title: Simultaneous beam sampling and aperture shape optimization for SPORT.
abstract: OBJECTIVE
  Station parameter optimized radiation therapy (SPORT) was recently proposed to fully utilize the technical capability of emerging digital linear accelerators, in which the station parameters of a delivery system, such as aperture shape and weight, couch position/angle, gantry/collimator angle, can be optimized simultaneously. SPORT promises to deliver remarkable radiation dose distributions in an efficient manner, yet there exists no optimization algorithm for its implementation. The purpose of this work is to develop an algorithm to simultaneously optimize the beam sampling and aperture shapes.
  
  
  METHODS
  The authors build a mathematical model with the fundamental station point parameters as the decision variables. To solve the resulting large-scale optimization problem, the authors devise an effective algorithm by integrating three advanced optimization techniques: column generation, subgradient method, and pattern search. Column generation adds the most beneficial stations sequentially until the plan quality improvement saturates and provides a good starting point for the subsequent optimization. It also adds the new stations during the algorithm if beneficial. For each update resulted from column generation, the subgradient method improves the selected stations locally by reshaping the apertures and updating the beam angles toward a descent subgradient direction. The algorithm continues to improve the selected stations locally and globally by a pattern search algorithm to explore the part of search space not reachable by the subgradient method. By combining these three techniques together, all plausible combinations of station parameters are searched efficiently to yield the optimal solution.
  
  
  RESULTS
  A SPORT optimization framework with seamlessly integration of three complementary algorithms, column generation, subgradient method, and pattern search, was established. The proposed technique was applied to two previously treated clinical cases: a head and neck and a prostate case. It significantly improved the target conformality and at the same time critical structure sparing compared with conventional intensity modulated radiation therapy (IMRT). In the head and neck case, for example, the average PTV coverage D99% for two PTVs, cord and brainstem max doses, and right parotid gland mean dose were improved, respectively, by about 7%, 37%, 12%, and 16%.
  
  
  CONCLUSIONS
  The proposed method automatically determines the number of the stations required to generate a satisfactory plan and optimizes simultaneously the involved station parameters, leading to improved quality of the resultant treatment plans as compared with the conventional IMRT plans.
authors: Department of Radiation Oncology, Stanford University, Stanford, California 94305.
authors: Masoud
authors: M
authors: Zarepisheh
authors: Department of Radiation Oncology, Stanford University, Stanford, California 94305.
authors: Ruijiang
authors: R
authors: Li
authors: Department of Management Science and Engineering, Stanford University, Stanford, California 94305.
authors: Yinyu
authors: Y
authors: Ye
authors: Department of Radiation Oncology, Stanford University, Stanford, California 94305.
authors: Lei
authors: L
authors: Xing
mesh_terms: D000465:Algorithms; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D013997:Time Factors
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