title: Treatment plan optimization and robustness of106Ru eye plaque brachytherapy using a novel software tool.
abstract: To analyze treatment plan robustness and plan optimization strategies of106Ru eye plaque brachytherapy using a novel software tool.
  
  
  
  A treatment planning software was developed that allows to calculate dose-volume metrics. Plaque misplacements were simulated and evaluated with respect to the effect on tumor coverage and dose changes in critical structures. Two treatment plan optimization approaches were analyzed: (a) reducing plaque size and (b) shifting the plaque away from organs-at-risk (OAR).
  
  
  
  Maximum tumor sizes were identified which can be covered by the prescribed dose for different robustness levels (0-2mm). For an apex height of 5mm a 1mm uncertainty yielded changes in D2%to the lens of up to ±13Gy in anterior and ±20Gy to the optic nerve in posterior tumors. By reducing the plaque size Dmeanand D2%to lens, optic nerve and macula were decreased by >60% for most simulated cases. Similarly, by shifting the plaque away from the lens dose reductions of 15%/mm in anterior and even 30%/mm in central tumors were achieved.
  
  
  
  Critical structures in the treatment of uveal melanomas with106Ru plaques can benefit from the proposed, computational treatment plan optimization.
authors.affiliation: Division Medical Radiation Physics, Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria. Electronic address: gerd.heilemann@meduniwien.ac.at.
authors.forename: Gerd
authors.initials: G
authors.lastname: Heilemann
authors.affiliation: Division Medical Radiation Physics, Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Fetty
authors.affiliation: WoogieWorks Animation Studio, Perchtoldsdorf, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Dulovits
authors.affiliation: Austrian Institute of Technology GmbH, Health & Environment Department Biomedical Systems, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Blaickner
authors.affiliation: Division Medical Radiation Physics, Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Nesvacil
authors.affiliation: Division Medical Radiation Physics, Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Georg
authors.affiliation: Department of Ophthalmology and Optometry, Medical University of Vienna/AKH Vienna, Austria.
authors.forename: Roman
authors.initials: R
authors.lastname: Dunavoelgyi
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy*; D009900:Optic Nerve / Q000528:radiation effects; D058958:Organs at Risk; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D012984:Software; D014604:Uveal Neoplasms / Q000532:radiotherapy*; D000098943:Uveal Melanoma
chemical_list: D012429:Ruthenium Radioisotopes
keywords: Brachytherapy; Eye plaque; Robustness; Treatment plan optimization; Uveal melanoma