采用低段多准则IMRT优化的三维适形规划
3D conformal planning using low segment multi-criteria IMRT optimization
摘要：
目的：评价自动多标准优化（MCO）-设计用于调强放射治疗（IMRT），但调用有限的分割-有效地产生高质量的3D适形治疗（3D-CRT）计划。方法：10例患者先前计划接受3D-CRT，采用低段逆多标准优化技术重新计划。MCO-3D计划使用与相应3D计划相同的射束数量、射束几何形状和机器参数，但限于6 MV的能量。使用基于通量的MCO IMRT算法优化MCO-3D计划，然后在MCO导航后，使用少量节段进行分段。通过评价单个危及器官（OAR）的平均剂量、合并OAR的平均剂量、均匀性指数（HI）、监测单位（MU）、医生偏好以及计划时间和计划可定制性的定性评估，对3D和MCO-3D计划进行比较。结果如下：MCO-3D计划显著降低了OAR平均剂量和监测单位，同时保持了良好的靶体积覆盖率和均匀性。MCO允许更精简的计划定制。所有MCO-3D计划都是医生首选的，而不是其相应的3D计划。结论：高质量的3D计划可以使用调强放射治疗优化技术产生，从而产生具有良好监视器单元效率的自动化场中场类型计划。在诊所中采用这项技术可以简化治疗计划的制定。
英文摘要：
Purpose: To evaluate automated multicriteria optimization (MCO)-- designed for intensity modulated radiation therapy (IMRT), but invoked with limited segmentation -- to efficiently produce high quality 3D conformal treatment (3D-CRT) plans. Methods: Ten patients previously planned with 3D-CRT were replanned with a low-segment inverse multicriteria optimized technique. The MCO-3D plans used the same number of beams, beam geometry and machine parameters of the corresponding 3D plans, but were limited to an energy of 6 MV. The MCO-3D plans were optimized using a fluence-based MCO IMRT algorithm and then, after MCO navigation, segmented with a low number of segments. The 3D and MCO-3D plans were compared by evaluating mean doses to individual organs at risk (OARs), mean doses to combined OARs, homogeneity indexes (HI), monitor units (MUs), physician preference, and qualitative assessments of planning time and plan customizability. Results: The MCO-3D plans significantly reduced the OAR mean doses and monitor units while maintaining good coverage and homogeneity of target volumes. MCO allows for more streamlined plan customization. All MCO-3D plans were preferred by physicians over their corresponding 3D plans. Conclusion: High quality 3D plans can be produced using IMRT optimization technology, resulting in automated field-in-field type plans with good monitor unit efficiency. Adopting this technology in a clinic could streamline treatment plan production.
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