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S P Goldman

Publications and source records attributed to S P Goldman.

2 recordsLinked to original sources

Feasibility of a fast inverse dose optimization algorithm for IMRT via matrix inversion without negative beamlet intensities.

A fast optimization algorithm is very important for inverse planning of intensity modulated radiation therapy (IMRT), and for adaptive radiotherapy of the future. Conventional numerical search algorithms such as the conjugate gradient search, with positive beam weight constraints, generally require numerous iterations and may produce suboptimal dose results due to trapping in local minima. A direct solution of the inverse problem using conventional quadratic objective functions without positive beam constraints is more efficient but will result in unrealistic negative beam weights. We present here a direct solution of the inverse problem that does not yield unphysical negative beam weights. The objective function for the optimization of a large number of beamlets is reformulated such that the optimization problem is reduced to a linear set of equations. The optimal set of intensities is found through a matrix inversion, and negative beamlet intensities are avoided without the need for externally imposed ad-hoc constraints. The method has been demonstrated with a test phantom and a few clinical radiotherapy cases, using primary dose calculations. We achieve highly conformal primary dose distributions with very rapid optimization times. Typical optimization times for a single anatomical slice (two dimensional) (head and neck) using a LAPACK matrix inversion routine in a single processor desktop computer, are: 0.03 s for 500 beamlets; 0.28 s for 1000 beamlets; 3.1 s for 2000 beamlets; and 12 s for 3000 beamlets. Clinical implementation will require the additional time of a one-time precomputation of scattered radiation for all beamlets, but will not impact the optimization speed. In conclusion, the new method provides a fast and robust technique to find a global minimum that yields excellent results for the inverse planning of IMRT.

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Attitudes to and use of a modified prescription form by general practitioners and pharmacists.

OBJECTIVE: To evaluate the rate of use and acceptance of a new prescription form designed to provide more information to pharmacists and patients. DESIGN: Prospective descriptive study. SETTING: A semi-rural community outside Melbourne, Victoria, in November 1994. PARTICIPANTS: GPs and pharmacists working three or more sessions per week in the locality, and 21 consumers who formed two consumer focus groups. INTERVENTION: An education session for GPs and pharmacists, followed by a one-month trial of new prescription forms which included notations to facilitate interprofessional communication. MAIN OUTCOME MEASURES: Rate of use and acceptability of the new prescription notations. RESULTS: Eighteen GPs and 10 pharmacists participated; 3600 forms were issued and 2521 prescriptions, including 3464 prescription items, were analysed. GPs and pharmacists used at least one of the new prescription notations in 45% (1559) of prescription items; 35% of prescription items (1222) were notated with the general purpose of the medication. Qualitative findings suggested that GPs, pharmacists and consumers considered the new prescription form to be beneficial and useful. CONCLUSIONS: A modified prescription form to increase communication between GPs and pharmacists is acceptable in clinical practice.

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