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On-line re-optimization of prostate IMRT plans for adaptive radiation therapy*

FEATURED ARTICLE

Q Jackie Wu1, Danthai Thongphiew1,2, Zhiheng Wang1, Boonyanit Mathayomchan2, Vira Chankong2, Sua Yoo1, W Robert Lee1 and Fang-Fang Yin1

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For intermediate and high risk prostate cancer, both the prostate gland and seminal vesicles are included in the clinical target volume. Internal motion patterns of these two organs vary, presenting a challenge for adaptive treatment. Adaptive techniques such as isocenter repositioning and soft tissue alignment are effective when tumor volumes only exhibit translational shift, while direct re-optimization of the intensity-modulated radiation therapy (IMRT) plan maybe more desirable when extreme deformation or differential positioning changes of the organs occur. Currently, direct re-optimization of the IMRT plan using beamlet (or fluence map) has not been reported. In this study, we report a novel on-line re-optimization technique that can accomplish plan adjustment on-line. Deformable image registration is used to provide position variation information on each voxel along the three dimensions. The original planned dose distribution is used as the 'goal' dose distribution for adaptation and to ensure planning quality. Fluence maps are re-optimized via linear programming, and a plan solution can be achieved within 2 min. The feasibility of this technique is demonstrated with a clinical case with large deformation. Such on-line ART process can be highly valuable with hypo-fractionated prostate IMRT treatment.


Footnote
*  Abstract and preliminary data presented at 49th AAPM Annual Meeting, Minneapolis, MN, USA, July 2007.
PACS

87.55.-x Treatment strategy

87.57.N- Image analysis

87.59.bd Computed radiography

87.55.Qr Quality assurance in radiotherapy

87.56.Da Ancillary equipment

87.19.X- Diseases

Subjects

Biological physics

Medical physics

Dates

Issue 3 (7 February 2008)

Received 20 September 2007, in final form 4 December 2007

Published 10 January 2008



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