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NASA NTRS2023

A General Procedure to Formulate 3D Elements for Finite Element Applications

This paper presents a general procedure to formulate and implement 3D elements of arbitrary order in meshes with multiple element types. This procedure includes obtaining shape functions and integration quadrature and establishing an approach for checking the generated element’s compatibility with adjacent elements’ surfaces. This procedure was implemented in Matlab, using its symbolic and graphics toolbox, and complied as a GUI interface named ShapeGen3D to provide finite element users with a tool to tailor elements according to their analysis needs. ShapeGen3D also outputs files with the element formulation needed to enable users to implement the generated elements in other programming languages or through user elements in commercial finite element software. Currently, finite element (FE) users are limited to employing element formulation available in the literature, commercial software, or existing element libraries. Thus, the developed procedure implemented in ShapeGen3D offers FEM users the possibility to employ elements beyond those readily available. The procedure was tested by generating the formulation for a brick element, a brick transition element, and higher-order hexahedron and tetrahedron elements that can be used in a spectral finite element analysis. The formulation obtained for the 20-node element was in perfect agreement with the formulation available in the literature. In addition, the results showed that the interpolation condition was met for all the generated elements, which provides confidence in the implementation of the process. Researchers and educators can use this procedure to efficiently develop and illustrate three-dimensional elements.

higher-order elements↗
DOE OSTI2016

Computer Based Procedures for Field Workers - FY16 Research Activities

The Computer-Based Procedure (CBP) research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. One of the primary missions of the LWRS program is to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. One area that could yield tremendous savings in increased efficiency and safety is in improving procedure use. A CBP provides the opportunity to incorporate context-driven job aids, such as drawings, photos, and just-in-time training. The presentation of information in CBPs can be much more flexible and tailored to the task, actual plant condition, and operation mode. The dynamic presentation of the procedure will guide the user down the path of relevant steps, thus minimizing time spent by the field worker to evaluate plant conditions and decisions related to the applicability of each step. This dynamic presentation of the procedure also minimizes the risk of conducting steps out of order and/or incorrectly assessed applicability of steps. This report provides a summary of the main research activities conducted in the Computer-Based Procedures for Field Workers effort since 2012. The main focus of the report is on the research activities conducted in fiscal year 2016. The activities discussed are the Nuclear Electronic Work Packages – Enterprise Requirements initiative, the development of a design guidance for CBPs (which compiles all insights gained through the years of CBP research), the facilitation of vendor studies at the Idaho National Laboratory (INL) Advanced Test Reactor (ATR), a pilot study for how to enhance the plant design modification work process, the collection of feedback from a field evaluation study at Plant Vogtle, and path forward to commercialize INL’s CBP system.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗
NASA NTRS2017

Designing Flightdeck Procedures: Literature Resources

This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.

flightdeck↗
NASA NTRS2017

Evaluation of Approval Request/Call for Release Coordination Procedures for Charlotte Douglas International Airport

NASA is collaborating with the Federal Aviation Administration (FAA) and aviation industry partners to develop and demonstrate new concepts and technologies for Integrated Arrival, Departure, and Surface (IADS) traffic management capabilities under the Airspace Technology Demonstration 2 (ATD-2) project. One of the goals of the IADS capabilities in the ATD-2 project is to increase predictability and throughput of airspace operations by improving Traffic Management Initiative (TMI) compliance. This paper focuses on the Approval Request (APREQ) procedures developed for the ATD-2 project between the Air Traffic Control (ATC) Tower at Charlotte Douglas International Airport and Washington Center. In March 2017, NASA conducted a Human-in-the-Loop (HITL) simulation to evaluate the operational procedures and information requirements for the APREQ procedures in the ATD-2 IADS system between ATC Tower and Center. The findings from the HITL are used to compare ATD-2 APREQ procedures with information about current day APREQ procedures.

APREQ↗
NASA NTRS2018

Tactical Surface Metering Procedures for Charlotte Douglas International Airport

NASA has been collaborating with the Federal Aviation Administration (FAA) and aviation industry partners to develop and demonstrate new concepts and technologies for the Integrated Arrival, Departure, and Surface (IADS) traffic management capabilities under the Airspace Technology Demonstration 2 (ATD-2) project. The primary goal of the ATD-2 project is to improve the predictability and the operational efficiency of the air traffic system in metroplex environments while maintaining or improving throughput by enhancing and integrating arrival, departure and surface prediction, scheduling, and management systems. In the Phase 1 Baseline IADS Demonstration, the tactical surface scheduling capability and the user interfaces for ramp controllers and ramp traffic managers were implemented for ramp operations. The purpose of the tactical surface scheduling capability is to provide the airline ramp controller with aircraft pushback advisories that prevent surface congestion and to respond to surface and airspace constraints that become known over relatively short time horizons. For this purpose, the tactical surface metering tool first estimates the capacity of current and near-future runway resources from flight schedule and surveillance data. With demand forecasts and predicted taxi trajectories, this tool computes an efficient runway schedule of aircraft in the planning horizon based on their readiness, Earliest Off-Block Times (EOBTs), and a ration by schedule (RBS) rule. Details on the implementation of the Tactical Surface Metering tool will be provided in the full paper. Both pushback and recommended hold times advisories provided by this surface metering tool are shown on the user interfaces for the ramp controller and the ramp traffic manager, called Ramp Traffic Console (RTC) and Ramp Manager Traffic Console (RMTC), respectively. There is excess queue time in the system due to demand capacity imbalance, this time can be taken as a hold on the runway queue or at the gate and was referred to as the Metering Value. This metering value can be adjusted by the Ramp Manager in collaboration with Air Traffic Controller-Tower Traffic Management Coordinator (TMC). They selected a set of metering values as default values for the tool during human-in-the-loop simulation. As the metering value increases, there is a decrease in the gate hold and increase in the queue time at the runway. Procedures and Information needs related to managing the surface metering procedures were researched in the simulated environment. These procedures will be compared to the procedures adopted at Charlotte Douglas International Airport when the tools were deployed and adopted in November 2017 for one departure push bank per day. Feedback regarding initial issues, information needs such as the need to see EOBTs on the flight data tags and how they compare to scheduled times will also be discussed in the full paper. Initial results will be provided regarding the choice of the metering value and how it was adjusted on a daily basis and what procedures evolved will also be presented in the paper.

surface metering↗
NASA NTRSDate not supplied

DO 365 Test Procedure Results and Analysis Discussion

CAL will leverage M&S tools and existing encounter data to evaluate the robustness of the DAA MOPS Test Procedures. Recently, the SC-147 ACAS-Xu team performed an analysis evaluating the Xu implementation against the DAA MOPS test procedures. Several areas of non-compliance were raised, some indicating shortfalls in our DAA test procedures and/or requirements. The ACAS-Xu team is expected to put out a report highlighting these exemptions. This work will build off that ACAS-Xu analysis/report and perform a full characterization of the statistical test procedures and document the findings. Additionally, CAL will provide recommendations for addressing these findings, potentially resulting in changes to test procedures and/or requirements.

ACAS-Xu↗
DOE OSTI2017

SUPPORTING THE INDUSTRY BY DEVELOPING A DESIGN GUIDANCE FOR COMPUTER-BASED PROCEDURES FOR FIELD WORKERS

The paper-based procedures currently used for nearly all activities in the commercial nuclear power industry have a long history of ensuring safe operation of the plants. However, there is potential to greatly increase efficiency and safety by improving how the human interacts with the procedures, which can be achieved through the use of computer-based procedures (CBPs). A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools and dynamic step presentation. As a step toward the goal of improving procedure use performance, the U.S. Department of Energy Light Water Reactor Sustainability Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with CBPs. The main purpose of the CBP research conducted at the Idaho National Laboratory was to provide design guidance to the nuclear industry to be used by both utilities and vendors. After studying existing design guidance for CBP systems, the researchers concluded that the majority of the existing guidance is intended for control room CBP systems, and does not necessarily address the challenges of designing CBP systems for instructions carried out in the field. Further, the guidance is often presented on a high level, which leaves the designer to interpret what is meant by the guidance and how to specifically implement it. The authors developed a design guidance to provide guidance specifically tailored to instructions that are carried out in the field based.

47 OTHER INSTRUMENTATION↗
DOE OSTI2025

Computer-Based Procedures Among Older Adults: Findings from the Rancor Microworld Simulator

As with many industries worldwide, nuclear energy is experiencing an aging workforce; older than other energy sources and the national average. For example, while almost one in three nuclear industry professionals are 55+ years, for oil and gas that number is one in five. The challenges brought about by an aging workforce are one of the industry’s top concerns. However, the industry lacks for empirical research that examines the effects of developmental aging in older workers, as well as the interactions between aging and new digital technologies. We present the results of an experiment that tested three different computer-based procedures in a sample of 30 older adults (55+ years). While the industry has traditionally relied on paper-based procedures, these are being modernized by digital technology. Participants were randomly assigned to one of three procedure-types that varied by the level of digitalization, based on the IEEE Standard-1786. Type 1 essentially represents a digital representation of a paper-based procedure, Type 2 adds embedded indicators, and Type 3 adds soft controls. Participants performed two different operational scenarios (startup and loss of feedwater) on a simplified nuclear power plant simulator. Results revealed a weak signal that Type 2 may produce lower workload and lower completion times in some instances. However, there were no significant effects of procedure-type across any other outcomes, including simulator log data, situation awareness, and preference ratings. We discuss our findings in terms of optimal levels of digitalization/automation for an aging nuclear workforce and suggest pathways for future directions.

46 - INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AN↗
DOE OSTI2015

Impact of 3D Rotational Angiography on Liver Embolization Procedures: Review of Technique and Applications

In the last years, the interest into interventional applications of C-arm cone-beam CT (CBCT) progressively raised, widening its clinical application from the original field of interventional neuroradiology to the field of peripheral procedures. Liver embolization procedures, due to their complexity and potential treatment-related life-threatening complications, represent one of the main clinical applications of this novel angiographic technique. CBCT has been demonstrated to render procedures safer and technically easier, and to predict outcome as well as to avoid major complications in different treatment scenarios (trans-arterial embolization, trans-arterial chemoembolization, selective internal radiation therapy, percutaneous portal vein embolization). This review summarizes all technical, dosimetric and procedural aspects of CBCT techniques, underlying all its potential clinical advantages in the field of liver embolization procedures. Moreover, the paper provides all the instructions to obtain the best diagnostic performance out of this novel angiographic technique.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2025

An efficient second-order adaptive procedure for inserting CAD geometries into hexahedral meshes using volume fractions

Here, this paper is concerned with inserting three-dimensional computer-aided design (CAD) geometries into meshes composed of hexahedral elements using a volume fraction representation. An adaptive procedure for doing so is presented. The procedure consists of two steps. The first step performs spatial acceleration using a k-d tree. The second step involves subdividing individual hexahedra in an adaptive mesh refinement (AMR)-like fashion and approximating the CAD geometry linearly (as a plane) at the finest subdivision. The procedure requires only two geometric queries from a CAD kernel: determining whether or not a queried spatial coordinate is inside or outside the CAD geometry and determining the closest point on the CAD geometry’s surface from a given spatial coordinate. We prove that the procedure is second-order accurate for sufficiently smooth geometries and sufficiently refined background meshes. We demonstrate the expected order of accuracy is achieved with several verification tests and illustrate the procedure’s effectiveness for several exemplar CAD geometries.

Adaptive↗
DOE OSTI2013

The Residual Setup Errors of Different IGRT Alignment Procedures for Head and Neck IMRT and the Resulting Dosimetric Impact

Purpose: To assess residual setup errors during head and neck radiation therapy and the resulting consequences for the delivered dose for various patient alignment procedures. Methods and Materials: Megavoltage cone beam computed tomography (MVCBCT) scans from 11 head and neck patients who underwent intensity modulated radiation therapy were used to assess setup errors. Each MVCBCT scan was registered to its reference planning kVCT, with seven different alignment procedures: automatic alignment and manual registration to 6 separate bony landmarks (sphenoid, left/right maxillary sinuses, mandible, cervical 1 [C1]-C2, and C7-thoracic 1 [T1] vertebrae). Shifts in the different alignments were compared with each other to determine whether there were any statistically significant differences. Then, the dose distribution was recalculated on 3 MVCBCT images per patient for every alignment procedure. The resulting dose-volume histograms for targets and organs at risk (OARs) were compared to those from the planning kVCTs. Results: The registration procedures produced statistically significant global differences in patient alignment and actual dose distribution, calling for a need for standardization of patient positioning. Vertically, the automatic, sphenoid, and maxillary sinuses alignments mainly generated posterior shifts and resulted in mean increases in maximal dose to OARs of >3% of the planned dose. The suggested choice of C1-C2 as a reference landmark appears valid, combining both OAR sparing and target coverage. Assuming this choice, relevant margins to apply around volumes of interest at the time of planning to take into account for the relative mobility of other regions are discussed. Conclusions: Use of different alignment procedures for treating head and neck patients produced variations in patient setup and dose distribution. With concern for standardizing practice, C1-C2 reference alignment with relevant margins around planning volumes seems to be a valid option.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Retrospective review of Contura HDR breast cases to improve our standardized procedure

To retrospectively review our first 20 Contura high dose rate breast cases to improve and refine our standardized procedure and checklists. We prepared in advance checklists for all steps, developed an in-house Excel spreadsheet for second checking the plan, and generated a procedure for efficient contouring and a set of optimization constraints to meet the dose volume histogram criteria. Templates were created in our treatment planning system for structures, isodose levels, optimization constraints, and plan report. This study reviews our first 20 high dose rate Contura breast treatment plans. We followed our standardized procedure for contouring, planning, and second checking. The established dose volume histogram criteria were successfully met for all plans. For the cases studied here, the balloon-skin and balloon-ribs distances ranged between 5 and 43 mm and 1 and 33 mm, respectively; air{sub s}eroma volume/PTV{sub E}val volume≤5.5% (allowed≤10%); asymmetry<1.2 mm (goal≤2 mm); PTV{sub E}val V90%≥97.6%; PTV{sub E}val V95%≥94.9%; skin max dose≤98%Rx; ribs max dose≤137%Rx; V150%≤29.8 cc; V200%≤7.8 cc; the total dwell time range was 225.4 to 401.9 seconds; and the second check agreement was within 3%. Based on this analysis, more appropriate ranges for the total dwell time and balloon diameter tolerance were found. Three major problems were encountered: balloon migration toward the skin for small balloon-to-skin distances, lumen obstruction, and length change for the flexible balloon. Solutions were found for these issues and our standardized procedure and checklists were updated accordingly. Based on our review of these cases, the use of checklists resulted in consistent results, indicating good coverage for the target without sacrificing the critical structures. This review helped us to refine our standardized procedure and update our checklists.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

SU-E-J-204: Radiation Dose to Patients Resulting From Image Guidance Procedures and AAPM TG-180 Update

Purpose: Image-guided radiation therapy (IGRT) is the new paradigm for patient positioning and target localization in radiotherapy. Daily imaging procedures add additional dose to the patient's treatment volume and normal tissues and may expose the organs at risk to unaccounted doses. This presentation is to update the progress of AAPM TG-180 which aims to provide strategies to quantify and account the dose from both MV and kV imaging in patient treatment planning. Methods: Our current knowledge on image guidance dose is presented. A summary of doses from image guidance procedures delivered to patients in relationship with therapeutic doses is given. Different techniques in reducing the image guidance dose are summarized. Typical organ doses resulting from different image acquisition procedures used in IGRT are tabulated. Results: Many techniques to reduce the imaging doses are available in clinical applications. There are large variations between dose to bone and dose to soft tissues for x-rays at kilovoltage energy range. Methods for clinical implementation of accounting for the imaging dose from an imaging procedure are available. Beam data from imaging systems can be generated by combining Monte Carlo simulations and experimental measurements for commissioning imaging beams in the treatment planning. Conclusion: The current treatment planning systems are not yet equipped to perform patient specific dose calculations resulting from kV imaging procedures. The imaging dose from current kV image devices has been significantly reduced and is generally much less than that resulting from MV. Because the magnitude of kV imaging dose is significantly low and the variation between patients is modest, it is feasible to estimate dose based on imaging producers or protocols using tabulated values which provides an alternative to accomplish the task of accounting and reporting imaging doses.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-BRB-07: Developing a QA Procedure for Gated VMAT SABR Treatments Using 10 MV Beam in Flattening-Filter Free Mode

Purpose: To develop a QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. Methods: An interface was constructed to attach the translational stage of a Quasar respiratory motion phantom to a pinpoint ion chamber insert and move the ion chamber inside an ArcCheck diode array. The Quasar phantom controller used a patient specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. An amplitude-based RPM tracking system was specified to turn the beam on during the exhale phase of the breathing pattern. SABR plans were developed using Eclipse for liver PTVs ranging in size from 3-12 cm in diameter using a 2-arc VMAT technique. Dose was measured in the middle of the penumbra region, where the high dose gradient allowed for sensitive detection of any inaccuracies in gated dose delivery. The overall fidelity of the dose distribution was confirmed using ArcCheck. The sensitivity of the gating QA procedure was investigated with respect to the following four parameters: PTV size, duration of exhale, baseline drift, and gating window size. Results: The difference between the measured dose to a point in the penumbra and the Eclipse calculated dose was under 2% for small residual motions. The QA procedure was independent of PTV size and duration of exhale. Baseline drift and gating window size, however, significantly affected the penumbral dose measurement, with differences of up to 30% compared to Eclipse. Conclusion: This study described a highly sensitive QA procedure for gated VMAT SABR treatments. The QA outcome was dependent on the gating window size and baseline drift. Analysis of additional patient breathing patterns will be required to determine a clinically relevant gating window size and an appropriate tolerance level for this procedure.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-D-209-05: Automatic Calculation of Organ and Effective Dose for CBCT and Interventional Fluoroscopic Procedures

Purpose: To compare PCXMC and EGSnrc calculated organ and effective radiation doses from cone-beam computed tomography (CBCT) and interventional fluoroscopically-guided procedures using automatic exposure-event grouping. Methods: For CBCT, we used PCXMC20Rotation.exe to automatically calculate the doses and compared the results to those calculated using EGSnrc with the Zubal patient phantom. For interventional procedures, we use the dose tracking system (DTS) which we previously developed to produce a log file of all geometry and exposure parameters for every x-ray pulse during a procedure, and the data in the log file is input into PCXMC and EGSnrc for dose calculation. A MATLAB program reads data from the log files and groups similar exposures to reduce calculation time. The definition files are then automatically generated in the format used by PCXMC and EGSnrc. Processing is done at the end of the procedure after all exposures are completed. Results: For the Toshiba Infinix CBCT LCI-Middle-Abdominal protocol, most organ doses calculated with PCXMC20Rotation closely matched those calculated with EGSnrc. The effective doses were 33.77 mSv with PCXMC20Rotation and 32.46 mSv with EGSnrc. For a simulated interventional cardiac procedure, similar close agreement in organ dose was obtained between the two codes; the effective doses were 12.02 mSv with PCXMC and 11.35 mSv with EGSnrc. The calculations can be completed on a PC without manual intervention in less than 15 minutes with PCXMC and in about 10 hours with EGSnrc, depending on the level of data grouping and accuracy desired. Conclusion: Effective dose and most organ doses in CBCT and interventional radiology calculated by PCXMC closely match those calculated by EGSnrc. Data grouping, which can be done automatically, makes the calculation time with PCXMC on a standard PC acceptable. This capability expands the dose information that can be provided by the DTS. Partial support from NIH Grant R01-EB002873 and Toshiba Medical Systems Corp.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-FG-201-12: Designing a Risk-Based Quality Assurance Program for a Newly Implemented Y-90 Microspheres Procedure

Purpose: To create a quality assurance program based upon a risk-based assessment of a newly implemented SirSpheres Y-90 procedure. Methods: A process map was created for a newly implemented SirSpheres procedure at a community hospital. The process map documented each step of this collaborative procedure, as well as the roles and responsibilities of each member. From the process map, different potential failure modes were determined as well as any current controls in place. From this list, a full failure mode and effects analysis (FMEA) was performed by grading each failure mode’s likelihood of occurrence, likelihood of detection, and potential severity. These numbers were then multiplied to compute the risk priority number (RPN) for each potential failure mode. Failure modes were then ranked based on their RPN. Additional controls were then added, with failure modes corresponding to the highest RPNs taking priority. Results: A process map was created that succinctly outlined each step in the SirSpheres procedure in its current implementation. From this, 72 potential failure modes were identified and ranked according to their associated RPN. Quality assurance controls and safety barriers were then added for failure modes associated with the highest risk being addressed first. Conclusion: A quality assurance program was created from a risk-based assessment of the SirSpheres process. Process mapping and FMEA were effective in identifying potential high-risk failure modes for this new procedure, which were prioritized for new quality assurance controls. TG 100 recommends the fault tree analysis methodology to design a comprehensive and effective QC/QM program, yet we found that by simply introducing additional safety barriers to address high RPN failure modes makes the whole process simpler and safer.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Technical Note: Procedure for the calibration and validation of kilo-voltage cone-beam CT models

Purpose: The aim of this work is to propose a general and simple procedure for the calibration and validation of kilo-voltage cone-beam CT (kV CBCT) models against experimental data. Methods: The calibration and validation of the CT model is a two-step procedure: the source model then the detector model. The source is described by the direction dependent photon energy spectrum at each voltage while the detector is described by the pixel intensity value as a function of the direction and the energy of incident photons. The measurements for the source consist of a series of dose measurements in air performed at each voltage with varying filter thicknesses and materials in front of the x-ray tube. The measurements for the detector are acquisitions of projection images using the same filters and several tube voltages. The proposed procedure has been applied to calibrate and assess the accuracy of simple models of the source and the detector of three commercial kV CBCT units. If the CBCT system models had been calibrated differently, the current procedure would have been exclusively used to validate the models. Several high-purity attenuation filters of aluminum, copper, and silver combined with a dosimeter which is sensitive to the range of voltages of interest were used. A sensitivity analysis of the model has also been conducted for each parameter of the source and the detector models. Results: Average deviations between experimental and theoretical dose values are below 1.5% after calibration for the three x-ray sources. The predicted energy deposited in the detector agrees with experimental data within 4% for all imaging systems. Conclusions: The authors developed and applied an experimental procedure to calibrate and validate any model of the source and the detector of a CBCT unit. The present protocol has been successfully applied to three x-ray imaging systems. The minimum requirements in terms of material and equipment would make its implementation suitable in most clinical environments.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 06: Patient-specific QA Procedure for Gated VMAT SABR Treatments using 10x Beam in Flattening-Filter Free Mode

Purpose: To develop a highly sensitive patient specific QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. Methods: A platform was constructed to attach the translational stage of a Quasar respiratory motion phantom to a pinpoint ion chamber insert and move the ion chamber inside the ArcCheck. The Quasar phantom controller uses a patient-specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. With this system the ion chamber is used to QA the correct phase of the gated delivery and the ArcCheck diodes are used to QA the overall dose distribution. This novel approach requires a single plan delivery for a complete QA of a gated plan. The sensitivity of the gating QA procedure was investigated with respect to the following parameters: PTV size, exhale duration, baseline drift, gating window size. Results: The difference between the measured dose to a point in the penumbra and the Eclipse calculated dose was under 2% for small residual motions. The QA procedure was independent of PTV size and duration of exhale. Baseline drift and gating window size, however, significantly affected the penumbral dose measurement, with differences of up to 30% compared to Eclipse. Conclusion: This study described a highly sensitive QA procedure for gated VMAT SABR treatments. The QA outcome was dependent on the gating window size and baseline drift. Analysis of additional patient breathing patterns is currently undergoing to determine a clinically relevant gating window size and an appropriate tolerance level for this procedure.

60 APPLIED LIFE SCIENCES↗