed in an economically advantageous location, thereby optimizing resources by consolidating expertise and enhancing operational efficiency. However, the implementation of a remote operation system for nuclear reactors raises new concerns regarding the security, reliability, and resilience of such a system. One way in which remote operations can be supported in a manner that maintains system security, reliability, and resilience is through the use of digital twins in a novel framework designed to verify and validate sensor data and commands communicated between the remote operations center and reactor. This framework, known as the Digital Twin Certification System (DTCS), has previously been proposed as an operations architecture that can bring security and resiliency levels of remote nuclear-reactor operations to a level acceptable for commercial deployment. This paper moves the proposed DTCS architecture from concept to reality by presenting the implementation and testing of the system. The rationale and implementation of the DTCS using tools such as DeepLynx and Apache Airflow, is covered in-depth. This is followed by a demonstration of the DTCS by applying the implemented system architecture to the Single Primary Heat Extraction and Removal Emulator, a small-scale non-nuclear test bed that emulates thermal behavior of a microreactor. The demonstration includes both normal and abnormal operating scenarios to highlight how the DTCS can increase the security, reliability, and resilience of a remote operations system.

22 - GENERAL STUDIES OF NUCLEAR REACTORS↗

DOE OSTI2017

Evaluation of the environmental impact assessment system and implementation in Myanmar: Its significance in oil and gas industry

Myanmar's political and economic transformation and drastic expansion of foreign direct investment in natural resource sector necessitate systematic safeguards to mitigate impacts from its development activities. Myanmar promulgated the first national EIA law and procedure only recently, in 2016, and the country's institutional and financial capacity is extremely limited to implement effective EIA. This article evaluates Myanmar's EIA system against a set of evaluative criteria developed by Wood (1995) and modified by Annandle (2001). The evaluation was based on the review of the literature, investigation of EIA legislative and administrative framework, and several other sources of data and information. Opinions of professionals from international and government agencies, and researchers are also solicited. The paper then evaluates the rate of EIA disclosure in O&G sector and whether EIA in Myanmar is significance in mitigating the impact of O&G operations on the environment. The review of EIA system indicates that Myanmar generally has sound legal and administrative framework for EIA, however, its practical implementation reveals several major challenges and weaknesses. The presence of more than one standard EIA procedure and lack of inter-departmental coordination and consultation are also major concerns. Overall, the quality of EIA reports and the level of disclosure in O&G sector is higher than that of other sectors in Myanmar. Through the analysis, the paper summarizes the fundamental challenges faced by companies and government, opportunities and good practices in implementing EIA systems and propose recommendations to strengthen EIA performance. The findings of this study expect to contribute to strengthening EIA system and performance in Myanmar and other developing countries, especially in Southeast Asia.

02 PETROLEUM↗

DOE OSTI2012

A One-Step Cone-Beam CT-Enabled Planning-to-Treatment Model for Palliative Radiotherapy-From Development to Implementation

Purpose: To develop a cone-beam computed tomography (CT)-enabled one-step simulation-to-treatment process for the treatment of bone metastases. Methods and Materials: A three-phase prospective study was conducted. Patients requiring palliative radiotherapy to the spine, mediastinum, or abdomen/pelvis suitable for treatment with simple beam geometry ({<=}2 beams) were accrued. Phase A established the accuracy of cone-beam CT images for the purpose of gross tumor target volume (GTV) definition. Phase B evaluated the feasibility of implementing the cone-beam CT-enabled planning process at the treatment unit. Phase C evaluated the online cone-beam CT-enabled process for the planning and treatment of patients requiring radiotherapy for bone metastases. Results: Eighty-four patients participated in this study. Phase A (n = 9) established the adequacy of cone-beam CT images for target definition. Phase B (n = 45) established the quality of treatment plans to be adequate for clinical implementation for bone metastases. When the process was applied clinically in bone metastases (Phase C), the degree of overlap between planning computed tomography (PCT) and cone-beam CT for GTV and between PCT and cone-beam CT for treatment field was 82% {+-} 11% and 97% {+-} 4%, respectively. The oncologist's decision to accept the plan under a time-pressured environment remained of high quality, with the cone-beam CT-generated treatment plan delivering at least 90% of the prescribed dose to 100% {+-} 0% of the cone-beam CT planning target volume (PTV). With the assumption that the PCT PTV is the gold-standard target, the cone-beam CT-generated treatment plan delivered at least 90% and at least 95% of dose to 98% {+-} 2% and 97% {+-} 5% of the PCT PTV, respectively. The mean time for the online planning and treatment process was 32.7 {+-} 4.0 minutes. Patient satisfaction was high, with a trend for superior satisfaction with the cone-beam CT-enabled process. Conclusions: The cone-beam CT-enabled palliative treatment process is feasible and is ready for clinical implementation for the treatment of bone metastases using simple beam geometry, providing a streamlined one-step process toward palliative radiotherapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2012

An efficient mixed-precision, hybrid CPU-GPU implementation of a nonlinearly implicit one-dimensional particle-in-cell algorithm

Recently, a fully implicit, energy- and charge-conserving particle-in-cell method has been developed for multi-scale, full-f kinetic simulations [G. Chen, et al., J. Comput. Phys. 230, 18 (2011)]. The method employs a Jacobian-free Newton-Krylov (JFNK) solver and is capable of using very large timesteps without loss of numerical stability or accuracy. A fundamental feature of the method is the segregation of particle orbit integrations from the field solver, while remaining fully self-consistent. This provides great flexibility, and dramatically improves the solver efficiency by reducing the degrees of freedom of the associated nonlinear system. However, it requires a particle push per nonlinear residual evaluation, which makes the particle push the most time-consuming operation in the algorithm. This paper describes a very efficient mixed-precision, hybrid CPU-GPU implementation of the implicit PIC algorithm. The JFNK solver is kept on the CPU (in double precision), while the inherent data parallelism of the particle mover is exploited by implementing it in single-precision on a graphics processing unit (GPU) using CUDA. Performance-oriented optimizations, with the aid of an analytical performance model, the roofline model, are employed. Despite being highly dynamic, the adaptive, charge-conserving particle mover algorithm achieves up to 300 400 GOp/s (including single-precision floating-point, integer, and logic operations) on a Nvidia GeForce GTX580, corresponding to 20 25% absolute GPU efficiency (against the peak theoretical performance) and 50-70% intrinsic efficiency (against the algorithm s maximum operational throughput, which neglects all latencies). This is about 200-300 times faster than an equivalent serial CPU implementation. When the single-precision GPU particle mover is combined with a double-precision CPU JFNK field solver, overall performance gains 100 vs. the double-precision CPU-only serial version are obtained, with no apparent loss of robustness or accuracy when applied to a challenging long-time scale ion acoustic wave simulation.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2012

Event-Based Parareal: A data-flow based implementation of parareal

Parareal is an iterative algorithm that, in effect, achieves temporal decomposition for a time-dependent system of differential or partial differential equations. A solution is obtained in a shorter wall-clock time, but at the expense of increased compute cycles. The algorithm combines a fine solver that solves the system to acceptable accuracy with an approximate coarse solver. The critical task for the successful implementation of parareal on any system is the development of a coarse solver that leads to convergence in a small number of iterations compared to the number of time slices in the full time interval, and is, at the same time, much faster than the fine solver. Fast coarse solvers may not lead to sufficiently rapid convergence, and slow coarse solvers may not lead to significant gains even if the number of iterations to convergence is satisfactory. We find that the difficulty of meeting these conflicting demands can be substantially eased by using a data-driven, event-based implementation of parareal instead of the conventional algorithm where solver tasks are executed sequentially. For given convergence properties, the event-based approach relaxes the speed requirements on the coarse solver by a factor of , where is the number of iterations required for a converged solution. This may, for many problems, lead to an efficient parareal implementation that would otherwise not be possible or would require substantial coarse solver development.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2014

Implementation of data acquisition interface using on-board field-programmable gate array (FPGA) universal serial bus (USB) link

Typically a system consists of hardware as the controller and software which is installed in the personal computer (PC). In the effective nuclear detection, the hardware involves the detection setup and the electronics used, with the software consisting of analysis tools and graphical display on PC. A data acquisition interface is necessary to enable the communication between the controller hardware and PC. Nowadays, Universal Serial Bus (USB) has become a standard connection method for computer peripherals and has replaced many varieties of serial and parallel ports. However the implementation of USB is complex. This paper describes the implementation of data acquisition interface between a field-programmable gate array (FPGA) board and a PC by exploiting the USB link of the FPGA board. The USB link is based on an FTDI chip which allows direct access of input and output to the Joint Test Action Group (JTAG) signals from a USB host and a complex programmable logic device (CPLD) with a 24 MHz clock input to the USB link. The implementation and results of using the USB link of FPGA board as the data interfacing are discussed.

42 ENGINEERING↗

DOE OSTI2016

An integral-factorized implementation of the driven similarity renormalization group second-order multireference perturbation theory

We report an efficient implementation of a second-order multireference perturbation theory based on the driven similarity renormalization group (DSRG-MRPT2) [C. Li and F. A. Evangelista, J. Chem. Theory Comput. 11, 2097 (2015)]. Our implementation employs factorized two-electron integrals to avoid storage of large four-index intermediates. It also exploits the block structure of the reference density matrices to reduce the computational cost to that of second-order Møller–Plesset perturbation theory. Our new DSRG-MRPT2 implementation is benchmarked on ten naphthyne isomers using basis sets up to quintuple-ζ quality. We find that the singlet-triplet splittings (Δ{sub ST}) of the naphthyne isomers strongly depend on the equilibrium structures. For a consistent set of geometries, the Δ{sub ST} values predicted by the DSRG-MRPT2 are in good agreements with those computed by the reduced multireference coupled cluster theory with singles, doubles, and perturbative triples.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2013

IMPLEMENTATION OF SINK PARTICLES IN THE ATHENA CODE

We describe the implementation and tests of sink particle algorithms in the Eulerian grid-based code Athena. The introduction of sink particles enables the long-term evolution of systems in which localized collapse occurs, and it is impractical (or unnecessary) to resolve the accretion shocks at the centers of collapsing regions. We discuss the similarities and differences of our methods compared to other implementations of sink particles. Our criteria for sink creation are motivated by the properties of the Larson-Penston collapse solution. We use standard particle-mesh methods to compute particle and gas gravity together. Accretion of mass and momenta onto sinks is computed using fluxes returned by the Riemann solver. A series of tests based on previous analytic and numerical collapse solutions is used to validate our method and implementation. We demonstrate use of our code for applications with a simulation of planar converging supersonic turbulent flow, in which multiple cores form and collapse to create sinks; these sinks continue to interact and accrete from their surroundings over several Myr.

79 ASTRONOMY AND ASTROPHYSICS↗

DOE OSTI2014

Simple implementation of general dark energy models

We present a formalism for the numerical implementation of general theories of dark energy, combining the computational simplicity of the equation of state for perturbations approach with the generality of the effective field theory approach. An effective fluid description is employed, based on a general action describing single-scalar field models. The formalism is developed from first principles, and constructed keeping the goal of a simple implementation into CAMB in mind. Benefits of this approach include its straightforward implementation, the generality of the underlying theory, the fact that the evolved variables are physical quantities, and that model-independent phenomenological descriptions may be straightforwardly investigated. We hope this formulation will provide a powerful tool for the comparison of theoretical models of dark energy with observational data.

79 ASTRONOMY AND ASTROPHYSICS↗

DOE OSTI2011

Quantum computers: Definition and implementations

The DiVincenzo criteria for implementing a quantum computer have been seminal in focusing both experimental and theoretical research in quantum-information processing. These criteria were formulated specifically for the circuit model of quantum computing. However, several new models for quantum computing (paradigms) have been proposed that do not seem to fit the criteria well. Therefore, the question is what are the general criteria for implementing quantum computers. To this end, a formal operational definition of a quantum computer is introduced. It is then shown that, according to this definition, a device is a quantum computer if it obeys the following criteria: Any quantum computer must consist of a quantum memory, with an additional structure that (1) facilitates a controlled quantum evolution of the quantum memory; (2) includes a method for information theoretic cooling of the memory; and (3) provides a readout mechanism for subsets of the quantum memory. The criteria are met when the device is scalable and operates fault tolerantly. We discuss various existing quantum computing paradigms and how they fit within this framework. Finally, we present a decision tree for selecting an avenue toward building a quantum computer. This is intended to help experimentalists determine the most natural paradigm given a particular physical implementation.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

DOE OSTI2014

Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT

Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry-mounted x-ray imager as input, making this method potentially more widely available than dedicated real-time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM. Methods: Informed by and adapting existing guideline documents from other real-time monitoring systems, KIM-specific QA practices were developed. The following five KIM-specific QA tests were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient-derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is <1 s. The tolerances for all other tests are that both the mean and standard deviation of the difference between the programmed trajectory and the measured data are <1 mm. The (5) clinical conditions accuracy test compared the KIM measured positions with those measured by kV/megavoltage (MV) triangulation from five treatment fractions acquired in a previous pilot study. Results: For the (1) static localization, (2) dynamic localization, and (3) treatment interruption accuracy tests, the mean and standard deviation of the difference are <1.0 mm. (4) The measured latency is 350 ms. (5) For the tests with previously acquired patient data, the mean and standard deviation of the difference between KIM and kV/MV triangulation are <1.0 mm. Conclusions: Clinical process and QA practices for the safe clinical implementation of KIM, a novel real-time monitoring system using commonly available equipment, have been developed and implemented for prostate cancer VMAT.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

TU-C-201-02: Clinical Implementation of HDR: Afterloader and Applicator Selection

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for each institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-P-04: Implementation of Dose Monitoring Software: Successes and Pitfalls

Purpose: to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management. Methods: Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On-site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’. Results: We are routinely using DMS as a tool in our Clinical Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability. Conclusion: Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

MO-E-BRC-00: Online Adaptive Radiotherapy - Considerations for Practical Clinical Implementation

Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled the implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

MO-E-BRC-01: Online Adaptive MR-Guided RT: Workflow and Clinical Implementation

Online adaptive radiation therapy has the potential to ensure delivery of optimal treatment to the patient by accounting for anatomical and potentially functional changes that occur from one fraction to the next and over the course of treatment. While on-line adaptive RT (ART) has been a topic of many publications, discussions, and research, it has until very recently remained largely a concept and not a practical implementation. However, recent advances in on-table imaging, use of deformable image registration for contour generation and dose tracking, faster and more efficient plan optimization, as well as fast quality assurance method has enabled the implementation of ART in the clinic in the past couple of years. The introduction of these tools into routine clinical use requires many considerations and progressive knowledge to understand how processes that have historically taken hours/days to complete can now be done in less than 30 minutes. This session will discuss considerations to perform real time contouring, planning and patient specific QA, as well as a practical workflow and the required resources. Learning Objectives: To understand the difficulties, challenges and available technologies for online adaptive RT. To understand how to implement online adaptive therapy in a clinical environment and to understand the workflow and resources required. To understand the limitations and sources of uncertainty in the online adaptive process I have research funding from ViewRay Inc. and Philips Medical Systems.; R. Kashani, I have research funding from ViewRay Inc. and Philips Medical Systems.; X. Li, Research supported by Elekta Inc.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TU-FG-201-12: Designing a Risk-Based Quality Assurance Program for a Newly Implemented Y-90 Microspheres Procedure

Purpose: To create a quality assurance program based upon a risk-based assessment of a newly implemented SirSpheres Y-90 procedure. Methods: A process map was created for a newly implemented SirSpheres procedure at a community hospital. The process map documented each step of this collaborative procedure, as well as the roles and responsibilities of each member. From the process map, different potential failure modes were determined as well as any current controls in place. From this list, a full failure mode and effects analysis (FMEA) was performed by grading each failure mode’s likelihood of occurrence, likelihood of detection, and potential severity. These numbers were then multiplied to compute the risk priority number (RPN) for each potential failure mode. Failure modes were then ranked based on their RPN. Additional controls were then added, with failure modes corresponding to the highest RPNs taking priority. Results: A process map was created that succinctly outlined each step in the SirSpheres procedure in its current implementation. From this, 72 potential failure modes were identified and ranked according to their associated RPN. Quality assurance controls and safety barriers were then added for failure modes associated with the highest risk being addressed first. Conclusion: A quality assurance program was created from a risk-based assessment of the SirSpheres process. Process mapping and FMEA were effective in identifying potential high-risk failure modes for this new procedure, which were prioritized for new quality assurance controls. TG 100 recommends the fault tree analysis methodology to design a comprehensive and effective QC/QM program, yet we found that by simply introducing additional safety barriers to address high RPN failure modes makes the whole process simpler and safer.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-209-00: Practical Implementation of Deep Inspiration Breath Hold Techniques for Breast Radiation Therapy

Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased. Also, in a majority of DIBH patients, the air drawn into the thoracic cavity increases the total lung volume. The DIBH was discussed by an AAPM Task Group 10 years ago in the AAPM TG 76 report. However, DIBH is still not the standard of care in many clinics, which may be partially due to challenges associated with its implementation. Therefore, this seccion will focus primarily on how to clinically implement four different DIBH techniques: (1) Active Breathing Control, (2) Spirometric Motion Management, (3) 3D Surface Image-Guided, and (4) Self-held Breath Control with Respiratory Monitoring and Feedback Guidance. Learning Objectives: Describe the physical displacement of the heart and the change in lung volume during DIBH and discuss dosimetric consequences of those changes. Provide an overview of the technical aspects. Describe work flow for patient simulation and treatment. Give an overview of commissioning and routine. Provide practical tips for clinical implementation.

60 APPLIED LIFE SCIENCES↗