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At least 1,783 records · Page 99

The Multi-Step CADIS Method for Shutdown Dose Rate Calculations and Uncertainty Propagation - Paper 137

The Multi-Step Consistent Adjoint Driven Importance Sampling (MS-CADIS) hybrid MC/deterministic method has been proposed to speed up the SDDR MC neutron transport calculation using an importance function that represents the neutron importance to the final SDDR. This paper provides some valuable insights regarding the MS-CADIS method, including physical interpretations of the MS-CADIS adjoint neutron source and the MS-CADIS adjoint neutron flux. The paper also describes the feasibility of using the MS-CADIS adjoint neutron source to calculate the SDDR uncertainty resulting from uncertainties in the MC neutron calculation. A companion paper will provide numerical results that demonstrate the effectiveness of the MS-CADIS method in speeding up SDDR MC simulations and in calculating SDDR uncertainties for problems related to fusion energy systems. (authors)

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The Standalone Package for Enhanced Estimation of Dose Distribution - Paper 139

As mankind looks to expand our current footprint in outer space and strives to further explore and understand our neighboring planets, many unique challenges present themselves. One such challenge, that directly impacts the longevity of any manned mission, is to manage the extreme radiation environment that awaits astronauts following their departure from the atmosphere. In order to ensure crew safety as well as the overall success of future missions, it is of paramount importance to have a comprehensive understanding of the quality and degree of the dose received. This includes both acute and long-term exposures and their effects. In this work, we aim to better understand these doses through the development of a dose estimation tool. Two major sources of extraterrestrial radiation are considered: galactic cosmic radiation (GCR), and lighter particles expelled from the sun during a solar particle event (SPE). (authors)

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Class II algorithm for charged-particle transport simulation - Paper 142

Simulation of the transport of high-energy charged particles is difficult because of the large number of interactions experienced by these particles before being brought to rest. Possible strategies to deal with this difficulty were analyzed by Berger. Most modern Monte Carlo codes use a mixture of complete-grouping (class I) and mixed (class II) schemes. In class I simulations, the global effect of all the interactions that occur along a trajectory segment of a given length s is described by means of precalculated distributions derived from multiple-scattering theories. In class II simulations, hard (or catastrophic) interactions (with energy loss W or polar scattering angle {theta} larger than given cutoff values) are sampled individually, while the effect of soft interactions (with energy losses and scattering angles smaller than the respective cutoffs) is described using a multiple-scattering approach. Although Berger effectively employed class II simulation only for energy-loss events, he did recognize the advantages of class II over class I also for multiple elastic scattering. On the one hand, because hard interactions are described exactly according to the adopted differential cross sections (DCSs), class II schemes are more accurate. On the other hand, multiple-scattering approximations, which are still required to describe the cumulative effect of soft interactions, are simpler and more accurate when individual interactions are limited to small energy transfers and angular deflections. For instance, for path lengths that are not too small, but still much less than the CSDA range, the energy-loss distribution due to multiple soft events is approximately Gaussian, by virtue of the central limit theorem. Similarly, the angular distribution caused by multiple small-angle deflections is also approximately Gaussian. However, class II schemes are more difficult to implement because of their dependence on specificities of the DCSs. In this article we briefly present the essentials of the class II algorithm for charged particles implemented in the last version of the penelope code, and provide evidence of its accuracy and stability with the simulation parameters. (authors)

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Development and Testing of Nuclear Data Libraries for Improved Energy Deposition Modeling - Paper 144

Accurate calculations of local energy deposition rates require the presence of gamma production data (GPD) in the nuclear data library used by radiation transport codes such as MCNP5, MONACO, or Denovo. The lack of GPD in the underlying nuclear data library can cause significant over-prediction of local heat generation rates with a corresponding under-prediction of heat generation rates away from a region of interest. To address this concern, continuous energy (CE) and multigroup (MG) cross section libraries with additional GPD have been created. Both ACE- and AMPX-formatted CE libraries, as well as ANISN- and AMPX-formatted MG libraries, have been created and are undergoing verification and validation (V and V) testing. A hybrid data set consisting of cross-section evaluations from five different nuclear data repositories has been developed. This hybrid data set, referred to as GPD-Rev0, is intended to support enhanced energy deposition calculations. Code-specific libraries in CE ACE, CE AMPX, MG AMPX, and MG ANISN formats have been created from the GPD-Rev0 data set. V and V testing has demonstrated that these various code-specific libraries are performing well for the intended applications. Localized over- and under-predictions of HFIR heating rates have been addressed without adversely affecting the prediction of other key operating parameters. (authors)

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In-situ characterization of a background calibration line for east coast aerial measuring

Report outlines the methodology used to establish a background calibration line for AMS-East operations at Joint Base Andrews. The results provide a general isotopic characterization of the soil within the calibration line at Joint Base Andrews, and the expected terrestrial exposure rate which can be used to aerial measuring.

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Design Analysis for Lunar Safe Haven Concepts

NASA’s plan to return humans to the lunar surface faces many challenges, especially in the sustained phases of the Artemis program. In combination with a habitat, a Lunar Safe Haven (LSH) would provide additional protection to crew, electronics, and equipment from the hazards of the space environment such as radiation, thermal extremes, micrometeoroids, and lunar dust. Influenced by the NASA Artemis program goals, the Lunar Safe Haven Study defined the high-level requirements, outlined the trade space for a LSH concept, and evaluated a set of concepts using a decision analysis structure. This paper will provide additional detail for two concepts that were designed and evaluated during the LSH study, the logic behind the choices, and some of the main driving design parameters.

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Treatment of left sided breast cancer for a patient with funnel chest: Volumetric-modulated arc therapy vs. 3D-CRT and intensity-modulated radiotherapy

This case study presents a rare case of left-sided breast cancer in a patient with funnel chest, which is a technical challenge for radiation therapy planning. To identify the best treatment technique for this case, 3 techniques were compared: conventional tangential fields (3D conformal radiotherapy [3D-CRT]), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT). The plans were created for a SynergyS® (Elekta, Ltd, Crawley, UK) linear accelerator with a BeamModulator™ head and 6-MV photons. The planning system was Oncentra Masterplan® v3.3 SP1 (Nucletron BV, Veenendal, Netherlands). Calculations were performed with collapsed cone algorithm. Dose prescription was 50.4 Gy to the average of the planning target volume (PTV). PTV coverage and homogeneity was comparable for all techniques. VMAT allowed reducing dose to the ipsilateral organs at risk (OAR) and the contralateral breast compared with IMRT and 3D-CRT: The volume of the left lung receiving 20 Gy was 19.3% for VMAT, 26.1% for IMRT, and 32.4% for 3D-CRT. In the heart, a D{sub 15%} of 9.7 Gy could be achieved with VMAT compared with 14 Gy for IMRT and 46 Gy for 3D-CRT. In the contralateral breast, D{sub 15%} was 6.4 Gy for VMAT, 8.8 Gy for IMRT, and 10.2 Gy for 3D-CRT. In the contralateral lung, however, the lowest dose was achieved with 3D-CRT with D{sub 10%} of 1.7 Gy for 3D-CRT, and 6.7 Gy for both IMRT and VMAT. The lowest number of monitor units (MU) per 1.8-Gy fraction was required by 3D-CRT (192 MU) followed by VMAT (518 MU) and IMRT (727 MU). Treatment time was similar for 3D-CRT (3 min) and VMAT (4 min) but substantially increased for IMRT (13 min). VMAT is considered the best treatment option for the presented case of a patient with funnel chest. It allows reducing dose in most OAR without compromising target coverage, keeping delivery time well below 5 minutes.

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Applicator-guided volumetric-modulated arc therapy for low-risk endometrial cancer

The aim of this study was to report the feasibility of volumetric-modulated arc therapy (VMAT) in the postoperative irradiation of the vaginal vault. Moreover, the VMAT technique was compared with 3D conformal radiotherapy (3D-CRT) and fixed-field intensity-modulated radiotherapy (IMRT), in terms of target coverage and organs at risk sparing. The number of monitor units and the delivery time were analyzed to score the treatment efficiency. All plans were verified in a dedicated solid water phantom using a 2D array of ionization chambers. Twelve patients with endometrial carcinoma who underwent radical hystero-adenexectomy and fixed-field IMRT treatments were retrospectively included in this analysis; for each patient, plans were compared in terms of dose-volume histograms, homogeneity index, and conformity indexes. All techniques met the prescription goal for planning target volume coverage, with VMAT showing the highest level of conformity at all dose levels. VMAT resulted in significant reduction of rectal and bladder volumes irradiated at all dose levels compared with 3D-CRT. No significant differences were found with respect to IMRT. Moreover, a significant improvement of the dose conformity was reached by VMAT technique not only at the 95% dose level (0.74 vs. 0.67 and 0.62) but also at 50% and 75% levels of dose prescription. In addition, VMAT plans showed a significant reduction of monitor units by nearly 28% with respect to IMRT, and reduced treatment time from 11 to <3 minutes for a single 6-Gy fraction. In conclusion, VMAT plans can be planned and carried out with high quality and efficiency for the irradiation of vaginal vault alone, providing similar or better sparing of organs at risk to fixed-field IMRT and resulting in the most efficient treatment option. VMAT is currently our standard approach for radiotherapy of low-risk endometrial cancer.

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Intensity-modulated radiation therapy and volumetric-modulated arc therapy for adult craniospinal irradiation—A comparison with traditional techniques

Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are compared with classic conformal planning in adults for both cranial and spine fields to develop a clinically feasible technique that is both effective and efficient. Ten adult patients treated with CSI were retrospectively identified. For the cranial fields, 5-field IMRT and dual 356° VMAT arcs were compared with opposed lateral 3D conformal radiotherapy (3D-CRT) fields. For the spine fields, traditional posterior-anterior (PA) PA fields were compared with isocentric 5-field IMRT plans and single 200° VMAT arcs. Two adult patients have been treated using this IMRT technique to date and extensive quality assurance, especially for the junction regions, was performed. For the cranial fields, the IMRT technique had the highest planned target volume (PTV) maximum and was the least efficient, whereas the VMAT technique provided the greatest parotid sparing with better efficiency. 3D-CRT provided the most efficient delivery but with the highest parotid dose. For the spine fields, VMAT provided the best PTV coverage but had the highest mean dose to all organs at risk (OAR). 3D-CRT had the highest PTV and OAR maximum doses but was the most efficient. IMRT provides the greatest OAR sparing but the longest delivery time. For those patients with unresectable disease that can benefit from a higher, definitive dose, 3D-CRT–opposed laterals are the most clinically feasible technique for cranial fields and for spine fields. Although inefficient, the IMRT technique is the most clinically feasible because of the increased mean OAR dose with the VMAT technique. Quality assurance of the beams, especially the junction regions, is essential.

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Determination of monitor unit check tolerances based on a comparison with measurement and treatment planning system data

ABSTRACT: This work describes the experimental validation of treatment planning system monitor unit (MU) calculations against measurement for a range of scenarios. This, together with a comparison of treatment planning system MUs and an independent MU check method, allows the derivation of confidence intervals for the check process. Data were collected for open and 60° motorized wedge fields using an Elekta Synergy linac at 6 and 8 MV using homogeneous and heterogeneous phantoms. Masterplan (Version 4.0) pencil-beam and collapsed cone algorithms were used for the primary MU calculations with full inhomogeneity correction. Results show that both algorithms agree with measurement to acceptable tolerance levels in the majority of the cases studied. The confidence interval for the pencil-beam algorithm MU against an independent check was determined as + 1.6% to −3.4%. This is modified to + 2.3% to −2.5% when data collected with low-density heterogeneities are removed as this algorithm is not used clinically for these cases. The corresponding interval for the collapsed cone algorithm was + 1.2% to −4.3%, indicating that an offset tolerance for the independent check is appropriate. Analysis of clinical conformal treatment plan data generated using the pencil-beam algorithm (1393 beams) returned 93% of beams within the independent check tolerance. Similarly, using the collapsed cone algorithm as the primary MU calculation, 77% (of 1434 beams) were within the confidence interval.

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A case study of radiotherapy planning for Intensity Modulation Radiation Therapy for the whole scalp with matching electron treatment

The purpose of this report is to communicate a technique to match an electron field to the dose distribution of an Intensity-Modulated Radiation Therapy (IMRT) plan. A patient with multiple areas of squamous cell carcinoma over the scalp was treated using 60 Gy in 2.0-Gy fractions to the entire scalp and first echelon nodes with multiple 6-MV photon fields. To deliver an adequate dose to the scalp, a custom 1.0-cm bolus helmet was fashioned using a solid piece of aquaplast. Along with the IMRT scalp treatment, a left zygoma area was treated with electrons matching the anterior border of the IMRT dose distribution. The border was matched by creating a left lateral field with the multileaf collimator shaped to the IMRT dose distribution. The result indicated an adequate dose to the skin match between the IMRT plan and the electron field. Results were confirmed using optically stimulated luminescence placed at the skin match area, so that the dose matched the prescription within 10%.

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Retrospective review of Contura HDR breast cases to improve our standardized procedure

To retrospectively review our first 20 Contura high dose rate breast cases to improve and refine our standardized procedure and checklists. We prepared in advance checklists for all steps, developed an in-house Excel spreadsheet for second checking the plan, and generated a procedure for efficient contouring and a set of optimization constraints to meet the dose volume histogram criteria. Templates were created in our treatment planning system for structures, isodose levels, optimization constraints, and plan report. This study reviews our first 20 high dose rate Contura breast treatment plans. We followed our standardized procedure for contouring, planning, and second checking. The established dose volume histogram criteria were successfully met for all plans. For the cases studied here, the balloon-skin and balloon-ribs distances ranged between 5 and 43 mm and 1 and 33 mm, respectively; air{sub s}eroma volume/PTV{sub E}val volume≤5.5% (allowed≤10%); asymmetry<1.2 mm (goal≤2 mm); PTV{sub E}val V90%≥97.6%; PTV{sub E}val V95%≥94.9%; skin max dose≤98%Rx; ribs max dose≤137%Rx; V150%≤29.8 cc; V200%≤7.8 cc; the total dwell time range was 225.4 to 401.9 seconds; and the second check agreement was within 3%. Based on this analysis, more appropriate ranges for the total dwell time and balloon diameter tolerance were found. Three major problems were encountered: balloon migration toward the skin for small balloon-to-skin distances, lumen obstruction, and length change for the flexible balloon. Solutions were found for these issues and our standardized procedure and checklists were updated accordingly. Based on our review of these cases, the use of checklists resulted in consistent results, indicating good coverage for the target without sacrificing the critical structures. This review helped us to refine our standardized procedure and update our checklists.

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Experimental evaluation of actual delivered dose using mega-voltage cone-beam CT and direct point dose measurement

Radiation therapy in patients is planned by using computed tomography (CT) images acquired before start of the treatment course. Here, tumor shrinkage or weight loss or both, which are common during the treatment course for patients with head-and-neck (H and N) cancer, causes unexpected differences from the plan, as well as dose uncertainty with the daily positional error of patients. For accurate clinical evaluation, it is essential to identify these anatomical changes and daily positional errors, as well as consequent dosimetric changes. To evaluate the actual delivered dose, the authors proposed direct dose measurement and dose calculation with mega-voltage cone-beam CT (MVCBCT). The purpose of the present study was to experimentally evaluate dose calculation by MVCBCT. Furthermore, actual delivered dose was evaluated directly with accurate phantom setup. Because MVCBCT has CT-number variation, even when the analyzed object has a uniform density, a specific and simple CT-number correction method was developed and applied for the H and N site of a RANDO phantom. Dose distributions were calculated with the corrected MVCBCT images of a cylindrical polymethyl methacrylate phantom. Treatment processes from planning to beam delivery were performed for the H and N site of the RANDO phantom. The image-guided radiation therapy procedure was utilized for the phantom setup to improve measurement reliability. The calculated dose in the RANDO phantom was compared to the measured dose obtained by metal-oxide-semiconductor field-effect transistor detectors. In the polymethyl methacrylate phantom, the calculated and measured doses agreed within about +3%. In the RANDO phantom, the dose difference was less than +5%. The calculated dose based on simulation-CT agreed with the measured dose within±3%, even in the region with a high dose gradient. The actual delivered dose was successfully determined by dose calculation with MVCBCT, and the point dose measurement with the image-guided radiation therapy procedure.

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A dosimetric comparative study: Volumetric modulated arc therapy vs intensity-modulated radiation therapy in the treatment of nasal cavity carcinomas

The purpose of this study was to evaluate the differences between volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) in the treatment of nasal cavity carcinomas. The treatment of 10 patients, who had completed IMRT treatment for resected tumors of the nasal cavity, was replanned with the Philips Pinnacle{sup 3} Version 9 treatment-planning system. The IMRT plans used a 9-beam technique whereas the VMAT (known as SmartArc) plans used a 3-arc technique. Both types of plans were optimized using Philips Pinnacle{sup 3} Direct Machine Parameter Optimization algorithm. IMRT and VMAT plans' quality was compared by evaluating the maximum, minimum, and mean doses to the target volumes and organs at risk, monitor units (MUs), and the treatment delivery time. Our results indicate that VMAT is capable of greatly reducing treatment delivery time and MUs compared with IMRT. The reduction of treatment delivery time and MUs can decrease the effects of intrafractional uncertainties that can occur because of patient movement during treatment delivery. VMAT's plans further reduce doses to critical structures that are in close proximity to the target volume.

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A comparison between anisotropic analytical and multigrid superposition dose calculation algorithms in radiotherapy treatment planning

Monte Carlo (MC) simulation is currently the most accurate dose calculation algorithm in radiotherapy planning but requires relatively long processing time. Faster model-based algorithms such as the anisotropic analytical algorithm (AAA) by the Eclipse treatment planning system and multigrid superposition (MGS) by the XiO treatment planning system are 2 commonly used algorithms. This study compared AAA and MGS against MC, as the gold standard, on brain, nasopharynx, lung, and prostate cancer patients. Computed tomography of 6 patients of each cancer type was used. The same hypothetical treatment plan using the same machine and treatment prescription was computed for each case by each planning system using their respective dose calculation algorithm. The doses at reference points including (1) soft tissues only, (2) bones only, (3) air cavities only, (4) soft tissue-bone boundary (Soft/Bone), (5) soft tissue-air boundary (Soft/Air), and (6) bone-air boundary (Bone/Air), were measured and compared using the mean absolute percentage error (MAPE), which was a function of the percentage dose deviations from MC. Besides, the computation time of each treatment plan was recorded and compared. The MAPEs of MGS were significantly lower than AAA in all types of cancers (p<0.001). With regards to body density combinations, the MAPE of AAA ranged from 1.8% (soft tissue) to 4.9% (Bone/Air), whereas that of MGS from 1.6% (air cavities) to 2.9% (Soft/Bone). The MAPEs of MGS (2.6%±2.1) were significantly lower than that of AAA (3.7%±2.5) in all tissue density combinations (p<0.001). The mean computation time of AAA for all treatment plans was significantly lower than that of the MGS (p<0.001). Both AAA and MGS algorithms demonstrated dose deviations of less than 4.0% in most clinical cases and their performance was better in homogeneous tissues than at tissue boundaries. In general, MGS demonstrated relatively smaller dose deviations than AAA but required longer computation time.

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On bolus for megavoltage photon and electron radiation therapy

Frequently, in radiation therapy one must treat superficial lesions on cancer patients; these are at or adjacent to the skin. Megavoltage photon radiotherapy penetrates through the skin to irradiate deep-seated tumors, with skin-sparing property. Hence, to treat superficial lesions, one must use a layer of scattering material to feign as the skin surface. Although megavoltage electron beams are used for superficial treatments, one occasionally needs to enhance the dose near the surface. Such is the function of a “bolus,” a natural or synthetically developed material that acts as a layer of tissue to provide a more effective treatment to the superficial lesions. Other uses of boluses are to correct for varying surface contours and to add scattering material around the patient's surface. Materials used as bolus vary from simple water to metal and include various mixtures and compounds. Even with the modernization of the technology for external-beam therapy and the emergence of various commercial boluses, the preparation and utilization of a bolus in clinical radiotherapy remains an art. Considering the varying experiences and practices, this paper briefly summarizes available boluses that have been proposed and are employed in clinical radiotherapy. Although this review is not exhaustive, it provides some initial guidance and answers questions that may arise in clinical practice.

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Analysis of high–dose rate brachytherapy dose distribution resemblance in CyberKnife hypofractionated treatment plans of localized prostate cancer

The present study is to analyze the CyberKnife hypofractionated dose distribution of localized prostate cancer in terms of high–dose rate (HDR) brachytherapy equivalent doses to assess the degree of HDR brachytherapy resemblance of CyberKnife dose distribution. Thirteen randomly selected localized prostate cancer cases treated using CyberKnife with a dose regimen of 36.25 Gy in 5 fractions were considered. HDR equivalent doses were calculated for 30 Gy in 3 fractions of HDR brachytherapy regimen. The D{sub 5%} of the target in the CyberKnife hypofractionation was 41.57 ± 2.41 Gy. The corresponding HDR fractionation (3 fractions) equivalent dose was 32.81 ± 1.86 Gy. The mean HDR fractionation equivalent dose, D{sub 98%}, was 27.93 ± 0.84 Gy. The V{sub 100%} of the prostate target was 95.57% ± 3.47%. The V{sub 100%} of the bladder and the rectum were 717.16 and 79.6 mm{sup 3}, respectively. Analysis of the HDR equivalent dose of CyberKnife dose distribution indicates a comparable resemblance to HDR dose distribution in the peripheral target doses (D{sub 98%} to D{sub 80%}) reported in the literature. However, there is a substantial difference observed in the core high-dose regions especially in D{sub 10%} and D{sub 5%}. The dose fall-off within the OAR is also superior in reported HDR dose distribution than the HDR equivalent doses of CyberKnife.

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