Pseudo optimization of radiotherapy treatment planning

A chain consisting of three computer programs has been developed for treatment planning of external beam radiotherapy without manual intervention. Apart from the data necessary to identify the patient, the institute, etc., the input consists only of the anatomical information indicated on an outline sheet. Firstly, combinations of incidence directions for a two or three-beam set-up are judged by the first program. Then a limited number of these combinations is selected by this program. For every beam of each selected combination a set of wedges and weights is calculated. Next the dose distributions belonging to each combination with wedges and weights are judged by the second program. Finally, the isodose pattern of the dose distribution judged the best is determined by the third program. The judgement of incidence directions is done by coarse score functions corresponding to a set of criteria. The judgement of dose distribution is done by detailed score functions corresponding to another set of criteria. These criteria with their score functions are treated in some detail. The use of the programs in the clinic is discusses and results are shown.     

Long-term ethanol administration enhances urinary ultraweak luminescence and age-dependent modulation of redox in central and peripheral organs of the rat

OBJECTIVES: The development of algorithms and computer programs for the analysis of screening performance in situations with multiple normally (Gaussian) distributed selection markers and a priori risks depending on a stratification of the population. METHODS: The S-PLUS programming language was used to construct programs producing distributions of log likelihood ratios based on the Monte Carlo simulation. These distributions were used to construct programs for the calculation of roc curves, including a possible stratification of the population. RESULTS: S-PLUS programs for the analysis of screening performance are listed and described. The programs can be used without any special knowledge of S-PLUS. An example of the use of the programs is given.     

Monte Carlo and analytical calculation of proton pencil beams for computerized treatment plan optimization

Proton pencil beams in water, in a format suitable for treatment planning algorithms and covering the radiotherapy energy range (50-250 MeV), have been calculated using a modified version of the Monte Carlo code PTRAN. A simple analytical model has also been developed for calculating proton broad-beam dose distributions which is in excellent agreement with the Monte Carlo calculations. Radial dose distributions are also calculated analytically and narrow proton pencil-beam dose distributions derived. The physical approximations in the Monte Carlo code and in the analytical model together with their limitations are discussed. Examples showing the use of the calculated set of proton pencil beams as input to an existing photon treatment planning algorithm based on biological optimization are given for fully 3D scanned proton pencil beams; these include intensity modulated beams with range shift and scanning in the transversal plane.     

The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity

A prospective assessment of late changes in breast appearance in 559 patients after tumour excision and radiotherapy for early breast cancer noted a strong association with breast size. Only 3/48 (6%) patients with small breasts developed moderate or severe late changes compared with 94/423 (22%) with medium sized breasts and 34/88 (39%) patients with large breasts (p < 0.001). One possibility is that greater radiation changes are related to greater dose inhomogeneity in women with large breasts. To explore this hypothesis, radiation dose distributions were assessed in a separate group of 37 women in whom three-level transverse computer tomographic images of the breast in the treatment position were available. A significant correlation was found between breast size and dose inhomogeneity which may account for the marked changes in breast appearance reported in women with large breasts.     

A software tool for the quantitative evaluation of 3D dose calculation algorithms

Current methods for evaluating modern radiation therapy treatment planning (RTP) systems include the manual superposition of calculated and measured isodose curves and the comparison of a limited number of calculated and measured point doses. Both techniques have significant limitations in providing quantitative evaluations of the large number of dose data generated by modern RTP systems. More sophisticated comparison techniques have been presented in the literature, including dose-difference and distance-to-agreement (DTA) analyses. A software tool has been developed that uses superimposed isodose plots, dose-difference, and DTA distributions to quantify errors in computed dose distributions. Dose-difference and DTA analyses are overly sensitive in regions of high- and low-dose gradient, respectively. The logical union of locations that fail both dose-difference and DTA acceptance criteria, termed the composite evaluation, is calculated and displayed. The composite evaluation provides a method for the physicist to efficiently identify regions that fail both the dose-difference and DTA acceptance criteria. The tool provides a computer platform for the quantitative comparison of calculated and measured dose distributions.     

The use of general purpose software in casting solidification simulation

Computer simulation of casting solidification has been developed to a degree that allows its use in industrial applications. This has been accomplished through the use of numerical techniques, the high speed digital computer, and development of procedures which eliminate previous assumptions of temperature-independent thermal properties, zero melt superheat, and intimate contact at all interfaces. However, for computer simulation to be a useful, economic tool, the manpower required to prepare a problem for the computer and to analyze the results must be minimized. These can be achieved by including in the programmatic goals of the project the use of generalized computer programs, simple data input, and easy-to-analyze computer output. One means of accomplishing this involves the use of general purpose heat transfer programs, preprocessing computer programs to aid in data input and color microfilm output. Such a procedure is described in this paper using a copper, flanged-barrel casting problem to demonstrate the versatility and ease-of-data analysis possible with this approach. This work was performed under the auspices of the USERDA.     

Three-dimensional visualization and measurement of conformal dose distributions using magnetic resonance imaging of BANG polymer gel dosimeters

PURPOSE/OBJECTIVE: The measurement of complex dose distributions (those created by irradiation through multiple beams, multiple sources, or multiple source dwell positions) requires a dosimeter that can integrate the dose during a complete treatment. Integrating dosimeter devices generally are capable of measuring only dose at a point (ion chamber, diode, TLD) or in a plane (film). With increasing use of conformal dose distributions requiring shaped, noncoplanar beams, there will be an increased requirement for a dosimeter that can record and display a 3D dose distribution. The use of a 3D dosimeter will be required to confirm the accuracy of treatment plans produced by the current generation of 3D treatment-planning computers. METHODS AND MATERIALS: The use of a Fricke-infused gel and magnetic resonance imaging (MRI) to demonstrate the localization of stereotactic beams has been demonstrated (11). The recently developed BANG polymer gel dosimetry system (MGS Research, Inc., Guilford, CT), based on radiation-induced chain polymerization of acrylic monomers dispersed in a tissue-equivalent gel, surpasses the Fricke-gel method by providing accurate, quantitative dose distribution data that do not deteriorate with time (6, 9). The improved BANG2 formulation contains 3% N,N'-methylene-bisacrylamide, 3% acrylic acid, 1% sodium hydroxide, 5% gelatin, and 88% water, where all percentages are by weight. The gel was poured into volumetric flasks, of dimensions comparable to a human head. The gels were irradiated with complex beam arrangements, similar to those used for conformal radiation therapy. Images of the gels were acquired using a Siemens 1.5T imager and a Hahn spin-echo pulse sequence (90 degrees-tau-180 degrees-tau-acquire, for different values of tau). The images were transferred via network to a Macintosh computer for which a data analysis and display program was written. The program calculates R2 maps on the basis of multiple TE images, using a monoexponential nonlinear least-squares fit based on the Levenberg-Marquardt algorithm. The program also creates a dose-to-R2 calibration function by fitting a polynomial to a set of dose and R2 data points, obtained from gels irradiated in test tubes to known doses. This function can then be applied to any other R2 map, so that a dose map can be computed and displayed. RESULTS: Through exposure to known doses of radiation, the gel has been shown to respond linearly with dose in the range of 0 to 10 Gy, and its response is independent of the beam energy or modality. Dose distributions have been imaged in orthogonal planes, and can be displayed in a convenient form for comparison with isodose plans. The response of the gel is stable; the gel can be irradiated at any time after its manufacture, and imaging can be conducted any time following a brief interval after irradiation. CONCLUSION: The polymer gel dosimeter has been shown to be a valuable device for displaying three-dimensional dose distributions. The imaged dose distribution can be compared easily with calculated dose distributions, to validate a treatment planning system. In the future, gels may be prepared in anthropomorphic phantoms, to confirm unique patient dose distributions.     

Optimization of permanent 125I prostate implants using fast simulated annealing

PURPOSE: Treatment planning of ultrasound-guided transperineal 125I permanent prostatic implants is a time-consuming task, due to the large number of seeds used and the very large number of possible source arrangements within the target volume. The goal of this work is to develop an algorithm based on fast simulated annealing allowing consistent and automatic dose distribution optimization in permanent 125I prostatic implants. METHODS AND MATERIALS: Fast simulated annealing is used to optimize the dose distribution by finding the best seed distribution through the minimization of a cost function. The cost function includes constraints on the dose at the periphery of the planned target volume and on the dose uniformity within this volume. Adjustment between peripheral dose and the dose uniformity can be achieved by varying the weight factor in the cost function. RESULTS: Fast simulated annealing algorithm finds very good seed distributions within 20,000 iterations. The computer time needed for the optimization of a typical permanent implant involving 60 seeds and 14 needles is approximately 15 min. An additional 5 min are necessary for isodose distribution computations and miscellaneous outputs. CONCLUSION: The use of fast simulated annealing allows for an efficient and rapid optimization of dose distribution. This algorithm is now routinely used at our institution in the clinical planning of 125I permanent transperineal prostate implants for early stage prostatic carcinoma.     

Numerical calculation of energy deposition by high-energy electron beams: III-B. Improvements to the 6D phase space evolution model

The phase space evolution model of Huizenga and Storchi, Morawska-Kaczyńska and Huizenga and Janssen et al has been modified to (i) allow application on currently available computer equipment with limited memory (128 Megabytes) and (ii) allow 3D dose calculations based on 3D computer tomographic patient data. This is a further development aimed at the use of the phase space evolution model in radiotherapy electrons beam treatment planning. The first modification regards the application of depth evolution of the phase space state combined with an alternative method to transport back-scattered electrons. This depth evolution method requires of the order of 15 times less computer memory than the energy evolution method. Results of previous and new electron transport methods are compared and show that the new electron transport method for back-scattered electrons hardly affects the accuracy of the calculated dose distributions. The second modification regards the simulation of electron transport through tissues with varying densities by applying distributed electron transport through similarly composed media with a limited number of fixed densities. Results of non-distributed and distributed electron transport are compared and show that the distributed electron transport method hardly affects the accuracy of the calculated dose distributions. It is also shown that the results of the new dose distribution calculations are still in good agreement with and require significantly less computation time than results obtained with the EGS4 Monte Carlo method.     

The reconstruction and dose-rate calculation of radium needle implants

A comprehensive computer program has been developed for carrying out the various tasks associated with radium needle implants. Data input for the program are obtained by digitizing an orthogonal pair of radiographs with an analogue tracing system. Corresponding needles in the two radiographs are automatically located, and the implant may be rotated to any desired position in three dimensional space, at the same time presenting a view of the rotation on a storage oscilloscope. Automatic determination of the mean plane of a planar implant is possible, and the dose-rate distribution may be calculated in any specified plane. A Paterson--Parker exposure rate calculation may be performed with a biological dose and treatment time correction incorporated. The program is written in Fortran and runs on a small interactive computer system.     

Magnetic resonance imaging of microbubbles in a superheated emulsion chamber for brachytherapy dosimetry

This paper describes development of magnetic resonance imaging (MRI) techniques for three-dimensional (3D) imaging of a position-sensitive detector for brachytherapy dosimetry. The detector is a 0.5 l chamber containing an emulsion of halocarbon-115 droplets in a tissue-equivalent glycerin-based gel. The halocarbon droplets are highly superheated and expand into vapor microbubbles upon irradiation. Brachytherapy sources can be inserted into the superheated emulsion chamber to create distributions of bubbles. Three-dimensional MRI of the chamber is then performed. A 3D gradient-echo technique was optimized for spatial resolution and contrast between bubbles and gel. Susceptibility gradients at the interfaces between bubbles and gel are exploited to enhance contrast so microscopic bubbles can be imaged using relatively large voxel sizes. Three-dimensional gradient-echo images are obtained with an isotropic resolution of 300 microns over a 77 mm x 77 mm x 9.6 mm field-of-view in an imaging time of 14 min. A post-processing technique was developed to semi-automatically segment the bubbles from the images and to assess dose distributions based on the measured bubble densities. Relative dose distributions are computed from MR images for a 125I brachytherapy source and the results compare favorably to relative radial dose distributions calculated as recommended by Task Group 43 of the American Association of Physicists in Medicine.     

Importance of in vivo dosimetry as part of a quality assurance program in tangential breast treatments

PURPOSE: The investigation of the accuracy and reproducibility in the daily dose delivered in tangential breast treatments with in vivo dose measurements. METHODS AND MATERIALS: In vivo dose measurements performed on the tangential treatment fields of 35 breast cancer patients are analysed for three units: a 6 MV linear accelerator, an old Cobalt unit and a new Cobalt unit. The results are plotted in frequency distributions. Deviations on the mean are often the expression of a systematic error in one of the core procedures of a department. A large spread of the results around the mean indicates a high burden of random set-up errors and/or systematic errors in individual patients. The reproducibility in dose delivery is studied by comparing repetitive checks to their respective mean for investigation of random day-to-day variation. RESULTS: A small systematic error on the entrance dose (+ 1.4%) is detected on the old Cobalt unit due to a discrepancy between measured and published percentage depth dose values. An unexpected systematic overdosage (+ 6%) is detected after implementation of a new software for dose calculation, proving that treatment quality is a process needing continuous monitoring. The transmission measurements demonstrate a systematic error in dose delivery of 1.5 to 3% due to the assumption that the breast is water equivalent when calculating the dose. The large spread of the transmission measurements (sa = 7.7%) shows that the weakest point in the treatment preparation chain is inaccurate acquisition of external body contours, leading to systematic errors in dose delivery for specific patients. The standard deviation for the reproducibility is 3.1% for the old Cobalt unit, vs. 1.6% on the other units, demonstrating the influence of staffing and mechanical characteristics of the units on daily precision in dose delivery. CONCLUSION: In vivo dosimetry is an important tool in a departmental quality assurance program to detect systematic errors in dose delivery, to identify inadequate treatment situations, to investigate weak points in the chain of treatment preparation and to ensure accurate dose delivery for individual patients. The predictive value of a single check for the accuracy in dose delivery during the whole treatment series is high for reproducible treatment methodologies.     

Water Distribution in Laterals and Units of Subsurface Drip Irrigation. I: Simulation

A complete methodology to predict water distribution in laterals and units of subsurface drip irrigation (SDI) is proposed. Two computer programs have been developed for the hydraulic characterization of SDI; one for laterals and the other for units. Emitter discharge was considered to depend on hydraulic variability, emitter’s manufacture and wear variation, and soil pressure variation. A new procedure to solve the hydraulic calculation of SDI looped network has been established. Moreover, spatial distribution of soil variability was estimated by a geostatistical modeling software that is coupled with the computer programs. Thus the evaluation and performance of laterals and units of SDI can be addressed by changing input variables such us: length and diameters of laterals; coefficients of emitter’s discharge equation; coefficient of variation of emitter’s manufacture and wear; local losses at the emitter insertion; inlet pressure; and soil hydraulic properties and its spatial variability. Finally, the methodology has been applied to different scenarios, and some recommendations are outlined for the selection of emitter discharge and inlet pressures.     

Intensity-modulated arc therapy with dynamic multileaf collimation: an alternative to tomotherapy

The desire to improve local tumour control and cure more cancer patients, coupled with advances in computer technology and linear accelerator design, has spurred the developments of three-dimensional conformal radiotherapy techniques. Optimized treatment plans, aiming to deliver high dose to the target while minimizing dose to the surrounding tissues, can be delivered with multiple fields each with spatially modulated beam intensities or with multiple-slice treatments. This paper introduces a new method, intensity-modulated arc therapy (IMAT), for delivering optimized treatment plans to improve the therapeutic ratio. It utilizes continuous gantry motion as in conventional arc therapy. Unlike conventional arc therapy, the field shape, which is conformed with the multileaf collimator, changes during gantry rotation. Arbitrary two-dimensional beam intensify distributions at different beam angles are delivered with multiple superimposing arcs. A system capable of delivering the IMAT has been implemented. An example is given that illustrates the feasibility of this new method. Advantages of this new technique over tomotherapy and other slice-based delivery schemes are also discussed.     

Dynamics of social interactive behavior: A computerized procedure for analyzing trends, patterns, and sequences.

Describes procedures that use detailed and sequential observations of monkey mother-infant interactive behavior to make a coordinated analysis of development. Computer programs provide for (1) organizing the behavioral data into frequency tables and developmental curves, (2) making analyses of variance and trends comparing groups of Ss, and (3) determining statistically the patterns of simultaneous behavior and the sequences of patterns that characterize individual Ss and groups. This treatment of a large volume of data is economically feasible. The computer programs have been generalized for application in various kinds of behavioral research. Analyses provide bases in concrete behavioral terms for deriving hypotheses about the dynamics of social behavior and development. This approach promises a more complete and developmental view of complex interactive processes. Greater sophistication in the use of computer capabilities and in the application of mathematical models and treatments can increase its effectiveness. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Methodologic studies on the optimization of the 60Co-teletherapy in combination with high dosage brachytherapy of cervix carcinoma

After dosimetric recording of the radium implants being in use at the radiological department of the gynecological clinics at Vienna, an attempt is made for the adaptation of cobalt-60 teletherapy to brachytherapy generally applied here and utilizing relatively high dosage. A biaxial, bisegmental small-angle rotation about two cranially convergent axes, combined with the radium doses, yields a relatively well equilibrated load on the parametrial tissue and on the essential areas of the lymph flow. The dose distribution is shown by transversal as well as by frontal sectional planes. If deviations of the position of the radium implants, always possible in an individual case, are verified by localization imaging, asymmetrical dose distributions can be calculated by a computer and compensated by means of different loads to the axes of rotation.     

Distributions of distances in information strings

Distances between identical symbols in information strings (biological, language, computer programs (*.exe files) are described with a different precision with four distributions: exponential, Weibull, log-normal and negative binomial. The correlations are sometimes highly significant.     

Genetic algorithms-based design and optimization of statistical quality-control procedures

In general, one cannot use algebraic or enumerative methods to optimize a quality-control (QC) procedure for detecting the total allowable analytical error with a stated probability with the minimum probability for false rejection. Genetic algorithms (GAs) offer an alternative, as they do not require knowledge of the objective function to be optimized and can search through large parameter spaces quickly. To explore the application of GAs in statistical QC, I developed two interactive computer programs based on the deterministic crowding genetic algorithm. Given an analytical process, the program "Optimize" optimizes a user-defined QC procedure, whereas the program "Design" designs a novel optimized QC procedure. The programs search through the parameter space and find the optimal or near-optimal solution. The possible solutions of the optimization problem are evaluated with computer simulation.     

Analysis of dose, dose-rate and treatment time in the production of injuries by radium treatment for cancer of the uterine cervix

A retrospective study has been made of 15 patients who had developed severe complications to the bladder, rectum and ureters after radiation therapy for carcinoma of the cervix. Comprehensive dose distribution in the pelvis were calculated with computer assistance to visualize how the normal organs had been irradiated. The risk of normal tissue injury was analysed graphically with respect to the maximum radium dose, dose-rate and irradiation time. The two groups of data representing the injured and non-injured organs separate much better in a dose-rate versus dose plot than in a conventional Strandqvist type dose-time plot. This implies that in radium therapy, the dose-rate rather than the treatment time, is the important parameter in modifying the risk of normal tissue injury. Our results show a good separation of injured from non-injured cases only when the maximum values of dose and dose-rate were used. This suggests that clinically significant injury may develop from relatively small regions of high dose and dose-rate. Since the dose-rate varies from point to point in the pelvis (unlike treatment time), comprehensive determinations of dose-rate distributions are required in order to locate the sites of potential injuries.     

Statistically representative three-dimensional microstructures based on orthogonal observation sections

Techniques are described that have been used to create a statistically representative three-dimensional model microstructure for input into computer simulations using the geometric and crystallographic observations from two orthogonal sections through an aluminum polycrystal. Orientation maps collected on the observation planes are used to characterize the sizes, shapes, and orientations of grains. Using a voxel-based tessellation technique, a microstructure is generated with grains whose size and shape are constructed to conform to those measured experimentally. Orientations are then overlaid on the grain structure such that distribution of grain orientations and the nearest-neighbor relationships, specified by the distribution of relative misorientations across grain boundaries, match the experimentally measured distributions. The techniques are applicable to polycrystalline materials with sufficiently compact grain shapes and can also be used to controllably generate a wide variety of hypothetical microstructures for initial states in computer simulations. This article is based on a presentation made at the symposium “Characterization and Representation of Material Microstructures in 3-D” held October 8–10, 2002, in Columbus, OH, under the auspices of ASM International’s Phase Transformations committee.