The overall long-term objective of this project is to incorporate clinical decisions through interactive feedback into the inverse treatment planning process for intensity-modulated radiotherapy. The hypotheses are that this will (i) make the inverse planning process more effective and (ii) increase the clinical relevancy of optimized plans, introducing better tradeoffs between target coverage and sparing of healthy tissues. The new approaches to tackle this problem include multi-criteria optimization techniques and an interactive plan navigation tool for searching a pre-calculated treatment plan database. The idea of multi-criteria optimization in treatment planning is that multiple planning criteria in different critical structures and in the target volume can be controlled simultaneously. In contrast, in current inverse planning algorithms a single objective (score function) is maximized or minimized. This conventional optimization gives only limited control of the planning result, and major manual plan tweaking using trial and error is often necessary. In the previous funding period the feasibility of the approach has been demonstrated in theoretical example cases and retrospective treatment planning studies. This showed the potential of the multi-criteria planning approach and a potential for improvement in some areas.
The first aim of the current project is to improve the usability of the method. This will include a reduction of the dimensionality of the problem, to make the tradeoff decision easier and faster for the clinician. It will also include the generation of plan databases with minimal user intervention, and developments of the plan navigation approach.
The second aim i s to extend functionality. Hardware and delivery aspects will be incorporated. A means to interactively optimize beam orientations will be provided. Dose conformality will be included in the tradeoff discussion, and the user will be able to make tradeoff decisions based on alternative biologically motivated criteria. Finally, in aim 3, the hypothesis that the multi-criteria planning paradigm will lead to better treatment plans in less time will be tested in the clinic. This work has the potential to lead to clinically more suitable and more individualized radiation treatment plans, with better dose coverage of the tumor target volume and/or reduced radiation dose to surrounding healthy tissues. Furthermore, shorter treatment planning times will reduce the overall cost.

Public Health Relevance

This work has the potential to lead to clinically more suitable and more individualized radiation treatment plans, with better dose coverage of the tumor target volume and/or reduced radiation dose to surrounding healthy tissues. Furthermore, shorter treatment planning times will reduce the overall cost.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA103904-08
Application #
8129771
Study Section
Radiation Therapeutics and Biology Study Section (RTB)
Program Officer
Deye, James
Project Start
2003-12-01
Project End
2012-07-31
Budget Start
2011-08-01
Budget End
2012-07-31
Support Year
8
Fiscal Year
2011
Total Cost
$269,163
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Khan, Fazal; Craft, David (2015) Three-dimensional conformal planning with low-segment multicriteria intensity modulated radiation therapy optimization. Pract Radiat Oncol 5:e103-11
Craft, David; Richter, Christian (2013) Deliverable navigation for multicriteria step and shoot IMRT treatment planning. Phys Med Biol 58:87-103
Craft, David L; Hong, Theodore S; Shih, Helen A et al. (2012) Improved planning time and plan quality through multicriteria optimization for intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 82:e83-90
Chen, Wei; Unkelbach, Jan; Trofimov, Alexei et al. (2012) Including robustness in multi-criteria optimization for intensity-modulated proton therapy. Phys Med Biol 57:591-608
Wala, Jeremiah; Salari, Ehsan; Chen, Wei et al. (2012) Optimal partial-arcs in VMAT treatment planning. Phys Med Biol 57:5861-74
Salari, Ehsan; Wala, Jeremiah; Craft, David (2012) Exploring trade-offs between VMAT dose quality and delivery efficiency using a network optimization approach. Phys Med Biol 57:5587-600
Craft, David; McQuaid, Dualta; Wala, Jeremiah et al. (2012) Multicriteria VMAT optimization. Med Phys 39:686-96
Teichert, K; Suss, P; Serna, J I et al. (2011) Comparative analysis of Pareto surfaces in multi-criteria IMRT planning. Phys Med Biol 56:3669-84
Chan, Timothy C Y; Tsitsiklis, John N; Bortfeld, Thomas (2010) Optimal margin and edge-enhanced intensity maps in the presence of motion and uncertainty. Phys Med Biol 55:515-33
Craft, David; Monz, Michael (2010) Simultaneous navigation of multiple Pareto surfaces, with an application to multicriteria IMRT planning with multiple beam angle configurations. Med Phys 37:736-41

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