Voxel-based automatic multi-criteria optimization for intensity modulated radiation therapy.

Background: Automatic multi-criteria optimization is necessary for intensity modulated radiation therapy (IMRT) because of low planning efficiency and large plan quality uncertainty in current clinical practice. Most studies focused on imitating dosimetrists' planning procedures to automate this pro...

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Publicado en:Radiation Oncology Vol. 13; no. 1
Autores principales: Mai, Yanhua, Kong, Fantu, Yang, Yiwei, Zhou, Linghong, Li, Yongbao, Song, Ting
Formato: Journal Article
Publicado: BioMed Central 12/5/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 12/5/2018
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      pub: BioMed Central
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        NLM30518381
        10.1186/s13014-018-1179-7
        NLM30518381
        133426788
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        atl: Voxel-based automatic multi-criteria optimization for intensity modulated radiation therapy.
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        au:
          Mai, Yanhua
          Kong, Fantu
          Yang, Yiwei
          Zhou, Linghong
          Li, Yongbao
          Song, Ting
        affil: Department of Biomedical Engineering, Southern Medical University, 510515, Guangzhou, Guangdong, China
      sug:
        subj:
          Genital Neoplasms, Female Radiotherapy
          Radiotherapy, Conformal Standards
          Radiotherapy, Computer-Assisted Standards
          Algorithms
          Radiotherapy, Conformal Methods
          Radiotherapy, Computer-Assisted Methods
          Automation
          Radiation Dosage
          Female
          Clinical Assessment Tools
          Ferrans and Powers Quality of Life Index
          Scales
          Female
      ab: Background: Automatic multi-criteria optimization is necessary for intensity modulated radiation therapy (IMRT) because of low planning efficiency and large plan quality uncertainty in current clinical practice. Most studies focused on imitating dosimetrists' planning procedures to automate this process and ignored the fact that organ-based objective functions typically used in commercial treatment planning systems (such as dose-volume function) usually lead to sub-optimal plans. To guarantee the optimum results and to automate this process, we incorporate an improved automation strategy and a voxel-based optimization algorithm to generate a novel automatic multi-criteria optimization framework. We then evaluate it in clinical cases.Methods: This novel automatic multi-criteria optimization framework incorporates a ranked priority-list based automatic constraints adjustment strategy and an in-house developed voxel-based optimization algorithm. Constraints are sequentially adjusted following a pre-defined priority list. Afterward, a voxel-based fluence map optimization (FMO) with an orientation to the newly updated constraints is launched to find a Pareto optimal solution. Loops of constraints adjustment are repeated until each of them could not be relaxed or tightened. The feasibility of the framework is evaluated with 10 automatic generated gynecology (GYN) cancer IMRT cases by comparing the dosimetric performance with the original.Results: Plan quality improvement is observed for our automatic multi-criteria optimization method. Comparable DVHs are found for the planning target volume (PTV), but with better organs-at-risk (OAR) dose sparing. Among 13 evaluated dosimetric endpoints, 5 of them show significant improvements in automatically generated plans compared with the original plans. Investigation of improvement tendency during optimization exhibits gradual change as the optimization stage proceeds. An initial voxel-based optimization stage and in-low-priority dosimetric criteria tighten can significantly contribute to the optimization procedure.Conclusions: We have successfully developed an automatic multi-criteria optimization framework that can dramatically reduce the current trial-and-error patterned planning workload while affording an efficient method to assure high plan quality consistency. This optimization framework is expected to greatly facilitate precise radiation therapy because of its advantages of planning efficiency and plan quality improvement.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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