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Optimal partial-arcs in VMAT treatment planning.

Jeremiah Wala¹, Ehsan Salari, Wei Chen

¹Department of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114, USA. jeremiah_wala@hms.harvard.edu

Physics in Medicine and Biology

|September 7, 2012

Summary

We developed pmerge, a new method to optimize volumetric modulated arc therapy (VMAT) delivery efficiency using partial-arc plans. This approach significantly reduces treatment time without compromising dose quality, especially for non-centralized targets.

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Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Planning

Background:

Volumetric Modulated Arc Therapy (VMAT) is a radiotherapy technique.
Improving VMAT delivery efficiency is crucial for patient comfort and throughput.
Existing VMAT algorithms may not fully optimize treatment time.

Purpose of the Study:

To present the pmerge algorithm for automatically generating optimal partial-arc VMAT plans.
To evaluate the impact of pmerge on delivery efficiency and dose quality.
To identify the applicability of partial-arc VMAT.

Main Methods:

Extended the vmerge algorithm to create partial-arc VMAT plans (pmerge).
Generated initial plans using multicriteria optimization with 180 beams.

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Iteratively merged and sequenced fluence maps, prioritizing reduced treatment time while maintaining dose constraints.

Applied pmerge to lung, liver, and prostate cancer cases.

Main Results:

Partial-arc plans created with pmerge showed reduced treatment times compared to full-arc VMAT (e.g., 127s vs. 211s for lung).
Mean doses to critical structures were maintained within 5% of the initial plan.
Target coverage by the prescription isodose remained above 98%.
Initial plan's fluence distribution predicted optimal partial-arc angles.

Conclusions:

Partial-arc VMAT, implemented via pmerge, improves delivery efficiency without sacrificing dose quality.
Partial-arc VMAT is particularly beneficial for non-centralized targets.
The pmerge algorithm offers a practical method for optimizing VMAT treatment times.