Evaluation of the minimum segment width and fluence smoothing tools for intensity-modulated techniques in Monaco treatment planning system
Jiménez-Puertas, Sara ; González Rodríguez, Andrea ; Lozares Cordero, Sergio (Universidad de Zaragoza) ; 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)
Resumen: 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.
Idioma: Inglés
DOI: 10.4103/jmp.jmp_156_23
Año: 2024
Publicado en: Journal of Medical Physics 49, 2 (2024), 250-260
ISSN: 0971-6203
Factor impacto SCIMAGO: 0.256 - Radiology, Nuclear Medicine and Imaging (Q3) - Biophysics (Q4)
Tipo y forma: Article (Published version)
Área (Departamento): Área Radiol. y Medicina Física (Dpto. Microb.Ped.Radio.Sal.Pú.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
Exportado de SIDERAL (2025-12-19-14:42:42)
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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.
Idioma: Inglés
DOI: 10.4103/jmp.jmp_156_23
Año: 2024
Publicado en: Journal of Medical Physics 49, 2 (2024), 250-260
ISSN: 0971-6203
Factor impacto SCIMAGO: 0.256 - Radiology, Nuclear Medicine and Imaging (Q3) - Biophysics (Q4)
Tipo y forma: Article (Published version)
Área (Departamento): Área Radiol. y Medicina Física (Dpto. Microb.Ped.Radio.Sal.Pú.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. Exportado de SIDERAL (2025-12-19-14:42:42)
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