Results for “End user” — Page 35

DOE OSTI2014

MO-F-16A-06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi-Modality Radiation Dose Data

Purpose: We have implemented a commercially available Radiation Exposure Monitoring System (REMS) to enhance the processes of radiation dose data collection, analysis and alerting developed over the past decade at our sites of practice. REMS allows for consolidation of multiple radiation dose information sources and quicker alerting than previously developed processes. Methods: Thirty-nine x-ray producing imaging modalities were interfaced with the REMS: thirteen computed tomography scanners, sixteen angiography/interventional systems, nine digital radiography systems and one mammography system. A number of methodologies were used to provide dose data to the REMS: Modality Performed Procedure Step (MPPS) messages, DICOM Radiation Dose Structured Reports (RDSR), and DICOM header information. Once interfaced, the dosimetry information from each device underwent validation (first 15–20 exams) before release for viewing by end-users: physicians, medical physicists, technologists and administrators. Results: Before REMS, our diagnostic physics group pulled dosimetry data from seven disparate databases throughout the radiology, radiation oncology, cardiology, electrophysiology, anesthesiology/pain management and vascular surgery departments at two major medical centers and four associated outpatient clinics. With the REMS implementation, we now have one authoritative source of dose information for alerting, longitudinal analysis, dashboard/graphics generation and benchmarking. REMS provides immediate automatic dose alerts utilizing thresholds calculated through daily statistical analysis. This has streamlined our Closing the Loop process for estimated skin exposures in excess of our institutional specific substantial radiation dose level which relied on technologist notification of the diagnostic physics group and daily report from the radiology information system (RIS). REMS also automatically calculates the CT size-specific dose estimate (SSDE) as well as provides two-dimensional angulation dose maps for angiography/interventional procedures. Conclusion: REMS implementation has streamlined and consolidated the dosimetry data collection and analysis process at our institutions while eliminating manual entry error and providing immediate alerting and access to dosimetry data to both physicists and physicians. Brent Stewart has funded research through GE Healthcare.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

TH-C-19A-04: Commissioning and Validation of EBT3 Gafchromic Films for Measurements of Dose Profiles and Integrals of Dose in Small Fields

Purpose: The use of a primary dosimeter larger than the radiation field gives access to the integral of dose over a specified surface normal to the beam. If a relative dose profile of the beam is well known, it is then possible to calculate the distribution of the absorbed dose at any point on the considered surface. This study aims at validating the use of EBT3 gafchromic films for the measurement of 2D dose distribution and integrals of dose in small fields for such use. Methods: New EBT3 films have been fully characterized: the response versus energy, dose-rate and dose has been investigated. Profiles measured in circular field with a diameter of 20 mm have been compared to the ones measured with a diamond detector developed at CEA/LIST/LCD. The ratio of dose area products measured with EBT3 on a 6 mm and 30 mm diameter surface has been compared to the ratio measured with primary dosimeters (calorimeters) and calculated with Monte Carlo simulations. Results: There was no significant difference between the dose-calibration curves in a 6 MV and a 60Co beam. Deviation was within uncertainty bars when the dose rate inside a pulse was divided by a factor of 80 in the 6 MV photon beam. Profiles in small fields are in good agreement with the diamond profiles. Dose area product ratios obtained with EBT3, calorimeters and simulations are within 1%. Conclusion: EBT3 films are good candidates for the measurement of relative dose distribution in small fields as long as the average of several films is considered. They can be used in association with primary measurements to determinate dosimetric references in small fields and to transfer them to the end user.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-A-210-00: AAPM Medical Physics Student Meeting: Medical Billing and Regulations: Everything You Always Wanted To Know, But Were Too Afraid To Ask

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

SU-A-210-01: Why Should We Learn Radiation Oncology Billing?

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

SU-A-210-02: Medical Physics Opportunities at the NRC

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

SU-A-210-03: Panel Discussion

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

SU-A-210-04: Panel Discussion

The purpose of this student annual meeting is to address topics that are becoming more relevant to medical physicists, but are not frequently addressed, especially for students and trainees just entering the field. The talk is divided into two parts: medical billing and regulations. Hsinshun Wu – Why should we learn radiation oncology billing? Many medical physicists do not like to be involved with medical billing or coding during their career. They believe billing is not their responsibility and sometimes they even refuse to participate in the billing process if given the chance. This presentation will talk about a physicist’s long career and share his own experience that knowing medical billing is not only important and necessary for every young medical physicist, but that good billing knowledge could provide a valuable contribution to his/her medical physics development. Learning Objectives: The audience will learn the basic definition of Current Procedural Terminology (CPT) codes performed in a Radiation Oncology Department. Understand the differences between hospital coding and physician-based or freestanding coding. Apply proper CPT coding for each Radiation Oncology procedure. Each procedure with its specific CPT code will be discussed in detail. The talk will focus on the process of care and use of actual workflow to understand each CPT code. Example coding of a typical Radiation Oncology procedure. Special procedure coding such as brachytherapy, proton therapy, radiosurgery, and SBRT. Maryann Abogunde – Medical physics opportunities at the Nuclear Regulatory Commission (NRC) The NRC’s responsibilities include the regulation of medical uses of byproduct (radioactive) materials and oversight of medical use end-users (licensees) through a combination of regulatory requirements, licensing, safety oversight including inspection and enforcement, operational experience evaluation, and regulatory support activities. This presentation will explore the career options for medical physicists in the NRC, how the NRC interacts with clinical medical physicists, and a physicist’s experience as a regulator. Learning Objectives: Explore non-clinical career pathways for medical physics students and trainees at the Nuclear Regulatory Commission. Overview of NRC medical applications and medical use regulations. Understand the skills needed for physicists as regulators. Abogunde is funded to attend the meeting by her employer, the NRC.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

MO-D-BRD-00: Electronic Brachytherapy

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

MO-D-BRD-01: Clinical Implementation of An Electronic Brachytherapy Program for the Skin

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

MO-D-BRD-02: Radiological Physics and Surface Lesion Treatments with Electronic Brachytherapy

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2015

MO-D-BRD-03: Radiobiology and Commissioning of Electronic Brachytherapy for IORT

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2015

MO-D-BRD-04: NIST Air-Kerma Standard for Electronic Brachytherapy Calibrations

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-201-00: Practical Guidelines for Commissioning Advanced Brachytherapy Dose Calculation Algorithms

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-201-01: Identify Key Clinical Applications Needing Advanced Dose Calculation in Brachytherapy

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-201-02: Review TG-186 and WGMBDCA Guidelines, Commission Process, and Dosimetry Benchmarks

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-201-03: Evaluate Clinical Cases Using Commercially Available Systems and Compare to TG-43 Dosimetry

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-249: Application of Human Factors Methods: Usability Testing in the Radiation Oncology Environment

Purpose: As a quality improvement measure, we undertook this work to incorporate usability testing into the implementation procedures for new electronic documents and forms used by four affiliated radiation therapy centers. Methods: A human factors specialist provided training in usability testing for a team of medical physicists, radiation therapists, and radiation oncologists from four radiotherapy centers. A usability testing plan was then developed that included controlled scenarios and standardized forms for qualitative and quantitative feedback from participants, including patients. Usability tests were performed by end users using the same hardware and viewing conditions that are found in the clinical environment. A pilot test of a form used during radiotherapy CT simulation was performed in a single department; feedback informed adaptive improvements to the electronic form, hardware requirements, resource accessibility and the usability testing plan. Following refinements to the testing plan, usability testing was performed at three affiliated cancer centers with different vault layouts and hardware. Results: Feedback from the testing resulted in the detection of 6 critical errors (omissions and inability to complete task without assistance), 6 non-critical errors (recoverable), and multiple suggestions for improvement. Usability problems with room layout were detected at one center and problems with hardware were detected at one center. Upon amalgamation and summary of the results, three key recommendations were presented to the document’s authors for incorporation into the electronic form. Documented inefficiencies and patient safety concerns related to the room layout and hardware were presented to administration along with a request for funding to purchase upgraded hardware and accessories to allow a more efficient workflow within the simulator vault. Conclusion: By including usability testing as part of the process when introducing any new document or procedure into clinical use, associated risks can be identified and mitigated before patient care and clinical workflow are impacted.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2024

Strain shift measured from stress-controlled oscillatory shear: Evidence for a continuous yielding transition and new techniques to determine recovery rheology measures

Understanding the yielding of complex fluids is an important rheological challenge that affects our ability to engineer and process materials for a wide variety of applications. Common theoretical understandings of yield stress fluids follow the Oldroyd–Prager formalism in which the material behavior below the yield stress is treated as solidlike, and above the yield stress as liquidlike, with an instantaneous transition between the two states. This formalism was built on a quasi-static approach to the yield stress, while most applications, ranging from material processing to end user applications, involve a transient approach to yielding over a finite timescale. Using stress-controlled oscillatory shear experiments, we show that yield stress fluids flow below their yield stresses. This is quantified through measuring the strain shift, which is the value about which the strain oscillates during a stress-controlled test and is a function of only the unrecoverable strain. Measurements of the strain shift are, therefore, measurements of flow having taken place. These experimental results are compared to the Herschel–Bulkley form of the Saramito model, which utilizes the Oldroyd–Prager formalism, and the recently published Kamani–Donley–Rogers (KDR) model, in which one constitutive equation represents the entire range of material responses. Scaling relationships are derived, which allow us to show why yield stress fluids will flow across all stresses, above and below their yield stress. Finally, derivations are presented that show strain shift can be used to determine average metrics previously attainable only through recovery rheology, and these are experimentally verified.

Mechanics↗