title: Consideration of time-dose-patterns in 3D treatment planning. An approach towards 4D treatment planning.
abstract: OBJECTIVE
  The rendering of the 3D dose distribution together with anatomical information and the volumes of interest (VoI) is essential to get a visual impression of the treatment plan and to find modifications for the optimization of the dose distribution. The integration of biological effects into the 3D treatment planning is of interest for the assessment of different time-dose patterns.
  
  
  METHODS
  One way of taking into account biological data is to relate the physical dose in critical structures to the corresponding tolerance dose. For that purpose the applied time-dose pattern has to be converted into the standard fractionation scheme being the basis of the tolerance dose. Generally any model can be used for these calculations. Here a modified incomplete repair model is used to calculate the relative biological dose distribution (RBD). The visualization of these biologically isoeffective dose distributions can be performed in the same manner as the physical dose so that the physical and biological dose distributions can by displayed side by side. As this is equivalent to introducing the time as a fourth dimension into 3D treatment planning this is called 4D treatment planning.
  
  
  RESULTS
  From 3D dose matrices the biologically isoeffective dose distributions are calculated for the organs at risk. The changes introduced by different time-dose patterns are displayed using the same technique as for rendering 3D treatment plans. The visualisation of the three-dimensional biological dose distributions is shown by means of a patient with an oesophagus carcinoma. The RBD related to the tolerance dose of the organs at risk is displayed for different time-dose fractionations.
  
  
  CONCLUSIONS
  The RBD distribution on a 3D treatment plan can be displayed in the same mode as the physical dose distribution. This offers additionally valuable information in a 3D treatment planning process about the dose to critical organs and the influence of different time-dose patterns.
authors.affiliation: Abteilung Strahlentherapie, Universitäts-Krankenhaus Eppendorf.
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
authors.forename: T
authors.initials: T
authors.lastname: Schiemann
authors.forename: W
authors.initials: W
authors.lastname: Schlegel
authors.forename: K H
authors.initials: KH
authors.lastname: Höhne
authors.forename: K H
authors.initials: KH
authors.lastname: Hübener
mesh_terms: D003116:Color; D003196:Computer Graphics; D003198:Computer Simulation; D006801:Humans; D016014:Linear Models; D008954:Models, Biological; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data; D012062:Relative Biological Effectiveness; D013997:Time Factors