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Evaluation of the Minimum Segment Width and Fluence Smoothing Tools for Intensity-modulated Techniques in Monaco Treatment Planning System.
- Source :
- Journal of Medical Physics; Apr-Jun2024, Vol. 49 Issue 2, p250-260, 13p
- Publication Year :
- 2024
-
Abstract
- Purpose: This study aims to minimize monitor units (MUs) of intensity-modulated treatments in the Monaco treatment planning system while preserving plan quality by optimizing the "Minimum Segment Width" (MSW) and "Fluence Smoothing" parameters. Materials and Methods: We retrospectively analyzed 30 prostate, 30 gynecological, 15 breast cancer, 10 head and neck tumor, 11 radiosurgery, and 10 hypo-fractionated plans. Original prostate plans employed "Fluence Smoothing" = Off and were reoptimized with Low, Medium, and High settings. The remaining pathologies initially used MSW = 0.5 cm and were reoptimized with MSW = 1.0 cm. Plan quality, including total MU, delivery time, and dosimetric constraints, was statistically analyzed with a paired t-test. Results: Prostate plans exhibited the highest MU variation when changing "Fluence Smoothing" from Off to High (average ΔMU = -5.1%; P < 0.001). However, a High setting may increase overall MU when MSW = 0.5 cm. Gynecological plans changed substantially when MSW increased from 0.5 cm to 1.0 cm (average ΔMU = -29%; P < 0.001). Organs at risk sparing and planning target volumes remained within 1.2% differences. Replanning other pathologies with MSW = 1.0 cm affected breast and head and neck tumor plans (average ΔMU = -168.38, average Δt = -11.74 s, and average ΔMU = -256.56, average Δt = -15.05 s, respectively; all with P < 0.004). Radiosurgery and hypofractioned highly modulated plans did not yield statistically significant results. Conclusions: In breast, pelvis, head and neck, and prostate plans, starting with MSW = 1.0 cm optimally reduces MU and treatment time without compromising plan quality. MSW has a greater impact on MU than the "Fluence Smoothing" parameter. Plans with high modulation might present divergent behavior, requiring a case-specific analysis with MSW values higher than 0.5 cm. [ABSTRACT FROM AUTHOR]
- Subjects :
- PROSTATE
BREAST
NECK tumors
HEAD tumors
VOLUMETRIC-modulated arc therapy
RADIOSURGERY
Subjects
Details
- Language :
- English
- ISSN :
- 09716203
- Volume :
- 49
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of Medical Physics
- Publication Type :
- Academic Journal
- Accession number :
- 178454658
- Full Text :
- https://doi.org/10.4103/jmp.jmp_156_23