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The Cut-Sort-Group algorithm for efficient delivery of collimated step-and-shoot proton arc therapy.

Karsten K Wake1, Laura C Bennett2, Blake R Smith3

  • 1Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Medical Physics
|May 19, 2025
PubMed
Summary
This summary is machine-generated.

A new Cut-Sort-Group (CSG) algorithm significantly speeds up dynamically collimated proton arc therapy (DC-PAT) delivery times by over 64%. This method enhances efficiency without compromising plan quality or robustness, making DC-PAT more clinically feasible.

Keywords:
Dynamic Collimation System (DCS)Pencil Beam Scanning (PBS)collimationdynamic collimationproton arc therapytreatment delivery time

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Proton Therapy

Background:

  • Proton arc therapy offers enhanced geometric flexibility for conformal treatments.
  • Dynamic Collimation System (DCS) improves target conformity and reduces normal tissue dose.
  • Dynamically collimated proton arc therapy (DC-PAT) requires efficient planning for clinical workflow.

Purpose of the Study:

  • To develop and demonstrate a post-processing algorithm for improving DC-PAT delivery efficiency.
  • To maintain or improve plan quality during DC-PAT efficiency enhancements.

Main Methods:

  • Baseline DC-PAT plans were created using a genetic optimizer for three intracranial cases.
  • The Cut-Sort-Group (CSG) algorithm was applied in post-processing to modify plans.
  • CSG involved low-weight control point removal, novel energy layer sorting, and trimmer reconfiguration.

Main Results:

  • CSG algorithm reduced beam delivery time (BDT) by over 64% (10-14 min).
  • Plan quality was maintained, with comparable PTV dose coverage and minimal impact on non-target doses.
  • PTV D2% remained under 10% of prescription, with a Homogeneity Index (HI) of 0.09-0.12.

Conclusions:

  • The CSG algorithm offers a simple post-processing solution to increase DC-PAT efficiency.
  • This method is independent of the treatment planning system or optimization algorithm used.
  • Reduced BDT (just over 10 min) approaches levels suitable for clinical implementation.