FusionArc optimization: a hybrid volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) planning strategy. 2013

Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109, USA. marthamm@med.umich.edu

OBJECTIVE To introduce a hybrid volumetric modulated arc therapy/intensity modulated radiation therapy (VMAT/IMRT) optimization strategy called FusionArc that combines the delivery efficiency of single-arc VMAT with the potentially desirable intensity modulation possible with IMRT. METHODS A beamlet-based inverse planning system was enhanced to combine the advantages of VMAT and IMRT into one comprehensive technique. In the hybrid strategy, baseline single-arc VMAT plans are optimized and then the current cost function gradients with respect to the beamlets are used to define a metric for predicting which beam angles would benefit from further intensity modulation. Beams with the highest metric values (called the gradient factor) are converted from VMAT apertures to IMRT fluence, and the optimization proceeds with the mixed variable set until convergence or until additional beams are selected for conversion. One phantom and two clinical cases were used to validate the gradient factor and characterize the FusionArc strategy. Comparisons were made between standard IMRT, single-arc VMAT, and FusionArc plans with one to five IMRT∕hybrid beams. RESULTS The gradient factor was found to be highly predictive of the VMAT angles that would benefit plan quality the most from beam modulation. Over the three cases studied, a FusionArc plan with three converted beams achieved superior dosimetric quality with reductions in final cost ranging from 26.4% to 48.1% compared to single-arc VMAT. Additionally, the three beam FusionArc plans required 22.4%-43.7% fewer MU∕Gy than a seven beam IMRT plan. While the FusionArc plans with five converted beams offer larger reductions in final cost--32.9%-55.2% compared to single-arc VMAT--the decrease in MU∕Gy compared to IMRT was noticeably smaller at 12.2%-18.5%, when compared to IMRT. CONCLUSIONS A hybrid VMAT∕IMRT strategy was implemented to find a high quality compromise between gantry-angle and intensity-based degrees of freedom. This optimization method will allow patients to be simultaneously planned for dosimetric quality and delivery efficiency without switching between delivery techniques. Example phantom and clinical cases suggest that the conversion of only three VMAT segments to modulated beams may result in a good combination of quality and efficiency.

UI MeSH Term Description Entries
D008297 Male Males
D010190 Pancreatic Neoplasms Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA). Cancer of Pancreas,Pancreatic Cancer,Cancer of the Pancreas,Neoplasms, Pancreatic,Pancreas Cancer,Pancreas Neoplasms,Pancreatic Acinar Carcinoma,Pancreatic Carcinoma,Acinar Carcinoma, Pancreatic,Acinar Carcinomas, Pancreatic,Cancer, Pancreas,Cancer, Pancreatic,Cancers, Pancreas,Cancers, Pancreatic,Carcinoma, Pancreatic,Carcinoma, Pancreatic Acinar,Carcinomas, Pancreatic,Carcinomas, Pancreatic Acinar,Neoplasm, Pancreas,Neoplasm, Pancreatic,Neoplasms, Pancreas,Pancreas Cancers,Pancreas Neoplasm,Pancreatic Acinar Carcinomas,Pancreatic Cancers,Pancreatic Carcinomas,Pancreatic Neoplasm
D011471 Prostatic Neoplasms Tumors or cancer of the PROSTATE. Cancer of Prostate,Prostate Cancer,Cancer of the Prostate,Neoplasms, Prostate,Neoplasms, Prostatic,Prostate Neoplasms,Prostatic Cancer,Cancer, Prostate,Cancer, Prostatic,Cancers, Prostate,Cancers, Prostatic,Neoplasm, Prostate,Neoplasm, Prostatic,Prostate Cancers,Prostate Neoplasm,Prostatic Cancers,Prostatic Neoplasm
D011880 Radiotherapy Planning, Computer-Assisted Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy. Computer-Assisted Radiotherapy Planning,Dosimetry Calculations, Computer-Assisted,Planning, Computer-Assisted Radiotherapy,Calculation, Computer-Assisted Dosimetry,Calculations, Computer-Assisted Dosimetry,Computer Assisted Radiotherapy Planning,Computer-Assisted Dosimetry Calculation,Computer-Assisted Dosimetry Calculations,Dosimetry Calculation, Computer-Assisted,Dosimetry Calculations, Computer Assisted,Planning, Computer Assisted Radiotherapy,Radiotherapy Planning, Computer Assisted
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D050397 Radiotherapy, Intensity-Modulated CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions. Helical Tomotherapy,Intensity-Modulated Arc Therapy,Volumetric-Modulated Arc Therapy,Arc Therapies, Intensity-Modulated,Arc Therapies, Volumetric-Modulated,Arc Therapy, Intensity-Modulated,Arc Therapy, Volumetric-Modulated,Helical Tomotherapies,Intensity Modulated Arc Therapy,Intensity-Modulated Arc Therapies,Intensity-Modulated Radiotherapies,Intensity-Modulated Radiotherapy,Radiotherapies, Intensity-Modulated,Radiotherapy, Intensity Modulated,Therapies, Intensity-Modulated Arc,Therapies, Volumetric-Modulated Arc,Therapy, Intensity-Modulated Arc,Therapy, Volumetric-Modulated Arc,Tomotherapies, Helical,Tomotherapy, Helical,Volumetric Modulated Arc Therapy,Volumetric-Modulated Arc Therapies
D019047 Phantoms, Imaging Devices or objects in various imaging techniques used to visualize or enhance visualization by simulating conditions encountered in the procedure. Phantoms are used very often in procedures employing or measuring x-irradiation or radioactive material to evaluate performance. Phantoms often have properties similar to human tissue. Water demonstrates absorbing properties similar to normal tissue, hence water-filled phantoms are used to map radiation levels. Phantoms are used also as teaching aids to simulate real conditions with x-ray or ultrasonic machines. (From Iturralde, Dictionary and Handbook of Nuclear Medicine and Clinical Imaging, 1990) Phantoms, Radiographic,Phantoms, Radiologic,Radiographic Phantoms,Radiologic Phantoms,Phantom, Radiographic,Phantom, Radiologic,Radiographic Phantom,Radiologic Phantom,Imaging Phantom,Imaging Phantoms,Phantom, Imaging

Related Publications

Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
June 2013, Journal of medical imaging and radiation sciences,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
July 2012, Journal of applied clinical medical physics,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
May 2024, Cureus,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
September 2013, Journal of medical radiation sciences,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
January 2014, Journal of cancer research and therapeutics,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
May 2020, The Gulf journal of oncology,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
January 2017, Medical dosimetry : official journal of the American Association of Medical Dosimetrists,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
August 2023, Journal of cancer research and clinical oncology,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
January 2015, Medical dosimetry : official journal of the American Association of Medical Dosimetrists,
Martha M Matuszak, and Jennifer M Steers, and Troy Long, and Daniel L McShan, and Benedick A Fraass, and H Edwin Romeijn, and Randall K Ten Haken
March 2019, Journal of medical radiation sciences,
Copied contents to your clipboard!