Jeffrey E Snyder, Martin F Fast, Prescilla Uijtewaal, Pim T S Borman, Peter Woodhead, Joël St-Aubin, Blake Smith, Andrew Shepard, Bas W Raaymakers, Daniel E Hyer
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VMAT plan and delivery quality during MRIgART is compared to step-and-shoot IMRT for prostate SBRT.</p><p><strong>Methods and materials: </strong>Ten prostate patients previously treated on a 1.5T MR-linac were retrospectively replanned to 36.25 Gy in five fractions using step-and-shoot IMRT and the clinical Hyperion optimizer within Monaco (Hyp-IMRT), the same optimizer with a VMAT technique (Hyp-VMAT), and a research-based optimizer with VMAT (OFL+PGD-VMAT). The plans were then adapted onto each daily MRI dataset using two different optimization strategies to evaluate the ATP workflow: \"optimize weights\" (IMRT-Weights and VMAT-Weights) and \"optimize shapes\" (IMRT-Shapes and VMAT-Shapes). Treatment efficiency was evaluated by measuring optimization time, delivery time, and total time (optimization + delivery). Plan quality was assessed by evaluating OAR sparing. Ten patient plans were measured using a modified linac control system to assess delivery accuracy via a gamma analysis (2%/2mm). Delivery efficiency was calculated as average dose rate divided by maximum dose rate.</p><p><strong>Results: </strong>For Hyp-VMAT and OFL+PGD-VMAT the total time was reduced by 124 ± 140 seconds (p = .020) and 459 ± 110 seconds (p < 0.001), respectively as compared to the clinical Hyp-IMRT group. Speed enhancements were also measured for ATP with reductions in total time of 404 ± 55 (p<0.001) for VMAT-Weights as compared to the clinical IMRT-Shapes group. Bladder and rectum DVH points were within 1.3 % or 0.8 cc for each group. All VMAT plans had gamma passing rates greater than 96 %. The delivery efficiency of VMAT plans was 89.7 ± 2.7 % compared to 50.0 ± 2.2 % for clinical IMRT.</p><p><strong>Conclusions: </strong>Incorporating VMAT into MRIgART will significantly reduce treatment session times while maintaining equivalent plan quality.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhancing Delivery Efficiency on the MR-Linac: A Comprehensive Evaluation of Prostate SBRT using VMAT.\",\"authors\":\"Jeffrey E Snyder, Martin F Fast, Prescilla Uijtewaal, Pim T S Borman, Peter Woodhead, Joël St-Aubin, Blake Smith, Andrew Shepard, Bas W Raaymakers, Daniel E Hyer\",\"doi\":\"10.1016/j.ijrobp.2024.10.028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Long treatment sessions are a limitation within MRIgART. This work aims for significantly enhancing the delivery efficiency on the MR-linac by introducing dedicated optimization and delivery techniques for VMAT. VMAT plan and delivery quality during MRIgART is compared to step-and-shoot IMRT for prostate SBRT.</p><p><strong>Methods and materials: </strong>Ten prostate patients previously treated on a 1.5T MR-linac were retrospectively replanned to 36.25 Gy in five fractions using step-and-shoot IMRT and the clinical Hyperion optimizer within Monaco (Hyp-IMRT), the same optimizer with a VMAT technique (Hyp-VMAT), and a research-based optimizer with VMAT (OFL+PGD-VMAT). The plans were then adapted onto each daily MRI dataset using two different optimization strategies to evaluate the ATP workflow: \\\"optimize weights\\\" (IMRT-Weights and VMAT-Weights) and \\\"optimize shapes\\\" (IMRT-Shapes and VMAT-Shapes). Treatment efficiency was evaluated by measuring optimization time, delivery time, and total time (optimization + delivery). Plan quality was assessed by evaluating OAR sparing. Ten patient plans were measured using a modified linac control system to assess delivery accuracy via a gamma analysis (2%/2mm). Delivery efficiency was calculated as average dose rate divided by maximum dose rate.</p><p><strong>Results: </strong>For Hyp-VMAT and OFL+PGD-VMAT the total time was reduced by 124 ± 140 seconds (p = .020) and 459 ± 110 seconds (p < 0.001), respectively as compared to the clinical Hyp-IMRT group. Speed enhancements were also measured for ATP with reductions in total time of 404 ± 55 (p<0.001) for VMAT-Weights as compared to the clinical IMRT-Shapes group. Bladder and rectum DVH points were within 1.3 % or 0.8 cc for each group. All VMAT plans had gamma passing rates greater than 96 %. 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Enhancing Delivery Efficiency on the MR-Linac: A Comprehensive Evaluation of Prostate SBRT using VMAT.
Purpose: Long treatment sessions are a limitation within MRIgART. This work aims for significantly enhancing the delivery efficiency on the MR-linac by introducing dedicated optimization and delivery techniques for VMAT. VMAT plan and delivery quality during MRIgART is compared to step-and-shoot IMRT for prostate SBRT.
Methods and materials: Ten prostate patients previously treated on a 1.5T MR-linac were retrospectively replanned to 36.25 Gy in five fractions using step-and-shoot IMRT and the clinical Hyperion optimizer within Monaco (Hyp-IMRT), the same optimizer with a VMAT technique (Hyp-VMAT), and a research-based optimizer with VMAT (OFL+PGD-VMAT). The plans were then adapted onto each daily MRI dataset using two different optimization strategies to evaluate the ATP workflow: "optimize weights" (IMRT-Weights and VMAT-Weights) and "optimize shapes" (IMRT-Shapes and VMAT-Shapes). Treatment efficiency was evaluated by measuring optimization time, delivery time, and total time (optimization + delivery). Plan quality was assessed by evaluating OAR sparing. Ten patient plans were measured using a modified linac control system to assess delivery accuracy via a gamma analysis (2%/2mm). Delivery efficiency was calculated as average dose rate divided by maximum dose rate.
Results: For Hyp-VMAT and OFL+PGD-VMAT the total time was reduced by 124 ± 140 seconds (p = .020) and 459 ± 110 seconds (p < 0.001), respectively as compared to the clinical Hyp-IMRT group. Speed enhancements were also measured for ATP with reductions in total time of 404 ± 55 (p<0.001) for VMAT-Weights as compared to the clinical IMRT-Shapes group. Bladder and rectum DVH points were within 1.3 % or 0.8 cc for each group. All VMAT plans had gamma passing rates greater than 96 %. The delivery efficiency of VMAT plans was 89.7 ± 2.7 % compared to 50.0 ± 2.2 % for clinical IMRT.
Conclusions: Incorporating VMAT into MRIgART will significantly reduce treatment session times while maintaining equivalent plan quality.
期刊介绍：
International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field.
This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.
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