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Complex optimization for big computational and experimental neutron datasets

Here, we present a framework to use high performance computing to determine accurate solutions to the inverse optimization problem of big experimental data against computational models. We demonstrate how image processing, mathematical regularization, and hierarchical modeling can be used to solve complex optimization problems on big data. We also demonstrate how both model and data information can be used to further increase solution accuracy of optimization by providing confidence regions for the processing and regularization algorithms. Finally, we use the framework in conjunction with the software package SIMPHONIES to analyze results from neutron scattering experiments on silicon single crystals, and refine first principles calculations to better describe the experimental data.

36 MATERIALS SCIENCE↗

Retrieval of high time resolution growth factor probability density function from a humidity-controlled fast integrated mobility spectrometer

Hygroscopicity describes the tendency of aerosol particle to uptake water and is among the key parameters in determining the impact of atmospheric aerosols on global radiation and climate. A hygroscopicity tandem differential mobility analyzer (HTDMA) system is the most widely utilized instrument for determining the aerosol hygroscopic growth. Because of the time needed to scan the classifying voltage of the DMA, HTDMA measurement normally requires a minimum of 30 min to characterize the particle hygroscopic growth at a single relative humidity for five to six different sizes. This slow speed is often inadequate for measurements onboard mobile platforms or when aerosols evolve rapidly. Recently, a humidity-controlled fast integrated mobility spectrometer (HFIMS) was developed for measuring the hygroscopic growth of particles. The measurement speed of the HFIMS is about one order of magnitude faster than that of the conventional HTDMA. Here, a data inversion routine is developed to retrieve the growth factor probability density function (GF-PDF) of particles measured by the HFIMS. The inversion routine considers the transfer functions of the upstream DMA and the downstream water-based fast integrated mobility spectrometer (FIMS), and derives the GF-PDF that reproduces the measured responses of the HFIMS. The performance of the inversion routine is examined using ambient measurements with different assumptions for the spectral shape of the particle GF-PDF (multimodal lognormal or piecewise linear). The influences of the data inversion parameters and counting statistics on the inverted GF-PDFs were further investigated, and an approach to determine the optimized inversion parameters is presented.

47 OTHER INSTRUMENTATION↗

SU-F-BRD-01: A Logistic Regression Model to Predict Objective Function Weights in Prostate Cancer IMRT

Purpose: To develop a statistical model that predicts optimization objective function weights from patient geometry for intensity-modulation radiotherapy (IMRT) of prostate cancer. Methods: A previously developed inverse optimization method (IOM) is applied retrospectively to determine optimal weights for 51 treated patients. We use an overlap volume ratio (OVR) of bladder and rectum for different PTV expansions in order to quantify patient geometry in explanatory variables. Using the optimal weights as ground truth, we develop and train a logistic regression (LR) model to predict the rectum weight and thus the bladder weight. Post hoc, we fix the weights of the left femoral head, right femoral head, and an artificial structure that encourages conformity to the population average while normalizing the bladder and rectum weights accordingly. The population average of objective function weights is used for comparison. Results: The OVR at 0.7cm was found to be the most predictive of the rectum weights. The LR model performance is statistically significant when compared to the population average over a range of clinical metrics including bladder/rectum V53Gy, bladder/rectum V70Gy, and mean voxel dose to the bladder, rectum, CTV, and PTV. On average, the LR model predicted bladder and rectum weights that are both 63% closer to the optimal weights compared to the population average. The treatment plans resulting from the LR weights have, on average, a rectum V70Gy that is 35% closer to the clinical plan and a bladder V70Gy that is 43% closer. Similar results are seen for bladder V54Gy and rectum V54Gy. Conclusion: Statistical modelling from patient anatomy can be used to determine objective function weights in IMRT for prostate cancer. Our method allows the treatment planners to begin the personalization process from an informed starting point, which may lead to more consistent clinical plans and reduce overall planning time.

60 APPLIED LIFE SCIENCES↗

Models for predicting objective function weights in prostate cancer IMRT

Purpose: To develop and evaluate the clinical applicability of advanced machine learning models that simultaneously predict multiple optimization objective function weights from patient geometry for intensity-modulated radiation therapy of prostate cancer. Methods: A previously developed inverse optimization method was applied retrospectively to determine optimal objective function weights for 315 treated patients. The authors used an overlap volume ratio (OV) of bladder and rectum for different PTV expansions and overlap volume histogram slopes (OVSR and OVSB for the rectum and bladder, respectively) as explanatory variables that quantify patient geometry. Using the optimal weights as ground truth, the authors trained and applied three prediction models: logistic regression (LR), multinomial logistic regression (MLR), and weighted K-nearest neighbor (KNN). The population average of the optimal objective function weights was also calculated. Results: The OV at 0.4 cm and OVSR at 0.1 cm features were found to be the most predictive of the weights. The authors observed comparable performance (i.e., no statistically significant difference) between LR, MLR, and KNN methodologies, with LR appearing to perform the best. All three machine learning models outperformed the population average by a statistically significant amount over a range of clinical metrics including bladder/rectum V53Gy, bladder/rectum V70Gy, and dose to the bladder, rectum, CTV, and PTV. When comparing the weights directly, the LR model predicted bladder and rectum weights that had, on average, a 73% and 74% relative improvement over the population average weights, respectively. The treatment plans resulting from the LR weights had, on average, a rectum V70Gy that was 35% closer to the clinical plan and a bladder V70Gy that was 29% closer, compared to the population average weights. Similar results were observed for all other clinical metrics. Conclusions: The authors demonstrated that the KNN and MLR weight prediction methodologies perform comparably to the LR model and can produce clinical quality treatment plans by simultaneously predicting multiple weights that capture trade-offs associated with sparing multiple OARs.

60 APPLIED LIFE SCIENCES↗

Enhanced mechanical property evaluation using innovative data analytics capability

This report focuses on efforts to improve Multiphysics Object-Oriented Simulation Environ-ment (MOOSE) for mechanical property evaluation using data analytics. These efforts involveimprovements to the stochastic tools module (STM) for stochastic simulations of MOOSE mul-tiphysics model and the development of inverse optimization capabilities. The report gives anoverview of the STM and describes recent updates to its core capabilities and theory on itsreduced-order model (ROM) schemes. Examples are also provided showing the impact of theseupdates and exhibits the usefulness of ROMs. An overview of the gradient based inverse opti-mziation algorithms are given along with examples of their application to source identification.Inverse optimization will provide a new methodology in STM for fitting model parameters toexperimental data.

97 MATHEMATICS AND COMPUTING↗

Anthropogenic emissions of NOx over China: Reconciling the difference of inverse modeling results using GOME-2 and OMI measurements

Inverse modeling using satellite observations of nitrogen dioxide (NO2) columns has been extensively used to estimate nitrogen oxides (NOx) emissions in China. Recently, the Global Ozone Monitoring Experiment-2 (GOME-2) and Ozone Monitoring Instrument (OMI) provide independent global NO2 column measurements on a nearly daily basis at around 9:30 and 13:30 local time across the equator, respectively. Anthropogenic NOx emission estimates by applying previously developed monthly inversion (MI) or daily inversion (DI) methods to these two sets of measurements show substantial differences. We improve the DI method by conducting model simulation, satellite retrieval, and inverse modeling sequentially on a daily basis. After each inversion, we update anthropogenic NOx emissions in the model simulation with the newly obtained a posteriori results. Consequently, the inversion-optimized emissions are used to compute the a priori NO2 profiles for satellite retrievals. As such, the a priori profiles used in satellite retrievals are now coupled to inverse modeling results. The improved procedure was applied to GOME-2 and OMI NO2 measurements in 2011. The new daily retrieval-inversion (DRI) method estimates an average NOx emission of 6.9 Tg N/yr over China, and the difference between using GOME-2 and OMI measurements is 0.4 Tg N/yr, which is significantly smaller than the difference of 1.3 Tg N/yr using the previous DI method. Using the more consistent DRI inversion results, we find that anthropogenic NOx emissions tend to be higher in winter and summer than spring (and possibly fall) and the weekday-to-weekend emission ratio tends to increase with NOx emission in China.

Gu, Dasa↗

Inverse transport calculations in optical imaging with subspace optimization algorithms

Inverse boundary value problems for the radiative transport equation play an important role in optics-based medical imaging techniques such as diffuse optical tomography (DOT) and fluorescence optical tomography (FOT). Despite the rapid progress in the mathematical theory and numerical computation of these inverse problems in recent years, developing robust and efficient reconstruction algorithms remains a challenging task and an active research topic. We propose here a robust reconstruction method that is based on subspace minimization techniques. The method splits the unknown transport solution (or a functional of it) into low-frequency and high-frequency components, and uses singular value decomposition to analytically recover part of low-frequency information. Minimization is then applied to recover part of the high-frequency components of the unknowns. We present some numerical simulations with synthetic data to demonstrate the performance of the proposed algorithm.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

SU-E-T-175: Clinical Evaluations of Monte Carlo-Based Inverse Treatment Plan Optimization for Intensity Modulated Radiotherapy

Purpose: Pencil-beam or superposition-convolution type dose calculation algorithms are routinely used in inverse plan optimization for intensity modulated radiation therapy (IMRT). However, due to their limited accuracy in some challenging cases, e.g. lung, the resulting dose may lose its optimality after being recomputed using an accurate algorithm, e.g. Monte Carlo (MC). It is the objective of this study to evaluate the feasibility and advantages of a new method to include MC in the treatment planning process. Methods: We developed a scheme to iteratively perform MC-based beamlet dose calculations and plan optimization. In the MC stage, a GPU-based dose engine was used and the particle number sampled from a beamlet was proportional to its optimized fluence from the previous step. We tested this scheme in four lung cancer IMRT cases. For each case, the original plan dose, plan dose re-computed by MC, and dose optimized by our scheme were obtained. Clinically relevant dosimetric quantities in these three plans were compared. Results: Although the original plan achieved a satisfactory PDV dose coverage, after re-computing doses using MC method, it was found that the PTV D95% were reduced by 4.60%–6.67%. After re-optimizing these cases with our scheme, the PTV coverage was improved to the same level as in the original plan, while the critical OAR coverages were maintained to clinically acceptable levels. Regarding the computation time, it took on average 144 sec per case using only one GPU card, including both MC-based beamlet dose calculation and treatment plan optimization. Conclusion: The achieved dosimetric gains and high computational efficiency indicate the feasibility and advantages of the proposed MC-based IMRT optimization method. Comprehensive validations in more patient cases are in progress.

60 APPLIED LIFE SCIENCES↗

Sci—Thur PM: Planning and Delivery — 03: Automated delivery and quality assurance of a modulated electron radiation therapy plan

Modulated electron radiation therapy (MERT) offers the potential to improve healthy tissue sparing through increased dose conformity. Challenges remain, however, in accurate beamlet dose calculation, plan optimization, collimation method and delivery accuracy. In this work, we investigate the accuracy and efficiency of an end-to-end MERT plan and automated-delivery workflow for the electron boost portion of a previously treated whole breast irradiation case. Dose calculations were performed using Monte Carlo methods and beam weights were determined using a research-based treatment planning system capable of inverse optimization. The plan was delivered to radiochromic film placed in a water equivalent phantom for verification, using an automated motorized tertiary collimator. The automated delivery, which covered 4 electron energies, 196 subfields and 6183 total MU was completed in 25.8 minutes, including 6.2 minutes of beam-on time with the remainder of the delivery time spent on collimator leaf motion and the automated interfacing with the accelerator in service mode. The delivery time could be reduced by 5.3 minutes with minor electron collimator modifications and the beam-on time could be reduced by and estimated factor of 2–3 through redesign of the scattering foils. Comparison of the planned and delivered film dose gave 3%/3 mm gamma pass rates of 62.1, 99.8, 97.8, 98.3, and 98.7 percent for the 9, 12, 16, 20 MeV, and combined energy deliveries respectively. Good results were also seen in the delivery verification performed with a MapCHECK 2 device. The results showed that accurate and efficient MERT delivery is possible with current technologies.

60 APPLIED LIFE SCIENCES↗

Machine learning-driven design and self-sensing capabilities of automotive bumper lattices for adaptive impact response

We present a novel approach to design an automotive bumper energy absorber using carbon fiber reinforced polymer composites, optimized to meet conflicting performance requirements for two distinct impact scenarios. The design must satisfy both a low-speed (2.5 mph) pendulum intrusion test, simulating vehicle-to-vehicle collisions, and a high-speed (25 mph) leg flexion test, replicating pedestrian impacts. These tests demand opposing deformation characteristics: high flexibility (deformation < 85 mm) for the former and high stiffness (deformation < 22 mm) for the latter. To address these contradictory requirements, we developed a machine learning (ML) framework for inverse optimization of lattice designs and material selection. Unlike traditional iterative design processes, our ML model directly outputs optimal design parameters and material choices based on target performance inputs. The energy absorber was fabricated using advanced additive manufacturing techniques, including extrusion deposition and digital light processing. The integration of carbon fibers provides multifunctionality to the bumper structure, enabling self-sensing capabilities through changes in electrical resistivity under compression. This electrical response demonstrates high repeatability under multiple cycles at 2% compression and exhibits distinct signatures during crack formation under high deformation. This research offers adaptive performance through innovative design methodologies and smart material integration. The approach has potential applications in various fields requiring adaptive energy absorption and real-time structural health monitoring.

Chawla, Komal [ORNL] (ORCID:0000000190327565)↗

SU-E-T-786: Utility of Gold Wires to Optimize Intensity Modulation Capacity of a Novel Directional Modulated Brachytherapy Tandem Applicator for Image Guided Cervical Cancer Brachytherapy

Purpose: To evaluate the impact of using gold wires to differentially fill various channels on plan quality compared with conventional T&R applicator, inside a novel directional modulated brachytherapy (DMBT) tandem applicator for cervical cancer brachytherapy. Materials and Methods: The novel DMBT tandem applicator has a 5.4-mm diameter MR-compatible tungsten alloy enclosed in a 0.3-mm thick plastic tubing that wraps around the tandem. To modulate the radiation intensity, 6 symmetric peripheral holes of 1.3-mm diameter are grooved along the tungsten alloy rod. These grooved holes are differentially filled with gold wires to generate various degrees of directional beams. For example, three different fill patterns of 1) all void, 2) all filled except the hole containing the 192-Ir source, and 3) two adjacent holes to the 192-Ir source filled were Monte Carlo simulated. The resulting 3D dose distributions were imported into an in-house-coded inverse optimization planning system to generate HDR brachytherapy clinical plans for 19 patient cases. All plans generated were normalized to the same D90 as the clinical plans and D2cc doses of OARs were evaluated. Prescription ranged between 15 and 17.5Gy. Results: In general, the plans in case 1) resulted in the highest D2cc doses for the OARs with 11.65±2.30Gy, 7.47±3.05Gy, and 9.84±2.48Gy for bladder, rectum, and sigmoid, respectively, although the differences were small. For the case 2), D2cc doses were 11.61±2.29Gy, 7.41±3.07Gy, and 9.75±2.45Gy, respectively. And, for the case 3), D2cc doses were 11.60±2.28Gy, 7.41±3.05Gy, and 9.74±2.45Gy, respectively. Difference between 1) and 2) cases were small with the average D2cc difference of <0.64%. Difference between 1) and 3) cases were even smaller with the average D2cc difference of <0.1%. Conclusions: There is a minimal clinical benefit by differentially filling grooved holes in the novel DMBT tandem applicator for image guided cervical cancer brachytherapy.

60 APPLIED LIFE SCIENCES↗

Estimation of extreme temperatures in direct solar methane pyrolysis within a porous medium

Porous media have wide application in renewable energy conversion processes, such as solar-thermal fuels production and decarbonization. Heat transport mechanisms within porous media can be highly complex, particularly under extreme conditions encountered in concentrated solar thermal reactors in which direct measurement of temperature is challenging. Here, we implement and report an inverse heat conduction model to estimate the temperature distribution throughout a porous substrate domain in a direct solar methane pyrolysis process. By solving a two-dimensional heat transfer problem and applying an inverse optimization algorithm, we estimate the quasi-steady state spatial temperature distribution in a fibrous porous carbon substrate. The results are validated indirectly by experimentally measured graphite deposition and a simplified reaction kinetic model.

finite difference method↗

SU-E-T-451: Hybrid-VMAT: A Novel Technique Combining VMAT and 3D in Planning Whole Breast Radiotherapy with a Simultaneously-Integrated Boost (WBRT+SIB)

Purpose: The RTOG 1005 trial offered a hypofractionated arm in delivering WBRT+SIB. Traditionally, treatments were planned at our institution using field-in-field (FiF) tangents with a concurrent 3D conformal boost. With the availability of VMAT, it is possible that a hybrid VMAT-3D planning technique could provide another avenue in treating WBRT+SIB. Methods: A retrospective study of nine patients previously treated using RTOG 1005 guidelines was performed to compare FiF+3D plans with the hybrid technique. A combination of static tangents and partial VMAT arcs were used in base-dose optimization. The hybrid plans were optimized to deliver 4005cGy to the breast PTVeval and 4800cGy to the lumpectomy PTVeval over 15 fractions. Plans were optimized to meet the planning goals dictated by RTOG 1005. Results: Hybrid plans yielded similar coverage of breast and lumpectomy PTVs (average D95 of 4013cGy compared to 3990cGy for conventional), while reducing the volume of high dose within the breast; the average D30 and D50 for the hybrid technique were 4517cGy and 4288cGy, compared to 4704cGy and 4377cGy for conventional planning. Hybrid plans increased conformity as well, yielding CI95% values of 1.22 and 1.54 for breast and lumpectomy PTVeval volumes; in contrast, conventional plans averaged 1.49 and 2.27, respectively. The nearby organs at risk (OARs) received more low dose with the hybrid plans due to low dose spray from the partial arcs, but all hybrid plans did meet the acceptable constraints, at a minimum, from the protocol. Treatment planning time was also reduced, as plans were inversely optimized (VMAT) rather than forward optimized. Conclusion: Hybrid-VMAT could be a solution in delivering WB+SIB, as plans yield very conformal treatment plans and maintain clinical standards in OAR sparing. For treating breast cancer patients with a simultaneously-integrated boost, Hybrid-VMAT offers superiority in dosimetric conformity and planning time as compared to FIF techniques.

60 APPLIED LIFE SCIENCES↗

The role of the metal core in the performance of WO x inverse catalysts

In this study, metal-metal oxide inverse catalysts are valuable in diverse applications but selecting pairs is challenging. Here we investigate the role of metal cores (Pt, Ru, Rh, Pd, Ni) in the formation and dynamics of Brønsted acid sites on WO x overlayer on carbon. By in situ/ex situ characterizations, probe chemistry kinetics, and DFT calculations, we demonstrate that metals with varying work functions promote the WO x dispersion, enhancing the Brønsted acidity than the 3D crystallites on carbon at submonolayer coverages by tuning the oxidation state of WO x . The metal core impacts the water splitting and hydroxylation of WO x . Water splitting on Ru-WO x is thermodynamically favorable compared to Ni-WO x and increases the dehydration rate on the former, leading to an activity enhancement by increasing the H 2 pulsing frequency. This study provides insights into optimizing inverse catalysts.

36 MATERIALS SCIENCE↗

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

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 of 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.

60 APPLIED LIFE SCIENCES↗

FIRM: federated image reconstruction using multimodal tomographic data

Here, we propose a federated algorithm for reconstructing images using multimodal tomographic data sourced from dispersed locations, addressing the challenges of traditional unimodal approaches that are prone to noise and reduced image quality, as well as the limitations of centralized multimodal approaches that require extensive data transfer, leading to significant communication overhead, storage demands, and potential data privacy concerns. Our approach formulates a joint inverse optimization problem incorporating multimodality constraints and solves it in a federated framework through local gradient computations complemented by lightweight central operations, thereby ensuring data decentralization. Leveraging the connection between our federated algorithm and the quadratic penalty method, we introduce an adaptive step-size rule with guaranteed sublinear convergence. Numerical results demonstrate superior computational efficiency and improved image reconstruction quality compared to existing approaches.

federated algorithm↗

Direction Modulated Brachytherapy for Treatment of Cervical Cancer. II: Comparative Planning Study With Intracavitary and Intracavitary–Interstitial Techniques

Purpose: To perform a comprehensive comparative planning study evaluating the utility of the proposed direction modulated brachytherapy (DMBT) tandem applicator against standard applicators, in the setting of image guided adaptive brachytherapy of cervical cancer. Methods and Materials: A detailed conceptual article was published in 2014. The proposed DMBT tandem applicator has 6 peripheral grooves of 1.3-mm width, along a 5.4-mm-thick nonmagnetic tungsten alloy rod of density 18.0 g/cm{sup 3}, capable of generating directional dose profiles. We performed a comparative planning study with 45 cervical cancer patients enrolled consecutively in the prospective observational EMBRACE study. In all patients, MRI-based planning was performed while utilizing various tandem-ring (27 patients) and tandem-ring-needles (18 patients) applicators, in accordance with the Groupe Européen de Curiethérapie–European Society for Radiotherapy and Oncology recommendations. For unbiased comparisons, all cases were replanned with an in-house–developed inverse optimization code while enforcing a uniform set of constraints that are reflective of the clinical practice. All plans were normalized to the same high-risk clinical target volume D90 values achieved in the original clinical plans. Results: In general, if the standard tandem was replaced with the DMBT tandem while maintaining all other planning conditions the same, there was consistent improvement in the plan quality. For example, among the 18 tandem-ring-needles cases, the average D2cm{sup 3} reductions achieved were −2.48% ± 11.03%, −4.45% ± 5.24%, and −5.66% ± 6.43% for the bladder, rectum, and sigmoid, respectively. An opportunity may also exist in avoiding use of needles altogether for when the total number of needles required is small (approximately 2 to 3 needles or less), if DMBT tandem is used. Conclusions: Integrating the novel DMBT tandem onto both intracavitary and intracavitary–interstitial applicator assembly enabled consistent improvement in the sparing of the OARs, over a standard “single-channel” tandem, though individual variations in benefit were considerable. Although at an early stage of development, the DMBT concept design is demonstrated to be useful and pragmatic for potential clinical translation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Pancreatic cancer planning: Complex conformal vs modulated therapies

To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45 Gy; with tumor/tumor bed boosted to 50.4 Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V{sub 30}, V{sub 35}), stomach (D{sub 10}%), stomach (V{sub 45}), mean right kidney dose, and right kidney (V{sub 15}) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V{sub 35}), and left kidney (V{sub 15}, V{sub 18}, V{sub 20}). VMAT plans decreased small bowel (D{sub 10}%, D{sub 15}%), small bowel (V{sub 35}, V{sub 45}), stomach (D{sub 10}%, D{sub 15}%), stomach (V{sub 35}, V{sub 45}), mean liver dose, liver (V{sub 35}), left kidney (V{sub 15}, V{sub 18}, V{sub 20}), and right kidney (V{sub 18}, V{sub 20}). VMAT plans significantly decreased small bowel (D{sub 10}%, D{sub 15}%), left kidney (V{sub 20}), and stomach (V{sub 45}) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average treatment delivery was within 10 minutes for simple and complex 3DCRT, IMRT, and VMAT treatments. This article shows significant improvements in 3D plan performance with complex planning over the more frequently compared 3- or 4-field simple 3D planning techniques. VMAT plans continue to demonstrate potential for the most organ sparing. However, further studies are required to identify if dosimetric benefits associated with inverse optimized planning can be translated into clinical benefits and if these treatment techniques are value-added therapies for this group of patients with cancer.

61 RADIATION PROTECTION AND DOSIMETRY↗