“…The algorithm uses a dose–volume cost function that includes the MC statistical uncertainty of each voxel, effectively reducing the contribution of voxels with high statistical uncertainty:
where O is the total number of optimization objectives,
and
are the priority and number of voxels in the structure for the objective j ,
and
are the relative statistical uncertainty and the current dose in voxel i , and
is the dose constraint used in the optimizer. The calculation of
was presented in Su et al
19 . Changes that lead to reduced cost are accepted and cost value, dose distribution, statistical uncertainty, and DVH are updated accordingly.…”