Novel inverse planning optimization algorithm for robotic radiosurgery: First clinical implementation and dosimetric evaluation

Zeverino, M.; Marguet, Maud; Zulliger, C.; Durham, André; Jumeau, R.; Herrera, Fernanda G.; Schiappacasse, Luis; Bourhis, Jean; Bochud, François; Moeckli, Raphaël

doi:10.1016/j.ejmp.2019.07.020

Cited by 24 publications

(37 citation statements)

References 20 publications

(15 reference statements)

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“…Our results arising from the comparison between VOLO and Sequential optimized plans highlighted a significant reduction of nodes, segments, total number of MU and treatment time in VOLO solutions. Comparing our results with those obtained in [15] we can suppose that higher efficiency of MLC VOLO-optimized plans is achievable for body lesions which are generally more complex and larger than most brain tumors. In Zeverino et al there is not a direct comparison between optimization times using the two algorithms, however they estimated a reduction of the optimization time up to ten times for SIB cases.…”

Section: Discussionsupporting

confidence: 74%

“…In the present study, for the first time, VOLO performances were evaluated in SBRT cases for different treatment sites planned with MLC. Performances of VOLO optimization algorithm for Cyberknife treatment planning has been recently investigated by Zeverino et al [15]. That study is mainly dedicated to the assessment of VOLO performances for optimization of Iris collimator treatment plans.…”

Section: Discussionmentioning

confidence: 99%

“…These optimization process for complex plans where several objectives are necessary, can require an extremely long time. Moreover the optimization of delivery efficiency may require two additional optional steps: time reduction and beam/ [31][32][33][34][35][36][37][38] node reduction [15]. If a high delivery efficiency is required, these processes can lead to a deterioration of target coverage.…”

Section: Treatment Plans Optimizationmentioning

confidence: 99%

“…Additional steps to improve delivery efficiency optimization may also be necessary [12]. As a result, complex treatment plans requiring many objectives and/or targeted to large lesions may necessitate extremely long optimization times which can extend up to four hours [12][13][14][15]. The VOLO optimization system was implemented to overcome the limitations of the Sequential algorithm.…”

Section: Introductionmentioning

confidence: 99%

“…The aim of this study was to assess VOLO performance on robotic MLC-based plans for different SBRT treatment sites in comparison with Sequential solutions. VOLO performance has already been evaluated by Zeverino et al [15] for Iris-based plans whereas for MLC-based plans the analysis is limited to brain lesions treatments. VOLO Iris optimization does not use a fluence-based approach.…”

Section: Introductionmentioning

confidence: 99%

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Performance assessment of a new optimization system for robotic SBRT MLC-based plans

Calusi

Doro²,

Cataldo³

et al. 2020

Physica Medica

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A B S T R A C TPurpose: To assess the performance of a new optimization system, VOLO, for CyberKnife MLC-based SBRT plans in comparison with the existing Sequential optimizer. Methods: MLC-plans were created for 25 SBRT cases (liver, prostate, pancreas and spine) using both VOLO and Sequential. Monitor units (MU), delivery time (DT), PTV coverage, conformity (nCI), dose gradient (R50%) and OAR doses were used for comparison and combined to obtain a mathematical score (MS) of plan quality for each solution. MS strength was validated by changing parameter weights and by a blinded clinical plan evaluation. The optimization times (OT) and the average segment areas (SA) were also compared. Results: VOLO solutions offered significantly lower mean DT (−19%) and MU (−13%). OT were below 15 min for VOLO, whereas for Sequential, values spanned from 8 to 160 min. SAs were significantly larger for VOLO: on average 10 cm 2 versus 7 cm 2 . VOLO optimized plans achieved a higher MS than Sequential for all tested parameter combinations. PTV coverage and OAR sparing were comparable for both groups of solutions. Although slight differences in R50% and nCI were found, the parameters most affecting MS were MU and DT. VOLO solutions were selected in 80% of cases by both physicians with 88% inter-observer agreement. Conclusions: The good performance of the VOLO optimization system, together with the large reduction in OT, make it a useful tool to improve the efficiency of CK SBRT planning and delivery. The proposed methodology for comparing different planning solutions can be applied in other contexts.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Treatment Plans Optimizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Performance assessment of a new optimization system for robotic SBRT MLC-based plans

Calusi

Doro²,

Cataldo³

et al. 2020

Physica Medica

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Largely reduced OAR doses, and planning and delivery times for challenging robotic SBRT cases, obtained with a novel optimizer

Gíżyńska

Rossi

Toom

et al. 2021

J Applied Clin Med Phys

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Recently, VOLO™ was introduced as a new optimizer for CyberKnife® planning. In this study, we investigated possibilities to improve treatment plans for MLC-based prostate SBRT with enhanced peripheral zone dose while sparing the urethra, and central lung tumors, compared to existing Sequential Optimization (SO). The primary focus was on reducing OAR doses. For 25 prostate and 25 lung patients treated with SO plans, replanning with VOLO™ was performed with the same planning constraints. For equal PTV coverage, almost all OAR plan parameters were improved with VOLO™. For prostate patients, mean rectum and bladder doses were reduced by 34.2% (P < 0.001) and 23.5% (P < 0.001), with reductions in D 0.03cc of 3.9%, 11.0% and 3.1% for rectum, mucosa and bladder (all P ≤ 0.01). Urethra D 5% and D 10% were 3.8% and 3.0% lower (P ≤ 0.002). For lung patients, esophagus, main bronchus, trachea, and spinal cord D 0.03cc was reduced by 18.9%, 11.1%, 16.1%, and 13.2%, respectively (all P ≤ 0.01). Apart from the dosimetric advantages of VOLO™ planning, average reductions in MU, numbers of beams and nodes for prostate/lung were 48.7/32.8%, 26.5/7.9% and 13.4/7.9%, respectively (P ≤ 0.003). VOLO™ also resulted in reduced delivery times with mean/max reductions of: 27/ 43% (prostate) and 15/41% (lung), P < 0.001. Planning times reduced from 6 h to 1.1 h and from 3 h to 1.7 h for prostate and lung, respectively. The new VOLO™ planning was highly superior to SO planning in terms of dosimetric plan quality, and planning and delivery times.

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Implementing and evaluating a high‐resolution diode array for patient‐specific quality assurance of robotic brain stereotactic radiosurgery/radiotherapy

Xu¹,

Huynh²,

Nie³

et al. 2022

J Applied Clin Med Phys

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The purpose of the study was to introduce and evaluate a high‐resolution diode array for patient‐specific quality assurance (PSQA) of CyberKnife brain stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). Thirty‐three intracranial plans were retrospectively delivered on the SRS MapCHECK using fixed cone, Iris, and multileaf collimator (MLC). The plans were selected to cover a range of sites from large tumor bed, single/multiple small brain metastases (METs) to trigeminal neuralgia. Fiducial tracking using the four fiducials embedded around the detector plane was used as image guidance. Results were analyzed before and after registration based on absolute dose gamma criterion of 1 mm distance‐to‐agreement and 0.5%–3% dose‐difference. Overall, the gamma passing rates (1 mm and 3% criterion) before registration for all the patients were above 90% for all three treatment modalities (96.8 ± 3.5%, the lowest passing rate of 90.4%), and were improved after registration (99.3 ± 1.5%). When tighter criteria (1 mm and 2%) were applied, the gamma passing rates after registration for all the cases dropped to 97.3 ± 3.2%. For trigeminal neuralgia cases, we applied 1 mm and 0.5% criterion and the passing rates dropped from 100 ± 0.0% to 98.5 ± 2.0%. The mean delivery time was 33.4 ± 11.7 min, 24.0 ± 4.9 min, and 17.1 ± 2.6 min for the fixed cone, Iris, and MLC, respectively. With superior gamma passing rates and reasonable quality assurance (QA) time, we believe the SRS MapCHECK could be a good option for routine PSQA for CyberKnife SRS/SRT.

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Novel inverse planning optimization algorithm for robotic radiosurgery: First clinical implementation and dosimetric evaluation

Cited by 24 publications

References 20 publications

Performance assessment of a new optimization system for robotic SBRT MLC-based plans

Performance assessment of a new optimization system for robotic SBRT MLC-based plans

Largely reduced OAR doses, and planning and delivery times for challenging robotic SBRT cases, obtained with a novel optimizer

Implementing and evaluating a high‐resolution diode array for patient‐specific quality assurance of robotic brain stereotactic radiosurgery/radiotherapy

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