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Potential advantages of gEUD optimisation as compared with conventional physical optimisation for stereotactic treatment planning

Published online by Cambridge University Press:  20 October 2023

A Aziz Sait Open the ORCID record for A Aziz Sait [Opens in a new window] ,
Glenn W. Jones ,
Nikhil Rastogi ,
Rebecca Mathew ,
Sunil Mani  and
Jason Berilgen
A Aziz Sait*
Affiliation:
Teerthanker Mahaveer University, Faculty of Engineering, Moradabad, India
Glenn W. Jones
Affiliation:
University of West Indies, School of Clinical Medicine and Research, Nassau, The Bahamas
Nikhil Rastogi
Affiliation:
Teerthanker Mahaveer University, Faculty of Engineering, Moradabad, India
Rebecca Mathew
Affiliation:
Advanced Medical Physics, Houston, TX, USA
Sunil Mani
Affiliation:
Advanced Medical Physics, Houston, TX, USA
Jason Berilgen
Affiliation:
Millennium Physicians, Radiation Oncology, The Woodlands, TX, USA
*
Corresponding author: A Aziz Sait; Email: azizsaitresearch@gmail.com
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Abstract

Introduction:

A small number of studies have confirmed the advantage of generalised equivalent uniform dose (gEUD) optimisation for some standard clinical scenarios; however, its performance with complicated stereotactic treatments is yet to be explored. Therefore, this study compared two planning optimisation methods, gEUD and Physical dose, in stereotactic treatments for several complex anatomical locations.

Methods:

Thirty patients were selected, ten each for sites of brain, lung and spine. Two stereotactic plans were generated for each case using the gEUD objective and Physical objective cost functions. Within each of the three sites, dosimetric indices for conformity, gradient and homogeneity, along with parameters of monitor units and dose–volume histograms (DVHs), were compared for statistical significance. Additionally, patient-specific quality assurance was conducted using portal dosimetry, and the gamma passing rate between the two plans was evaluated.

Results:

Optimisation was better with a gEUD objective as compared with Physical objective, notably sparing critical organs. Overall, the differences in mean values for six critical organs at risk favoured gEUD-based over Physical-based plans (all six 2-tailed p-values were < 0·0002). Furthermore, all differences in mean values for DVH parameters favoured gEUD-based plans: GTVmean, GTVmax, PTVD100V, homogeneity index, gradient index and monitor unit (treatment time) (each 2-tailed p < 0·05).

Conclusions:

gEUD optimisation in stereotactic treatment plans has a clear and general statistical advantage over Physical dose optimisation.

Keywords

gEUDradiobiological optimisationstereotactic treatmentstreatment planningVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e112
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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