Robust optimization should be used to replace PTV in radiotherapy treatment planning

Biston, Marie-Claude; Liang, Xiaoying; Li, Zuofeng

doi:10.1002/mp.15249

Cited by 6 publications

(5 citation statements)

References 12 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the dose prescription for robust optimization method, the robustness level of the CTV, as assessed by the dose evaluation, could be a possible practical approach for dose prescription and reporting in robust optimization. 6 In the clinical implementation of the robust optimization process, the utilization of real-time position monitoring and the assessment of delivered dose by incorporating the actual target position during treatment will provide the necessary confidence in achieving uncompromised dose delivery to the CTV.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Robust Optimization for Prostate Radiation Therapy: Assessment of Delivered Dose by Incorporating Intrafraction Prostate Position Deviations

Arumugam,

Sidhom

2024

Advances in Radiation Oncology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…In robust optimization, uncertainties related to the desired robust clinical objectives are also incorporated into the optimization process to generate robust treatment plans. 4 , 5 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Robust Optimization for Prostate Radiation Therapy: Assessment of Delivered Dose by Incorporating Intrafraction Prostate Position Deviations

Arumugam,

Sidhom

2024

Advances in Radiation Oncology

View full text Add to dashboard Cite

“…In the dose prescription for robust optimization method, the robustness level of the CTV, as assessed by the dose evaluation, could be a possible practical approach for dose prescription and reporting in robust optimization [25]. In the clinical implementation of the robust optimization process, the utilization of realtime position monitoring and the assessment of delivered dose by incorporating the actual target position during treatment will provide the necessary con dence in achieving uncompromised dose delivery to the CTV.…”

Section: Discussionmentioning

confidence: 99%

Robust optimization for prostate radiotherapy: Assessment of delivered dose by incorporating intrafraction prostate position deviations

Arumugam,

Sidhom

2023

Preprint

View full text Add to dashboard Cite

Aim To assess the robustness of the dose delivered to the clinical target volume (CTV) using planning target volume (PTV) based and robust optimization planning approaches in localized prostate cancer radiotherapy. Methods Retrospective data of twenty prostate cancer patients, including radiotherapy and real-time prostate position, were analyzed. Two sets of volumetric modulated arc therapy plans were generated per patient: PTV-based and robust optimization. PTV-based planning used 7mm CTV-PTV margin, while robust planning considered same-magnitude position deviations. Differences in CTV D99, PTV D95, bladder and rectum V40, and V60 values were evaluated. The target position, determined by in-house position monitoring system, was incorporated for dose assessment with and without position deviation correction. Results In the robust optimization approach, compared to PTV-based planning, the mean (SD) V40 and V60 values of the bladder were reduced by 5.2% (4.1%) and 5.1% (1.9%), respectively. Similarly, for the rectum, the reductions were 0.8% (0.5%) and 0.6% (0.6%). In corrected treatment scenarios, both planning approaches resulted in a mean (SD) CTV D99 difference of 0.1 Gy (0.1 Gy). In the not corrected scenario, PTV-based planning reduced CTV D99 by 0.1 Gy (0.5 Gy), while robust planning reduced it by 0.2 Gy (0.6 Gy). There was no statistically significant difference observed in the planned and delivered rectum and bladder dose for both corrected and not corrected scenarios. Conclusion Robust optimization resulted in lower V40 and V60 values for the bladder compared to PTV-based planning. However, no difference in CTV dose accuracy was found between the two approaches.

show abstract

“…By maximising these pass-rates, or maximising (minimising) the means and spreads, a treatment plan is (1) robustly optimised for a wide range of treatment scenarios and (2) incorporates a measure of the probability of what could be delivered to the patient. Criticism of the probabilistic approach surrounds the computational demands required to calculate dose in a large number of uncertainty scenarios, hence the increased planning time that may lead to compromised plan quality 10,11 . Robust optimisation is currently being researched in intensity-modulated-radiotherapy (IMRT) [12][13][14] , BT 4,5,15 and primarily in intensity-modulated-proton-therapy (IMPT) 14 .…”

Section: A Robust Optimisationmentioning

confidence: 99%

“…A critical component of a robust optimiser is the method employed to evaluate the robustness of the final robust-optimised treatment plans 2,11 . The current paper expands on two previous works.…”

Section: B Robust Evaluationmentioning

confidence: 99%

Implementation of a robust optimisation genetic algorithm for HDR prostate brachytherapy including all major uncertainties

Kennedy,

Douglass,

Santos

2024

Preprint

View full text Add to dashboard Cite

Introduction In high-dose-rate prostate brachytherapy, uncertainties cause a deviation from the nominal treatment plan, leading to a possible failure of clinical objectives in the delivered scenario. Robust optimisation has the potential to maximise the probability that these objectives are met during treatment. Method A computationally efficient probabilistic robust optimisation algorithm was developed and evaluated comprehensively on one patient by comparing it to the treatment-planning-systems (TPS) optimised plan. Three objective functions were maximised within a genetic algorithm (NSGA-ii), each an approximation for robustness against uncertainty for three clinical objectives: the minimum dose to the hottest 90% of the prostate target, \({\text{D}}_{90}^{\text{P}}\), and the maximum doses to the urethra, \({\text{D}}_{0.01 \text{c}\text{c}}^{\text{U}}\), and the rectum, \({\text{D}}_{0.1 \text{c}\text{c}}^{\text{R}}\). The approximations are derived from a probabilistic robust evaluation algorithm incorporating 14 major planning and treatment uncertainties. The robustness of a plan was quantified as a pass-rate from 500 probabilistic uncertainty scenarios for \({\text{D}}_{90}^{\text{P}}, {\text{D}}_{0.01 \text{c}\text{c}}^{\text{U}}\), and\({\text{D}}_{0.1 \text{c}\text{c}}^{\text{R}}\). Two hundred robust-optimised plans are generated that are the best trade-off between the three-competing DVH metric pass-rates. Results The robust-optimised plans on average (mean) increased in overall robustness by 58.5 ± 3.0% (SD: 7.1%, min: 34.1%, max: 67.7%) compared to the TPS-optimised plan. The robustness increase for the \({\text{D}}_{90}^{\text{P}}\) pass-rate was 31.2 ± 2.2% (SD: 15.6%, min: -5.1%, max: 46.7%), for the \({\text{D}}_{0.01 \text{c}\text{c}}^{\text{U}}\) pass-rate, the increase was 48.2 ± 2.6% (SD: 11.9%, min: 26.9%, max: 67.7%), and for the \({\text{D}}_{0.1 \text{c}\text{c}}^{\text{R}}\) pass-rate, the change was 0.0 ± 1.1% (SD: 0.72%, min: -2.6%, max: 0.4%). Conclusion The robust optimisation algorithm was demonstrated to produce more robust plans than the TPS, in an increased probability of target coverage and organs-at-risk sparing within a clinically reasonable time.

show abstract

Robust optimization should be used to replace PTV in radiotherapy treatment planning

Cited by 6 publications

References 12 publications

Robust Optimization for Prostate Radiation Therapy: Assessment of Delivered Dose by Incorporating Intrafraction Prostate Position Deviations

Robust Optimization for Prostate Radiation Therapy: Assessment of Delivered Dose by Incorporating Intrafraction Prostate Position Deviations

Robust optimization for prostate radiotherapy: Assessment of delivered dose by incorporating intrafraction prostate position deviations

Implementation of a robust optimisation genetic algorithm for HDR prostate brachytherapy including all major uncertainties

Contact Info

Product

Resources

About