With the recent CyberKnife treatment planning system (TPS) upgrade from Precision 1.0 to Precision 2.0, the new VOLO optimizer was released for plan optimization. The VOLO optimizer sought to overcome some of the limitations seen with the Sequential optimizer from previous TPS versions. The purpose of this study was to investigate the clinical impact of the VOLO optimizer on treatment plan quality and clinical treatment efficiency as compared to the Sequential optimizer. Treatment plan quality was evaluated in four categories of patients: Brain Simple (BS), Brain Complex (BC), Spine Complex (SC), and Prostate (PC). A total of 60 treatment plans were compared using both the Sequential and VOLO optimizers with Iris and MLC collimation with the same clinical constraints. Metrics evaluated included estimated treatment time, monitor units (MUs) delivered, conformity index (CI), and gradient index (GI). Furthermore, the clinical impact of the VOLO optimizer was evaluated through statistical analysis of the patient population treated during the 4 months before (n = 297) and 4 months after (n = 285) VOLO introduction. Significant MU and time reductions were observed for all four categories planned. MU reduction ranged from −14% (BS Iris) to −52% (BC MLC), and time reduction ranged from −11% (BS Iris) to −22% (BC MLC). The statistical analysis of patient population before and after VOLO introduction for patients using 6D Skull tracking with fixed cone, 6D Skull tracking with Iris, and Xsight Spine tracking with Iris were −4.6%, −22.2%, and −17.8% for treatment time reduction, −1.1%, −22.0%, and −28.4% for beam reduction and −3.2%, −21.8%, and −28.1% for MU reduction, respectively. The VOLO optimizer maintains or improves the plan quality while decreases the plan complexity and improves treatment efficiency. We anticipate an increase in patient throughput with the introduction of the VOLO optimizer.

中文翻译：

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VOLO优化器对Cyber​​Knife的治疗计划质量和临床治疗效率的临床影响。

随着最近的射波刀治疗计划系统（TPS）从Precision 1.0升级到Precision 2.0，发布了新的VOLO优化器以进行计划优化。VOLO优化器试图克服先前TPS版本中的顺序优化器所遇到的一些限制。这项研究的目的是调查与顺序优化器相比，VOLO优化器对治疗计划质量和临床治疗效率的临床影响。对四类患者的治疗计划质量进行了评估：简单大脑（BS），复杂大脑（BC），脊柱复杂（SC）和前列腺（PC）。使用具有相同临床约束的Iris和MLC准直的Sequential和VOLO优化器对总共60种治疗计划进行了比较。评估的指标包括估计的治疗时间，监视的交付单位（MU），合格指数（CI）和梯度指数（GI）。此外，通过对VOLO引入前（n = 297）和前四个月（n = 285）接受治疗的患者群体进行统计分析，评估了VOLO优化器的临床影响。对于计划中的所有四个类别，观察到了显着的MU和时间减少。MU的降低范围为-14％（BS Iris）至-52％（BC MLC），时间降低的范围为-11％（BS Iris）至-22％（BC MLC）。使用固定锥度的6D头骨追踪，使用虹膜的6D头骨追踪和使用虹膜的Xsight脊柱追踪的患者在VOLO引入前后的患者人数的统计分析分别为-4.6％，-22.2％和-17.8％，以减少治疗时间，对于波束减少而言，为-1.1％，-22.0％和-28.4％，对于MU减少而言为-3.2％，-22.8％和-28.1％，分别。VOLO优化器可保持或改善计划质量，同时降低计划复杂性并提高治疗效率。我们预计，随着VOLO优化器的推出，患者的吞吐量将会增加。