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The purpose of this study is to examine in a clinical setting a novelformulation of objective functions for intensity-modulated radiotherapytreatment plan multicriteria optimization (MCO) that we suggested in a recentstudy. The proposed objective functions are extended with dynamic multileafcollimator (DMLC) delivery constraints from the literature, and a tailoredinterior point method is described to efficiently solve the resultingoptimization formulation. In a numerical planning study involving three patientcases, DMLC plans Pareto optimal to the MCO formulation with the proposedobjective functions are generated. Evaluated based on pre-defined plan qualityindices, these DMLC plans are compared to conventionally generated DMLC plans.Comparable or superior plan quality is observed. Supported by these results,the proposed objective functions are argued to have a potential to streamlinethe planning process, since they are designed to overcome the methodologicalshortcomings associated with the conventional penalty-based objective functionsassumed to cause the current need for time-consuming trial-and-error parametertuning. In particular, the increased accuracy of the planning tools imposed bythe proposed objective functions has the potential to make the planning processless complicated. These conclusions position the proposed formulation as analternative to existing methods for automated planning.

physics in medicine and biology/physics in medicine and biology

Increased accuracy of planning tools for optimization of dynamic  multileaf collimator delivery of radiotherapy through reformulated objective  functions