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The influence of the dwell time deviation constraint (DTDC) parameter on dosimetry with IPSA optimisation for HDR prostate brachytherapy

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Abstract

To investigate how the dwell time deviation constraint (DTDC) parameter, applied to inverse planning by simulated annealing (IPSA) optimisation limits large dwell times from occurring in each catheter and to characterise the effect on the resulting dosimetry for prostate high dose rate (HDR) brachytherapy treatment plans. An unconstrained IPSA optimised treatment plan, using the Oncentra Brachytherapy treatment planning system (version 4.3, Nucletron an Elekta company, Elekta AB, Stockholm, Sweden), was generated for 20 consecutive HDR prostate brachytherapy patients, with the DTDC set to zero. Successive constrained optimisation plans were also created for each patient by increasing the DTDC parameter by 0.2, up to a maximum value of 1.0. We defined a “plan modulation index”, to characterise the change of dwell time modulation as the DTDC parameter was increased. We calculated the dose volume histogram indices for the PTV (D90, V100, V150, V200%) and urethra (D10%) to characterise the effect on the resulting dosimetry. The average PTV D90% decreases as the DTDC is applied, on average by only 1.5 %, for a DTDC = 0.4. The measures of high dose regions in the PTV, V150 and V200%, increase on average by less than 5 and 2 % respectively. The net effect of DTDC on the modulation of dwell times has been characterised by the introduction of the plan modulation index. DTDC applied during IPSA optimisation of HDR prostate brachytherapy plans reduce the occurrence of large isolated dwell times within individual catheters. The mechanism by which DTDC works has been described and its effect on the modulation of dwell times has been characterised. The authors recommend using a DTDC parameter no greater than 0.4 to obtain a plan with dwell time modulation comparable to a geometric optimised plan. This yielded on average a 1.5 % decrease in PTV coverage and an acceptable increase in V150%, without compromising the urethral dose.

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Authors and Affiliations

  1. William Buckland Radiation Oncology, The Alfred Hospital, Commercial Road, Melbourne, 3004, Australia

    Ryan L. Smith, Vanessa Panettieri, Natasha Mason & Jeremy L. Millar

  2. Monash Partners Comprehensive Cancer Consortium, Clayton, VIC, 3168, Australia

    Ryan L. Smith, Rick D. Franich & Jeremy L. Millar

  3. School of Applied Sciences and Health Innovations Research Institute, RMIT University, Melbourne, VIC, 3000, Australia

    Ryan L. Smith & Jeremy L. Millar

  4. Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, QLD, 4029, Australia

    Craig Lancaster

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  1. Ryan L. Smith
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  2. Vanessa Panettieri
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  3. Craig Lancaster
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  4. Natasha Mason
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  5. Rick D. Franich
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Correspondence to Ryan L. Smith.

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Smith, R.L., Panettieri, V., Lancaster, C. et al. The influence of the dwell time deviation constraint (DTDC) parameter on dosimetry with IPSA optimisation for HDR prostate brachytherapy. Australas Phys Eng Sci Med 38, 55–61 (2015). https://doi.org/10.1007/s13246-014-0317-2

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  • DOI: https://doi.org/10.1007/s13246-014-0317-2

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