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Title: MO-FG-CAMPUS-TeP2-05: Optimizing Stereotactic Radiosurgery Treatment of Multiple Brain Metastasis Lesions with Individualized Rotational Arc Trajectories

Abstract

Purpose: Radiosurgery of multiple (n>4) brain metastasis lesions requires 3–4 noncoplanar VMAT arcs with excessively high monitor units and long delivery time. We investigated whether an improved optimization technique would decrease the needed arc numbers and increase the delivery efficiency, while improving or maintaining the plan quality. Methods: The proposed 4pi arc space optimization algorithm consists of two steps: automatic couch angle selection followed by aperture generation for each arc with optimized control points distribution. We use a greedy algorithm to select the couch angles. Starting from a single coplanar arc plan we search through the candidate noncoplanar arcs to pick a single noncoplanar arc that will bring the best plan quality when added into the existing treatment plan. Each time, only one additional noncoplanar arc is considered making the calculation time tractable. This process repeats itself until desired number of arc is reached. The technique is first evaluated in coplanar arc delivery scheme with testing cases and then applied to noncoplanar treatments of a case with 12 brain metastasis lesions. Results: Clinically acceptable plans are created within minutes. For the coplanar testing cases the algorithm yields singlearc plans with better dose distributions than that of two-arc VMAT, simultaneously withmore » a 12–17% reduction in the delivery time and a 14–21% reduction in MUs. For the treatment of 12 brain mets while Paddick conformity indexes of the two plans were comparable the SCG-optimization with 2 arcs (1 noncoplanar and 1 coplanar) significantly improved the conventional VMAT with 3 arcs (2 noncoplanar and 1 coplanar). Specifically V16 V10 and V5 of the brain were reduced by 11%, 11% and 12% respectively. The beam delivery time was shortened by approximately 30%. Conclusion: The proposed 4pi arc space optimization technique promises to significantly reduce the brain toxicity while greatly improving the treatment efficiency.« less

Authors:
;  [1];  [2]
  1. Stanford University School of Medicine, Stanford, CA (United States)
  2. UCSF Comprehensive Cancer Center, San Francisco, CA (United States)
Publication Date:
OSTI Identifier:
22653909
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; ALGORITHMS; BRAIN; DELIVERY; METASTASES; OPTIMIZATION; PRODUCTIVITY; RADIATION DOSE DISTRIBUTIONS; RADIOTHERAPY; SURGERY

Citation Formats

Dong, P, Xing, L, and Ma, L. MO-FG-CAMPUS-TeP2-05: Optimizing Stereotactic Radiosurgery Treatment of Multiple Brain Metastasis Lesions with Individualized Rotational Arc Trajectories. United States: N. p., 2016. Web. doi:10.1118/1.4957363.
Dong, P, Xing, L, & Ma, L. MO-FG-CAMPUS-TeP2-05: Optimizing Stereotactic Radiosurgery Treatment of Multiple Brain Metastasis Lesions with Individualized Rotational Arc Trajectories. United States. doi:10.1118/1.4957363.
Dong, P, Xing, L, and Ma, L. Wed . "MO-FG-CAMPUS-TeP2-05: Optimizing Stereotactic Radiosurgery Treatment of Multiple Brain Metastasis Lesions with Individualized Rotational Arc Trajectories". United States. doi:10.1118/1.4957363.
@article{osti_22653909,
title = {MO-FG-CAMPUS-TeP2-05: Optimizing Stereotactic Radiosurgery Treatment of Multiple Brain Metastasis Lesions with Individualized Rotational Arc Trajectories},
author = {Dong, P and Xing, L and Ma, L},
abstractNote = {Purpose: Radiosurgery of multiple (n>4) brain metastasis lesions requires 3–4 noncoplanar VMAT arcs with excessively high monitor units and long delivery time. We investigated whether an improved optimization technique would decrease the needed arc numbers and increase the delivery efficiency, while improving or maintaining the plan quality. Methods: The proposed 4pi arc space optimization algorithm consists of two steps: automatic couch angle selection followed by aperture generation for each arc with optimized control points distribution. We use a greedy algorithm to select the couch angles. Starting from a single coplanar arc plan we search through the candidate noncoplanar arcs to pick a single noncoplanar arc that will bring the best plan quality when added into the existing treatment plan. Each time, only one additional noncoplanar arc is considered making the calculation time tractable. This process repeats itself until desired number of arc is reached. The technique is first evaluated in coplanar arc delivery scheme with testing cases and then applied to noncoplanar treatments of a case with 12 brain metastasis lesions. Results: Clinically acceptable plans are created within minutes. For the coplanar testing cases the algorithm yields singlearc plans with better dose distributions than that of two-arc VMAT, simultaneously with a 12–17% reduction in the delivery time and a 14–21% reduction in MUs. For the treatment of 12 brain mets while Paddick conformity indexes of the two plans were comparable the SCG-optimization with 2 arcs (1 noncoplanar and 1 coplanar) significantly improved the conventional VMAT with 3 arcs (2 noncoplanar and 1 coplanar). Specifically V16 V10 and V5 of the brain were reduced by 11%, 11% and 12% respectively. The beam delivery time was shortened by approximately 30%. Conclusion: The proposed 4pi arc space optimization technique promises to significantly reduce the brain toxicity while greatly improving the treatment efficiency.},
doi = {10.1118/1.4957363},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}