Open AccessLimiting treatment plan complexity by applying a novel commercial tool
Author(s) -
Scaggion Alessandro,
Fusella Marco,
Agnello Giancarmelo,
Bettinelli Andrea,
Pivato Nicola,
Roggio Antonella,
Rossato Marco A.,
Sepulcri Matteo,
Paiusco Marta
Publication year - 2020
Publication title -
journal of applied clinical medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 48
ISSN - 1526-9914
DOI - 10.1002/acm2.12908
Subject(s) - plan (archaeology) , metric (unit) , computer science , reduction (mathematics) , limiting , quality (philosophy) , reliability engineering , aperture (computer memory) , mathematics , operations management , engineering , mechanical engineering , philosophy , geometry , archaeology , epistemology , history
Purpose A recently introduced commercial tool is tested to assess whether it is able to reduce the complexity of a treatment plan and improve deliverability without compromising overall quality. Methods Ten prostate and ten oropharynx plans of previously treated patients were reoptimized using the aperture shape controller (ASC) tool recently introduced in Eclipse TPS (Varian Medical Systems, Palo Alto, CA). The performance of ASC was assessed in terms of the overall plan quality using a plan quality metric, the reduction in plan complexity through the analysis of 14 of the most common plan complexity metrics, and the change in plan deliverability through 3D dosimetric measurements. Similarly, plans optimized limiting the total number of delivered monitor units was assessed and compared. The two strategies were also combined to assess their potential combination. Results The plans optimized by exploiting the ASC generally show a reduced number of total Monitor Units, a more constant gantry rotation and a MLC modulation characterized by larger and less complicated shapes with leaves traveling shorter overall lengths. Conclusions This first experience suggests that the ASC is an effective tool to reduce the unnecessary complexity of a plan. This turns into an increased plan deliverability with no loss of plan quality.