[Study on the sensitivity of a volumetric modulated arc therapy plan verification equipment on multi-leaf collimator opening and closing errors and its gamma pass rate limit].

To investigate the γ pass rate limit of plan verification equipment for volumetric modulated arc therapy (VMAT) plan verification and its sensitivity on the opening and closing errors of multi-leaf collimator (MLC), 50 cases of nasopharyngeal carcinoma VMAT plan with clockwise and counterclockwise full arcs were randomly selected. Eight kinds of MLC opening and closing errors were introduced in 10 cases of them, and 80 plans with errors were generated. Firstly, the plan verification was conducted in the form of field-by-field measurement and true composite measurement. The γ analysis with the criteria of 3% dose difference, distance to agreement of 2 mm, 10% dose threshold, and absolute dose global normalized conditions were performed for these fields. Then gradient analysis was used to investigate the sensitivity of field-by-field measurement and true composite measurement on MLC opening and closing errors, and the receiver operating characteristic curve (ROC) was used to investigate the optimal threshold of γ pass rate for identifying errors. Tolerance limits and action limits for γ pass rates were calculated using statistical process control (SPC) method for another 40 cases. The error identification ability using the tolerance limit calculated by SPC method and the universal tolerance limit (95%) were compared with using the optimal threshold of ROC. The results show that for the true composite measurement, the clockwise arc and the counterclockwise arc, the descent gradients of the γ passing rate with per millimeter MLC opening error are 10.61%, 7.62% and 6.66%, respectively, and the descent gradients with per millimeter MLC closing error are 9.75%, 7.36% and 6.37%, respectively. The optimal thresholds obtained by the ROC method are 99.35%, 97.95% and 98.25%, respectively, and the tolerance limits obtained by the SPC method are 98.98%, 97.74% and 98.62%, respectively. The tolerance limit calculated by SPC method is close to the optimal threshold of ROC, both of which could identify all errors of ±2 mm, while the universal tolerance limit can only partially identify them, indicating that the universal tolerance limit is not sensitive on some large errors. Therefore, considering the factors such as ease of use and accuracy, it is suggested to use the true composite measurement in clinical practice, and to formulate tolerance limits and action limits suitable for the actual process of the institution based on the SPC method. In conclusion, it is expected that the results of this study can provide some references for institutions to optimize the radiotherapy plan verification process, set appropriate pass rate limit, and promote the standardization of plan verification.

[PyRERT: Python Research Environment for Radiation Therapy].

OBJECTIVE: The Python research environment for radiation therapy (PyRERT) is a set of business software for hospital physicists to conduct radiation therapy research. METHODS: Choose the open source Enthought Tool Suite（ETS） as the core external dependency library of PyRERT. PyRERT is divided into base layer, content layer and interaction layer, and each layer is composed of different functional modules. RESULTS: PyRERT V1.0 provide a good development environment for scientific research programming in DICOM RT file processing, batch processing of water tank scan data, digital phantom creation, 3D medical image volume visualization, virtual radiotherapy equipment driver, and film scan image analysis. CONCLUSIONS: PyRERT enables the results of the research group to be iteratively inherited in the form of software. It's reusable basic classes and functional modules greatly improve the efficiency of scientific research task programming.

[Design and Validation of Remote Radiotherapy System].

Telemedicine technology is a means of deploying medical resources with low cost and high efficiency. A set of remote radiotherapy system based on Citrix was designed in this paper, so that the senior radiation therapists from the developed areas can provide medical services effectively for the patients in the rural areas. This paper focused on the design ideas and the detail of the technical implementation of how to design a remote radiotherapy system based on the existing equipment in the primary hospital. And the technical reliability and security of the remote radiotherapy system were verified by the scientific test method with pairwise comparison. The early practical experience shows that through the remote radiotherapy system the primary radiotherapy personnel and the radiotherapy experts from thirdgrade class-A hospital can form effective alliance in radiotherapy techniques to allow patients in rural areas to receive more professional radiation therapy.

[Application of REDCap Software in Radiotherapy Quality Control Platform REDCap].

In order to digitize the radiotherapy quality control data, convenient to carry on the dynamic quantitative analysis to the equipment condition, this paper presents a low-cost open radiotherapy quality control platform based on REDCap. The platform uses the REDCap data acquisition system as a carrier to achieve the digital storage of this data, anytime, anywhere data entry, and can be easily derived for data analysis by creating REDCap research projects and inputting radiotherapy quality control data. It is proved that REDCap can be used in the construction of radiotherapy quality control platform.

[Development of a Compared Software for Automatically Generated DVH in Eclipse TPS].

Objective: This study is to automatically calculate the dose volume histogram(DVH) for the treatment plan, then to compare it with requirements of doctor's prescriptions. Methods: The scripting language Autohotkey and programming language C# were used to develop a compared software for automatically generated DVH in Eclipse TPS. This software is named Show Dose Volume Histogram (ShowDVH), which is composed of prescription documents generation, operation functions of DVH, software visualization and DVH compared report generation. Results: Ten cases in different cancers have been separately selected, in Eclipse TPS 11.0 ShowDVH could not only automatically generate DVH reports but also accurately determine whether treatment plans meet the requirements of doctor's prescriptions, then reports gave direction for setting optimization parameters of intensity modulated radiated therapy. Conclusions: The ShowDVH is an user-friendly and powerful software, and can automatically generated compared DVH reports fast in Eclipse TPS 11.0. With the help of ShowDVH, it greatly saves plan designing time and improves working efficiency of radiation therapy physicists.

[Development of a Software for Automatically Generated Contours in Eclipse TPS].

OBJECTIVE: The automatic generation of planning targets and auxiliary contours have achieved in Eclipse TPS 11.0. METHODS: The scripting language autohotkey was used to develop a software for automatically generated contours in Eclipse TPS. This software is named Contour Auto Margin (CAM), which is composed of operational functions of contours, script generated visualization and script file operations. RESULTS Ten cases in different cancers have separately selected, in Eclipse TPS 11.0 scripts generated by the software could not only automatically generate contours but also do contour post-processing. For different cancers, there was no difference between automatically generated contours and manually created contours. CONCLUSION: The CAM is a user-friendly and powerful software, and can automatically generated contours fast in Eclipse TPS 11.0. With the help of CAM, it greatly save plan preparation time and improve working efficiency of radiation therapy physicists.

Multi-scale bioimpedance flexible sensing with causal hierarchical machine learning for fish vitality evaluation under adversity stress.

It is expected that waterless low-temperature stressful environments will induce stress responses in fish and affect their vitality. In this study, we developed a laser-activated, stretchable, highly conductive liquid metal (LM) based flexible sensor system for fish multi-scale bioimpedance detection. It has excellent conformability, electrical conductivity, bending and cyclic tensile stability. Meanwhile, test result showed that wireless power supply is a potential solution for realizing safe power supply for devices inside waterless low-temperature packages. In addition, a hierarchical regression model (GC-HRM) based on Granger causality was established. The result showed that tissue bioimpedance can induce changes in individual bioimpedance with unidirectional Granger causality. The R2 of the linear regression (LR), support vector regression (SVR) and artificial neural network (ANN) models under single-scale individual bioimpedance were 0.85, 0.90 and 0.78, respectively. By adding the multi-scale bioimpedance features, the R2 of the LR, SVR and ANN models were improved to 0.95, 1.00 and 0.98, respectively.

Sensitivity of Three Patient-Specific Quality Assurance Systems to MLC Aperture Errors With Volumetric Modulated Arc Therapy.

Purpose: To compare the sensitivity of ArcCHECK (AC), portal dosimetry (PD), and an in-house logfile-based system (LF) to multileaf collimators (MLC) aperture errors and the ability to identify these errors. Methods and Materials: For 12 retrospective original head and neck volumetric modulated arc therapy (VMAT) plans, MLC aperture errors of ± 0.4mm, ± 1.2mm, ± 2mm, and ± 3mm were introduced for each plan, resulting in 96 plans with errors. AC, PD, and LF were used for the gamma evaluation at 3%/3mm, 3%/2mm, and 2%/2mm criteria. Gradient analysis was used to evaluate the sensitivity to MLC aperture errors. The area under the curve (AUC) obtained from the receiver operating characteristic (ROC) curve was used to evaluate the ability to identify MLC aperture errors and dose errors, and the optimal cut-off value to identify the error was obtained. Results: The gamma pass rate (%GP) of LF had the smallest descent gradient as the MLC error increases in any case. The descent gradient of PD was larger than AC, except for the case at the 2%/2mm criteria. For the 3%/3mm criteria, the MLC aperture errors that can be perfectly identified by AC, PD, and LF were ± 3mm, ± 2mm, and ± 1.2mm, respectively, and the average percent dose error (%DEs) of dose metrics in targets that can be perfectly identified were 4% to 5%, 3% to 4%, and 2% to 3%, respectively. For the 3%/2mm criteria, the errors that AC, PD, and LF can perfectly identify were the same as the 3%/3mm criteria. For the 2%/2mm criteria, AC can perfectly identify the MLC error of ± 2mm and the %DE of 3% to 4%. PD and LF can identify the MLC error of ± 1.2mm and the %DE of 2% to 3%. Conclusion: Different patient-specific quality assurance (PSQA) systems have different sensitivity and recognition abilities to MLC aperture errors. Institutions should formulate their own customized %GP limits based on their PSQA process through ROC or other methods.

Modeling traceability information and functionality requirement in export-oriented tilapia chain.

BACKGROUND: Tilapia has been named as the 'food fish of the 21st century' and has become the most important farmed fish. China is the world leader in tilapia production and export. Identifying information and functional requirements is critical in developing an efficient traceability system because traceability has become a fundamental prerequisite for exporting aquaculture products. RESULTS: This paper examines the export-oriented tilapia chains and information flow in the chains, and identifies the key actors, information requirements and information-capturing points. Unified Modeling Language (UML) technology is adopted to describe the information and functionality requirement for chain traceability. The barriers of traceability system adoption are also identified. CONCLUSION: The results show that the traceability data consist of four categories that must be recorded by each link in the chain. The functionality requirement is classified into four categories from the fundamental information record to decisive quality control; the top three barriers to the traceability system adoption are: high costs of implementing the system, lack of experienced and professional staff; and low level of government involvement and support.