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DOE OSTI2015

TU-A-304-02: Treatment Simulation, Planning and Delivery for SBRT

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

TU-A-304-03: Quality Assurance, Safety, and Other Practical Aspects of SBRT

60 APPLIED LIFE SCIENCES↗

DOE OSTI2020

A large-scale, agent-based simulation of metropolitan freight movements with passenger and freight market interactions

This study summarizes the first stage in the implementation of an agent-based freight modeling system that has a global representation of agents and detailed modeling of a large-scale transportation network. The model is used to evaluate the transportation and energy impacts of goods movement across urban and national scales. The framework is implemented within POLARIS, a C++-based Planning and Operations Language for Agent-based Regional Integrated Simulation, which consists of an activity-based modeling (ABM) and dynamic traffic assignment (DTA) system that has robust features for passenger travel. This platform provides a tool to model interactions among consumers, producers, and the transportation system. The main objective of this initial implementation is to implement a freight model within POLARIS following an agent-based paradigm with behavioral and simulation methods. This paper presents the initial framework and illustrates the application of the model. Building upon earlier works, a parcel location assignment algorithm for business establishments in the population is documented, along with a method for estimating establishment production and consumption volumes. In addition to population generation, other features of the model include push-pull supply chains, multimodal path choice, choice of transportation logistics node, and dynamic traffic assignment. A module with e-commerce supply and demand was also developed to analyze the effects of e-commerce delivery on last-mile energy use and congestion.

agent-based freight↗

DOE OSTI2016

Upgrade Your Work Plans for Better Performance - 16103

Most work plans involve at least two basic pieces: a list of things to do and a timeline for doing them. These 'tasks-and-times' plans can be used for managing a project, an organizational change, or the implementation of a strategic objective. But given the high rate of plan failures - often cited as ranging from 35% to over 80% - something must be missing. Three ideas for upgrading work plans have demonstrated higher success rates than the time-and-task method alone. First, maintain a 'GPS Scorecard' of the Goals, Performance metrics, and Schedules for accomplishment. Second, maintain a Performance Circle Register of all key players, and the key deliverables to and from each of them, that will ensure success. Third, implement all three parts of an accountability management system, collectively referred to as 'T3': Tracking, Team assignments, and Talk-times to update status and progress against the plan. Why bother to take the extra steps to strengthen work plans? There are three reasons: (a) Because traveling without a map is risky in times of high change in infrastructure, staffing, and technology; (b) Because 'expectations' do not guarantee delivery as reliably as well-defined agreements; and (c) Because 'accountability' is a management practice, not a personality trait. Together, implementing these three ideas can provide for clarity of purpose, guidance in establishing the productive relationships necessary for success, and a system of supporting accountability for all participants, both on the team and with others inside and outside of the organization. (authors)

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2016

SU-F-T-359: Incorporating Dose Volume Histogram Prediction Into Auto-Planning for Volumetric-Modulated Arc Therapy in Rectal Cancer

Purpose: To incorporate dose volume histogram (DVH) prediction into Auto-Planning for volumetric-modulated arc therapy (VMAT) treatment planning and investigate the benefit of this new technique for rectal cancer. Methods: Ninety clinically accepted VMAT plans for patients with rectal cancer were selected and trained in the RapidPlan for DVH prediction. Both internal and external validations were performed before implementing the prediction model. A new VMAT planning method (hybrid-VMAT) was created with combining the DVH prediction and Auto-Planning. For each new patient, the DVH will be predicted and individual DVH constrains will be obtained and were exported as the original optimization parameters to the Auto-Planning (Pinnacle3 treatment planning system, v9.10) for planning. A total of 20 rectal cancer patients previously treated with manual VMAT (manual-VMAT) plans were replanned using this new method. Dosimetric comparisons were performed between manual VMAT and new method plans. Results: Hybrid-VMAT shows similar PTV coverage to manual-VMAT in D2%, D98% and HI (p>0.05) and superior coverage in CI (p=0.000). For the bladder, the means of V40 and mean dose are 36.0% and 35.6Gy for hybrid-VMAT and 42% and 38.0Gy for the manual-VMAT. For the left (right) femur, the means of V30 and mean dose are 10.6% (11.6%) and 17.9Gy (19.2Gy) for the hybrid-VMAT and 25.6% (24.1%) and 27.3Gy (26.2Gy) for the manual-VMAT. The hybrid-VMAT has significantly improved the organs at risk sparing. Conclusion: The integration of DVH prediction and Auto-Planning significantly improve the VMAT plan quality in the rectal cancer radiotherapy. Our results show the benefit of the new method and will be further investigated in other tumor sites.

60 APPLIED LIFE SCIENCES↗

NASA NTRS2004

EUROPA2: Plan Database Services for Planning and Scheduling Applications

NASA missions require solving a wide variety of planning and scheduling problems with temporal constraints; simple resources such as robotic arms, communications antennae and cameras; complex replenishable resources such as memory, power and fuel; and complex constraints on geometry, heat and lighting angles. Planners and schedulers that solve these problems are used in ground tools as well as onboard systems. The diversity of planning problems and applications of planners and schedulers precludes a one-size fits all solution. However, many of the underlying technologies are common across planning domains and applications. We describe CAPR, a formalism for planning that is general enough to cover a wide variety of planning and scheduling domains of interest to NASA. We then describe EUROPA(sub 2), a software framework implementing CAPR. EUROPA(sub 2) provides efficient, customizable Plan Database Services that enable the integration of CAPR into a wide variety of applications. We describe the design of EUROPA(sub 2) from the perspective of both modeling, customization and application integration to different classes of NASA missions.

Bedrax-Weiss, Tania↗

DOE OSTI2023

FERC Order No. 2222 and Considerations for Distributed Wind

The Federal Energy Regulatory Commission (FERC) issued Order No. 2222 in October 2020. The rule directs Regional Transmission Organizations and Independent System Operators (ISOs) to amend their tariffs and participation models to accommodate heterogeneous distributed energy resource (DER) aggregations in the wholesale energy markets that they operate, including capacity, energy, and ancillary service markets. The Commission issued the rule to better capture the benefits provided by DERs deployed in the United States, whose use has been expanding rapidly. The Commission defines DERs as “any resource located on the distribution system, any subsystem thereof or behind a customer meter,” including but not limited to “electric storage resources, distributed generation, demand response, energy efficiency, thermal storage, and electric vehicles and their supply equipment.” The rule aims to increase DER participation in wholesale markets by allowing the creation of DER aggregations, in which multiple DERs that are too small to meet minimum capacity requirements for wholesale markets individually would be able to participate in markets as a single unit. As of June 20, 2023, all ISOs have filed initial compliance plans and a number have begun implementation. Compliance dates range from 2024 to 2029, with Midcontinent ISO having the latest date of compliance proposed for 2029. Southwest Power Pool still has an outstanding date, having no final order yet from FERC, but a target date of the third quarter of calendar year 2025. The rule, which is technology agnostic and requires ISOs to create participation plans that accommodate different DERs, provides an opportunity for distributed wind market expansion. In addition, distributed wind can bring benefits to heterogenous DER aggregations. These benefits include resource diversity (i.e., a complementary generation profile to other types of distributed generation), its small footprint and ability to be co-located with load, and its potential to provide frequency response, voltage support, and black start services, among other ancillary services. This report provides a status update on FERC Order No. 2222, the current state of ISO compliance, and information relevant to the distributed wind industry as DER aggregators and other stakeholders expand their participation to wholesale energy markets.

17 WIND ENERGY↗

DOE OSTI2024

STREAM: Strategic Technology Roadmapping and Energy, Environmental, and Economic Analysis Model

This is the implementation of the framework for the planning of the technological makeup of the industrial sector. Motivated by the efforts to achieve carbon neutrality, the model of this framework modifies the portfolio of technologies over time for the sector of interest such that, - Net Present Value (NPV) is minimized - Constraint on Greenhouse Emissions (GHG), e.g. carbon dioxide, is satisfied - Demand of the underlying commodity is satisfied - The current implementation reflects a case study for the electric power sector. The for a given initial set of capacities of different vintages, the space of decisions include, - Retirement of the existing capacities. - Retrofitting the existing capacities to alternative characteristics. - Creation of new capacities from a technology portfolio. All the associated quantities with the deployments, e.g. CO2, heat requirement, etc.

Thiery, David↗

DOE OSTI2016

SU-F-T-423: Automating Treatment Planning for Cervical Cancer in Low- and Middle- Income Countries

Purpose: To develop and test two independent algorithms that automatically create the photon treatment fields for a four-field box beam arrangement, a common treatment technique for cervical cancer in low- and middle-income countries. Methods: Two algorithms were developed and integrated into Eclipse using its Advanced Programming Interface:3D Method: We automatically segment bony anatomy on CT using an in-house multi-atlas contouring tool and project the structures into the beam’s-eye-view. We identify anatomical landmarks on the projections to define the field apertures. 2D Method: We generate DRRs for all four beams. An atlas of DRRs for six standard patients with corresponding field apertures are deformably registered to the test patient DRRs. The set of deformed atlas apertures are fitted to an expected shape to define the final apertures. Both algorithms were tested on 39 patient CTs, and the resulting treatment fields were scored by a radiation oncologist. We also investigated the feasibility of using one algorithm as an independent check of the other algorithm. Results: 96% of the 3D-Method-generated fields and 79% of the 2D-method-generated fields were scored acceptable for treatment (“Per Protocol” or “Acceptable Variation”). The 3D Method generated more fields scored “Per Protocol” than the 2D Method (62% versus 17%). The 4% of the 3D-Method-generated fields that were scored “Unacceptable Deviation” were all due to an improper L5 vertebra contour resulting in an unacceptable superior jaw position. When these same patients were planned with the 2D method, the superior jaw was acceptable, suggesting that the 2D method can be used to independently check the 3D method. Conclusion: Our results show that our 3D Method is feasible for automatically generating cervical treatment fields. Furthermore, the 2D Method can serve as an automatic, independent check of the automatically-generated treatment fields. These algorithms will be implemented for fully automated cervical treatment planning.

60 APPLIED LIFE SCIENCES↗

NASA NTRS2018

Deep Space Optical Communications (DSOC)

NASA’s future deep space science and exploration missions will require enhanced communications and navigation services. Laser communications offers expanded bandwidth and the potential for satisfying this need, with comparable mass and power as state of the art telecommunication systems. Consequently, NASA is planning a Deep Space Optical Communications (DSOC) technology demonstration, to retire the risk for future enhanced optical communication services. NASA’s upcoming Psyche Mission scheduled to launch in August of 2022 plans to host a DSOC flight laser transceiver (FLT) for demonstrating optical links from deep-space to earth. Existing ground assets retrofitted with laser transmitters and photon-counting receivers will be used for the technology demonstration. Advancing optical technology from near-Earth ranges to deep space (> 0.01 astronomical units or AU) involves orders of magnitude increased link difficulty (defined as data-rate squared distance). The plan to bridge the difficulty gap implements new technologies developed over the past two decades. These technologies emphasize high photon efficiency (HPE) with the use of high-peak-to-average power laser transmitters in space, and single photon counting sensitivity detectors, that together support signaling schemes for achieving approximately 23 information bits per detected photon. Implementing HPE schemes relies on accurate and stable pointing of narrow laser beams from space platforms using active control. Key developments needed for future technology infusion, following a successful DSOC technology demonstration, include, cost-effective ground infrastructure, long term reliability of space lasers and detection systems, and solutions for high precision laser ranging. The current status of the DSOC Project and plans for future development will be discussed in this paper.

Biswas, Abhijit↗

DOE OSTI2015

Shortening Delivery Times of Intensity Modulated Proton Therapy by Reducing Proton Energy Layers During Treatment Plan Optimization

Purpose: To shorten delivery times of intensity modulated proton therapy by reducing the number of energy layers in the treatment plan. Methods and Materials: We have developed an energy layer reduction method, which was implemented into our in-house-developed multicriteria treatment planning system “Erasmus-iCycle.” The method consisted of 2 components: (1) minimizing the logarithm of the total spot weight per energy layer; and (2) iteratively excluding low-weighted energy layers. The method was benchmarked by comparing a robust “time-efficient plan” (with energy layer reduction) with a robust “standard clinical plan” (without energy layer reduction) for 5 oropharyngeal cases and 5 prostate cases. Both plans of each patient had equal robust plan quality, because the worst-case dose parameters of the standard clinical plan were used as dose constraints for the time-efficient plan. Worst-case robust optimization was performed, accounting for setup errors of 3 mm and range errors of 3% + 1 mm. We evaluated the number of energy layers and the expected delivery time per fraction, assuming 30 seconds per beam direction, 10 ms per spot, and 400 Giga-protons per minute. The energy switching time was varied from 0.1 to 5 seconds. Results: The number of energy layers was on average reduced by 45% (range, 30%-56%) for the oropharyngeal cases and by 28% (range, 25%-32%) for the prostate cases. When assuming 1, 2, or 5 seconds energy switching time, the average delivery time was shortened from 3.9 to 3.0 minutes (25%), 6.0 to 4.2 minutes (32%), or 12.3 to 7.7 minutes (38%) for the oropharyngeal cases, and from 3.4 to 2.9 minutes (16%), 5.2 to 4.2 minutes (20%), or 10.6 to 8.0 minutes (24%) for the prostate cases. Conclusions: Delivery times of intensity modulated proton therapy can be reduced substantially without compromising robust plan quality. Shorter delivery times are likely to reduce treatment uncertainties and costs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2026

Overview of Community Solar Project Development [Slides]

The Energy to Communities (E2C) peer-learning cohort program provides technical assistance to groups of 15 community entities around a common energy topic over the course of 6 months. Every month, participants join a virtual meeting where they hear from experts and exchange strategies and best practices with their peers. This cohort, "Successful Energy Project Implementation" will explore common challenges in implementing energy projects and learn strategies to turn project plans into reality. Each participant will focus on a local energy project or priority as a cornerstone for their learning throughout the series. This presentation overviews the basics of developing community solar projects with emphasis on technical scope and ownership structures.

24 POWER TRANSMISSION AND DISTRIBUTION↗

DOE OSTI2014

Comparing four volumetric modulated arc therapy beam arrangements for the treatment of early-stage prostate cancer

This study compared four different volumetric modulated arc therapy (VMAT) beam arrangements for the treatment of early-stage prostate cancer examining plan quality and the impact on a radiotherapy department's resources. Twenty prostate cases were retrospectively planned using four VMAT beam arrangements (1) a partial arc (PA), (2) one arc (1A), (3) one arc plus a partial arc (1A + PA) and (4) two arcs (2A). The quality of the dose distributions generated were compared by examining the overall plan quality, the homogeneity and conformity to the planning target volume (PTV), the number of monitor units and the dose delivered to the organs at risk. Departmental resources were considered by recording the planning time and beam delivery time. Each technique produced a plan of similar quality that was considered adequate for treatment; though some differences were noted. The 1A, 1A + PA and 2A plans demonstrated a better conformity to the PTV which correlated to improved sparing of the rectum in the 60–70 Gy range for the 1A + PA and 2A techniques. The time needed to generate the plans was different for each technique ranging from 13.1 min for 1A + PA to 17.8 min for 1A. The PA beam delivery time was fastest with a mean time of 0.9 min. Beam-on times then increased with an increase in the number of arcs up to an average of 2.2 min for the 2A technique. Which VMAT technique is best suited for clinical implementation for the treatment of prostate cancer may be dictated by the individual patient and the availability of departmental resources.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

MO-FG-303-06: Evaluation of the Performance of Very High-Energy Electron (VHEE) Beams in Radiotherapy: Five Clinical Cases

Purpose: To evaluate the performance of 100–120 MeV very-high energy electron (VHEE) scanning pencil beams to radiotherapy by means of Monte Carlo (MC) simulations. Methods: We selected five clinical cases with target sizes of 1.2 cm{sup 3} to 990.4 cm{sup 3}. We calculated VHEE treatment plans using the MC EGSnrc code implemented in a MATLAB-based graphical user interface developed by our group. We generated phase space data for beam energies: 100 and 120 MeV and pencil beam spot sizes of 1, 3, and 5 mm at FWHM. The number of equidistant beams considered in this work was 16 or 32. Dose was calculated and then imported into a research version of RayStation where treatment plan optimization was performed. We compared the VHEE plans with the clinically delivered volumetric modulated arc therapy (VMAT) plan to evaluate VHEE plans performance. Results: VHEE plans provided the same PTV coverage and dose homogeneity than VMAT plans for all the cases. In average, the mean dose to organs at risk (OARs) was 24% lower for the VHEE plans. The structures that benefited the most from using VHEE were: large bowel for the esophagus case, chest wall for the liver case, brainstem for the acoustic case, carina for the lung case, and genitalia for the anal case, with 23.7–34.6% lower dose. VHEE dose distributions were more conformal than VMAT solution as confirmed by conformity indices CI100 and CI50. Integral dose to the body was in average 19.6% (9.2%–36.5%) lower for the VHEE plans. Conclusion: We have shown that VHEE plans resulted in similar or superior dose distributions compared to clinical VMAT plans for five different cases and a wide range of target volumes, including a case with a small target (1.2 cm{sup 3}), which represents a challenge for VMAT planning and might require the use of more complex non-coplanar VMAT plans. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Laboratories AB. E Hynning: Employee, RaySearch Laboratories AB. B Qu: None. B Loo Jr.: Research support, RaySearch, Varian. P Maxim: Research support, RaySearch, Varian.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2022

Adaptive Sampling for In Situ Cloud Probe (Final Report)

Clouds play a leading role in the Earth's global energy and solar radiation balance and hydrological cycle. Improving cloud models requires detailed information on the cloud microphysical properties, such as droplet size distribution and number density, liquid water content and cloud composition (droplets, ice particles), which can only be provided by aerial in situ measurements. However, for many atmospheric measurement instruments, the lack of flexibility in selecting the operational mode during operation can lead to uncertainties in sampling and measurement characteristics under continuously varying atmospheric conditions. This SBIR project is developing an advanced, compact optical imaging technology for in situ characterization of cloud hydrometeors. The development involves a deep modification of the existing Mesa Photonics’ Cloud Droplet Measurement System (CDMS) in order to implement real-time automatic adaptive sampling based on the acquired in situ data and environmental parameters. The new system, CDMS-2, implements two measurement modes: side-scatter imaging for smaller hydrometeors and direct bright-field-illumination imaging for larger hydrometeors in a significantly larger sample volume. The system measures the droplet size distribution (DSD) and number density with an added capability of discriminating between liquid water and ice hydrometeors (based on polarization-resolved side-scatter imaging). The instrument will implement automatic switching or alternating between the regular side-scatter imaging mode and sparse/large hydrometeor mode (based on the acquired data). Other adaptive sampling capabilities include variable sample volume and dynamic range (based on the measured DSD). The preferred deployment platforms are uncrewed aircraft systems (UAS) and tethered balloon/kite systems (TBS). The Phase I project achieved (or exceeded) the goals listed in the Work Plan. A CDMS-2 laboratory prototype implementing the polarization-resolved side-scatter imaging mode and direct bright-field-illumination imaging mode was designed and built. Additional capabilities included the variable illumination pulse energy and sample volume. The smallest detectable droplet diameter was improved to 3–4 μm (from the nominal 10 μm value specified for the original CDMS). Discrimination between water droplets and ice particles was experimentally demonstrated. The Phase I prototype was extensively tested and calibrated in the laboratory and also tested in the Pi Cloud Chamber at Michigan Technological University (MTU). The two intensive experimental campaigns at MTU provided unique opportunities of testing the CDMS-2 laboratory prototype under realistic warm and mixed-phase cloud conditions (stable for long periods of time), testing different sampling modes and intercomparing the CDMS-2 prototype to other co-located cloud characterization instruments. The Phase I project successfully demonstrated the feasibility of the proposed technology and identified the engineering challenges of designing a field deployable prototype instrument in Phase II. The Phase I study provides a solid basis for development, characterization and field-testing of the proposed advanced cloud probe with adaptive sampling in Phase II followed by commercialization of the technology in Phase III.

47 OTHER INSTRUMENTATION↗

DOE OSTI2025

A product data network to enable faster, easier, and better planning of building envelopes

The building envelopes contributes significantly to the energy-efficiency of the building. Building performance simulation has made it possible to compare façade technologies regarding energy demand, daylighting, thermal and visual comfort in detail. Planners, such as architects and engineers, need experience to find product data with the right quality and level of detail, and to process the data to fit the calculation and the application. In the available time, planners can compare only a limited number of products, which means that better solutions could go unnoticed. This paper presents a new concept for making product data easily accessible for building façade planning. The concept consists of a network of databases for the efficient exchange and use of optical and calorimetric data of glazing units, shading devices, and combinations of both. The paper presents the research questions, an analysis of the current challenges, six design goals for the product data network and its implementation together with a discussion. Many product data sources can be connected to many planning software applications via the specified application programming interface. When planning software connects to the product data network, the planning of building envelopes can be much faster because planners do not need to spend so much time to search and process product data manually. The planning of building envelopes can also become much easier, especially for planners with limited experience. They do not need to understand all the details about which data fits which calculation if the software company implements this. The planning of building envelopes can become much more reliable when software companies validate their use of the product data network, because the current manual process is prone to errors. The planning of building envelopes can also improve because more products can be compared in the available time, allowing better solutions to be found.

Maurer, Christoph↗

DOE OSTI2024

Unlocking the Path to Decarbonized Building Thermal Systems: Strategies for Designers and Contractors: Preprint

The design and construction community plays a pivotal role in facilitating the transition to decarbonized thermal systems that maintain human comfort while reducing building emissions. Through the U.S. Department of Energy Better Buildings initiative's Design and Construction Allies, a cohort of leading architecture, engineering, and construction firms have identified top ranked barriers that designers and contractors face when implementing solutions for building owners. These barriers to decarbonizing thermal - especially heating - systems include equipment availability; electrical capacity constraints; space allocations; complex system configurations; and lack of experience in designing, installing, and maintaining heat pumps. These impediments significantly amplify the risk and financial burden associated with the adoption of decarbonized solutions. The barriers also decrease the likelihood that designers, contractors, and owners will adopt decarbonization strategies without clear plans and guidance on how to implement these solutions, mitigate risk, and overcome the identified barriers. The National Renewable Energy Laboratory, the Design and Construction Allies, and the American Society of Heating, Refrigerating, and Air-Conditioning Engineers have developed "how to" thermal decarbonization guidance based on best practices. The subjects covered range from the role of energy efficiency in facilitating decarbonized heating solutions to strategies for decarbonizing new and existing heating, ventilating, and air-conditioning systems. The focus is on overcoming barriers so that energy-efficient, electrified buildings - both new and retrofit - become the industry standard. This paper outlines 1) the method used to collect and organize this guidance, 2) industry barriers to decarbonization, and 3) decarbonization techniques that have broad market applicability.

building heating↗

DOE OSTI2014

Sci—Fri AM: Mountain — 05: Unified Optimization and Delivery of Intensity-modulated Radiation Therapy and Volume-modulated Arc Therapy

Purpose: To study the feasibility of a unified intensity-modulated arc therapy (UIMAT) that combines IMRT and VMAT optimization and delivery in order to produce efficient and superior radiation treatment plans. Methods: Inverse planning for UIMAT was prototyped on the Pinnacle treatment planning system (Philips Medical Systems). UIMAT integrates IMRT and VMAT delivery in the same arc where IMRT was delivered with gantry speed close to zero. Optimal gantry angles for the IMRT phases were selected automatically by the inverse optimization algorithm. Optimization of the VMAT phases and IMRT phases were done simultaneously using Pinnacle's direct machine parameter optimization algorithm. Five treatment plans each for prostate, head and neck, and lung were generated using our unified technique and compared with clinical VMAT or IMRT plans. Delivery verification was performed on an ArcCheck phantom (Sun Nuclear) and delivered in clinical mode on a Varian TrueBeam linear accelerator. Results: In this prototype implementation, compared to the VMAT or IMRT plans, with the plans normalized to the same dose coverage to the planning target volumes, the UIMAT plans produced improved OAR sparing for head and neck cases, while for lung and prostate cases, the dosimetric improvements for OARs were not as significant. In this proof-of-concept work, we demonstrated that a novel radiation therapy delivery technique combining VMAT and IMRT delivery in the same arc is feasible. Initial results showed UIMAT has the potential to be superior to either standard IMRT or VMAT.

60 APPLIED LIFE SCIENCES↗