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Direct aperture optimization for online adaptive radiation therapy.

Ante Mestrovic1, Marie-Pierre Milette, Alan Nichol

  • 1Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada. amestrovic@bccancer.bc.ca

Medical Physics
|June 9, 2007
PubMed
Summary

Direct aperture optimization (DAO) speeds up plan adaptation for online adaptive radiation therapy (ART). Adaptive radiation delivery (ARD) merges planning and delivery, minimizing patient couch time for prostate cancer treatment.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Image-Guided Therapy

Background:

  • Online adaptive radiation therapy (ART) aims to improve treatment accuracy by adjusting plans based on daily anatomical changes.
  • Direct aperture optimization (DAO) is a technique for optimizing radiation beam shapes.
  • Prostate cancer treatment often requires precise dose delivery, making adaptive strategies crucial.

Purpose of the Study:

  • To investigate the efficacy of direct aperture optimization (DAO) for online adaptive radiation therapy (ART) in prostate cancer cases.
  • To evaluate the time efficiency of DAO-based plan adaptation compared to complete plan regeneration.
  • To introduce and assess a novel concurrent adaptive radiation delivery (ARD) approach.

Main Methods:

  • Creation of a prostate anatomy model with simulated interfractional deformations (0.25-1.00 cm).

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  • Application of DAO techniques for adapting treatment plans to anatomical changes.
  • Development and testing of a modified DAO algorithm to accelerate optimization.
  • Implementation and evaluation of adaptive radiation delivery (ARD) merging plan adaptation and radiation delivery.

    • Main Results:

    • DAO plan adaptation was approximately twice as fast as complete plan regeneration across deformations.
    • Modified DAO significantly accelerated adaptation, achieving 6x efficiency for 0.25 cm deformation.
    • Efficiency gains decreased with larger deformations, with 1.00 cm showing no improvement, indicating a limit.
    • ARD minimally increased treatment time (2-6s) for deformations up to 0.75 cm, demonstrating potential for efficient online adaptation.

    Conclusions:

    • DAO is an effective method for accelerating plan adaptation in online ART for prostate cancer.
    • Adaptive radiation delivery (ARD) offers a promising approach to minimize treatment time extension in online ART.
    • The 1.00 cm deformation highlights the limitations of current adaptive strategies, necessitating further research for extreme anatomical variations.