WE‐AB‐209‐07: Explicit and Convex Optimization of Plan Quality Metrics in Intensity‐Modulated Radiation Therapy Treatment Planning

摘要

Purpose: To formulate objective functions of a multicriteria fluence map optimization model that correlate well with plan quality metrics, and to solve this multicriteria model by convex approximation. Methods: In this study, objectives of a multicriteria model are formulated to explicitly either minimize or maximize a dose‐at‐volume measure. Given the widespread agreement that dose‐at‐volume levels play important roles in plan quality assessment, these objectives correlate well with plan quality metrics. This is in contrast to the conventional objectives, which are to maximize clinical goal achievement by relating to deviations from given dose‐at‐volume thresholds: while balancing the new objectives means explicitly balancing dose‐at‐volume levels, balancing the conventional objectives effectively means balancing deviations. Constituted by the inherently non‐convex dose‐at‐volume measure, the new objectives are approximated by the convex mean‐tail‐dose measure (CVaR measure), yielding a convex approximation of the multicriteria model. Results: Advantages of using the convex approximation are investigated through juxtaposition with the conventional objectives in a computational study of two patient cases. Clinical goals of each case respectively point out three ROI dose‐at‐volume measures to be considered for plan quality assessment. This is translated in the convex approximation into minimizing three mean‐tail‐dose measures. Evaluations of the three ROI dose‐at‐volume measures on Pareto optimal plans are used to represent plan quality of the Pareto sets. Besides providing increased accuracy in terms of feasibility of solutions, the convex approximation generates Pareto sets with overall improved plan quality. In one case, the Pareto set generated by the convex approximation entirely dominates that generated with the conventional objectives. Conclusion: The initial computational study indicates that the convex approximation outperforms the conventional objectives in aspects of accuracy and plan quality.