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An empirical method for splitting arcs in VMAT.

Bojarajan Perumal1, S Harikrishna Etti2, Vaitheeswaran Ranganathan3

  • 1Philips Health Systems, Philips India Ltd, Bangalore, India; Department of Medical Physics, Bharathiar University, Coimbatore, India.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)
|July 30, 2021
PubMed
Summary
This summary is machine-generated.

This study introduces an optimal arc splitting method for VMAT radiotherapy, reducing treatment time and radiation dose to healthy tissues. The new VMAT_S technique improves efficiency without compromising cancer treatment quality.

Keywords:
Control pointsMonitor unitsObjective functionTreatment timeVMAT

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Volumetric Modulated Arc Therapy (VMAT) is a sophisticated radiotherapy technique.
  • Optimizing beam angles and arc segments is crucial for VMAT plan quality.
  • Current methods may not fully exploit potential efficiencies in arc delivery.

Purpose of the Study:

  • To develop and validate a novel algorithm for determining optimal arc splitting in VMAT.
  • To extend a previously developed algorithm for optimal beam angle selection in Intensity Modulated Radiation Therapy (IMRT).
  • To reduce treatment time, monitor units, and low-dose bath in VMAT plans.

Main Methods:

  • An objective function-based scoring method, the "ψ - score", was developed to identify optimal arc splitting strategies.
  • The algorithm was tested on clinical cases including Abdomen-Para aortic node, Lung, Pancreas, and Prostate.
  • Two sets of plans were generated: standard VMAT and VMAT_S (with optimized arc splitting).
  • Avoidable arc portions were identified and removed using the ψ - score plot before final optimization.

Main Results:

  • VMAT_S plans achieved equivalent or superior Organ at Risk (OAR) sparing and comparable target coverage compared to standard VMAT.
  • VMAT_S resulted in a 24.2% reduction in control points and a 12.9% decrease in monitor units.
  • Average beam on time was reduced by 21.9%, and the 5 Gy isodose volume to healthy tissues decreased by 4.9%.

Conclusions:

  • The proposed arc splitting method effectively reduces monitor units, beam on time, and low-dose volume.
  • Plan quality is maintained without significant compromise.
  • This method is particularly beneficial for non-centrically located targets in VMAT radiotherapy.