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Feasibility study for marker-based VMAT plan optimization toward tumor tracking.

Azeez A Omotayo1,2, Sankar Venkataraman1,2,3, Niranjan Venugopal1

  • 1Division of Medical Physics, CancerCare Manitoba, Winnipeg, MB, Canada.

Journal of Applied Clinical Medical Physics
|June 12, 2020
PubMed
Summary
This summary is machine-generated.

This study integrates fiducial marker visibility into Volumetric Modulated Arc Therapy (VMAT) planning. This approach enhances real-time tumor tracking while maintaining acceptable dose distributions for cancer treatment.

Keywords:
VMATconstraintsfiducial markerplan optimizationtumor tracking

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Image-Guided Therapy

Background:

  • Volumetric Modulated Arc Therapy (VMAT) is a sophisticated radiation therapy technique.
  • Real-time tumor tracking is crucial for precise radiation delivery.
  • Fiducial markers can aid in localizing tumors during treatment.

Purpose of the Study:

  • To investigate the feasibility of incorporating fiducial marker visibility parameters into VMAT plan optimization.
  • To develop VMAT plans that support real-time tumor tracking using exit imaging.
  • To evaluate the impact of marker visibility constraints on dosimetric outcomes.

Main Methods:

  • Modified MonArc optimization software to include "hard" and "soft" marker visibility constraints.
  • Created VMAT plans for thorax and prostate sites with inserted fiducial markers.
  • Compared dosimetric parameters (CI, HI, GM, PTV/OAR doses) of constrained plans against non-constrained plans.

Main Results:

  • Non-constrained (NC) plans yielded the best target conformity and lowest organ at risk (OAR) doses.
  • Soft constraint (SC) VMAT plans achieved acceptable dosimetric tolerances for targets and OARs.
  • Hard constraint (HC) plans showed potential for increased OAR doses depending on marker placement.

Conclusions:

  • Fiducial marker visibility constraints can be successfully integrated into VMAT optimization alongside dosimetric objectives.
  • This dual-objective approach can produce treatment plans suitable for real-time tracking applications.
  • The proposed method holds promise for improving the clinical success of VMAT with real-time tracking.