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Beginner's Guide to Understanding Power System Model Results for Long-Term Resource Plans

This guide was developed to improve decision-making in the electricity planning process by strengthening dialogue between electricity system planners and stakeholders throughout the process. This document was created for anyone who is first getting exposed to scenario results from power system planning models, or for those who are beginning to interact with power system modelers. It does not assume any experience with power system modeling, or familiarity with electricity planning concepts. This guide can be helpful to a wide range of people, including but not limited to state utility commissioners and commission staff, state energy offices, and intervenors in the planning process. It is targeted to those who are evaluating or reviewing model results presented by a utility, which typically span utility-scale generation and storage (and associated transmission) assets. This guide is designed to provide enough background and guidance that stakeholders can formulate and ask questions to evaluate model results through a deeper understanding of the key assumptions, data, and methods that drive decision outcomes. The ultimate purpose of this work is to increase transparency in the electricity planning process by enabling stakeholders to better engage and evaluate model results. A follow-on guide will provide a deeper dive into emerging topics, which are expected to become more prominent in the electricity planning process, but whose methods and approaches are still being refined.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Beginner's Guide to Understanding Power System Model Results for Long-Term Resource Plans

This presentation summarizes a recently published beginner's guide for understanding power system model results for long-term resource plans. This guide is designed to improve decision-making in the electricity planning process by strengthening dialogue between system planners and relevant stakeholders. It focuses on interpreting scenario results generated by power system planning models. These results are often used to inform integrated resource plans, which are long-term plans for a utility to meet future electricity requirements. Whether you are a state utility commissioner, commission staff, part of a state energy office, an intervenor in the planning process, or another stakeholder, this guide is designed to help you better weigh in on the modeling methods or interpret the model results to improve decision-making. This guide can enhance your understanding to ask the right questions, which can enable better understanding of results and key assumptions, data, and methods.

ENERGY PLANNING, POLICY, AND ECONOMY↗

Adaptive Planning in Intensity-Modulated Radiation Therapy for Head and Neck Cancers: Single-Institution Experience and Clinical Implications

Purpose: Anatomic changes and positional variability during intensity-modulated radiation therapy (IMRT) for head and neck cancer can lead to clinically significant dosimetric changes. We report our single-institution experience using an adaptive protocol and correlate these changes with anatomic and positional changes during treatment. Methods and Materials: Twenty-three sequential head and neck IMRT patients underwent serial computed tomography (CT) scans during their radiation course. After undergoing the planning CT scan, patients underwent planned rescans at 11, 22, and 33 fractions; a total of 89 scans with 129 unique CT plan combinations were thus analyzed. Positional variability and anatomic changes during treatment were correlated with changes in dosimetric parameters to target and avoidance structures between planning CT and subsequent scans. Results: A total of 15/23 patients (65%) benefited from adaptive planning, either due to inadequate dose to gross disease or to increased dose to organs at risk. Significant differences in primary and nodal targets (planning target volume, gross tumor volume, and clinical tumor volume), parotid, and spinal cord dosimetric parameters were noted throughout the treatment. Correlations were established between these dosimetric changes and weight loss, fraction number, multiple skin separations, and change in position of the skull, mandible, and cervical spine. Conclusions: Variations in patient positioning and anatomy changes during IMRT for head and neck cancer can affect dosimetric parameters and have wide-ranging clinical implications. The interplay between random positional variability and gradual anatomic changes requires careful clinical monitoring and frequent use of CT- based image-guided radiation therapy, which should determine variations necessitating new plans.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

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

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗

MR-OPERA: A Multicenter/Multivendor Validation of Magnetic Resonance Imaging–Only Prostate Treatment Planning Using Synthetic Computed Tomography Images

Purpose: To validate the dosimetric accuracy and clinical robustness of a commercially available software for magnetic resonance (MR) to synthetic computed tomography (sCT) conversion, in an MR imaging–only workflow for 170 prostate cancer patients. Methods and Materials: The 4 participating centers had MriPlanner (Spectronic Medical), an atlas-based sCT generation software, installed as a cloud-based service. A T2-weighted MR sequence, covering the body contour, was added to the clinical protocol. The MR images were sent from the MR scanner workstation to the MriPlanner platform. The sCT was automatically returned to the treatment planning system. Four MR scanners and 2 magnetic field strengths were included in the study. For each patient, a CT-treatment plan was created and approved according to clinical practice. The sCT was rigidly registered to the CT, and the clinical treatment plan was recalculated on the sCT. The dose distributions from the CT plan and the sCT plan were compared according to a set of dose-volume histogram parameters and gamma evaluation. Treatment techniques included volumetric modulated arc therapy, intensity modulated radiation therapy, and conventional treatment using 2 treatment planning systems and different dose calculation algorithms. Results: The overall (multicenter/multivendor) mean dose differences between sCT and CT dose distributions were below 0.3% for all evaluated organs and targets. Gamma evaluation showed a mean pass rate of 99.12% (0.63%, 1 SD) in the complete body volume and 99.97% (0.13%, 1 SD) in the planning target volume using a 2%/2-mm global gamma criteria. Conclusions: Results of the study show that the sCT conversion method can be used clinically, with minimal differences between sCT and CT dose distributions for target and relevant organs at risk. The small differences seen are consistent between centers, indicating that an MR imaging–only workflow using MriPlanner is robust for a variety of field strengths, vendors, and treatment techniques.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A product data network to enable faster, easier, and better planning of building envelopes

The building envelopes contributes significantly to the energy-efficiency of the building. Building performance simulation has made it possible to compare façade technologies regarding energy demand, daylighting, thermal and visual comfort in detail. Planners, such as architects and engineers, need experience to find product data with the right quality and level of detail, and to process the data to fit the calculation and the application. In the available time, planners can compare only a limited number of products, which means that better solutions could go unnoticed. This paper presents a new concept for making product data easily accessible for building façade planning. The concept consists of a network of databases for the efficient exchange and use of optical and calorimetric data of glazing units, shading devices, and combinations of both. The paper presents the research questions, an analysis of the current challenges, six design goals for the product data network and its implementation together with a discussion. Many product data sources can be connected to many planning software applications via the specified application programming interface. When planning software connects to the product data network, the planning of building envelopes can be much faster because planners do not need to spend so much time to search and process product data manually. The planning of building envelopes can also become much easier, especially for planners with limited experience. They do not need to understand all the details about which data fits which calculation if the software company implements this. The planning of building envelopes can become much more reliable when software companies validate their use of the product data network, because the current manual process is prone to errors. The planning of building envelopes can also improve because more products can be compared in the available time, allowing better solutions to be found.

Maurer, Christoph↗

The Accuracy of Inhomogeneity Corrections in Intensity Modulated Radiation Therapy Planning in Philips Pinnacle System

The degree of accuracy of inhomogeneity corrections in a treatment planning system is dependent on the algorithm used by the system. The choice of field size, however, could have an effect on the calculation accuracy as well. There have been several evaluation studies on the accuracy of inhomogeneity corrections used by different algorithms. Most of these studies, however, focus on evaluating the dose in phantom using simplified geometry and open/static fields. This work focuses on evaluating the degree of dose accuracy in calculations involving intensity-modulated radiation therapy (IMRT) fields incident on a phantom containing both lung- and bone-equivalent heterogeneities using 6 and 10 MV beams. IMRT treatment plans were generated using the Philips Pinnacle treatment planning system and delivered to a phantom containing 55 thermoluminescent dosimeter (TLD) locations within the lung and bone and near the lung and bone interfaces with solid water. The TLD readings were compared with the dose predicted by the planning system. We find satisfactory agreement between planned and delivered doses, with an overall absolute average difference between measurement and calculation of 1.2% for the 6 MV and 3.1% for the 10 MV beam with larger variations observed near the interfaces and in areas of high-dose gradient. The results presented here demonstrate that the convolution algorithm used in the Pinnacle treatment planning system produces accurate results in IMRT plans calculated and delivered to inhomogeneous media, even in regions that potentially lack electronic equilibrium.

61 RADIATION PROTECTION AND DOSIMETRY↗

A comparison between anisotropic analytical and multigrid superposition dose calculation algorithms in radiotherapy treatment planning

Monte Carlo (MC) simulation is currently the most accurate dose calculation algorithm in radiotherapy planning but requires relatively long processing time. Faster model-based algorithms such as the anisotropic analytical algorithm (AAA) by the Eclipse treatment planning system and multigrid superposition (MGS) by the XiO treatment planning system are 2 commonly used algorithms. This study compared AAA and MGS against MC, as the gold standard, on brain, nasopharynx, lung, and prostate cancer patients. Computed tomography of 6 patients of each cancer type was used. The same hypothetical treatment plan using the same machine and treatment prescription was computed for each case by each planning system using their respective dose calculation algorithm. The doses at reference points including (1) soft tissues only, (2) bones only, (3) air cavities only, (4) soft tissue-bone boundary (Soft/Bone), (5) soft tissue-air boundary (Soft/Air), and (6) bone-air boundary (Bone/Air), were measured and compared using the mean absolute percentage error (MAPE), which was a function of the percentage dose deviations from MC. Besides, the computation time of each treatment plan was recorded and compared. The MAPEs of MGS were significantly lower than AAA in all types of cancers (p<0.001). With regards to body density combinations, the MAPE of AAA ranged from 1.8% (soft tissue) to 4.9% (Bone/Air), whereas that of MGS from 1.6% (air cavities) to 2.9% (Soft/Bone). The MAPEs of MGS (2.6%±2.1) were significantly lower than that of AAA (3.7%±2.5) in all tissue density combinations (p<0.001). The mean computation time of AAA for all treatment plans was significantly lower than that of the MGS (p<0.001). Both AAA and MGS algorithms demonstrated dose deviations of less than 4.0% in most clinical cases and their performance was better in homogeneous tissues than at tissue boundaries. In general, MGS demonstrated relatively smaller dose deviations than AAA but required longer computation time.

61 RADIATION PROTECTION AND DOSIMETRY↗

Role of decommissioning plan and its progress for the PUSPATI TRIGA Reactor

Malaysian nuclear research reactor, the PUSPATI TRIGA Reactor, reached its first criticality in 1982, and since then, it has been serving for more than 30 years for training, radioisotope production and research purposes. Realizing the age and the need for its decommissioning sometime in the future, a ground basis of assessment and an elaborative project management need to be established, covering the entire process from termination of reactor operation to the establishment of final status, documented as the Decommissioning Plan. At international level, IAEA recognizes the absence of Decommissioning Plan as one of the factors hampering progress in decommissioning of nuclear facilities in the world. Throughout the years, IAEA has taken initiatives and drawn out projects in promoting progress in decommissioning programmes, like CIDER, DACCORD and R2D2P, for which Malaysia is participating in these projects. This paper highlights the concept of Decommissioning plan and its significances to the Agency. It will also address the progress, way forward and challenges faced in developing the Decommissioning Plan for the PUSPATI TRIGA Reactor. The efforts in the establishment of this plan helps to provide continual national contribution at the international level, as well as meeting the regulatory requirement, if need be. The existing license for the operation of PUSPATI TRIGA Reactor does not impose a requirement for a decommissioning plan; however, the renewal of license may call for a decommissioning plan to be submitted for approval in future.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

The impacts of dental filling materials on RapidArc treatment planning and dose delivery: Challenges and solution

Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined initially and weekly during the course of radiotherapy.Results: For a RapidArc treatment technique, the backscatter dose from the DFM insert was measured to be 9.25 ± 2.17 in the IMRT-verification-phantom. The measured backscatter upstream dose from DFM for a single-field was 22% higher than without the DFM, whereas the downstream dose was lower by 14%. The values of homogeneity index for the plans with and without the application of mask were 0.09 and 0.14, respectively. The calculated mean treatment planning volume (PTV) dose differed from the delivered dose by 13% and was reduced to 2% when using the mask and virtual filter together. A grade 3 mucosa reaction was observed in the control group after 22–24 fractions (44–48 Gy). In contrast, no grade 3 mucositis was observed in the patients wearing the PDM after 25–26 fractions (50–52 Gy).Conclusions: The backscatter from the DFM for a single, parallel-opposed fields, and RapidArc treatment technique was found significant. The application of mask in replacing streaking artifacts can be useful in improving dose homogeneity in the PTV. The use of a virtual filter around the teeth during the planning phase reduces the target underdosage issue in the phantom. Furthermore, a reduction in mucositis is observed in the head and neck patients with the use of PDM.

61 RADIATION PROTECTION AND DOSIMETRY↗

Video-rate optical dosimetry and dynamic visualization of IMRT and VMAT treatment plans in water using Cherenkov radiation

Purpose: A novel technique for optical dosimetry of dynamic intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans was investigated for the first time by capturing images of the induced Cherenkov radiation in water. Methods: A high-sensitivity, intensified CCD camera (ICCD) was configured to acquire a two-dimensional (2D) projection image of the Cherenkov radiation induced by IMRT and VMAT plans, based on the Task Group 119 (TG-119) C-Shape geometry. Plans were generated using the Varian Eclipse treatment planning system (TPS) and delivered using 6 MV x-rays from a Varian TrueBeam Linear Accelerator (Linac) incident on a water tank doped with the fluorophore quinine sulfate. The ICCD acquisition was gated to the Linac target trigger pulse to reduce background light artifacts, read out for a single radiation pulse, and binned to a resolution of 512 × 512 pixels. The resulting videos were analyzed temporally for various regions of interest (ROI) covering the planning target volume (PTV) and organ at risk (OAR), and summed to obtain an overall light intensity distribution, which was compared to the expected dose distribution from the TPS using a gamma-index analysis. Results: The chosen camera settings resulted in 23.5 frames per second dosimetry videos. Temporal intensity plots of the PTV and OAR ROIs confirmed the preferential delivery of dose to the PTV versus the OAR, and the gamma analysis yielded 95.9% and 96.2% agreement between the experimentally captured Cherenkov light distribution and expected TPS dose distribution based upon a 3%/3 mm dose difference and distance-to-agreement criterion for the IMRT and VMAT plans, respectively. Conclusions: The results from this initial study demonstrate the first documented use of Cherenkov radiation for video-rate optical dosimetry of dynamic IMRT and VMAT treatment plans. The proposed modality has several potential advantages over alternative methods including the real-time nature of the acquisition, and upon future refinement may prove to be a robust and novel dosimetry method with both research and clinical applications.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-87: Comparison Study of Dose Reconstruction From Cylindrical Diode Array Measurements, with TLD Measurements and Treatment Planning System Calculations in Anthropomorphic Head and Neck and Lung Phantoms

Purpose: To assess dose calculated by the 3DVH software (Sun Nuclear Systems, Melbourne, FL) against TLD measurements and treatment planning system calculations in anthropomorphic phantoms. Methods: The IROC Houston (RPC) head and neck (HN) and lung phantoms were scanned and plans were generated using Eclipse (Varian Medical Systems, Milpitas, CA) following IROC Houston procedures. For the H and N phantom, 6 MV VMAT and 9-field dynamic MLC (DMLC) plans were created. For the lung phantom 6 MV VMAT and 15 MV 9-field dynamic MLC (DMLC) plans were created. The plans were delivered to the phantoms and to an ArcCHECK (Sun Nuclear Systems, Melbourne, FL). The head and neck phantom contained 8 TLDs located at PTV1 (4), PTV2 (2), and OAR Cord (2). The lung phantom contained 4 TLDs, 2 in the PTV, 1 in the cord, and 1 in the heart. Daily outputs were recorded before each measurement for correction. 3DVH dose reconstruction software was used to project the calculated dose to patient anatomy. Results: For the HN phantom, the maximum difference between 3DVH and TLDs was -3.4% and between 3DVH and Eclipse was 1.2%. For the lung plan the maximum difference between 3DVH and TLDs was 4.3%, except for the spinal cord for which 3DVH overestimated the TLD dose by 12%. The maximum difference between 3DVH and Eclipse was 0.3%. 3DVH agreed well with Eclipse because the dose reconstruction algorithm uses the diode measurements to perturb the dose calculated by the treatment planning system; therefore, if there is a problem in the modeling or heterogeneity correction, it will be carried through to 3DVH. Conclusion: 3DVH agreed well with Eclipse and TLD measurements. Comparison of 3DVH with film measurements is ongoing. Work supported by PHS grant CA10953 and CA81647 (NCI, DHHS)

60 APPLIED LIFE SCIENCES↗

SU-E-T-153: Establish a Comprehensive Patient-Specific Plan QA Database for Instituitional Quality Control Program

Purpose: Since the publication of TG-119, several new treatment techniques requiring new QA devices have been implemented in the clinic. To monitor and analyze our institutional QA performance, we have created a comprehensive QA database using Research Electronic Data Capture (REDCap). The database will also assist us in creating IMRT QA Analysis practice guidelines. Methods: Since Oct. 2013, 336 patient plan QA results were entered into the database. Plan parameters such as plan ID, treatment site, technique, energy, optimization constraints, modulation factor, leaf speed, leaf opening.etc were automatically extracted from the Varian Eclipse database to allow us to refine our evaluation and analysis method. Specific QA device, LINAC-related information, and measurement and analysis results were manually entered by the QA team. IMRT plans were measured using MapCHECK2 while RapidArc plans were measured using ArcCHECK. Distance-To-Agreement 3%/3mm without global maximum normalization was used. Results: The data indicates that different treatment techniques might benefit from a different site-specific action level(AL) depending on the complexity of the plan and optimization parameter used (e.g., breast IMRT QA= 97.8% and pelvis IMRT QA=93.1%). Different QA devices may also benefit from a different AL (MapCHECK2 = 94.1% while ArcCHECK = 83.0%). The relationship between the parameters and passing rate suggests that the complexity of each plan, characterized by leaf travel, leaf opening and modulation factor, affect the passing rate significantly. The database is reviewed regularly, and any abnormal point of the QA result or a trend of lower QA passing rate on a specific LINAC is further investigated. Conclusion: Establishing a comprehensive QA database provides an overview of the quality assurance program. It not only helps in answering the question “what is a reasonable and achievable standard for each institution”, but also saves time in monitoring and investigating the daily machine and QA performance.

07 ISOTOPE AND RADIATION SOURCES↗

SU-E-T-287: Robustness Study of Passive-Scattering Proton Therapy in Lung: Is Range and Setup Uncertainty Calculation On the Initial CT Enough to Predict the Plan Robustness?

Purpose: Plan robustness of the passive-scattering proton therapy treatment of lung tumors has been studied previously using combined uncertainties of 3.5% in CT number and 3 mm geometric shifts. In this study, we investigate whether this method is sufficient to predict proton plan robustness by comparing to plans performed on weekly verification CT scans. Methods: Ten lung cancer patients treated with passive-scattering proton therapy were randomly selected. All plans were prescribed 6660cGy in 37 fractions. Each initial plan was calculated using +/− 3.5% range and +/− 0.3cm setup uncertainty in x, y and z directions in Eclipse TPS(Method-A). Throughout the treatment course, patients received weekly verification CT scans to assess the daily treatment variation(Method-B). After contours and imaging registrations are verified by the physician, the initial plan with the same beamline and compensator was mapped into the verification CT. Dose volume histograms (DVH) were evaluated for robustness study. Results: Differences are observed between method A and B in terms of iCTV coverage and lung dose. Method-A shows all the iCTV D95 are within +/− 1% difference, while 20% of cases fall outside +/−1% range in Method-B. In the worst case scenario(WCS), the iCTV D95 is reduced by 2.5%. All lung V5 and V20 are within +/−5% in Method-A while 15% of V5 and 10% of V20 fall outside of +/−5% in Method-B. In the WCS, Lung V5 increased by 15% and V20 increased by 9%. Method A and B show good agreement with regard to cord maximum and Esophagus mean dose. Conclusion: This study suggests that using range and setup uncertainty calculation (+/−3.5% and +/−3mm) may not be sufficient to predict the WCS. In the absence of regular verification scans, expanding the conventional uncertainty parameters(e.g., to +/−3.5% and +/−4mm) may be needed to better reflect plan actual robustness.

60 APPLIED LIFE SCIENCES↗

SU-E-T-473: A Patient-Specific QC Paradigm Based On Trajectory Log Files and DICOM Plan Files

Purpose: To evaluate a remote QC tool for monitoring treatment machine parameters and treatment workflow. Methods: The Varian TrueBeamTM linear accelerator is a digital machine that records machine axis parameters and MLC leaf positions as a function of delivered monitor unit or control point. This information is saved to a binary trajectory log file for every treatment or imaging field in the patient treatment session. A MATLAB analysis routine was developed to parse the trajectory log files for a given patient, compare the expected versus actual machine and MLC positions as well as perform a cross-comparison with the DICOM-RT plan file exported from the treatment planning system. The parsing routine sorts the trajectory log files based on the time and date stamp and generates a sequential report file listing treatment parameters and provides a match relative to the DICOM-RT plan file. Results: The trajectory log parsing-routine was compared against a standard record and verify listing for patients undergoing initial IMRT dosimetry verification and weekly and final chart QC. The complete treatment course was independently verified for 10 patients of varying treatment site and a total of 1267 treatment fields were evaluated including pre-treatment imaging fields where applicable. In the context of IMRT plan verification, eight prostate SBRT plans with 4-arcs per plan were evaluated based on expected versus actual machine axis parameters. The average value for the maximum RMS MLC error was 0.067±0.001mm and 0.066±0.002mm for leaf bank A and B respectively. Conclusion: A real-time QC analysis program was tested using trajectory log files and DICOM-RT plan files. The parsing routine is efficient and able to evaluate all relevant machine axis parameters during a patient treatment course including MLC leaf positions and table positions at time of image acquisition and during treatment.

60 APPLIED LIFE SCIENCES↗

SU-E-T-587: Monte Carlo Versus Ray-Tracing for Treatment Planning Involving CNS Tumors On the MultiPlan System for CyberKnife Radiosurgery

Purpose: MultiPlan, the treatment planning system for the CyberKnife Robotic Radiosurgery system offers two approaches to dose computation, namely Ray-Tracing (RT), the default technique and Monte Carlo (MC), an option. RT is deterministic, however it accounts for primary heterogeneity only. MC on the other hand has an uncertainty associated with the calculation results. The advantage is that in addition, it accounts for heterogeneity effects on the scattered dose. Not all sites will benefit from MC. The goal of this work was to focus on central nervous system (CNS) tumors and compare dosimetrically, treatment plans computed with RT versus MC. Methods: Treatment plans were computed using both RT and MC for sites covering (a) the brain (b) C-spine (c) upper T-spine (d) lower T-spine (e) L-spine and (f) sacrum. RT was first used to compute clinically valid treatment plans. Then the same treatment parameters, monitor units, beam weights, etc., were used in the MC algorithm to compute the dose distribution. The plans were then compared for tumor coverage to illustrate the difference if any. All MC calculations were performed at a 1% uncertainty. Results: Using the RT technique, the tumor coverage for the brain, C-spine (C3–C7), upper T-spine (T4–T6), lower T-spine (T10), Lspine (L2) and sacrum were 96.8%, 93.1%, 97.2%, 87.3%, 91.1%, and 95.3%. The corresponding tumor coverage based on the MC approach was 98.2%, 95.3%, 87.55%, 88.2%, 92.5%, and 95.3%. It should be noted that the acceptable planning target coverage for our clinical practice is >95%. The coverage can be compromised for spine tumors to spare normal tissues such as the spinal cord. Conclusion: For treatment planning involving the CNS, RT and MC appear to be similar for most sites but for the T-spine area where most of the beams traverse lung tissue. In this case, MC is highly recommended.

60 APPLIED LIFE SCIENCES↗

SU-E-T-592: Relationship Between Dose of Distribution and Area of Segment Fields Among Different Intensity-Modulated Radiotherapy Planning in Cervix Cancer

Purpose: In premise of uninfluenced to dose distribution of tumor target and organ at risk(OAR) in cervical cancer,area of segment fields was changed to increase efficacy and optimize treatment method by designing different plan of intensity modulated radiotherapy(IMRT). Methods: 12 cases of cervical cancer were confirmed in pathology and treated with step and shoot IMRT. Dose of PTV was 50Gy/25fractions. Every patient was designed 9 treatment plans of IMRT by Pinnacle 8.0m planning system,each plan was used with 9 beams of uniform distribution and fixing incidence direction(200°,240°,280°,320°,0°,40°,80°,120°and 160°respectively),and designed for delivery on Elekta Synergy linear accelerator. All plans were optimized with the direct machine parameter optimization(DMPO) algorithm using the same set of optimization objectives. Number of maximum segment field was defined at 80 and minimum MU in each segment was 5MU,and minimal segment area was 2*1cm{sup 2},2*2cm{sup 2},3*3cm{sup 2},4*4cm{sup 2},5*5cm{sup 2},6*6cm{sup 2},7*7cm{sup 2},8*8cm{sup 2}and 9*9cm{sup 2},respectively.Coverage,homogeneity and conformity of PTV,sparing of OAR, MU and number of segment were compared. Results: In this group, mean volume of PTV was 916.8±228.7 cm{sup 3}. Compared with the area of minimal segment field increased from 2*1cm{sup 2} to 9*9 cm{sup 2},the number of mean MU was decreased from 1405±170 to 490±47 and the number of segment field was reduced from 76±4 to 39±7 respectively(p<0.05). When the limit of minimal segment area was increased from 2*1cm{sup 2} to 7*7 cm{sup 2},dose distribution of PTV,OAR,CI,HI and V{sub 2} {sub 3} were not different (p>0.05),but when the minimal segment area was 8*8 cm{sup 2} and 9*9 cm{sup 2},they were changed compared with 7*7 cm{sup 2} and below(p<0.05). Conclusion: The minimal segment field of IMRT plan designed by Pinnacle 8.0m planning system in cervical carcinoma should be enlarge reasonably and minimal segment area of 7*7 cm{sup 2} was recommend.

60 APPLIED LIFE SCIENCES↗

SU-F-BRD-03: Determination of Plan Robustness for Systematic Setup Errors Using Trilinear Interpolation

Purpose: Treatment plan evaluations in radiotherapy are currently ignoring the dosimetric impact of setup uncertainties. The determination of the robustness for systematic errors is rather computational intensive. This work investigates interpolation schemes to quantify the robustness of treatment plans for systematic errors in terms of efficiency and accuracy. Methods: The impact of systematic errors on dose distributions for patient treatment plans is determined by using the Swiss Monte Carlo Plan (SMCP). Errors in all translational directions are considered, ranging from −3 to +3 mm in mm steps. For each systematic error a full MC dose calculation is performed leading to 343 dose calculations, used as benchmarks. The interpolation uses only a subset of the 343 calculations, namely 9, 15 or 27, and determines all dose distributions by trilinear interpolation. This procedure is applied for a prostate and a head and neck case using Volumetric Modulated Arc Therapy with 2 arcs. The relative differences of the dose volume histograms (DVHs) of the target and the organs at risks are compared. Finally, the interpolation schemes are used to compare robustness of 4- versus 2-arcs in the head and neck treatment plan. Results: Relative local differences of the DVHs increase for decreasing number of dose calculations used in the interpolation. The mean deviations are <1%, 3.5% and 6.5% for a subset of 27, 15 and 9 used dose calculations, respectively. Thereby the dose computation times are reduced by factors of 13, 25 and 43, respectively. The comparison of the 4- versus 2-arcs plan shows a decrease in robustness; however, this is outweighed by the dosimetric improvements. Conclusion: The results of this study suggest that the use of trilinear interpolation to determine the robustness of treatment plans can remarkably reduce the number of dose calculations. This work was supported by Varian Medical Systems. This work was supported by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗