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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.

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DOE OSTI2015

SU-E-T-173: Clinical Comparison of Treatment Plans and Fallback Plans for Machine Downtime

Purpose: The purpose of this study was to determine the clinical effectiveness and dosimetric quality of fallback planning in relation to machine downtime. Methods: Plans for a Varian Novalis TX were mimicked, and fallback plans using an Elekta VersaHD machine were generated using a dual arc template. Plans for thirty (n=30) patients of various treatment sites optimized and calculated using RayStation treatment planning system. For each plan, a fall back plan was created and compared to the original plan. A dosimetric evaluation was conducted using the homogeneity index, conformity index, as well as DVH analysis to determine the quality of the fallback plan on a different treatment machine. Fallback plans were optimized for 60 iterations using the imported dose constraints from the original plan DVH to give fallback plans enough opportunity to achieve the dose objectives. Results: The average conformity index and homogeneity index for the NovalisTX plans were 0.76 and 10.3, respectively, while fallback plan values were 0.73 and 11.4. (Homogeneity =1 and conformity=0 for ideal plan) The values to various organs at risk were lower in the fallback plans as compared to the imported plans across most organs at risk. Isodose difference comparisons between plans were also compared and the average dose difference across all plans was 0.12%. Conclusion: The clinical impact of fallback planning is an important aspect to effective treatment of patients. With the complexity of LINACS increasing every year, an option to continue treating during machine downtime remains an essential tool in streamlined treatment execution. Fallback planning allows the clinic to continue to run efficiently should a treatment machine become offline due to maintenance or repair without degrading the quality of the plan all while reducing strain on members of the radiation oncology team.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

A Knowledge-Based Approach to Improving and Homogenizing Intensity Modulated Radiation Therapy Planning Quality Among Treatment Centers: An Example Application to Prostate Cancer Planning

Purpose: Intensity modulated radiation therapy (IMRT) treatment planning can have wide variation among different treatment centers. We propose a system to leverage the IMRT planning experience of larger institutions to automatically create high-quality plans for outside clinics. We explore feasibility by generating plans for patient datasets from an outside institution by adapting plans from our institution. Methods and Materials: A knowledge database was created from 132 IMRT treatment plans for prostate cancer at our institution. The outside institution, a community hospital, provided the datasets for 55 prostate cancer cases, including their original treatment plans. For each “query” case from the outside institution, a similar “match” case was identified in the knowledge database, and the match case’s plan parameters were then adapted and optimized to the query case by use of a semiautomated approach that required no expert planning knowledge. The plans generated with this knowledge-based approach were compared with the original treatment plans at several dose cutpoints. Results: Compared with the original plan, the knowledge-based plan had a significantly more homogeneous dose to the planning target volume and a significantly lower maximum dose. The volumes of the rectum, bladder, and femoral heads above all cutpoints were nominally lower for the knowledge-based plan; the reductions were significantly lower for the rectum. In 40% of cases, the knowledge-based plan had overall superior (lower) dose–volume histograms for rectum and bladder; in 54% of cases, the comparison was equivocal; in 6% of cases, the knowledge-based plan was inferior for both bladder and rectum. Conclusions: Knowledge-based planning was superior or equivalent to the original plan in 95% of cases. The knowledge-based approach shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced institutions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Knowledge-based treatment planning and its potential role in the transition between treatment planning systems

Commissioning a new treatment planning system (TPS) involves many time-consuming tasks. We investigated the role that knowledge-based planning (KBP) can play in aiding a clinic's transition to a new TPS. Sixty clinically treated prostate/prostate bed intensity-modulated radiation therapy (IMRT) plans were exported from an in-house TPS and were used to create a KBP model in a newly implemented commercial application. To determine the benefit that KBP may have in a TPS transition, the model was tested on 2 groups of patients. Group 1 consisted of the first 10 prostate/prostate bed patients treated in the commercial TPS after the transition from the in-house TPS. Group 2 consisted of 10 patients planned in the commercial TPS after 8 months of clinical use. The KBP-generated plan was compared with the clinically used plan in terms of plan quality (ability to meet planning objectives and overall dose metrics) and planning efficiency (time required to generate clinically acceptable plans). The KBP-generated plans provided a significantly improved target coverage (p = 0.01) compared with the clinically used plans for Group 1, but yielded plans of comparable target coverage to the clinically used plans for Group 2. For the organs at risk, the KBP-generated plans produced lower doses, on average, for every normal-tissue objective except for the maximum dose to 0.1 cc of rectum. The time needed for the KBP-generated plans ranged from 6 to 15 minutes compared to 30 to 150 and 15 to 60 minutes for manual planning in Groups 1 and 2, respectively. KBP is a promising tool to aid in the transition to a new TPS. Our study indicates that high-quality treatment plans could have been generated in the newly implemented TPS more efficiently compared with not using KBP. Even after 8 months of the clinical use, KBP still showed an increase in plan quality and planning efficiency compared with manual planning.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-J-70: Feasibility Study of Dynamic Arc and IMRT Treatment Plans Utilizing Vero Treatment Unit and IPlan Planning Computer for SRS/FSRT Brain Cancer Patients

Purpose: To investigate the feasibility of utilizing Dynamic Arc (DA) and IMRT with 5mm MLC leaf of VERO treatment unit for SRS/FSRT brain cancer patients with non-invasive stereotactic treatments. The DA and IMRT plans using the VERO unit (BrainLab Inc, USA) are compared with cone-based planning and proton plans to evaluate their dosimetric advantages. Methods: The Vero treatment has unique features like no rotational or translational movements of the table during treatments, Dynamic Arc/IMRT, tracking of IR markers, limitation of Ring rotation. Accuracies of the image fusions using CBCT, orthogonal x-rays, and CT are evaluated less than ∼ 0.7mm with a custom-made target phantom with 18 hidden targets. 1mm margin is given to GTV to determine PTV for planning constraints considering all the uncertainties of planning computer and mechanical uncertainties of the treatment unit. Also, double-scattering proton plans with 6F to 9F beams and typical clinical parameters, multiple isocenter plans with 6 to 21 isocenters, and DA/IMRT plans are evaluated to investigate the dosimetric advantages of the DA/IMRT for complex shape of targets. Results: 3 Groups of the patients are divided: (1) Group A (complex target shape), CI's are same for IMRT, and DGI of the proton plan are better by 9.5% than that of the IMRT, (2) Group B, CI of the DA plans (1.91+/−0.4) are better than cone-based plan, while DGI of the DA plan is 4.60+/−1.1 is better than cone-based plan (5.32+/−1.4), (3) Group C (small spherical targets), CI of the DA and cone-based plans are almost the same. Conclusion: For small spherical targets, cone-based plans are superior to other 2 plans: DS proton and DA plans. For complex or irregular plans, dynamic and IMRT plans are comparable to cone-based and proton plans for complex targets.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-358: Is Auto-Planning Useful for Volumetric-Modulated Arc Therapy Planning in Rectal Cancer Radiotherapy?

Purpose: To evaluate whether Auto-Planning based volumetric-modulated radiotherapy (auto-VMAT) can reduce manual interaction time during treatment planning and improve plan quality for rectal cancer radiotherapy. Methods: Ten rectal cancer patients (stage II and III) after radical resection using Dixon surgery were enrolled. All patients were treated with VMAT technique. The manual VMAT plans (man-VMAT) were designed in the Pinnacle treatment planning system (Version 9.10) following the standard treatment planning procedure developed in our department. Clinical plans were manually designed by our experienced dosimetrists. Additionally, an auto-VMAT plan was created for each patient using Auto-Planning module. However, manual interaction was still applied to meet the clinical requirements. The treatment planning time and plan quality surrogated by the DVH parameters were compared between manual and automated plans. Results: The total planning time and manual interaction time were 50.38 and 4.47 min for the auto-VMAT and 36.81 and 16.94 min for the man-VMAT (t=60.14,−23.86; p=0.000, 0.000). In terms of plan quality, both plans meet the clinical requirements. The PTV homogeneity index (HI) and conformity index (CI) were 0.054 and 0.822 for the auto-VMAT and 0.059 and 0.815 for the man-VMAT (t=−1.72, 0.36;p=0.119,0.730).Compared to the man-VMAT, the auto-VMAT showed reduction of 11.9% and 0.7% in V40 and V50 of the bladder, respectively.The V30 and D mean were reduced by 14.0% and 5.1Gy in the left femur and 12.2% and 3.8Gy in the right femur. Conclusion: The Auto-Planning based VMAT plans not only shows similar or superior plan quality to the manual ones in the rectal cancer radiotherapy, but also improve the planning efficiency significantly. However, manual interactions are still required to achieve a clinically acceptable plan based on our experiences.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Plan evaluation for heat resilience: complementary methods to comprehensively assess heat planning in Tempe and Tucson, Arizona

Abstract Escalating impacts from climate change and urban heat are increasing the urgency for communities to equitably plan for heat resilience. Cities in the desert Southwest are among the hottest and fastest warming in the U.S., placing them on the front lines of heat planning. Urban heat resilience requires an integrated planning approach that coordinates strategies across the network of plans that shape the built environment and risk patterns. To date, few studies have assessed cities’ progress on heat planning. This research is the first to combine two emerging plan evaluation approaches to examine how networks of plans shape urban heat resilience through case studies of Tempe and Tucson, Arizona. The first methodology, Plan Quality Evaluation for Heat Resilience, adapts existing plan quality assessment approaches to heat. We assess whether plans meet 56 criteria across seven principles of high-quality planning and the types of heat strategies included in the plans. The second methodology, the Plan Integration for Resilience Scorecard™ (PIRS™) for Heat, focuses on plan policies that could influence urban heat hazards. We categorize policies by policy tool and heat mitigation strategy and score them based on their heat impact. Scored policies are then mapped to evaluate their spatial distribution and the net effect of the plan network. The resulting PIRS™ for Heat scorecard is compared with heat vulnerability indicators to assess policy alignment with risks. We find that both cities are proactively planning for heat resilience using similar plan and strategy types, however, there are clear and consistent opportunities for improvement. Combining these complementary plan evaluation methods provides a more comprehensive understanding of how plans address heat and a generalizable approach that communities everywhere could use to identify opportunities for improved heat resilience planning.

Environmental Sciences & Ecology↗
DOE OSTI2016

SU-F-T-312: Identifying Distinct Radiation Therapy Plan Classes Through Multi-Dimensional Analysis of Plan Complexity Metrics

Purpose: To determine whether body site-specific treatment plans form unique “plan class” clusters in a multi-dimensional analysis of plan complexity metrics such that a single beam quality correction determined for a representative plan could be universally applied within the “plan class”, thereby increasing the dosimetric accuracy of a detector’s response within a subset of similarly modulated nonstandard deliveries. Methods: We collected 95 clinical volumetric modulated arc therapy (VMAT) plans from four body sites (brain, lung, prostate, and spine). The lung data was further subdivided into SBRT and non-SBRT data for a total of five plan classes. For each control point in each plan, a variety of aperture-based complexity metrics were calculated and stored as unique characteristics of each patient plan. A multiple comparison of means analysis was performed such that every plan class was compared to every other plan class for every complexity metric in order to determine which groups could be considered different from one another. Statistical significance was assessed after correcting for multiple hypothesis testing. Results: Six out of a possible 10 pairwise plan class comparisons were uniquely distinguished based on at least nine out of 14 of the proposed metrics (Brain/Lung, Brain/SBRT lung, Lung/Prostate, Lung/SBRT Lung, Lung/Spine, Prostate/SBRT Lung). Eight out of 14 of the complexity metrics could distinguish at least six out of the possible 10 pairwise plan class comparisons. Conclusion: Aperture-based complexity metrics could prove to be useful tools to quantitatively describe a distinct class of treatment plans. Certain plan-averaged complexity metrics could be considered unique characteristics of a particular plan. A new approach to generating plan-class specific reference (pcsr) fields could be established through a targeted preservation of select complexity metrics or a clustering algorithm that identifies plans exhibiting similar modulation characteristics. Measurements and simulations will better elucidate potential plan-class specific dosimetry correction factors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Direct leaf trajectory optimization for volumetric modulated arc therapy planning with sliding window delivery

Purpose: The authors propose a novel optimization model for volumetric modulated arc therapy (VMAT) planning that directly optimizes deliverable leaf trajectories in the treatment plan optimization problem, and eliminates the need for a separate arc-sequencing step. Methods: In this model, a 360° arc is divided into a given number of arc segments in which the leaves move unidirectionally. This facilitates an algorithm that determines the optimal piecewise linear leaf trajectories for each arc segment, which are deliverable in a given treatment time. Multileaf collimator constraints, including maximum leaf speed and interdigitation, are accounted for explicitly. The algorithm is customized to allow for VMAT delivery using constant gantry speed and dose rate, however, the algorithm generalizes to variable gantry speed if beneficial. Results: The authors demonstrate the method for three different tumor sites: a head-and-neck case, a prostate case, and a paraspinal case. The authors first obtain a reference plan for intensity modulated radiotherapy (IMRT) using fluence map optimization and 20 intensity-modulated fields in equally spaced beam directions, which is beyond the standard of care. Modeling the typical clinical setup for the treatment sites considered, IMRT plans using seven or nine beams are also computed. Subsequently, VMAT plans are optimized by dividing the 360° arc into 20 corresponding arc segments. Assuming typical machine parameters (a dose rate of 600 MU/min, and a maximum leaf speed of 3 cm/s), it is demonstrated that the optimized VMAT plans with 2–3 min delivery time are of noticeably better quality than the 7–9 beam IMRT plans. The VMAT plan quality approaches the quality of the 20-beam IMRT benchmark plan for delivery times between 3 and 4 min. Conclusions: The results indicate that high quality treatments can be delivered in a single arc with 20 arc segments if sufficient time is allowed for modulation in each segment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-D-BRD-04: The Impact of Automatic Radiation Therapy Plan Checks in Treatment Planning

Purpose: The physics plan check verifies various aspects of a treatment plan after dosimetrists have finished creating the plan. Some errors in the plan which are caught by the physics check could be caught earlier in the departmental workflow. The purpose of this project was to evaluate a plan checking script that can be run within the treatment planning system (TPS) by the dosimetrists prior to plan approval and export to the record and verify system. Methods: A script was created in the Pinnacle TPS to automatically check 15 aspects of a plan for clinical practice conformity. The script outputs a list of checks which the plan has passed and a list of checks which the plan has failed so that appropriate adjustments can be made. For this study, the script was run on a total of 108 plans: IMRT (46/108), VMAT (35/108) and SBRT (27/108). Results: Of the plans checked by the script, 77/108 (71%) failed at least one of the fifteen checks. IMRT plans resulted in more failed checks (91%) than VMAT (51%) or SBRT (63%), due to the high failure rate of an IMRT-specific check, which checks that no IMRT segment < 5 MU. The dose grid size and couch removal checks caught errors in 10% and 14% of all plans – errors that ultimately may have resulted in harm to the patient. Conclusion: Approximately three-fourths of the plans being examined contain errors that could be caught by dosimetrists running an automated script embedded in the TPS. The results of this study will improve the departmental workflow by cutting down on the number of plans that, due to these types of errors, necessitate re-planning and re-approval of plans, increase dosimetrist and physician workload and, in urgent cases, inconvenience patients by causing treatment delays.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-D-BRD-01: Cloud-Based Radiation Treatment Planning: Performance Evaluation of Dose Calculation and Plan Optimization

Purpose: To report the first experience on the development of a cloud-based treatment planning system and investigate the performance improvement of dose calculation and treatment plan optimization of the cloud computing platform. Methods: A cloud computing-based radiation treatment planning system (cc-TPS) was developed for clinical treatment planning. Three de-identified clinical head and neck, lung, and prostate cases were used to evaluate the cloud computing platform. The de-identified clinical data were encrypted with 256-bit Advanced Encryption Standard (AES) algorithm. VMAT and IMRT plans were generated for the three de-identified clinical cases to determine the quality of the treatment plans and computational efficiency. All plans generated from the cc-TPS were compared to those obtained with the PC-based TPS (pc-TPS). The performance evaluation of the cc-TPS was quantified as the speedup factors for Monte Carlo (MC) dose calculations and large-scale plan optimizations, as well as the performance ratios (PRs) of the amount of performance improvement compared to the pc-TPS. Results: Speedup factors were improved up to 14.0-fold dependent on the clinical cases and plan types. The computation times for VMAT and IMRT plans with the cc-TPS were reduced by 91.1% and 89.4%, respectively, on average of the clinical cases compared to those with pc-TPS. The PRs were mostly better for VMAT plans (1.0 ≤ PRs ≤ 10.6 for the head and neck case, 1.2 ≤ PRs ≤ 13.3 for lung case, and 1.0 ≤ PRs ≤ 10.3 for prostate cancer cases) than for IMRT plans. The isodose curves of plans on both cc-TPS and pc-TPS were identical for each of the clinical cases. Conclusion: A cloud-based treatment planning has been setup and our results demonstrate the computation efficiency of treatment planning with the cc-TPS can be dramatically improved while maintaining the same plan quality to that obtained with the pc-TPS. This work was supported in part by the National Cancer Institute (1R01 CA133474) and by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (MSIP) (Grant No.2009-00420)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned using an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved target coverage. M. Matuszak has research funding for KBP from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Community Planning for Solar: Compiling a Community Solar Action Plan

This document provides an annotated outline for a Community Solar Action Plan. This document is designed to assist community officials, volunteers, and regional planning agency staff in preparing a draft Community Solar Action Plan for a municipality, community, or other jurisdiction. Preparing a Community Solar Action Plan is the fifth step in the Community Planning for Solar process (ag.umass.edu/solarplanning). The plan is intended to be the culmination of the planning process. The contents of the plan will include summaries of information gathered as part of foregoing steps in the process, including completion of a Solar Resource and Infrastructure Assessment, administering of a Community Solar Survey, interpretation of survey results, and review of Solar Financing and Ownership Options and tools. Once the Community Solar Action Plan has been drafted, it should be reviewed by municipal board and commission members and presented at an open community forum. Any important comments or revisions can be incorporated before the final Community Solar Action Plan is approved and implemented. The approved Community Solar Action Plan is a living document that guides community solar planning action over time. As conditions change, new information becomes available, or actions progress over the life of the plan, adjustments may be necessary to maintain the plan's relevance. The Monitoring, Evaluating, and Updating Your Community Solar Action Plan fact sheet (Step 6, Item a) describes some things to consider when updating the Community Solar Action Plan over time.

14 SOLAR ENERGY↗
DOE OSTI2015

SU-E-T-268: Differences in Treatment Plan Quality and Delivery Between Two Commercial Treatment Planning Systems for Volumetric Arc-Based Radiation Therapy

Purpose: To clinically evaluate the differences in volumetric modulated arc therapy (VMAT) treatment plan and delivery between two commercial treatment planning systems. Methods: Two commercial VMAT treatment planning systems with different VMAT optimization algorithms and delivery approaches were evaluated. This study included 16 clinical VMAT plans performed with the first system: 2 spine, 4 head and neck (HN), 2 brain, 4 pancreas, and 4 pelvis plans. These 16 plans were then re-optimized with the same number of arcs using the second treatment planning system. Planning goals were invariant between the two systems. Gantry speed, dose rate modulation, MLC modulation, plan quality, number of monitor units (MUs), VMAT quality assurance (QA) results, and treatment delivery time were compared between the 2 systems. VMAT QA results were performed using Mapcheck2 and analyzed with gamma analysis (3mm/3% and 2mm/2%). Results: Similar plan quality was achieved with each VMAT optimization algorithm, and the difference in delivery time was minimal. Algorithm 1 achieved planning goals by highly modulating the MLC (total distance traveled by leaves (TL) = 193 cm average over control points per plan), while maintaining a relatively constant dose rate (dose-rate change <100 MU/min). Algorithm 2 involved less MLC modulation (TL = 143 cm per plan), but greater dose-rate modulation (range = 0-600 MU/min). The average number of MUs was 20% less for algorithm 2 (ratio of MUs for algorithms 2 and 1 ranged from 0.5-1). VMAT QA results were similar for all disease sites except HN plans. For HN plans, the average gamma passing rates were 88.5% (2mm/2%) and 96.9% (3mm/3%) for algorithm 1 and 97.9% (2mm/2%) and 99.6% (3mm/3%) for algorithm 2. Conclusion: Both VMAT optimization algorithms achieved comparable plan quality; however, fewer MUs were needed and QA results were more robust for Algorithm 2, which more highly modulated dose rate.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-P-64: The Impact of Plan Complexity Parameters On the Plan Quality and Deliverability of Volumetric Modulated Arc Therapy with Canonical Correlation Analysis

Purpose: To evaluate the impact of complexity indices on the plan quality and deliverability of volumetric modulated arc therapy (VMAT), and to determine the most significant parameters in the generation of an ideal VMAT plan. Methods: A multi-dimensional exploratory statistical method, canonical correlation analysis (CCA) was adopted to study the correlations between VMAT parameters of complexity, quality and deliverability, as well as their contribution weights with 32 two-arc VMAT nasopharyngeal cancer (NPC) patients and 31 one-arc VMAT prostate cancer patients. Results: The MU per arc (MU/Arc) and MU per control point (MU/CP) of NPC were 337.8±25.2 and 3.7±0.3, respectively, which were significantly lower than those of prostate cancer patients (MU/Arc : 506.9±95.4, MU/CP : 5.6±1.1). The plan complexity indices indicated that two-arc VMAT plans were more complex than one-arc VMAT plans. Plan quality comparison confirmed that one-arc VMAT plans had a high quality than two-arc VMAT plans. CCA results implied that plan complexity parameters were highly correlated with plan quality with the first two canonical correlations of 0.96, 0.88 (both p<0.001) and significantly correlated with deliverability with the first canonical correlation of 0.79 (p<0.001), plan quality and deliverability was also correlated with the first canonical correlation of 0.71 (p=0.02). Complexity parameters of MU/CP, segment area (SA) per CP, percent of MU/CP less 3 and planning target volume (PTV) were weighted heavily in correlation with plan quality and deliveability . Similar results obtained from individual NPC and prostate CCA analysis. Conclusion: Relationship between complexity, quality, and deliverability parameters were investigated with CCA. MU, SA related parameters and PTV volume were found to have strong effect on the plan quality and deliverability. The presented correlation among different quantified parameters could be used to improve the plan quality and the efficiency of the radiotherapy process when creating a complex VMAT plan.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

MO-G-201-01: A Multi-Institutional Study Investigating the Performance of a Knowledge-Based Planning System Against Pinnacle Auto-Planning Engine in SIB-IMRT for the Head-And-Neck Cancer

Purpose: Knowledge-based Planning (KBP) founded on prior planning experience and Auto-Planning Engine (APE; commercialized in Pinnacle v9.10 TPS) based on progressive optimization algorithm both aim to eliminate the trial-and-error process in radiotherapy inverse planning. This study investigates the performance of the approaches in a multi-institutional setting to evaluate their functionalities in oropharyngeal cancer and offers suggestions how they can be implemented in the clinic. Methods: Radboud University Medical Center (RUMC) provided 35 oropharyngeal cancer patients (SIB-IMRT with two-dose-level prescription: 68 Gy to PTV68 and 50.3 Gy to PTV50.3) with corresponding comparative APE plans. Johns Hopkins University (JHU) contributed to a three-dose-level (70 Gy 63 Gy and 58.1 Gy) plan library for RUMC’s patient KBP generation. MedStar Georgetown University Hospital (MGUH) contributed to a KBP approach employing overlap-volume histogram (OVH-KBP) for generating RUMC’s patient KBP plans using JHU’s plan library. Since both approaches need their own user-defined parameters as initial inputs the first 10 patients were set aside as training set to finalize them. Meanwhile cross-institutional comparisons and adjustments were implemented for investigating institutions’ protocol discrepancies and the approaches’ user-defined parameters were updated accordingly. The finalized parameters were then applied to the remaining 25 patients for OVH-KBP and APE generation. A Wilcoxon rank-sum test was used for statistical comparison with significance level of p<0.05. Results: On average PTV68’s V95 was 96.5% in APE plans vs. 97% in OVH-KBP plans (p=0.36); PTV50.3’s V95 in APE plans was 97.8% vs.97.6% in OVH-KBP plans (p=0.6); cord’s D0.1 cc was 38.6 Gy in OVH-KBP plans vs. 43.7 Gy in APE plans (p=0.0001); mean doses to larynxes oral cavities parotids and submandibular glands were similar with p>0.2. Conclusions: The study demonstrates that KBP and APE can generate plans of comparable quality in a multi-institutional setting. Variations in clinical protocols can be effectively addressed for cross-institutional adaptations. Binbin Wu and Todd McNutt are the co-inventors of a patent associated with the proposed knowledge-based planning system which was licensed to Varian Medical Systems in 2015; This research was in part supported by Philips Radiation Oncology Systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Lightweight Software Process Improvement Using Productivity and Sustainability Improvement Planning (PSIP)

Productivity and Sustainability Improvement Planning (PSIP) is a lightweight, iterative workflow that allows software development teams to identify development bottlenecks and track progress to overcome them. In this paper, we present an overview of PSIP and how it compares to other software process improvement (SPI) methodologies, and provide two case studies that describe how the use of PSIP led to successful improvements in team effectiveness and efficiency.

Heroux, Michael A.↗
DOE OSTI2014

SU-E-T-580: Comparison of Cervical Carcinoma IMRT Plans From Four Commercial Treatment Planning Systems (TPS)

Purpose: Different treatment planning systems (TPS) use different treatment optimization and leaf sequencing algorithms. This work compares cervical carcinoma IMRT plans optimized with four commercial TPSs to investigate the plan quality in terms of target conformity and delivery efficiency. Methods: Five cervical carcinoma cases were planned with the Corvus, Monaco, Pinnacle and Xio TPSs by experienced planners using appropriate optimization parameters and dose constraints to meet the clinical acceptance criteria. Plans were normalized for at least 95% of PTV to receive the prescription dose (Dp). Dose-volume histograms and isodose distributions were compared. Other quantities such as Dmin(the minimum dose received by 99% of GTV/PTV), Dmax(the maximum dose received by 1% of GTV/PTV), D100, D95, D90, V110%, V105%, V100% (the volume of GTV/PTV receiving 110%, 105%, 100% of Dp), conformity index(CI), homogeneity index (HI), the volume of receiving 40Gy and 50 Gy to rectum (V40,V50) ; the volume of receiving 30Gy and 50 Gy to bladder (V30,V50) were evaluated. Total segments and MUs were also compared. Results: While all plans meet target dose specifications and normal tissue constraints, the maximum GTVCI of Pinnacle plans was up to 0.74 and the minimum of Corvus plans was only 0.21, these four TPSs PTVCI had significant difference. The GTVHI and PTVHI of Pinnacle plans are all very low and show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans require significantly less segments and MUs to deliver than the other plans. Conclusion: To deliver on a Varian linear-accelerator, the Pinnacle plans show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans have faster beam delivery.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

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

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

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗