Engineering topics

Taylor, Russell

Publications and source records attributed to Taylor, Russell.

3 records

DOE OSTI2012

Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2011

Data-Driven Approach to Generating Achievable Dose-Volume Histogram Objectives in Intensity-Modulated Radiotherapy Planning

Purpose: To propose a method of intensity-modulated radiotherapy (IMRT) planning that generates achievable dose-volume histogram (DVH) objectives using a database containing geometric and dosimetric information of previous patients. Methods and Materials: The overlap volume histogram (OVH) is used to compare the spatial relationships between the organs at risk and targets of a new patient with those of previous patients in a database. From the OVH analysis, the DVH objectives of the new patient were generated from the database and used as the initial planning goals. In a retrospective OVH-assisted planning demonstration, 15 patients were randomly selected from a database containing clinical plans (CPs) of 91 previous head-and-neck patients treated by a three-level IMRT-simultaneous integrated boost technique. OVH-assisted plans (OPs) were planned in a leave-one-out manner by a planner who had no knowledge of CPs. Thus, DVH objectives of an OP were generated from a subdatabase containing the information of the other 90 patients. Those DVH objectives were then used as the initial planning goals in IMRT optimization. Planning efficiency was evaluated by the number of clicks of the 'Start Optimization' button in the course of planning. Although the Pinnacle{sup 3} treatment planning system allows planners to interactively adjust the DVH parameters during optimization, planners in our institution have never used this function in planning. Results: The average clicks required for completing the CP and OP was 27.6 and 1.9, respectively (p <.00001); three OPs were finished within a single click. Ten more patient's cord + 4 mm reached the sparing goal D{sub 0.1cc} <44 Gy (p <.0001), where D{sub 0.1cc} represents the dose corresponding to 0.1 cc. For planning target volume uniformity, conformity, and other organ at risk sparing, the OPs were at least comparable with the CPs. Additionally, the averages of D{sub 0.1cc} to the cord + 4 mm decreased by 6.9 Gy (p <.0001); averages of D{sub 0.1cc} to the brainstem decreased by 7.7 Gy (p <.005). The averages of V(30 Gy) to the contralateral parotid decreased by 8.7% (p <.0001), where V(30 Gy) represents the percentage volume corresponding to 30 Gy. Conclusion: The method heralds the possibility of automated IMRT planning.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2011

Real-time dose computation: GPU-accelerated source modeling and superposition/convolution

Purpose: To accelerate dose calculation to interactive rates using highly parallel graphics processing units (GPUs). Methods: The authors have extended their prior work in GPU-accelerated superposition/convolution with a modern dual-source model and have enhanced performance. The primary source algorithm supports both focused leaf ends and asymmetric rounded leaf ends. The extra-focal algorithm uses a discretized, isotropic area source and models multileaf collimator leaf height effects. The spectral and attenuation effects of static beam modifiers were integrated into each source's spectral function. The authors introduce the concepts of arc superposition and delta superposition. Arc superposition utilizes separate angular sampling for the total energy released per unit mass (TERMA) and superposition computations to increase accuracy and performance. Delta superposition allows single beamlet changes to be computed efficiently. The authors extended their concept of multi-resolution superposition to include kernel tilting. Multi-resolution superposition approximates solid angle ray-tracing, improving performance and scalability with a minor loss in accuracy. Superposition/convolution was implemented using the inverse cumulative-cumulative kernel and exact radiological path ray-tracing. The accuracy analyses were performed using multiple kernel ray samplings, both with and without kernel tilting and multi-resolution superposition. Results: Source model performance was <9 ms (data dependent) for a high resolution (400{sup 2}) field using an NVIDIA (Santa Clara, CA) GeForce GTX 280. Computation of the physically correct multispectral TERMA attenuation was improved by a material centric approach, which increased performance by over 80%. Superposition performance was improved by {approx}24% to 0.058 and 0.94 s for 64{sup 3} and 128{sup 3} water phantoms; a speed-up of 101-144x over the highly optimized Pinnacle{sup 3} (Philips, Madison, WI) implementation. Pinnacle{sup 3} times were 8.3 and 94 s, respectively, on an AMD (Sunnyvale, CA) Opteron 254 (two cores, 2.8 GHz). Conclusions: The authors have completed a comprehensive, GPU-accelerated dose engine in order to provide a substantial performance gain over CPU based implementations. Real-time dose computation is feasible with the accuracy levels of the superposition/convolution algorithm.

60 APPLIED LIFE SCIENCES↗