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. 2009 Oct 7;10(4):117-131.
doi: 10.1120/jacmp.v10i4.3068.

Comparing planning time, delivery time and plan quality for IMRT, RapidArc and Tomotherapy

Mike Oliver  1 , Will Ansbacher  1 , Wayne A Beckham  1
Affiliations

Comparing planning time, delivery time and plan quality for IMRT, RapidArc and Tomotherapy

Mike Oliver et al. J Appl Clin Med Phys. .

Abstract

The purpose of this study is to examine plan quality, treatment planning time, and estimated treatment delivery time for 5- and 9-field sliding window IMRT, single and dual arc RapidArc, and tomotherapy. For four phantoms, 5- and 9-field IMRT, single and dual arc RapidArc and tomotherapy plans were created. Plans were evaluated based on the ability to meet dose-volume constraints, dose homogeneity index, radiation conformity index, planning time, estimated delivery time, integral dose, and volume receiving more than 2 and 5 Gy. For all of the phantoms, tomotherapy was able to meet the most optimization criteria during planning (50% for P1, 67% for P2, 0% for P3, and 50% for P4). RapidArc met less of the optimization criteria (25% for P1, 17% for P2, 0% for P3, and 0% for P4), while IMRT was never able to meet any of the constraints. In addition, tomotherapy plans were able to produce the most homogeneous dose. Tomotherapy plans had longer planning time, longer estimated treatment times, lower conformity index, and higher integral dose. Tomotherapy plans can produce plans of higher quality and have the capability to conform dose distributions better than IMRT or RapidArc in the axial plane, but exhibit increased dose superior and inferior to the target volume. RapidArc, however, is capable of producing better plans than IMRT for the test cases examined in this study.

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Figures

Figure 1
Figure 1
A block diagram of the different major pieces of software used in this study, along with the sections of the methods where these points are further explained and the data that is transferred, listed either as an incoming or outgoing arrow from that module.
Figure 2
Figure 2
Axial slices of all phantoms with PTV and OARs shown: (a) Phantom1 with PTV (green) and OAR1 (red); (b) Phantom 2 with PTV (green), OAR1 (red) and OAR2 (blue); (c) Phantom 3 with PTV (green), OAR1 (red), OAR2 (blue) and OAR3 (purple); (d) Phantom 4 with PTV (green) and OAR (red).
Figure 3
Figure 3
The red dot on the plot represents the desired dose‐volume objective and the green curve demonstrates the optimized dose volume histogram (DVH) for the organ. In this case the desired dose is 15 Gy to 50% of the volume. The values that are reported in Table 4 are the dose to 50% volume and volume receiving 15 Gy.
Figure 4
Figure 4
Dose volume histograms for 9‐field IMRT (IMRT9, solid), 2‐arc RapidArc (RA2, dotted) and tomotherapy (TOMO, dash dotted) plans delivered to Phantom 1 (a), Phantom 2 (b), Phantom 3 (c) and Phantom 4 (d).
Figure 5
Figure 5
Axial dose distribution of Phantoms 1 (first row), 2 (second row), 3 (third row), and 4 (fourth row) for 9‐field IMRT (left), dual arc RapidArc (center), and tomotherapy (right) with isodose lines at 65, 60, 55, 40, 20 and 10 Gy.
Figure 6
Figure 6
A dose profile through the geometric center of Phantom 4 with dose plotted as a function of position along the superior‐inferior direction for 9‐field IMRT (IMRT9) shown with a solid line, dual arc RapidArc (RA2) shown with a dashed line, and tomotherapy (TOMO) shown with a dotted line. Note that the PTV is within −3.75cm to +3.75cm.
See this image and copyright information in PMC

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