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Efficient optimization of R50% when planning multiple cranial metastases simultaneously in single isocenter SRS/SRT
Journal of Applied Clinical Medical Physics ( IF 2.0 ) Pub Date : 2021-05-07 , DOI: 10.1002/acm2.13254
Dharmin D Desai 1 , Ivan L Cordrey 1 , E L Johnson 2
Affiliation  

Simultaneous optimization of multiple Planning Target Volumes (PTVs) of varying size and location in the cranium is a non-trivial task. The rate of dose falloff around PTV structures is variable and depends on PTV characteristics such as the volume. The metric R50% is one parameter that can be used to quantify dose falloff achieved in a given treatment plan. An important treatment planning question is how to construct optimization conditions that result in the efficient production of acceptable plan outcomes considering metrics such as R50%. Guidance provided in literature suggests generating multiple shell control structures around each PTV. The constraints applied to these shells can vary significantly depending on PTV volume. Additionally, there is no clear guidance on how to prospectively determine objective constraints for the optimization shells to achieve a specified goal of R50%. Based on physical principles and empirical evidence, we provide clear quantitative guidance on how to translate the desired R50% outcome into appropriately sized optimization structures around PTVs via an equation that depends on a desired goal for R50% and the volume of PTV. Optimization schema are also provided that allow the goal R50% to be approached or achieved for all PTVs individually. We demonstrate the application of the methodology using commercially available treatment planning software and radiotherapy treatment equipment.

中文翻译:

在单等中心 SRS/SRT 中同时规划多个颅骨转移时,R50% 的有效优化

同时优化颅骨中不同大小和位置的多个计划目标体积 (PTV) 是一项非常重要的任务。PTV 结构周围的剂量衰减率是可变的,取决于 PTV 特性,例如体积。度量 R50% 是一个参数,可用于量化给定治疗计划中实现的剂量下降。一个重要的治疗计划问题是如何构建优化条件,以考虑 R50% 等指标,从而有效产生可接受的计划结果。文献中提供的指导建议在每个 PTV 周围生成多个 shell 控制结构。应用于这些壳的约束可能会因 PTV 体积而显着不同。此外,关于如何前瞻性地确定优化壳的目标约束以实现 R50% 的指定目标,没有明确的指导。基于物理原理和经验证据,我们提供了关于如何通过取决于 R50% 的预期目标和 PTV 体积的方程将所需的 R50% 结果转化为围绕 PTV 的适当大小的优化结构的明确定量指导。还提供了优化方案,允许单独为所有 PTV 接近或实现目标 R50%。我们使用市售的治疗计划软件和放射治疗设备演示了该方法的应用。我们提供了关于如何通过取决于 R50% 的预期目标和 PTV 量的方程将所需的 R50% 结果转化为围绕 PTV 的适当大小的优化结构的明确定量指导。还提供了优化方案,允许单独为所有 PTV 接近或实现目标 R50%。我们使用市售的治疗计划软件和放射治疗设备演示了该方法的应用。我们通过一个取决于 R50% 的预期目标和 PTV 量的方程,就如何将所需的 R50% 结果转化为围绕 PTV 的适当大小的优化结构提供了明确的定量指导。还提供了优化方案,允许单独为所有 PTV 接近或实现目标 R50%。我们使用市售的治疗计划软件和放射治疗设备演示了该方法的应用。
更新日期:2021-06-14
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