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At least 109 records · Page 6
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

The development and verification of a highly accurate collision prediction model for automated noncoplanar plan delivery

Purpose: Significant dosimetric benefits had been previously demonstrated in highly noncoplanar treatment plans. In this study, the authors developed and verified an individualized collision model for the purpose of delivering highly noncoplanar radiotherapy and tested the feasibility of total delivery automation with Varian TrueBeam developer mode. Methods: A hand-held 3D scanner was used to capture the surfaces of an anthropomorphic phantom and a human subject, which were positioned with a computer-aided design model of a TrueBeam machine to create a detailed virtual geometrical collision model. The collision model included gantry, collimator, and couch motion degrees of freedom. The accuracy of the 3D scanner was validated by scanning a rigid cubical phantom with known dimensions. The collision model was then validated by generating 300 linear accelerator orientations corresponding to 300 gantry-to-couch and gantry-to-phantom distances, and comparing the corresponding distance measurements to their corresponding models. The linear accelerator orientations reflected uniformly sampled noncoplanar beam angles to the head, lung, and prostate. The distance discrepancies between measurements on the physical and virtual systems were used to estimate treatment-site-specific safety buffer distances with 0.1%, 0.01%, and 0.001% probability of collision between the gantry and couch or phantom. Plans containing 20 noncoplanar beams to the brain, lung, and prostate optimized via an in-house noncoplanar radiotherapy platform were converted into XML script for automated delivery and the entire delivery was recorded and timed to demonstrate the feasibility of automated delivery. Results: The 3D scanner measured the dimension of the 14 cm cubic phantom within 0.5 mm. The maximal absolute discrepancy between machine and model measurements for gantry-to-couch and gantry-to-phantom was 0.95 and 2.97 cm, respectively. The reduced accuracy of gantry-to-phantom measurements was attributed to phantom setup errors due to the slightly deformable and flexible phantom extremities. The estimated site-specific safety buffer distance with 0.001% probability of collision for (gantry-to-couch, gantry-to-phantom) was (1.23 cm, 3.35 cm), (1.01 cm, 3.99 cm), and (2.19 cm, 5.73 cm) for treatment to the head, lung, and prostate, respectively. Automated delivery to all three treatment sites was completed in 15 min and collision free using a digital Linac. Conclusions: An individualized collision prediction model for the purpose of noncoplanar beam delivery was developed and verified. With the model, the study has demonstrated the feasibility of predicting deliverable beams for an individual patient and then guiding fully automated noncoplanar treatment delivery. This work motivates development of clinical workflows and quality assurance procedures to allow more extensive use and automation of noncoplanar beam geometries.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2013

Medicine Delivery Device with Integrated Sterilization and Detection

Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. The application of semiconductor processing techniques and technologies to the problems of fluid manipulation and delivery has enabled the integration of chemical, electrical, and mechanical manipulation of samples all within a single microfluidic device. This approach has been successfully applied at JPL to the automated processing, detection, and analysis of minute quantities (parts per trillion level) of biomaterials to develop instruments for in situ exploration or extraterrestrial bodies. The same nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely high-surface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL's ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization or identification of the medicine itself. This constrained volume that is located immediately prior to delivery into a patient, ensures that the medicine delivery device is inherently sterile. An additional benefit to integrating a high-surface-area template within the fluid channel of a medicine delivery device is that one can envision a number of different functional coatings that could facilitate the capture and analysis of either microbial contaminants or the medicine itself. For example, one could attach antibodies or some other binding agent with a specific affinity to the silicon nanotip template. Once a target molecule or microbe is bound to the high-surface- area template, one could use an optical analytical technique such as fluorescence or adsorption to determine the identity and potentially the concentration of the species of interest. By illuminating the bound species from the back, it may also be possible to probe only the molecules with an evanescent wave, making detection of the species from the front side of the device much simpler.

Shearn, Michael J.↗
DOE OSTI2023

Do parcel lockers reduce delivery times? Evidence from the field

Common-carrier parcel lockers have emerged as a secure, automated, self-service means of delivery consolidation in congested urban areas, which are believed to mitigate last-mile delivery challenges through reducing out-of-vehicle delivery times and consequently vehicle dwell times at the curb. However, little research exists to empirically demonstrate the environmental and efficiency gains from this technology. In this study, we designed a nonequivalent groups pre-test/post-test control experiment to estimate the causal effects of a parcel locker on delivery times in a residential building in downtown Seattle, WA. Here, the causal effects are measured in terms of vehicle dwell time and the time delivery couriers spend inside the building, through the difference-in-difference method and using a similar nearby residential building as a control. The results showed a statistically significant decrease in time spent inside the building, and small yet insignificant reduction in delivery vehicle dwell time at the curb. The locker was also well received by the building managers and residents.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2021

Nanoparticle cellular internalization is not required for RNA delivery to mature plant leaves

Rapidly growing interest in the nanoparticle-mediated delivery of DNA and RNA to plants requires a better understanding of how nanoparticles and their cargoes translocate in plant tissues and into plant cells. However, little is known about how the size and shape of nanoparticles influence transport in plants and the delivery efficiency of their cargoes, limiting the development of nanotechnology in plant systems. In this study we employed non-biolistically delivered DNA-modified gold nanoparticles (AuNPs) of various sizes (5-20 nm) and shapes (spheres and rods) to systematically investigate their transport following infiltration into Nicotiana benthamiana leaves. Generally, smaller AuNPs demonstrated more rapid, higher and longer-lasting levels of association with plant cell walls compared with larger AuNPs. We observed internalization of rod-shaped but not spherical AuNPs into plant cells, yet, surprisingly, 10 nm spherical AuNPs functionalized with small-interfering RNA (siRNA) were the most efficient at siRNA delivery and inducing gene silencing in mature plant leaves. These results indicate the importance of nanoparticle size in efficient biomolecule delivery and, counterintuitively, demonstrate that efficient cargo delivery is possible and potentially optimal in the absence of nanoparticle cellular internalization. Additionally, our results highlight nanoparticle features of importance for transport within plant tissues, providing a mechanistic overview of how nanoparticles can be designed to achieve efficacious biocargo delivery for future developments in plant nanobiotechnology.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2012

The dosimetric impact of inversely optimized arc radiotherapy plan modulation for real-time dynamic MLC tracking delivery

Purpose: Real-time dynamic multileaf collimator (MLC) tracking for management of intrafraction tumor motion can be challenging for highly modulated beams, as the leaves need to travel far to adjust for target motion perpendicular to the leaf travel direction. The plan modulation can be reduced by using a leaf position constraint (LPC) that reduces the difference in the position of adjacent MLC leaves in the plan. The purpose of this study was to investigate the impact of the LPC on the quality of inversely optimized arc radiotherapy plans and the effect of the MLC motion pattern on the dosimetric accuracy of MLC tracking delivery. Specifically, the possibility of predicting the accuracy of MLC tracking delivery based on the plan modulation was investigated. Methods: Inversely optimized arc radiotherapy plans were created on CT-data of three lung cancer patients. For each case, five plans with a single 358 deg. arc were generated with LPC priorities of 0 (no LPC), 0.25, 0.5, 0.75, and 1 (highest possible LPC), respectively. All the plans had a prescribed dose of 2 Gy x 30, used 6 MV, a maximum dose rate of 600 MU/min and a collimator angle of 45 deg. or 315 deg. To quantify the plan modulation, an average adjacent leaf distance (ALD) was calculated by averaging the mean adjacent leaf distance for each control point. The linear relationship between the plan quality [i.e., the calculated dose distributions and the number of monitor units (MU)] and the LPC was investigated, and the linear regression coefficient as well as a two tailed confidence level of 95% was used in the evaluation. The effect of the plan modulation on the performance of MLC tracking was tested by delivering the plans to a cylindrical diode array phantom moving with sinusoidal motion in the superior-inferior direction with a peak-to-peak displacement of 2 cm and a cycle time of 6 s. The delivery was adjusted to the target motion using MLC tracking, guided in real-time by an infrared optical system. The dosimetric results were evaluated using gamma index evaluation with static target measurements as reference. Results: The plan quality parameters did not depend significantly on the LPC (p {>=} 0.066), whereas the ALD depended significantly on the LPC (p < 0.001). The gamma index failure rate depended significantly on the ALD, weighted to the percentage of the beam delivered in each control point of the plan (ALD{sub w}) when MLC tracking was used (p < 0.001), but not for delivery without MLC tracking (p {>=} 0.342). The gamma index failure rate with the criteria of 2% and 2 mm was decreased from > 33.9% without MLC tracking to <31.4% (LPC 0) and <2.2% (LPC 1) with MLC tracking. Conclusions: The results indicate that the dosimetric robustness of MLC tracking delivery of an inversely optimized arc radiotherapy plan can be improved by incorporating leaf position constraints in the objective function without otherwise affecting the plan quality. The dosimetric robustness may be estimated prior to delivery by evaluating the ALD{sub w} of the plan.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-151: Breathing Synchronized Delivery (BSD) Planning for RapicArc Treatment

Purpose: To propose a workflow for breathing synchronized delivery (BSD) planning for RapicArc treatment. Methods: The workflow includes three stages: screening/simulation, planning, and delivery. In the screening/simulation stage, a 4D CT with the corresponding breathing pattern is acquired for each of the selected patients, who are able to follow their own breathing pattern. In the planning stage, one breathing phase is chosen as the reference, and contours are delineated on the reference image. Deformation maps to other phases are performed along with contour propagation. Based on the control points of the initial 3D plan for the reference phase and the respiration trace, the correlation with respiration phases, the leaf sequence and gantry angles is determined. The beamlet matrices are calculated with the corresponding breathing phase and deformed to the reference phase. Using the 4D dose evaluation tool and the original 3D plan DVHs criteria, the leaf sequence is further optimized to meet the planning objectives and the machine constraints. In the delivery stage, the patients are instructed to follow the programmed breathing patterns of their own, and all other parts are the same as the conventional Rapid-Arc delivery. Results: Our plan analysis is based on comparison of the 3D plan with a static target (SD), 3D plan with motion delivery (MD), and the BSD plan. Cyclic motion of range 0 cm to 3 cm was simulated for phantoms and lung CT. The gain of the BSD plan over MD is significant and concordant for both simulation and lung 4DCT, indicating the benefits of 4D planning. Conclusion: Our study shows that the BSD plan can approach the SD plan quality. However, such BSD scheme relies on the patient being able to follow the same breathing curve that is used in the planning stage during radiation delivery. Funded by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-649: Quality Assurances for Proton Therapy Delivery Equipment

Purpose: The number of proton therapy centers has increased dramatically over the past decade. Currently, there is no comprehensive set of guidelines that addresses quality assurance (QA) procedures for the different technologies used for proton therapy. The AAPM has charged task group 224 (TG-224) to provide recommendations for QA required for accurate and safe dose delivery, using existing and next generation proton therapy delivery equipment. Methods: A database comprised of QA procedures and tolerance limits was generated from many existing proton therapy centers in and outside of the US. These consist of proton therapy centers that possessed double scattering, uniform scanning, and pencil beams delivery systems. The diversity in beam delivery systems as well as the existing devices to perform QA checks for different beam parameters is the main subject of TG-224. Based on current practice at the clinically active proton centers participating in this task group, consensus QA recommendations were developed. The methodologies and requirements of the parameters that must be verified for consistency of the performance of the proton beam delivery systems are discussed. Results: TG-224 provides procedures and QA checks for mechanical, imaging, safety and dosimetry requirements for different proton equipment. These procedures are categorized based on their importance and their required frequencies in order to deliver a safe and consistent dose. The task group provides daily, weekly, monthly, and annual QA check procedures with their tolerance limits. Conclusions: The procedures outlined in this protocol provide sufficient information to qualified medical physicists to perform QA checks for any proton delivery system. Execution of these procedures should provide confidence that proton therapy equipment is functioning as commissioned for patient treatment and delivers dose safely and accurately within the established tolerance limits. The report will be published in late 2015.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery

Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. ArcCHECK Machine QA tool is used to test geometric and delivery aspects of linear accelerator. In this study we evaluated the performance of this tool. Methods: Machine QA feature allows user to perform quality assurance tests using ArcCHECK phantom. Following tests were performed 1) Gantry Speed 2) Gantry Rotation 3) Gantry Angle 4)MLC/Collimator QA 5)Beam Profile Flatness & Symmetry. Data was collected on trueBEAM stX machine for 6 MV for a period of one year. The Gantry QA test allows to view errors in gantry angle, rotation & assess how accurately the gantry moves around the isocentre. The MLC/Collimator QA tool is used to analyze & locate the differences between leaf bank & jaw position of linac. The flatness & Symmetry test quantifies beam flatness & symmetry in IEC-y & x direction. The Gantry & Flatness/Symmetry test can be performed for static & dynamic delivery. Results: The Gantry speed was 3.9 deg/sec with speed maximum deviation around 0.3 deg/sec. The Gantry Isocentre for arc delivery was 0.9mm & static delivery was 0.4mm. The maximum percent positive & negative difference was found to be 1.9 % & – 0.25 % & maximum distance positive & negative diff was 0.4mm & – 0.3 mm for MLC/Collimator QA. The Flatness for Arc delivery was 1.8 % & Symmetry for Y was 0.8 % & X was 1.8 %. The Flatness for gantry 0°,270°,90° & 180° was 1.75,1.9,1.8 & 1.6% respectively & Symmetry for X & Y was 0.8,0.6% for 0°, 0.6,0.7% for 270°, 0.6,1% for 90° & 0.6,0.7% for 180°. Conclusion: ArcCHECK Machine QA is an useful tool for QA of Modern linear accelerators as it tests both geometric & delivery aspects. This is very important for VMAT, SRS & SBRT treatments.

43 PARTICLE ACCELERATORS↗
DOE OSTI2022

Partner with a Third-Party Delivery Service or Not? A Prediction-and-Decision Tool for Restaurants Facing Takeout Demand Surges During a Pandemic

Amidst the COVID-19 pandemic, restaurants become more reliant on no-contact pick-up or delivery ways for serving customers. As a result, they need to make tactical planning decisions such as whether to partner with online platforms, to form their own delivery team, or both. In this paper, we develop an integrated prediction-decision model to analyze the profit of combining the two approaches and to decide the needed number of drivers under stochastic demand. We first use the susceptible-infected-recovered (SIR) model to forecast future infected cases in a given region and then construct an autoregressive-moving-average (ARMA) regression model to predict food-ordering demand. Using predicted demand samples, we formulate a stochastic integer program to optimize food delivery plans. We conduct numerical studies using COVID-19 data and food-ordering demand data collected from local restaurants in Nuevo Leon, Mexico, from April to October 2020, to show results for helping restaurants build contingency plans under rapid market changes. Our method can be used under unexpected demand surges, various infection/vaccination status, and demand patterns. Here, our results show that a restaurant can benefit from partnering with third-party delivery platforms when (i) the subscription fee is low, (ii) customers can flexibly decide whether to order from platforms or from restaurants directly, (iii) customers require more efficient delivery, (iv) average delivery distance is long, or (v) demand variance is high.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2024

Delivering Clean Air in Denver: Propane Trucks and Infrastructure in Mail Delivery Application

In 2021, Drive Clean Colorado, a Denver-based Clean Cities coalition, initiated the deployment of five Class 6 medium-duty propane autogas delivery trucks into a United States Postal Service (USPS) mail delivery contractor fleet with the goal of providing a proof-of-concept demonstration for mail delivery fleets nationwide. Funded by the U.S. Department of Energy's Office of Energy Efficiency & Renewable Energy, the project, titled "Delivering Clean Air in Denver: Propane Trucks and Infrastructure in Mail Delivery Application," enabled the purchase and deployment of the propane-powered trucks, refueling infrastructure, and supporting analysis by the National Renewable Energy Laboratory (NREL). Key objectives of the analysis included calculating the propane vehicles' emissions reductions, analyzing the costs and operational performance of the propane fleet compared to conventional diesel-powered vehicles, and evaluating the viability of propane as a clean and cost-effective alternative to conventional diesel trucks (AFDC 2023b, 2023c). The primary goal of the project was to demonstrate alternative fuel vehicles in a mail transport application and evaluate the viability of propane as a clean and cost-effective alternative to conventional diesel trucks. This proof-of-concept demonstration is expected to lead to improved understanding of the performance attributes, costs, and operational issues to inform technology adoption decisions, helping to spur market transformation toward lower-emission truck fleets. By reducing the risk of first adoption, potential exists to transform the U.S. Postal Service (USPS) mail delivery system into a lower-carbon national fleet. This technical report details the vehicle duty cycle characterization and fleet cost and performance comparison performed by the National Renewable Energy Laboratory, in addition to estimated emissions reductions for delivery operations.

33 ADVANCED PROPULSION SYSTEMS↗
NASA NTRS1996

Transmembrane transport of peptide type compounds: prospects for oral delivery

Synthesis and delivery of potential therapeutic peptides and peptidomimetic compounds has been the focus of intense research over the last 10 years. While it is widely recognized that numerous limitations apply to oral delivery of peptides, some of the limiting factors have been addressed and their mechanisms elucidated, which has lead to promising strategies. This article will briefly summarize the challenges, results and current approaches of oral peptide delivery and give some insight on future strategies. The barriers determining peptide bioavailability after oral administration are intestinal membrane permability, size limitations, intestinal and hepatic metabolism and in some cases solubility limitations. Poor membrane permeabilities of hydrophilic peptides might be overcome by structurally modifying the compounds, thus increasing their membrane partition characteristics and/or their affinity to carrier proteins. Another approach is the site-specific delivery of the peptide to the most permeable parts of the intestine. The current view on size limitation for oral drug delivery has neglected partition considerations. Recent studies suggest that compounds with a molecular weight up to 4000 might be significantly absorbed, assuming appropriate partition behavior and stability. Metabolism, probably the most significant factor in the absorption fate of peptides, might be controlled by coadministration of competitive enzyme inhibitors, structural modifications and administration of the compound as a well absorbed prodrug that is converted into the therapeutically active agent after its absorption. For some peptides poor solubility might present a limitation to oral absorption, an issue that has been addressed by mechanistically defining and therefore improving formulation parameters. Effective oral peptide delivery requires further development in understanding these complex mechanisms in order to maximize the therapeutic potential of this class of compounds.

NASA Discipline Regulatory Physiology↗
DOE OSTI2018

Toxics (Pb, Cd) and trace elements (Zn, Cu, Mn) in women during pregnancy and at delivery, South Benin, 2014–2015

Highlights: • Lack of data on maternal exposure to toxic and trace elements in Africa. • Longitudinal blood measurements of Pb, Cd, Zn, Cu and Mn during pregnancy in Benin. • Evidence of maternal exposure to Pb and Cd. • Identification of potential sources for Pb exposure during pregnancy. During pregnancy, fetal development can be hindered by maternal exposure to toxic elements and abnormal concentrations of trace elements. Few data are available in African countries. Our goal was to assess the body burden of lead (Pb), cadmium (Cd), manganese (Mn), zinc (Zn) and copper (Cu) in pregnant women in Benin. The study was carried out in Sô-Ava district, from November 2015 to April 2016. Sixty women were recruited from the RECIPAL pre-conceptional cohort study. In all women, blood samples were collected during the first trimester of pregnancy. Thirty-two women had additional maternal and cord blood samples collected at delivery. Blood samples were analyzed by inductively coupled plasma mass spectrometry. At delivery, Cd median (IQR) concentration in maternal blood was 0.34 µg/L (0.24–0.46) in this non-smoking population. Pb median (IQR) concentration in maternal blood at delivery was 37.4 µg/L (30.5–52.0), with 31.3% of blood Pb levels above the 50 μg/L threshold. These pregnant women lived in semi-rural lakeside villages. Potential sources of Pb exposure identified during pregnancy were having water supply by drill pump and activities such as smoking fish by the woman and fishing by the household head. At delivery, Zn, Cu, and Mn median (IQR) concentrations in maternal blood were, respectively, 5415 μg/L (4894–5822), 1609 μg/L (1295–1771) and 16.0 μg/L (12.5–20.8). Pb, Cd, Mn and Cu blood concentrations were significantly higher at delivery than during the first trimester of pregnancy. Pb, Cd, Zn and Cu concentrations were significantly lower in cord blood than in maternal blood, contrary to Mn concentration, which was significantly higher in cord blood than in maternal blood at delivery. This exploratory study is the first one performed in Benin, and warns us about exposition of women from Sô-Ava district to Pb and Cd during pregnancy.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2011

FOAM: NOVEL DELIVERY TECHNOLOGY FOR REMEDIATION OF VADOSE ZONE ENVIRONMENTS

Deep vadose zone environments can be a primary source and pathway for contaminant migration to groundwater. These environments present unique characterization and remediation challenges that necessitate scrutiny and research. The thickness, depth, and intricacies of the deep vadose zone, combined with a lack of understanding of the key subsurface processes (e.g., biogeochemical and hydrologic) affecting contaminant migration, make it difficult to create validated conceptual and predictive models of subsurface flow dynamics and contaminant behavior across multiple scales. These factors also make it difficult to design and deploy sustainable remedial approaches and monitor long-term contaminant behavior after remedial actions. Functionally, the methods for addressing contamination must remove and/or reduce transport of contaminants. This problem is particularly challenging in the arid western United States where the vadose zone is hundreds of feet thick, rendering transitional excavation methods exceedingly costly and ineffective. Delivery of remedial amendments is one of the most challenging and critical aspects for all remedy-based approaches. The conventional approach for delivery is through injection of aqueous remedial solutions. However, heterogeneous deep vadose zone environments present hydrologic and geochemical challenges which limit the effectiveness. Because the flow of solution infiltration is dominantly controlled by gravity and suction, injected liquid preferentially percolates through highly permeable pathways, by-passing low-permeability zones which frequently contain the majority of contamination. Moreover, the wetting front can readily mobilize and enhance contaminant transport to the underlying aquifer prior to stabilization. Development of innovative, in-situ technologies may be the only way to meet remedial action objectives and long-term stewardship goals. Surfactants can be used to lower the liquid surface tension and create stabile foams, which readily penetrate low permeability zones. Although surfactant foams have been utilized for subsurface mobilization efforts in the oil and gas industry, so far, the concept of using foams as a delivery mechanism for transporting remedial amendments into deep vadose zone environments to stabilize metal and long-lived radionuclide contaminants has not been explored. Foam flow can be directed by pressure gradients, rather than being dominated by gravity; and, foam delivery mechanisms limit the volume of water (< 5% vol.) required for remedy delivery and emplacement, thus mitigating contaminant mobilization. We will present the results of a numerical modeling and integrated laboratory- / intermediate-scale investigation to simulate, develop, demonstrate, and monitor (i.e. advanced geophysical techniques and advanced predictive biomarkers) foam-based delivery of remedial amendments to remediate metals and radionuclides in vadose zone environments.

Environmental Molecular Sciences Laboratory↗
DOE OSTI2012

A real time dose monitoring and dose reconstruction tool for patient specific VMAT QA and delivery

Purpose: To develop a real time dose monitoring and dose reconstruction tool to identify and quantify sources of errors during patient specific volumetric modulated arc therapy (VMAT) delivery and quality assurance. Methods: The authors develop a VMAT delivery monitor tool called linac data monitor that connects to the linac in clinical mode and records, displays, and compares real time machine parameters with the planned parameters. A new measure, called integral error, keeps a running total of leaf overshoot and undershoot errors in each leaf pair, multiplied by leaf width, and the amount of time during which the error exists in monitor unit delivery. Another tool reconstructs Pinnacle{sup 3} Trade-Mark-Sign format delivered plan based on the saved machine logfile and recalculates actual delivered dose in patient anatomy. Delivery characteristics of various standard fractionation and stereotactic body radiation therapy (SBRT) VMAT plans delivered on Elekta Axesse and Synergy linacs were quantified. Results: The MLC and gantry errors for all the treatment sites were 0.00 {+-} 0.59 mm and 0.05 {+-} 0.31 Degree-Sign , indicating a good MLC gain calibration. Standard fractionation plans had a larger gantry error than SBRT plans due to frequent dose rate changes. On average, the MLC errors were negligible but larger errors of up to 6 mm and 2.5 Degree-Sign were seen when dose rate varied frequently. Large gantry errors occurred during the acceleration and deceleration process, and correlated well with MLC errors (r= 0.858, p= 0.0004). PTV mean, minimum, and maximum dose discrepancies were 0.87 {+-} 0.21%, 0.99 {+-} 0.59%, and 1.18 {+-} 0.52%, respectively. The organs at risk (OAR) doses were within 2.5%, except some OARs that showed up to 5.6% discrepancy in maximum dose. Real time displayed normalized total positive integral error (normalized to the total monitor units) correlated linearly with MLC (r= 0.9279, p < 0.001) and gantry errors (r= 0.742, p= 0.005). There is a strong correlation between total integral error and PTV mean (r= 0.683, p= 0.015), minimum (r= 0.6147, p= 0.033), and maximum dose (r= 0.6038, p= 0.0376). Conclusions: Errors may exist during complex VMAT planning and delivery. Linac data monitor is capable of detecting and quantifying mechanical and dosimetric errors at various stages of planning and delivery.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-325: The New Evaluation Method of the VMAT Plan Delivery Using Varian DynaLog Files and Modulation Complexity Score (MCS)

Purpose: The aim of the study is to evaluate the use of Varian DynaLog files to verify VMAT plans delivery and modulation complexity score (MCS) of VMAT. Methods: Delivery accuracy of machine performance was quantified by multileaf collimator (MLC) position errors, gantry angle errors and fluence delivery accuracy for volumetric modulated arc therapy (VMAT). The relationship between machine performance and plan complexity were also investigated using the modulation complexity score (MCS). Plan and Actual MLC positions, gantry angles and delivered fraction of monitor units were extracted from Varian DynaLog files. These factors were taken from the record and verify system of MLC control file. Planned and delivered beam data were compared to determine leaf position errors and gantry angle errors. Analysis was also performed on planned and actual fluence maps reconstructed from those of the DynaLog files. This analysis was performed for all treatment fractions of 5 prostate VMAT plans. The analysis of DynaLog files have been carried out by in-house programming in Visual C++. Results: The root mean square of leaf position and gantry angle errors were about 0.12 and 0.15, respectively. The Gamma of planned and actual fluence maps at 3%/3 mm criterion was about 99.21. The gamma of the leaf position errors were not directly related to plan complexity as determined by the MCS. Therefore, the gamma of the gantry angle errors were directly related to plan complexity as determined by the MCS. Conclusion: This study shows Varian dynalog files for VMAT plan can be diagnosed delivery errors not possible with phantom based quality assurance. Furthermore, the MCS of VMAT plan can evaluate delivery accuracy for patients receiving of VMAT. Machine performance was found to be directly related to plan complexity but this is not the dominant determinant of delivery accuracy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Feasibility of a unified approach to intensity-modulated radiation therapy and volume-modulated arc therapy optimization and delivery

Purpose: To study the feasibility of unified intensity-modulated arc therapy (UIMAT) which combines intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) optimization and delivery to produce superior radiation treatment plans, both in terms of dose distribution and efficiency of beam delivery when compared with either VMAT or IMRT alone. Methods: An inverse planning algorithm for UIMAT was prototyped within the PINNACLE treatment planning system (Philips Healthcare). The IMRT and VMAT deliveries are unified within the same arc, with IMRT being delivered at specific gantry angles within the arc. Optimized gantry angles for the IMRT and VMAT phases are assigned automatically by the inverse optimization algorithm. Optimization of the IMRT and VMAT phases is done simultaneously using a direct aperture optimization algorithm. Five treatment plans each for prostate, head and neck, and lung were generated using a unified optimization technique and compared with clinical IMRT or VMAT plans. Delivery verification was performed with an ArcCheck phantom (Sun Nuclear) on a Varian TrueBeam linear accelerator (Varian Medical Systems). Results: In this prototype implementation, the UIMAT plans offered the same target dose coverage while reducing mean doses to organs at risk by 8.4% for head-and-neck cases, 5.7% for lung cases, and 3.5% for prostate cases, compared with the VMAT or IMRT plans. In addition, UIMAT can be delivered with similar efficiency as VMAT. Conclusions: In this proof-of-concept work, a novel radiation therapy optimization and delivery technique that interlaces VMAT or IMRT delivery within the same arc has been demonstrated. Initial results show that unified VMAT/IMRT has the potential to be superior to either standard IMRT or VMAT.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-106: An Institutional Review of Using Commercially Available Software to Evaluate Treatment Plan Quality for Various Treatment Sites and Beam Deliveries

Purpose: Use Sun Nuclear Quality Reports™ with PlanIQ™ to evaluate different treatment delivery techniques for various treatment sites. Methods: Fifteen random patients with different treatment sites were evaluated. These include the Head/Neck, prostate, pelvis, lung, esophagus, axilla, bladder and abdomen. Initially, these sites were planned on the Pinnacle {sup 3} V9.6 treatment planning system and utilized nine 6MV step-n-shoot IMRT fields. The RT plan, dose and structure sets were sent to Quality Reports™ where a DVH was recreated and the plans were compared to a unique Plan Algorithm for each treatment site. Each algorithm has its own plan quality metrics and objectives, which include the PTV coverage, PTV maximum dose, the prescription dose outside the target, doses to the critical structures, and the global maximum dose and its location. Each plan was scored base on meeting each objective. Plans may have been reoptimized and reevaluated with Quality Reports™ based on the initial score. PlanIQ™ was used to evaluate if any objective not met was achievable or difficult to obtain. A second plan using VMAT delivery was created for each patient and scored with Quality Reports™. Results: There were a wide range of scores for the different treatment sites with some scoring better for IMRT plans and some better for the VMAT deliveries. The variation in the scores could be attributed to the treatment site, location, and shape of the target. Most deliveries were chosen for the VMAT due to the short treatment times and quick patient throughput with acceptable plan scores. Conclusion: The tools are provided for both physician and dosimetrist to objectively evaluate the use of VMAT delivery versus the step-n-shoot IMRT delivery for various sites. PlanIQ validates if objectives can be met. For the physicist, a concise pass/fail report is created for plan evaluation.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-CD-304-01: FEATURED PRESENTATION and BEST IN PHYSICS (THERAPY): Trajectory Modulated Arc Therapy: Development of Novel Arc Delivery Techniques Integrating Dynamic Table Motion for Extended Volume Treatments

Purpose: Integration of coordinated robotic table motion with inversely-planned arc delivery has the potential to resolve table-top delivery limitations of large-field treatments such as Total Body Irradiation (TBI), Total Lymphoid Irradiation (TLI), and Cranial-Spinal Irradiation (CSI). We formulate the foundation for Trajectory Modulated Arc Therapy (TMAT), and using Varian Developer Mode capabilities, experimentally investigate its practical implementation for such techniques. Methods: A MATLAB algorithm was developed for inverse planning optimization of the table motion, MLC positions, and gantry motion under extended-SSD geometry. To maximize the effective field size, delivery trajectories for TMAT TBI were formed with the table rotated at 270° IEC and dropped vertically to 152.5cm SSD. Preliminary testing of algorithm parameters was done through retrospective planning analysis. Robotic delivery was programmed using custom XML scripting on the TrueBeam Developer Mode platform. Final dose was calculated using the Eclipse AAA algorithm. Initial verification of delivery accuracy was measured using OSLDs on a solid water phantom of varying thickness. Results: A comparison of DVH curves demonstrated that dynamic couch motion irradiation was sufficiently approximated by static control points spaced in intervals of less than 2cm. Optimized MLC motion decreased the average lung dose to 68.5% of the prescription dose. The programmed irradiation integrating coordinated table motion was deliverable on a TrueBeam STx linac in 6.7 min. With the couch translating under an open 10cmx20cm field angled at 10°, OSLD measurements along the midline of a solid water phantom at depths of 3, 5, and 9cm were within 3% of the TPS AAA algorithm with an average deviation of 1.2%. Conclusion: A treatment planning and delivery system for Trajectory Modulated Arc Therapy of extended volumes has been established and experimentally demonstrated for TBI. Extension to other treatment techniques such as TLI and CSI is readily achievable through the developed platform. Grant Funding by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗