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Optimal delivery of DMLC Arc Therapy

机译:DMLC ARC疗法的最佳交付

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Purpose: The continuous delivery of a specific treatment plan for an arc therapy can be achieved with multiple solutions for speed of gantry rotation, beam dose rate variation in time and with various speed trajectories of MLC leaves. This non-uniqueness of arc therapy delivery creates situations that given treatment plans can be delivered with arc with variable degrees of efficiency. The goal of this study is to find the most time efficient realization of the arc delivery provided all constraints of the delivery system are satisfied. Methods and Materials: The starting point for our considerations is that the specific plan of treatment has been derived for arc radiation therapy. We identify first the invariants of the arc therapy. These are parameters of the plan that have to be kept unchanged during delivery to preserve the integrity of the plan, i.e. they assure that plan delivered leads to dose distribution that is identical to dose distribution derived at the treatment planning process. We find that dose delivery invariants include file defining apertures of MLC as function of gantry angle and file defining beam intensity (MU) as function of gantry angle. The other point of our considerations exemplifies limitations of delivery systems for arc therapies. These constraints include gantry angular speed limit, beam dose rate limit and MLC leaf speed limits. Provided above invariants and limitations are satisfied, there exist multiple solutions for arc therapy delivery. We derive formula for such determination of gantry rotation speed, beam dose rate variation and MLC leaf speeds during delivery that lead to minimal time of arc therapy of a given plan. Results: We investigate the example of arc therapy comparing delivery performed under standard delivery algorithm (Varian Medical system) and our time optimized delivery. We first solve the optimization problem and define delivery files. We then simulate deliveries based on parameters derived from standard algorithms and from our solutions. In our preliminary study we find that both deliveries provide identical dose distributions and observe that our algorithm leads to 10-15% decrease in delivery time. Conclusions: Investigation of minimal delivery time arc radiation therapy demonstrates that the proposed method provides a viable option for continuous delivery of arc therapy treatments implemented with clinical TPS and clinical linear accelerators. The phantom study shows that minimal delivery time arc radiation therapy improves treatment efficiency without compromising dosimetric integrity of dose parameters at irradiation process.
机译:目的:可以通过多种解决方案实现龙门旋转的速度,梁剂量率随时间变化以及MLC叶子的各种速度轨迹来实现用于电弧疗法的特定治疗计划的连续递送。这种非唯一性的弧度治疗递送产生了可以使用可变效率的电弧提供给定治疗计划的情况。本研究的目标是找到最有效的弧传递时间的实现,所以提供了递送系统的所有约束。方法和材料:我们考虑的起点是,用于电弧放射治疗的特定治疗计划。我们首先识别ARC疗法的不变性。这些是在交付期间必须保持不变的计划的参数,以保留计划的完整性,即它们确保送达的计划导致剂量分布与治疗计划过程中衍生的剂量分布相同。我们发现剂量递送不变包括根据龙门角角度定义光束强度(mu)的龙门角角度和文件定义光束强度(mu)的函数。我们注意事项的另一个点举例说明了用于电弧疗法的递送系统的限制。这些约束包括龙门角速度限制,光束剂量率限制和MLC叶速度限制。满足上述不变性和限制,存在多种用于电弧疗法的解决方案。我们在递送过程中导出了这种龙门旋转速度,光束剂量率变化和MLC叶速度的测定的公式,这导致给定计划的最小弧形治疗时间。结果:我们调查了在标准交付算法(Varian Medical System)下进行的电弧治疗的示例和我们的时间优化交付。我们首先解决优化问题并定义传送文件。然后,我们根据标准算法和我们的解决方案源自派生的参数来模拟交付。在我们的初步研究中,我们发现两个交付都提供相同的剂量分布,并观察到我们的算法导致10-15%的交货时间降低。结论:对最小递送时间弧辐射治疗的研究表明,所提出的方法提供了可连续递送临床TPS和临床线性促进剂的弧治疗治疗的可行选择。 Phantom研究表明,最小的递送时间电弧辐射治疗在不影响照射过程中不影响剂量参数的剂量参数的剂量完整性,提高了治疗效率。

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