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We consider Pareto surface based multi-criteria optimization for step andshoot IMRT planning. By analyzing two navigation algorithms, we show boththeoretically and in practice that the number of plans needed to form convexcombinations of plans during navigation can be kept small (much less than thetheoretical maximum number needed in general, which is equal to the number ofobjectives for on-surface Pareto navigation). Therefore a workable approach fordirectly deliverable navigation in this setting is to segment the underlyingPareto surface plans and then enforce the mild restriction that only a smallnumber of these plans are active at any time during plan navigation, thuslimiting the total number of segments used in the final plan.

Deliverable navigation for multicriteria step and shoot IMRT treatment planning