Evaluating the impact of real-time multicriteria optimizers integrated with interactive plan navigation tools for HDR brachytherapy

Abstract

PurposeCurrently in high-dose-rate (HDR) brachytherapy planning, manual fine-tuning of an objective function is a common practice. Furthermore, automated planning approaches such as multicriteria optimization (MCO) are still limited to the automatic generation of a single treatment plan. This study aims to quantify planning efficiency gains when using a graphics processing unit–based MCO (gMCO) algorithm combined with a novel graphical user interface (gMCO-GUI) that integrates efficient automated and interactive plan navigation tools. Methods and MaterialsThe gMCO algorithm was used to generate 1000 Pareto optimal plans per case for 379 prostate cases. gMCO-GUI was developed to allow plan navigation through all plans. gMCO-GUI integrates interactive parameter selection tools directly with the optimization algorithm to allow plan navigation. The quality of each plan was evaluated based on the Radiation Treatment Oncology Group 0924 protocol and a more stringent institutional protocol (INSTp). gMCO-GUI allows real-time time display of the dose–volume histogram indices, the dose–volume histogram curves, and the isodose lines during the plan navigation. ResultsOver the 379 cases, the fraction of Radiation Treatment Oncology Group 0924 protocol valid plans with target coverage greater than 95% was 90.8%, compared with 66.0% for clinical plans. The fraction of INSTp valid plans with target coverage greater than 95% was 81.8%, compared with 62.3% for clinical plans. The average time to compute 1000 deliverable plans with gMCO was 12.5 s, including the full computation of the 3D dose distributions. ConclusionsCombining the gMCO algorithm with automated and interactive plan navigation tools resulted in simultaneous gains in both plan quality and planning efficiency.