Results for “Protection Challenges” — Page 81

DOE OSTI2015

SU-E-T-219: Comprehensive Validation of the Electron Monte Carlo Dose Calculation Algorithm in RayStation Treatment Planning System for An Elekta Linear Accelerator with AgilityTM Treatment Head

Purpose: This study evaluated the performance of the electron Monte Carlo dose calculation algorithm in RayStation v4.0 for an Elekta machine with Agility™ treatment head. Methods: The machine has five electron energies (6–8 MeV) and five applicators (6×6 to 25×25 cm {sup 2}). The dose (cGy/MU at d{sub max}), depth dose and profiles were measured in water using an electron diode at 100 cm SSD for nine square fields ≥2×2 cm{sup 2} and four complex fields at normal incidence, and a 14×14 cm{sup 2} field at 15° and 30° incidence. The dose was also measured for three square fields ≥4×4 cm{sup 2} at 98, 105 and 110 cm SSD. Using selected energies, the EBT3 radiochromic film was used for dose measurements in slab-shaped inhomogeneous phantoms and a breast phantom with surface curvature. The measured and calculated doses were analyzed using a gamma criterion of 3%/3 mm. Results: The calculated and measured doses varied by <3% for 116 of the 120 points, and <5% for the 4×4 cm{sup 2} field at 110 cm SSD at 9–18 MeV. The gamma analysis comparing the 105 pairs of in-water isodoses passed by >98.1%. The planar doses measured from films placed at 0.5 cm below a lung/tissue layer (12 MeV) and 1.0 cm below a bone/air layer (15 MeV) showed excellent agreement with calculations, with gamma passing by 99.9% and 98.5%, respectively. At the breast-tissue interface, the gamma passing rate is >98.8% at 12–18 MeV. The film results directly validated the accuracy of MU calculation and spatial dose distribution in presence of tissue inhomogeneity and surface curvature - situations challenging for simpler pencil-beam algorithms. Conclusion: The electron Monte Carlo algorithm in RayStation v4.0 is fully validated for clinical use for the Elekta Agility™ machine. The comprehensive validation included small fields, complex fields, oblique beams, extended distance, tissue inhomogeneity and surface curvature.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

Vision 20/20: Magnetic resonance imaging-guided attenuation correction in PET/MRI: Challenges, solutions, and opportunities

Attenuation correction is an essential component of the long chain of data correction techniques required to achieve the full potential of quantitative positron emission tomography (PET) imaging. The development of combined PET/magnetic resonance imaging (MRI) systems mandated the widespread interest in developing novel strategies for deriving accurate attenuation maps with the aim to improve the quantitative accuracy of these emerging hybrid imaging systems. The attenuation map in PET/MRI should ideally be derived from anatomical MR images; however, MRI intensities reflect proton density and relaxation time properties of biological tissues rather than their electron density and photon attenuation properties. Therefore, in contrast to PET/computed tomography, there is a lack of standardized global mapping between the intensities of MRI signal and linear attenuation coefficients at 511 keV. Moreover, in standard MRI sequences, bones and lung tissues do not produce measurable signals owing to their low proton density and short transverse relaxation times. MR images are also inevitably subject to artifacts that degrade their quality, thus compromising their applicability for the task of attenuation correction in PET/MRI. MRI-guided attenuation correction strategies can be classified in three broad categories: (i) segmentation-based approaches, (ii) atlas-registration and machine learning methods, and (iii) emission/transmission-based approaches. This paper summarizes past and current state-of-the-art developments and latest advances in PET/MRI attenuation correction. The advantages and drawbacks of each approach for addressing the challenges of MR-based attenuation correction are comprehensively described. The opportunities brought by both MRI and PET imaging modalities for deriving accurate attenuation maps and improving PET quantification will be elaborated. Future prospects and potential clinical applications of these techniques and their integration in commercial systems will also be discussed.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2016

TU-FG-BRB-08: Challenges, Limitations and Future Outlook Towards Clinical Translation of Proton Acoustic Range Verification

Purpose: To report our investigations of proton acoustic imaging, including computer simulations and preliminary experimental studies at clinical facilities. The ultimate achievable accuracy, sensitivity and clinical translation challenges are discussed. Methods: The acoustic pulse due to pressure rise was estimated using finite element model. Since the ionoacoustic pulse is highly dependent on the proton pulse width and energy, multiple pulse widths were studied. Based on the received signal spectrum at piezoelectric ultrasound transducer with consideration of random thermal noise, maximum spatial resolution of the proton-acoustic imaging modality was calculated. The simulation studies defined the design specifications of the system to detect proton acoustic signal from Hitachi and Mevion clinical machines. A 500 KHz hydrophone with 100 dB amplification was set up in a water tank placed in front of the proton nozzle A 40 MHz data acquisition was synchronized by a trigger signal provided by the machine. Results: Given 30–800 mGy dose per pulse at the Bragg peak, the minimum number of protons detectable by the proton acoustic technique was on the order of 10×10^6 per pulse. The broader pulse widths produce signal with lower acoustic frequencies, with 10 µs pulses producing signals with frequency less than 100 kHz. As the proton beam pulse width increases, a higher dose rate is required to measure the acoustic signal. Conclusion: We have established the minimal detection limit for protonacoustic range validation for a variety of pulse parameters. Our study indicated practical proton-acoustic range verification can be feasible with a pulse shorter than 10 µs, 5×10^6 protons/pulse, 50 nA beam current and a highly sensitive ultrasonic transducer. The translational challenges into current clinical machines include proper magnetic shielding of the measurement equipment, providing a clean trigger signal from the proton machine, providing a shorter proton beam pulse and higher dose per pulse.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-H-BRC-09: Simulated Errors in Mock Radiotherapy Plans to Quantify the Effectiveness of the Physics Plan Review

Purpose: A standard tool for ensuring the quality of radiation therapy treatments is the initial physics plan review. However, little is known about its performance in practice. The goal of this study is to measure the effectiveness of physics plan review by introducing simulated errors into “mock” treatment plans and measuring the performance of plan review by physicists. Methods: We generated six mock treatment plans containing multiple errors. These errors were based on incident learning system data both within the department and internationally (SAFRON). These errors were scored for severity and frequency. Those with the highest scores were included in the simulations (13 errors total). Observer bias was minimized using a multiple co-correlated distractor approach. Eight physicists reviewed these plans for errors, with each physicist reviewing, on average, 3/6 plans. The confidence interval for the proportion of errors detected was computed using the Wilson score interval. Results: Simulated errors were detected in 65% of reviews [51–75%] (95% confidence interval [CI] in brackets). The following error scenarios had the highest detection rates: incorrect isocenter in DRRs/CBCT (91% [73–98%]) and a planned dose different from the prescribed dose (100% [61–100%]). Errors with low detection rates involved incorrect field parameters in record and verify system (38%, [18–61%]) and incorrect isocenter localization in planning system (29% [8–64%]). Though pre-treatment QA failure was reliably identified (100%), less than 20% of participants reported the error that caused the failure. Conclusion: This is one of the first quantitative studies of error detection. Although physics plan review is a key safety measure and can identify some errors with high fidelity, others errors are more challenging to detect. This data will guide future work on standardization and automation. Creating new checks or improving existing ones (i.e., via automation) will help in detecting those errors with low detection rates.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Digital Engineering and Cybersecurity Decision Analysis in Early Phases of SMR-Driven IES Projects

Considerable efforts are underway to ensure cybersecurity is integrated into the systems engineering lifecycle. Cyber-informed engineering and security-by-design frameworks are intended to identify and engineer out cybersecurity risks throughout the lifecycle. While these approaches are valuable for promoting the need to include cybersecurity considerations in early design phases to create more secure systems, they may not consider the entirety of digital risks. Digital risks in a digital instrumentation and control system include adversarial and unintentional risks from internal and external factors, such as human performance errors, design flaws, environmental conditions, and equipment degradation or failure. This report provides a detailed discussion on digital risk prior to describing the background and concept of operations for a small modular reactor-driven integrated energy system connected to industrial applications. The challenges of competing objectives and competing stakeholder requirements are discussed and the impacts on digital engineering, security considerations, and interdependencies are evaluated for mission-level, facility-level, and system-level decisions.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

DOE OSTI2015

Mechanisms mediating enhanced neutralization efficacy of Staphylococcal enterotoxin B by combinations of monoclonal antibodies

Staphylococcal enterotoxin B (SEB) is a superantigen that cross-links the major histocompatibility complex class II and specific V-β chains of the T-cell receptor, thus forming a ternary complex. Developing neutralizing mAb to disrupt the ternary complex and abrogate the resulting toxicity is a major therapeutic challenge because SEB is effective at very low concentrations. We show that combining two SEB-specific mAbs enhances their efficacy, even though one of the two mAbs by itself has no effect on neutralization. Crystallography was employed for fine-mapping conformational epitopes in binary and ternary complexes between SEB and Fab fragments. NMR spectroscopy was used to validate and identify subtle allosteric changes induced by mAbs binding to SEB. The mapping of epitopes established that a combination of different mAbs can enhance efficacy of mAb-mediated protection from SEB induced lethal shock by two different mechanisms: one mAb mixture promoted clearance of the toxin both in vitro and in vivo by FcR-mediated cross-linking and clearance, whereas the other mAb mixture induced subtle allosteric conformational changes in SEB that perturbed formation of the SEB·T-cell receptor·major histocompatibility complex class II trimer. Lastly structural information accurately predicted mAb binding to other superantigens that share conformational epitopes with SEB. Fine mapping of conformational epitopes is a powerful tool to establish the mechanism and optimize the action of synergistic mAb combinations.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2023

Interphase Stabilization of LiNi 0.5 Mn 1.5 O 4 Cathode for 5 V–Class All–Solid–State Batteries

Employing high voltage cobalt-free spinel LiNi 0.5 Mn 1.5 O 4 (LNMO) as a cathode is promising for high energy density and cost-effectiveness, but it has challenges in all-solid-state batteries (ASSBs). Here, it is revealed that the limitation of lithium argyrodite sulfide solid electrolyte (Li 6 PS 5 Cl) with the LNMO cathode is due to the intrinsic chemical incompatibility and poor oxidative stability. Through a careful analysis of the interphase of LNMO, it is elucidated that even the halide solid electrolyte (Li 3 InCl 6 ) with high oxidative stability can be decomposed to form resistive interphase layers with LNMO in ASSBs. Interestingly, with Fe-doping and a Li 3 PO 4 protective layer coating, LNMO with Li 3 InCl 6 displays stable cycle performance with a stabilized interphase at a high voltage (≈4.7 V) in ASSBs. The enhanced interfacial stability with the extended electrochemical stability window through doping and coating enables high electrochemical stability with LNMO in ASSBs. Furthermore, this work provides guidance for employing high-voltage cathodes in ASSBs and highlights the importance of stable interphases to enable stable cycling in ASSBs.

25 ENERGY STORAGE↗

DOE OSTI2011

A Jacobian-free Newton Krylov method for mortar-discretized thermomechanical contact problems

Multibody contact problems are common within the field of multiphysics simulation. Applications involving thermomechanical contact scenarios are also quite prevalent. Such problems can be challenging to solve due to the likelihood of thermal expansion affecting contact geometry which, in turn, can change the thermal behavior of the components being analyzed. This paper explores a simple model of a light water reactor nuclear fuel rod, which consists of cylindrical pellets of uranium dioxide (UO{sub 2}) fuel sealed within a Zircalloy cladding tube. The tube is initially filled with helium gas, which fills the gap between the pellets and cladding tube. The accurate modeling of heat transfer across the gap between fuel pellets and the protective cladding is essential to understanding fuel performance, including cladding stress and behavior under irradiated conditions, which are factors that affect the lifetime of the fuel. The thermomechanical contact approach developed here is based on the mortar finite element method, where Lagrange multipliers are used to enforce weak continuity constraints at participating interfaces. In this formulation, the heat equation couples to linear mechanics through a thermal expansion term. Lagrange multipliers are used to formulate the continuity constraints for both heat flux and interface traction at contact interfaces. The resulting system of nonlinear algebraic equations are cast in residual form for solution of the transient problem. A Jacobian-free Newton Krylov method is used to provide for fully-coupled solution of the coupled thermal contact and heat equations.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

DOE OSTI2023

Constructing stable interface layer for boosting high-voltage cycling performance of single-crystal Ni-rich cathodes

Increasing demand for electric vehicles (EVs) worldwide and the requirements for environmental protection have greatly promoted the development of low-Co, Ni-rich layered cathodes due to their high energy density, reasonable cost, and less environmental pollution. Nevertheless, serious performance degradation and safety concerns resulting from structural/interfacial instability under high operating voltages (≥4.3 V) have greatly hindered its commercialization. Herein, we propose a feasible surface modification strategy by introducing a multifunctional Li 2 SiO 3 (LSO) coating layer onto the surface of Co less single-crystalline LiNi 0.63 Co 0.07 Mn 0.3 O 2 (NCM) to solve the above challenges. Additionally, the uniform Li 2 SiO 3 coating layer has a unique three-dimensional (3D) ion diffusion channel, which greatly promotes the transmission of Li + and alleviates interfacial stress accumulation. Equally important, the electrochemically inert Li 2 SiO 3 coating layer has a stable structure framework with strong Si-O bonds, which inhibit anisotropic particle volume expansion and the occurrence of side reactions during long-term cycling. As a consequence, LSO modified NCM exhibits greatly improved electrochemical properties even at harsh testing conditions and achieves capacity retention of 79.1% after 200 cycles at 25°C within 2.95-4.5 V in half cells. Furthermore, it provides an outstanding capacity retention of 94.7% after 300 cycles at 25°C within 2.95-4.4 V when tested in pouch full cells.

25 ENERGY STORAGE↗

DOE OSTI2020

The erosion of biodiversity and biomass in the Atlantic Forest biodiversity hotspot

Tropical forests are being deforested worldwide, and the remaining fragments are suffering from biomass and biodiversity erosion. Quantifying this erosion is challenging because ground data on tropical biodiversity and biomass are often sparse. Here, we use an unprecedented dataset of 1819 field surveys covering the entire Atlantic Forest biodiversity hotspot. We show that 83-85% of the surveys presented losses in forest biomass and tree species richness, functional traits, and conservation value. On average, forest fragments have 25-32% less biomass, 23-31% fewer species, and 33, 36, and 42% fewer individuals of late-successional, large-seeded, and endemic species, respectively. Biodiversity and biomass erosion are lower inside strictly protected conservation units, particularly in large ones. We estimate that biomass erosion across the Atlantic Forest remnants is equivalent to the loss of 55-70 thousand km 2 of forests or US$2.3-2.6 billion in carbon credits. These figures have direct implications on mechanisms of climate change mitigation.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2020

Sustainable lead management in halide perovskite solar cells

Despite the rapid development of perovskite solar cells (PSCs) toward commercialization, the toxic lead (Pb) ions in PSCs pose a potential threat to the environment, health and safety. Managing Pb via recycling represents a promising approach to mitigating its toxicity. However, managing Pb from commonly used organic solvents has been challenging due to the lack of suitable Pb adsorbents. Here, we report a new adsorbent for both separation and recovery of Pb from PSC pollutants. The synthesized iron-incorporated hydroxyapatite possesses a strongly negatively charged surface that improves electrostatic interaction through surface-charge delocalization, thus leading to enhanced Pb adsorption. Finally, we demonstrate the feasibility of a complete Pb management process, including the purification of Pb-containing non-aqueous solvents below 15 parts per 10 9 , a level compliant with the standards of the US Environmental Protection Agency, as well as recycling of 99.97% of Pb ions by forming lead iodide.

14 SOLAR ENERGY↗

DOE OSTI2016

Evolvix BEST Names for semantic reproducibility across code2brain interfaces

Names in programming are vital for understanding the meaning of code and big data. We define code2brain (C2B) interfaces as maps in compilers and brains between meaning and naming syntax, which help to understand executable code. While working toward an Evolvix syntax for general‐purpose programming that makes accurate modeling easy for biologists, we observed how names affect C2B quality. To protect learning and coding investments, C2B interfaces require long‐term backward compatibility and semantic reproducibility (accurate reproduction of computational meaning from coder‐brains to reader‐brains by code alone). Semantic reproducibility is often assumed until confusing synonyms degrade modeling in biology to deciphering exercises. We highlight empirical naming priorities from diverse individuals and roles of names in different modes of computing to show how naming easily becomes impossibly difficult. We present the Evolvix BEST (Brief, Explicit, Summarizing, Technical) Names concept for reducing naming priority conflicts, test it on a real challenge by naming subfolders for the Project Organization Stabilizing Tool system, and provide naming questionnaires designed to facilitate C2B debugging by improving names used as keywords in a stabilizing programming language. Our experiences inspired us to develop Evolvix using a flipped programming language design approach with some unexpected features and BEST Names at its core.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2015

TU-G-BRB-01: Topic Introduction: Do We Need Clinical Trials in Particle Therapy and How Can Medical Physics Support Them?

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial development and support. Research reported in this presentation is supported by the National Cancer Institute of the National; Institutes of Health under Award Number P20CA183640.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-G-BRB-02: Clinical Trials in Particle Therapy - Open Questions

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial development and support. Research reported in this presentation is supported by the National Cancer Institute of the National; Institutes of Health under Award Number P20CA183640.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-G-BRB-03: IROC Houston’s Proton Beam Validation for Clinical Trials

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial development and support. Research reported in this presentation is supported by the National Cancer Institute of the National; Institutes of Health under Award Number P20CA183640.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-G-BRB-04: Digital Phantoms for Developing Protocols in Particle Therapy

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial development and support. Research reported in this presentation is supported by the National Cancer Institute of the National; Institutes of Health under Award Number P20CA183640.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-G-BRB-05: Panel Discussion: Clinical Trials in Proton and Ion Therapy - Are We Ready?

Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial development and support. Research reported in this presentation is supported by the National Cancer Institute of the National; Institutes of Health under Award Number P20CA183640.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-419: Evaluation of PlanIQ Feasibility DVH as Planning Objectives for Skull Base SBRT Patients

Purpose: PlanIQ(Sun Nuclear Corporation) can provide feasibility measures on organs-at-risk(OARs) around the target based on depth, local anatomy density and energy of radiation beam used. This study is to test and evaluate PlanIQ feasibility DVHs as optimization objectives in the treatment planning process, and to investigate the potential to use them in routine clinical cases to improve planning efficiency. Methods: Two to three arcs VMAT Treatment plans were generated in Pinnacle based on PlanIQ feasibility DVH for six skull base patients who previously treated with SBRT. The PlanIQ feasibility DVH for each OAR consists of four zones – impossible (at 100% target coverage), difficult, challenging and probable. Constrains to achieve DVH in difficult zone were used to start plan optimization. Further adjustment was made to improve coverage. The plan DVHs were compared to PlanIQ feasibility DVH to assess the dose received by 0%(D0), 5%(D5), 10%(D10) and 50%(D50) of the OAR volumes. Results: A total of 90 OARs were evaluated for 6 patients (mean 15 OARs, range 11–18 OARs). We used >98% PTV coverage as planning goal since it’s difficult to achieve 100% target coverage. For the generated plans, 96.7% of the OARs achieved D0 or D5 within difficult zone or impossible zone (ipsilateral OARs 93.5%, contralateral OARs 100%), while 90% and 65.6% of the OARs achieved D10 and D50 within difficult zone, respectively. Seventeen of the contralateral and out of field OARs achieved DVHs in impossible zone. For OARs adjacent or overlapped with target volume, the D0 and D5 are challenging to be optimized into difficult zone. All plans were completed within 2–4 adjustments to improve target coverage and uniformity. Conclusion: PlanIQ feasibility tool has the potential to provide difficult but achievable initial optimization objectives and therefore reduce the planning time to obtain a well optimized plan.

60 APPLIED LIFE SCIENCES↗