Plaque Simulator Treatment PlanPlaque Simulator :08:53, page 1

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1 Plaque Simulator Treatment PlanPlaque Simulator :08:53, page 1 Patient name:anterior Tutorial Anterior TutorialEthnicity code: 0Ethnicity code: 0 Medical record #: CPT Code(s): CPT Code(s): Gender: MGender: M Other: DOB: Oct 31, 1952DOB: Oct 31, 1952 Institution: Age at implant: 62Age at implant: 62 PSID: 194B71E7Patien Ethnicity code: 0Medic Gender: MOther DOB: Oct 31, 1952Institu Implant:Mon Jun 23, 2014 at Mon 10:00 Jun 23, 2014 at 10:00 Removal: Age at implant: 62Implan Removal:Mon Jun 30, 2014 at Mon 10:00 Jun 30, 2014 at 10:00 Range: ± 3.36 hr (2.0%)Range: ± 3.36 hr (2.0% Duration (hours): Prescription: Prescription:85.00 Gy to Tumor TAX Gy to Inner+ Tumor TAX mminner mmplaque: Plaque:1 (EP2025P) 1 (EP2025P)Nominal diameter: Nominal diameter:19.98 mm19.98 mmnumber of sources: Number of sources:25 of 2525 of 25Suture coordinates: Suture coordinates:a (9:18,3.9mm), A (9:18,3.9mm), B (5:43,3.9mm) B (5:43,3.9mm)Scleral offset: Scleral offset:-0.50 mm mmwobble (x,y,z): Wobble (x,y,z):0.00,0.00, ,0.00,13.00 Total strength: Total strength:i-125 (IAI-125A) I U (IAI-125A) (39.29mCi) 49.90U on (39.29mCi) 6/23/14 on 6/23/14Avg. strength: Avg. strength:1.996u (1.572mCi) 1.996U on (1.572mCi) 6/23/14 on 6/23/14Tumor #: Tumor #:1 1Apex (margin): Apex (margin):4.52 mm ( mm) mm (2.00 mm)post.pole->center (ext.coord): Post.pole->center (ext.coord): 18.0 mm (7:28,6.6mm)Radial x Circumferential: Radial x Circumferential: x x mm mmlength x Width: Length x Width:13.08 x mm x mmarea (Volume): Area (Volume):135.6 sq.mm (0.36 sq.mm ml) (0.36 ml)% of retinal surface: % of retinal surface:9.6 % 9.6 % Range: ± 3.36 hr (2.0%)Durat EP2025P A B D C Plan by for, approved by (MD)PSID: 194B71E7PSID: 1 Institution:, EULA: astrahan.2014, User: Melvin AstrahanPlan by for Plaque Simulator :08:53, page 1 of 3Institution:, EULA: astrahan.2014

2 Plaque Simulator Treatment PlanPlaque Simulator :08:53, page 2 Dose calc. mode: Line, F[Ø], B[r], Pexp, no T, SlotPt:Anterior Tutorial, Right eye, DOB: Oct 31, 1952, M, T=168 EP2025P CAXAvg. Dose RateAvg. Dose RateTotal Total Dose Dose (mm) (mm)(cgy/hr) (cgy/hr)(gy) (Gy) Critical Site Critical SiteAvg. Dose Rate Avg. Dose RateTotal Total DoseDoseDistance From Distance Plaque From Plaque (cgy/hr) (cgy/hr)(gy) (Gy)(mm) (mm)prescription point Prescription point Tumor TAX Inner+ Tumor TAX mminner mmsclera Sclera (from plaque 0.500(from center) plaque center)qa_point QA_Point (from plaque 6.000(from center) plaque center)qa_check (isotropic p QA_Check (isotropic pt srce in water) Point/Check = Point/Check 0.96 = 0.96Optic disc Optic disc (center to 20.31(center center) to center)opposite retina Opposite retina (from plaque 23.37(from center) plaque center)lens Lens (center to 11.73(center center) to center)eye origin Eye origin (from plaque 11.93(from center) plaque center)macula (posterior pole Macula (posterior pole) (center to 18.62(center center) to center)apex of tumor #1 Apex of tumor # (from plaque 6.432(from center) plaque center)dose calc. mode: Line, Institution:, EULA: astrahan.2014, User: Melvin AstrahanEP2025P CAX Plaque Simulator :08:53, page 2 of 3Institution:, EULA: astrahan.2014

3 Plaque Simulator Treatment PlanPlaque Simulator :08:54, page mm mm Institution:, EULA: astrahan.2014, User: Melvin Astrahan Plaque Simulator :08:54, page 3 of 3Institution:, EULA: astrahan.2014

4 Plaque Simulator Retinal DiagramPlaque Simulator :08:55, page 1 Rx plaque:1 (EP2025P) 1 (EP2025P)Dose matrix set: Dose matrix set:1 (retinal surface) 1 (retinal surface)prescribed (Rx) dose: Prescribed (Rx) dose: Gy to Tumor Gy to 1 Tumor TAX Inner+ 1 TAX 7.00 Inner+ mm 7.00 mmdose matrix max: Dose matrix max: Gy Gy Gy Suture coordinates: Sup. Rectus 12 Sup. Oblique equator Distance between sutures (mm):plaque Plaque #1 (EP2025P)A:B=1 A:B=15.3Pt:An 1 2 ora limbus Lat. Rectus 9:18,3.9mm 100 Inf. Oblique Med. Rectus Suture coordinates:plaque #1 (EP2025P) Plaque #1 (EP2025P)A (9:18,3.9mm) A (9:18,3.9mm)B (5:43,3.9mm) B (5:43,3.9mm)Distance between sutures (mm): Inf. Rectus 5:43,3.9mm Institution:, EULA: astrahan.2014, User: Melvin AstrahanRx plaque: Plaque Simulator :08:55, page 1 of 2Institution:, EULA: astrahan.2014

5 Plaque Simulator Retinal DiagramPlaque Simulator :08:55, page 2 Rx plaque:1 (EP2025P) 1 (EP2025P)Dose matrix set: Dose matrix set:1 (retinal surface) 1 (retinal surface)prescribed (Rx) dose: Prescribed (Rx) dose: Gy to Tumor Gy to 1 Tumor TAX Inner+ 1 TAX 7.00 Inner+ mm 7.00 mmdose matrix max: Dose matrix max: Gy Gy Gy Sup. Rectus Suture coordinates: Sup. Oblique equator Distance between sutures (mm):plaque Plaque #1 (EP2025P)A:B=1 A:B=15.3Pt:An 6050 ora 5040 limbus Lat. Rectus 171,3.9mm 100 Inf. Oblique Med. Rectus Suture coordinates:plaque #1 (EP2025P) 7060 Plaque #1 (EP2025P)A (171,3.9mm) 8070 A (171,3.9mm)B (98,3.9mm) B (98,3.9mm)Distance between sutures (mm): Inf. Rectus 98,3.9mm Institution:, EULA: astrahan.2014, User: Melvin AstrahanRx plaque: Plaque Simulator :08:55, page 2 of 2Institution:, EULA: astrahan.2014

6 Plaque Simulator Loading DiagramPlaque Simulator :08:56, page Radionuclide source summary:plaque #: Plaque #:1 Plaque name:ep2025p Radionuclide:I-125 (IAI-125A) Inventory name:anterior Tutorial Number of sources:25 Assay date:6/23/14 Avg. (total) assay:1.57 mci (39.29 mci) Avg. (total) implant:1.57 mci (39.29 mci) EP2025PFACE (concave view) FACE (concave view) A B 1Plaque name: EP2025PRadionuclide: I-125 (IAI-125A)Inventory name: Anterior TutorialNumber of sources: 25Assay date: 6/23/14Avg. (total) assay: 1.57 mci (39.29 mci)avg. (total) implant: 1.57 mci (39.29 mci) D C EP2025PBACK (convex view) BACK (convex view)pt:anterior Tutorial, Right eye, DOB: Oct 31, 1952, M, T= hrs, PREPLAN C D B A Institution:, EULA: astrahan.2014, User: Melvin AstrahanRadionuclide source summary: Plaque Simulator :08:56, page 1 of 1Institution:, EULA: astrahan.2014

7 Plaque Simulator Isodose PlotPlaque Simulator :08:57, page 1 of 2 Markers1 mm 1 mmprescribed (Rx) dose Prescribed (Rx) dose85.00 Gy to Tumor Gy to 1 Tumor TAX Inner+ 1 TAX 7.00 Inner+ mm7.00 mmdose matrix set Dose matrix set1 1Meridian plane longitudes Meridian plane longitudes & & Dose matrix maximum Dose matrix maximum Gy Gy400.0 Gy Gy Rx Institution:, EULA: astrahan.2014, User: Melvin AstrahanMarkers Plaque Simulator :08:57, page 1 of 2Institution:, EULA: astrahan.2014

8 Plaque Simulator Isodose PlotPlaque Simulator :08:58, page 2 of 2 Markers1 mm 1 mmprescribed (Rx) dose Prescribed (Rx) dose85.00 Gy to Tumor Gy to 1 Tumor TAX Inner+ 1 TAX 7.00 Inner+ mm7.00 mmdose matrix set Dose matrix set1 1Equatorial plane offset Equatorial plane offset3.7 mm3.7 mmdose matrix maximum Dose matrix maximum Gy Gy400.0 Gy Gy Institution:, EULA: astrahan.2014, User: Melvin AstrahanMarkers Plaque Simulator :08:58, page 2 of 2Institution:, EULA: astrahan.2014

9 Plaque Simulator Retina Dose-Area HistogramPlaque Simulator Tumor 1 basetumor 1+marginNot marginmaculaoptic disctumor 1 base Tumor 1 basetumor 1+margin Tumor 1+marginNot margin Not marginmacula MaculaOptic disc Optic discrx = Gy Rx = Gy to Tumor 1 T to Tumor 1 TAX Inner mmmargin = 2.0 Margin = 2.0 mmplaque #1 EP2 Plaque #1 EP2025P Relative Area (%) Dose (Gy) Institution:, EULA: astrahan.2014, User: Melvin Astrahan Plaque Simulator :08:58, page 1 of 1Institution:, EULA: astrahan.2014

10 Plaque Simulator QA Check (isotropic point source in water) Plaque #1 EP2025P, implant 6/23/14 for T = hourstavg (hours) = x 24.0 x half-life(in days) Tavg (hours) = x 24.0 x half-life(in days)r = distance from source center to QA point on plaque CAX at (6.0,0.0 r = distance from source center to QA point on plaque CAX at (6.0,0.0,0.0)Dose (Gy) = Strength {x ActivityToSk} x Ta Dose (Gy) = Strength {x ActivityToSk} x Tavg x DoseRateConstant x (1 - exp(-t/tavg)) x (1/r^2) x g(r)s# S#Model ModelStrength ActivityTavg TavgDose-Rate XY YZ Zr rg(r) g(r)dosedosecheck Check 1IAAI 2IAAI 3IAAI 4IAAI 5IAAI 6IAAI 7IAAI to Skhours hoursconstant mmmm mmmm mmmm mm Gy Gyby by1 1.27U/mCi U/mCi U/mCi U/mCi U/mCi U/mCi U/mCi U/mCi U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi IAAI 1.27U/mCi QA_Point QA_Point Dose = QA_Check Dose = Point /Point /Check = = 0.96 EP2025PPt:Anterior Tutorial, Right eye, DOB: Oct 31, 1952, M, T= hrs, PREPLAN S4 S5 S2 S21 S20 S22 S6 S7 S19 S18 S25 S8 S3 S17 S23 S9 S10 S16 S15 S24 S11 S12 S1 S14 S13 Institution:, EULA: astrahan.2014, User: Melvin AstrahanPlaque #1 EP2025P, implant 6/23/1 Plaque Simulator :08:59, page 1 of 1Institution:, EULA: astrahan.2014

11 Plaque Simulator QA Check (isotropic point source in water) Lat. t:anterior Pt:Anterior Post.pole->center 18.0 Pt:Anterior Med. Sup. Inf. 0.0 Plaque Strength Activity Dose-Rate X@implant to Constant mm 1.572mCi 1.27U/mCi QA_Point QA_Check 0.96 Rectus Sk Oblique Rectus Gy mm Simulator (isotropic Tutorial, (7:28,6.6mm) Tutorial, Tutorial, pt (ext.coord): srce Right Right 600 Right in water) Right eye, eye, eye, eye, DOB: DOB: DOB: DOB: Oct Oct 17:09:00, Oct 31, Oct 31, 31, 1952, 31, 1952, page 1952, M, M, 1 M, of T= M, 1T= hrs, hrs, hrs, hrs, PREPLAN S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 S25 EP2025P = PREPLAN PREPLAN utorial, Right eye, DOB: Oct 31, 1952, M, T= hrs, PREPLAN Pt:Anterior Tutorial, Right eye, DOB: Oct 31, 1952, M, T= hrs, PREPLANPlaque Simulato Plaque Simulator SetupPlaque Simulator :09:00, page 1 of 1 Institution:, EULA: astrahan.2014, User: Melvin Astrahan Plaque Simulator :09:00, page 1 of 1Institution:, EULA: astrahan.2014

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