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Title: The Tradeoff Between Treatment Plan Quality and Required Number of Monitor Units in Intensity-modulated Radiotherapy

Abstract

Purpose: To provide a mathematical approach for quantifying the tradeoff between intensity-modulated radiotherapy (IMRT) complexity and plan quality. Methods and Materials: We solve a multi-objective program that includes IMRT complexity, measured as the number of monitor units (MU) needed to deliver the plan using a multileaf collimator, as an objective. Clinical feasibility of plans is ensured by the use of hard constraints in the formulation. Optimization output is a Pareto surface of treatment plans, which allows the tradeoffs between IMRT complexity, tumor coverage, and tissue sparing to be observed. Paraspinal and lung cases are presented. Results: Although the amount of possible MU reduction is highly dependent on the difficulty of the underlying treatment plan (difficult plans requiring a high degree of intensity modulation are more sensitive to MU reduction), in some cases the number of MU can be reduced more than twofold with a <1% increase in the objective function. Conclusions: The largely increased number of MU and irradiation time in IMRT is sometimes unnecessary. Tools like the one presented should be considered for integration into daily clinical practice to avoid this problem.

Authors:
 [1];  [2];  [3]
  1. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States). E-mail: dcraft@partners.org
  2. Department of Optimization, Fraunhofer Institut fuer Techno- und, Wirtschaftsmathematik, Kaiserslautern (Germany)
  3. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
Publication Date:
OSTI Identifier:
20951608
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.034; PII: S0360-3016(06)03501-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COLLIMATORS; IRRADIATION; LUNGS; MODULATION; OPTIMIZATION; RADIOTHERAPY

Citation Formats

Craft, David, Suess, Philipp, and Bortfeld, Thomas. The Tradeoff Between Treatment Plan Quality and Required Number of Monitor Units in Intensity-modulated Radiotherapy. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.11.034.
Craft, David, Suess, Philipp, & Bortfeld, Thomas. The Tradeoff Between Treatment Plan Quality and Required Number of Monitor Units in Intensity-modulated Radiotherapy. United States. doi:10.1016/j.ijrobp.2006.11.034.
Craft, David, Suess, Philipp, and Bortfeld, Thomas. Sun . "The Tradeoff Between Treatment Plan Quality and Required Number of Monitor Units in Intensity-modulated Radiotherapy". United States. doi:10.1016/j.ijrobp.2006.11.034.
@article{osti_20951608,
title = {The Tradeoff Between Treatment Plan Quality and Required Number of Monitor Units in Intensity-modulated Radiotherapy},
author = {Craft, David and Suess, Philipp and Bortfeld, Thomas},
abstractNote = {Purpose: To provide a mathematical approach for quantifying the tradeoff between intensity-modulated radiotherapy (IMRT) complexity and plan quality. Methods and Materials: We solve a multi-objective program that includes IMRT complexity, measured as the number of monitor units (MU) needed to deliver the plan using a multileaf collimator, as an objective. Clinical feasibility of plans is ensured by the use of hard constraints in the formulation. Optimization output is a Pareto surface of treatment plans, which allows the tradeoffs between IMRT complexity, tumor coverage, and tissue sparing to be observed. Paraspinal and lung cases are presented. Results: Although the amount of possible MU reduction is highly dependent on the difficulty of the underlying treatment plan (difficult plans requiring a high degree of intensity modulation are more sensitive to MU reduction), in some cases the number of MU can be reduced more than twofold with a <1% increase in the objective function. Conclusions: The largely increased number of MU and irradiation time in IMRT is sometimes unnecessary. Tools like the one presented should be considered for integration into daily clinical practice to avoid this problem.},
doi = {10.1016/j.ijrobp.2006.11.034},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 67,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2007},
month = {Sun Apr 01 00:00:00 EDT 2007}
}