arXiv subjects

Jay Flanz

Publications and source records attributed to Jay Flanz.

3 recordsLinked to original sources

arXiv2026

PTCOG Treatment Efficiency Subcommittee Risk Assessment Report on Patient-Specific Quality Assurance

Patient-specific quality assurance (PSQA) in pencil beam scanning proton therapy (PBS-PT) is often treated as a purely technical verification task. This PTCOG Treatment Efficiency Subcommittee White Paper instead frames PSQA as a workflow-embedded risk-control strategy and asks how different PSQA approaches reshape the same clinical risk landscape. Using a generic PBS-PT process-driven Failure Mode and Effects Analysis (pFMEA), 44 validated PSQA-relevant failure modes across 20 process steps were scored under a common no-PSQA baseline and three PSQA pathways: measurement-based PSQA, log file-based PSQA, and independent secondary dose calculation. A staged mathematical formalism separates preparatory data-stage effects, method-specific full-stage verification, cumulative endstate effects, and a Data-to-Cum bridge that quantifies additional verification benefit on the baseline scale. In this expert-scored, baseline-anchored model, log file-based PSQA produced the largest cumulative workflow-level risk-score reduction, followed by measurement-based PSQA and independent secondary dose calculation. The ranking is not a winner-takes-all rule or probability-calibrated risk estimate; instead, each method shows distinct risk-control strengths in different workflow regions. The White Paper therefore supports a risk-informed hybrid PSQA architecture, where log file-based PSQA, measurement-based PSQA, and independent secondary dose calculation are assigned to the workflow segments in which their signatures are strongest. It provides a transparent, semi-quantitative, stage-resolved framework for institutions seeking to evaluate, implement, or evolve PSQA in PBS-PT and emphasizes that log file-based PSQA must itself be supported by validated and governed log data and treatment records.

physics.med-ph↗

arXiv2022

Does the greater power of pencil beam scanning reduce the need for a proton gantry? A study of head-and-neck and brain tumors

Proton therapy systems without a gantry can be more compact and less expensive in terms of capital cost, and therefore more available to a larger patient population. Would the advances in pencil beam scanning and robotics make gantry-less treatment possible? In this study, we explore if high-quality treatment plans can be obtained without a gantry. We recently showed that proton treatments with the patient in an upright position may be feasible with a new soft robotic immobilization device and imaging which enables multiple possible patient orientations during a treatment. In this study, we evaluate if this new treatment geometry could enable high quality treatment plans without a gantry. We created pencil beam scanning (PBS) treatment plans for seven patients with head-and-neck or brain tumors. Each patient was planned with two scenarios: one with a gantry with the patient in supine position and the other with a gantry-less fixed horizontal beam-line with the patient sitting upright. For the treatment plans, dose-volume-histograms (DVHs), target homogeneity index (HI), mean dose, D_2 and D_98 are reported. A robustness analysis of one plan was performed with +/-2.5 mm setup errors and +/-3.5% range uncertainties with nine scenarios. Most of the PBS-gantry-less plans had similar target HI and OAR mean dose as compared to PBS-gantry plans, and similar robustness with respect to range uncertainties and setup errors. Pencil beam scanning provides sufficient power to deliver high quality treatment plans without requiring a gantry for head-and-neck or brain tumors. In combination with the development of the new positioning and immobilization methods required to support this treatment geometry, this work suggests the feasibility of further development of a compact proton therapy system with a fixed horizontal beam-line to treat patients in sitting and reclined positions.

physics.med-ph↗

arXiv2018

Future (of) Synchrotrons for Particle Therapy

The field of particle therapy is quickly growing and yet it's more widespread adoption is limited by size, cost and adaptation to the more conformal treatment techniques. In order to realize the benefits of this modality the equipment used to generate and deliver the beam is evolving. The accelerator is one of the key components and its future is dictated by the ability to accommodate the clinical requirements. This lecture is intended to provide an introduction to these requirements and identify how synchrotrons are designed to deliver the desired beams as well as what limitations exist and expectations for the future of synchrotrons.

physics.med-ph↗