A study to determine the impact of IMPT optimization techniques on prostate synthetic CT image sets dose comparison against CT image sets

Background

The objective of this study is to determine the impact of intensity modulated proton therapty (IMPT) optimization techniques on the proton dose comparison of commercially available magnetic resonance for calculating attenuation (MRCA T) images, a synthetic computed tomography CT (sCT) based on magnetic resonance imaging (MRI) scan against the CT images and find out the optimization technique which creates plans with the least dose differences against the regular CT image sets.

Material and methods

Regular CT data sets and sCT image sets were obtained for 10 prostate patients for the study. Six plans were created using six distinct IMPT optimization techniques including multi-field optimization (MFO), single field uniform dose (SFUD) optimization, and robust optimization (RO) in CT image sets. These plans were copied to MRCA T, sCT datasets and doses were computed. Doses from CT and MRCA T data sets were compared for each patient using 2D dose distribution display, dose volume histograms (DVH), homogeneity index (HI), conformation number (CN) and 3D gamma analysis. A two tailed t-test was conducted on HI and CN with 5% significance level with a null hypothesis for CT and sCT image sets.

Results

Analysis of ten CT and sCT image sets with different IMPT optimization techniques shows that a few of the techniques show significant differences between plans for a few evaluation parameters. Isodose lines, DVH, HI, CN and t-test analysis shows that robust optimizations with 2% range error incorporated results in plans, when re-computed in sCT image sets results in the least dose differences against CT plans compared to other optimization techniques. The second best optimization technique with the least dose differences was robust optimization with 5% range error.

Conclusion

This study affirmatively demonstrates the impact of IMPT optimization techniques on synthetic CT image sets dose comparison against CT images and determines the robust optimization with 2% range error as the optimization technique which gives the least dose difference when compared to CT plans.

An experimental investigation on the effect of beam angle optimization on the reduction of beam numbers in IMRT of head and neck tumors

In static intensity-modulated radiation therapy (IMRT), the fundamental factors that determine the quality of a plan are the number of beams and their angles. The objective of this study is to investigate the effect of beam angle optimization (BAO) on the beam number in IMRT. We used six head and neck cases to carry out the study. Basically the methodology uses a parameter called "Beam Intensity Profile Perturbation Score" (BIPPS) to determine the suitable beam angles in IMRT. We used two set of plans in which one set contains plans with equispaced beam configuration starting from beam numbers 3 to 18, and another set contains plans with optimal beam angles chosen using the in-house BAO algorithm. We used quadratic dose-based single criteria objective function as a measure of the quality of a plan. The objective function scores obtained for equispaced beam plans and optimal beam angle plans for six head and neck cases were plotted against the beam numbers in a single graphical plot for effective comparison. It is observed that the optimization of beam angles reduces the beam numbers required to produce clini-cally acceptable dose distribution in IMRT of head and neck tumors. Especially N0.1 (represents the beam number at which the objective function reaches a value of 0.1) is considerably reduced by beam angle optimization in almost all the cases included in the study. We believe that the experimental findings of this study will be helpful in understanding the interplay between beam angle optimization and beam number selection process in IMRT which, in turn, can be used to improve the performance of BAO algorithms and beam number selection process in IMRT.

Dosimetric analysis of beam-matching procedure of two similar linear accelerators

Linear accelerators from the same vendor in a radiation therapy center are usually beam-matched following Vendor's acceptance criteria. This protocol is limited to check the difference at particular points on the ionization curve for depth dose or beam profiles. This article describes different tests done after commissioning to evaluate the level of agreement between matched beams of two ONCOR Impression plus linear accelerators from Siemens. Total scatter factors, collimator scatter factors, wedge transmission factors were measured in water for 6-MV photon. All these factors for ONCOR2 were within ±1% of those values for ONCOR1. Along with these point dose measurements we have essentially used γ-index to compare the planar dose distribution from two beam-matched accelerators. For this study a set of ready packed EDR2 films was exposed on both accelerators. The set consisted of films for percentage depth dose, beam profiles, a pyramid shape, multileaf collimator's positional and dose delivery accuracy, and a film to compare head scatter at tray level. To include treatment planning system calculations, a film kept in axial plane was exposed to 3DCRT and IMRT plans with actual gantry angles and monitor units. These films were analyzed for γ in OmniPro IMRT software using different combinations of Δdose and - Δdistances. All these films have shown good agreement for - Δdistance of 3 mm and Δdose of 3 %.

An algorithm for fast beam angle selection in intensity modulated radiotherapy

PURPOSE

This article aims to introduce a novel algorithm for fast beam angle selection in intensity modulated radiotherapy (IMRT).

METHODS

The algorithm models the optimization problem as a beam angle ranking problem and chooses suitable beam angles according to their rank. A new parameter called "beam intensity profile perturbation score (BIPPS)" is used for ranking the beam angles. The BIPPS-based beam angle ranking implicitly accounts for the dose-volume effects of the involved structures. A simulated phantom case with obvious optimal beam angles is used to verify the validity of the presented technique. In addition, the efficiency of the algorithm was examined in three clinical cases (prostate, pancreas, and head and neck) in terms of DVH and dose distribution. In all cases, the judgment of the algorithm's efficiency was based on the comparison between plans with equidistant beams (equal-angle-plan) and plans with beams obtained using the algorithm (suitable-angle-plan).

RESULTS

It is observed from the study that the beam angle ranking function over BIPPS instantly picks up a suitable set of beam angles for a specific case. It takes only about 15 min for choosing the suitable beam angles even for the most complicated cases. The DVHs and dose distributions confirm that the proposed algorithm can efficiently reduce the mean or maximum dose to OARs, while guaranteeing the target coverage and dose uniformity. On the average, about 17% reduction in the mean dose to critical organs, such as rectum, bladder, kidneys and parotids, is observed. Also, about 12% (averaged) reduction in the maximum dose to critical organs (spinal cord) is observed in the clinical cases presented in this study.

CONCLUSIONS

This study demonstrates that the algorithm can be effectively applied to IMRT scenarios to get fast and case specific beam angle configurations.