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Dose optimization with fully flexible vertex positioning for LATTICE radiotherapy.

Xin Tong1, Weijie Zhang1, Ya-Nan Zhu2

  • 1Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA.

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A new lattice radiotherapy (LATTICE) planning method optimizes vertex positions and dose simultaneously. This approach improves treatment quality by allowing fully flexible vertex placement, outperforming conventional methods.

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LATTICEPVDRSFRTinverse optimizationtreatment planning

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Computational Biology

Background:

  • Lattice radiotherapy (LATTICE) uses spatially fractionated radiation therapy (SFRT) to deliver high doses to tumor vertices while sparing healthy tissue.
  • Conventional LATTICE planning often uses rigid, regular vertex arrangements, limiting adaptability to irregular tumor shapes and critical structures.
  • Optimizing vertex placement is crucial for precise targeting and minimizing damage, but methods for fully flexible vertex placement are lacking.

Purpose of the Study:

  • Develop a novel LATTICE treatment planning method enabling fully flexible vertex placement and simultaneous dose optimization.
  • Enhance overall plan quality compared to traditional LATTICE methods that rely on manual, regular vertex placements.

Main Methods:

  • Formulated a constrained optimization problem incorporating flexible lattice vertex positions alongside dose variables (proton spot weights or photon fluences).
  • Implemented constraints for center-to-center vertex distance and distance to target boundaries.
  • Solved the optimization problem using the alternating direction method of multipliers and iterative convex relaxation techniques.

Main Results:

  • The new method (NEW) generated LATTICE plans comparable to or better than the best conventional plans across patient cases.
  • Photon LATTICE plans for an abdominal tumor showed a 31.1% improvement in objective function F and a 14.0% improvement in target PVDR compared to the best conventional plans.
  • Significant improvements in target PVDR and OAR sparing were observed with the flexible vertex placement approach.

Conclusions:

  • Introduced a new LATTICE treatment planning approach with fully flexible, simultaneously optimized vertex positions and dose distribution.
  • The proposed method demonstrates superior performance in improving target PVDR and organ-at-risk (OAR) sparing over conventional LATTICE techniques.