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Title: Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system

Abstract

The purpose of this study was to evaluate the dosimetric and practical effects of the Monaco treatment planning system “max arcs-per-beam” optimization parameter in pelvic radiotherapy treatments. We selected for this study a total of 17 previously treated patients with a range of pelvic disease sites including prostate (9), bladder (1), uterus (3), rectum (3), and cervix (1). For each patient, 2 plans were generated, one using an arc-per-beam setting of “1” and another with an arc-per-beam setting of “2” using the volumes and constraints established from the initial clinical treatments. All constraints and dose coverage objects were kept the same between plans, and all plans were normalized to 99.7% to ensure 100% of the planning target volume (PTV) received 95% of the prescription dose. Plans were evaluated for PTV conformity, homogeneity, number of monitor units, number of control points, and overall plan acceptability. Treatment delivery time, patient-specific quality assurance procedures, and the impact on clinical workflow were also assessed. We found that for complex-shaped target volumes (small central volumes with extending arms to cover nodal regions), the use of 2 arc-per-beam (2APB) parameter setting achieved significantly lower average dose-volume histogram values for the rectum V{sub 20} (p = 0.0012) and bladdermore » V{sub 30} (p = 0.0036) while meeting the high dose target constraints. For simple PTV shapes, we found reduced monitor units (13.47%, p = 0.0009) and control points (8.77%, p = 0.0004) using 2APB planning. In addition, we found a beam delivery time reduction of approximately 25%. In summary, the dosimetric benefit, although moderate, was improved over a 1APB setting for complex PTV, and equivalent in other cases. The overall reduced delivery time suggests that the use of mulitple arcs per beam could lead to reduced patient-on-table time, increased clinical throughput, and reduced medical physics quality assurance effort.« less

Authors:
 [1];  [2]; ;  [3];  [1];  [2];  [3]; ; ; ;  [1];  [2]
  1. Department of Radiation Oncology, University of Washington, Seattle, Washington (United States)
  2. (United States)
  3. Seattle Cancer Care Alliance, Seattle, Washington (United States)
Publication Date:
OSTI Identifier:
22685193
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 42; Journal Issue: 2; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; BLADDER; COMPARATIVE EVALUATIONS; LIMITING VALUES; MONITORS; OPTIMIZATION; PATIENTS; PLANNING; PROSTATE; QUALITY ASSURANCE; RADIATION DOSES; RADIOTHERAPY; RECTUM; UTERUS; QUALITY MANAGEMENT

Citation Formats

Kalet, Alan M., E-mail: amkalet@uw.edu, Seattle Cancer Care Alliance, Seattle, Washington, Richardson, Hannah L., Nikolaisen, Darrin A., Cao, Ning, Seattle Cancer Care Alliance, Seattle, Washington, Lavilla, Myra A., Dempsey, Claire, Meyer, Juergen, Koh, Wui-Jin, Russell, Kenneth J., and Seattle Cancer Care Alliance, Seattle, Washington. Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system. United States: N. p., 2017. Web. doi:10.1016/J.MEDDOS.2017.02.001.
Kalet, Alan M., E-mail: amkalet@uw.edu, Seattle Cancer Care Alliance, Seattle, Washington, Richardson, Hannah L., Nikolaisen, Darrin A., Cao, Ning, Seattle Cancer Care Alliance, Seattle, Washington, Lavilla, Myra A., Dempsey, Claire, Meyer, Juergen, Koh, Wui-Jin, Russell, Kenneth J., & Seattle Cancer Care Alliance, Seattle, Washington. Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system. United States. doi:10.1016/J.MEDDOS.2017.02.001.
Kalet, Alan M., E-mail: amkalet@uw.edu, Seattle Cancer Care Alliance, Seattle, Washington, Richardson, Hannah L., Nikolaisen, Darrin A., Cao, Ning, Seattle Cancer Care Alliance, Seattle, Washington, Lavilla, Myra A., Dempsey, Claire, Meyer, Juergen, Koh, Wui-Jin, Russell, Kenneth J., and Seattle Cancer Care Alliance, Seattle, Washington. Sat . "Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system". United States. doi:10.1016/J.MEDDOS.2017.02.001.
@article{osti_22685193,
title = {Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system},
author = {Kalet, Alan M., E-mail: amkalet@uw.edu and Seattle Cancer Care Alliance, Seattle, Washington and Richardson, Hannah L. and Nikolaisen, Darrin A. and Cao, Ning and Seattle Cancer Care Alliance, Seattle, Washington and Lavilla, Myra A. and Dempsey, Claire and Meyer, Juergen and Koh, Wui-Jin and Russell, Kenneth J. and Seattle Cancer Care Alliance, Seattle, Washington},
abstractNote = {The purpose of this study was to evaluate the dosimetric and practical effects of the Monaco treatment planning system “max arcs-per-beam” optimization parameter in pelvic radiotherapy treatments. We selected for this study a total of 17 previously treated patients with a range of pelvic disease sites including prostate (9), bladder (1), uterus (3), rectum (3), and cervix (1). For each patient, 2 plans were generated, one using an arc-per-beam setting of “1” and another with an arc-per-beam setting of “2” using the volumes and constraints established from the initial clinical treatments. All constraints and dose coverage objects were kept the same between plans, and all plans were normalized to 99.7% to ensure 100% of the planning target volume (PTV) received 95% of the prescription dose. Plans were evaluated for PTV conformity, homogeneity, number of monitor units, number of control points, and overall plan acceptability. Treatment delivery time, patient-specific quality assurance procedures, and the impact on clinical workflow were also assessed. We found that for complex-shaped target volumes (small central volumes with extending arms to cover nodal regions), the use of 2 arc-per-beam (2APB) parameter setting achieved significantly lower average dose-volume histogram values for the rectum V{sub 20} (p = 0.0012) and bladder V{sub 30} (p = 0.0036) while meeting the high dose target constraints. For simple PTV shapes, we found reduced monitor units (13.47%, p = 0.0009) and control points (8.77%, p = 0.0004) using 2APB planning. In addition, we found a beam delivery time reduction of approximately 25%. In summary, the dosimetric benefit, although moderate, was improved over a 1APB setting for complex PTV, and equivalent in other cases. The overall reduced delivery time suggests that the use of mulitple arcs per beam could lead to reduced patient-on-table time, increased clinical throughput, and reduced medical physics quality assurance effort.},
doi = {10.1016/J.MEDDOS.2017.02.001},
journal = {Medical Dosimetry},
number = 2,
volume = 42,
place = {United States},
year = {Sat Jul 01 00:00:00 EDT 2017},
month = {Sat Jul 01 00:00:00 EDT 2017}
}