165189 20260219090944.0 doi 10.4103/jmp.jmp_156_23 sideral 146974 ART-2024-146974 eng Jiménez-Puertas, Sara Evaluation of the minimum segment width and fluence smoothing tools for intensity-modulated techniques in Monaco treatment planning system 2024 Access copy available to the general public Unrestricted Purpose: This study aims to minimize monitor units (MUs) of intensity-modulated treatments in the Monaco treatment planning system while preserving plan quality by optimizing the “Minimum Segment Width” (MSW) and “Fluence Smoothing” parameters. Materials and Methods: We retrospectively analyzed 30 prostate, 30 gynecological, 15 breast cancer, 10 head and neck tumor, 11 radiosurgery, and 10 hypo-fractionated plans. Original prostate plans employed “Fluence Smoothing” = Off and were reoptimized with Low, Medium, and High settings. The remaining pathologies initially used MSW = 0.5 cm and were reoptimized with MSW = 1.0 cm. Plan quality, including total MU, delivery time, and dosimetric constraints, was statistically analyzed with a paired t-test. Results: Prostate plans exhibited the highest MU variation when changing “Fluence Smoothing” from Off to High (average ΔMU = −5.1%; P < 0.001). However, a High setting may increase overall MU when MSW = 0.5 cm. Gynecological plans changed substantially when MSW increased from 0.5 cm to 1.0 cm (average ΔMU = −29%; P < 0.001). Organs at risk sparing and planning target volumes remained within 1.2% differences. Replanning other pathologies with MSW = 1.0 cm affected breast and head and neck tumor plans (average ΔMU = −168.38, average Δt = −11.74 s, and average ΔMU = −256.56, average Δt = −15.05 s, respectively; all with P < 0.004). Radiosurgery and hypofractioned highly modulated plans did not yield statistically significant results. Conclusions: In breast, pelvis, head and neck, and prostate plans, starting with MSW = 1.0 cm optimally reduces MU and treatment time without compromising plan quality. MSW has a greater impact on MU than the “Fluence Smoothing” parameter. Plans with high modulation might present divergent behavior, requiring a case-specific analysis with MSW values higher than 0.5 cm. info:eu-repo/semantics/openAccess by-nc-sa https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es 0.7 2024 0.256 2024 Radiology, Nuclear Medicine and Imaging 2024 Q3 Biophysics 2024 Q4 1.1 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion González Rodríguez, Andrea Lozares Cordero, Sergio Universidad de Zaragoza (orcid)0000-0002-1530-5662 González González, Tomás Díez Chamarro, Javier Hernández Hernández, Mónica Castro Moreno, Raquel Sánchez Casi, Marta Villa Gazulla, David Carlos Gandía Martínez, Almudena Campos Bonel, Arantxa Puertas Valiño, Maria del Mar Font Gómez, José Antonio Universidad de Zaragoza (orcid)0000-0003-4732-7409 1011 770 Universidad de Zaragoza Dpto. Microb.Ped.Radio.Sal.Pú. Área Radiol. y Medicina Física 49, 2 (2024), 250-260 Journal of Medical Physics 0971-6203 2363777 http://zaguan.unizar.es/record/165189/files/texto_completo.pdf Versión publicada 3081924 http://zaguan.unizar.es/record/165189/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:165189 articulos driver 2026-02-19-09:00:58 ARTICLE