Accounting for the tongue-and-groove effect using a robust direct aperture optimization approach推荐.pdfVIP

Accounting for the tongue-and-groove effect using a robust direct aperture optimization approach Ehsan Salaria Department of Industrial and Systems Engineering, University of Florida, Gainesville, Florida 32611-6595 Chunhua Men Department of Radiation Oncology, University of California San Diego, La Jolla, California 92037-0843 H. Edwin Romeijn Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan 48109-2117 Received 2 August 2010; revised 4 January 2011; accepted for publication 6 January 2011; published 14 February 2011 Purpose: Traditionally, the tongue-and-groove effect due to the multileaf collimator architecture in intensity-modulated radiation therapy IMRT has typically been deferred to the leaf sequencing stage. The authors propose a new direct aperture optimization method for IMRT treatment planning that explicitly incorporates dose calculation inaccuracies due to the tongue-and-groove effect into the treatment plan optimization stage. Methods: The authors avoid having to accurately estimate the dosimetric effects of the tongue- and-groove architecture by using lower and upper bounds on the dose distribution delivered to the patient. They then develop a model that yields a treatment plan that is robust with respect to the corresponding dose calculation inaccuracies. Results: Tests on a set of ten clinical head-and-neck cancer cases demonstrate the effectiveness of the new method in developing robust treatment plans with tight dose distributions in targets and critical structures. This is contrasted with the very loose bounds on the dose distribution that are obtained by solving a traditional treatment plan optimization model that ignores