Feasibility study for marker-based VMAT plan optimization toward tumor tracking.

Journal of Applied Clinical Medical Physics
Azeez A OmotayoBoyd McCurdy

Abstract

This work investigates the incorporation of fiducial marker-based visibility parameters into the optimization of volumetric modulated arc therapy (VMAT) plans. We propose that via this incorporation, one may produce treatment plans that aid real-time tumor tracking approaches employing exit imaging of the therapeutic beam (e.g., via EPID), in addition to satisfying purely dosimetric requirements. We investigated the feasibility of this approach for a thorax and prostate site using optimization software (MonArc). For a thorax phantom and a lung patient, three fiducial markers were inserted around the tumor and VMAT plans were created with two partial arcs and prescription dose of 48 Gy (4 fractions). For a prostate patient with three markers in the prostate organ, a VMAT plan was created with two partial arcs and prescription dose 72.8 Gy (28 fractions). We modified MonArc to include marker-based visibility constraints ("hard"and "soft"). A hard constraint (HC) imposes full visibility for all markers, while a soft constraint (SC) penalizes visibility for specific markers in the beams-eye-view. Dose distributions from constrained plans (HC and SC) were compared to the reference nonconstrained (NC) plan using metrics including con...Continue Reading

References

Apr 10, 1999·Seminars in Radiation Oncology·T Bortfeld
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Software Mentioned

Eclipse ®
Acuros XB
Varian Eclipse Treatment Planning System ( TPS )
Eclipse
MonArc
VMAT
Eclipse TPS

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