Three-dimensional conformal planning with low-segment multicriteria intensity modulated radiation therapy...

Area of Science:

• Medical Physics
• Radiation Oncology
• Computational Biology

Background:

• Intensity modulated radiation therapy (IMRT) planning systems are complex.
• Traditional 3-dimensional (3D) conformal radiation therapy (3D-CRT) planning can be time-consuming.
• Automated planning tools aim to improve efficiency and quality.

Purpose of the Study:

• To evaluate the efficacy of automated multicriteria optimization (MCO) for generating 3D-CRT plans.
• To assess if MCO, typically used for IMRT, can produce high-quality 3D-CRT plans with limited segmentation.
• To compare MCO-generated 3D-CRT plans against manually created 3D-CRT plans.

Main Methods:

• Ten patient treatment plans (brain, breast, lung, abdomen, pelvis) were replanned using a low-segment inverse MCO technique.
• MCO-3D plans utilized the same beam geometry as original 3D-CRT plans but were limited to 6 MV energy.
• Plans were optimized using MCO IMRT, then segmented, and compared based on dose metrics, monitor units, and physician preference.

Main Results:

• MCO-3D plans significantly reduced mean doses to organs at risk (41/45 OARs; P << .01).
• Monitor units were reduced in 70% of MCO-3D plans (average 17% reduction; P = .08).
• Target coverage and homogeneity were maintained, and physicians preferred MCO-3D plans over 3D-CRT plans.

Conclusions:

• Automated MCO-IMRT optimization can efficiently produce high-quality, field-in-field-type 3D-CRT plans.
• This approach offers good monitor unit efficiency.
• Adopting this technology can enhance plan quality and streamline production for both IMRT and 3D planning.