Advanced integrated system for personalized radiotherapy treatment planning optimization

The physical planning of a radiotherapy treatment is based on: (1) Localization of the target volume; (2) Choice of the treatment position; (3) Acquisition of contour and heterogeneity data in the treatment position; (4) Choice of the irradiation techniques and dosimetric calculation to obtain an optimized 3-D dose distribution; (5) Automatic verification of the accepted plan; (6) Simulation of the accepted plan; (7) Execution and control of the treatment. An integrated system for personalized treatment planning has been realized. It is based on the automatic acquisition of the relevant data (by X-Y digitizer, TV camera, CT unit) and on the display and utilization of CT, US and NMR information. The software has been adapted to evaluate dose distributions in teletherapy, curietherapy and in cases of a combination of both. It is then possible to display three-dimensional dose distribution on different types of images. As regards point (5) a first check can be made using dose-volume histograms to verify the dose to the target volume or to healthy surrounding structures. Further checking of the radiotherapy technique chosen can be carried out by automatic methods with routines belonging to the computer system's application software, for example the 'beam's eye view', with which it is possible to check accurately the true radiation of the target volume while sparing healthy structures. As regards points (6) and (7), we have developed an automatic simulation system based on a second-generation computed tomography scanner, including the application software for dosimetric optimization of treatment planning. Special hardware and software have been added to modify the scanner in order to allow simulation of the portals and the impact points of single radiation beams for each treatment technique chosen. 12 refs, 7 figs