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Lexicographic optimization-based planning for stereotactic radiosurgery of brain metastases.
Trivellato, Sara; Caricato, Paolo; Pellegrini, Roberto; Daniotti, Martina Camilla; Bianchi, Sofia; Bordigoni, Bianca; Carminati, Stefano; Faccenda, Valeria; Panizza, Denis; Montanari, Gianluca; Arcangeli, Stefano; De Ponti, Elena.
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  • Trivellato S; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Caricato P; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; Department of Physics, University of Milan, Milan, Italy; Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
  • Pellegrini R; Medical Affairs, Elekta AB, Stockholm, Sweden.
  • Daniotti MC; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; Department of Physics, University of Milan, Milan, Italy.
  • Bianchi S; School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy; Radiation Oncology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Bordigoni B; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Carminati S; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; Department of Physics, University of Milan, Milan, Italy.
  • Faccenda V; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Panizza D; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.
  • Montanari G; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Arcangeli S; School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy; Radiation Oncology Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy. Electronic address: stefano.arcangeli@unimib.it.
  • De Ponti E; Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.
Radiother Oncol ; 196: 110308, 2024 07.
Article en En | MEDLINE | ID: mdl-38677330
ABSTRACT

AIM:

To validate a fully-automated lexicographic optimization-planning system (mCycle, Elekta) for single-(SL) and multiple-(ML, up to 4 metastases) lesions in intracranial stereotactic radiosurgery (SRS, 21 Gy, single fraction).

METHODS:

A pre-determined priority list, Wish-List (WL), represents a dialogue between planner and clinician, establishing strict constraints and pursuing objectives. In order to satisfy the clinical protocol without manual intervention, four patients were required to tweak and fine-tune each WL (SLp, MLp) for coplanar arcs. Thirty-five testing plans (20 SLp, 15 MLp) were automatically re-planned (mCP). Automatic and manual plans were compared including dose constraints, conformality, modulation complexity score (MCS), delivery time, and local gamma analysis (2%/2 mm). To ensure plan clinical acceptability, two radiation oncologists conducted an independent blind plan choice.

RESULTS:

Each WL-tuning took 3 days. Estimated median manual plans and mCP calculation time were 8 and 3 h, respectively. Significant increases in SLp and MLp target coverage and conformity were registered. mCP showed a not significant and clinically acceptable higher median brain V12Gy. SLp registered a -5.8% MU decrease with comparable median delivery time (MP 2.0 min, mCP 1.9 min) while MLp showed a +9.8% MU increase and longer delivery time (MP 3.5 min, mCP 4.4 min). mCP MCS resulted significantly higher without affecting gamma passing rates. At blind choice, mCP were preferred in the majority of cases.

CONCLUSIONS:

Lexicographic optimization produced acceptable SRS plans with coplanar arcs significantly reducing the overall planning time in cases with up to 4 brain metastases. These planning improvements suggest further investigations by setting high-quality non-coplanar arc plans as a reference.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Planificación de la Radioterapia Asistida por Computador / Neoplasias Encefálicas / Radiocirugia Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Planificación de la Radioterapia Asistida por Computador / Neoplasias Encefálicas / Radiocirugia Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Irlanda