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Photon Optimizer (PO) prevails over Progressive Resolution Optimizer (PRO) for VMAT planning with or without

Fan Jiang1, Hao Wu1, Haizhen Yue1

  • 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing Cancer Hospital, Beijing, China.

Journal of Applied Clinical Medical Physics
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PubMed
Summary
This summary is machine-generated.

Knowledge-based planning using RapidPlan and the Photon Optimizer (PO) significantly reduces organ-at-risk exposure in VMAT. The Photon Optimizer (PO) algorithm is superior to the Progressive Resolution Optimizer (PRO) for VMAT planning.

Keywords:
VMATPhoton OptimizerProgressive Resolution OptimizerRapidPlanknowledge-based planning

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment Planning

Background:

  • Knowledge-based planning (KBP) in Volumetric Modulated Arc Therapy (VMAT) planning may enhance dosimetric performance.
  • The contribution of patient-specific optimization objectives (RapidPlan) and the Photon Optimizer (PO) algorithm versus the Progressive Resolution Optimizer (PRO) engine requires evaluation.
  • Understanding optimizer performance is crucial for algorithm selection in VMAT planning.

Purpose of the Study:

  • To compare the dosimetric performance of VMAT plans optimized with RapidPlan (PO) and PRO.
  • To assess the individual contributions of KBP objectives and the PO algorithm to dosimetric improvements.
  • To provide practical guidelines for algorithm selection in VMAT planning.

Main Methods:

  • Reoptimized 30 historical rectal cancer VMAT plans using RapidPlan (PO).
  • Reoptimized the same plans using the PRO algorithm with converted dose-volume constraints.
  • Compared target dose coverage and organs-at-risk (OAR) exposure between clinical (PRO), PO, and PRO plans.

Main Results:

  • Combined KBP objectives and PO significantly reduced OAR exposure (23.49-32.72%) compared to clinical plans.
  • Dosimetric improvements were largely maintained when PRO replaced PO, indicating refined objectives were primary drivers.
  • PO offered an additional dosimetric benefit (1.54-3.74%) over PRO, independent of RapidPlan.

Conclusions:

  • Knowledge-based objectives, even with the PRO algorithm, offer significant dosimetric benefits for VMAT planning.
  • The Photon Optimizer (PO) algorithm provides incremental dosimetric advantages over PRO for VMAT.
  • PO should be prioritized for VMAT planning, irrespective of RapidPlan implementation.