RAdiotherapy Dose Accumulation Routine (RADAR)-A Novel Dose Accumulation Script With Built-In Uncertainty

Area of Science:

• Radiation Oncology
• Medical Physics
• Radiotherapy Planning

Background:

• Accurate dose accumulation is crucial for effective reirradiation.
• Uncertainty in patient positioning and anatomy can lead to dose inaccuracies.
• Existing methods may not fully account for these uncertainties.

Purpose of the Study:

• To introduce and evaluate the RAdiotherapy Dose Accumulation Routine (RADAR) script.
• To incorporate uncertainty into dose accumulation for reirradiation using a novel algorithm.

Main Methods:

• Developed the RADAR script for the Eclipse treatment planning system.
• Introduced a voxel-wise ellipsoid search algorithm to model uncertainty.
• Demonstrated RADAR on a spine reirradiation case and conducted user evaluations with 11 participants.

Main Results:

• The ellipsoid search algorithm significantly impacted accumulated spinal cord dose, increasing it when considering adjacent structures.
• Restricting the search to within the spinal cord mitigated this dose increase.
• User evaluations showed an average increase of 31.6% in spinal cord dose with uncertainty applied, and a decrease of 16.7% when restricted.

Conclusions:

• RADAR provides a novel method for directly addressing uncertainty in dose accumulation.
• The voxel-wise ellipsoid search algorithm enhances the accuracy of reirradiation dose calculations.
• RADAR supports dose accumulation with and without dose discounts for flexible planning.