Monaco treatment planning system tools and optimization processes

Clements, Mac; Schupp, Nicholas; Tattersall, Megan; Brown, Anthony M.; Larson, Randy

doi:10.1016/j.meddos.2018.02.005

Cited by 40 publications

(21 citation statements)

References 21 publications

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“…The sequencing algorithms implemented in both TPSs are different (i.e. Monaco: Smart Sequencing [16]; Pinnacle 3 : Direct Machine Parameter Optimization [17]) and the segmentation outcome is therefore likely to be different. Furthermore, the increase in MUs for MR-linac and quasi MR-linac plans compared to clinical plans might partly be due the non-flattened beam profile of the MR-linac beam in combination with the increased number of off-axis apertures caused by the fixed MR-linac isocenter.…”

Section: Mr-linac -Clinical Mr-linac -Quasi Mr-linac Clinicalmentioning

confidence: 99%

Evaluation of plan quality in radiotherapy planning with an MR-linac

Schoot

Wollenberg

Carbaat

et al. 2019

Physics and Imaging in Radiation Oncology

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Background & purpose: Clinical introduction of magnetic resonance (MR)-guided radiotherapy involves treatment planning while taking into account machinespecific characteristics. Our aim was to investigate the feasibility of high-quality MR-linac treatment planning for an MR-linac and to benchmark MR-linac plan quality (IMRT) against current clinical practice (VMAT). Materials & methods: Data of eight rectal and eight prostate cancer patients, who received radiotherapy on a conventional CBCT-integrated linac, were selected. Clinically acquired CTs and associated delineations of target volumes and organs-at-risk (OARs) were used for MR-linac treatment planning in Monaco. To investigate treatment planning software bias 'quasi MR-linac plans' were generated in Pinnacle 3 by mimicking MR-linac specific beam characteristics. MR-linac, quasi MR-linac, and clinical plans were compared and differences in target and OAR doses assessed. Differences in plan complexity were determined by the number of segments and monitor units. Results: Compared to clinical plans, MR-linac plans showed a statistically significant decrease in plan homogeneity, an increase in PTV D mean (prostate: 0.6 Gy; rectum: 0.8 Gy) and D 1% (prostate: 1.9 Gy; rectum: 2.0 Gy), and increases in OAR dose. Quasi MR-linac plans were comparable to MR-linac plans with respect to OAR dose and plan homogeneity. For rectal cancer an increase was seen in PTV D mean (0.12 Gy) and D 1% (0.5 Gy) compared to regular MR-linac plans. All created plans were clinically equivalent to current clinical practice. Conclusions: This study demonstrates the feasibility of creating high-quality MR-linac treatment plans. The results supported the clinical introduction of an MR-linac.

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Section: Mr-linac -Clinical Mr-linac -Quasi Mr-linac Clinicalmentioning

confidence: 99%

Evaluation of plan quality in radiotherapy planning with an MR-linac

Schoot

Wollenberg

Carbaat

et al. 2019

Physics and Imaging in Radiation Oncology

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“…Existem diversos sistemas comercias para planejamento para teleterapia, tais como: iPlan RT (BrainLAB A.G., Heimstetten, Germany) 23 , XiO (Elekta AB, Stockholm, Sweden) 24,25 , Monaco (Elekta AB, Stockholm, Sweden) [26][27][28] , Pinnacle (Philips Radiation Oncology Systems, Fitchburg, WI) 29,30 , Eclipse (Varian Medical Systems, Palo Alto, CA, USA) 31,32 , RayStation 33,34 e Panther 3D 35,36 .…”

Section: Sistemas De Planejamento Em Teleterapia Com Fótonsmentioning

confidence: 99%

Sistemas de Planejamento em Radioterapia

Yoriyaz

Fonseca²,

Bellezzo³

2019

Rev Bras Fis Med

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ResumoEste artigo apresenta uma breve descrição do histórico do desenvolvimento de sistemas de planejamento, seguida da descrição dos atuais sistemas comerciais utilizados nos centros de radioterapia no país e no mundo. É apresentado também um novo sistema de planejamento denominado A Medical Image-based Graphical platfOrm (AMIGO). Esse software foi desenvolvido em parceria com o Instituto de Pesquisas Energéticas e Nucleares, a Universidade de São Paulo e a Universidade de Maastricht. A primeira versão do software foi desenvolvida para simular tratamentos braquiterápicos por meio de uma interface gráfica com recursos similares aos sistemas de planejamento comerciais. Uma nova versão está sendo desenvolvida para uso em teleterapia, como uma alternativa aos softwares comercias, e permitirá a análise de diversos detalhes do tratamento, além da validação dos cálculos realizados pelos sistemas comerciais. Palavras-chave: sistema de planejamento; radioterapia; radiologia; Monte Carlo. AbstractThis article presents a brief description of the history and development of treatment planning systems followed by a description of the current commercial systems used in radiotherapy centers in the country and in the world. Also, a new planning system called AMIGO is presented in this work. This software was developed in partnership with Nuclear and Energy Research Institute (Instituto de Pesquisas Energéticas e Nucleares -IPEN), the Universidade de São Paulo (USP) and the University of Maastricht (UM). The first version of the software was developed to simulate brachytherapy treatments through a graphical interface with features similar to commercial planning systems. A new version is being developed for use in external beam radiotherapy as an alternative to commercial software and will allow the analysis of various treatment details, as well as the validation of the calculations performed by commercial systems.

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“…Within the TPS, the minimum segment width (MSW) parameter plays a critical role in the shaping of optimized apertures as well as the creation of segments of varying sizes and shapes.By and large,in treatment planning,intensity distributions formed by optimization methods are altered into multileaf collimator (MLC) leaf trajectories in order to provide preferred dose distributions of any shape. 8,9 A comprehensive quality assurance (QA) program ensures the effectiveness and safety of radiation therapy. 10 From a clinical perspective, the QA results used for dose verification should focus on detrimental dose differences, as these will ultimately influence whether or not a treatment plan is justified for treatment.…”

Section: Introductionmentioning

confidence: 99%

Investigation of optimum minimum segment width on VMAT plan quality and deliverability: A comprehensive dosimetric and clinical evaluation using DVH analysis

Yoosuf

Ahmad

Al-Shehri

et al. 2021

J Applied Clin Med Phys

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Minimum segment width (MSW) plays a fundamental role in the shaping of optimized apertures and creation of segments of varying sizes and shapes in complex radiotherapy treatment plans. The purpose of this work was to study the effect of MSW on dose distribution in patients planned with VMAT for various treatment sites using dose volume histogram (DVH) analysis. Materials and methods: For the validation of optimum MSW, 125 clinical treatment plans were evaluated. Five groups were identified (brain, head and neck, thorax, pelvis, and extremity), and five cases were chosen from each group. For each case, five plans were created with different MSW (0.5, 0.8, 1.0, 1.25, and 1.5 cm). The quality of treatment plans created using different MSW were compared using dosimetric indicators such as target coverage (D 98 -dose to 98% of the planning target volume (PTV), maximum dose (D 2 -maximum dose to 2% of the PTV), monitor units (MU), and DVH parameters related to organs at risk (OAR). The effect of the MSW on delivery accuracy was quantitatively analyzed using the measured fluence utilizing ionization chamber-based transmission detector and model-based dose verification system. Traditional global gamma analysis (2%, 2 mm) and dose volume information was gathered for the PTV and organs at risk and compared for different MSWs. Results: A total of 125 plans were created and compared across five groups. In terms of treatment plan quality, the plans using MSW of 0.5 cm was found to be superior in all groups. PTV coverage (D 98 ) decreased significantly (p < 0.05) as the MSW increased. Similarly, the maximum dose (D 2 ) was found to be increased significantly (p < 0.05) as the MSW increased from 0.5 cm, with MSW of 1.5 cm being the least in terms of plan quality for both PTVs and OARs.In terms of plan deliverability using DVH analysis,treatment planning system (TPS) compared to measured fluence, VMAT plans produced with MSW of 0.5 cm showed a better dosimetric index and a smaller deviation for both PTVs and OARs. The deliverability of the plans deteriorated as the MSW increased. Conclusion: Dose volume histogram (DVH) analysis demonstrated that treatment plans with minimal MSW showed better plan quality and deliverability and provided clinical relevance as compared to gamma index analysis.

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Monaco treatment planning system tools and optimization processes

Cited by 40 publications

References 21 publications

Evaluation of plan quality in radiotherapy planning with an MR-linac

Evaluation of plan quality in radiotherapy planning with an MR-linac

Sistemas de Planejamento em Radioterapia

Investigation of optimum minimum segment width on VMAT plan quality and deliverability: A comprehensive dosimetric and clinical evaluation using DVH analysis

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