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Purpose  To provide a fast computational method, based on the proximal graph solver ( POGS ) – A convex optimization solver using the alternating direction method of multipliers ( ADMM ), for calculating an optimal treatment plan in rotating shield brachytherapy ( RSBT ).  RSBT  treatment planning has more degrees of freedom than conventional high‐dose‐rate brachytherapy due to the addition of emission direction, and this necessitates a fast optimization technique to enable clinical usage.    Methods  The multi‐helix  RSBT  (H‐ RSBT ) delivery technique was investigated for five representative cervical cancer patients. Treatment plans were generated for all patients using the  POGS  method and the commercially available solver  IBM ILOG CPLEX . The rectum, bladder, sigmoid colon, high‐risk clinical target volume ( HR ‐ CTV ), and  HR ‐ CTV  boundary were the structures included in our optimization, which applied an asymmetric dose‐volume optimization with smoothness control. Dose calculation resolution was 1 × 1 × 3 mm 3  for all cases. The H‐ RSBT  applicator had 6 helices, with 33.3 mm of translation along the applicator per helical rotation and 1.7 mm spacing between dwell positions, yielding 17.5° emission angle spacing per 5 mm along the applicator.    Results  For each patient,  HR ‐ CTV   D  90 ,  HR ‐ CTV   D  100 , rectum  D 2cc  , sigmoid  D 2cc  , and bladder  D 2cc   matched within 1% for  CPLEX  and  POGS  methods. Also, similar  EQD 2 values between  CPLEX  and  POGS  methods were obtained.  POGS  was around 18 times faster than  CPLEX . For all patients, total optimization times were 32.1–65.4 s for  CPLEX  and 2.1–3.9 s for  POGS .    Conclusions   POGS  reduced treatment plan optimization time approximately 18 times for  RSBT  with similar  HR ‐ CTV   D  90 , organ at risk ( OAR )  D 2cc   values, and  EQD 2 values compared to  CPLEX , which is significant progress toward clinical translation of  RSBT .

Fast dose optimization for rotating shield brachytherapy