The aim of this project is to study computer optimization techniques for planning computer-controlled conformational therapy treatments. Primary emphasis will be given to linear programming techniques. They are the most general and the most amenable to solving the problem of developing plans for computer-controlled therapy treatments using multileaf collimators, beam tracking, and segmented delivery. Variables such as beam angle, beam energy, and wedge filtering are readily cast into the linear programming formalism. Other variables, such as beam shape and isocenter location, will require that gradient search and gradient projection methods be included in the optimization process as adjuncts to linear programming. A number of basic issues need to be studied before linear programming can be efficiently used for the planning of conformational therapy treatments. These include locations for dose constraint points, values for dose limits for dose constraint points, effects of objective functions, beam angle quantization, beam shape, use of multiple isocenters, and production of concave shaped high dose regions. In addition, the interactions between variables are significant and will be examined. The suitability of using gradient search and gradient projection methods to improve plans produced by linear programming will be studied. Furthermore, each form of conformational therapy has its own special problems which need to be examined. Based on the results of these studies, software tools will be developed and tested for planning the different forms of computer-controlled radiation therapy. These software tools will enable physicists and physicians to generate sophisticated plans which meet their specifications and clinical treatment objectives and maximally utilize the advantages of computer-controlled conformal therapy techniques.
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