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All sourcesNASA NTRSDOE OSTI
NASA NTRS2012

Emperical Tests of Acceptance Sampling Plans

Acceptance sampling is a quality control procedure applied as an alternative to 100% inspection. A random sample of items is drawn from a lot to determine the fraction of items which have a required quality characteristic. Both the number of items to be inspected and the criterion for determining conformance of the lot to the requirement are given by an appropriate sampling plan with specified risks of Type I and Type II sampling errors. In this paper, we present the results of empirical tests of the accuracy of selected sampling plans reported in the literature. These plans are for measureable quality characteristics which are known have either binomial, exponential, normal, gamma, Weibull, inverse Gaussian, or Poisson distributions. In the main, results support the accepted wisdom that variables acceptance plans are superior to attributes (binomial) acceptance plans, in the sense that these provide comparable protection against risks at reduced sampling cost. For the Gaussian and Weibull plans, however, there are ranges of the shape parameters for which the required sample sizes are in fact larger than the corresponding attributes plans, dramatically so for instances of large skew. Tests further confirm that the published inverse-Gaussian (IG) plan is flawed, as reported by White and Johnson (2011).

White, K. Preston, Jr.↗
NASA NTRS2012

Real-Time Projection to Verify Plan Success During Execution

The Mission Data System provides a framework for modeling complex systems in terms of system behaviors and goals that express intent. Complex activity plans can be represented as goal networks that express the coordination of goals on different state variables of the system. Real-time projection extends the ability of this system to verify plan achievability (all goals can be satisfied over the entire plan) into the execution domain so that the system is able to continuously re-verify a plan as it is executed, and as the states of the system change in response to goals and the environment. Previous versions were able to detect and respond to goal violations when they actually occur during execution. This new capability enables the prediction of future goal failures; specifically, goals that were previously found to be achievable but are no longer achievable due to unanticipated faults or environmental conditions. Early detection of such situations enables operators or an autonomous fault response capability to deal with the problem at a point that maximizes the available options. For example, this system has been applied to the problem of managing battery energy on a lunar rover as it is used to explore the Moon. Astronauts drive the rover to waypoints and conduct science observations according to a plan that is scheduled and verified to be achievable with the energy resources available. As the astronauts execute this plan, the system uses this new capability to continuously re-verify the plan as energy is consumed to ensure that the battery will never be depleted below safe levels across the entire plan.

Wagner, David A.↗
NASA NTRS2014

Towards a Formal Semantics of Flight Plans and Trajectories

In the National Airspace System, ight plans are often used only as a planning tool by air trac controllers and aircraft operators. These plans are implicitly translated into trajectories by the pilot or by the ight management system, and subsequently own by the aircraft. This translation process inevitably introduces di erences between the plan and the trajectory. However, given the current intended usage, exact correspondence between the plan and the trajectory is not needed. To achieve greater capacity and eciency, future air trac management concepts are being designed around the use of trajectories where predictability is extremely important. In this paper, a mathematical relationship between ight plans and trajectories is explored with the goal of making feasible, highly accurate predictions of future positions and velocities of aircraft. The goal here is to describe, in mathematically precise detail, a formal language of trajectories, whereby all receivers of the trajectory information will be able to arrive at precisely the same trajectory predication and to do this without having aircraft broadcast a large amount of data. Although even a four-dimensional ight plan is simple in structure, this paper will show that it is inherently ambiguous and will explore these issues in detail. In e ect, we propose that a rigorous semantics for ight plans can be developed and this will serve as an important stepping stone towards trajectory-based operations in the National Airspace System.

Hagen, George E.↗
NASA NTRS2017

Integrated Extravehicular Activity Human Research Plan: 2017

Multiple organizations within NASA as well as industry and academia fund and participate in research related to extravehicular activity (EVA). In October 2015, representatives of the EVA Office, the Crew and Thermal Systems Division (CTSD), and the Human Research Program (HRP) at NASA Johnson Space Center agreed on a formal framework to improve multi-year coordination and collaboration in EVA research. At the core of the framework is an Integrated EVA Human Research Plan and a process by which it will be annually reviewed and updated. The over-arching objective of the collaborative framework is to conduct multi-disciplinary cost-effective research that will enable humans to perform EVAs safely, effectively, comfortably, and efficiently, as needed to enable and enhance human space exploration missions. Research activities must be defined, prioritized, planned and executed to comprehensively address the right questions, avoid duplication, leverage other complementary activities where possible, and ultimately provide actionable evidence-based results in time to inform subsequent tests, developments and/or research activities. Representation of all appropriate stakeholders in the definition, prioritization, planning and execution of research activities is essential to accomplishing the over-arching objective. A formal review of the Integrated EVA Human Research Plan will be conducted annually. Coordination with stakeholders outside of the EVA Office, CTSD, and HRP is already in effect on a study-by-study basis; closer coordination on multi-year planning with other EVA stakeholders including academia is being actively pursued. Details of the preliminary Integrated EVA Human Research Plan are presented including description of ongoing and planned research activities in the areas of: physiological and performance capabilities; suit design parameters; EVA human health and performance modeling; EVA tasks and concepts of operations; EVA informatics; human-suit sensors; suit sizing and fit; and EVA injury risk and mitigation. This paper represents the 2017 update to the Integrated EVA Human Research Plan.

Abercromby, Andrew↗
NASA NTRS2019

Overview of the PLEXIL Plan Execution Technology and its Applications in Autonomous Piloting Projects at NASA

Automated planning is a key Artificial Intelligence technology enabling Unmanned Aerial Systems (UAS) and the eminent reality of Urban Air Mobility (UAM). It produces plans, which formalize procedures often performed by humans. Plans differ from other kinds of computer programs in their ability to react and interact with a dynamically changing environment. Aviation plans must encode the procedural knowledge, reasoning capability, and capacity for multi-tasking held by competent human pilots. Correct execution of these plans (performed by software called an executive) in the dynamic airspace environment is vital to the success of each automated flight, and the safety of the vehicle and all things in its path. In the early 2000s NASA developed a plan representation language and executive called PLEXIL (Plan Execution Interchange Language) that has successfully been applied in several NASA aviation and UAS projects. Autonomy Operating System (AOS), Cockpit Hierarchical Automated Planning and Execution (CHAP-E), and ICAROUS are all projects that have used PLEXIL to help encode and automatically execute flight procedures, some normally performed by human pilots. AOS also automates a subset of pilot/Air Traffic Control communication towards enabling UAS entry into the National Airspace. PLEXIL has been open-source software since 2008 and has seen usage in a wide range of prototypical autonomy applications in academia, government, and industry. In this presentation, we describe PLEXIL and highlight its significant accomplishments in the aviation domain.

Dalal, Michael↗
NASA NTRS2019

Integrated Research Plan to Assess the Combined Effects of Space Radiation, Altered Gravity, and Isolation and Confinement on Crew Health and Performance: Implementation Strategy

This document supplements the white paper titled CBS Integrated Research Plan: Problem Statement. The Problem Statement describes why it is important to implement a fully integrated research plan to derive risk estimates for the combined, potentially synergistic, effects of the three major spaceflight hazards (space radiation; isolated, confined, and extreme environments; altered gravity). These risk estimates will help establish acceptable maximum decrement or change in a physiological or behavioral parameter during or after spaceflight, and the acceptable limit of exposure to the combined spaceflight hazards. This Implementation Strategy describes how the research plan will accomplish the CBS Integrated Research Plan goals. The Implementation Strategy includes approaches to evaluate relationships among biological responses underlying three risks that are managed by three of NASA’s Human Research Project (HRP) organizational “elements”. This CBS (Acute effects of radiation on CNS, BMed, Sensorimotor) Integrated Research Plan also identifies strategies to monitor and mitigate decrements to operationally relevant performance. Currently, the strategy that was initiated in 2018, includes an eight-year research plan and a four-year validation plan that extend to the year 2030. Once the monitoring tools and countermeasures are developed, they will be validated and refined during four years of early exploration missions. The planned tasks and their associated research products and deliverables have been mapped to the individual research emphases to clearly demonstrate how each research area helps ensure crew health and safety during exploration missions.

Susan Steinberg↗
NASA NTRS2020

Parsing-based Approaches for Verification and Recognition of Hierarchical Plans

Hierarchical Task Networks were proposed as a method todescribe plans by decomposition of tasks to sub-tasks untilprimitive tasks, actions, are obtained. Plan verification assumesa complete plan as input, and the objective is findinga task that decomposes to this plan. In plan recognition, aprefix of the plan is given and the objective is finding a taskthat decomposes to the (shortest) plan with the given prefix.This paper describes how to verify and recognize plans usinga common method known from formal grammars, by parsing.

Bartak, Roman↗
DOE OSTI2013

The Revised WIPP Passive Institutional Controls Program - A Conceptual Plan - 13145

The Department of Energy/Carlsbad Field Office (DOE/CBFO) is responsible for managing all activities related to the disposal of TRU and TRU-mixed waste in the geologic repository, 650 m below the land surface, at WIPP, near Carlsbad, New Mexico. The main function of the Passive Institutional Controls (PIC's) program is to inform future generations of the long-lived radioactive wastes buried beneath their feet in the desert. For the first 100 years after cessation of disposal operations, the rooms are closed and the shafts leading underground sealed, WIPP is mandated by law to institute Active Institutional Controls (AIC's) with fences, gates, and armed guards on patrol. At this same time a plan must be in place of how to warn/inform the future, after the AIC's are gone, of the consequences of intrusion into the geologic repository disposal area. A plan was put into place during the 1990's with records management and storage, awareness triggers, permanent marker design concepts and testing schedules. This work included the thoughts of expert panels and individuals. The plan held up under peer review and met the requirements of the U.S. Environmental Protection Agency (EPA). Today the NEA is coordinating a study called the 'Preservation of Records, Knowledge and Memory (RK and M) Across Generations' to provide the international nuclear waste repository community with a guide on how a nuclear record archive programs should be approached and developed. CBFO is cooperating and participating in this project and will take what knowledge is gained and apply that to the WIPP program. At the same time CBFO is well aware that the EPA and others are expecting DOE to move forward with planning for the future WIPP PIC's program; so a plan will be in place in time for WIPP's closure slated for the early 2030's. The DOE/CBFO WIPP PIC's program in place today meets the regulatory criteria, but complete feasibility of implementation is questionable, and may not be in conformance with the international guidance being developed. International guidance currently under development may suggest that the inter-generational equity principle strives to warn the future, however, in doing so not to unduly burden present generations. Building markers and monuments that are out of proportion to the risk being presented to the future is not in keeping with generational equity. With this in mind the DOE/CBFO is developing conceptual plans for re-evaluating and revising the current WIPP PIC's program. These conceptual plans will suggest scientific and technical work that must be completed to develop a 'new' PICs program that takes the best ideas of the present plan, blended with new ideas from the RK and M project, and proposed alternative permanent markers designs and materials in consideration. (authors)

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

Prototyping and validating requirements of radiation and nuclear emergency plan simulator

Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder’s intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties’ absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗
DOE OSTI2017

State Engagement in Electric Distribution System Planning

Electric distribution system planning is focused on assessing needed physical and operational changes to the local grid to maintain safe, reliable, and affordable service. While electric utilities have always engaged in this activity, the planning horizon has typically been short and involvement by state utility regulators minimal. Safety, reliability, and affordability remain top objectives for deeper state engagement in longer-term distribution system planning. Other drivers are proposed utility investments to replace aging infrastructure and modernize grids, opportunities to improve distribution system efficiency, enabling consumers to have greater control over energy costs and sources, and integrating higher levels of distributed energy resources (DERs) such as rooftop solar, distributed energy storage, and price-responsive demand. This report provides a snapshot of current state engagement in distribution system planning: •Part 1 describes activities in states that have adopted some elements of integrated distribution system planning and analysis (see Figure 1): New York, California, Hawaii, Massachusetts, and Minnesota. It summarizes their impetus for early action, stated goals, regulatory requirements, additional state activities related to distribution system planning, and next steps. •Part 2 covers a broader array of state approaches throughout the country. For example, some of these states have long-standing distribution reliability and performance codes, requiring regulated utilities to report regularly on poor-performing circuits and propose investments for improvements. Other states require regulated utilities to make filings related to proposed grid modernization investments. A growing number of states are beginning to consider comprehensive distribution system planning processes. As this report highlights, approaches vary significantly from state to state, in part stemming from differences in electricity market structure. States can learn from each other and tailor successful approaches to their unique circumstances. Reviewing the broad range of legislative and public utility commission activities described in this report is a useful starting point.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2018

A Guide for Incorporating Energy Efficiency in State Energy Plans

State energy planning offers an opportunity for states to develop a vision of their energy future. States that include energy efficiency policies and programs in their energy plans are well-positioned to develop programs that support energy policies that increase energy affordability, reliability, and resiliency. The two most cited goals of the forty states with active energy plans as of 2017 are to: (1) ensure a reliable supply of energy and (2) manage costs so energy is affordable for businesses and residents. Energy efficiency is an important strategy for achieving both goals. To explore these areas fully, states may also wish to update or build on their existing state energy plans. States may want to consider the use of enhanced stakeholder engagement experts and/or modeling approaches described in this guide. Energy planning teams–often led by state energy offices–should also consider the use of metrics or other approaches to track implementation progress over time. States may wish to use the examples, plans, and resources referenced as they develop their own unique energy plans.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2023

Principles for Equitable Transmission Planning

Energy justice is gaining traction in the planning processes that govern the generation and supply of electric power in the U.S., with a growing number of federal and state authorities applying it as a framework to ensure that the benefits of a clean energy future extend to all levels of society. However, the principles of energy justice have not yet been integrated into electric transmission planning processes, which are designed to meet established reliability criteria and have not historically considered externalities like social inequities. This paper presents a review of transmission planning requirements in the U.S. and existing literature on energy justice, then synthesizes them to propose a framework for incorporating energy justice principles into transmission planning processes to yield more equitable outcomes. By applying procedural and recognition justice principles to create more extensive, inclusive, and diverse public participation in the planning process, planners can gain insight into—and begin to correct—the inequities created by previous planning decisions. Equipped with this understanding and informed by affected communities, planners can improve the distributional outcomes of the planning process and identify opportunities for energy system investments that will restore communities and place them on more equitable footing.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2024

Brazil's Action Plan for Rapid Decarbonization of Power Sectors

A collaborative report from the Clean Energy Ministerial (CEM) on Lessons Learned for Rapid Decarbonization of Power Sectors was delivered to energy ministers and presented at the CEM13 in the United States in September 2022. In light of these lessons learned and discussed at CEM13, several jurisdictions signaled intent to develop Action Plans for power sector decarbonization. The first cohort of Action Plans was released at CEM14 in India in July 2023. The second cohort of action plans will be presented at CEM15 in Brazil. The Action Plans, supported by the 21st Century Power Partnership, and other CEM workstreams via direct technical assistance and capacity building, are intended to focus on select implementation actions, given each country's existing power sector goals and activities, and are an opportunity for countries to display leadership in power sector decarbonization. The Action Plans are organized in a framework for Planning, Building and Operating, as well as Stakeholder Engagement where appropriate based on country priorities. They complement, but are differentiated from, other international power sector initiatives such as the Breakthrough Agenda (whose broad purpose is to raise collective ambition) and the Global Power System Transformation Consortium (whose goals are to convene power system operators to accelerate research innovations and foster peer learning). These Action Plans are voluntary, developed by each country individually, not comprehensive of all activities within the jurisdiction, and are living documents that are subject to change.

21st Century Power Partnership↗
DOE OSTI2022

Recent advances and challenges in optimization models for expansion planning of power systems and reliability optimization

Optimization models for expansion planning of power systems aim to determine capacities, investment timing, and location of power systems to satisfy the power demands while minimizing the total cost. The models have become complex in recent years to reflect both regulations on conventional energy sources and the increasing penetration of renewable energy sources (RES). This paper reviews the basic concepts and optimization models for expansion planning of power systems. We first explain the definition and features of generation expansion planning (GEP), transmission expansion planning (TEP), and generation and transmission expansion planning (GTEP). To address the computational challenges of large-scale expansion planning problems, we review several simplifications including temporal and spatial aggregation, and decomposition methods. This paper also addresses power system reliability defined as the probability of satisfying the load demand while withstanding failures of components. Finally, the goal of this paper is to provide a research overview, discuss trends in expansion planning of power systems, and suggest directions for future research.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2011

Patient-Specific Monte Carlo-Based Dose-Kernel Approach for Inverse Planning in Afterloading Brachytherapy

Purpose: Brachytherapy planning software relies on the Task Group report 43 dosimetry formalism. This formalism, based on a water approximation, neglects various heterogeneous materials present during treatment. Various studies have suggested that these heterogeneities should be taken into account to improve the treatment quality. The present study sought to demonstrate the feasibility of incorporating Monte Carlo (MC) dosimetry within an inverse planning algorithm to improve the dose conformity and increase the treatment quality. Methods and Materials: The method was based on precalculated dose kernels in full patient geometries, representing the dose distribution of a brachytherapy source at a single dwell position using MC simulations and the Geant4 toolkit. These dose kernels are used by the inverse planning by simulated annealing tool to produce a fast MC-based plan. A test was performed for an interstitial brachytherapy breast treatment using two different high-dose-rate brachytherapy sources: the microSelectron iridium-192 source and the electronic brachytherapy source Axxent operating at 50 kVp. Results: A research version of the inverse planning by simulated annealing algorithm was combined with MC to provide a method to fully account for the heterogeneities in dose optimization, using the MC method. The effect of the water approximation was found to depend on photon energy, with greater dose attenuation for the lower energies of the Axxent source compared with iridium-192. For the latter, an underdosage of 5.1% for the dose received by 90% of the clinical target volume was found. Conclusion: A new method to optimize afterloading brachytherapy plans that uses MC dosimetric information was developed. Including computed tomography-based information in MC dosimetry in the inverse planning process was shown to take into account the full range of scatter and heterogeneity conditions. This led to significant dose differences compared with the Task Group report 43 approach for the Axxent source.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

An Atlas-Based Electron Density Mapping Method for Magnetic Resonance Imaging (MRI)-Alone Treatment Planning and Adaptive MRI-Based Prostate Radiation Therapy

Purpose: Prostate radiation therapy dose planning directly on magnetic resonance imaging (MRI) scans would reduce costs and uncertainties due to multimodality image registration. Adaptive planning using a combined MRI-linear accelerator approach will also require dose calculations to be performed using MRI data. The aim of this work was to develop an atlas-based method to map realistic electron densities to MRI scans for dose calculations and digitally reconstructed radiograph (DRR) generation. Methods and Materials: Whole-pelvis MRI and CT scan data were collected from 39 prostate patients. Scans from 2 patients showed significantly different anatomy from that of the remaining patient population, and these patients were excluded. A whole-pelvis MRI atlas was generated based on the manually delineated MRI scans. In addition, a conjugate electron-density atlas was generated from the coregistered computed tomography (CT)-MRI scans. Pseudo-CT scans for each patient were automatically generated by global and nonrigid registration of the MRI atlas to the patient MRI scan, followed by application of the same transformations to the electron-density atlas. Comparisons were made between organ segmentations by using the Dice similarity coefficient (DSC) and point dose calculations for 26 patients on planning CT and pseudo-CT scans. Results: The agreement between pseudo-CT and planning CT was quantified by differences in the point dose at isocenter and distance to agreement in corresponding voxels. Dose differences were found to be less than 2%. Chi-squared values indicated that the planning CT and pseudo-CT dose distributions were equivalent. No significant differences (p > 0.9) were found between CT and pseudo-CT Hounsfield units for organs of interest. Mean {+-} standard deviation DSC scores for the atlas-based segmentation of the pelvic bones were 0.79 {+-} 0.12, 0.70 {+-} 0.14 for the prostate, 0.64 {+-} 0.16 for the bladder, and 0.63 {+-} 0.16 for the rectum. Conclusions: The electron-density atlas method provides the ability to automatically define organs and map realistic electron densities to MRI scans for radiotherapy dose planning and DRR generation. This method provides the necessary tools for MRI-alone treatment planning and adaptive MRI-based prostate radiation therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Dosimetric Verification Using Monte Carlo Calculations for Tissue Heterogeneity-Corrected Conformal Treatment Plans Following RTOG 0813 Dosimetric Criteria for Lung Cancer Stereotactic Body Radiotherapy

Purpose: The recently activated Radiation Therapy Oncology Group (RTOG) studies of stereotactic body radiation therapy (SBRT) for non-small-cell lung cancer (NSCLC) require tissue density heterogeneity correction, where the high and intermediate dose compliance criteria were established based on superposition algorithm dose calculations. The study was aimed at comparing superposition algorithm dose calculations with Monte Carlo (MC) dose calculations for SBRT for NSCLC and to evaluate whether compliance criteria need to be adjusted for MC dose calculations. Methods and Materials: Fifteen RTOG 0236 study sets were used. The planning tumor volumes (PTV) ranged from 10.7 to 117.1 cm{sup 3}. SBRT conformal treatment plans were generated using XiO (CMS Inc.) treatment planning software with superposition algorithm to meet the dosimetric high and intermediate compliance criteria recommended by the RTOG 0813 protocol. Plans were recalculated using the MC algorithm of a Monaco (CMS, Inc.) treatment planning system. Tissue density heterogeneity correction was applied in both calculations. Results: Overall, the dosimetric quantities of the MC calculations have larger magnitudes than those of the superposition calculations. On average, R{sub 100%} (ratio of prescription isodose volume to PTV), R{sub 50%} (ratio of 50% prescription isodose volume to PTV), D{sub 2cm} (maximal dose 2 cm from PTV in any direction as a percentage of prescription dose), and V{sub 20} (percentage of lung receiving dose equal to or larger than 20 Gy) increased by 9%, 12%, 7%, and 18%, respectively. In the superposition plans, 3 cases did not meet criteria for R{sub 50%} or D{sub 2cm}. In the MC-recalculated plans, 8 cases did not meet criteria for R{sub 100%}, R{sub 50%}, or D{sub 2cm}. After reoptimization with MC calculations, 5 cases did not meet the criteria for R{sub 50%} or D{sub 2cm}. Conclusions: Results indicate that the dosimetric criteria, e.g., the criteria for R{sub 50%} recommended by RTOG 0813 protocol, may need to be adjusted when the MC dose calculation algorithm is used.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗