79 research outputs found
Optimal partial-arcs in VMAT treatment planning
Purpose: To improve the delivery efficiency of VMAT by extending the recently
published VMAT treatment planning algorithm vmerge to automatically generate
optimal partial-arc plans.
Methods and materials: A high-quality initial plan is created by solving a
convex multicriteria optimization problem using 180 equi-spaced beams. This
initial plan is used to form a set of dose constraints, and a set of
partial-arc plans is created by searching the space of all possible partial-arc
plans that satisfy these constraints. For each partial-arc, an iterative
fluence map merging and sequencing algorithm (vmerge) is used to improve the
delivery efficiency. Merging continues as long as the dose quality is
maintained above a user-defined threshold. The final plan is selected as the
partial arc with the lowest treatment time. The complete algorithm is called
pmerge.
Results: Partial-arc plans are created using pmerge for a lung, liver and
prostate case, with final treatment times of 127, 245 and 147 seconds.
Treatment times using full arcs with vmerge are 211, 357 and 178 seconds. Dose
quality is maintained across the initial, vmerge, and pmerge plans to within 5%
of the mean doses to the critical organs-at-risk and with target coverage above
98%. Additionally, we find that the angular distribution of fluence in the
initial plans is predictive of the start and end angles of the optimal
partial-arc.
Conclusions: The pmerge algorithm is an extension to vmerge that
automatically finds the partial-arc plan that minimizes the treatment time.
VMAT delivery efficiency can be improved by employing partial-arcs without
compromising dose quality. Partial arcs are most applicable to cases with
non-centralized targets, where the time savings is greatest
Accelerated Partial Breast Irradiation: Using the CyberKnife as the Radiation Delivery Platform in the Treatment of Early Breast Cancer
We evaluate the CyberKnife (Accuray Incorporated, Sunnyvale, CA, USA) for non-invasive delivery of accelerated partial breast irradiation (APBI) in early breast cancer patients. Between 6/2009 and 5/2011, nine patients were treated with CyberKnife APBI. Normal tissue constraints were imposed as outlined in the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 (NSABP/RTOG) Protocol (Vicini and White, 2007). Patients received a total dose of 30 Gy in five fractions (group 1, n = 2) or 34 Gy in 10 fractions (group 2, n = 7) delivered to the planning treatment volume (PTV) defined as the clinical target volume (CTV) +2 mm. The CTV was defined as either the lumpectomy cavity plus 10 mm (n = 2) or 15 mm (n = 7). The cavity was defined by a T2-weighted non-contrast breast MRI fused to a planning non-contrast thoracic CT. The CyberKnife Synchrony system tracked gold fiducials sutured into the cavity wall during lumpectomy. Treatments started 4–5 weeks after lumpectomy. The mean PTV was 100 cm3 (range, 92–108 cm3) and 105 cm3 (range, 49–241 cm3) and the mean PTV isodose prescription line was 70% for groups 1 and 2, respectively. The mean percent of whole breast reference volume receiving 100 and 50% of the dose (V100 and V50) for group 1 was 11% (range, 8–13%) and 23% (range, 16–30%) and for group 2 was 11% (range, 7–14%) and 26% (range, 21–35.0%), respectively. At a median 7 months follow-up (range, 4–26 months), no acute toxicities were seen. Acute cosmetic outcomes were excellent or good in all patients; for those patients with more than 12 months follow-up the late cosmesis outcomes were excellent or good. In conclusion, the lack of observable acute side effects and current excellent/good cosmetic outcomes is promising. We believe this suggests the CyberKnife is a suitable non-invasive radiation platform for delivering APBI with achievable normal tissue constraints
A Hierachical Evolutionary Algorithm for Multiobjective Optimization in IMRT
Purpose: Current inverse planning methods for IMRT are limited because they
are not designed to explore the trade-offs between the competing objectives
between the tumor and normal tissues. Our goal was to develop an efficient
multiobjective optimization algorithm that was flexible enough to handle any
form of objective function and that resulted in a set of Pareto optimal plans.
Methods: We developed a hierarchical evolutionary multiobjective algorithm
designed to quickly generate a diverse Pareto optimal set of IMRT plans that
meet all clinical constraints and reflect the trade-offs in the plans. The top
level of the hierarchical algorithm is a multiobjective evolutionary algorithm
(MOEA). The genes of the individuals generated in the MOEA are the parameters
that define the penalty function minimized during an accelerated deterministic
IMRT optimization that represents the bottom level of the hierarchy. The MOEA
incorporates clinical criteria to restrict the search space through protocol
objectives and then uses Pareto optimality among the fitness objectives to
select individuals.
Results: Acceleration techniques implemented on both levels of the
hierarchical algorithm resulted in short, practical runtimes for optimizations.
The MOEA improvements were evaluated for example prostate cases with one target
and two OARs. The modified MOEA dominated 11.3% of plans using a standard
genetic algorithm package. By implementing domination advantage and protocol
objectives, small diverse populations of clinically acceptable plans that were
only dominated 0.2% by the Pareto front could be generated in a fraction of an
hour.
Conclusions: Our MOEA produces a diverse Pareto optimal set of plans that
meet all dosimetric protocol criteria in a feasible amount of time. It
optimizes not only beamlet intensities but also objective function parameters
on a patient-specific basis
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