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SU-F-BRD-10: Improving Plan Delivery Efficiency of Intensity Modulated Proton Plans with Prioritized Optimization

Purpose: To integrate treatment delivery time into plan optimization in spot scanning intensity modulated proton therapy. Utilizing a dedicated research treatment planning system we present an optimization approach to explore the trade-off between the correlated parameters treatment time and plan quality on an astrocytoma patient case. Methods: The planning system is based on prioritized optimization, a stepwise approach of implementing clinical goals. After each optimization step, dosimetric achievements are turned into hard constraints to maintain the achieved plan quality. Prior achievements can be violated by a so-called slip-factor which allows to study possible trade-offs of conflicting goals. Plan quality is obtained in the first two steps, while the third step optimizes delivery efficiency by working on the spot weight distribution via four alternative Methods: elimination of low weighted spots (1), elimination of spots hardly contributing to PTV dose, followed by reoptimization of the resulting smaller optimization problem (2), reduction of spot weights variance within each energy layer (3), and reduction of the overall spot weight sum (4). Treatment times were calculated assuming either constant or variable beam current depending on the lowest spot weight. Results: Delivery efficiency can be improved remarkably without influencing the plan quality. Absolute time savings depend on the utilized method and facility properties. By varying slip-factor and spot reduction limits, a border of worsening quality is detectable for all methods.Deleting low weighted spots by 10% results in a noticeable decrease in minimum target dose. Further reduction results in more heterogeneous dose distributions and insufficient coverage. Option 2 showed constant plan quality for spot reductions of more than 10%. Conclusion: Including treatment time optimization as a final step into prioritized optimization allows for more efficient treatment plans by redistributing the spot patterns without compromising plan quality, which has to remain the main intent of radiotherapy treatment. The authors report grants from German Research Foundation (DFG) during the conduct of the study.

60 APPLIED LIFE SCIENCES↗

SU-F-J-156: The Feasibility of MR-Only IMRT Planning for Prostate Anatomy

Purpose: For prostate anatomy, previous investigations have shown that simulated CT (sCT) generated from MR images can be used for accurate dose computation. In this study, we demonstrate the feasibility of MR-only IMRT planning for prostate case. Methods: Regular CT (rCT) and MR images of the same patient were acquired for prostate anatomy. Regions-of-interest (ROIs) i.e. target and risk structures are delineated on the rCT. A simulated CT (sCT) is generated from the MR image using the method described by Schadewaldt N et al. Their work establishes the clinical acceptability of dose calculation results on the sCT when compared to rCT. rCT and sCT are rigidly registered to ensure proper alignment between the two images. rCT and sCT are overlaid on each other and slice-wise visual inspection confirms excellent agreement between the two images. ROIs on the rCT are copied over to sCT. Philips AutoPlanning solution is used for generating treatment plans. The same treatment technique protocol (plan parameters and clinical goals) is used to generate AutoPlan-rCT and AutoPlan-sCT respectively for rCT and and sCT. DVH comparison on ROIs and slice-wise evaluation of dose is performed between AutoPlan-rCT and AutoPlan-sCT. Delivery parameters i.e. beam and corresponding segments from the AutoPlan-sCT are copied over to rCT and dose is computed to get AutoPlan-sCT-on-rCT. Results: Plan evaluation is done based on Dose Volume Histogram (DVH) of ROIs and manual slice-wise inspection of dose distribution. Both AutoPlan-rCT and AutoPlan-sCT provide a clinically acceptable plan. Also, AutoPlan-sCT-on-rCT shows excellent agreement with AutoPlan-sCT. Conclusion: The study demonstrates that it is feasible to do IMRT planning on the simulated CT image obtained from MR image for prostate anatomy. The research is supported by Philips India Ltd.

60 APPLIED LIFE SCIENCES↗

A method to evaluate dose errors introduced by dose mapping processes for mass conserving deformations

Purpose: To present a method to evaluate the dose mapping error introduced by the dose mapping process. In addition, apply the method to evaluate the dose mapping error introduced by the 4D dose calculation process implemented in a research version of commercial treatment planning system for a patient case. Methods: The average dose accumulated in a finite volume should be unchanged when the dose delivered to one anatomic instance of that volume is mapped to a different anatomic instance--provided that the tissue deformation between the anatomic instances is mass conserving. The average dose to a finite volume on image S is defined as d{sub S}=e{sub s}/m{sub S}, where e{sub S} is the energy deposited in the mass m{sub S} contained in the volume. Since mass and energy should be conserved, when d{sub S} is mapped to an image R(d{sub S{yields}R}=d{sub R}), the mean dose mapping error is defined as {Delta}d{sub m}=|d{sub R}-d{sub S}|=|e{sub R}/m{sub R}-e{sub S}/m{sub S}|, where the e{sub R} and e{sub S} are integral doses (energy deposited), and m{sub R} and m{sub S} are the masses within the region of interest (ROI) on image R and the corresponding ROI on image S, where R and S are the two anatomic instances from the same patient. Alternatively, application of simple differential propagation yields the differential dose mapping error, {Delta}d{sub d}=|({partial_derivative}d/{partial_derivative}e)*{Delta}e+({partial_derivative}d/{partial_derivative}m)*{Delta}m|=|((e{sub S}-e{sub R})/m{sub R})-((m{sub S}-m{sub R})/m{sub R}{sup 2})*e{sub R}|={alpha}|d{sub R}-d{sub S}| with {alpha}=m{sub S}/m{sub R}. A 4D treatment plan on a ten-phase 4D-CT lung patient is used to demonstrate the dose mapping error evaluations for a patient case, in which the accumulated dose, D{sub R}={Sigma}{sub S=0}{sup 9}d{sub S{yields}R}, and associated error values ({Delta}D{sub m} and {Delta}D{sub d}) are calculated for a uniformly spaced set of ROIs. Results: For the single sample patient dose distribution, the average accumulated differential dose mapping error is 4.3%, the average absolute differential dose mapping error is 10.8%, and the average accumulated mean dose mapping error is 5.0%. Accumulated differential dose mapping errors within the gross tumor volume (GTV) and planning target volume (PTV) are lower, 0.73% and 2.33%, respectively. Conclusions: A method has been presented to evaluate the dose mapping error introduced by the dose mapping process. This method has been applied to evaluate the 4D dose calculation process implemented in a commercial treatment planning system. The method could potentially be developed as a fully-automatic QA method in image guided adaptive radiation therapy (IGART).

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-498: Energy Minimization and Dose-Volume Inverse Optimization in Prostate Cancer

Purpose: To compare dose-volume (DVH) and energy minimization-based (EM) optimization for prostate cancer cases. Methods: A dozen of prostate plans were retrospectively studied. For each case two IMRT plans were generated, one with DVH and the other with EM objective cost function. Those different objective functions were used only for the organs at risk (OARs), while target objectives were achieved through DVH cost functions. The plans used the same beam angles, maximum number of segments per plan, minimum segment area and MUs per segment. Both plans were normalized such that 95% of the PTV was covered by the same prescription dose. After prescription was achieved, doses to the OARs were iteratively lowered until the standard deviation of the dose across the PTV was ~3.5%. Plan quality was evaluated by several dose indices (DIs). A DI represents the dose delivered to certain volume of a structure. Tallied DIs were for rectum and bladder 10%, 40%, 60% volumes, and 1% volumes of the femoral heads as surrogate for maximum doses. Statistical significance in the differences among DIs was quantified with two-tailed paired t-tests. Results: On average EM plans performed better than DVH plans. Statistically significant dose reduction in rectum DI10, DI40, and DI60, were 2.6%, 25.7%, and 35.9%, respectively. For bladder DI10, DI40, and DI60 the differences were 1.1%, 20.8%, and 29.7%. Left and right femoral head DI1s were better by 33.8% and 27.8% in EM plans. The quoted dose reduction is with respect to EM absolute doses for the DIs. Conclusion: The performance of EM optimization with respect to DVH optimization is patient and DI dependent. While in some cases specific DIs were better with DVH optimization, on average the energy minimization allows better (ranging from 1% to ~40%) OAR sparing than DVH optimization. NIH-NCI.

60 APPLIED LIFE SCIENCES↗

Myths and realities: Defining re-engineering for a large organization

This paper describes the background and results of three studies concerning software reverse engineering, re-engineering, and reuse (R3) hosted by the Internal Revenue Service in 1991 and 1992. The situation at the Internal Revenue--aging, piecemeal computer systems and outdated technology maintained by a large staff--is familiar to many institutions, especially among management information systems. The IRS is distinctive for the sheer magnitude and diversity of its problems; the country's tax records are processed using assembly language and COBOL and spread across tape and network DBMS files. How do we proceed with replacing legacy systems? The three software re-engineering studies looked at methods, CASE tool support, and performed a prototype project using re-engineering methods and tools. During the course of these projects, we discovered critical issues broader than the mechanical definitions of methods and tool technology.

Yin, Sandra↗

Finite-element analysis of top-casing electric source method for imaging hydraulically active fracture zones

Imaging hydraulically active fracture zones (HAFZ) is of paramount importance to subsurface resource extraction, geologic storage, and hazardous waste disposal. We have developed advanced 3D finite-element (FE) electrical imaging algorithms for HAFZ in the presence of a steel-cased well. The algorithms use tetrahedral FE meshes in the simulation domain and coarse rectangular finite-difference meshes in the imaging domain. This heterogeneous dual-mesh approach is well suited to modeling the multiscale earth model due to steel-cased wells. We find that the algorithms accurately and efficiently simulate surface electric field measurements over a 3D HAFZ at depth when one end point of a surface electric source is connected to a wellhead. For brevity, this configuration is called the top-casing electric source method. By replacing a hollow cased well with a solid prism, we improve our computational efficiency without affecting the solution accuracy. The sensitivity of the top-casing source method to HAFZ highly depends on the continuity of a steel-cased well because it makes currents preferentially flow to HAFZ. The sensitivity also depends on conductivity structures around the well because they control current leaking from the steel-cased well. We find that the method can image a localized HAFZ and detect changes in its width and height. Here, the imaging results are improved when a volume of the imaging domain is constrained from geomechanical perspectives. A primary advantage of the method is the fact that the sources and receivers are placed on the surface, thus not interrupting the well operation.

3D↗

SU-F-T-97: Outlier Identification in Radiation Therapy Knowledge Modeling

Purpose: To investigate the impact of outliers on knowledge modeling in radiation therapy, and develop a systematic workflow for identifying and analyzing geometric and dosimetric outliers using pelvic cases. Methods: Four groups (G1-G4) of pelvic plans were included: G1 (37 prostate cases), G2 (37 prostate plus lymph node cases), and G3 (37 prostate bed cases) are all clinical IMRT cases. G4 are 10 plans outside G1 re-planned with dynamic-arc to simulate dosimetric outliers. The workflow involves 2 steps: 1. identify geometric outliers, assess impact and clean up; 2. identify dosimetric outliers, assess impact and clean up.1. A baseline model was trained with all G1 cases. G2/G3 cases were then individually added to the baseline model as geometric outliers. The impact on the model was assessed by comparing leverage statistic of inliers (G1) and outliers (G2/G3). Receiver-operating-characteristics (ROC) analysis was performed to determine optimal threshold. 2. A separate baseline model was trained with 32 G1 cases. Each G4 case (dosimetric outliers) was then progressively added to perturb this model. DVH predictions were performed using these perturbed models for remaining 5 G1 cases. Normal tissue complication probability (NTCP) calculated from predicted DVH were used to evaluate dosimetric outliers’ impact. Results: The leverage of inliers and outliers was significantly different. The Area-Under-Curve (AUC) for differentiating G2 from G1 was 0.94 (threshold: 0.22) for bladder; and 0.80 (threshold: 0.10) for rectum. For differentiating G3 from G1, the AUC (threshold) was 0.68 (0.09) for bladder, 0.76 (0.08) for rectum. Significant increase in NTCP started from models with 4 dosimetric outliers for bladder (p<0.05), and with only 1 dosimetric outlier for rectum (p<0.05). Conclusion: We established a systematic workflow for identifying and analyzing geometric and dosimetric outliers, and investigated statistical metrics for detecting. Results validated the necessity for outlier detection and clean-up to enhance model quality in clinical practice. Research Grant: Varian master research grant.

60 APPLIED LIFE SCIENCES↗

Energy Northwest – Horn Rapids Solar and Storage: A Techno-economic Assessment

In 2017, as part of the second round of funding from the Washington State Clean Energy Fund, the Washington State Department of Commerce granted up to $\$3$ million in matching funds to develop an estimated $6.5 million project that deployed a 4-MW, 20-acre solar generating array of photovoltaic (PV) panels coupled with a 1 MW/4 MWh (nameplate capacity) lithium-iron-phosphate battery energy storage system (BESS) in Richland, Washington. The combination of PV and BESS will provide a predictable, renewable generating source and will also serve as a training ground for solar and battery technicians throughout the nation. This report documents the techno-economic assessment of the integrated system, including the definition of use cases and applications, collection and preparation of data and input parameters, development of modeling and optimization methods, case studies, and analysis results.

14 SOLAR ENERGY↗

CLimate Impact: Determining Etiology thRough pAthways (CLDERA)

Climate impacts have broad economic, health, political, and national security ramifications. Societally relevant impacts are typically farther downstream, are the product of multiple interacting processes, and can arise over small regions and timeframes because their sources are short-term and localized. Short-term forcings (as can be seen in volcanic eruptions, climatic tipping points (e.g., the collapse of rainforests or the disappearance of sea ice), or in increasingly plausible climate interventions) fundamentally possess low signal-to-noise and could benefit from accounting for the multiple conditional processes through which a downstream impact arises. Under the Grand Challenge LDRD CLDERA (CLimate impacts: Discovering Etiology thRough pAthways), we have developed tools to enable downstream impact attribution from geographically and temporally localized source forcings in the climate. CLDERA developed methods that can distinguish how a localized source drives the climate system to respond with particular impacts. The how is embodied in pathways – the spatio-temporally evolving chain of physical processes that connects a source to a series of increasingly distant impacts. Novel analytic methods in pursuit of downstream impact attribution were developed and demonstrated on simulations and observations of the 1991 eruption of Mt. Pinatubo in the Philippines. As described within this report we have • developed stratospheric expertise and aerosol modeling capabilities in E3SM, • created original methods to detect and model pathways from source-to-impact, and • advanced climate attribution through novel methods, cases, and approaches. Further, CLDERA developed a tiered verification process consisting of controlled datasets to prototype, verify, and refine the original method development. CLDERA increased Sandia’s footprint in the climate analytics community and developed new climate collaborations whilst also creating a cadre of climate analysts at Sandia. The products from CLDERA have been extensive with a total of 9 journal articles published, 12 articles submitted and under review, and an additional 8 articles in preparation. We have produced 1750 simulated years and developed 9 code-bases. This report details these accomplishments and serves as a summary of the work completed during the CLDERA Grand Challenge.

54 ENVIRONMENTAL SCIENCES↗

Proton Beam Therapy and Accountable Care: The Challenges Ahead

Purpose: Proton beam therapy (PBT) centers have drawn increasing public scrutiny for their high cost. The behavior of such facilities is likely to change under the Affordable Care Act. We modeled how accountable care reform may affect the financial standing of PBT centers and their incentives to treat complex patient cases. Methods and Materials: We used operational data and publicly listed Medicare rates to model the relationship between financial metrics for PBT center performance and case mix (defined as the percentage of complex cases, such as pediatric central nervous system tumors). Financial metrics included total daily revenues and debt coverage (daily revenues − daily debt payments). Fee-for-service (FFS) and accountable care (ACO) reimbursement scenarios were modeled. Sensitivity analyses were performed around the room time required to treat noncomplex cases: simple (30 minutes), prostate (24 minutes), and short prostate (15 minutes). Sensitivity analyses were also performed for total machine operating time (14, 16, and 18 h/d). Results: Reimbursement under ACOs could reduce daily revenues in PBT centers by up to 32%. The incremental revenue gained by replacing 1 complex case with noncomplex cases was lowest for simple cases and highest for short prostate cases. ACO rates reduced this incremental incentive by 53.2% for simple cases and 41.7% for short prostate cases. To cover daily debt payments after ACO rates were imposed, 26% fewer complex patients were allowable at varying capital costs and interest rates. Only facilities with total machine operating times of 18 hours per day would cover debt payments in all scenarios. Conclusions: Debt-financed PBT centers will face steep challenges to remain financially viable after ACO implementation. Paradoxically, reduced reimbursement for noncomplex cases will require PBT centers to treat more such cases over cases for which PBT has demonstrated superior outcomes. Relative losses will be highest for those facilities focused primarily on treating noncomplex cases.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Terrestrial case studies of ilmenite exploration and lunar implications

The Space Exploration Initiative (SEI) includes space resource utilization as one of the four architectures to achieve U.S. goals in space. Space resource utilization will make use of lunar resources to support long term activities on the lunar surface. Lunar ilmenite and regolith are two of the materials that can be mined and processed for lunar oxygen production. During this investigation, several sources were reviewed to assess terrestrial exploration methods used for locating ilmenite resources. These sources included published reports on terrestrial ilmenite exploration methods, analytical methods, case histories, chemical and physical properties, and associations with other minerals. Using a terrestrial analog and considering the differences between terrestrial and lunar environmental conditions, rocks, and minerals, exploration methods and analytical instruments can be recommended for a lunar orbiter and lander for assessing lunar resources. Twelve terrestrial case histories were reviewed to gain insight into ilmenite exploration on the Moon. All exploration case histories follow the same pattern. They begin with a model, use remote geophysical techniques, define regional sampling sites from the model and geophysics, narrow down the area of exploration based on the preceding work, collect more samples and cores, and perform laboratory analyses of samples. An important part of this process is the collection of samples to determine the correctness of the model. Surface and core samples are collected in areas expected to contain both high and low concentration of the commodity to test the model. After samples are analyzed and the area of mineralization is defined, reserves are calculated to determine the cost/benefit ratio, the necessary capacity of the processing plant, and the life of the mine. The exploration methods used for locating terrestrial ilmenite resources are reviewed with respect to the petrology, chemistry, and mineral associations of the terrestrial and lunar environments.

Feldman, S. C.↗

Combining Emergent Constraints for Climate Sensitivity

A method is proposed for combining information from several emergent constraints into a probabilistic estimate for a climate sensitivity proxy Y such as equilibrium climate sensitivity (ECS). The method is based on fitting a multivariate Gaussian PDF for Y and the emergent constraints using an ensemble of global climate models (GCMs); it can be viewed as a form of multiple linear regression of Y on the constraints. The method accounts for uncertainties in sampling this multidimensional PDF with a small number of models, for observational uncertainties in the constraints, and for overconfidence about the correlation of the constraints with the climate sensitivity. Its general form (Method C) accounts for correlations between the constraints. Method C becomes less robust when some constraints are too strongly related to each other; this can be mitigated using regularization approaches such as ridge regression. An illuminating special case, Method U, neglects any correlations between constraints except through their mutual relationship to the climate proxy; it is more robust to small GCM sample size and is appealingly interpretable. These methods are applied to ECS and the climate feedback parameter using a previously published set of 11 possible emergent constraints derived from climate models in the Coupled Model Intercomparison Project (CMIP). The ±2σ posterior range of ECS for Method C with no overconfidence adjustment is 4.3 ± 0.7 K. For Method U with a large overconfidence adjustment, it is 4.0 ± 1.3 K. This study adds confidence to past findings that most constraints predict higher climate sensitivity than the CMIP mean.

54 ENVIRONMENTAL SCIENCES↗

Comparative Analysis of Soft-Error Detection Strategies: A Case Study with Iterative Methods

Undetected soft errors caused by transient bit flips can lead to silent data corruption (SDC), an undesirable outcome where invalid results pass for valid ones. This has motivated the design of soft error detectors to minimize SDCs. However, the detectors have been studied under different contexts, making comparative evaluation difficult. In this paper, we present the first comprehensive evaluation of four online soft error detection techniques in detecting the adverse impact of soft errors on iterative methods. We observe that, across five iterative methods, the detectors studied achieve high but not perfect detection rates. To understand the potential for improved detection, we evaluate a machine-learning based detector that takes as features that are the runtime features observed by the individual detectors to arrive at their conclusions. Our evaluation demonstrates improved but still far from perfect detection accuracy for the machine learning based detectors. This extensive evaluation demonstrates the need for designing error detectors to handle the evolutionary behavior exhibited by iterative solvers.

Silent data corruption, Soft error detection, Iter↗

Treatment planning for radiotherapy with very high-energy electron beams and comparison of VHEE and VMAT plans

Purpose: The aim of this work was to develop a treatment planning workflow for rapid radiotherapy delivered with very high-energy electron (VHEE) scanning pencil beams of 60–120 MeV and to study VHEE plans as a function of VHEE treatment parameters. Additionally, VHEE plans were compared to clinical state-of-the-art volumetric modulated arc therapy (VMAT) photon plans for three cases. Methods: VHEE radiotherapy treatment planning was performed by linking EGSnrc Monte Carlo (MC) dose calculations with inverse treatment planning in a research version of RayStation. In order to study the effect of VHEE treatment parameters on VHEE dose distributions, a MATLAB graphical user interface (GUI) for calculation of VHEE MC pencil beam doses was developed. Through the GUI, pediatric case MC simulations were run for a number of beam energies (60, 80, 100, and 120 MeV), number of beams (13, 17, and 36), pencil beam spot (0.1, 1.0, and 3.0 mm) and grid (2.0, 2.5, and 3.5 mm) sizes, and source-to-axis distance, SAD (40 and 50 cm). VHEE plans for the pediatric case calculated with the different treatment parameters were optimized and compared. Furthermore, 100 MeV VHEE plans for the pediatric case, a lung, and a prostate case were calculated and compared to the clinically delivered VMAT plans. All plans were normalized such that the 100% isodose line covered 95% of the target volume. Results: VHEE beam energy had the largest effect on the quality of dose distributions of the pediatric case. For the same target dose, the mean doses to organs at risk (OARs) decreased by 5%–16% when planned with 100 MeV compared to 60 MeV, but there was no further improvement in the 120 MeV plan. VHEE plans calculated with 36 beams outperformed plans calculated with 13 and 17 beams, but to a more modest degree (<8%). While pencil beam spacing and SAD had a small effect on VHEE dose distributions, 0.1–3 mm pencil beam sizes resulted in identical dose distributions. For the 100 MeV VHEE pediatric plan, OAR doses were up to 70% lower and the integral dose was 33% lower for VHEE compared to 6 MV VMAT. Additionally, VHEE conformity indices (CI{sub 100} = 1.09 and CI{sub 50} = 4.07) were better than VMAT conformity indices (CI{sub 100} = 1.30 and CI{sub 50} = 6.81). The 100 MeV VHEE lung plan resulted in mean dose decrease to all OARs by up to 27% for the same target coverage compared to the clinical 6 MV flattening filter-free (FFF) VMAT plan. The 100 MeV prostate plan resulted in 3% mean dose increase to the penile bulb and the urethra, but all other OAR mean doses were lower compared to the 15 MV VMAT plan. The lung case CI{sub 100} and CI{sub 50} conformity indices were 3% and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. The prostate case CI{sub 100} and CI{sub 50} conformity indices were 1% higher and 8% lower, respectively, in the VHEE plan compared to the VMAT plan. Conclusions: The authors have developed a treatment planning workflow for MC dose calculation of pencil beams and optimization for treatment planning of VHEE radiotherapy. The authors have demonstrated that VHEE plans resulted in similar or superior dose distributions for pediatric, lung, and prostate cases compared to clinical VMAT plans.

60 APPLIED LIFE SCIENCES↗

On the analysis of signal peaks in pulse-height spectra

The estimation of the signal location and intensity of a peak in a pulse height spectrum is important for X- ray and γ-ray spectroscopy, charged-particle spectrometry, liquid chromatography, and many other subfields. However, both the ‘‘centroid’’ and ‘‘signal intensity’’ of a peak in a pulse-height spectrum are ill-defined quantities and different methods of analysis will yield different numerical results. Here, we apply three methods of analysis. Method A is based on simple count summation and is likely the technique most frequently applied in practice. The analysis is straightforward and fast, and does not involve any statistical modeling. We find that it provides reliable results only for high signal-to-noise data, but has severe limitations in all other cases. Method B employs a Bayesian model to extract signal counts and centroid from the measured total and background counts. The resulting values are derived from the respective posteriors and, therefore, have a rigorous statistical meaning. The method makes no assumptions about the peak shape. It yields reliable and relatively small centroid uncertainties. However, it provides relatively large signal count uncertainties. Method C makes a strong assumption regarding the peak shape by fitting a Gaussian function to the data. Furthermore, the fit is based again on a Bayesian model. Although Method C requires careful consideration of the Gaussian width (usually given by the detector resolution) used in the fitting, it provides reliable values and relatively small uncertainties both for the signal counts and the centroid.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

MO-H-19A-01: FEATURED PRESENTATION - Treatment Planning Tool for Radiotherapy with Very High-Energy Electron Beams

Purpose: To develop a tool for treatment planning optimization for fast radiotherapy delivered with very high-energy electron beams (VHEE) and to compare VHEE plans to state-of-the-art plans for challenging pelvis and H'N cases. Methods: Treatment planning for radiotherapy delivered with VHEE scanning pencil beams was performed by integrating EGSnrc Monte Carlo (MC) dose calculations with spot scanning optimization run in a research version of RayStation. A Matlab GUI for MC beamlet generation was developed, in which treatment parameters such as the pencil beam size and spacing, energy and number of beams can be selected. Treatment planning study for H'N and pelvis cases was performed and the effect of treatment parameters on the delivered dose distributions was evaluated and compared to the clinical treatment plans. The pelvis case with a 691cm3 PTV was treated with 2-arc 15MV VMAT and the H'N case with four PTVs with total volume of 531cm3 was treated with 4-arc 6MV VMAT. Results: Most studied VHEE plans outperformed VMAT plans. The best pelvis 80MeV VHEE plan with 25 beams resulted in 12% body dose sparing and 8% sparing to the bowel and right femur compared to the VMAT plan. The 100MeV plan was superior to the 150MeV plan. Mixing 100 and 150MeV improved dose sparing to the bladder by 7% compared to either plan. Plans with 16 and 36 beams did not significantly affect the dose distributions compared to 25 beam plans. The best H'N 100MeV VHEE plan decreased mean doses to the brainstem, chiasm, and both globes by 10-42% compared to the VMAT plan. Conclusion: The pelvis and H'N cases suggested that sixteen 100MeV beams might be sufficient specifications of a novel VHEE treatment machine. However, optimum machine parameters will be determined with the presented VHEE treatment-planning tool for a large number of clinical cases. BW Loo and P Maxim received research support from RaySearch Laboratories. E Hynning and B Hardemark are employees of RaySearch Laboratories.

60 APPLIED LIFE SCIENCES↗

Root Cause Analysis of Gastroduodenal Ulceration After Yttrium-90 Radioembolization

Introduction: A root cause analysis was performed on the occurrence of gastroduodenal ulceration after hepatic radioembolization (RE). We aimed to identify the risk factors in the treated population and to determine the specific mechanism of nontarget RE in individual cases. Methods: The records of 247 consecutive patients treated with yttrium-90 RE for primary (n = 90) or metastatic (n = 157) liver cancer using either resin (n = 181) or glass (n = 66) microspheres were reviewed. All patients who developed a biopsy-proven microsphere-induced gastroduodenal ulcer were identified. Univariate and multivariate analyses were performed on baseline parameters and procedural data to determine possible risk factors in the total population. Individual cases were analyzed to ascertain the specific cause, including identification of the culprit vessel(s) leading to extrahepatic deposition of the microspheres. Results: Eight patients (3.2 %) developed a gastroduodenal ulcer. Stasis during injection was the strongest independent risk factor (p = 0.004), followed by distal origin of the gastroduodenal artery (p = 0.004), young age (p = 0.040), and proximal injection of the microspheres (p = 0.043). Prolonged administrations, pain during administration, whole liver treatment, and use of resin microspheres also showed interrelated trends in multivariate analysis. Retrospective review of intraprocedural and postprocedural imaging showed a probable or possible culprit vessel, each a tiny complex collateral vessel, in seven patients. Conclusion: Proximal administrations and those resulting in stasis of flow presented increased risk for gastroduodenal ulceration. Patients who had undergone bevacizumab therapy were at high risk for developing stasis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

On the Use of Quartic Force Fields in Variational Calculations

The use of quartic force fields (QFFs) has been shown to be one of the most effective ways to efficiently compute vibrational frequencies for small molecules. In this paper we outline and discuss how the simple-internal or bond-length bond-angle (BLBA) coordinates can be transformed into Morse-cosine(-sine) coordinates which produce potential energy surfaces from QFFs that possess proper limiting behavior and can effectively describe the vibrational (or rovibrational) energy levels of an arbitrary molecular system. We investigate parameter scaling in the Morse coordinate, symmetry considerations, and examples of transformed QFFs making use of the MULTIMODE, TROVE, and VTET variational vibrational methods. Cases are referenced where variational computations coupled with transformed QFFs produce accuracies compared to experiment for fundamental frequencies on the order of 5 cm(exp −1) and often as good as 1 cm(exp −1).

quartic force field↗