A nomogram to determine required seed air kerma strength in planar 131 Cesium permanent seed implant brachytherapy

Purpose: Intraoperatively implanted Cesium-131 ( 131 Cs) permanent seed brachytherapy is used to deliver highly localized re-irradiation in recurrent head and neck cancers. A single planar implant of uniform air kerma strength (AKS) seeds and 10 mm seed-to-seed spacing is used to deliver the prescribed dose to a point 5 mm or 10 mm perpendicular to the center of the implant plane. Nomogram tables to quickly determine the required AKS for rectangular and irregularly shaped implants were created and dosimetrically verified. By eliminating the need for a full treatment planning system plan, nomogram tables allow for fast dose calculation for intraoperative re-planning and for a second check method. Material and methods: TG-43U1 recommended parameters were used to create a point-source model in MATLAB. The dose delivered to the prescription point from a single 1 U seed at each possible location in the implant plane was calculated. Implant tables were verified using an independent seed model in MIM Symphony LDR™. Implant tables were used to retrospectively determine seed AKS for previous cases: three rectangular and three irregular. Results: For rectangular implants, the percent difference between required seed AKS calculated using MATLAB and MIM was at most 0.6%. For irregular implants, the percent difference between MATLAB and MIM calculations for individual seed locations was within 1.5% with outliers of less than 3.1% at two distal locations (10.6 cm and 8.8 cm), which have minimal dose contribution to the prescription point. The retrospectively determined AKS for patient implants using nomogram tables agreed with previous calculations within 5% for all six cases. Conclusions: Nomogram tables were created to determine required AKS per seed for planar uniform AKS 131 Cs implants. Comparison with the treatment planning system confirms dosimetric accuracy that is acceptable for use as a second check or for dose calculation in cases of intraoperative re-planning

Optimal randomized incremental construction for guaranteed logarithmic planar point location

Given a planar map of $n$ segments in which we wish to efficiently locate points, we present the first randomized incremental construction of the well-known trapezoidal-map search-structure that only requires expected $O(n \log n)$ preprocessing time while deterministically guaranteeing worst-case linear storage space and worst-case logarithmic query time. This settles a long standing open problem; the best previously known construction time of such a structure, which is based on a directed acyclic graph, so-called the history DAG, and with the above worst-case space and query-time guarantees, was expected $O(n \log^2 n)$. The result is based on a deeper understanding of the structure of the history DAG, its depth in relation to the length of its longest search path, as well as its correspondence to the trapezoidal search tree. Our results immediately extend to planar maps induced by finite collections of pairwise interior disjoint well-behaved curves.Comment: The article significantly extends the theoretical aspects of the work presented in http://arxiv.org/abs/1205.543