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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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All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Investigation of the effects of cell model and subcellular location of gold nanoparticles on nuclear dose enhancement factors using Monte Carlo simulation

Purpose: The authors’ aims were to model how various factors influence radiation dose enhancement by gold nanoparticles (AuNPs) and to propose a new modeling approach to the dose enhancement factor (DEF).Methods: The authors used Monte Carlo N-particle (MCNP 5) computer code to simulate photon and electron transport in cells. The authors modeled human breast cancer cells as a single cell, a monolayer, or a cluster of cells. Different numbers of 5, 30, or 50 nm AuNPs were placed in the extracellular space, on the cell surface, in the cytoplasm, or in the nucleus. Photon sources examined in the simulation included nine monoenergetic x-rays (10–100 keV), an x-ray beam (100 kVp), and {sup 125}I and {sup 103}Pd brachytherapy seeds. Both nuclear and cellular dose enhancement factors (NDEFs, CDEFs) were calculated. The ability of these metrics to predict the experimental DEF based on the clonogenic survival of MDA-MB-361 human breast cancer cells exposed to AuNPs and x-rays were compared.Results: NDEFs show a strong dependence on photon energies with peaks at 15, 30/40, and 90 keV. Cell model and subcellular location of AuNPs influence the peak position and value of NDEF. NDEFs decrease in the order of AuNPs in the nucleus, cytoplasm, cell membrane, and extracellular space. NDEFs also decrease in the order of AuNPs in a cell cluster, monolayer, and single cell if the photon energy is larger than 20 keV. NDEFs depend linearly on the number of AuNPs per cell. Similar trends were observed for CDEFs. NDEFs using the monolayer cell model were more predictive than either single cell or cluster cell models of the DEFs experimentally derived from the clonogenic survival of cells cultured as a monolayer. The amount of AuNPs required to double the prescribed dose in terms of mg Au/g tissue decreases as the size of AuNPs increases, especially when AuNPs are in the nucleus and the cytoplasm. For 40 keV x-rays and a cluster of cells, to double the prescribed x-ray dose (NDEF = 2) using 30 nm AuNPs, would require 5.1 ± 0.2, 9 ± 1, 10 ± 1, 10 ± 1 mg Au/g tissue in the nucleus, in the cytoplasm, on the cell surface, or in the extracellular space, respectively. Using 50 nm AuNPs, the required amount decreases to 3.1 ± 0.3, 8 ± 1, 9 ± 1, 9 ± 1 mg Au/g tissue, respectively.Conclusions: NDEF is a new metric that can predict the radiation enhancement of AuNPs for various experimental conditions. Cell model, the subcellular location and size of AuNPs, and the number of AuNPs per cell, as well as the x-ray photon energy all have effects on NDEFs. Larger AuNPs in the nucleus of cluster cells exposed to x-rays of 15 or 40 keV maximize NDEFs.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

TU-CD-207-08: Intrinsic Image Quality Comparison of Synthesized 2-D and FFDM Images

Purpose: With the combined interest of managing patient dose, maintaining or improving image quality, and maintaining or improving the diagnostic utility of mammographic data, this study aims to compare the intrinsic image quality of Hologic’s synthesized 2-D (C-View) and 2-D FFDM images in terms of resolution, contrast, and noise. Methods: This study utilized a novel 3-D printed anthropomorphic breast phantom in addition to the American College of Radiology (ACR) mammography accreditation phantom. Analysis of the 3-D anthropomorphic phantom included visual assessment of resolution and analysis of the normalized noise power spectrum. Analysis of the ACR phantom included both visual inspection and objective automated analysis using in-house software. The software incorporates image- and object-specific CNR visibility thresholds which account for image characteristics such as noise texture which affect object visualization. T- test statistical analysis was also performed on ACR phantom scores. Results: The spatial resolution of C-View images is markedly lower (at least 50% worse) than that of FFDM. And while this is generally associated with the benefit of reduced relative noise magnitude, the noise in C-View images tends to have a more mottled (predominantly low-frequency) texture. In general, for high contrast objects, C-View provides superior visualization over FFDM; however this benefit diminishes for low contrast objects and is applicable only to objects that are sufficiently larger than the spatial resolution threshold. Based on both observer and automated ACR phantom analysis, between 50–70% of C-View images failed to meet ACR minimum accreditation requirements – primarily due to insufficient (unbroken) fiber visibility. Conclusion: Compared to FFDM, C-View offers better depiction of objects of certain size and contrast, but provides poorer overall resolution and noise properties. Based on these findings, the utilization of C-View images in the clinical setting requires careful consideration, especially if considering the discontinuation of FFDM imaging.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-A-19A-05: Modeling Physics Properties and Biologic Effects Induced by Proton and Helium Ions

Purpose: Currently, proton and carbon ions are used for cancer treatment. More recently, other light ions including helium ions have shown interesting physical and biological properties. The purpose of this work is to study the biological and physical properties of helium ions (He-3) in comparison to protons. Methods: Monte Carlo simulations with FLUKA, GEANT4 and MCNPX were used to calculate proton and He-3 dose distributions in water phantoms. The energy spectra of proton and He-3 beams were calculated with high resolution for use in biological models. The repair-misrepairfixation (RMF) model was subsequently used to calculate the RBE. Results: The proton Bragg curve calculations show good agreement between the three general purpose Monte Carlo codes. In contrast, the He-3 Bragg curve calculations show disagreement (for the magnitude of the Bragg peak) between FLUKA and the other two Monte Carlo codes. The differences in the magnitude of the Bragg peak are mainly due to the discrepancy in the secondary fragmentation cross sections used by the codes. The RBE for V79 cell lines is about 0.96 and 0.98 at the entrance of proton and He-3 ions depth dose respectively. The RBE increases to 1.06 and 1.59 at the Bragg peak of proton and He-3 ions. The results demonstrated that LET, microdosimetric parameters (such as dose-mean lineal energy) and RBE are nearly constant along the plateau region of Bragg curve, while all parameters increase within the Bragg peak and at the distal edge for both proton and He-3 ions. Conclusion: The Monte Carlo codes should revise the fragmentation cross sections to more accurately simulate the physical properties of He-3 ions. The increase in RBE for He-3 ions is higher than for proton beams at the Bragg peak.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

Percutaneous Bone Biopsies: Comparison between Flat-Panel Cone-Beam CT and CT-Scan Guidance

PurposeThis study was designed to compare the accuracy of targeting and the radiation dose of bone biopsies performed either under fluoroscopic guidance using a cone-beam CT with real-time 3D image fusion software (FP-CBCT-guidance) or under conventional computed tomography guidance (CT-guidance).MethodsSixty-eight consecutive patients with a bone lesion were prospectively included. The bone biopsies were scheduled under FP-CBCT-guidance or under CT-guidance according to operating room availability. Thirty-four patients underwent a bone biopsy under FP-CBCT and 34 under CT-guidance. We prospectively compared the two guidance modalities for their technical success, accuracy, puncture time, and pathological success rate. Patient and physician radiation doses also were compared.ResultsAll biopsies were technically successful, with both guidance modalities. Accuracy was significantly better using FP-CBCT-guidance (3 and 5 mm respectively: p = 0.003). There was no significant difference in puncture time (32 and 31 min respectively, p = 0.51) nor in pathological results (88 and 88 % of pathological success respectively, p = 1). Patient radiation doses were significantly lower with FP-CBCT (45 vs. 136 mSv, p < 0.0001). The percentage of operators who received a dose higher than 0.001 mSv (dosimeter detection dose threshold) was lower with FP-CBCT than CT-guidance (27 vs. 59 %, p = 0.01).ConclusionsFP-CBCT-guidance for bone biopsy is accurate and reduces patient and operator radiation doses compared with CT-guidance.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

Use of Receiver Operating Curve Analysis and Machine Learning With an Independent Dose Calculation System Reduces the Number of Physical Dose Measurements Required for Patient-Specific Quality Assurance

Our purpose was to assess the use of machine learning methods and Mobius 3D (M3D) dose calculation software to reduce the number of physical ion chamber (IC) dose measurements required for patient-specific quality assurance during corona virus disease 2019.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Clinical implementation of total skin electron irradiation treatment with a 6 MeV electron beam in high-dose total skin electron mode

Total skin electron irradiation (TSEI) is a special treatment technique offered by modern radiation oncology facilities, given for the treatment of mycosis fungoides, a rare skin disease, which is type of cutaneous T-cell lymphoma [1]. During treatment the patient’s entire skin is irradiated with a uniform dose. The aim of this work is to present implementation of total skin electron irradiation treatment using IAEA TRS-398 code of practice for absolute dosimetry and taking advantage of the use of radiochromic films.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Shielded radiography with a laser-driven MeV-energy X-ray source

We report the results of experimental and numerical-simulation studies of shielded radiography using narrowband MeV-energy X-rays from a compact all-laser-driven inverse-Compton-scattering X-ray light source. This recently developed X-ray light source is based on a laser-wakefield accelerator with ultra-high-field gradient (GeV/cm). We demonstrate experimentally high-quality radiographic imaging (image contrast of 0.4 and signal-to-noise ratio of 2:1) of a target composed of 8-mm thick depleted uranium shielded by 80-mm thick steel, using a 6-MeV X-ray beam with a spread of 45% (FWHM) and 10 7 photons in a single shot. The corresponding dose of the X-ray pulse measured in front of the target is ~100 nGy/pulse. Simulations performed using the Monte-Carlo code MCNPX accurately reproduce the experimental results. These simulations also demonstrate that the narrow bandwidth of the Compton X-ray source operating at 6 and 9 MeV leads to a reduction of deposited dose as compared to broadband bremsstrahlung sources with the same end-point energy. The X-ray beam’s inherently low-divergence angle (~mrad) is advantageous and effective for interrogation at standoff distance. Furthermore, these results demonstrate significant benefits of all-laser driven Compton X-rays for shielded radiography.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2015

SU-E-T-536: LINAC-Based Single Isocenter Frameless SRT for Brain Metastases

Purpose: Single-isocenter Stereotactic Radiotherapy of multiple brain metastases with Varian 21 IX LINAC, using Aktina Pinpoint system for patient setup. Methods: In 2014, five single-isocenter RapidArc SRT plans were delivered to five patients with 2 to 8 brain metastases using Varian 21 IX. Aktina Pinpoint system was used for setup and 2mm PTV margin were used. CBCT was acquired before and after the beam delivery. The prescription is 2100 cGy in 3 fractions. Eclipse planning system was used for treatment planning. Depending on the number of metastases and their locations, 1 to 5 coplanar or non coplanar arcs were used. Typically, 2 or 3 arcs are used. IMRT QAs were performed by comparing an A1SL ion chamber point dose measurement in solid water phantom to point dose of the plan; also, based on EPID measurement, 3D spatial dose was calculated using DosimetryCheck software package from MathResolutions Inc. The EPID system has an active area of 40cm by 30cm with 1024 by 768 photodiodes, which corresponds to a resolution of 0.4mm by 0.4mm pixel dimension. Results: for all the plans, at least 95% PTV coverage was achieved for full prescription dose, with plan normalization > 75%. RTOG conformity indices are less than 1.1 and Paddick gradient indices are less than 4.5. The distance from prescription IDL to 50% IDL increases as the number of metastases increases, and it ranges from 0.6mm to 0.8mm. Treatment time varies from 10mins to 30mins, depending on the number of arcs and if the arcs are coplanar. IMRT QA shows that the ion chamber measurement agree with the eclipse calculation within 3%, and 95% of the points passed Gamma, using 3% dose difference and 3mm DTA Conclusion: High quality single isocenter RapidArc SRT plan can be optimized and accurately delivered using Eclipse and Varian 21IX.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2025

Simulation of the radiological impact during selected space travel scenarios using the Monte Carlo code FLUKA

Radiation is one of the major challenges of space exploration and can negatively impact both biological and electronic systems, particularly in the case of long-term journeys or if the spaceship features inadequate shielding. Here, in this work, the cumulative dose levels from prompt radiation in the spacecraft are quantified alongside the residual dose contributions arising from activation of vessel components. The radiological impact was assessed for various space exploration scenarios, considering the same spaceship model featuring three shielding design variants. In each scenario, the radiation environment was generated with the Monte Carlo particle transport and interaction code FLUKA. These results can be used to quantify the contribution of prompt and residual dose in spacefaring ventures and help determine optimal radiation shielding needed to mitigate the overall radiological impact on both astronauts and equipment.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2013

Accuracy of pencil-beam redefinition algorithm dose calculations in patient-like cylindrical phantoms for bolus electron conformal therapy

Purpose: The purpose of this study was to document the improved accuracy of the pencil beam redefinition algorithm (PBRA) compared to the pencil beam algorithm (PBA) for bolus electron conformal therapy using cylindrical patient phantoms based on patient computed tomography (CT) scans of retromolar trigone and nose cancer.Methods: PBRA and PBA electron dose calculations were compared with measured dose in retromolar trigone and nose phantoms both with and without bolus. For the bolus treatment plans, a radiation oncologist outlined a planning target volume (PTV) on the central axis slice of the CT scan for each phantom. A bolus was designed using the planning.decimal{sup Registered-Sign} (p.d) software (.decimal, Inc., Sanford, FL) to conform the 90% dose line to the distal surface of the PTV. Dose measurements were taken with thermoluminescent dosimeters placed into predrilled holes. The Pinnacle{sup 3} (Philips Healthcare, Andover, MD) treatment planning system was used to calculate PBA dose distributions. The PBRA dose distributions were calculated with an in-house C++ program. In order to accurately account for the phantom materials a table correlating CT number to relative electron stopping and scattering powers was compiled and used for both PBA and PBRA dose calculations. Accuracy was determined by comparing differences in measured and calculated dose, as well as distance to agreement for each measurement point.Results: The measured doses had an average precision of 0.9%. For the retromolar trigone phantom, the PBRA dose calculations had an average {+-}1{sigma} dose difference (calculated - measured) of -0.65%{+-} 1.62% without the bolus and -0.20%{+-} 1.54% with the bolus. The PBA dose calculation had an average dose difference of 0.19%{+-} 3.27% without the bolus and -0.05%{+-} 3.14% with the bolus. For the nose phantom, the PBRA dose calculations had an average dose difference of 0.50%{+-} 3.06% without bolus and -0.18%{+-} 1.22% with the bolus. The PBA dose calculations had an average dose difference of 0.65%{+-} 6.21% without bolus and 1.75%{+-} 5.94% with the bolus. From a clinical perspective an agreement of 5% or better between planned (calculated) and delivered (measured) dose is desired. Statistically, this was true for 99% ({+-}2{sigma}) of the dose points for three of the four cases for the PBRA dose calculations, the exception being the nose without bolus for which this was true for 89% ({+-}1.6{sigma}) of the dose points. For the retromolar trigone, with and without bolus, the PBA showed agreement of 5% or better for approximately 86% ({+-}1.5{sigma}) of the dose points. For the nose, with and without bolus, the PBA showed agreement of 5% or better for only approximately 58% ({+-}0.8{sigma}) of the dose points.Conclusions: The measured data, whose high precision makes them useful for evaluation of the accuracy of electron dose algorithms, will be made publicly available. Based on the spread in dose differences, the PBRA has at least twice the accuracy of the PBA. From a clinical perspective the PBRA accuracy is acceptable in the retromolar trigone and nose for electron therapy with and without bolus.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-564: 3 Year Experience of Treatment Plan QualityAssurance for Vero SBRT Patients

Purpose: To verify treatment plan monitor units from iPlan treatment planning system for Vero Stereotactic Body Radiotherapy (SBRT) treatment using both software-based and (homogeneous and heterogeneous) phantom-based approaches. Methods: Dynamic conformal arcs (DCA) were used for SBRT treatment of oligometastasis patients using Vero linear accelerator. For each plan, Monte Carlo calculated treatment plans MU (prescribed dose to water with 1% variance) is verified first by RadCalc software with 3% difference threshold. Beyond 3% differences, treatment plans were copied onto (homogeneous) Scanditronix phantom for non-lung patients and copied onto (heterogeneous) CIRS phantom for lung patients and the corresponding plan dose was measured using a cc01 ion chamber. The difference between the planed and measured dose was recorded. For the past 3 years, we have treated 180 patients with 315 targets. Out of these patients, 99 targets treatment plan RadCalc calculation exceeded 3% threshold and phantom based measurements were performed with 26 plans using Scanditronix phantom and 73 plans using CIRS phantom. Mean and standard deviation of the dose differences were obtained and presented. Results: For all patient RadCalc calculations, the mean dose difference is 0.76% with a standard deviation of 5.97%. For non-lung patient plan Scanditronix phantom measurements, the mean dose difference is 0.54% with standard deviation of 2.53%; for lung patient plan CIRS phantom measurements, the mean dose difference is −0.04% with a standard deviation of 1.09%; The maximum dose difference is 3.47% for Scanditronix phantom measurements and 3.08% for CIRS phantom measurements. Conclusion: Limitations in secondary MU check software lead to perceived large dose discrepancies for some of the lung patient SBRT treatment plans. Homogeneous and heterogeneous phantoms were used in plan quality assurance for non-lung patients and lung patients, respectively. Phantom based QA showed the relative good agreement between iPlan calculated dose and measured dose.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2003

A new dynamical atmospheric ionizing radiation (AIR) model for epidemiological studies

A new Atmospheric Ionizing Radiation (AIR) model is currently being developed for use in radiation dose evaluation in epidemiological studies targeted to atmospheric flight personnel such as civilian airlines crewmembers. The model will allow computing values for biologically relevant parameters, e.g. dose equivalent and effective dose, for individual flights from 1945. Each flight is described by its actual three dimensional flight profile, i.e. geographic coordinates and altitudes varying with time. Solar modulated primary particles are filtered with a new analytical fully angular dependent geomagnetic cut off rigidity model, as a function of latitude, longitude, arrival direction, altitude and time. The particle transport results have been obtained with a technique based on the three-dimensional Monte Carlo transport code FLUKA, with a special procedure to deal with HZE particles. Particle fluxes are transformed into dose-related quantities and then integrated all along the flight path to obtain the overall flight dose. Preliminary validations of the particle transport technique using data from the AIR Project ER-2 flight campaign of measurements are encouraging. Future efforts will deal with modeling of the effects of the aircraft structure as well as inclusion of solar particle events. Published by Elsevier Ltd on behalf of COSPAR.

Aviation↗
DOE OSTI2014

SU-E-T-523: On the Radiobiological Impact of Lateral Scatter in Proton Beams

Introduction: In proton therapy, justified concern has been voiced with respect to an increased efficiency in cell kill at the distal end of the Bragg peak. This coupled with range uncertainty is a counter indication to use the Bragg peak to define the border of a treated volume with a critical organ. An alternative is to use the lateral edge of the proton beam, obtaining more robust plans. We investigate the spectral and biological effects of the lateral scatter . Methods: A general purpose Monte Carlo simulation engine (MCNPX 2.7c) installed on a Scientific Linux cluster, calculated the dose deposition spectrum of protons, knock on electrons and generated neutrons for a proton beam with maximal kinetic energy of 200MeV. Around the beam at different positions in the beam direction the spectrum is calculated in concentric rings of thickness 1cm. The deposited dose is converted to a double strand break map using an analytical expression.based on micro dosimetric calculations using a phenomenological Monte Carlo code (MCDS). A strict version of RBE is defined as the ratio of generation of double strand breaks in the different modalities. To generate the reference a Varian linac was modelled in MCNPX and the generated electron dose deposition spectrum was used . Results: On a pristine point source 200MeV beam the RBE before the Bragg peak was of the order of 1.1, increasing to 1.7 right behind the Bragg peak. When using a physically more realistic beam of 10cm diameter the effect was smaller. Both the lateral dose and RBE increased with increasing beam depth, generating a dose deposition with mixed biological effect. Conclusions: The dose deposition in proton beams need to be carefully examined because the biological effect will be different depending on the treatment geometry. Deeply penetrating proton beams generate more biologically effective lateral scatter.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2026

A Streamlined, Open Source Neutronics Toolkit for Fusion Reactor Design (Final Report)

Final report for the DOE Fusion Energy Sciences project titled "A Streamlined, Open Source Neutronics Toolkit for Fusion Reactor Design". This project developed unstructured mesh tracking capabilities in OpenMC as well as two shutdown dose rate methodologies, and performed extensive performance improvements and validation of the open source Monte Carlo code, OpenMC.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗
DOE OSTI2016

SU-F-T-155: Validation of a Commercial Monte Carlo Dose Calculation Algorithm for Proton Therapy

Purpose: Compare proton pencil beam scanning dose measurements to GATE/GEANT4 (GMC) and RayStation™ Monte Carlo (RMC) simulations. Methods: Proton pencil beam models of the IBA gantry at the Seattle Proton Therapy Center were developed in the GMC code system and a research build of the RMC. For RMC, a preliminary beam model that does not account for upstream halo was used. Depth dose and lateral profiles are compared for the RMC, GMC and a RayStation™ pencil beam dose (RPB) model for three spread out Bragg peaks (SOBPs) in homogenous water phantom. SOBP comparisons were also made among the three models for a phantom with a (i) 2 cm bone and a (ii) 0.5 cm titanium insert. Results: Measurements and GMC estimates of R80 range agree to within 1 mm, and the mean point-to-point dose difference is within 1.2% for all integrated depth dose (IDD) profiles. The dose differences at the peak are 1 to 2%. All of the simulated spot sigmas are within 0.15 mm of the measured values. For the three SOBPs considered, the maximum R80 deviation from measurement for GMC was −0.35 mm, RMC 0.5 mm, and RPB −0.1 mm. The minimum gamma pass using the 3%/3mm criterion for all the profiles was 94%. The dose comparison for heterogeneous inserts in low dose gradient regions showed dose differences greater than 10% at the distal edge of interface between RPB and GMC. The RMC showed improvement and agreed with GMC to within 7%. Conclusion: The RPB dosimetry show clinically significant differences (> 10%) from GMC and RMC estimates. The RMC algorithm is superior to the RPB dosimetry in heterogeneous media. We suspect modelling of the beam’s halo may be responsible for a portion of the remaining discrepancy and that RayStation will reduce this discrepancy as they finalize the release. Erik Traneus is employed as a Research Scientist at RaySearch Laboratories. The research build of the RayStation TPS used in the study was made available to the SCCA free of charge. RaySearch did not provide any monetary support other than a license to use the research build of the TPS.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Monte Carlo Simulation On X-Ray Produced At High Intensity Laser Facilities - Paper 20

With the rapid development of laser technology, a number of high intensity laser devices are emerging in the world. At the same time, the ionizing radiation hazard produced from the interaction between high intensity laser and solid target has gradually been observed. Because Laser-plasma interactions can accelerate electrons to high energies (10's to 1000's of keV). These hot electrons subsequently interact with ions in the target and generate Bremsstrahlung X-rays, which become an ionizing radiation source. Measurements show that significant amounts of radiation can be generated from this ionizing radiation source at high intensity laser facilities. However, very limited studies have been made on the laser-induced ionizing radiation hazard and the protection issues. In this paper, a X-ray dose calculation model was developed and X-ray dose produced in the interaction between high intensity laser and solid target was studied by simulation using Monte Carlo code. (authors)

42 ENGINEERING↗
DOE OSTI2015

WE-AB-201-00: Treatment Planning System Commissioning and QA

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in terms of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG # 5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-516: Effects of Inter-Fraction Organ Displacement/deformation On the Delivered Doses to the Heart, Esophagus, and Lungs in Patients Receiving Thoracic Radiotherapy

Purpose: To quantitatively assess the effects of inter-fraction changes in organ shape and location on the delivered dose distribution to the organs at risk (OAR) in lung cancer patients. Methods: This study analyzes treatment data of 10 patients, who were treated to 60Gy in 30 fractions. In each fraction a cone beam CT (CBCT) was acquired. Each CBCT was registered with the planning CT using deformable registration tools within MIM Software. The daily setup shifts were used to translate the planned dose distribution on the deformed planning CT. The structures of lungs, esophagus and heart were re-delineated by a physician on each CBCT. The doses delivered to each OAR, reflecting changes in the position and shape variations, were recomputed. Resultant daily dose volume histograms (DVHs) for OARs were computed and compared to those from the planning CT. Results: Based on the findings of two patients and 24 CBCTs analyzed so far, higher doses are delivered to the lungs and esophagus compared to the treatment plan. The dose differences per fraction between the delivered doses and those in the treatment plan are: for patient 1, lung mean dose = 5.3±1.3cGy and esophagus mean dose = 3.4±3.5cGy. For patient 2, lung mean dose = 12.0±3.9cGy and esophagus mean dose = 34.2±7.5cGy. Regarding the maximum dose to heart, the results varied (−18.9±22.0cGy for patient1 and 53.0±62.2cGy for patient2). Conclusion: The dosimetric effects of inter-fractional anatomical variations could be estimated using deformable image registration and manual organ segmentation for each CBCT. A considerable dose distribution variation between fractions was observed for the OARs. These changes are currently not taken into account while treating the patients and these may explain cases with severe side effects even when the treatment plan looks satisfactory. These results suggest the need for automated daily dose tracking and accumulation.

60 APPLIED LIFE SCIENCES↗