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At least 1,189 records · Page 66
All sourcesNASA NTRSDOE OSTI
DOE OSTI2020

Error detection on quantum computers improving the accuracy of chemical calculations

The ultimate goal of quantum error correction is to achieve the fault-tolerance threshold beyond which quantum computers can be made arbitrarily accurate. This requires extraordinary resources and engineering efforts. We show that even without achieving full fault-tolerance, quantum error detection is already useful on the current generation of quantum hardware. We demonstrate this by executing an end-to-end chemical calculation for the hydrogen molecule encoded in the [[4, 2, 2]] quantum error-detecting code. The encoded calculation with logical qubits significantly improves the accuracy of the molecular ground-state energy.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2021

Extending quantum probabilistic error cancellation by noise scaling

Here, we propose a general framework for quantum error mitigation that combines and generalizes two techniques: probabilistic error cancellation (PEC) and zero-noise extrapolation (ZNE). Similar to PEC, the proposed method represents ideal operations as linear combinations of noisy operations that are implementable on hardware. However, instead of assuming a fixed level of hardware noise, we extend the set of implementable operations by noise scaling. By construction, this method encompasses both PEC and ZNE as particular cases and allows us to investigate a larger set of hybrid techniques. For example, gate extrapolation can be used to implement PEC without requiring knowledge of the device’s noise model, e.g., avoiding gate-set tomography. Alternatively, probabilistic error reduction can be used to estimate expectation values at intermediate virtual noise strengths (below the hardware level), leading to partially mitigated results at a lower sampling cost. Moreover, multiple results obtained with different noise-reduction factors can be further postprocessed with ZNE to better approximate the zero-noise limit.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗
DOE OSTI2022

Computationally efficient zero-noise extrapolation for quantum-gate-error mitigation

Zero noise extrapolation (ZNE) is a widely used technique for gate error mitigation on near term quantum computers because it can be implemented in software and does not require knowledge of the quantum computer noise parameters. Traditional ZNE requires a significant resource overhead in terms of quantum operations. A recent proposal using a targeted (or random) instead of fixed identity insertion method (riim versus fiim) requires significantly fewer quantum gates for the same formal precision. We start by showing that riim can allow for ZNE to be deployed on deeper circuits than fiim but requires many more measurements to maintain the same statistical uncertainty. We develop two extensions to fiim and riim. The List Identity Insertion Method (liim) allows to mitigate the error from certain cnot gates, typically those with the largest error. Set Identity Insertion Method (siim) naturally interpolates between the measurement-efficient fiim and the gate-efficient riim allowing to trade off fewer cnot gates for more measurements. Finally, we investigate a way to boost the number of measurements, namely to run ZNE in parallel, utilizing as many quantum devices as are available. We explore the performance of riim in a parallel setting where there is a non-trivial spread in noise across sets of qubits within or across quantum computers.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2024

Self-calibration strategies for reducing systematic slope measurement errors of autocollimators in deflectometric profilometry

Deflectometric profilometers are used to precisely measure the form of beam shaping optics of synchrotrons and X-ray free-electron lasers. They often utilize autocollimators which measure slope by evaluating the displacement of a reticle image on a detector. Based on our privileged access to the raw image data of an autocollimator, novel strategies to reduce the systematic measurement errors by using a set of overlapping images of the reticle obtained at different positions on the detector are discussed. It is demonstrated that imaging properties such as, for example, geometrical distortions and vignetting, can be extracted from this redundant set of images without recourse to external calibration facilities. This approach is based on the fact that the properties of the reticle itself do not change – all changes in the reticle image are due to the imaging process. Firstly, by combining interpolation and correlation, it is possible to determine the shift of a reticle image relative to a reference image with minimal error propagation. Secondly, the intensity of the reticle image is analysed as a function of its position on the CCD and a vignetting correction is calculated. Thirdly, the size of the reticle image is analysed as a function of its position and an imaging distortion correction is derived. It is demonstrated that, for different measurement ranges and aperture diameters of the autocollimator, reductions in the systematic errors of up to a factor of four to five can be achieved without recourse to external measurements.

47 OTHER INSTRUMENTATION↗
DOE OSTI2022

SZ3: A Modular Framework for Composing Prediction-Based Error-Bounded Lossy Compressors

Today's scientific simulations require a significant reduction of data volume because of extremely large amounts of data they produce and the limited I/O bandwidth and storage space. Here, error-bounded lossy compression has been considered one of the most effective solutions to the above problem. In practice, however, the best-fit compression method often needs to be customized or optimized in particular because of diverse characteristics in different datasets and various user requirements on the compression quality and performance. In this paper, we address this issue with a novel modular, composable compression framework named SZ3. Our contributions are four-folds. (1) We develop SZ3 which features an innovative modular abstraction for the prediction-based compression framework, such that compression modules can be plugged in easily to create new compressors based on characteristics of data and user requirements. (2) We create a new compression pipeline by SZ3 for GAMESS data, which significantly improves the compression ratios over state-of-the-art compressors. (3) We develop an adaptive compression pipeline by SZ3 for APS data with minimal efforts, which leads to the best rate-distortion among all existing error-bounded lossy compressors for any bit-rate. (4) We compare the sustainability of SZ3 with leading error-bounded prediction-based compressors, and then demonstrate the necessity of diverse pipelines by integrating and evaluating several compression pipelines on diverse scientific datasets from multiple disciplines. Experiments show that SZ3 incurs very limited overhead in compressor integration and our customized compression pipelines lead to up to 20% improvement in compression ratios under the same data distortion, when compared with the best existing approach.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2020

Layer-Dependent Bit Error Variation in 3-D NAND Flash Under Ionizing Radiation

In this paper, we studied the total ionization dose (TID) effects on the multilevel-cell (MLC) 3-D NAND flash memory using Co-60 gamma radiation. We found a significant page-to-page bit error variation within a physical memory block of the irradiated memory chip. Our analysis showed that the origin of the bit error variation is the unique vertical layer-dependent TID response of the 3-D NAND. We found that the memory pages located at the upper and lower layers of the 3-D stack show higher fails compared to the middle-layer pages of a given memory block. We confirmed our findings by comparing radiation response of four different chips of the same specification. In addition, we compared the TID response of the MLC 3-D NAND with that of the 2-D NAND chip, which showed less page-to-page variation in bit error within a given memory block. We discuss the possible application of our findings for the radiation-tolerant smart memory controller design.

3-D NAND flash↗
DOE OSTI2017

Optimization of Error-Bounded Lossy Compression for Hard-to-Compress HPC Data

Since today’s scientific applications are producing vast amounts of data, compressing them before storage/transmission is critical. Results of existing compressors show two types of HPC data sets: highly compressible and hard to compress. In this work, we carefully design and optimize the error-bounded lossy compression for hard-tocompress scientific data. We propose an optimized algorithm that can adaptively partition the HPC data into best-fit consecutive segments each having mutually close data values, such that the compression condition can be optimized. Another significant contribution is the optimization of shifting offset such that the XOR-leading-zero length between two consecutive unpredictable data points can be maximized. We finally devise an adaptive method to select the best-fit compressor at runtime for maximizing the compression factor. We evaluate our solution using 13 benchmarks based on real-world scientific problems, and we compare it with 9 other state-of-the-art compressors. Experiments show that our compressor can always guarantee the compression errors within the user-specified error bounds. Most importantly, our optimization can improve the compression factor effectively, by up to 49% for hard-tocompress data sets with similar compression/decompression time cost.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2014

SU-E-T-51: Bayesian Network Models for Radiotherapy Error Detection

Purpose: To develop a probabilistic model of radiotherapy plans using Bayesian networks that will detect potential errors in radiation delivery. Methods: Semi-structured interviews with medical physicists and other domain experts were employed to generate a set of layered nodes and arcs forming a Bayesian Network (BN) which encapsulates relevant radiotherapy concepts and their associated interdependencies. Concepts in the final network were limited to those whose parameters are represented in the institutional database at a level significant enough to develop mathematical distributions. The concept-relation knowledge base was constructed using the Web Ontology Language (OWL) and translated into Hugin Expert Bayes Network files via the the RHugin package in the R statistical programming language. A subset of de-identified data derived from a Mosaiq relational database representing 1937 unique prescription cases was processed and pre-screened for errors and then used by the Hugin implementation of the Estimation-Maximization (EM) algorithm for machine learning all parameter distributions. Individual networks were generated for each of several commonly treated anatomic regions identified by ICD-9 neoplasm categories including lung, brain, lymphoma, and female breast. Results: The resulting Bayesian networks represent a large part of the probabilistic knowledge inherent in treatment planning. By populating the networks entirely with data captured from a clinical oncology information management system over the course of several years of normal practice, we were able to create accurate probability tables with no additional time spent by experts or clinicians. These probabilistic descriptions of the treatment planning allow one to check if a treatment plan is within the normal scope of practice, given some initial set of clinical evidence and thereby detect for potential outliers to be flagged for further investigation. Conclusion: The networks developed here support the use of probabilistic models into clinical chart checking for improved detection of potential errors in RT plans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-318: The Effect of Patient Positioning Errors On Target Coverage and Cochlear Dose in Stereotactic Radiosurgery Treatment of Acoustic Neuromas

Purpose: Setup errors on the order of millimeters may cause under-dosing of targets and significant changes in dose to critical structures especially when planning with tight margins in stereotactic radiosurgery. This study evaluates the effects of these types of patient positioning uncertainties on planning target volume (PTV) coverage and cochlear dose for stereotactic treatments of acoustic neuromas. Methods: Twelve acoustic neuroma patient treatment plans were retrospectively evaluated in Brainlab iPlan RT Dose 4.1.3. All treatment beams were shaped by HDMLC from a Varian TX machine. Seven patients had planning margins of 2mm, five had 1–1.5mm. Six treatment plans were created for each patient simulating a 1mm setup error in six possible directions: anterior-posterior, lateral, and superiorinferior. The arcs and HDMLC shapes were kept the same for each plan. Change in PTV coverage and mean dose to the cochlea was evaluated for each plan. Results: The average change in PTV coverage for the 72 simulated plans was −1.7% (range: −5 to +1.1%). The largest average change in coverage was observed for shifts in the patient's superior direction (−2.9%). The change in mean cochlear dose was highly dependent upon the direction of the shift. Shifts in the anterior and superior direction resulted in an average increase in dose of 13.5 and 3.8%, respectively, while shifts in the posterior and inferior direction resulted in an average decrease in dose of 17.9 and 10.2%. The average change in dose to the cochlea was 13.9% (range: 1.4 to 48.6%). No difference was observed based on the size of the planning margin. Conclusion: This study indicates that if the positioning uncertainty is kept within 1mm the setup errors may not result in significant under-dosing of the acoustic neuroma target volumes. However, the change in mean cochlear dose is highly dependent upon the direction of the shift.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-405: Robustness of Volumetric-Modulated Arc Therapy (VMAT) Plans to Systematic MLC Positional Errors

Purpose: To evaluate the dosimetric impact of systematic MLC positional errors (PEs) on the quality of volumetric-modulated arc therapy (VMAT) plans. Methods: Five patients with head-and-neck cancer (HN) and five patients with prostate cancer were randomly chosen for this study. The clinically approved VMAT plans were designed with 2–4 coplanar arc beams with none-zero collimator angles in the Pinnacle planning system. The systematic MLC PEs of 0.5, 1.0, and 2.0 mm on both MLC banks were introduced into the original VMAT plans using an in-house program, and recalculated with the same planned Monitor Units in the Pinnacle system. For each patient, the original VMAT plans and plans with MLC PEs were evaluated according to the dose-volume histogram information and Gamma index analysis. Results: For one primary target, the ratio of V100 in the plans with 0.5, 1.0, and 2.0 mm MLC PEs to those in the clinical plans was 98.8 ± 2.2%, 97.9 ± 2.1%, 90.1 ± 9.0% for HN cases and 99.5 ± 3.2%, 98.9 ± 1.0%, 97.0 ± 2.5% for prostate cases. For all OARs, the relative difference of Dmean in all plans was less than 1.5%. With 2mm/2% criteria for Gamma analysis, the passing rates were 99.0 ± 1.5% for HN cases and 99.7 ± 0.3% for prostate cases between the planar doses from the original plans and the plans with 1.0 mm MLC errors. The corresponding Gamma passing rates dropped to 88.9 ± 5.3% for HN cases and 83.4 ± 3.2% for prostate cases when comparing planar doses from the original plans and the plans with 2.0 mm MLC errors. Conclusion: For VMAT plans, systematic MLC PEs up to 1.0 mm did not affect the plan quality in term of target coverage, OAR sparing, and Gamma analysis with 2mm/2% criteria.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

Purpose: Base of skull meningioma can be treated with both intensity modulated radiation therapy (IMRT) and spot scanned proton therapy (PT). One of the main benefits of PT is better sparing of organs at risk, but due to the physical and dosimetric characteristics of protons, spot scanned PT can be more sensitive to the uncertainties encountered in the treatment process compared with photon treatment. Therefore, robustness analysis should be part of a comprehensive comparison between these two treatment methods in order to quantify and understand the sensitivity of the treatment techniques to uncertainties. The aim of this work was to benchmark a spot scanning treatment planning system for planning of base of skull meningioma and to compare the created plans and analyze their robustness to setup errors against the IMRT technique. Methods: Plans were produced for three base of skull meningioma cases: IMRT planned with a commercial TPS [Monaco (Elekta AB, Sweden)]; single field uniform dose (SFUD) spot scanning PT produced with an in-house TPS (PSI-plan); and SFUD spot scanning PT plan created with a commercial TPS [XiO (Elekta AB, Sweden)]. A tool for evaluating robustness to random setup errors was created and, for each plan, both a dosimetric evaluation and a robustness analysis to setup errors were performed. Results: It was possible to create clinically acceptable treatment plans for spot scanning proton therapy of meningioma with a commercially available TPS. However, since each treatment planning system uses different methods, this comparison showed different dosimetric results as well as different sensitivities to setup uncertainties. The results confirmed the necessity of an analysis tool for assessing plan robustness to provide a fair comparison of photon and proton plans. Conclusions: Robustness analysis is a critical part of plan evaluation when comparing IMRT plans with spot scanned proton therapy plans.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-J-170: Dosimetric Consequences of Uncorrected Rotational Setup Errors During Stereotactic Body Radiation Therapy (SBRT) Treatment of Pancreatic Cancers

Purpose: To explore the dosimetric consequences of uncorrected rotational setup errors during SBRT for pancreatic cancer patients. Methods: This was a retrospective study utilizing data from ten (n=10) previously treated SBRT pancreas patients. For each original planning CT, we applied rotational transformations to derive additional CT images representative of possible rotational setup errors. This resulted in 6 different sets of rotational combinations, creating a total of 60 CT planning images. The patients’ clinical dosimetric plans were then applied to their corresponding rotated CT images. The 6 rotation sets encompassed a 3, 2 and 1-degree rotation in each rotational direction and a 3-degree in just the pitch, a 3-degree in just the yaw and a 3-degree in just the roll. After the dosimetric plan was applied to the rotated CT images, the resulting plan was then evaluated and compared with the clinical plan for tumor coverage and normal tissue sparing. Results: PTV coverage, defined here by V33 throughout all of the patients’ clinical plans, ranged from 92–98%. After an n degree rotation in each rotational direction that range decreased to 68–87%, 85–92%, and 88– 94% for n=3, 2 and 1 respectively. Normal tissue sparing defined here by the proximal stomach V15 throughout all of the patients’ clinical plans ranged from 0–8.9 cc. After an n degree rotation in each rotational direction that range increased to 0–17 cc, 0–12 cc, and 0–10 cc for n=3, 2, and 1 respectively. Conclusion: For pancreatic SBRT, small rotational setup errors in the pitch, yaw and roll direction on average caused under dosage to PTV and over dosage to proximal normal tissue. The 1-degree rotation was on average the least detrimental to the normal tissue and the coverage of the PTV. The 3-degree yaw created on average the lowest increase in volume coverage to normal tissue. This research was sponsored by the AAPM Education Council through the AAPM Education and Research Fund for the AAPM Summer Undergraduate Fellowship Program.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-172: Bio-Physical Effects of Patients Set-Up Errors According to Whole Breast Irradiation Techniques

Purpose: The dose-related effects of patient setup errors on biophysical indices were evaluated for conventional wedge (CW) and field-in-field (FIF) whole breast irradiation techniques. Methods: The treatment plans for 10 patients receiving whole left breast irradiation were retrospectively selected. Radiobiological and physical effects caused by dose variations were evaluated by shifting the isocenters and gantry angles of the treatment plans. Dose-volume histograms of the planning target volume (PTV), heart, and lungs were generated, and conformity index (CI), homogeneity index (HI), tumor control probability (TCP), and normal tissue complication probability (NTCP) were determined. Results: For “isocenter shift plan” with posterior direction, the D95 of the PTV decreased by approximately 15% and the TCP of the PTV decreased by approximately 50% for the FIF technique and by 40% for the CW; however, the NTCPs of the lungs and heart increased by about 13% and 1%, respectively, for both techniques. Increasing the gantry angle decreased the TCPs of the PTV by 24.4% (CW) and by 34% (FIF). The NTCPs for the two techniques differed by only 3%. In case of CW, the CIs and HIs were much higher than that of the FIF in all cases. It had a significant difference between two techniques (p<0.01). According to our results, however, the FIF had more sensitive response by set up errors rather than CW in bio-physical aspects. Conclusions: The radiobiological-based analysis can detect significant dosimetric errors then, can provide a practical patient quality assurance method to guide the radiobiological and physical effects.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-631: Preliminary Results for Analytical Investigation Into Effects of ArcCHECK Setup Errors

Purpose: As three-dimensional diode arrays increase in popularity for patient-specific quality assurance for intensity-modulated radiation therapy (IMRT), it is important to evaluate an array’s susceptibility to setup errors. The ArcCHECK phantom is set up by manually aligning its outside marks with the linear accelerator’s lasers and light-field. If done correctly, this aligns the ArcCHECK cylinder’s central axis (CAX) with the linear accelerator’s axis of rotation. However, this process is prone to error. This project has developed an analytical expression including a perturbation factor to quantify the effect of shifts. Methods: The ArcCHECK is set up by aligning its machine marks with either the sagittal room lasers or the light-field of the linear accelerator at gantry zero (IEC). ArcCHECK has sixty-six evenly-spaced SunPoint diodes aligned radially in a ring 14.4 cm from CAX. The detector response function (DRF) was measured and combined with inverse-square correction to develop an analytical expression for output. The output was calculated using shifts of 0 (perfect alignment), +/−1, +/−2 and +/−5 mm. The effect on a series of simple inputs was determined: unity, 1-D ramp, steps, and hat-function to represent uniform field, wedge, evenly-spaced modulation, and single sharp modulation, respectively. Results: Geometric expressions were developed with perturbation factor included to represent shifts. DRF was modeled using sixth-degree polynomials with correlation coefficient 0.9997. The output was calculated using simple inputs such as unity, 1-D ramp, steps, and hat-function, with perturbation factors of: 0, +/−1, +/−2 and +/−5 mm. Discrepancies have been observed, but large fluctuations have been somewhat mitigated by aliasing arising from discrete diode placement. Conclusion: An analytical expression with perturbation factors was developed to estimate the impact of setup errors on an ArcCHECK phantom. Presently, this has been applied to simple functions, but is being developed to handle more realistic clinical cases.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

TU-AB-201-05: Automatic Adaptive Per-Operative Re-Planning for HDR Prostate Brachytherapy - a Simulation Study On Errors in Needle Positioning

Purpose: To develop adaptive planning with feedback for MRI-guided focal HDR prostate brachytherapy with a single divergent needle robotic implant device. After each needle insertion, the dwell positions for that needle are calculated and the positioning of remaining needles and dosimetry are both updated based on MR imaging. Methods: Errors in needle positioning may occur due to inaccurate needle insertion (caused by e.g. the needle’s bending) and unpredictable changes in patient anatomy. Consequently, the dose plan quality might dramatically decrease compared to the preplan. In this study, a procedure was developed to re-optimize, after each needle insertion, the remaining needle angulations, source positions and dwell times in order to obtain an optimal coverage (D95% PTV>19 Gy) without exceeding the constraints of the organs at risk (OAR) (D10% urethra<21 Gy, D1cc bladder<12 Gy and D1cc rectum<12 Gy). Complete HDR procedures with 6 needle insertions were simulated for a patient MR-image set with PTV, prostate, urethra, bladder and rectum delineated. Random angulation errors, modeled by a Gaussian distribution (standard deviation of 3 mm at the needle’s tip), were generated for each needle insertion. We compared the final dose parameters for the situations (I) without re-optimization and (II) with the automatic feedback. Results: The computation time of replanning was below 100 seconds on a current desk computer. For the patient tested, a clinically acceptable dose plan was achieved while applying the automatic feedback (median(range) in Gy, D95% PTV: 19.9(19.3–20.3), D10% urethra: 13.4(11.9–18.0), D1cc rectum: 11.0(10.7–11.6), D1cc bladder: 4.9(3.6–6.8)). This was not the case without re-optimization (median(range) in Gy, D95% PTV: 19.4(14.9–21.3), D10% urethra: 12.6(11.0–15.7), D1cc rectum: 10.9(8.9–14.1), D1cc bladder: 4.8(4.4–5.2)). Conclusion: An automatic guidance strategy for HDR prostate brachytherapy was developed to compensate errors in needle positioning and improve the dose distribution. Without re-optimization, target coverage and OAR constraints may not be achieved. M. Borot de Battisti is funded by Philips Medical Systems Nederland B.V.; M. Moerland is principal investigator on a contract funded by Philips Medical Systems Nederland B.V.; G. Hautvast and D. Binnekamp are full-time employees of Philips Medical Systems Nederland B.V.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-G-BRD-01: Quantifying the Effectiveness of the Physics Pre-Treatment Plan Review for Detecting Errors in Radiation Therapy

Purpose: Physics pre-treatment plan review is crucial to safe radiation oncology treatments. Studies show that most errors originate in treatment planning, which underscores the importance of physics plan review. As a QA measure the physics review is of fundamental importance and is central to the profession of medical physics. However, little is known about its effectiveness. More hard data are needed. The purpose of this study was to quantify the effectiveness of physics review with the goal of improving it. Methods: This study analyzed 315 “potentially serious” near-miss incidents within an institutional incident learning system collected over a two-year period. 139 of these originated prior to physics review and were found at the review or after. Incidents were classified as events that: 1)were detected by physics review, 2)could have been detected (but were not), and 3)could not have been detected. Category 1 and 2 events were classified by which specific check (within physics review) detected or could have detected the event. Results: Of the 139 analyzed events, 73/139 (53%) were detected or could have been detected by the physics review; although, 42/73 (58%) were not actually detected. 45/73 (62%) errors originated in treatment planning, making physics review the first step in the workflow that could detect the error. Two specific physics checks were particularly effective (combined effectiveness of >20%): verifying DRRs (8/73) and verifying isocenter (7/73). Software-based plan checking systems were evaluated and found to have potential effectiveness of 40%. Given current data structures, software implementations of some tests such as isocenter verification check would be challenging. Conclusion: Physics plan review is a key safety measure and can detect majority of reported events. However, a majority of events that potentially could have been detected were NOT detected in this study, indicating the need to improve the performance of physics review.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-JeP3-02: Comparison of Magnitude and Frequency of Patient Positioning Errors in Breast Irradiation Using AlignRT 3D Optical Surface Imaging and Skin Mark Techniques

Purpose: To evaluate clinical usefulness of AlignRT (Vision RT Ltd., London, UK) in reducing patient positioning errors in breast irradiation. Methods: 60 patients undergoing whole breast irradiation were selected for this study. Patients were treated to the left or right breast lying on Qfix Access breast board (Qfix, Avondale, PA) in supine position for 28 fractions using tangential fields. 30 patients were aligned using AlignRT by aligning a breast surface region of interest (ROI) to the same area from a reference surface image extracted from planning CT. When the patient’s surface image deviated from the reference by more than 3mm on one or more translational and rotational directions, a new reference was acquired using AlignRT in-room cameras. The other 30 patients were aligned to the skin marks with room lasers. On-Board MV portal images of medial field were taken daily and matched to the DRRs. The magnitude and frequency of positioning errors were determined from measured translational shifts. Kolmogorov-Smirnov test was used to evaluate statistical differences of positional accuracy and precision between AlignRT and non-AlignRT patients. Results: The percentage of port images with no shift required was 46.5% and 27.0% in vertical, 49.8% and 25.8% in longitudinal, 47.6% and 28.5% in lateral for AlignRT and non-AlignRT patients, respectively. The percentage of port images requiring more than 3mm shifts was 18.1% and 35.1% in vertical, 28.6% and 50.8% in longitudinal, 11.3% and 24.2% in lateral for AlignRT and non-AlignRT patients, respectively. Kolmogorov-Smirnov test showed that there were significant differences between the frequency distributions of AlignRT and non-AlignRT in vertical, longitudinal, and lateral shifts. Conclusion: As confirmed by port images, AlignRT-assisted patient positioning can significantly reduce the frequency and magnitude of patient setup errors in breast irradiation compared to the use of lasers and skin marks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

The effectiveness of pretreatment physics plan review for detecting errors in radiation therapy

Purpose: The pretreatment physics plan review is a standard tool for ensuring treatment quality. Studies have shown that the majority of errors in radiation oncology originate in treatment planning, which underscores the importance of the pretreatment physics plan review. This quality assurance measure is fundamentally important and central to the safety of patients and the quality of care that they receive. However, little is known about its effectiveness. The purpose of this study was to analyze reported incidents to quantify the effectiveness of the pretreatment physics plan review with the goal of improving it. Methods: This study analyzed 522 potentially severe or critical near-miss events within an institutional incident learning system collected over a three-year period. Of these 522 events, 356 originated at a workflow point that was prior to the pretreatment physics plan review. The remaining 166 events originated after the pretreatment physics plan review and were not considered in the study. The applicable 356 events were classified into one of the three categories: (1) events detected by the pretreatment physics plan review, (2) events not detected but “potentially detectable” by the physics review, and (3) events “not detectable” by the physics review. Potentially detectable events were further classified by which specific checks performed during the pretreatment physics plan review detected or could have detected the event. For these events, the associated specific check was also evaluated as to the possibility of automating that check given current data structures. For comparison, a similar analysis was carried out on 81 events from the international SAFRON radiation oncology incident learning system. Results: Of the 356 applicable events from the institutional database, 180/356 (51%) were detected or could have been detected by the pretreatment physics plan review. Of these events, 125 actually passed through the physics review; however, only 38% (47/125) were actually detected at the review. Of the 81 events from the SAFRON database, 66/81 (81%) were potentially detectable by the pretreatment physics plan review. From the institutional database, three specific physics checks were particularly effective at detecting events (combined effectiveness of 38%): verifying the isocenter (39/180), verifying DRRs (17/180), and verifying that the plan matched the prescription (12/180). The most effective checks from the SAFRON database were verifying that the plan matched the prescription (13/66) and verifying the field parameters in the record and verify system against those in the plan (23/66). Software-based plan checking systems, if available, would have potential effectiveness of 29% and 64% at detecting events from the institutional and SAFRON databases, respectively. Conclusions: Pretreatment physics plan review is a key safety measure and can detect a high percentage of errors. However, the majority of errors that potentially could have been detected were not detected in this study, indicating the need to improve the pretreatment physics plan review performance. Suggestions for improvement include the automation of specific physics checks performed during the pretreatment physics plan review and the standardization of the review process.

60 APPLIED LIFE SCIENCES↗