Prism: A new approach to radiotherapy planning software

Kalet, Ira J.; Jacky, Jonathan; Austin-Seymour, Mary; Hummel, Sharon; Sullivan, Kevin; Unger, Jonathan

doi:10.1016/s0360-3016(96)00322-7

Cited by 40 publications

(19 citation statements)

References 24 publications

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“…2-step IMAT was implemented into the current version (Version 1.51) of the University of Washington treatment planning system Prism [29-32]. Prism is written in Common Lisp; the source code is freely available for non-commercial use.…”

Section: Methodsmentioning

confidence: 99%

Two-step intensity modulated arc therapy (2-step IMAT) with segment weight and width optimization

2011

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Background2-step intensity modulated arc therapy (IMAT) is a simplified IMAT technique which delivers the treatment over typically two continuous gantry rotations. The aim of this work was to implement the technique into a computerized treatment planning system and to develop an approach to optimize the segment weights and widths.Methods2-step IMAT was implemented into the Prism treatment planning system. A graphical user interface was developed to generate the plan segments automatically based on the anatomy in the beam's-eye-view. The segment weights and widths of 2-step IMAT plans were subsequently determined in Matlab using a dose-volume based optimization process. The implementation was tested on a geometric phantom with a horseshoe shaped target volume and then applied to a clinical paraspinal tumour case.ResultsThe phantom study verified the correctness of the implementation and showed a considerable improvement over a non-modulated arc. Further improvements in the target dose uniformity after the optimization of 2-step IMAT plans were observed for both the phantom and clinical cases. For the clinical case, optimizing the segment weights and widths reduced the maximum dose from 114% of the prescribed dose to 107% and increased the minimum dose from 87% to 97%. This resulted in an improvement in the homogeneity index of the target dose for the clinical case from 1.31 to 1.11. Additionally, the high dose volume V105 was reduced from 57% to 7% while the maximum dose in the organ-at-risk was decreased by 2%.ConclusionsThe intuitive and automatic planning process implemented in this study increases the prospect of the practical use of 2-step IMAT. This work has shown that 2-step IMAT is a viable technique able to achieve highly conformal plans for concave target volumes with the optimization of the segment weights and widths. Future work will include planning comparisons of the 2-step IMAT implementation with fixed gantry intensity modulated radiotherapy (IMRT) and commercial IMAT implementations.

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Section: Methodsmentioning

confidence: 99%

Two-step intensity modulated arc therapy (2-step IMAT) with segment weight and width optimization

2011

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“…The intensity modulated compensator (IM‐compensator) was implemented using an in‐house treatment planning system, Prism 10 . Results are presented for seven patients.…”

Section: Methodsmentioning

confidence: 99%

Use of intensity modulation for missing tissue compensation of pediatric spinal fields

Phillips

Cho

Parsai

et al. 2003

J Applied Clin Med Phys

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Irradiation of the cranio‐spinal axis is often one of the treatment modalities of certain childhood cancers, e.g., medulloblastoma. In order to achieve a uniform dose to the spinal cord, missing tissue compensators are required. In the past, our practice was to fabricate compensators out of strips of lead. We report on the use of intensity modulated fields to achieve the desired compensation. Seven cases of pediatric cancer whose treatment involved irradiation of the cranio‐spinal axis had compensators designed using a beam intensity modulation method rather than making mechanical compensators. The compensators only adjusted for missing tissue along the spinal axis. Comparisons between calculated and measured doses were made at depth in phantoms and on the surface of the patient. The intensity modulated fields were delivered using a step‐and‐shoot delivery on an Elekta SL20 accelerator equipped with multileaf collimator. The intensity‐modulated compensators provided more flexibility in design than the physical compensator method. Finer intensity steps were achievable, more accurate dose distributions were able to be calculated, and adjustments during treatment, e.g., junction changes, were more easily implemented. Convolution/superposition dose calculations were within ±3% of measurements. Intensity modulated fields are a practical and more efficient method of delivering uniform doses to the spine in pediatric cancer treatments. They provide many advantages over mechanical compensators with regard to time and flexibility.PACS number(s): 87.53.–j, 87.90.+y

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“…These may then be displayed along with the patient's anatomy. A clinician may select volumes to be irradiated and those to be spared, and both interactive human and computer optimisation may be carried out (Schmidt et al, 1994;Kalet et al, 1996). It has been reported that the doses can be calculated and displayed along with the anatomy in real time making it easy to explore a variety of treatment strategies (Matthews et al, 1996).…”

Section: Radiotherapy Planningmentioning

confidence: 99%

Clinical applications of computer aided visualization

Linney

Alusi

1998

J Vis

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The clinical applications of computer aided three-dimensional (3D) data visualization are now numerous. In this paper, we describe the importance of visualization in clinical applications and the methods that are appropriate to particular specialisations. We discuss the requirements of some of these clinical specialisations and describe how developmentshave taken place over the years to meet these both in terms of new computer algorithms and hardware. We present some selected examples of major clinical applications of data visualization, and end with a note on social, legal and ethical implications.

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Prism: A new approach to radiotherapy planning software

Cited by 40 publications

References 24 publications

Two-step intensity modulated arc therapy (2-step IMAT) with segment weight and width optimization

Two-step intensity modulated arc therapy (2-step IMAT) with segment weight and width optimization

Use of intensity modulation for missing tissue compensation of pediatric spinal fields

Clinical applications of computer aided visualization

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