Progressive resolution optimizer (PRO) predominates over photon optimizer (PO) in sparing of spinal cord for spine SABR VMAT plans

we assessed the performance of the optimization algorithms by comparing volumetric modulated arc therapy generated by a progressive resolution optimized (VMAT ) and photon optimizer (VMAT ) in terms of plan quality, MU reduction, sparing of the spinal cord (or cauda equina), and plan complexity. Fif...

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Bibliographic Details
Published in:BMC cancer 2023-05, Vol.23 (1), p.445-12, Article 445
Main Authors: Son, Sangjun, Park, So-Yeon
Format: Article
Language:English
Subjects:
Algorithms
Conformity
Humans
Lumbar Vertebrae
Metastasis
Optimization algorithms
Organs at Risk
Photon optimizer
Planning
Progressive resolution optimizer
Prostate
Radiation therapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Radiotherapy, Intensity-Modulated - methods
Retrospective Studies
Spinal Cord
Spine
Spine (lumbar)
Statistics
Stereotactic ablative radiation therapy
Volumetric modulated arc therapy
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Summary:we assessed the performance of the optimization algorithms by comparing volumetric modulated arc therapy generated by a progressive resolution optimized (VMAT ) and photon optimizer (VMAT ) in terms of plan quality, MU reduction, sparing of the spinal cord (or cauda equina), and plan complexity. Fifty-seven patients who received spine stereotactic ablative radiotherapy (SABR) with tumors located in the cervical, thoracic, and lumbar spine were retrospectively selected. For each patient, VMAT and VMAT with two full arcs were generated with using the PRO and PO algorithms. For dosimetric evaluation, the dose-volumetric (DV) parameters of the planning target volume (PTV), organs at risk (OARs), the corresponding planning organs at risk (PRV), and 1.5-cm ring structure surrounding the PTV (Ring ) were calculated for all VMAT plans. The total number of monitor units (MUs) and the modulation complexity score for the VMAT (MCS ) were compared. To investigate the correlations of OAR sparing to plan complexity, Pearson's and Spearman's correlation tests were conducted between the two algorithms (PO - PRO, denoted as Δ) in the DV parameters for normal tissues, total MUs, and MCS . For the PTVs, Target conformity and dose homogeneity in the PTVs of VMAT were better than those of VMAT with statistical significance. For the spinal cords (or cauda equine) and the corresponding PRVs, all of the DV parameters for VMAT were markedly lower than those for VMAT , with statistical significance (all p 
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-023-10925-z