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All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-T-443: Quantification of Dosimetric Effects of Dental Metallic Implant On VMAT Plans

Purpose: To evaluate the dosimetric impact of metallic implant that correlates with the size of targets and metallic implants and distance in between on volumetric-modulated arc therapy (VMAT) plans for head and neck (H&N) cancer patients with dental metallic implant. Methods: CT images of H&N cancer patients with dental metallic implant were used. Target volumes with different sizes and locations were contoured. Metal artifact regions excluding surrounding critical organs were outlined and assigned with CT numbers close to water (0HU). VMAT plans with half-arc, one-full-arc and two-full-arcs were constructed and same plans were applied to structure sets with and without CT number assignment of metal artifact regions and compared. D95% was utilized to investigate PTV dose coverage and SNC Patient− Software was used for the analysis of dose distribution difference slice by slice. Results: For different targets sizes, variation of PTV dose coverage (Delta-D95%) with and without CT number replacement reduced with larger target volume for all half-arc, one-arc and two-arc VMAT plans even though there were no clinically significant differences. Additionally, there were no significant variations of the maximum percent difference (max.%diff) of dose distribution. With regard to the target location, Delta-D95% and max. %diff dropped with increasing distance between target and metallic implant. Furthermore, half-arc plans showed greater impact than one-arc plans, and two-arc plans had smallest influence for PTV dose coverage and dose distribution. Conclusion: The target size has less correlation of doseimetric impact than the target location relative to metallic implants. Plans with more arcs alleviate the dosimetric effect of metal artifact because of less contribution to the target dose from beams going through the regions with metallic artifacts. Incorrect CT number causes inaccurate dose distribution, therefore appropriately overwriting metallic artifact regions with reasonable CT numbers is recommended. More patient data are collected and under further analysis.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

Accelerator shield design of KIPT neutron source facility

Argonne National Laboratory (ANL) of the United States and Kharkov Institute of Physics and Technology (KIPT) of Ukraine have been collaborating on the design development of a neutron source facility at KIPT utilizing an electron-accelerator-driven subcritical assembly. Electron beam power is 100 kW, using 100 MeV electrons. The facility is designed to perform basic and applied nuclear research, produce medical isotopes, and train young nuclear specialists. The biological shield of the accelerator building is designed to reduce the biological dose to less than 0.5-mrem/hr during operation. The main source of the biological dose is the photons and the neutrons generated by interactions of leaked electrons from the electron gun and accelerator sections with the surrounding concrete and accelerator materials. The Monte Carlo code MCNPX serves as the calculation tool for the shield design, due to its capability to transport electrons, photons, and neutrons coupled problems. The direct photon dose can be tallied by MCNPX calculation, starting with the leaked electrons. However, it is difficult to accurately tally the neutron dose directly from the leaked electrons. The neutron yield per electron from the interactions with the surrounding components is less than 0.01 neutron per electron. This causes difficulties for Monte Carlo analyses and consumes tremendous computation time for tallying with acceptable statistics the neutron dose outside the shield boundary. To avoid these difficulties, the SOURCE and TALLYX user subroutines of MCNPX were developed for the study. The generated neutrons are banked, together with all related parameters, for a subsequent MCNPX calculation to obtain the neutron and secondary photon doses. The weight windows variance reduction technique is utilized for both neutron and photon dose calculations. Two shielding materials, i.e., heavy concrete and ordinary concrete, were considered for the shield design. The main goal is to maintain the total dose outside the shield boundary at less than 0.5-mrem/hr. The shield configuration and parameters of the accelerator building have been determined and are presented in this paper. (authors)

43 PARTICLE ACCELERATORS↗
DOE OSTI2015

SU-E-T-345: Effect of DLG and MLC Transmission Value Set in the Treatment Planning System (TPS) On Dosimetric Accuracy of True Beam Hypofractionated SRT/SBRT and 2Gy/fx Prostate Rapid Arc Plans

Purpose: Due to limited commissioning time, we previously only released our True beam non-FFF mode for prostate treatment. Clinical demand now pushes us to release the non-FFF mode for SRT/SBRT treatment. When re-planning on True beam previously treated SRT/SBRT cases on iX machine we found the patient specific QA pass rate was worse than iX’s, though the 2Gy/fx prostate Result had been as good. We hypothesize that in TPS the True beam DLG and MLC transmission values, of those measured during commissioning could not yet provide accurate SRS/SBRT dosimetry. Hence this work is to investigate how the TPS DLG and transmission value affects Rapid Arc plans’ dosimetric accuracy. Methods: We increased DLG and transmission value of True beam in TPS such that their percentage differences against the measured matched those of iX’s. We re-calculated 2 SRT, 1 SBRT and 2 prostate plans, performed patient specific QA on these new plans and compared the results to the previous. Results: With DLG and transmission value set respectively 40 and 8% higher than the measured, the patient specific QA pass rate (at 3%/3mm) improved from 95.0 to 97.6% vs previous iX’s 97.8% in the case of SRT. In the case of SBRT, the pass rate improved from 75.2 to 93.9% vs previous iX’s 92.5%. In the case of prostate, the pass rate improved from 99.3 to 100%. The maximum dose difference in plans before and after adjusting DLG and transmission was approximately 1% of the prescription dose among all plans. Conclusion: The impact of adjusting DLG and transmission value on dosimetry might be the same among all Rapid Arc plans regardless hypofractionated or not. The large variation observed in patient specific QA pass rate might be due to the data analysis method in the QA software being more sensitive to hypofractionated plans.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2011

Dose response of alanine detectors irradiated with carbon ion beams

Purpose: The dose response of the alanine detector shows a dependence on particle energy and type when irradiated with ion beams. The purpose of this study is to investigate the response behavior of the alanine detector in clinical carbon ion beams and compare the results to model predictions. Methods: Alanine detectors have been irradiated with carbon ions with an energy range of 89-400 MeV/u. The relative effectiveness of alanine has been measured in this regime. Pristine and spread out Bragg peak depth-dose curves have been measured with alanine dosimeters. The track structure based alanine response model developed by Hansen and Olsen has been implemented in the Monte Carlo code FLUKA and calculations were compared to experimental results. Results: Calculations of the relative effectiveness deviate less than 5% from the measured values for monoenergetic beams. Measured depth-dose curves deviate from predictions in the peak region, most pronounced at the distal edge of the peak. Conclusions: The used model and its implementation show a good overall agreement for quasimonoenergetic measurements. Deviations in depth-dose measurements are mainly attributed to uncertainties of the detector geometry implemented in the Monte Carlo simulations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-32: Benchmarking Head CT Doses: A Pooled Vs. Protocol Specific Analysis of Radiation Doses in Adult Head CT Examinations

Purpose: The aim of this study was to collect CT dose index data from adult head exams to establish benchmarks based on either: (a) values pooled from all head exams or (b) values for specific protocols. One part of this was to investigate differences in scan frequency and CT dose index data for inpatients versus outpatients. Methods: We collected CT dose index data (CTDIvol) from adult head CT examinations performed at our medical facilities from Jan 1st to Dec 31th, 2014. Four of these scanners were used for inpatients, the other five were used for outpatients. All scanners used Tube Current Modulation. We used X-ray dose management software to mine dose index data and evaluate CTDIvol for 15807 inpatients and 4263 outpatients undergoing Routine Brain, Sinus, Facial/Mandible, Temporal Bone, CTA Brain and CTA Brain-Neck protocols, and combined across all protocols. Results: For inpatients, Routine Brain series represented 84% of total scans performed. For outpatients, Sinus scans represented the largest fraction (36%). The CTDIvol (mean ± SD) across all head protocols was 39 ± 30 mGy (min-max: 3.3–540 mGy). The CTDIvol for Routine Brain was 51 ± 6.2 mGy (min-max: 36–84 mGy). The values for Sinus were 24 ± 3.2 mGy (min-max: 13–44 mGy) and for Facial/Mandible were 22 ± 4.3 mGy (min-max: 14–46 mGy). The mean CTDIvol for inpatients and outpatients was similar across protocols with one exception (CTA Brain-Neck). Conclusion: There is substantial dose variation when results from all protocols are pooled together; this is primarily a function of the differences in technical factors of the protocols themselves. When protocols are analyzed separately, there is much less variability. While analyzing pooled data affords some utility, reviewing protocols segregated by clinical indication provides greater opportunity for optimization and establishing useful benchmarks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-268: A Feasibility Study of Independent Dose Verification for Vero4DRT

Purpose: Vero4DRT (Mitsubishi Heavy Industries Ltd.) has been released for a few years. The treatment planning system (TPS) of Vero4DRT is dedicated, so the measurement is the only method of dose verification. There have been no reports of independent dose verification using Clarksonbased algorithm for Vero4DRT. An independent dose verification software program of the general-purpose linac using a modified Clarkson-based algorithm was modified for Vero4DRT. In this study, we evaluated the accuracy of independent dose verification program and the feasibility of the secondary check for Vero4DRT. Methods: iPlan (Brainlab AG) was used as the TPS. PencilBeam Convolution was used for dose calculation algorithm of IMRT and X-ray Voxel Monte Carlo was used for the others. Simple MU Analysis (SMU, Triangle Products, Japan) was used as the independent dose verification software program in which CT-based dose calculation was performed using a modified Clarkson-based algorithm. In this study, 120 patients’ treatment plans were collected in our institute. The treatments were performed using the conventional irradiation for lung and prostate, SBRT for lung and Step and shoot IMRT for prostate. Comparison in dose between the TPS and the SMU was done and confidence limits (CLs, Mean ± 2SD %) were compared to those from the general-purpose linac. Results: As the results of the CLs, the conventional irradiation (lung, prostate), SBRT (lung) and IMRT (prostate) show 2.2 ± 3.5% (CL of the general-purpose linac: 2.4 ± 5.3%), 1.1 ± 1.7% (−0.3 ± 2.0%), 4.8 ± 3.7% (5.4 ± 5.3%) and −0.5 ± 2.5% (−0.1 ± 3.6%), respectively. The CLs for Vero4DRT show similar results to that for the general-purpose linac. Conclusion: The independent dose verification for the new linac is clinically available as a secondary check and we performed the check with the similar tolerance level of the general-purpose linac. This research is partially supported by Japan Agency for Medical Research and Development (AMED)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Comparison of the calculated absorbed dose using the Cadplan™ treatment planning software and Tld-100 measurements in an Alderson-Rando phantom for a bronchogenic treatment

To verify the accuracy of the absorbed doses D calculated by a TPS Cadplan for a bronchogenic treatment (in an Alderson-Rando phantom) are chosen ten points with the following D's and localizations. Point 1, posterior position on the left edge with 136.4 Gy. Points: 2, 3 and 4 in the left lung with 104.9, 104.3 and 105.8 Gy, respectively; points 5 and 6 at the mediastinum with 192.4 and 173.5 Gy; points 7, 8 and 9 in the right lung with 105.8, 104.2 and 104.7 Gy, and 10 at posterior position on right edge with 143.7 Gy. IAEA type capsules with TLD 100 powder are placed, planned and irradiated. The evaluation of the absorbed dose is carried out a curve of calibration for the LiF response (nC) {sup vs} {sup DW}, to several cavity theories. The traceability for the DW is obtained with a secondary standard calibrated at the NRC (Canada). The dosimetric properties for the materials considered are determined from the Hounsfield numbers reported by the TPS. The stopping power ratios are calculated for nominal spectrum to 6 MV photons. The percent variations among the planned and determined D in all the cases they are < ± 3%.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-I-66: Radiomics and Image Registration Updates for the Computational Environment for Radiotherapy Research (CERR)

Purpose: To present new tools in CERR for Radiomics, image registration and other software updates and additions. Methods: Radiomics: CERR supports generating 3-D texture metrics based on gray scale co-occurance. Two new ways to calculate texture features were added: (1) Local Texture Averaging: Local texture is calculated around a voxel within the userdefined bounding box. The final texture metrics are the average of local textures for all the voxels. This is useful to detect any local texture patterns within an image. (2) Image Smoothing: A convolution ball of user-defined radius is rolled over an image to smooth out artifacts. The texture metrics are then computed on the smooth image. Image Registration: (1) Support was added to import deformation vector fields as well as non-deformable transformation matrices generated by vendor software and stored in standard DICOM format. (2) Support was added to use image within masks while computing image deformations. CT to MR registration is supported. This registration uses morphological edge information within the images to guide the deformation process. In addition to these features, other noteworthy additions to CERR include (1) Irregularly shaped ROI: This is done by taking intersection between infinitely extended irregular polygons drawn on any of the two views. Such an ROI is more conformal and useful in avoiding any unwanted parts of images that cannot be avoided with the conventional cubic box. The ROI is useful to generate Radiomics metrics. (2) Ability to insert RTDOSE in DICOM format to existing CERR plans. (3) Ability to import multi-frame PET-CT and SPECT-CT while maintaining spatial registration between the two modalities. (4) Ability to compile CERR on Unix-like systems. Results: The new features and updates are available via https://www.github.com/adityaapte/cerr . Conclusion: Features added to CERR increase its utility in Radiomics, Image-Registration and Outcomes modeling.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

TU-F-CAMPUS-T-05: Replacement Computational Phantoms to Estimate Dose in Out-Of-Field Organs and Tissues

Purpose: To estimate the absorbed dose in organs and tissues at risk for radiogenic cancer for children receiving photon radiotherapy for localized brain tumors (LBTs) by supplementing their missing body anatomies with those of replacement computational phantoms. Applied beyond the extent of the RT Images collected by computed tomography simulation, these phantoms included RT Image and RT Structure Set objects that encompassed sufficient extents and contours for dosimetric calculations. Method: Nine children, aged 2 to 14 years, who received three-dimensional conformal radiotherapy for low-grade LBTs, were randomly selected for this study under Institutional-Review-Board protocol. Because the extents of their RT Images were cranial only, they were matched for size and sex with patients from a previous study with larger extents and for whom contours of organs at risk for radiogenic cancer had already been delineated. Rigid fusion was performed between the patients’ data and those of the replacement computational phantoms using commercial software. In-field dose was calculated with a clinically-commissioned treatment planning system, and out-of-field dose was estimated with an analytical model. Results: Averaged over all nine children and normalized for a therapeutic dose of 54 Gy prescribed to the PTV, where the PTV is the GTV, the highest mean organ doses were 3.27, 2.41, 1.07, 1.02, 0.24, and 0.24 Gy in the non-tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs, respectively. The mean organ doses ranged by a factor of 3 between the smallest and largest children. Conclusion: For children receiving photon radiotherapy for LBTs, we found their doses in organs at risk for second cancer to be non-negligible, especially in the non-tumor remainder, red bone marrow, thyroid, skin, breasts, and lungs. This study demonstrated the feasibility for patient dosimetry studies to augment missing patient anatomy by applying size- and sex-matched replacement computational phantoms with pre-contoured organs. Funding is in part by the Fogarty International Center award K01TW008409, and the Portland Chapter of the Achievement Rewards for College Scientists. The content is solely the responsibility of the authors, and does not necessarily represent the official views of the sponsors. The authors declare no conflict of interest.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2025

An Advanced Machine Learning and Artificial Intelligence System for Demonstrating Radiation Regulatory Compliance in DOE Accelerator Facilities

In this Phase II proposal, Applied Research LLC (ARLLC), Thomas Jefferson National Accelerator Facility (Jefferson Lab), and Old Dominion University (ODU) propose the combination of domain knowledge (beam characteristics, fixed structural shielding, earthen burden (the soil and foliage added to the dome of the experimental halls as additional shielding), etc.), machine learning (ML) and/or artificial intelligence (AI) to correlate a variety of multi-modal onsite signals and the radiation fields seen in accessible areas of the accelerator site and the site boundary. The ML/AI will consider the complex influence of environmental parameters affecting the radon contribution of the measurements, focusing on actual data obtained from Jefferson Lab. In Phase I, the coded beam and location data were fed into a deep learning model to predict doses at several designated locations in Jefferson Lab’s facility. Moreover, a dense radiation map was generated using only a sparse collection of the samples in a facility. In Phase II, we will develop a software prototype containing a radiation prediction algorithm, dense radiation map algorithms, and background noise prediction algorithms, with actual data used to evaluate the prototype. This work will provide a framework for evaluation of radiation measurement results around the site based on learned responses. In addition, the proposed approach allows more granular mapping of radiation levels. Better understanding and communication of these levels is related to the overall approach in keeping doses to personnel ALARA.

43 PARTICLE ACCELERATORS↗
NASA NTRS1993

Proton irradiation on materials

A computer code is developed by utilizing a radiation transport code developed at NASA Langley Research Center to study the proton radiation effects on materials which have potential application in NASA's future space missions. The code covers the proton energy from 0.01 Mev to 100 Gev and is sufficient for energetic protons encountered in both low earth and geosynchronous orbits. With some modification, the code can be extended for particles heavier than proton as the radiation source. The code is capable of calculating the range, stopping power, exit energy, energy deposition coefficients, dose, and cumulative dose along the path of the proton in a target material. The target material can be any combination of the elements with atomic number ranging from 1 to 92, or any compound with known chemical composition. The generated cross section for a material is stored and is reused in future to save computer time. This information can be utilized to calculate the proton dose a material would receive in an orbit when the radiation environment is known. It can also be used to determine, in the laboratory, the parameters such as beam current of proton and irradiation time to attain the desired dosage for accelerated ground testing of any material. It is hoped that the present work be extended to include polymeric and composite materials which are prime candidates for use as coating, electronic components, and structure building. It is also desirable to determine, for ground testing these materials, the laboratory parameters in order to simulate the dose they would receive in space environments. A sample print-out for water subject to 1.5 Mev proton is included as a reference.

Chang, C. Ken↗
NASA NTRS2009

A Monte-Carlo Model for the Formation of Radiation-induced Chromosomal Aberrations

Purpose: To simulate radiation-induced chromosome aberrations in mammalian cells (e.g., rings, translocations, and dicentrics) and to calculate their frequency distributions following exposure to DNA double strand breaks (DSBs) produced by high-LET ions. Methods: The interphase genome was assumed to be comprised of a collection of 2 kbp rigid-block monomers following the random-walk geometry. Additional details for the modeling of chromosomal structure, such as chromosomal domains and chromosomal loops, were included. A radial energy profile for heavy ion tracks was used to simulate the high-LET pattern of induced DSBs. The induced DSB pattern depended on the ion charge and kinetic energy, but always corresponded to the DSB yield of 25 DSBs/cell/Gy. The sum of all energy contributions from Poisson-distributed particle tracks was taken to account for all possible one-track and multi-track effects. The relevant output of the model was DNA fragments produced by DSBs. The DSBs, or breakpoints, were defined by (x, y, z, l) positions, where x, y, z were the Euclidian coordinates of a DSB, and where l was the relative position along the genome. Results: The code was used to carry out Monte Carlo simulations for DSB rejoinings at low doses. The resulting fragments were analyzed to estimate the frequencies of specific types of chromosomal aberrations. Histograms for relative frequencies of chromosomal aberrations and P.D.F.s (probability density functions) of a given aberration type were produced. The relative frequency of dicentrics to rings was compared to empirical data to calibrate rejoining probabilities. Of particular interest was the predicted distribution of ring sizes, irrespective of their frequencies relative to other aberrations. Simulated ring sizes were . 4 kbp, which are far too small to be observed experimentally (i.e., by microscopy) but which, nevertheless, are conjectured to exist. Other aberrations, for example, inversions, translocations, as well as multi-centrics were also recorded. Conclusion: High-LET DNA damage affects the frequencies of chromosomal aberrations. The ratio of rings to dicentrics is correct for the genomic size cut-offs corresponding to available experimental data. The present work predicts a relative abundance of small rings following irradiation by heavy ions.

Ponomarev, Artem L.↗
DOE OSTI2015

FPGA-based prototype of portable environmental radiation monitor

This new portable radiological environmental monitor consists of 2 main components, Gamma ionization chamber and a FPGA-based electronic enclosure linked to convivial software for treatment and analyzing. The HPIC ion chamber is the heart of this radiation measurement system and is running in range from 0 to 100 mR/h, so that the sensitivity at the output is 20 mV/μR/h, with a nearly flat energy response from 0,07 to 10 MEV. This paper presents a contribution for developing a new nuclear measurement data acquisition system based on Cyclone III FPGA Starter Kit ALTERA, and a user-friendly software to run real-time control and data processing. It was developed to substitute the older radiation monitor RSS-112 PIC installed in CNESTEN's Laboratory in order to improve some of its functionalities related to acquisition time and data memory capacity. As for the associated acquisition software, it was conceived under the virtual LabView platform from National Instrument, and offers a variety of system setup for radiation environmental monitoring. It gives choice to display both the statistical data and the dose rate. Statistical data shows a summary of current data, current time/date and dose integrator values, and the dose rate displays the current dose rate in large numbers for viewing from a distance as well as the date and time. The prototype version of this new instrument and its data processing software has been successfully tested and validated for viewing and monitoring the environmental radiation of Moroccan nuclear center. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2010

Shielding Studies for Superconducting RF Cavities at Fermilab

A semi-empirical method that allows us to predict intensity of generated field emission in superconducting RF cavities is described. Spatial, angular and energy distributions of the generated radiation are calculated with the FISHPACT code. The Monte Carlo code MARS15 is used for modeling the radiation transport in matter. A comparison with dose rate measurements performed in the Fermilab Vertical Test Facility for ILC-type cavities with accelerating gradients up to 35 MV/m is presented as well.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2015

MO-D-213-05: Sensitivity of Routine IMRT QA Metrics to Couch and Collimator Rotations

Purpose: To assess the sensitivity of gamma index and other IMRT QA metrics to couch and collimator rotations. Methods: Two brain IMRT plans with couch and/or collimator rotations in one or more of the fields were evaluated using the IBA MatriXX ion chamber array and its associated software (OmniPro-I’mRT). The plans were subjected to routine QA by 1) Creating a composite planar dose in the treatment planning system (TPS) with the couch/collimator rotations and 2) Creating the planar dose after “zeroing” the rotations. Plan deliveries to MatriXX were performed with all rotations set to zero on a Varian 21ex linear accelerator. This in effect created TPS-created planar doses with an induced rotation error. Point dose measurements for the delivered plans were also performed in a solid water phantom. Results: The IMRT QA of the plans with couch and collimator rotations showed clear discrepancies in the planar dose and 2D dose profile overlays. The gamma analysis, however, did pass with the criteria of 3%/3mm (for 95% of the points), albeit with a lower percentage pass rate, when one or two of the fields had a rotation. Similar results were obtained with tighter criteria of 2%/2mm. Other QA metrics such as percentage difference or distance-to-agreement (DTA) histograms produced similar results. The point dose measurements did not obviously indicate the error due to location of dose measurement (on the central axis) and the size of the ion chamber used (0.6 cc). Conclusion: Relying on Gamma analysis, percentage difference, or DTA to determine the passing of an IMRT QA may miss critical errors in the plan delivery due to couch/collimator rotations. A combination of analyses for composite QA plans, or per-beam analysis, would detect these errors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-P-35: A Multi-Institutional Plan Quality Checking Tool Built On Oncospace: A Shared Radiation Oncology Database System

Purpose: Late toxicity from radiation to critical structures limits the possible dose in Radiation Therapy. Perfectly conformal treatment of a target is not realizable, so the clinician must accept a certain level of collateral radiation to nearby OARs. But how much? General guidelines exist for healthy tissue sparing which guide RT treatment planning, but are these guidelines good enough to create the optimal plan given the individualized patient anatomy? We propose a means to evaluate the planned dose level to an OAR using a multi-institutional data-store of previously treated patients, so a clinician might reconsider planning objectives. Methods: The tool is built on Oncospace, a federated data-store system, which consists of planning data import, web based analysis tools, and a database containing:1) DVHs: dose by percent volume delivered to each ROI for each patient previously treated and included in the database.2) Overlap Volume Histograms (OVHs): Anatomical measure defined as the percent volume of an ROI within a given distance to target structures.Clinicians know what OARs are important to spare. For any ROI, Oncospace knows for which patients’ anatomy that ROI was harder to plan in the past (the OVH is less). The planned dose should be close to the least dose of previous patients. The tool displays the dose those OARs were subjected to, and the clinician can make a determination about the planning objectives used.Multiple institutions contribute to the Oncospace Consortium, and their DVH and OVH data are combined and color coded in the output. Results: The Oncospace website provides a plan quality display tool which identifies harder to treat patients, and graphically displays the dose delivered to them for comparison with the proposed plan. Conclusion: The Oncospace Consortium manages a data-store of previously treated patients which can be used for quality checking new plans. Grant funding by Elekta.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-33: Comparison Between Soft Tissue Alignment and Bony Alignment for Pancreatic Cancer Radiotherapy

Purpose An IGRT modality for pancreatic cancer treatment with dose escalation at our institution is in-room daily CT imaging. The purpose of this study is to assess the difference between soft tissue alignment and bony alignment for pancreatic tumor localization. Methods Eighteen patients with pancreatic tumors who underwent IMRT treatment with an inspiration breath-hold technique between July 2012 and February 2015 are included in this study. Prior to each treatment, a CT scan was acquired. The CT image guidance started with auto-alignment to either the bony anatomy (vertebral bodies) or fiducials (for the six patients with the stent in/near the tumor) and then, when necessary, manual adjustments were made based on soft tissue alignment using clinical software (CT-Assisted Targeting system). The difference between soft tissue alignment and bony/fiducial alignment was evaluated. Results Of all 380 treatments, manual adjustment was made in 225 treatments, ranging from 11% (3 treatments out of 28) to 96% (27 treatments out of 28) per patient. The mean of the difference between soft tissue alignment and bony/fiducial alignment per patient ranged from −3.6 to 0.3 mm, −1.5 to 2.8 mm, and −3.3 to 3.4 mm in the AP, SI, and RL directions, respectively. The maximum difference over all treatments was −9.5, −14.6, and −14.6 mm in the AP, SI, and RL directions, respectively. Conclusion About 60% of the time, manual adjustment based on soft tissue alignment was required. The extent of manual adjustment was usually small but varied significantly from patient to patient. The ultimate goal of the IGRT modality using daily CT imaging is not to fully cover the target but to spare organs-at-risk as much as possible to avoid them moving into higher dose gradients than accepted in the treatment plan. To this end, manual adjustment based on soft tissue alignment is critically important.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-502: Initial Results of a Comparison of Treatment Plans Produced From Automated Prioritized Planning Method and a Commercial Treatment Planning System

Purpose We developed an automated treatment planning system based on a hierarchical goal programming approach. To demonstrate the feasibility of our method, we report the comparison of prostate treatment plans produced from the automated treatment planning system with those produced by a commercial treatment planning system. Methods In our approach, we prioritized the goals of the optimization, and solved one goal at a time. The purpose of prioritization is to ensure that higher priority dose-volume planning goals are not sacrificed to improve lower priority goals. The algorithm has four steps. The first step optimizes dose to the target structures, while sparing key sensitive organs from radiation. In the second step, the algorithm finds the best beamlet weight to reduce toxicity risks to normal tissue while holding the objective function achieved in the first step as a constraint, with a small amount of allowed slip. Likewise, the third and fourth steps introduce lower priority normal tissue goals and beam smoothing. We compared with prostate treatment plans from Memorial Sloan Kettering Cancer Center developed using Eclipse, with a prescription dose of 72 Gy. A combination of liear, quadratic, and gEUD objective functions were used with a modified open source solver code (IPOPT). Results Initial plan results on 3 different cases show that the automated planning system is capable of competing or improving on expert-driven eclipse plans. Compared to the Eclipse planning system, the automated system produced up to 26% less mean dose to rectum and 24% less mean dose to bladder while having the same D95 (after matching) to the target. Conclusion We have demonstrated that Pareto optimal treatment plans can be generated automatically without a trial-and-error process. The solver finds an optimal plan for the given patient, as opposed to database-driven approaches that set parameters based on geometry and population modeling.

60 APPLIED LIFE SCIENCES↗