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All sourcesNASA NTRSDOE OSTI
DOE OSTI2011

Energy-water analysis of the 10-year WECC transmission planning study cases.

In 2011 the Department of Energy's Office of Electricity embarked on a comprehensive program to assist our Nation's three primary electric interconnections with long term transmission planning. Given the growing concern over water resources in the western U.S. the Western Electricity Coordinating Council (WECC) requested assistance with integrating water resource considerations into their broader electric transmission planning. The result is a project with three overarching objectives: (1) Develop an integrated Energy-Water Decision Support System (DSS) that will enable planners in the Western Interconnection to analyze the potential implications of water stress for transmission and resource planning. (2) Pursue the formulation and development of the Energy-Water DSS through a strongly collaborative process between the Western Electricity Coordinating Council (WECC), Western Governors Association (WGA), the Western States Water Council (WSWC) and their associated stakeholder teams. (3) Exercise the Energy-Water DSS to investigate water stress implications of the transmission planning scenarios put forward by WECC, WGA, and WSWC. The foundation for the Energy-Water DSS is Sandia National Laboratories Energy-Power-Water Simulation (EPWSim) model (Tidwell et al. 2009). The modeling framework targets the shared needs of energy and water producers, resource managers, regulators, and decision makers at the federal, state and local levels. This framework provides an interactive environment to explore trade-offs, and 'best' alternatives among a broad list of energy/water options and objectives. The decision support framework is formulated in a modular architecture, facilitating tailored analyses over different geographical regions and scales (e.g., state, county, watershed, interconnection). An interactive interface allows direct control of the model and access to real-time results displayed as charts, graphs and maps. The framework currently supports modules for calculating water withdrawal and consumption for current and planned electric power generation; projected water demand from competing use sectors; and, surface and groundwater availability. WECC's long range planning is organized according to two target planning horizons, a 10-year and a 20-year. This study supports WECC in the 10-year planning endeavor. In this case the water implications associated with four of WECC's alternative future study cases (described below) are calculated and reported. In future phases of planning we will work with WECC to craft study cases that aim to reduce the thermoelectric footprint of the interconnection and/or limit production in the most water stressed regions of the West.

13 HYDRO ENERGY↗
DOE OSTI2014

Nevada National Security Site Integrated Groundwater Sampling Plan, Revision 0

The purpose of the Nevada National Security Site (NNSS) Integrated Sampling Plan (referred to herein as the Plan) is to provide a comprehensive, integrated approach for collecting and analyzing groundwater samples to meet the needs and objectives of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Underground Test Area (UGTA) Activity. Implementation of this Plan will provide high-quality data required by the UGTA Activity for ensuring public protection in an efficient and cost-effective manner. The Plan is designed to ensure compliance with the UGTA Quality Assurance Plan (QAP). The Plan’s scope comprises sample collection and analysis requirements relevant to assessing the extent of groundwater contamination from underground nuclear testing. This Plan identifies locations to be sampled by corrective action unit (CAU) and location type, sampling frequencies, sample collection methodologies, and the constituents to be analyzed. In addition, the Plan defines data collection criteria such as well-purging requirements, detection levels, and accuracy requirements; identifies reporting and data management requirements; and provides a process to ensure coordination between NNSS groundwater sampling programs for sampling of interest to UGTA. This Plan does not address compliance with requirements for wells that supply the NNSS public water system or wells involved in a permitted activity.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2018

Nevada National Security Site Integrated Groundwater Sampling Plan, Revision 1

The purpose is to provide a comprehensive, integrated approach for collecting and analyzing groundwater samples to meet the needs and objectives of the DOE/EM Nevada Program’s UGTA Activity. Implementation of this Plan will provide high-quality data required by the UGTA Activity for ensuring public protection in an efficient and cost-effective manner. The Plan is designed to ensure compliance with the UGTA Quality Assurance Plan (QAP) (NNSA/NFO, 2015); Federal Facility Agreement and Consent Order (FFACO) (1996, as amended); and DOE Order 458.1, Radiation Protection of the Public and the Environment (DOE, 2013). The Plan’s scope comprises sample collection and analysis requirements relevant to assessing both the extent of groundwater contamination from underground nuclear testing and impact of testing on water quality in downgradient communities. This Plan identifies locations to be sampled by CAU and location type, sampling frequencies, sample collection methodologies, and the constituents to be analyzed. In addition, the Plan defines data collection criteria such as well purging, detection levels, and accuracy requirements/recommendations; identifies reporting and data management requirements; and provides a process to ensure coordination between NNSS groundwater sampling programs for sampling analytes of interest to UGTA. Information used in the Plan development—including the rationale for selection of wells, sampling frequency, and the analytical suite—is discussed under separate cover (N-I, 2014) and is not reproduced herein. This Plan does not address compliance for those wells involved in a permitted activity. Sampling and analysis requirements associated with these wells are described in their respective permits and are discussed in NNSS environmental reports (see Section 5.2). In addition, sampling for UGTA CAUs that are in the Closure Report (CR) stage are not included in this Plan. Sampling requirements for these CAUs are described in the CR. Frenchman Flat is currently the only UGTA CAU in the CR stage. Sampling requirements for this CAU are described in Underground Test Area (UGTA) Closure Report for Corrective Action Unit 98: Frenchman Flat Nevada National Security Site, Nevada (NNSA/NFO, 2016).

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2018

Nevada National Security Site Integrated Groundwater Sampling Plan, Revision 1, with ROTC-1

The purpose of the Nevada National Security Site (NNSS) Integrated Groundwater Sampling Plan (referred to herein as the Plan) is to provide a comprehensive, integrated approach for collecting and analyzing groundwater samples to meet the needs and objectives of the U.S. Department of Energy (DOE), Environmental Management (EM) Nevada Program’s Underground Test Area (UGTA) Activity. Implementation of this Plan will provide high-quality data required by the UGTA Activity for ensuring public protection in an efficient and cost-effective manner. The Plan is designed to ensure compliance with the UGTA Quality Assurance Plan (QAP) (NNSA/NFO, 2015). The Plan’s scope comprises sample collection and analysis requirements relevant to assessing both the extent of groundwater contamination from underground nuclear testing and impact of testing on water quality in downgradient communities. This Plan identifies locations to be sampled by corrective action unit (CAU) and location type, sampling frequencies, sample collection methodologies, and the constituents to be analyzed. In addition, the Plan defines data collection criteria such as well purging, detection levels, and accuracy requirements/recommendations; identifies reporting and data management requirements; and provides a process to ensure coordination between NNSS groundwater sampling programs for sampling analytes of interest to UGTA. Information used in the Plan development—including the rationale for selection of wells, sampling frequency, and the analytical suite—is discussed under separate cover (N-I, 2014) and is not reproduced herein.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2022

National Ignition Facility. Facility and Infrastructure Systems Maintenance Plan

Ensuring the reliability of the NIF, including its support systems, laser systems, target diagnostic systems, and utilities, is essential to the availability of the NIF in its support of NNSA missions. NIF is a key capability in the DOE Stockpile Stewardship Program and supports high energy physics experiments for nuclear weapons, energy, and astrophysics applications. High system reliability provides opportunities for shots and scientific discoveries with opportunities to enhance and upgrade capabilities. This Maintenance Plan (MP) identifies the policies and procedures used to perform and support asset management of the NIF Facility and Infrastructure Systems (FInS), NIF Lasers & Alignment (LASE), NIF Target Experimental Operations (TOPS), NIF Target Area Science and Engineering (TASE), and NIF&PS Control Systems (NCS). The FInS systems include the facility, HVAC, contamination control, beampath, and Line Replaceable Units (LRUs) as well as utilities which create the beampath environments, such as vacuum, argon, or clean dry air. The LASE systems are Programmatic systems which include laser diagnostics, alignment, power conditioning, pulsed power, and input laser systems. The TOPS and TASE systems are also Programmatic systems which include target and diagnostic delivery systems and positioners, many different insertable and fixed target diagnostics, and cryogenic and target gas fill systems. Finally, the NCS systems include both software and hardware for industrial and shot operation control systems. Policies governing administrative and operational practices related to maintenance of FInS, LASE, TOPS, TASE, and NCS systems are described in this plan. In addition, the plan provides processes and procedures for managing, tracking, and documenting the work. This document, the NIF Operations Management Plan, NIF-5020544 (Ref. 1), and NIF Shot Operations Plan, NIF-5018506 (Ref. 2), together satisfy the requirements of the Conduct of Operations. Duties, responsibilities, and reporting requirements of the various positions associated with FInS, LASE, and TOPS maintenance are detailed in this plan. The FInS systems include both Real Property systems with asset management requirements specified in DOE Order 430.1C (Ref. 3) and Programmatic systems. In addition, for FInS, there is a list of the System Level Maintenance Plans (SLMPs) in NIF-1007419198 (Ref. 4) which provide the system descriptions and maintenance plan and schedule. In addition, the list includes the Reliability Centered Maintenance (RCM) and Experience Centered Maintenance (ECM) evaluations that have been performed for applicable FInS systems as well as reliability criticality per Section 3.5. The -AM version of the NIF Maintenance Plan focuses on the reliability program for FInS, LASE, TOPS, TASE, and NCS within the context of the overall NIF Reliability, Availability, and Maintainability (RAM) program and incorporates changes since the -AL version from August 2011 and has been updated to be fully consistent with the updates to Ref. 1. It also includes asset management considerations, updates to the Work Order (WO) process within the NIF Computerized Maintenance Management System (CMMS) which is EAM infor® System Maintenance and Reliability Tracking (SMaRT) (Ref. 5), and updates to metrics and key performance indicators (KPIs).

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2019

Risk Inequality and the Food-Energy-Water (FEW) Nexus: A Study of 43 City Adaptation Plans

Goals aimed at adapting to climate change in sustainable and just ways are embedded in global agreements such as the Sustainable Development Goals and the New Urban Agenda. However, largely unexamined, are the ways that narrative understandings conveyed in adaptation plans consider and attempt to address inequality in climate risk to urban populations and FEW-systems. In this paper, we examine whether and how adaptation plans from C40 member cities address inequality in risk, by planning actions to reduce hazard exposure or tackling the drivers of social vulnerability. C40 is a network of 94 of the world's cities fostering policies to address climate change. We apply a mixed methods approach, including a discourse analysis and meta-analysis of adaptation plans. The discourse analysis helps to unpack framings of urban equity issues as they relate to policy actions, and the meta-analysis seeks to quantitatively investigate patterns of framing and policy across adaptation plans. Our findings suggest that FEW-nexus thinking is not yet embedded in narrative understandings of risk and planned adaptation actions, within the adaptation plans we studied. In the city adaptation plans we analyzed, we found multiple frames coexisting behind the broader adaptation visions (e.g., risk and resilience). Rather than converging, issues, and principles such as those of equality, coexist with economic issues in an imbalance of incongruent political movements and priorities. Techno-infrastructural and economic investments and concerns tend to take precedence over concerns and interests for inequality in climate risks. We discuss some of the institutional factors explaining this. Knowledge integration, for instance, is constrained by the existence of a plurality of sectors, levels of government, power, values, and ways of understanding and managing climate risk. We also suggest that the relatively low importance of equality considerations in the adaptation plans will likely limit the capacity of cities to support broader goals such as those of the New Urban Agenda and the Sustainable Development Goals.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2016

Strategic Planning and Decisions Tools to Enhance EM Mission Execution - 16552

Maximizing the success of an organization depends on many things with a key one being the focus and quality of the management decisions made by the organisation's senior leadership team. Successfully advancing an organisation's agenda requires operational, tactical, and strategic decisions. These decisions involve both decisions on specific actions, as well as decisions about planning. In addition to the day-to-day decisions of running the business, the leadership team should be allocating appropriate time toward developing organizational strategic objectives. Strategic planning is an organisation's process of defining its direction and strategies, and plotting how to accomplish those strategies. Strategic planning is essential to the long term viability of the organization. The pathway to success with strategic planning is not nearly so obvious and straight forward as with operational decisions. Organizational leaders must resist the temptation to minimize the time allocated to strategic thinking and strategic planning. Strategic thinking and strategic planning are centered around making sure that your organization is doing the right things, instead of just doing things right. Management guru Peter Drucker noted that 'There is nothing more wasteful than becoming highly efficient at doing the wrong things'. Strategic thinking is used in deciding what to do. Tactical thinking is used in deciding how to do it. Decision tools can be utilized to improve the results of the strategic planning process. In certain situations, properly selected decision tools will provide a mechanism or a process for making better decisions, or for channeling strategic thought and strategic planning toward enlightened alternative approaches. Decision tools can also provide for assigning a quantitative measure of merit or goodness, or at least a semi-quantitative measure of merit to multiple decision options. Properly selected and utilized, decision tools provide the leadership team with additional insight into the consequences of their decisions. Appropriately selected decision tools can be utilized to maximize the effectiveness of your strategic planning efforts. Decision tools can be used to quantify strategic decision options within a particular framework, providing insights into alternatives to improve an organisation's most effective execution of the DOE EM clean up mission. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2015

Intensity modulated radiotherapy and 3D conformal radiotherapy for whole breast irradiation: a comparative dosimetric study and introduction of a novel qualitative index for plan evaluation, the normal tissue index

We report on a retrospective dosimetric study, comparing 3D conformal radiotherapy (3DCRT) and hybrid intensity modulated radiotherapy (hIMRT). We evaluated plans based on their planning target volume coverage, dose homogeneity, dose to organs at risk (OARs) and exposure of normal tissue to radiation. The Homogeneity Index (HI) was used to assess the dose homogeneity in the target region, and we describe a new index, the normal tissue index (NTI), to assess the dose in the normal tissue inside the tangent treatment portal. Plans were generated for 25 early-stage breast cancer patients, using a hIMRT technique. These were compared with the 3DCRT plans of the treatment previously received by the patients. Plan quality was evaluated using the HI, NTI and dose to OARs. The hIMRT technique was significantly more homogenous than the 3DCRT technique, while maintaining target coverage. The hIMRT technique was also superior at minimising the amount of tissue receiving D{sub 105%} and above (P < 0.0001). The ipsilateral lung and contralateral breast maximum were significantly lower in the hIMRT plans (P < 0.05 and P < 0.005), but the 3DCRT technique achieved a lower mean heart dose in left-sided breast cancer patients (P < 0.05). Hybrid intensity modulated radiotherapy plans achieved improved dose homogeneity compared to the 3DCRT plans and superior outcome with regard to dose to normal tissues. We propose that the addition of both HI and NTI in evaluating the quality of intensity modulated radiotherapy (IMRT) breast plans provides clinically relevant comparators which more accurately reflect the new paradigm of treatment goals and outcomes in the era of breast IMRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Simultaneous {sup 68}Ga-DOTATOC-PET/MRI for IMRT Treatment Planning for Meningioma: First Experience

Purpose: To evaluate intensity-modulated radiotherapy (IMRT) treatment planning based on simultaneous positron-emission tomography and magnetic resonance imaging (PET/MRI) of meningioma. Methods and Materials: A meningioma patient was examined prior to radiotherapy with dedicated planning computed tomography (CT), MRI, PET/CT with gallium-68-labeled DOTATOC ({sup 68}Ga-DOTATOC), and simultaneous {sup 68}Ga-DOTATOC-PET/MRI. The first gross target volume (GTV) was defined based on a combination of separate MR and {sup 68}Ga-DOTATOC-PET/CT imaging (GTV{sub PET/CT+MR}). Then, the simultaneous PET/MR images were used to delineate a second GTV (GTV{sub PET/MR}) by following exactly the same delineation strategy. After an isotropic expansion of those volumes by a 4-mm safety margin, the resulting planning target volumes (PTVs) were compared by calculating the intersection volume and the relative complements. A cross-evaluation of IMRT plans was performed, where the treatment plan created for the PTV{sub PET/CT+MR} was applied to the PET/MR-based PTV{sub PET/MR}. Results: Generally, target volumes for IMRT treatment planning did not differ between MRI plus {sup 68}Ga-DOTATOC-PET/CT and simultaneous PET/MR imaging. Only in certain regions of the GTV were differences observed. The overall volume of the PET/MR-based PTV was approximately the same as that obtained from PET/CT data. A small region of infiltrative tumor growth next to the main tumor mass was better visualized with combined PET/MR due to smaller PET voxel sizes and improved recovery. An IMRT treatment plan was optimized for the PTV{sub PET/CT+MR}. The evaluation of this plan with respect to the PTV{sub PET/MR} showed parts of the target volume that would not have received the full radiation dose after delineation of the tumor, based on simultaneous PET/MR. Conclusion: This case showed that differences in target volumes delineated on the basis of separate MR and PET/CT and simultaneous PET/MR may be observed that can have significant consequences for an effectively applied radiotherapy treatment plan.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Assessing dose variance from immobilization devices in VMAT head and neck treatment planning: A retrospective case study analysis

Immobilization devices serve several purposes in radiation oncology including improved positional reproducibility and decreased patient movement. If immobilization device beam attenuation is unaccounted for in the treatment planning process, planning target volume (PTV) coverage can be compromised. A retrospective case study was performed to evaluate beam attenuation from head and neck (HN) immobilization devices in volumetric-modulated arc therapy using the Eclipse treatment planning system and the Anisotropic Analytical Algorithm. Three facilities retrospectively evaluated 15 patients with various HN carcinomas. A test plan was created from each patient's existing plan in Eclipse to include immobilization devices in the dose calculation. Plan comparisons were performed using dose-volume histograms, which assessed the maximum dose, percentage of the PTV that received 95% of the prescription dose (V{sub 95}), and dose covering 100% of the PTV (D{sub 100}). The test plan normalization values were then adjusted to match the original PTV coverage. The maximum dose difference calculated ranged from 0.3% to 4.1%. The absolute difference in V{sub 95} coverage between the HN and the test plans ranged from 0.4% to 2.3%. The difference in the D{sub 100} was more statistically significant, reporting a range of 1.2% to 71.4%. Finally, to achieve the same PTV coverage as observed in the HN plan, an adjustment to the normalization value was needed, which required a change ranging from 0.1 to 7.7. Attenuation from immobilization devices, when unaccounted for, can cause a misrepresentation of the dose delivered to the PTV. It is not a standardized practice among institutions to include immobilization devices within the body contour for dose calculations. However, with the increasing use of volumetric-modulated arc therapy for treatment of the HN region, precision is of the utmost importance, and inclusion of immobilization devices should be standardized.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

SU-E-T-24: A Simple Correction-Based Method for Independent Monitor Unit (MU) Verification in Monte Carlo (MC) Lung SBRT Plans

Purpose: Lung-SBRT uses hypo-fractionated dose in small non-IMRT fields with tissue-heterogeneity corrected plans. An independent MU verification is mandatory for safe and effective delivery of the treatment plan. This report compares planned MU obtained from iPlan-XVM-Calgorithm against spreadsheet-based hand-calculation using most commonly used simple TMR-based method. Methods: Treatment plans of 15 patients who underwent for MC-based lung-SBRT to 50Gy in 5 fractions for PTV V100%=95% were studied. ITV was delineated on MIP images based on 4D-CT scans. PTVs(ITV+5mm margins) ranged from 10.1- 106.5cc(average=48.6cc). MC-SBRT plans were generated using a combination of non-coplanar conformal arcs/beams using iPlan XVM-Calgorithm (BrainLAB iPlan ver.4.1.2) for Novalis-TX consisting of micro-MLCs and 6MV-SRS (1000MU/min) beam. These plans were re-computed using heterogeneity-corrected Pencil-Beam (PB-hete) algorithm without changing any beam parameters, such as MLCs/MUs. Dose-ratio: PB-hete/MC gave beam-by-beam inhomogeneity-correction-factors (ICFs):Individual Correction. For independent-2nd-check, MC-MUs were verified using TMR-based hand-calculation and obtained an average ICF:Average Correction, whereas TMR-based hand-calculation systematically underestimated MC-MUs by ∼5%. Also, first 10 MC-plans were verified with an ion-chamber measurement using homogenous phantom. Results: For both beams/arcs, mean PB-hete dose was systematically overestimated by 5.5±2.6% and mean hand-calculated MU systematic underestimated by 5.5±2.5% compared to XVMC. With individual correction, mean hand-calculated MUs matched with XVMC by - 0.3±1.4%/0.4±1.4 for beams/arcs, respectively. After average 5% correction, hand-calculated MUs matched with XVMC by 0.5±2.5%/0.6±2.0% for beams/arcs, respectively. Smaller dependence on tumor volume(TV)/field size(FS) was also observed. Ion-chamber measurement was within ±3.0%. Conclusion: PB-hete overestimates dose to lung tumor relative to XVMC. XVMC-algorithm is much more-complex and accurate with tissues-heterogeneities. Measurement at machine is time consuming and need extra resources; also direct measurement of dose for heterogeneous treatment plans is not clinically practiced, yet. This simple correction-based method was very helpful for independent-2nd-check of MC-lung-SBRT plans and routinely used in our clinic. A look-up table can be generated to include TV/FS dependence in ICFs.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-182: Feasibility of Dose Painting by Numbers in Proton Therapy with Contour-Driven Plan Optimization

Purpose: The work aims to 1) prove the feasibility of dose painting by numbers (DPBN) in proton therapy with usual contour-driven plan optimization and 2) compare the achieved plan quality to that of rotational IMRT. Methods: For two patients with head and neck cancers, voxel-by-voxel prescription to the target volume (PTV-PET) was calculated from {sup 18} FDG-PET images and converted to contour-based prescription by defining several sub-contours. Treatments were planned with RayStation (RaySearch Laboratories, Sweden) and proton pencil beam scanning modality. In order to determine the optimal plan parameters to approach the DPBN prescription, the effect of the number of fields, number of sub-contours and use of range shifter were tested separately on each patient. The number of sub-contours were increased from 3 to 11 while the number of fields were set to 3, 5, 7 and 9. Treatment plans were also optimized on two rotational IMRT systems (TomoTherapy and Varian RapidArc) using previously published guidelines. Results: For both patients, more than 99% of the PTV-PET received at least 95% of the prescribed dose while less than 1% of the PTV-PET received more than 105%, which demonstrates the feasibility of the treatment. Neither the use of a range shifter nor the increase of the number of fields had a significant influence on PTV coverage. Plan quality increased when increasing number of fields up to 7 or 9 and slightly decreased for a bigger number of sub-contours. Good OAR sparing is achieved while keeping high plan quality. Finally, proton therapy achieved significantly better plan quality than rotational IMRT. Conclusion: Voxel-by-voxel prescriptions can be approximated accurately in proton therapy using a contour-driven optimization. Target coverage is nearly insensitive to the number of fields and the use of a range shifter. Finally, plan quality assessment confirmed the superiority of proton therapy compared to rotational IMRT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-488: An Iso-Dose Curve Based Interactive IMRT Optimization System for Physician-Driven Plan Tuning

Purpose: In treatment plan optimization for Intensity Modulated Radiation Therapy (IMRT), after a plan is initially developed by a dosimetrist, the attending physician evaluates its quality and often would like to improve it. As opposed to having the dosimetrist implement the improvements, it is desirable to have the physician directly and efficiently modify the plan for a more streamlined and effective workflow. In this project, we developed an interactive optimization system for physicians to conveniently and efficiently fine-tune iso-dose curves. Methods: An interactive interface is developed under C++/Qt. The physician first examines iso-dose lines. S/he then picks an iso-dose curve to be improved and drags it to a more desired configuration using a computer mouse or touchpad. Once the mouse is released, a voxel-based optimization engine is launched. The weighting factors corresponding to voxels between the iso-dose lines before and after the dragging are modified. The underlying algorithm then takes these factors as input to re-optimize the plan in near real-time on a GPU platform, yielding a new plan best matching the physician's desire. The re-optimized DVHs and iso-dose curves are then updated for the next iteration of modifications. This process is repeated until a physician satisfactory plan is achieved. Results: We have tested this system for a series of IMRT plans. Results indicate that our system provides the physicians an intuitive and efficient tool to edit the iso-dose curves according to their preference. The input information is used to guide plan re-optimization, which is achieved in near real-time using our GPU-based optimization engine. Typically, a satisfactory plan can be developed by a physician in a few minutes using this tool. Conclusion: With our system, physicians are able to manipulate iso-dose curves according to their preferences. Preliminary results demonstrate the feasibility and effectiveness of this tool.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation

Purpose: An important challenge facing online adaptive radiation therapy is the development of feasible and efficient quality assurance (QA). This project aimed to validate the deliverability of online adapted plans and develop a proof-of-concept online delivery monitoring system for online adaptive radiation therapy QA. Methods: The first part of this project benchmarked automatically online adapted prostate treatment plans using traditional portal dosimetry IMRT QA. The portal dosimetry QA results of online adapted plans were compared to original (unadapted) plans as well as randomly selected prostate IMRT plans from our clinic. In the second part, an online delivery monitoring system was designed and validated via a simulated treatment with intentional multileaf collimator (MLC) errors. This system was based on inputs from the dynamic machine information (DMI), which continuously reports actual MLC positions and machine monitor units (MUs) at intervals of 50 ms or less during delivery. Based on the DMI, the system performed two levels of monitoring/verification during the delivery: (1) dynamic monitoring of cumulative fluence errors resulting from leaf position deviations and visualization using fluence error maps (FEMs); and (2) verification of MLC positions against the treatment plan for potential errors in MLC motion and data transfer at each control point. Validation of the online delivery monitoring system was performed by introducing intentional systematic MLC errors (ranging from 0.5 to 2 mm) to the DMI files for both leaf banks. These DMI files were analyzed by the proposed system to evaluate the system’s performance in quantifying errors and revealing the source of errors, as well as to understand patterns in the FEMs. In addition, FEMs from 210 actual prostate IMRT beams were analyzed using the proposed system to further validate its ability to catch and identify errors, as well as establish error magnitude baselines for prostate IMRT delivery. Results: Online adapted plans were found to have similar delivery accuracy in comparison to clinical IMRT plans when validated with portal dosimetry IMRT QA. FEMs for the simulated deliveries with intentional MLC errors exhibited distinct patterns for different MLC error magnitudes and directions, indicating that the proposed delivery monitoring system is highly specific in detecting the source of errors. Implementing the proposed QA system for online adapted plans revealed excellent delivery accuracy: over 99% of leaf position differences were within 0.5 mm, and >99% of pixels in the FEMs had fluence errors within 0.5 MU. Patterns present in the FEMs and MLC control point analysis for actual patient cases agreed with the error pattern analysis results, further validating the system’s ability to reveal and differentiate MLC deviations. Calculation of the fluence map based on the DMI was performed within 2 ms after receiving each DMI input. Conclusions: The proposed online delivery monitoring system requires minimal additional resources and time commitment to the current clinical workflow while still maintaining high sensitivity to leaf position errors and specificity to error types. The presented online delivery monitoring system therefore represents a promising QA system candidate for online adaptive radiation therapy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-D-BRB-02: Patient-Specific Rectal Toxicity Predictor Based Plan Quality Control for Prostate Stereotactic Body Radiation Therapy (SBRT)

Purpose: To develop a patient-specific rectal toxicity predictor guided plan quality control tool for prostate SBRT plans. Methods: For prostate SBRT cases, four segments of rectal walls including peri-prostatic anterior rectal wall, peri-prostatic lateral rectal walls, peri-prostatic posterior rectal wall and rectum superior to prostate are identified as organs at risk and the circumference of rectal wall receiving more than 39 Gy (CRW39) and 24 Gy (CRW24) are rectal toxicity predictors. In this new geometry-dosimetry model, a patient geometry descriptor, differential circumference of rectal wall (dCRW) is used as model input geometry parameters and plan dosimetric endpoints CRW39 and CRW24 are output dosimetric parameters. Linear models are built to correlate dCRW to both CRW39 and CRW24 and established with both a linear regression method and a modified bagging ensemble machine learning method. 27 SBRT prostate cases are retrospectively studied from a dose-escalated clinical trial research. 20 prescribed 50 Gy SBRT cases are recruited to train the model and the other rescaled 7 cases are used to evaluated model feasibility and accuracy. Results: Each solved linear coefficient sequence related to CRW39 or CRW24 is a one-dimensional decreasing function of the distance from the PTV boundary, indicating that the different locations of each rectal circumference have different contributions to each particular dosimetric endpoint. The fitting errors for those trained 20 prostate SBRT cases are small with mean values of 2.39%, 2.45% relative to the endpoint values for SBRT rectal toxicity predictor CRW39 and CRW24 respectively. 1 out of 7 evaluation plans is identified as poor quality plan. After re-planning, the CRW39 and CRW24 can be reduced by 3.34% and 3%, without sacrificing PTV coverage. Conclusion: The proposed patient geometry-plan toxicity predictor model for SBRT plans can be successfully applied to plan quality control for prostate SBRT cases.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-166: Characterization of Efficiency and Plan Quality for the FFF Beams On Various Anatomical Sites

Purpose: To characterize efficiency and plan quality for the FFF beams for various sites. Methods: 5 brain, Head and Neck, prostate, lung and liver cancer patients IMRT plans (25 total) were generated on either Prowess 4.6 or Eclipse 13.5 using the same dose constraints for each treatment site. Step and shoot with static gantry IMRT was used for treatment delivery. PTV coverage, critical structure doses, MUs, number of segments and beam on times were compared. Results: The average PTV size was 29.0, 34.9, 89.2, 257.6, 289.2 cm3 for liver, lung, prostate, head and neck and brain respectively.All plans were normalized such that 95% of the PTV volume would receive at least 95% of prescribed dose. All doses to the critical structures for both the FFF and flat beam met the targeted dose constraints.For plans with field sizes < 10 cm, the number of segments and MUs required to achieve the same plan quality were similar. For these small field sizes with large dose per fraction, an increase in efficiency up to 58.8% is seen.Plans with field sizes > 10 cm, required 10% – 20% more segments and MUs for the FFF beam to achieve the same plan quality as the flat beam. Despite this, for fraction sizes less than 2.5 Gy the FFF beam is still approximately 13.9% more efficient in terms of delivery time. Conclusion: For the various treatment sites studied here, plans generated with the FFF beam were dosimetrically similar to those generated with a flattened beam. Despite the greater number of MUs and segments required to achieve the same plan quality as the flat beam for some plans, the FFF beam is still more efficient compared to the flat beam.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

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↗
DOE OSTI2015

SU-E-T-370: Evaluating Plan Quality and Dose Delivery Accuracy of Tomotherapy SBRT Treatments for Lung Cancer

Purpose: This study evaluated the plan quality and dose delivery accuracy of stereotactic body radiotherapy (SBRT) helical Tomotherapy (HT) treatments for lung cancer. Results were compared with those previously reported by our group for flattening filter (FF) and flattening filter free (FFF) VMAT treatments. This work forms part of an ongoing multicentre and multisystem planning and dosimetry audit on FFF beams for lung SBRT. Methods: CT datasets and DICOM RT structures delineating the target volume and organs at risk for 6 lung cancer patients were selected. Treatment plans were generated using the HT treatment planning system. Tumour locations were classified as near rib, near bronchial tree or in free lung with prescribed doses of 48Gy/4fr, 50Gy/5fr and 54Gy/3fr respectively. Dose constraints were specified by a modified RTOG0915 protocol used for an Australian SBRT phase II trial. Plan quality was evaluated using mean PTV dose, PTV volume receiving 100% of the prescribed dose (V100%), target conformity (CI=VD100%/VPTV) and low dose spillage (LDS=VD50%/VPTV). Planned dose distributions were compared to those measured using an ArcCheck phantom. Delivery accuracy was evaluated using a gamma-index pass rate of 95% with 3% (of max dose) and 3mm criteria. Results: Treatment plans for all patients were clinically acceptable in terms of quality and accuracy of dose delivery. The following DVH metrics are reported as averages (SD) of all plans investigated: mean PTV dose was 115.3(2.4)% of prescription, V100% was 98.8(0.9)%, CI was 1.14(0.03) and LDS was 5.02(0.37). The plans had an average gamma-index passing rate of 99.3(1.3)%. Conclusion: The results reported in this study for HT agree within 1 SD to those previously published by our group for VMAT FF and FFF lung SBRT treatments. This suggests that HT delivers lung SBRT treatments of comparable quality and delivery accuracy as VMAT using both FF and FFF beams.

60 APPLIED LIFE SCIENCES↗