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DOE OSTI2014

SU-E-J-127: Real-Time Dosimetric Assessment for Adaptive Head-And-Neck Treatment Via A GPU-Based Deformable Image Registration Framework

Purposes: To systematically monitor anatomic variations and their dosimetric consequences during head-and-neck (H'N) radiation therapy using a GPU-based deformable image registration (DIR) framework. Methods: Eleven H'N IMRT patients comprised the subject population. The daily megavoltage CT and weekly kVCT scans were acquired for each patient. The pre-treatment CTs were automatically registered with their corresponding planning CT through an in-house GPU-based DIR framework. The deformation of each contoured structure was computed to account for non-rigid change in the patient setup. The Jacobian determinant for the PTVs and critical structures was used to quantify anatomical volume changes. Dose accumulation was performed to determine the actual delivered dose and dose accumulation. A landmark tool was developed to determine the uncertainty in the dose distribution due to registration error. Results: Dramatic interfraction anatomic changes leading to dosimetric variations were observed. During the treatment courses of 6–7 weeks, the parotid gland volumes changed up to 34.7%, the center-of-mass displacement of the two parotids varied in the range of 0.9–8.8mm. Mean doses were within 5% and 3% of the planned mean doses for all PTVs and CTVs, respectively. The cumulative minimum/mean/EUD doses were lower than the planned doses by 18%, 2%, and 7%, respectively for the PTV1. The ratio of the averaged cumulative cord maximum doses to the plan was 1.06±0.15. The cumulative mean doses assessed by the weekly kVCTs were significantly higher than the planned dose for the left-parotid (p=0.03) and right-parotid gland (p=0.006). The computation time was nearly real-time (∼ 45 seconds) for registering each pre-treatment CT to the planning CT and dose accumulation with registration accuracy (for kVCT) at sub-voxel level (<1.5mm). Conclusions: Real-time assessment of anatomic and dosimetric variations is feasible using the GPU-based DIR framework. Clinical implementation of this technology may enable timely plan adaption and potentially lead to improved outcome.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-617: Remotely Pre-Planned Stereotactic Ablative Radiation Therapy: Validation of Treatment Plan Quality

Purpose: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors. Methods: Target/normal structures were contoured on dxCT; a plan was created and approved by the physician. Structures were transferred to simCT using deformable image registration and the plan was re-optimized on simCT. Plan quality was evaluated through comparison to gold-standard structures contoured on simCT and a gold-standard plan based on these structures. Workflow-generated plan quality in this study represents a worst-case scenario as these patients were not treated using custom immobilization to match dxCT position as would be done when the workflow is implemented clinically. Results: 5/6 plans created through the pre-planning workflow were clinically acceptable. For all six plans, the gold-standard GTV received full prescription dose, along with median PTV V95%=95.2% and median PTV D95%=95.4%. Median GTV DSC=0.80, indicating high degree of similarity between the deformed and gold-standard GTV contours despite small GTV sizes (mean=3.0cc). One outlier (DSC=0.49) resulted in inadequate PTV coverage (V95%=62.9%) in the workflow plan; in clinical practice, this mismatch between deformed/gold-standard GTV would be revised by the physician after deformable registration. For all patients, normal tissue doses were comparable to the gold-standard plan and well within constraints. Conclusion: Pre-planning SABR cases on diagnostic imaging generated clinically acceptable plans. Coupled with rapid-prototyped custom immobilization, this workflow may improve treatment access for rural patients.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-EF-BRB-03: Significant Cord and Esophagus Dose Reduction by 4π Non-Coplanar Spine Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

Purpose: To demonstrate significant organ-at-risk (OAR) sparing achievable with 4π non-coplanar radiotherapy on spine SBRT and SRS patients. Methods: Twenty-five stereotactic spine cases previously treated with VMAT (n = 23) or IMRT (n = 2) were included in this study. A computer-aided-design model of a Linac with a 3D-scanned human surface was utilized to determine the feasible beam space throughout the 4π steradian and beam specific source-to-target-distances (STD) required for collision avoidance. 4π radiotherapy plans integrating beam orientation and fluence map optimization were then created using a column-generation algorithm. Twenty optimal beams were selected for each case. To evaluate the tradeoff between dosimetric benefit and treatment complexity, 4π plans including only isocentrically deliverable beams were also created. Beam angles of all standard and isocentric 4π plans were imported into Eclipse to recalculate the dose using the same calculation engine as the clinical plans for unbiased comparison. OAR and PTV dose statistics for the clinical, standard-4π, and isocentric-4π plans were compared. Results: Comparing standard-4π to clinical plans, particularly significant average percent reduction in the [mean, maximum] dose of the cord and esophagus of [41%, 21.7%], and [38.7%, 36.4%] was observed, along with global decrease in all other OAR dose statistics. The average cord volume receiving more than 50% prescription dose was substantially decreased by 76%. In addition, improved PTV coverage was demonstrated with a maximum dose reduction of 0.93% and 1.66% increase in homogeneity index (D95/D5). All isocentric-4π plans achieved dosimetric performance equivalent to that of the standard-4π plans with higher delivery complexity. Conclusion: 4π radiotherapy significantly improves stereotactic spine treatment dosimetry. With the substantial OAR dose sparing, PTV dose escalation is considerably safer. Isocentric-4π is sufficient to achieve the dosimetric gain. The successful implementation of 4π using an FDA approved planning system paves the way for a prospective clinical trial. Varian Medical Systems, NIH R43CA183390 and R01CA188300, NSF graduate research fellowship DGE-1144087.

60 APPLIED LIFE SCIENCES↗

NASA NTRS2007

Managing Space Technology Development at NASA

NASA uses a structured process for managing projects that develop advanced space technologies and transition them into the designs of flight systems. The four-part process consists of formulation, approval, implementation, and transition. In the formulation phase, technology needs are derived from mission concept studies, various technical approaches for meeting the technology needs are identified, technical performance goals called Key Performance Parameters (KPPs) are established, and a project plan is developed. Prior to project approval, an Independent Formulation Review is conducted to ensure that the project objectives are aligned with the mission needs, and that the project is well planned to meet the objectives. In the implementation phase, the technology development project matures the technology, and progress towards the KPPs is evaluated in periodic status reviews. Technology Readiness Levels (TRLs) are used throughout the project lifecycle to assess the progress of technology maturation. In the transition phase, technologies that are successful in achieving the required level of maturity are transitioned to a customer for further development, are used in system designs, or are thoroughly documented for resumption of development at a later date. The customer or end-user of the technology is involved in all phases of the technology development process.

Moore, Christopher L.↗

NASA NTRS2005

Model compilation for real-time planning and diagnosis with feedback

This paper describes MEXEC, an implemented micro executive that compiles a device model that can have feedback into a structure for subsequent evaluation. This system computes both the most likely current device mode from n sets of sensor measurements and the n-1 step reconfiguration plan that is most likely to result in reaching a target mode - if such a plan exists. A user tunes the system by increasing n to improve system capability at the cost of real-time performance.

diagnosis↗

NASA NTRS2012

Changing the Project Execution Culture at NASA Dryden

Dryden has embarked on implementing Critical Chain Project Management (CCPM) philosophies and tools to reduce workforce stress and increase the centers work throughput. This effort has been under way for over one year and represents a fundamental state change in how various projects are planned and executed at the center. The implementation of CCPM philosophies and the required cultural changes represent the most difficult aspects of the implementation.

Horn, Thomas J.↗

NASA NTRS2005

Model compilation for real-time planning and diagnosis with feedback

Barrett, Anthony↗

DOE OSTI2018

Strategic Environmental Assessment, key issues of its effectiveness. The results of the Speedy Project

This paper describes the results of the European Speedy Project, concerning the application of cross-border SEA, a research that had two main objectives. The first has been the definition of cooperation modalities between various public body as well as private entity through the realization of a digital platform. The aims of this innovative platform include sharing of multidisciplinary knowledge, the training, the participation, etc. The second objective has been to draft a proposal for revision of Directive 2001/42/EC based on the criticalities of implementation in individual Member States emerged during the development of the project. This revision has taken, in the final research report, the form of problem areas and suggestions for amending the Directive. A particularly important result, in addition to those related to platform implementation and the SEA Directive revision, is the e-learning section of the same platform. The continuous training provision of the e-learning system, as well as providing a valuable support for professional upgrading, can provide a useful link between the experiences developed by territorial authorities or individual professionals and the construction of a disciplinary and technical corpus that meet new challenges arising from the changes in society and the evolution of the environmental system.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

DOE OSTI2014

Metrics for Energy Resilience

Energy lies at the backbone of any advanced society and constitutes an essential prerequisite for economic growth, social order and national defense. However there is an Achilles heel to today?s energy and technology relationship; namely a precarious intimacy between energy and the fiscal, social, and technical systems it supports. Recently, widespread and persistent disruptions in energy systems have highlighted the extent of this dependence and the vulnerability of increasingly optimized systems to changing conditions. Resilience is an emerging concept that offers to reconcile considerations of performance under dynamic environments and across multiple time frames by supplementing traditionally static system performance measures to consider behaviors under changing conditions and complex interactions among physical, information and human domains. This paper identifies metrics useful to implement guidance for energy-related planning, design, investment, and operation. Recommendations are presented using a matrix format to provide a structured and comprehensive framework of metrics relevant to a system?s energy resilience. The study synthesizes previously proposed metrics and emergent resilience literature to provide a multi-dimensional model intended for use by leaders and practitioners as they transform our energy posture from one of stasis and reaction to one that is proactive and which fosters sustainable growth.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2014

Relative Biological Effectiveness Variation Along Monoenergetic and Modulated Bragg Peaks of a 62-MeV Therapeutic Proton Beam: A Preclinical Assessment

Purpose: The biological optimization of proton therapy can be achieved only through a detailed evaluation of relative biological effectiveness (RBE) variations along the full range of the Bragg curve. The clinically used RBE value of 1.1 represents a broad average, which disregards the steep rise of linear energy transfer (LET) at the distal end of the spread-out Bragg peak (SOBP). With particular attention to the key endpoint of cell survival, our work presents a comparative investigation of cell killing RBE variations along monoenergetic (pristine) and modulated (SOBP) beams using human normal and radioresistant cells with the aim to investigate the RBE dependence on LET and intrinsic radiosensitvity. Methods and Materials: Human fibroblasts (AG01522) and glioma (U87) cells were irradiated at 6 depth positions along pristine and modulated 62-MeV proton beams at the INFN-LNS (Catania, Italy). Cell killing RBE variations were measured using standard clonogenic assays and were further validated using Monte Carlo simulations and the local effect model (LEM). Results: We observed significant cell killing RBE variations along the proton beam path, particularly in the distal region showing strong dose dependence. Experimental RBE values were in excellent agreement with the LEM predicted values, indicating dose-averaged LET as a suitable predictor of proton biological effectiveness. Data were also used to validate a parameterized RBE model. Conclusions: The predicted biological dose delivered to a tumor region, based on the variable RBE inferred from the data, varies significantly with respect to the clinically used constant RBE of 1.1. The significant RBE increase at the distal end suggests also a potential to enhance optimization of treatment modalities such as LET painting of hypoxic tumors. The study highlights the limitation of adoption of a constant RBE for proton therapy and suggests approaches for fast implementation of RBE models in treatment planning.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2017

Computerized System for Safety Verification of External Beam Radiation Therapy Planning

Purpose: To report an assessment of in-house software, Verifier, developed to improve efficacy and efficiency of the radiation therapy (RT) treatment planning process and quality control review (QCR). Methods and Materials: Radiation therapy plan parameters retrieved from our treatment planning database are used by automated tests to give 75 types of warnings, such as prescription and plan discrepancies. The software is continuously updated on the basis of new issues, ideas, and planning policies. Verifier was retrospectively assessed (2007-2015) by examining impact on treatment plan revisions, frequency of quality improvement incident reports of avoidable RT plan-related safety events, unaddressed issues, and staff efficiency. Results: Plan revisions for specific issues declined dramatically in response to implementation of corresponding Verifier tests. Between 2012 and 2015 our institution's total rate of plan revisions dropped from 18.0% to 11.2%. Between 2008 and 2015 specific tests were added to Verifier while the rate of corresponding avoidable safety events was reduced from 0.34% to 0.00% over the same period. Simulations suggest Verifier saves approximately 2 to 5 minutes per QCR. Conclusions: The decrease in quantifiable metrics of plan revisions and incident reports suggests automatic RT plan-checking software enhances patient safety and clinical efficiency. Although only modest time savings may be gained using Verifier for the QCR itself, the greater impact on efficiency is through avoiding late-stage plan modifications and improving documentation via automation. We encourage other institutions to consider working toward adding similar technologies to enhance their RT quality assurance programs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2017

Adhesion and aerodynamic forces for the resuspension of non-spherical particles in outdoor environments

Particles deposited on an outdoor surface can be resuspended by wind gusts, become airborne, and be inhaled if small enough. If toxic or infectious, these particles may be dangerous for the populace health. It is therefore important to determine under which weather conditions a deposit of particle could be resuspended to implement the best response actions and plan clean-up. To this scope, one needs to consider the competing forces acting on the particle keeping it attached to the surface (gravity and adhesion) or trying to remove it (aerodynamic forces, i.e., lift and drag). Here, this article reviews the current understanding of the aforementioned forces for colloidal spherical particles and extends the existing theories to rod-shaped particles, representative for instance of Bacillus spores. In particular, for the adhesion force, the Derjaguin approximation was used and the adhesion force was computed from the radii of curvature of the particle and the surface at the point of closest approach. For the aerodynamic forces, we re-derived the equations for the drag and lift forces accounting for the shape of the particle. Both smooth and rough surfaces will be discussed, the former as idealized cases, the latter as more representative of real outdoor surfaces.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2025

Energy innovation in the US buildings sector: Setting the stage and mapping the future

Jared Langevin is a staff scientist at Lawrence Berkeley National Laboratory, where he leads modeling of US buildings sector innovation and its implications for energy demand, consumer costs, and the power grid. Eric Wilson is a senior research engineer in the Building Technologies and Sciences Center at the National Renewable Energy Laboratory (NREL). Much of his 15-year career at NREL has revolved around modeling and analysis of the US building stock. Jared and Eric co-led the development of a National Blueprint for buildings sector innovation while serving as advisors to the US Department of Energy’s Deputy Assistant Secretary for Buildings and Industry.

Langevin, Jared↗

DOE OSTI2022

Current and future federal and state sampling guidance for per- and polyfluoroalkyl substances in environmental matrices

Per- and polyfluoroalkyl substances (PFAS) are a class of emerging contaminants composed of an estimated 5000 to 10,000 human-made, fluorinated, organic chemicals. Due to the complexity of PFAS, the need for multiple environmental matrix considerations and the absence of a promulgated federal standard for environmental sampling and analysis, U.S. states have begun developing health-based regulatory and/or guidance values for a limited number of PFAS in environmental matrices. As there is a growing body of science to inform PFAS sampling guidance standard development, it is important to understand which U.S. states are implementing sampling guidelines and how they plan to handle emerging PFAS. This critical review discusses the current and impending federal and state sampling guidelines for PFAS in environmental matrices, the data gaps surrounding PFAS sampling guidance in U.S. states, and the future impacts of impending guidance documents and regulations. Ten federal guidance documents are available for PFAS sampling guidance and analysis. The maximum number of PFAS covered in these guidance documents is 25 analytes spanning across 8 unique media. While the EPA has developed several different sampling and analytical guidelines for PFAS, there is no formal regulation of PFAS or requirements of states to enforce these guidelines. Consequently, only 31 states have informally adopted sampling guidelines, while the other 19 states have no guidance documentation in place for PFAS. The introduction of new PFAS sampling guidelines by the EPA, as well as updated analytical guidelines that target more PFAS or total organofluoride, is expected to continuously shift the landscape of federal and state guidance for PFAS sampling moving forward.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2014

TU-C-BRE-06: Effect of Implementing In-House Treatment Couch Model On Patient Specific QA for Pinnacle SmartArc Treatment Plans

Purpose: Failure to model the treatment couch during VMAT QA planar dose calculation may Result in discrepancies between measured and calculated dose. These discrepancies are due to beam attenuation by the treatment couch that is not included in dose calculation. This work evaluates effects of accounting for this attenuation on patient specific VMAT QA results using an in-house created Varian Exact couch model in Pinnacl Methods: Patient specific VMAT QA results for 13 Pinnacle SmartArc plans generated for treatment on a Varian iX accelerator were studied. These plans included 3 treatment sites (7 H'N, 5 brain, 1 prostate). A Pinnacle model for Varian Exact couch was created in-house to replace the CT simulator couch. Composite arc planar doses were calculated with no couch present (NC) and with the Exact couch model (CM) in place for each plan. QA measurements were taken using IBA Matrixx Evolution ion chamber array set up in IBA MultiCube and were compared to each planar dose. Gamma passing criteria of both 3%/3mm and 2%/2mm tolerances were used. Results: Over all treatment sites, increases in gamma passing rates from NC to CM ranged from -0.4% to +27.3% at 3%/3mm and +0.1% to +30.5% at 2%/2mm. Mean increases in passing rates were +3.7% and +5.3% for 3%/3mm and 2%/2mm tolerances, respectively. Site-specific mean increases (NC to CM) in gamma passing rates were +4.4%, +3.4%, +0.4% (3%/3mm tolerance) and +6.9%, +3.7%, and +2.9% at (2%/2mm tolerance) for H'N, brain, and prostate, respectively. Conclusion: Results support use of a couch model when generating planar dose for patient specific VMAT QA analysis. The improvements were most noticeable at 2%/2mm tolerance and for the H'N and brain sites. Eliminating treatment couch beam attenuation as a source of discrepancy in QA measurements may improve the ability to recognize otherwise masked delivered dose errors.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-669: Commissioning of An Electronic Brachytherapy System for Targeted Mouse Irradiation

Purpose: The aim of this study was to commission the Xoft Axxent™ electronic brachytherapy (eBT) source and 10 mm diameter surface applicator with NIST traceability for targeted irradiations of mouse anal carcinomas. Methods: The Xoft Axxent™ electronic brachytherapy (eBT) and 10 mm diameter surface applicator was chosen by the collaborating physician as a radiation delivery mechanism for mouse anal carcinomas. The target dose was 2 Gy at a depth of 3 mm in tissue to be delivered in a single fraction. To implement an accurate and reliable irradiation plan, the system was commissioned by first determining the eBT source output and corresponding dose rate at a depth of 3 mm in tissue. This was determined through parallel-plate ion chamber measurements and published conversion factors. Well-type ionization chamber measurements were used to determine a transfer coefficient, which correlates the measured dose rate at 3 mm to the NIST-traceable quantity, air-kerma rate at 50 cm in air, for eBT sources. By correlating these two quantities, daily monitoring in the well chamber becomes an accurate and efficient quality assurance technique. Once the dose-rate was determined, a treatment recipe was developed and confirmed with chamber measurements to deliver the requested dose. Radiochromic film was used to verify the dose distribution across the field. Results: Dose rates at 3 mm depth in tissue were determined for two different Xoft Axxent™ sources and correlated with NIST-traceable well-type ionization chamber measurements. Unique transfer coefficients were determined for each source and the treatment recipe was validated by measurements. Film profiles showed a uniform dose distribution across the field. Conclusion: A Xoft Axxent™ eBT system was successfully commissioned for use in the irradiation of mouse rectal tumors. Dose rates in tissue were determined as well as other pertinent parameters to ensure accurate delivery of dose to the target region.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

TH-EF-BRB-06: Implementation of a Modulated-Arc Total Body Irradiation (TBI) Technique Using the RayStation Treatment Planning System

Purpose: To develop a clinical workflow for delivering a modulated-arc total body irradiation (TBI) with RayStation scripting. This technique uses arc fields with the patient lying at floor level on a padded table and is validated through measurements taken on a custom-made TBI phantom. Methods: Treatment planning was performed for a retrospective cohort of eight patients with a diverse range of heights and body types. Each was replanned using an open-field dual arc method, with the patient in supine and prone positions on the floor of the vault. All plans were optimized using Raystation Planning 4.7.2.5 (RaySearch Laboratories, Stockholm, Sweden), with 200 cGy prescribed to the 95% of the body contour − 5mm. This results in an open-field beam that sweeps craniocaudally across the length of the patient. The technique is validated with measurements at 10 cm intervals in a custom-milled, 5 cm thick acrylic phantom. A centrally located CC13 ion chamber and a Mobile MOSFET (Best Medical Canada, Ottawa, ON) detector array were used to measure dose. Supine and prone arcs for each patient were consecutively delivered, and the aggregate dose at each point was compared to the planned dose calculated in the phantom. Results: The ion chamber measurements differed from the planned dose by an average of .5%, with a standard deviation of 2.1%. All measured data for the MOSFETS were within 10% of the corresponding planned dose except for two outlying points. The standard deviation of dose differences across the entire cohort was 4.0%. Most significant discrepancies occurred either in inhomogeneous regions with large gradients, or at inferior points where beam angle was steepest. Conclusion: We have confirmed that the planned dose is well matched to our measurements within 10% for this method of planning and delivery. We are currently incorporating this technique into our clinical workflow. This work is supported by RaySearch.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2022

MIDAS-DC-AC Tool: Fully Automating the Acquisition of AC Power Flow Solution (MIDAS-DC2AC)

MIDAS DC2AC is an automated tool for achieving a converged AC power flow solution from any dispatch, e.g., determined using DC power flow model based optimal power flow. The entire process is free of human interference. It is usually encountered in practice that, even with a DC power flow solution, acquiring the solved AC power flow solution, if exists, sometimes could be a challenging task, especially during the planning stage. It is also difficult to distinguish the unsolvable cases from diverging iterations. Manual adjustments to approach the desired power flow condition has been largely relied on in the past using lots of engineering heuristics. This tool provides a systematic way to first achieve a solvable AC power flow case by modifying the power flow condition, and then try to track the AC power flow solution while gradually removing the adopted changes. If all adopted changes can be completely removed, then the original AC power flow solution is obtained. Otherwise, insights for actionable controls are derived to help operation and planning. Currently, this tool has been implemented in Python using SIEMENS PTI PSS/E as power flow solver, where only adjusting generator terminal voltage set point is considered as an available means to try to turn an unsolved power flow to a solved one. In future, more means should be considered, including the operation of tap-changing transformers, switched shunts and redispatch of active power.

Tan, Jin↗