TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation
Purpose: To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non‐coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing. Methods: A 3D scanner was used to digitize the human and phantom subject...
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| Veröffentlicht in: | Medical physics (Lancaster) 2015-06, Vol.42 (6Part32), p.3599-3599 |
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| creator | Yu, V Nguyen, D Tran, A Ruan, D Cao, M Kaprealian, T Kupelian, P Low, D Sheng, K |
| description | Purpose:
To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non‐coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing.
Methods:
A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients.
Results:
Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion.
Conclusion:
The mathematical modeling utilized in 4π is accurate to create and guide highly complex non‐coplanar IMRT treatments that consistently and significantly outperform human‐operator‐created plans. Deliverability of such plans is clinically demonstrated.
This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE‐1144087. |
| doi_str_mv | 10.1118/1.4925574 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22563041</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>MP5574</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1004-9e64c6473b455f3e26de41b5503ddc957643e41b1500f53667c8ccc397c319bb3</originalsourceid><addsrcrecordid>eNp1kEtOwzAQhi0EEqWw4AaWWLFIGcePNN2hQKFSCwi1a8txHBqUxFFiqeoOcQE4CLfgJj0J7mPL5p-Zfz6NZgahSwIDQsjwhgxYHHIesSPUC1lEAxZCfIx6ADELQgb8FJ113TsACMqhh6r5YvPxndx5ocC8Ah9h9vu1-fzBT7be9mxTqlq1-FVlhXVL06pmPcLj1lZ4pnxdKVdoVeKZzUxZ1G_YWZz4ZGdOqqY0lamdh2x9jk5yVXbm4hD7aDG-nyePwfT5YZLcTgNNAFgQG8G08NunjPOcmlBkhpGUc6BZpmMeCUa3BuEAOadCRHqotaZxpCmJ05T20dV-ru1cITtdOKOX2ta10U6GIRf-VuKp6z2lW9t1rcll0xaVateSgNx-UxJ5-KZngz27Kkqz_h-Us5cd_wfkVHd_</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Yu, V ; Nguyen, D ; Tran, A ; Ruan, D ; Cao, M ; Kaprealian, T ; Kupelian, P ; Low, D ; Sheng, K</creator><creatorcontrib>Yu, V ; Nguyen, D ; Tran, A ; Ruan, D ; Cao, M ; Kaprealian, T ; Kupelian, P ; Low, D ; Sheng, K</creatorcontrib><description>Purpose:
To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non‐coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing.
Methods:
A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients.
Results:
Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion.
Conclusion:
The mathematical modeling utilized in 4π is accurate to create and guide highly complex non‐coplanar IMRT treatments that consistently and significantly outperform human‐operator‐created plans. Deliverability of such plans is clinically demonstrated.
This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE‐1144087.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>DOI: 10.1118/1.4925574</identifier><language>eng</language><publisher>United States: American Association of Physicists in Medicine</publisher><subject>60 APPLIED LIFE SCIENCES ; ACCURACY ; ALGORITHMS ; Anatomy ; BRAIN ; Cancer ; Collision theories ; Computer modeling ; Computer simulation ; Dosimetry ; HEAD ; Image scanners ; Intensity modulated radiation therapy ; LIVER ; LUNGS ; NECK ; NEOPLASMS ; Optimization ; PATIENTS ; PHANTOMS ; PROSTATE ; RADIATION PROTECTION AND DOSIMETRY ; RADIOTHERAPY ; SAFETY MARGINS</subject><ispartof>Medical physics (Lancaster), 2015-06, Vol.42 (6Part32), p.3599-3599</ispartof><rights>2015 American Association of Physicists in Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1118%2F1.4925574$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45551</link.rule.ids><backlink>$$Uhttps://www.osti.gov/biblio/22563041$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, V</creatorcontrib><creatorcontrib>Nguyen, D</creatorcontrib><creatorcontrib>Tran, A</creatorcontrib><creatorcontrib>Ruan, D</creatorcontrib><creatorcontrib>Cao, M</creatorcontrib><creatorcontrib>Kaprealian, T</creatorcontrib><creatorcontrib>Kupelian, P</creatorcontrib><creatorcontrib>Low, D</creatorcontrib><creatorcontrib>Sheng, K</creatorcontrib><title>TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation</title><title>Medical physics (Lancaster)</title><description>Purpose:
To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non‐coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing.
Methods:
A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients.
Results:
Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion.
Conclusion:
The mathematical modeling utilized in 4π is accurate to create and guide highly complex non‐coplanar IMRT treatments that consistently and significantly outperform human‐operator‐created plans. Deliverability of such plans is clinically demonstrated.
This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE‐1144087.</description><subject>60 APPLIED LIFE SCIENCES</subject><subject>ACCURACY</subject><subject>ALGORITHMS</subject><subject>Anatomy</subject><subject>BRAIN</subject><subject>Cancer</subject><subject>Collision theories</subject><subject>Computer modeling</subject><subject>Computer simulation</subject><subject>Dosimetry</subject><subject>HEAD</subject><subject>Image scanners</subject><subject>Intensity modulated radiation therapy</subject><subject>LIVER</subject><subject>LUNGS</subject><subject>NECK</subject><subject>NEOPLASMS</subject><subject>Optimization</subject><subject>PATIENTS</subject><subject>PHANTOMS</subject><subject>PROSTATE</subject><subject>RADIATION PROTECTION AND DOSIMETRY</subject><subject>RADIOTHERAPY</subject><subject>SAFETY MARGINS</subject><issn>0094-2405</issn><issn>2473-4209</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kEtOwzAQhi0EEqWw4AaWWLFIGcePNN2hQKFSCwi1a8txHBqUxFFiqeoOcQE4CLfgJj0J7mPL5p-Zfz6NZgahSwIDQsjwhgxYHHIesSPUC1lEAxZCfIx6ADELQgb8FJ113TsACMqhh6r5YvPxndx5ocC8Ah9h9vu1-fzBT7be9mxTqlq1-FVlhXVL06pmPcLj1lZ4pnxdKVdoVeKZzUxZ1G_YWZz4ZGdOqqY0lamdh2x9jk5yVXbm4hD7aDG-nyePwfT5YZLcTgNNAFgQG8G08NunjPOcmlBkhpGUc6BZpmMeCUa3BuEAOadCRHqotaZxpCmJ05T20dV-ru1cITtdOKOX2ta10U6GIRf-VuKp6z2lW9t1rcll0xaVateSgNx-UxJ5-KZngz27Kkqz_h-Us5cd_wfkVHd_</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Yu, V</creator><creator>Nguyen, D</creator><creator>Tran, A</creator><creator>Ruan, D</creator><creator>Cao, M</creator><creator>Kaprealian, T</creator><creator>Kupelian, P</creator><creator>Low, D</creator><creator>Sheng, K</creator><general>American Association of Physicists in Medicine</general><scope>AAYXX</scope><scope>CITATION</scope><scope>OTOTI</scope></search><sort><creationdate>201506</creationdate><title>TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation</title><author>Yu, V ; Nguyen, D ; Tran, A ; Ruan, D ; Cao, M ; Kaprealian, T ; Kupelian, P ; Low, D ; Sheng, K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1004-9e64c6473b455f3e26de41b5503ddc957643e41b1500f53667c8ccc397c319bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>60 APPLIED LIFE SCIENCES</topic><topic>ACCURACY</topic><topic>ALGORITHMS</topic><topic>Anatomy</topic><topic>BRAIN</topic><topic>Cancer</topic><topic>Collision theories</topic><topic>Computer modeling</topic><topic>Computer simulation</topic><topic>Dosimetry</topic><topic>HEAD</topic><topic>Image scanners</topic><topic>Intensity modulated radiation therapy</topic><topic>LIVER</topic><topic>LUNGS</topic><topic>NECK</topic><topic>NEOPLASMS</topic><topic>Optimization</topic><topic>PATIENTS</topic><topic>PHANTOMS</topic><topic>PROSTATE</topic><topic>RADIATION PROTECTION AND DOSIMETRY</topic><topic>RADIOTHERAPY</topic><topic>SAFETY MARGINS</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, V</creatorcontrib><creatorcontrib>Nguyen, D</creatorcontrib><creatorcontrib>Tran, A</creatorcontrib><creatorcontrib>Ruan, D</creatorcontrib><creatorcontrib>Cao, M</creatorcontrib><creatorcontrib>Kaprealian, T</creatorcontrib><creatorcontrib>Kupelian, P</creatorcontrib><creatorcontrib>Low, D</creatorcontrib><creatorcontrib>Sheng, K</creatorcontrib><collection>CrossRef</collection><collection>OSTI.GOV</collection><jtitle>Medical physics (Lancaster)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, V</au><au>Nguyen, D</au><au>Tran, A</au><au>Ruan, D</au><au>Cao, M</au><au>Kaprealian, T</au><au>Kupelian, P</au><au>Low, D</au><au>Sheng, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation</atitle><jtitle>Medical physics (Lancaster)</jtitle><date>2015-06</date><risdate>2015</risdate><volume>42</volume><issue>6Part32</issue><spage>3599</spage><epage>3599</epage><pages>3599-3599</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><abstract>Purpose:
To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non‐coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing.
Methods:
A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients.
Results:
Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion.
Conclusion:
The mathematical modeling utilized in 4π is accurate to create and guide highly complex non‐coplanar IMRT treatments that consistently and significantly outperform human‐operator‐created plans. Deliverability of such plans is clinically demonstrated.
This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE‐1144087.</abstract><cop>United States</cop><pub>American Association of Physicists in Medicine</pub><doi>10.1118/1.4925574</doi><tpages>1</tpages></addata></record> |
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| identifier | ISSN: 0094-2405 |
| ispartof | Medical physics (Lancaster), 2015-06, Vol.42 (6Part32), p.3599-3599 |
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| source | Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | 60 APPLIED LIFE SCIENCES ACCURACY ALGORITHMS Anatomy BRAIN Cancer Collision theories Computer modeling Computer simulation Dosimetry HEAD Image scanners Intensity modulated radiation therapy LIVER LUNGS NECK NEOPLASMS Optimization PATIENTS PHANTOMS PROSTATE RADIATION PROTECTION AND DOSIMETRY RADIOTHERAPY SAFETY MARGINS |
| title | TU‐CD‐304‐05: 4Ï€ Non‐Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation |
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