Engineering Papers⌕ Search

SEARCH · Engineering Papers

Results for “planned”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,261 records · Page 70
All sourcesNASA NTRSDOE OSTI
DOE OSTI2021

Wide-Scale Clinical Implementation of Knowledge-Based Planning: An Investigation of Workforce Efficiency, Need for Post-automation Refinement, and Data-Driven Model Maintenance

Our purpose was to investigate the effect of automated knowledge-based planning (KBP) on real-world clinical workflow efficiency, assess whether manual refinement of KBP plans improves plan quality across multiple disease sites, and develop a data-driven method to periodically improve KBP automated planning routines.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

A class solution for volumetric-modulated arc therapy planning in postprostatectomy radiotherapy

This study is aimed to test a postprostatectomy volumetric-modulated arc therapy (VMAT) planning class solution. The solution applies to both the progressive resolution optimizer algorithm version 2 (PRO 2) and the algorithm version 3 (PRO 3), addressing the effect of an upgraded algorithm. A total of 10 radical postprostatectomy patients received 68 Gy to 95% of the planning target volume (PTV), which was planned using VMAT. Each case followed a set of planning instructions; including contouring, field setup, and predetermined optimization parameters. Each case was run through both algorithms only once, with no user interaction. Results were averaged and compared against Radiation Therapy Oncology Group (RTOG) 0534 end points. In addition, the clinical target volume (CTV) D{sub 100}, PTV D{sub 99}, and PTV mean doses were recorded, along with conformity indices (CIs) (95% and 98%) and the homogeneity index. All cases satisfied PTV D{sub 95} of 68 Gy and a maximum dose < 74.8 Gy. The average result for the PTV D{sub 99} was 64.1 Gy for PRO 2 and 62.1 Gy for PRO 3. The average PTV mean dose for PRO 2 was 71.4 Gy and 71.5 Gy for PRO 3. The CTV D{sub 100} average dose was 67.7 and 68.0 Gy for PRO 2 and PRO 3, respectively. The mean homogeneity index for both algorithms was 0.08. The average 95% CI was 1.17 for PRO 2 and 1.19 for PRO 3. For 98%, the average results were 1.08 and 1.12 for PRO 2 and PRO 3, respectively. All cases for each algorithm met the RTOG organs at risk dose constraints. A successful class solution has been established for prostate bed VMAT radiotherapy regardless of the algorithm used.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer

The primary objective of this study was to compare dosimetric variables as well as treatment times of multiple static fields (MSFs), conformal arcs (CAs), and volumetric modulated arc therapy (VMAT) techniques for the treatment of early stage lung cancer using stereotactic body radiotherapy (SBRT). Treatments of 23 patients previously treated with MSF of 48 Gy to 95% of the planning target volume (PTV) in 4 fractions were replanned using CA and VMAT techniques. Dosimetric parameters of the Radiation Therapy Oncology Group (RTOG) 0915 trial were evaluated, along with the van't Riet conformation number (CN), monitor units (MUs), and actual and calculated treatment times. Paired t-tests for noninferiority were used to compare the 3 techniques. CA had significant dosimetric improvements over MSF for the ratio of the prescription isodose volume to PTV (R{sub 100%}, p < 0.0001), the maximum dose 2 cm away from the PTV (D{sub 2} {sub cm}, p = 0.005), and van't Riet CN (p < 0.0001). CA was not statistically inferior to MSF for the 50% prescription isodose volume to PTV (R{sub 50%}, p = 0.05). VMAT was significantly better than CA for R{sub 100%} (p < 0.0001), R{sub 50%} (p < 0.0001), D{sub 2} {sub cm} (p = 0.006), and CN (p < 0.0001). CA plans had significantly shorter treatment times than those of VMAT (p < 0.0001). Both CA and VMAT planning showed significant dosimetric improvements and shorter treatment times over those of MSF. VMAT showed the most favorable dosimetry of all 3 techniques; however, the dosimetric effect of tumor motion was not evaluated. CA plans were significantly faster to treat, and minimize the interplay of tumor motion and dynamic multileaf collimator (MLC) motion effects. Given these results, CA has become the treatment technique of choice at our facility.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2017

Impact of intravenous contrast used in computed tomography on radiation dose to carotid arteries and thyroid in intensity-modulated radiation therapy planning for nasopharyngeal carcinoma

The aim of this study was to investigate if intravenous contrast injection affected the radiation doses to carotid arteries and thyroid during intensity-modulated radiation therapy (IMRT) planning for nasopharyngeal carcinoma (NPC). Thirty consecutive patients with NPC underwent plain computed tomography (CT) followed by repeated scanning after contrast injection. Carotid arteries (common, external, internal), thyroid, target volumes, and other organs-at-risk (OARs), as well as IMRT planning, were based on contrast-enhanced CT (CE-CT) images. All these structures and the IMRT plans were then copied and transferred to the non–contrast-enhanced CT (NCE-CT) images, and dose calculation without optimization was performed again. The radiation doses to the carotid arteries and the thyroid based on CE-CT and NCE-CT were then compared. Based on CE-CT, no statistical differences, despite minute numeric decreases, were noted in all dosimetric parameters (minimum, maximum, mean, median, D05, and D01) of the target volumes, the OARs, the carotid arteries, and the thyroid compared with NCE-CT. Our results suggested that compared with NCE-CT planning, CE-CT scanning should be performed during IMRT for better target and OAR delineation, without discernible change in radiation doses.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2017

Importance of deformable image registration and biological dose summation in planning of radiotherapy retreatments

The purpose of this study is to evaluate the effect of nonrigid and fractionation-corrected dose summation on total doses in radiotherapy and to demonstrate the benefits of such dose summation on clinical decision-making for planning of retreatments. Dose summation of organs at risk (OARs) was investigated for 3 clinical cases with need of retreatment to the same site: head and neck, brain, and mediastinum. Three different summation methods over old and new radiotherapy treatment plans are presented and compared: (1) rigid raw sum with rigid registration of the planning images and direct dose summing; (2) deformable raw sum with deformable image registration and direct dose summing; and (3) deformable biological sum with deformable registration and takes into account the dose per fraction in biological manner in certain critical organs. In 2 cases, a user-defined dose downscaling is applied to take into account the time between the treatments and the healing from the radiation-induced effects. Of the 3 summation methods presented, the deformable biological sum was considered to offer the most biologically plausible account of the treatment. There were remarkable differences between near-maximum doses (D0.1cc) and dose-volume histogram (DVH) curves for OARs between different summation methods. The differences between deformable raw sum and rigid raw sum D0.1cc doses are in the range from −8 Gy to 2 Gy. Similarly, the deviation was from −14 Gy to 5 Gy for the deformable biological sum compared with the rigid raw sum. These differences come from incorrect summation of doses in the rigid raw sum case, and from the dose per fraction effect in biological summation. We conclude that computing the 3-dimensional deformable biological summation could be a valuable tool for treating patients with complex retreatments. It has the potential to assist the oncologist in refining plans for maximally curative doses while respecting appropriate tissue tolerances.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Modeling the target dose fall-off in IMRT and VMAT planning techniques for cervical SBRT

There has been growing interest in the use of stereotactic body radiotherapy (SBRT) technique for the treatment of cervical cancer. The purpose of this study was to characterize dose distributions as well as model the target dose fall-off for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) delivery techniques using 6 and 10 MV photon beam energies. Fifteen (n = 15) patients with non-bulky cervical tumors were planned in Pinnacle{sup 3} with a Varian Novalis Tx (HD120 MLC) using 6 and 10 MV photons with the following techniques: (1) IMRT with 10 non-coplanar beams (2) dual, coplanar 358° VMAT arcs (4° spacing), and (3) triple, non-coplanar VMAT arcs. Treatment volumes and dose prescriptions were segmented according to University of Texas Southwestern (UTSW) Phase II study. All plans were normalized such that 98% of the planning target volume (PTV) received 28 Gy (4 fractions). For the PTV, the following metrics were evaluated: homogeneity index, conformity index, D{sub 2cc}, D{sub mean}, D{sub max}, and dose fall-off parameters. For the organs at risk (OARs), D{sub 2cc}, D{sub 15cc}, D{sub 0.01cc}, V{sub 20}, V{sub 40}, V{sub 50}, V{sub 60}, and V{sub 80} were evaluated for the bladder, bowel, femoral heads, rectum, and sigmoid. Statistical differences were evaluated using a Friedman test with a significance level of 0.05. To model dose fall-off, expanding 2-mm-thick concentric rings were created around the PTV, and doses were recorded. Statistically significant differences (p 3-arc , as compared with IMRT. VMAT{sub 3-arc} improved the bladder V{sub 40}, V{sub 50}, and V{sub 60}, and the bowel V{sub 20} and V{sub 50}. All fitted regressions had an R{sup 2} ≥ 0.98. For cervical SBRT plans, a VMAT{sub 3-arc} approach offers a steeper dose fall-off outside of the target volume. Faster dose fall-off was observed in smaller targets as opposed to medium and large targets, denoting that OAR sparing is dependent on target size. These improvements are further pronounced with the use of 10-MV photons.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

RayStation: External beam treatment planning system

RaySearch Laboratories is a world leader in the field of advanced software and creator of the RayStation treatment planning system for radiation therapy. The aim with RayStation is to deliver an unmatched user experience and leading functionality. Unique features described here include multiatlas based autosegmentation for contouring, deformable registration with 2 different algorithms, multicriteria optimization, Plan Explorer, fallback planning, ultrafast computation speed, and 4-dimensional (4D) adaptive radiation therapy. RayStation can be used to plan for electrons and photons on traditional linacs, for protons on various delivery systems, and for Accuray's helical TomoTherapy system. This paper describes some of these modalities, with reference to clinical cases and including descriptions of the impact on workflow.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Household waste compositional analysis variation from insular communities in the framework of waste prevention strategy plans

Highlights: • Waste framework directive has set clear waste prevention procedures. • Household Compositional analysis. • Waste management plans. • Zero waste approach. • Waste generation. - Abstract: Waste management planning requires reliable data regarding waste generation, affecting factors on waste generation and forecasts of waste quantities based on facts. In order to decrease the environmental impacts of waste management the choice of prevention plan as well as the treatment method must be based on the features of the waste that are produced in a specific area. Factors such as culture, economic development, climate, and energy sources have an impact on waste composition; composition influences the need of collecting waste more or less frequently of waste collection and disposition. The research question was to discover the main barriers concerning the compositional analysis in Insular Communities under warm climate conditions and the findings from this study enabled the main contents of a waste management plan to be established. These included advice to residents on waste minimisation, liaison with stakeholders and the expansion of kerbside recycling schemes.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2021

Climate-Induced Tradeoffs in Planning and Operating Costs of a Regional Electricity System

Electricity grid planners design the system in order to supply electricity to end users reliably and affordably. Climate change threatens both objectives through potentially compounding supply- and demand-side climate-induced impacts. Uncertainty surrounds each of these future potential impacts. Given long planning horizons, system planners must weigh investment costs against operational costs under this uncertainty. Here, we developed a comprehensive and coherent integrated modeling framework combining physically-based models with cost-minimizing optimization models in the power system. We applied this modeling framework to analyze potential tradeoffs in planning and operating costs in the power grid due to climate change in the Southeast U.S. in 2050. We find that planning decisions that do not account for climate-induced impacts would result in a substantial increase in social costs associated with loss of load. These social costs are a result of under-investment in new capacity and capacity deratings of thermal generators when we included climate change impacts in the operation stage. Finally, these results highlight the importance of including climate change effects in the planning process.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2025

Visual‐Analytics Bridge Complexity and Accessibility for Robust Urban Water Planning

Urban water resources planning is complicated by unprecedented uncertainty in supply and demand. Real‐world planning often simplifies the full range of uncertainty faced by a system into a limited set of deterministic scenarios to enhance accessibility for decision‐makers and the public. However, overlooking uncertainty can expose the system to failures. On the other end of the spectrum, academically developed tools for scenario analysis rigorously quantify the combined effects of multiple sources of uncertainty, but the practical application of these models is limited by the challenges of information visualization and communication of results. In short, municipal water supply planners lack access to planning frameworks that effectively integrate a rigorous treatment of uncertainty with accessible, user‐friendly visual and interactive tools to enhance user accessibility. In this work, we fill this gap by proposing Visual‐Robust Decision Making, and demonstrate an application for the city of Santa Barbara (SB), CA. Santa Barbara faces multiple uncertainties from pending state and federal regulations to changing hydrology and water demand. The city seeks to increase its water portfolio robustness by expanding its seawater desalination plant, but must decide how much capacity to add. We introduce computational tools that assess uncertainty across nine uncertain drivers identified with the help of water planners in SB. To allow public participation in the desalination expansion decision, we develop interactive visual‐analytics to aid decision‐makers and stakeholders in navigating complex scenario analysis outcomes. Our results quantify the tradeoffs between increased capacity and system robustness and aim to enhance participation and uncertainty characterization of urban water planning efforts.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2020

Cost and Efficiency Analysis for Hybrid AC/DC Distribution System Planning with PV and Battery

Distribution system planning is one of the main tasks for the electric utilities. Cost and energy efficiency are two main concerns in the distribution planning process. In this work, cost and efficiency analyses are conducted for the hybrid AC and DC distribution grids for the planning purposes. The IEEE 34-bus feeder has been applied for the case studies. The investment cost, operation and maintenance cost, replacement cost, etc., have been considered in the life cycle cost analysis. Power losses of both the AC and DC section are calculated with an open source simulation tool, the Open Distribution Simulator Software (OpenDSS). The proposed framework can be applied to quantitatively evaluate the cost and efficiency of hybrid AC and DC distribution grids and help comparing different planning options.

AC/DC hybrid system planning↗
DOE OSTI2026

Plan It Together: Optimizing Across Generation, Transmission, Distribution, and Distributed Energy Resources

Integrated planning holds the promise of unlocking lower total system cost solutions by connecting previously siloed planning processes. This article summarizes the state of bulk and local grid planning today and details multiple new analytical approaches that can enable more holistic planning methods to develop comprehensive solutions to generation, transmission, distribution, and distributed energy resource needs. These include both iterative approaches as well as cooptimization techniques. In addition to the benefits of these methods, the technical and institutional challenges and associated solutions are also discussed.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2022

Joint Planning of Electricity Transmission and Hydrogen Transportation Networks

The abundance and uneven distribution of renewable energy might cause congestion and curtailment in electric power systems. Transmission expansions can potentially alleviate transmission congestion and reduce renewable energy curtailment. On the other hand, with the substantial cost reduction of electrolyzer technology and the continuing rise of hydrogen demand, converting surplus renewable energy to hydrogen provides synergistic benefits to power and hydrogen systems, but consequently requires joint planning of the two systems. To this end, we propose a joint planning approach for power transmission and hydrogen transportation networks to coordinately optimize the investment and operation of power and hydrogen infrastructure. In our proposed model, detailed truck routing, pipeline, and hydrogen storage are formulated to quantify the flexibility of hydrogen transportation system. A robust joint planning approach is also proposed to address various uncertainties from renewable energy, electric load, and hydrogen demand. Furthermore, our numerical simulations show that the proposed joint planning model can save the total system cost, reduce renewable energy curtailment, and increase the utilization level of transmission lines.

08 HYDROGEN↗
DOE OSTI2015

Endogenous Assessment of the Capacity Value of Solar PV in Generation Investment Planning Studies

There exist several different reliability-and approximation-based methods to determine the contribution of solar resources toward resource adequacy. However, most of these approaches require knowing in advance the installed capacities of both conventional and solar generators. This is a complication since generator capacities are actually decision variables in capacity planning studies. In this paper, we study the effect of time resolution and solar PV penetration using a planning model that accounts for the full distribution of generator outages and solar resource variability. We also describe a modification of a standard deterministic planning model that enforces a resource adequacy target through a reserve margin constraint. Our numerical experiments show that at least 50 days worth of data are necessary to approximate the results of the full-resolution model with a maximum error of 2.5% on costs and capacity. We also show that the amount of displaced capacity of conventional generation decreases rapidly as the penetration of solar PV increases. We find that using an exogenously defined and constant capacity value based on time-series data can yield relatively accurate results for small penetration levels. For higher penetration levels, the modified deterministic planning model better captures avoided costs and the decreasing value of solar PV.

14 SOLAR ENERGY↗
DOE OSTI2014

MRI-based treatment planning with pseudo CT generated through atlas registration

Purpose: To evaluate the feasibility and accuracy of magnetic resonance imaging (MRI)-based treatment planning using pseudo CTs generated through atlas registration. Methods: A pseudo CT, providing electron density information for dose calculation, was generated by deforming atlas CT images previously acquired on other patients. The authors tested 4 schemes of synthesizing a pseudo CT from single or multiple deformed atlas images: use of a single arbitrarily selected atlas, arithmetic mean process using 6 atlases, and pattern recognition with Gaussian process (PRGP) using 6 or 12 atlases. The required deformation for atlas CT images was derived from a nonlinear registration of conjugated atlas MR images to that of the patient of interest. The contrasts of atlas MR images were adjusted by histogram matching to reduce the effect of different sets of acquisition parameters. For comparison, the authors also tested a simple scheme assigning the Hounsfield unit of water to the entire patient volume. All pseudo CT generating schemes were applied to 14 patients with common pediatric brain tumors. The image similarity of real patient-specific CT and pseudo CTs constructed by different schemes was compared. Differences in computation times were also calculated. The real CT in the treatment planning system was replaced with the pseudo CT, and the dose distribution was recalculated to determine the difference. Results: The atlas approach generally performed better than assigning a bulk CT number to the entire patient volume. Comparing atlas-based schemes, those using multiple atlases outperformed the single atlas scheme. For multiple atlas schemes, the pseudo CTs were similar to the real CTs (correlation coefficient, 0.787–0.819). The calculated dose distribution was in close agreement with the original dose. Nearly the entire patient volume (98.3%–98.7%) satisfied the criteria of chi-evaluation (<2% maximum dose and 2 mm range). The dose to 95% of the volume and the percentage of volume receiving at least 95% of the prescription dose in the planning target volume differed from the original values by less than 2% of the prescription dose (root-mean-square, RMS < 1%). The PRGP scheme did not perform better than the arithmetic mean process with the same number of atlases. Increasing the number of atlases from 6 to 12 often resulted in improvements, but statistical significance was not always found. Conclusions: MRI-based treatment planning with pseudo CTs generated through atlas registration is feasible for pediatric brain tumor patients. The doses calculated from pseudo CTs agreed well with those from real CTs, showing dosimetric accuracy within 2% for the PTV when multiple atlases were used. The arithmetic mean process may be a reasonable choice over PRGP for the synthesis scheme considering performance and computational costs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-J-72: Geant4 Simulations of Spot-Scanned Proton Beam Treatment Plans

Purpose: To evaluate density inhomogeneities which can effect dose distributions for real-time image gated spot-scanning proton therapy (RGPT), a dose calculation system, using treatment planning system VQA (Hitachi Ltd., Tokyo) spot position data, was developed based on Geant4. Methods: A Geant4 application was developed to simulate spot-scanned proton beams at Hokkaido University Hospital. A CT scan (0.98 × 0.98 × 1.25 mm) was performed for prostate cancer treatment with three or four inserted gold markers (diameter 1.5 mm, volume 1.77 mm3) in or near the target tumor. The CT data was read into VQA. A spot scanning plan was generated and exported to text files, specifying the beam energy and position of each spot. The text files were converted and read into our Geant4-based software. The spot position was converted into steering magnet field strength (in Tesla) for our beam nozzle. Individual protons were tracked from the vacuum chamber, through the helium chamber, steering magnets, dose monitors, etc., in a straight, horizontal line. The patient CT data was converted into materials with variable density and placed in a parametrized volume at the isocenter. Gold fiducial markers were represented in the CT data by two adjacent voxels (volume 2.38 mm3). 600,000 proton histories were tracked for each target spot. As one beam contained about 1,000 spots, approximately 600 million histories were recorded for each beam on a blade server. Two plans were considered: two beam horizontal opposed (90 and 270 degree) and three beam (0, 90 and 270 degree). Results: We are able to convert spot scanning plans from VQA and simulate them with our Geant4-based code. Our system can be used to evaluate the effect of dose reduction caused by gold markers used for RGPT. Conclusion: Our Geant4 application is able to calculate dose distributions for spot scanned proton therapy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-J-141: Comparison of Dose Calculation On Automatically Generated MRBased ED Maps and Corresponding Patient CT for Clinical Prostate EBRT Plans

Purpose: To analyze the effect of computing radiation dose on automatically generated MR-based simulated CT images compared to true patient CTs. Methods: Six prostate cancer patients received a regular planning CT for RT planning as well as a conventional 3D fast-field dual-echo scan on a Philips 3.0T Achieva, adding approximately 2 min of scan time to the clinical protocol. Simulated CTs (simCT) where synthesized by assigning known average CT values to the tissue classes air, water, fat, cortical and cancellous bone. For this, Dixon reconstruction of the nearly out-of-phase (echo 1) and in-phase images (echo 2) allowed for water and fat classification. Model based bone segmentation was performed on a combination of the DIXON images. A subsequent automatic threshold divides into cortical and cancellous bone. For validation, the simCT was registered to the true CT and clinical treatment plans were re-computed on the simCT in pinnacle{sup 3}. To differentiate effects related to the 5 tissue classes and changes in the patient anatomy not compensated by rigid registration, we also calculate the dose on a stratified CT, where HU values are sorted in to the same 5 tissue classes as the simCT. Results: Dose and volume parameters on PTV and risk organs as used for the clinical approval were compared. All deviations are below 1.1%, except the anal sphincter mean dose, which is at most 2.2%, but well below clinical acceptance threshold. Average deviations are below 0.4% for PTV and risk organs and 1.3% for the anal sphincter. The deviations of the stratifiedCT are in the same range as for the simCT. All plans would have passed clinical acceptance thresholds on the simulated CT images. Conclusion: This study demonstrated the clinical usability of MR based dose calculation with the presented Dixon acquisition and subsequent fully automatic image processing. N. Schadewaldt, H. Schulz, M. Helle and S. Renisch are employed by Phlips Technologie Innovative Techonologies, a subsidiary of Royal Philips NV.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-265: Practical Issues and Solutions in Reconstructing and Using 4DCT for Radiotherapy Planning of Lung Cancer

Purpose: To report practical issues and solutions in reconstructing and using 4DCT to account for respiratory motion in radiotherapy planning. Methods: Quiet breathing 4DCT was used to account for respiratory motion for patients with lung or upper abdomen tumor. A planning CT and a 4DCT were acquired consecutively with a Philips Brilliance CT scanner and Varian RPM System. The projections were reconstructed into 10 phases. In Pinnacle RTP system, we contour a GTV in each phase and unite all 10 GTVs as ITV. The ITV is then mapped to the planning CT. We describe practical issues, their causes, our solutions and reasoning during this process. Results: In 6 months, 9 issues were reported for 8 patients with lung cancer. For two patients, part of the GTV (∼50% and 10%) in planning CT fell outside the ITV in 4DCT. There was a 7 mm variation in first patient back position because less restricted immobilization had to be used. The second discrepancy was due to moderate variation in breathing amplitude. We extended the ITV to include the GTV since both variations may likely happen during treatment. A LUL tumor showed no motion due to a 10-s long no-breathing period. An RLL tumor appeared double due to an abnormally deeper breath at the tumor region. We repeated 4DCT reiterating the importance of quiet, regular breathing. One patient breathed too light to generate RPM signal. Two issues (no motion in lung, incomplete images in 90% phase) were due to incorrect tag positions. Two unexplainable errors disappeared when repeating reconstruction. In summary, 5 issues were patient-related and 4 were technique issues. Conclusion: Improving breathing regularity avoided large artifacts in 4DCT. One needs to closely monitor patient breathing. For uncontrollable variations, larger PTVs are necessary which requires appropriate communication between physics and the treating physician.

60 APPLIED LIFE SCIENCES↗