Reformulated McNamara RBE-weighted beam orientation optimization for intensity modulated proton therapy.
Reformulated McNamara RBE-weighted beam orientation optimization for intensity modulated proton therapy.
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DOI：
10.1002/mp.15552
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发表时间：
2022-04
期刊：
影响因子：
3.8
通讯作者：
Sheng, Ke
中科院分区：
文献类型：
--
作者：
Ramesh, Pavitra;Lyu, Qihui;Gu, Wenbo;Ruan, Dan;Sheng, Ke
经验相对生物有效性（RBE）模型已用于估计质子治疗中的生物剂量，但不能充分捕捉影响治疗计划RBE值的因素。我们重新制定了麦克纳马拉RBE模型，以便它可以作为线性生物剂量保真度项添加到我们之前开发的灵敏度正则化和异质性加权光束定向优化（SHBOO）框架中。基于我们的SHBOO框架，我们制定了最小麦克纳马拉RBE总剂量的生物优化问题。我们使用两种优化算法：FISTA （McNam-FISTA）和Chambolle-Pock （McNam-CP）来解决这个问题。我们将它们的性能与假设RBE=1.1的物理剂量优化器（物理- fista）和let加权剂量模型（LET-FISTA）进行比较。选取3例头颈部患者，采用4种方法进行剂量学和稳健性比较。与physical - ista相比，McNam-CP能够与CTV [HI， Dmax, D95%， D98%]相匹配[0.00,0.05%,1.4%,0.8%]。McNam-FISTA和McNam-CP能够显著提高总体OAR [Dmean， Dmax]，平均分别为[36.1%，26.4%]和[29.6%,20.3%]。关于CTV稳健性，在范围和设置不确定性的组合下，McNam-FISTA和McNam-CP的最差[Dmax， V95%, D95%， D98%]改善[- 6.6%,6.2%,6.0%，4.8%]和[2.7%,2.7%,5.3%,- 4.3%]。对于OARs， McNam-FISTA和McNam-CP分别平均改善[25.0%，19.2%]和[29.5%，36.5%]最差[Dmax， Dmean]。与LET-FISTA相比，McNam-FISTA显著改善了剂量学和CTV稳健性，获得了更好的最坏情况OAR剂量。这四种优化技术为头颈部病例提供可比较的生物剂量。除了适度的CTV覆盖率和稳健性改善外，mcnama - fista和mcnama - cp的OAR生物剂量和稳健性也得到了显着改善，显示了直接将McNamara RBE纳入质子治疗计划的潜在益处。
Empirical relative biological effectiveness (RBE) models have been used to estimate the biological dose in proton therapy but do not adequately capture the factors influencing RBE values for treatment planning. We reformulate the McNamara RBE model such that it can be added as a linear biological dose fidelity term within our previously developed sensitivity-regularized and heterogeneity-weighted beam orientation optimization (SHBOO) framework. Based on our SHBOO framework, we formulated the biological optimization problem to minimize total McNamara RBE dose to OARs. We solve this problem using two optimization algorithms: FISTA (McNam-FISTA) and Chambolle-Pock (McNam-CP). We compare their performances with a physical dose optimizer assuming RBE=1.1 in all structures (PHYS-FISTA) and an LET-weighted dose model (LET-FISTA). Three head and neck patients were planned with the four techniques and compared on dosimetry and robustness. Compared to Phys-FISTA, McNam-CP was able to match CTV [HI, Dmax, D95%, D98%] by [0.00, 0.05%, 1.4%, 0.8%]. McNam-FISTA and McNam-CP were able to significantly improve overall OAR [Dmean, Dmax] by an average of [36.1%,26.4%] and [29.6%, 20.3%], respectively. Regarding CTV robustness, worst [Dmax, V95%, D95%, D98%] improvement of [−6.6%, 6.2%, 6.0%, 4.8%] was reported for McNam-FISTA and [2.7%, 2.7%, 5.3%, −4.3%] for McNam-CP under combinations of range and setup uncertainties. For OARs, worst [Dmax, Dmean] were improved by McNam-FISTA and McNam-CP by an average of [25.0%, 19.2%] and [29.5%, 36.5%], respectively. McNam-FISTA considerably improved dosimetry and CTV robustness compared to LET-FISTA, which achieved a better worst-case OAR doses. The four optimization techniques deliver comparable biological doses for the head and neck cases. Beside modest CTV coverage and robustness improvement, OAR biological dose and robustness were substantially improved with both McNam-FISTA and McNam-CP, showing potential benefit for directly incorporating McNamara RBE in proton treatment planning.
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