SU-E-T-478: IMRT Delivery Parameter Dependence of Dose-Mass Optimization




To compare DMH and DVH optimization sensitivity to changes in IMRT delivery parameters.


Two lung and two head and neck (HN) cases were retrospectively optimized using DVH and DMH optimization. For both optimization approaches, changes to two parameters were studied: number of IMRT segments (5 and 10 per beam) and the minimum segment area (2 and 6 cm2). The number of beams, beam angles, and minimum MUs per segment were the same for both optimizations approaches for each patient. During optimization, doses to the organs at risk (OARs) were iteratively lowered until the standard deviation across the PTV was above ∼3.0%. For each patient DVH and DMH plans were normalized such that 95% of the PTV received the same dose. Plan quality was evaluated by dose indices (DIs), which represent the dose delivered to a certain anatomical structure volume. For the lung cases, DIs assessed included: 1% cord, 33% heart, both lungs 20% and 30%, and 50% esophagus. In the HN cases: 1% cord, 1% brainstem, left/right parotids 50%, 50% larynx, and 50% esophagus.


When increasing the number of segments, while keeping a small segment area (2cm2), the average percent change of all DIs for DVH/DMH optimizations for each patient were: −4.66/4.71, 3.21/3.46, −9.62/21.69 and −3.28/−7.62. For a large segment area (6cm2): −0.26/−1.46, −5.04/−1.92, −5.23/−2.19 and 4.12/19.63. Results from increasing segment area while keeping a small number of segments (5segments/beam) were: 1.41/7.90, 8.17/11.66, 0.09/33.58 and −4.83/−11.60 for each case. For large number of segments (10 segments/beam): 8.35/1.30, −0.91/5.77, 6.29/7.08 and 2.62/5.16.


This preliminary study showed case dependent results. Changes in IMRT parameters did not show consistent DI changes for either optimization approach. A larger population of patients is warranted for such comparison.