A shortest path-based approach to the multileaf collimator sequencing problem

AbstractThe multileaf collimator sequencing problem is an important component in effective cancer treatment delivery. The problem can be formulated as finding a decomposition of an integer matrix into a weighted sequence of binary matrices whose rows satisfy a consecutive ones property. Minimising the cardinality of the decomposition is an important objective and has been shown to be strongly NP-hard, even for a matrix restricted to a single column or row. We show that in this latter case it can be solved efficiently as a shortest path problem, giving a simple proof that the one-row problem is fixed-parameter tractable in the maximum intensity. We develop new linear and constraint programming models exploiting this result. Our approaches significantly improve the best known for the problem, bringing real-world sized problem instances within reach of exact algorithms

Applications of mathematical network theory

This thesis is a collection of papers on a variety of optimization problems where network structure can be used to obtain efficient algorithms. The considered applications range from the optimization of radiation treatment plkans in cancer therapy to maintenance planning for maximizing the throughput in bulk good supply chains

Accounting for the tongue-and-groove effect using a robust direct aperture optimization approach

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98733/1/MPH001266.pd

Beam selection for stereotactic ablative radiotherapy using Cyberknife with multileaf collimation.

The Cyberknife system (Accuray Inc., Sunnyvale, CA) enables radiotherapy using stereotactic ablative body radiotherapy (SABR) with a large number of non-coplanar beam orientations. Recently, a multileaf collimator has also been available to allow flexibility in field shaping. This work aims to evaluate the quality of treatment plans obtainable with the multileaf collimator. Specifically, the aim is to find a subset of beam orientations from a predetermined set of candidate directions, such that the treatment quality is maintained but the treatment time is reduced. An evolutionary algorithm is used to successively refine a randomly selected starting set of beam orientations. By using an efficient computational framework, clinically useful solutions can be found in several hours. It is found that 15 beam orientations are able to provide treatment quality which approaches that of the candidate beam set of 110 beam orientations, but with approximately half of the estimated treatment time. Choice of an efficient subset of beam orientations offers the possibility to improve the patient experience and maximise the number of patients treated

Approximated multileaf collimator field segmentation

In intensity-modulated radiation therapy the aim is to realize given intensity distributions as a superposition of differently shaped fields. Multileaf collimators are used for field shaping. This segmentation task leads to discrete optimization problems, that are considered in this dissertation. A variety of algorithms for exact and approximated segmentation, for different objective functions and various technical as well as dosimetric constraints are developed

Improvements on the planning and delivery of intensity-modulated arc therapy

In the past decade, intensity-modulated radiation therapy (IMRT) has taken a significant step towards dose conformality and has now become a standard radiotherapy technique in the clinic. In this era, a rotational IMRT technique called intensity-modulated arc therapy (IMAT) was also proposed to possibly further reduce normal tissue toxicity and compete with conventional IMRT. However, clinical implementation of IMAT had been stagnant primarily due to the lack of mature planning and delivery systems. In this study, various aspects of treatment planning and delivery of IMAT have been investigated and improved. The dosimetric accuracy and computational efficiency of IMAT planning has been greatly augmented by the use of Monte Carlo technique which is immune to the large number of discrete beams in approximating a continuous rotation as compared with traditional arc calculation methods. An efficient single-arc form of IMAT delivery has also been explored and extended in contrast to the original multi-arc IMAT. Here the clinical feasibility of single-arc IMAT was established by comparing to multi-arc IMAT and conventional IMRT. It was demonstrated that when using multiple arcs, the requirements on aperture shape connectivity incurred fewer constraints on the optimisation so that the plan quality became the best among the three methods studied although the dosimetric differences among them were generally small and considered clinically insignificant. Nevertheless, single-arc IMAT was able to provide a plan quality in between multi-arc IMAT and fixed-field IMRT with a significant delivery efficiency advantage. Single-arc IMAT may require dose-rate variation for delivery, which is only available with the new treatment machines. To expand the clinical utilisation, an alternative planning and delivery approach was developed such that single-arc IMAT can be delivered using constant dose-rate with the existing machines, sparing the expensive and time-consuming upgrades

IMRT and Rotational IMRT (mARC) Using Flat and Unflat Photon Beams

For more than 50 years attening filters have been inserted into the beam path oflinacs to produce a uniform energy fluence distribution of the photon beam and make it suitable for clinical use. Recently, linacs without flattening fifilter (Flattening FilterFree - FFF) are increasingly used in radiotherapy because of its benefifits, e.g. high dose rate (2000 MU/min), reduced scattered and leakage radiation. Hypofractionated radiotherapy is interested in the high dose rate of FFF beams to shorten the treatment delivery time (TDT) especially the FFF beams have acceptable flatness at small fifieldsizes. Radiotherapy techniques that deliver intensity-modulated beams (IMBs), e.g.Tomotherapy, intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), deal with the non-uniformity of the FFF beam profifile and produce homogeneous dose to the target as FF beams do. Siemens modified the Artiste linac in order to enable photon beam delivery with and without a flattening fifilter. The VMAT version developed by Siemens for Artiste linacs as a novel radiation technique is a modulated arc therapy (mARC). mARC technique is available with single, double and multiple complete or partial arcs. The aims of the current study were the determination of the main characteristics of 7 MV and 11 MV FFF photon beams in comparison with their corresponding 6 MV and 10 MV FF photon beams from Artiste digital linacs. Furthermore, IMRT planning comparisons using FF and FFF photon beams were performed using an Oncentra planning system. The performance of various mARC techniques were estimated and compared with Step and Shoot (S&S) IMRT by using a RayStation planning system. The mARC plans created by FF and FFF beams were evaluated to know which technique is the best. All the treatment plans were created for simple and complex shaped target volumes. The treatment plans are compared using two parameters - plan quality and treatment effi ciency. In addition to the planning study, the plan quality assurance of IMRT and mARC plans were performed using two difffferent volumetric quality assurance devices, Delta4 and Octavius 4D. Removal of the flattening fifilter causes changes in the dosimetric features of photon beams. IMRT plans with and without flattening fifilter were clinically acceptable where both plans have similar quality. In comparison with IMRT-FF, IMRT-FFF plansrequire more MUs and for some clinical cases require longer TDT. mARC technique can deliver dose distributions that are comparable to S&S-IMRT and could be an alternative with a potential to improve the effi ciency of the IMRT treatment delivery.:Abstract Abbreviation list 1 Introduction 2 Theory 2.1 Linac head configuration 2.2 Flattening fifilter disadvantages 2.3 Flattening fifilter free beams 2.4 Intensity modulated radiation therapy 2.5 Multi leaf collimator 2.6 Step and shoot IMRT 2.7 Dynamic delivery 2.8 Intensity modulated arc therapy 2.9 Modulated arc therapy 2.10 Verification of IMRT and mARC treatment plans 3 Materials and Methods 3.1 Materials 3.1.1 Linear accelerator 3.1.2 Dosimetric tools 3.1.3 Dosimetric verification systems 3.1.4 Treatment planning systems 3.2 Methods 3.2.1 Dosimetric parameters of FF and FFF beams 3.2.2 Comparison of IMRT-FF and IMRT-FFF 3.2.3 mARC planning study 3.2.4 Planning comparison parameters 3.2.5 Dosimetric verification 4 Results 4.1 Dosimetric characteristics of FF and FFF beams 4.1.1 Dose rate 4.1.2 Dose profile 4.1.3 Depth dose curve 4.1.4 Dose in buildup region 4.2 Comparison of IMRT-FF and IMRT-FFF 4.2.1 Plan quality 4.2.2Treatment e ciency 4.3 mARC 4.3.1 Final gantry spacing (F.G.S) 4.3.2 mARC and IMRT 4.3.3 Comparison of mARC 10 MV FF and 11 MV FFF plans 4.3.4 Plan verifications 5 Discussion 5.1 Dosimetric parameters of FF and FFF beams 5.2 IMRT-FF and IMRT-FFF 5.3 mARC Summary Bibliography Selbst\u7fandigkeitserkl\u7farung Curriculum Vitae Acknowledgemen

On the minimum cardinality problem in intensity modulated radiotherapy

The thesis examines an optimisation problem that appears in the treatment planning of intensity modulated radiotherapy. An approach is presented which solved the optimisation problem in question while also extending the approach to execute in a massively parallel environment. The performance of the approach presented is among the fastest available