A multiplan treatment-planning framework: a paradigm shift for intensity-modulated radiotherapy.

Purpose: To describe a multiplan intensity-modulated radiotherapy (IMRT) planning framework, and to describe a decision support system (DSS) for ranking multiple plans and modeling the planning surface.

Methods And Materials: One hundred twenty-five plans were generated sequentially for a head-and-neck case and a pelvic case by varying the dose-volume constraints on each of the organs at risk (OARs). A DSS was used to rank plans according to dose-volume histogram (DVH) values, as well as equivalent uniform dose (EUD) values.

A difference-matrix metaheuristic for intensity map segmentation in step-and-shoot IMRT delivery.

At an intermediate stage of radiation treatment planning for IMRT, most commercial treatment planning systems for IMRT generate intensity maps that describe the grid of beamlet intensities for each beam angle. Intensity map segmentation of the matrix of individual beamlet intensities into a set of MLC apertures and corresponding intensities is then required in order to produce an actual radiation delivery plan for clinical use. Mathematically, this is a very difficult combinatorial optimization problem, especially when mechanical limitations of the MLC lead to many constraints on aperture shape, and setup times for apertures make the number of apertures an important factor in overall treatment time.