An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use

Pulse Parameter Optimization for Ultra High Dose Rate Electron Beams

Purpose: The eFLASH Mobetron delivers UHDR doses at discrete combinations of pulse width (PW), pulse repetition frequency (PRF) and number of pulses (N), which dictate unique combinations of dose and dose rates. Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating and looking up values in large spreadsheets for every collimator. The purpose of this work is to present a MATLAB based pulse parameter optimizer tool to match intended dose and dose rate more precisely and efficiently. Methods: A constrained optimization problem for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB. The beam and machine data required for the software were acquired using GafChromic film and Alternating Current Current Tranformers (ACCTs), including dose per pulse for every collimator, pulse widths measured using ACCT, and air gap factors. Results: Using N, PRF, PW and air gap factors as the parameters, the software was created to optimize for dose and dose rate. By largely automating this dose calculation part, we have greatly reduced safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be irradiated. Conclusion: A pulse parameter optimization tool was built in MATLAB for the eFLASH Mobetron to increase efficiency in the dose, dose rate and pulse parameter prescription proces

Searching standard parameters for volumetric modulated arc therapy (VMAT) of prostate cancer

Background Since December 2009 a new VMAT planning system tool is available in Oncentra® MasterPlan v3.3 (Nucletron B.V.). The purpose of this study was to work out standard parameters for the optimization of prostate cancer. Methods For ten patients with localized prostate cancer plans for simultaneous integrated boost were optimized, varying systematically the number of arcs, collimator angle, the maximum delivery time, and the gantry spacing. Homogeneity in clinical target volume, minimum dose in planning target volume, median dose in the organs at risk, maximum dose in the posterior part of the rectum, and number of monitor units were evaluated using student’s test for statistical analysis. Measurements were performed with a 2D-array, taking the delivery time, and compared to the calculation by the gamma method. Results Plans with collimator 45° were superior to plans with collimator 0°. Single arc resulted in higher minimum dose in the planning target volume, but also higher dose values to the organs at risk, requiring less monitor units per fraction dose than dual arc. Single arc needs a higher value (per arc) for the maximum delivery time parameter than dual arc, but as only one arc is needed, the measured delivery time was shorter and stayed below 2.5 min versus 3 to 5 min. Balancing plan quality, dosimetric results and calculation time, a gantry spacing of 4° led to optimal results. Conclusion A set of parameters has been found which can be used as standard for volumetric modulated arc therapy planning of prostate cancer

Research pressure instrumentation for NASA Space Shuttle main engine, modification no. 5

The objective of the research project described is to define and demonstrate methods to advance the state of the art of pressure sensors for the space shuttle main engine (SSME). Silicon piezoresistive technology was utilized in completing tasks: generation and testing of three transducer design concepts for solid state applications; silicon resistor characterization at cryogenic temperatures; experimental chip mounting characterization; frequency response optimization and prototype design and fabrication. Excellent silicon sensor performance was demonstrated at liquid nitrogen temperature. A silicon resistor ion implant dose was customized for SSME temperature requirements. A basic acoustic modeling software program was developed as a design tool to evaluate frequency response characteristics

A planning study for palliative spine treatment using StatRT and megavoltage CT simulation.

Megavoltage CT (MVCT) simulation on the TomoTherapy Hi·Art system is an alternative to conventional CT for treatment planning in the presence of severe metal artifact. StatRT is a new feature that was implemented on the TomoTherapy operator station for performing online MVCT scanning, treatment planning and treatment delivery in one session. The clinical feasibility of using the StatRT technique and MVCT simulation to palliative treatment for a patient with substantial spinal metallic hardware is described. A patient with metastatic non-small-cell lung cancer involving the thoracic spine underwent conventional kilovoltage CT simulation. The metal artifact due to stainless steel spine-stabilizing rods was too severe for treatment planning, despite attempts to correct using density override. The patient was then re-scanned using MVCT on a tomotherapy unit. Plans were generated using both StatRT and conventional tomotherapy planning (Tomo plan) with different settings for comparison. StatRT planning ran a total of five iterations in a short planning window (10-15 min). Two Tomo plans were generated using: (1) five iterations in the "full scatter" mode, and (2) 300 iterations in the "beamlet" mode. It was noted that the DVH of the StatRT plan was almost identical to the Tomo plan optimized by the "full scatter" mode and the same number of iterations. Dose distribution analysis reveals that these three planning methods yielded comparable doses to heart, lungs and targets. This work also demonstrated that undermodulation can result in a high degree of thread effects. The overall time for the treatment process (including 7 minutes for simulation, 15 minutes for contouring, 10 minutes for planning and 5 minutes for delivery) decreases from hours to around 40 minutes using the StatRT procedure. StatRT is a feasible treatment-planning tool for physicians to scan, contour and treat patients within one hour. This can be particularly beneficial in urgent palliative treatments

Explicit optimization of plan quality measures in intensity-modulated radiation therapy treatment planning

Conventional planning objectives in optimization of intensity-modulated radiotherapy treatment (IMRT) plans are designed to minimize the violation of dose-volume histogram (DVH) thresholds using penalty functions. Although successful in guiding the DVH curve towards these thresholds, conventional planning objectives offer limited control of the individual points on the DVH curve (doses-at-volume) used to evaluate plan quality. In this study, we abandon the usual penalty-function framework and propose planning objectives that more explicitly relate to DVH statistics. The proposed planning objectives are based on mean-tail-dose, resulting in convex optimization. We also demonstrate how to adapt a standard optimization method to the proposed formulation in order to obtain a substantial reduction in computational cost. We investigate the potential of the proposed planning objectives as tools for optimizing DVH statistics through juxtaposition with the conventional planning objectives on two patient cases. Sets of treatment plans with differently balanced planning objectives are generated using either the proposed or the conventional approach. Dominance in the sense of better distributed doses-at-volume is observed in plans optimized within the proposed framework, indicating that the DVH statistics are better optimized and more efficiently balanced using the proposed planning objectives

A GPU-based multi-criteria optimization algorithm for HDR brachytherapy

Currently in HDR brachytherapy planning, a manual fine-tuning of an objective function is necessary to obtain case-specific valid plans. This study intends to facilitate this process by proposing a patient-specific inverse planning algorithm for HDR prostate brachytherapy: GPU-based multi-criteria optimization (gMCO). Two GPU-based optimization engines including simulated annealing (gSA) and a quasi-Newton optimizer (gL-BFGS) were implemented to compute multiple plans in parallel. After evaluating the equivalence and the computation performance of these two optimization engines, one preferred optimization engine was selected for the gMCO algorithm. Five hundred sixty-two previously treated prostate HDR cases were divided into validation set (100) and test set (462). In the validation set, the number of Pareto optimal plans to achieve the best plan quality was determined for the gMCO algorithm. In the test set, gMCO plans were compared with the physician-approved clinical plans. Over 462 cases, the number of clinically valid plans was 428 (92.6%) for clinical plans and 461 (99.8%) for gMCO plans. The number of valid plans with target V100 coverage greater than 95% was 288 (62.3%) for clinical plans and 414 (89.6%) for gMCO plans. The mean planning time was 9.4 s for the gMCO algorithm to generate 1000 Pareto optimal plans. In conclusion, gL-BFGS is able to compute thousands of SA equivalent treatment plans within a short time frame. Powered by gL-BFGS, an ultra-fast and robust multi-criteria optimization algorithm was implemented for HDR prostate brachytherapy. A large-scale comparison against physician approved clinical plans showed that treatment plan quality could be improved and planning time could be significantly reduced with the proposed gMCO algorithm.Comment: 18 pages, 7 figure

Online Adaptive Radiation Therapy: Implementation of a New Process of Care.

Onboard magnetic resonance imaging (MRI) guided radiotherapy is now clinically available in nine centers in the world. This technology has facilitated the clinical implementation of online adaptive radiotherapy (OART), or the ability to alter the daily treatment plan based on tumor and anatomical changes in real-time while the patient is on the treatment table. However, due to the time sensitive nature of OART, implementation in a large and busy clinic has many potential obstacles as well as patient-related safety considerations. In this work, we have described the implementation of this new process of care in the Department of Radiation Oncology at the University of California, Los Angeles (UCLA). We describe the rationale, the initial challenges such as treatment time considerations, technical issues during the process of re-contouring, re-optimization, quality assurance, as well as our current solutions to overcome these challenges. In addition, we describe the implementation of a coverage system with a physician of the day as well as online planners (physicists or dosimetrists) to oversee each OART treatment with patient-specific 'hand-off' directives from the patient's treating physician. The purpose of this effort is to streamline the process without compromising treatment quality and patient safety. As more MRI-guided radiotherapy programs come online, we hope that our experience can facilitate successful adoption of OART in a way that maximally benefits the patient

Using Box–Behnken experimental design to optimize the degradation of Basic Blue 41 dye by Fenton reaction

Degradation of a Basic Blue 41 dye using Fenton reagent was examined at laboratory scale in batch experiments using Box-Behnken statistical experiment design. Dyestuff, hydrogen peroxide (H2O2) and ferrous ion (Fe2+) concentrations were selected as independent factors. On the other hand, color and chemical oxygen demand (COD) removal were considered as the response functions. The value of coefficient of determination (R-2) for both color and chemical oxygen demand removal with values 0.98 and 0.99 shows the best agreement between predicted value and experimental values. Perturbation plots indicated that iron dosage has the most effect on both color and COD removal. Normalized plot of residuals also indicated that the models were adequate to predict for both responses. Color and COD removal increased with increasing H2O2 and Fe2+ concentrations up to a certain level. High concentrations of H2O2 and Fe2+ did not result in better removal of color and COD due to hydroxyl radical being gradually consumed by both oxidant and catalyst. Percent color removal was higher than COD removal indicating the production of colorless compounds. The second-order polynomial model revealed optimal process factor ratio. The ratio of H2O2/Fe2+/dyestuff which gives a complete color removal and 95% COD removal was found to be 1195 mg/L/90 mg/L/255 mg/L