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DOE OSTI2015

SU-E-T-01: (In)dependence of Plan Quality On Treatment Modalities and Target-To-Critical Structure Geometry for Brain Tumor

Purpose: To evaluate and test the hypothesis that plan quality may be systematically affected by treatment delivery techniques and target-tocritical structure geometric relationship in radiotherapy for brain tumor. Methods: Thirty-four consecutive brain tumor patients treated between 2011–2014 were analyzed. Among this cohort, 10 were planned with 3DCRT, 11 with RadipArc, and 13 with helical IMRT on TomoTherapy. The selected dosimetric endpoints (i.e., PTV V100, maximum brainstem/chiasm/ optic nerve doses) were considered as a vector in a highdimensional space. A Pareto analysis was performed to identify the subset of Pareto-efficient plans.The geometric relationships, specifically the overlapping volume and centroid-of-mass distance between each critical structure to the PTV were extracted as potential geometric features. The classification-tree analyses were repeated using these geometric features with and without the treatment modality as an additional categorical predictor. In both scenarios, the dominant features to prognosticate the Pareto membership were identified and the tree structures to provide optimal inference were recorded. The classification performance was further analyzed to determine the role of treatment modality in affecting plan quality. Results: Seven Pareto-efficient plans were identified based on dosimetric endpoints (3 from 3DCRT, 3 from RapicArc, 1 from Tomo), which implies that the evaluated treatment modality may have a minor influence on plan quality. Classification trees with/without the treatment modality as a predictor both achieved accuracy of 88.2%: with 100% sensitivity and 87.1% specificity for the former, and 66.7% sensitivity and 96.0% specificity for the latter. The coincidence of accuracy from both analyses further indicates no-to-weak dependence of plan quality on treatment modality. Both analyses have identified the brainstem to PTV distance as the primary predictive feature for Pareto-efficiency. Conclusion: Pareto evaluation and classification-tree analyses have indicated that plan quality depends strongly on geometry for brain tumor, specifically PTV-tobrain-stem-distance but minimally on treatment modality.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, and it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching

Purpose: To develop a clinical feasible and robust proton therapy technique to spare bowel, bladder and rectum for high-risk prostate cancer patients Methods: The study includes 3 high-risk prostate cancer cases treated with bilateral opposed SFUD with lateral penumbra gradient matching technique prescribed to 5400cGyE in 30 fx in our institution. To treat whole pelvic lymph node chain, the complicated ‘H’ shape, using SFUD technique, we divided the target into two sub-targets (LLAT beam treating ‘90 degree T-shape’ and RLAT beam treating ‘: shape’) in Plan A and use lateral penumbra gradient matching at patient’s left side. Vice verse in Plan B. Each plan deliver half of the prescription dose. Beam-specific PTVs were created to take range uncertainty and setup error into account. For daily treatment, patient received four fields from both plan A and B per day. Robustness evaluation were performed in the worst case scenario with 3.5% range uncertainty and 1, 2, 3mm overlap or gap between LLAT and RLAT field matching in Raystation 4.0. All of cases also have a Tomotherapy backup plan approved by physician as a dosimetric comparison. Results: The total treatment time take 15–20mins including IGRT and four fields delivery on ProteusONE, a compact size PBS proton system, compared to 25–30min in traditional Tomotherapy. Robustness analysis shows that this plan technique is insensitive to the range uncertainties. With the lateral gradient matching, 1, 2, 3mm overlap renders only 2.5%, 5.5% and 8% hot or cool spot in the junction areas. Dosimetric comparisons with Tomotherapy show a significant dose reduction in bladder D50%(14.7±9.3Gy), D35%(7.3±5.8Gy); small bowel and rectum average dose(19.6±7.5Gy and 14.5±6.3Gy respectively). Conclusion: The bilateral opposed(SFUD) plan with lateral penumbra gradient matching has been approved to be a safe, robust and efficient treatment option for whole pelvis high-risk prostate cancer patient which significantly spares the OARs.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-240: Design and Implement of An Electronic Records Function for Treatment Plan Checked Meeting

Purpose: To replace the paper records, we designed an electronic records function for plan checked meeting in our in-house developed radiotherapy information management system(RTIMS). Methods: Since 2007, the RTIMS has been developed on a database and web service of Apache+PHP+MySQL, and almost all computers and smartphones could access the RTIMS through IE browser, to input, search, count, and print the data. In 2012, we also established an radiation therapy case conference multi-media system(RTCCMMS) based on Windows Remote Desktop feature. Since 2013, we have carried out the treatment plan checked meeting of the physics division in every afternoon for about half an hour. In 2014, we designed an electronic records function, which includes a meeting information record and a checked plan record. And the meeting record includes the following items: meeting date, name, place, length, status, attendee, content, etc. The plan record includes the followings: meeting date, meeting name, patient ID, gender, age, patient name, course, plan, purpose, position, technique, CTsim type, plan type, primary doctor, other doctor, primary physicist, other physicist, difficulty, quality, score, opinion, status, note, etc. Results: In the past year, the electronic meeting records function has been successfully developed and implemented in the division, and it could be accessed from an smartphone. Almost all items have the corresponding pull-down menu selection, and each option would try to intelligently inherit default value from the former record or other form. According to the items, we could do big data mining to the input data. It also has both Chinese and English two versions. Conclusion: It was demonstrated to be user-friendly and was proven to significantly improve the clinical efficiency and quality of treatment plan. Since the RTIMS is an in-house developed system, more functions can be added or modified to further enhance its potentials in research and clinical practice. Project supported by the National Natural Science Foundation of China (Grant No.81101694)

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-273: Do Task Group External Beam QA Recommendations Guarantee Accurate Treatment Plan Dose Delivery?

Purpose: AAPM task groups 40/142 have provided an invaluable set of goals for physicists designing QA programs, attempting to standardize what would otherwise likely be a highly variable phenomenon across institutions. However, with the complexity of modalities such as VMAT, we hypothesize that following these guidelines to the letter might still allow unacceptable dose discrepancies. To explore this hypothesis we simulated machines bordering on QA acceptability, and calculated the effect on patient plans. Methods: Two errant machines were simulated in Aria/Eclipse, each just within task group criteria for output, percent depth dose, beam profile, gantry and collimator rotations, and jaw and MLC positions. One machine minimized dose to the PTV (machine A) and the other maximized dose to the OARs (machine B). Clinical treatment plans (3-phase prostate, n=3; hypofractionated lung, n=1) were calculated on these machines and the dose distributions compared. A prostate case was examined for contribution of error sources and evaluated using delivery QA data. Results: The prostate plans showed mean decreases in target D95 of 9.9% of prescription dose on machine A. On machine B, The rectal and bladder V70Gy each increased by 7.1 percentage points, while their V45Gy increased by 16.2% and 15.0% respectively. In the lung plan, the target D95 decreased by 12.8% and the bronchial tree Dmax increased by 21% of prescription dose, on machines A and B. One prostate plan showed target dose errors of 3.8% from MLC changes, 2% from output, ∼3% from energy and ∼0.5% from other factors. This plan achieved an 88.4% gamma passing rate using 3%/3mm using ArcCHECK. Conclusion: In the unlikely event that a machine exhibits all maximum errors allowed by TG 40/142, unacceptably large changes in dose delivered are possible especially in highly modulated VMAT plans, despite the machine passing routine QA.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-277: Dose Calculation Comparisons Between Monaco, Pinnacle and Eclipse Treatment Planning Systems

Purpose: Monaco treatment planning system (TPS) version 5.0 uses a Monte-Carlo based dose calculation engine. The aim of this study is to verify and compare the Monaco based dose calculations with both Pinnacle{sup 3} collapsed cone convolution superposition (CCC) and Eclipse analytical anisotropic algorithm (AAA) calculations. Methods: For this study, previously treated SBRT lung, head and neck and abdomen patients were chosen to compare dose calculations between Pinnacle, Monaco and Eclipse. Plans were chosen from those that had been treated using the Elekta VersaHD or a NovalisTX linac. The plans included 3D conventional and IMRT beams using 6MV and 6MV Flattening filter free (FFF) photon beams. The original plans calculated with CCCS or AAA along with the recalculated ones using MC from the three TPS were exported into Velocity software for inter-comparison. Results: To compare the dose calculations, Mean Lung Dose (MLD), lung V5 and V20 values, and PTV Heterogeneity indexes (HI) and Conformity indexes (CI) were all calculated and recorded from the dose volume histograms (DVH). For each patient, the CI values were identical but there were differences in all other parameters. The HI was computed higher by 5 and 4% for calculated plans AAA and CCCS respectively, compared to the MC ones. The DVH graphs showed large differences between the CCCS and AAA and Monaco for 3D FFF, VMAT and IMRT plans. Better DVH agreement between was observed for 3D conventional plans. Conclusion: Better agreement was observed between CCCS and MC calculations than AAA and MC calculations. Those differences were more profound as the field size was decreasing and in the presence of inhomogeneities.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-320: Dosimetric Evaluation of Intracranial Stereotactic Radiotherapy Plans Using Jaws-Only Collimation On a LINAC

Purpose: To evaluate the dosimetry of cranial stereotactic radiotherapy (SRT) plans using jaws-only collimation on linac that meets appropriate TG-142 tolerances. Methods: Seventeen spherical targets were generated in the center of a head phantom with diameters ranging from 8 mm to 40 mm. Plans balanced treatment time with dose gradient and conformity using 13 static fields and 3 couch angles: 9 non-opposed and coplanar fields and 4 non-coplanar fields. The symmetrical jaws field size was target diameter plus 2 mm. The prescription (Rx) was 7 Gy per fraction to the 80% isodose line. Two plans were created for each target: one kept the collimator at 0° (C0), one adjusted the collimator angle 40° for each field to create a 360° sweep over the 9 coplanar fields (CR).Conformity of the Rx to the target was evaluated using a ratio of Rx to target volume (PITV). Heterogeneity was determined using a ratio of maximum dose to Rx dose. Falloff was scored using CGIg: the difference of effective radii of spheres equal to half and full Rx volumes. Results: All plans met RTOG SRS criteria for conformity and heterogeneity. The use of collimator rotation improved conformity by 3.2% on average, the mean PITV was 1.7±0.1 for C0 plans and 1.6±0.1 for CR. Mean heterogeneity was 1.25±0.0 for both C0 and CR. The mean CGIg was 75.9±16.4 for C0 plans and 74.4±17.0 for CR; with a mean dose falloff degradation of 2.5% by CR. Conclusion: Clinically acceptable SRT plans for spherical targets were created using jaws-only collimation with static fields. The addition of sweeping collimator rotation improves conformity at the expense of gradient. This technique can expand the availability of SRT to patients especially to those who cannot travel to a facility with a dedicated stereotactic radiosurgery machine.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-634: Pre-Verification of FFF Prostate VMAT Plans with Gamma Method and DVHs Reconstructed Based On Measurements with 2D-ARRAY (PTW 1500) and OCTAVIUS 4D

Purpose: The aim of this work was to characterize the clinical correctness of FFF prostate treatment VMAT plans based on analysis of DVHs reconstructed from pre-verification 2D-arrays measurements. Methods: The new 2D ion chamber array 1500 with rotational phantom cylindrical Octavius 4D and Verisoft 6.1 software with DVH option (PTW, Freiburg) were used to determine the clinical usefulness of the treatment plans. Ten patients treated with VMAT high-fractionated (2 fraction x 7,5 Gy) FFF prostate plans (TrueBeam, Varian) were analyzed using the 3D gamma analysis by local dose method with a 5% threshold for various tolerance parameters DTA [mm] and DD [%] were 1%/1, 2%/2, 3%/3. Additional, based on the measurements of irradiation dose distributions and patients’ CT scans with contoured structures of organs, the DVHs were reconstructed using a software. The obtained DVHs were compared to planned dose distributions and the deviations were analysed with parameters: for CTV D50, D98, D2, and D25, D50, Dmax for OARs — rectum, bladder and left/right femoral heads. Results: The analyzed treatment plans passed gamma criteria (3/3%; 95%), the results obtained were as follow: mean value and standard deviation of gamma score for criteria (DTA[mm]/DD[%]): 1/1% (L53.3±3.2); 2/2% (L87.0±2.2); 3/3% (L97.5±0.9). In the DVH analysis, the highest differences were observed for OARs (especially for bladder): the mean percentage differences values for rectum, bladder and left/right femoral heads were: D25 (1.67; 6.83)%, D50 (0.18; 7.18; 1.53; 0.30)%, Dmax (−0.84; −1.64; 0.37; −4.63)%, respectively. For the CTV mean relative deviations for proper parameters were in good agreement with TPS: D98 (0.95±2.21)%, D50 (1.93±0.67)%, D2 (1.76±0.76)%. Conclusion: The gamma method is recommended tool for pre-verification analysis of correctness of treatment plans. Moreover, the scrutiny checking with reconstructed DVH gives additional, clinical information about quality of plan, especially about coverage of CTV and sparing of health tissues.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

SU-E-T-653: Quantifying Inter-Fraction Range Uncertainty for Input Into Robust Proton Planning

Purpose: To provide a method for quantifying centre- and tumour site-specific population range uncertainty due to inter-fraction motion for use within robust proton planning and plan analysis. PTV-based and probabilistic/robust plans depend upon accurate knowledge of geometric and range uncertainties. If the uncertainty model is inaccurate, both types of plan, PTV or probabilistic, could produce under-dosing of the target and/or overdosing of OAR. Methods: Daily mega-voltage volumetric imaging data from previously treated radiotherapy patients has been used to investigate inter-fraction changes to water equivalent path-length (WEPL). Daily image-guidance scans were carried out for each patient and corrected for changes in CTV position (using rigid transformations). An effective depth algorithm was used to determine residual range changes, after corrections were applied, by comparing WEPL within the CTV at each fraction for several beam angles. This method has been demonstrated for nine prostate and seven head and neck. Results: Inter-fraction range changes for the head and neck patient sample were Σ=3.39mm, σ=4.72mm and overall mean =−1.82mm; for prostate Σ=5.64mm, σ=5.91mm and overall mean =0.98 mm. The choice of beam angle for head and neck did not affect the inter-fraction range error significantly; however this was not the same for prostate. Greater range changes were seen using a lateral beam compared to an anterior beam for prostate due to relative motion of the prostate and femoral heads. Conclusion: A method has been developed to quantify population range changes due to inter-fraction motion. The results show a non-zero mean for these samples, as well as significant Σ and σ, highlighting the importance of quantifying uncertainties and use of image guidance. Such information can be used in robust optimisation algorithms and for analysing treatment plan robustness. It may also help in establishing beam start conditions at planning and for establishing adaptive planning protocols.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

SU-E-T-657: Quantitative Assessment of Plan Robustness for Helical Tomotherapy for Head and Neck Cancer Radiotherapy

Introduction: Geometric uncertainties in daily patient setup can lead to variations in the planned dose, especially when using highly conformal techniques such as helical Tomotherapy. To account for the potential effect of geometric uncertainty, our clinical practice is to expand critical structures by 3mm expansion into planning risk volumes (PRV). The PRV concept assumes the spatial dose cloud is insensitive to patient positioning. However, no tools currently exist to determine if a Tomotherapy plan is robust to the effects of daily setup variation. We objectively quantified the impact of geometric uncertainties on the 3D doses to critical normal tissues during helical Tomotherapy. Methods: Using a Matlab-based program created and validated by Accuray (Madison, WI), the planned Tomotherapy delivery sinogram recalculated dose on shifted CT datasets. Ten head and neck patients were selected for analysis. To simulate setup uncertainty, the patient anatomy was shifted ±3mm in the longitudinal, lateral and vertical axes. For each potential shift, the recalculated doses to various critical normal tissues were compared to the doses delivered to the PRV in the original plan Results: 18 shifted scenarios created from Tomotherapy plans for three patients with head and neck cancers were analyzed. For all simulated setup errors, the maximum doses to the brainstem, spinal cord, parotids and cochlea were no greater than 0.6Gy of the respective original PRV maximum. Despite 3mm setup shifts, the minimum dose delivered to 95% of the CTVs and PTVs were always within 0.4Gy of the original plan. Conclusions: For head and neck sites treated with Tomotherapy, the use of a 3mm PRV expansion provide a reasonable estimate of the dosimetric effects of 3mm setup uncertainties. Similarly, target coverage appears minimally effected by a 3mm setup uncertainty. Data from a larger number of patients will be presented. Future work will include other anatomical sites.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2016

SU-F-T-272: Patient Specific Quality Assurance of Prostate VMAT Plans with Portal Dosimetry

Purpose: To evaluate the effectiveness of using the Portal Dosimetry (PD) method for patient specific quality assurance of prostate VMAT plans. Methods: As per institutional protocol all VMAT plans were measured using the Varian Portal Dosimetry (PD) method. A gamma evaluation criterion of 3%-3mm with a minimum area gamma pass rate (gamma <1) of 95% is used clinically for all plans. We retrospectively evaluated the portal dosimetry results for 170 prostate patients treated with VMAT technique. Three sets of criterions were adopted for re-evaluating the measurements; 3%-3mm, 2%-2mm and 1%-1mm. For all criterions two areas, Field+1cm and MLC-CIAO were analysed.To ascertain the effectiveness of the portal dosimetry technique in determining the delivery accuracy of prostate VMAT plans, 10 patients previously measured with portal dosimetry, were randomly selected and their measurements repeated using the ArcCHECK method. The same criterion used in the analysis of PD was used for the ArcCHECK measurements. Results: All patient plans reviewed met the institutional criteria for Area Gamma pass rate. Overall, the gamma pass rate (gamma <1) decreases for 3%-3mm, 2%-2mm and 1%-1mm criterion. For each criterion the pass rate was significantly reduced when the MLC-CIAO was used instead of FIELD+1cm. There was noticeable change in sensitivity for MLC-CIAO with 2%-2mm criteria and much more significant reduction at 1%-1mm. Comparable results were obtained for the ArcCHECK measurements. Although differences were observed between the clockwise verses the counter clockwise plans in both the PD and ArcCHECK measurements, this was not deemed to be statistically significant. Conclusion: This work demonstrates that Portal Dosimetry technique can be effectively used for quality assurance of VMAT plans. Results obtained show similar sensitivity compared to ArcCheck. To reveal certain delivery inaccuracies, the use of a combination of criterions may provide an effective way in improving the overall sensitivity of PD. Funding provided in part by the Prostate Ride for Dad, Kitchener-Waterloo, Canada.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-384: Step and Shoot IMRT, VMAT and Autoplan VMAT Nasopharnyx Plan Robustness to Linear Accelerator Delivery Errors

Purpose: To identify the robustness of different treatment techniques in respect to simulated linac errors on the dose distribution to the target volume and organs at risk for step and shoot IMRT (ssIMRT), VMAT and Autoplan generated VMAT nasopharynx plans. Methods: A nasopharynx patient dataset was retrospectively replanned with three different techniques: 7 beam ssIMRT, one arc manual generated VMAT and one arc automatically generated VMAT. Treatment simulated uncertainties: gantry, collimator, MLC field size and MLC shifts, were introduced into these plans at increments of 5,2,1,−1,−2 and −5 (degrees or mm) and recalculated in Pinnacle. The mean and maximum doses were calculated for the high dose PTV, parotids, brainstem, and spinal cord and then compared to the original baseline plan. Results: Simulated gantry angle errors have <1% effect on the PTV, ssIMRT is most sensitive. The small collimator errors (±1 and ±2 degrees) impacted the mean PTV dose by <2% for all techniques, however for the ±5 degree errors mean target varied by up to 7% for the Autoplan VMAT and 10% for the max dose to the spinal cord and brain stem, seen in all techniques. The simulated MLC shifts introduced the largest errors for the Autoplan VMAT, with the larger MLC modulation presumably being the cause. The most critical error observed, was the MLC field size error, where even small errors of 1 mm, caused significant changes to both the PTV and the OAR. The ssIMRT is the least sensitive and the Autoplan the most sensitive, with target errors of up to 20% over and under dosages observed. Conclusion: For a nasopharynx patient the plan robustness observed is highest for the ssIMRT plan and lowest for the Autoplan generated VMAT plan. This could be caused by the more complex MLC modulation seen for the VMAT plans. This project is supported by a grant from NSW Cancer Council.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-528: Relationship Between Tumor Size and Plan Quality Using FFF and Non-FFF Modes in Rapidarc

Purpose: For a give PTV dose, beam-on time is shorter in the FFF than the non-FFF mode because of higher MU/min. Larger tumors usually require more complex intensity modulation, which might affect plan quality and total MU. We investigated the relationship between PTV size and plan quality using FFF and non-FFF modes. Methods: Two different PTV volumes (PTV and PTV+1 cm margin) were drawn in brain, lung and liver. 3-full to 7-partial arc (Rapidarc) of 6 MV, 1400 MU/min were studied. Plan quality was evaluated by: (a) DVH for PTV and normal tissues, (b) total MU and beam-on time, and (c) passing rate for IMRT plan QA. Results: For the same PTV coverage, DVH for normal tissue was the same or slightly lower in the FFF compared with non-FFF. Total MU was 13% higher in FFF than non-FFF in the 3-arc, 7 Gy treatment, but the difference became smaller when arc number increased to 6–7 for 10–24 Gy. Larger PTV did not affect the difference in the total MU. FFF required a short beam-on time and the ratio of FFF and non-FFF was 0.34 to 0.88 for 7- and 3-arc, respectively. For larger PTV, the ratio increased to 0.45–0.90. Ratio of total MU for large PTV was 3–8% lower in the non-FFF plans. Although the small difference in MU, beam-on time was 1.1 to-1.6 times longer in the 3- and 7-arc non-FFF plans. Plan verification showed the similar gamma index passing rate. Conclusion: While total MU was similar with FFF and non-FFF modes, the beam-on time was shorter in the FFF treatment. The advantage of FFF was greater in treatments with high dose per fraction using more arc numbers. For dose less than 10 Gy, using FFF and non-FFF modes, tumor size did not affect the relationship of total MU, beam-on time.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-604: Dosimetric Evaluation of Intracranial Stereotactic Radiotherapy Plans On a LINAC

Purpose: To evaluate the dosimetry of cranial stereotactic radiotherapy (SRT) plans of varying techniques on linac that meets appropriate TG-142 tolerances using 1 cm leaf width multileaf collimator (MLC). Methods: Seventeen spherical targets were generated in the center of a head phantom with diameters ranging 8 mm to 40 mm. SRT plans used 100° non-coplanar arcs and 5 couch angles with 35° spacing. The field size was target plus 1 mm margin. Four plans were created for each target: symmetrical jaws blocking for 5 arcs with 0° collimator (J1C), symmetrical jaws blocking with 5 clockwise arcs with 0° collimator and 5 counter-clockwise arcs with 45° collimator (J2C), MLC blocking for 5 dynamic conformal arcs with 0° collimator (M1C), and MLC blocking for 5 clockwise dynamic conformal arcs with 0° collimators and 5 counter-clockwise dynamic conformal arcs with 45° collimator (M2C).Conformity was evaluated using a ratio of Rx to target volume (PITV). Heterogeneity was determined using a ratio of maximum dose to Rx dose. Falloff was scored using CGIg: difference of effective radii of spheres equal to half and full Rx volumes. Results: All plans met RTOG SRS criteria for conformity and heterogeneity. The mean PITV was 1.52±0.07, 1.49±0.08, 1.39±0.05, and 1.37±0.04 for J1C, J2C, M1C, and M2C plans respectively. The mean CGIg was 75.35±15.79, 74.19±16.66, 77.14±15.12, and 76.28±15.78 for J1C, J2C, M1C, and M2C plans respectively. The mean MDPD was 1.25±0.00 for all techniques. Conclusion: Clinically acceptable SRT plans for spherical targets were created on a linac with 1 cm MLC. Adding two collimator angles and MLC to arcs each improved conformity. The MLC improved the dose falloff while two collimator angles degraded it. This technique can expand the availability of SRT to patients especially to those who cannot travel to a facility with a dedicated stereotactic radiosurgery machine.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-619: Dose Evaluation of Specific Patient Plans Based On Monte Carlo Algorithm for a CyberKnife Stereotactic Radiosurgery System

Purpose: This study will use Monte Carlo to simulate the Cyberknife system, and intend to develop the third-party tool to evaluate the dose verification of specific patient plans in TPS. Methods: By simulating the treatment head using the BEAMnrc and DOSXYZnrc software, the comparison between the calculated and measured data will be done to determine the beam parameters. The dose distribution calculated in the Raytracing, Monte Carlo algorithms of TPS (Multiplan Ver4.0.2) and in-house Monte Carlo simulation method for 30 patient plans, which included 10 head, lung and liver cases in each, were analyzed. The γ analysis with the combined 3mm/3% criteria would be introduced to quantitatively evaluate the difference of the accuracy between three algorithms. Results: More than 90% of the global error points were less than 2% for the comparison of the PDD and OAR curves after determining the mean energy and FWHM.The relative ideal Monte Carlo beam model had been established. Based on the quantitative evaluation of dose accuracy for three algorithms, the results of γ analysis shows that the passing rates (84.88±9.67% for head,98.83±1.05% for liver,98.26±1.87% for lung) of PTV in 30 plans between Monte Carlo simulation and TPS Monte Carlo algorithms were good. And the passing rates (95.93±3.12%,99.84±0.33% in each) of PTV in head and liver plans between Monte Carlo simulation and TPS Ray-tracing algorithms were also good. But the difference of DVHs in lung plans between Monte Carlo simulation and Ray-tracing algorithms was obvious, and the passing rate (51.263±38.964%) of γ criteria was not good. It is feasible that Monte Carlo simulation was used for verifying the dose distribution of patient plans. Conclusion: Monte Carlo simulation algorithm developed in the CyberKnife system of this study can be used as a reference tool for the third-party tool, which plays an important role in dose verification of patient plans. This work was supported in part by the grant from Chinese Natural Science Foundation (Grant No. 11275105). Thanks for the support from Accuray Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2024

Carbon Transport and Storage Planning and Viability Support Tools

The EDX disCO2ver Carbon Transport and Storage Planning and Viability Support Tools are made up of the Carbon Storage Planning Inquiry Tool (CS PlanIT, Justman et al. 2024) and the Carbon Storage Technical Viability Approach Support Tool (CS TVA). Together, these tools support data access to support understanding data availability to support planning efforts for carbon transport and storage. The Carbon Storage Planning Inquiry Tool (CS PlanIT) is an online web mapping application designed to help users explore, query, and evaluate multiple data layers to support and accelerate carbon storage resource and feasibility assessments and planning efforts. CS PlanIT currently contains a range of datasets associated with geologic, technical, and infrastructure factors. The data sets can be filtered geographically for an area of interest to update statistics and charts within the dashboard. The dashboard is divided into different sections called widgets, relating to different steps in the carbon storage planning process. The resources in this submission include a link to PlanIT, as well as a data catalog and link to user documentation. The original citation for the CS PlanIT tool, which has now been integrated into the toolset here, was: - Devin Justman, Scott Pantaleone, Maneesh Sharma, Lucy Romeo, Paige Morkner, CS PlanIT (Carbon Storage Planning Inquiry Tool) , 6/28/2024, https://edx.netl.doe.gov/dataset/cs-planit-carbon-storage-planning-inquiry-tool, DOI: 10.18141/2377953 The Carbon Storage Technical Viability Approach Support (CS TVA) Tool displays spatial data availability for the many components of Geologic Carbon Storage (GCS) technical viability assessment (Creason al 2025). Identifying sites suitable for GCS requires evaluating the intersection of myriad factors, including reservoir conditions, subsurface and surface hazards, infrastructure requirements, and energy community metrics. The technical viability of a site can only be confirmed for instances where all these factors have data available, and where those data support viability. Additional Resources related to the Technical Viability Assessment Tool: - Julia Mulhern, Casey White, Araceli Lara, Neyda Cordero Rodriguez, Zachary Jackson, Jacob Shay, Gabriel Creason, MacKenzie Mark-Moser, Paige Morkner, Kelly Rose, Carbon Storage Technical Viability Approach (CS TVA) Database, 3/26/2025, https://edx.netl.doe.gov/dataset/edx4ccs-carbon-storage-technical-viability-approach-database , DOI:10.18141/1984655 - Julia Mulhern, MacKenzie Mark-Moser, Gabriel Creason, Casey White, Araceli Lara, Neyda Cordero Rodriguez, Zach Jackson, Paige Morkner, Kelly Rose, Carbon Storage Technical Viability Approach (CS TVA) Matrix, 3/27/2025, https://edx.netl.doe.gov/dataset/carbon-storage-technical-viability-approach-cs-tva-matrix , DOI: 10.18141/2539979 - Gabriel Creason, Zach Jackson, Neyda Cordero Rodriguez, Julia Mulhern, Casey White, Araceli Lara, MacKenzie Mark-Moser, Paige Morkner, Kelly Rose, Carbon Storage Technical Viability Approach (CS TVA) Data Availability Results Database, 3/27/2025, https://edx.netl.doe.gov/dataset/carbon-storage-technical-viability-approach-cs-tva-data-availability-results-database, DOI:10.18141/2538557

Carbon storage↗

DOE OSTI2012

Ground Control Annual Plan for the Waste Isolation Pilot Plant (Rev. 10)

This Ground Control Annual Plan (GCAP) is a guidance document for short- and long-term planning for the Washington TRU Solutions LLC (WTS) underground ground control operations. Because ground conditions are dynamic, the data collected for the plan and the evaluation of these data are most useful when used or considered immediately after collection. Use of the data becomes more difficult and less certain with time. This plan is updated annually, and each successive document supersedes the previous document. The data, evaluations, and support plans may be updated more frequently. This document is not intended to be used as a final plan for construction. Detailed plans and work instructions are developed specifically for that purpose.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2013

Y-12 National Security Complex Biological Monitoring and Abatement Program Plan

This document provides the Biological Monitoring and Abatement Program (BMAP) Plan for East Fork Poplar Creek (EFPC), as required by the Y-12 National Security Complex (Y-12 Complex) National Pollutant Discharge Elimination System (NPDES) permit which became effective December 1, 2011. The BMAP was first developed in 1985 by staff in the Environmental Science Division at the Oak Ridge National Laboratory at the request of the Y-12 Complex. The multidisciplinary and quantitative biological monitoring approaches used for the BMAP were developed, from the beginning, in close consultation with Y-12 Complex Environmental Compliance staff, as well as the State of Tennessee and the Environmental Protection Agency. A draft BMAP Plan was submitted to the Tennessee Department of Environment and Conservation (TDEC) in May 2012 and was approved by TDEC with revision in December 2012. The TDEC’s Plan changes are incorporated in this final BMAP Plan issued in January 2013. The general approach to the 2013 BMAP Plan follows previous precedent, and addresses all BMAP-related NPDES permit requirements. The focus of the monitoring effort is on EFPC and comparable reference streams, including Brushy Fork and Hinds Creek. Two other stream systems near the Y-12 Complex, Bear Creek and McCoy Branch, are similarly monitored using BMAP and TDEC protocols as required in the permit; however, these streams are monitored by Comprehensive Environmental Response, Compensation, and Liability Act -funded programs and are only briefly summarized in this Plan. Three major tasks comprise the current program: fish bioaccumulation, benthic macroinvertebrate community, and fish community. A concomitant task, toxicity testing of storm drains, is also implemented at the Y-12 Complex and briefly described in the Plan. Each BMAP task differs slightly in the number of sites and frequency of sampling, depending on need as determined by previous monitoring. Sampling rationale and specific methods for each task are provided herein. A summary of program integration components, including data management, quality assurance, and reporting aspects, are also provided. The BMAP is an internationally recognized biological monitoring program that is a valuable case study for the U.S. Department of Energy (DOE) and the nation. First and foremost, the program evaluates Tennessee Water Quality Criteria (as required in the NPDES permit) by conducting studies to annually evaluate bioaccumulation of contaminants of concern, and the receiving streams’ biological integrity. The program has been successful in evaluating ecological effects and their causes, and has provided actionable information in the design and application of pollution abatement actions. Most importantly, the program design focuses on assessing spatial and temporal change, and has documented substantial ecological recovery in response to various facility actions. The program results have therefore become a key measure of how well the DOE facilities are doing relative to protecting the environment, and provide assurance to regulators and the public that stream conditions are improving. The DOE’s mission and environmental management in Oak Ridge will continue to evolve as the facilities modernize and various decontamination and decommissioning activities and pollution abatement actions are implemented. Many changes are expected at the Y-12 Complex in the next few years that have the potential to positively affect, or on a short-term basis negatively affect, the stream environment. The BMAP approach described here will continue to provide an important integrated measure of receiving stream conditions and ecological response to future facility actions.

Peterson, Mark J.↗