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: Artículo (Versión definitiva)
Área (Departamento): Área Radiol. y Medicina Física (Dpto. Microb.Ped.Radio.Sal.Pú.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace.
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: Artículo (Versión definitiva)
Área (Departamento): Área Radiol. y Medicina Física (Dpto. Microb.Ped.Radio.Sal.Pú.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. Exportado de SIDERAL (2025-12-19-14:42:42)
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Artículos > Artículos por área > Radiología y Medicina Física
Registro creado el 2025-12-19, última modificación el 2025-12-19