A new concept for interactive radiotherapy planning with multicriteria optimization: first clinical evaluation

Area of Science:

• Medical Physics
• Radiation Oncology
• Computational Biology

Background:

• Intensity-modulated radiotherapy (IMRT) inverse planning is often time-consuming due to conflicting optimization objectives.
• The full potential of IMRT is not always realized in clinical practice because individual objectives cannot be simultaneously optimized.
• Multicriteria optimization and interactive navigation offer a promising solution to these inverse planning challenges.

Purpose of the Study:

• To develop and evaluate a novel inverse planning system, the Multicriteria Interactive Radiotherapy Assistant (MIRA).
• To address the inherent complexities of multicriteria optimization in IMRT.
• To reduce the time and effort required for IMRT plan generation.

Main Methods:

• Developed the MIRA system, which generates a database of Pareto-optimal plan proposals.
• Utilized an intuitive user interface with interactive plan navigation and standard dose visualizations (DVH, isodose).
• Tested MIRA on two clinical cases (paraspinal meningioma, prostate) and compared results with the KonRad planning system.

Main Results:

• MIRA generated optimization databases in approximately 2-3 hours per case without user interaction.
• Interactive exploration identified the best plan within minutes, significantly reducing overall planning time.
• Achieved comparable plan quality to KonRad, with added benefits of plan alternatives for sensitivity analysis and compromise decisions.

Conclusions:

• The MIRA system effectively provides a comprehensive database of treatment plans and enables real-time interactive exploration of the solution space.
• MIRA is well-suited for the complex, multicriteria nature of inverse IMRT treatment planning.
• This approach enhances clinical decision-making by offering a range of viable treatment options.