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BAO, Eclipse, Varian Medical System

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**Beam Angle Optimization (BAO) –
**

A White Paper

Version: 0.3

Date: October 5, 2007

Author: Katja Pesola

TABLE OF CONTENTS Introduction 2 Description of Plan Geometry Optimizer (PGO) 2 Global optimization mode Initial field geometries Removing forbidden fields from the initial field distribution The final number of fields in the plan Number of fluence optimization iterations per global geometric iteration Field reduction Field number constraint Lateral inhibition Proximity effect Minimum field separation angle Initial field removal effects Local optimization mode Number of fluence optimization iterations per local geometric iteration Initialization phase Optimization phase Additional stopping criteria Normal Tissue Objective (NTO) 10 NTO shape Appendix A: Input parameters for PGO 12 List of PGO input parameters Use of PGO input parameters .

an algorithm for was developed. 1 | VA R I A N M E D I C A L S Y S T E M S .. especially to the sensitive Organs At Risk (OARs). The goodness of the optimization results is meas- ured from the OF value.” beam angle optimization in IMRT was developed at Varian Medical Systems Finland Oy (VMSFi). the selection of beam angles is generally based upon process for IMRT treatments and the experience of the human planner. The algorithm is supposed to be run before the optimization of fluences to be delivered during the IMRT treat- ment. the value of OF is proportional to the fulfillment of the user-given dose-volume histogram (DVH)-based objectives for “In order to speed up the planning PTV and for OARs.. the beam angle optimization algorithm in the Eclipse Treatment Planning System shall be called Plan Geometry Optimizer (PGO). The beam angle optimization algorithm is based on the beam profile (fluence) optimization algorithm used in the Inverse Planning module inside the Eclipse™ Treatment Planning System. prolonging the time matic tool for selecting optimal required for treatment planning up to several hours. while spar- ing OARs and normal tissue as much as possible. beam angles. the dose to the surrounding normal tissue. Intensity-modulated radiotherapy (IMRT) is a powerful technology for produc- ing highly three-dimensionally conformal dose distributions to the PTV. should be minimized. Hereafter. Typically. Simultaneously. an algorithm for In order to speed up the planning process for IMRT treatments and to provide beam angle optimization in IMRT the user with an automatic tool for selecting optimal beam angles. Currently. homogeneous dose delivered to the Planning Target Volume (PTV). which is proportional to the fulfillment of the objectives. The conventional IMRT planning starts with the selection of suitable beam angles followed by an optimization of beam profiles (intensity matrices) using inverse optimization methods in order to minimize the value of an objective function (OF). Several trial-and-error attempts are normally to provide the user with an auto- needed in order to find a group of acceptable beam angles.Introduction The goal of beam angle optimization in external radiation therapy is to find an opti- mal positioning of incident treatment beams. The optimality of a treatment plan is usually defined in terms of a prescribed. The same DVH–based objectives can be used both in fluence optimization and in beam angle optimization.

Coplanar (2D) 2.. In the global mode. Throughout the optimization process. These beam angle optimization iterations. these fields are removed from the field geometry. The initial search space is covered with a preset number of uniformly distributed fields. are then continued until the desired number of fields in the final plan has been reached. Non-coplanar (3D) 2 | VA R I A N M E D I C A L S Y S T E M S . either a 2D (coplanar) or a 3D (non- coplanar) search space may be used. The effect of removing each of the fields separately is evaluated by calculat- ing the corresponding OF value. The beam angle optimization iterations are continued until the desired the desired number of fields has number of fields has been reached. which removal causes the smallest increase in the value of the objective function. Description of Plan Geometry Optimizer (PGO) PGO may be run in two operating modes: the global optimization mode and the local optimization mode. Therefore. The relative importance of each field is determined by removing the field from the plan and calculating the “The beam angle optimization corresponding OF value. The PGO algorithm uses a fixed isocenter. The isocenter is copied from the first field in the field list. The initial field distribution in global optimization may be one of the following: 1. The fields. Initial field geometries The geometry of the initial field configuration can be controlled with a parame- ter value. There is also a possibility to optimize the final been reached.e. The local beam angle optimization mode is used for locally expanding the initial- ly discrete search space into a continuous one. After the initial field geometry has been created. a few fluence optimization itera- tions are calculated in order to produce an optimal beam profile for each field. The field parameters are modified within a local environment in order to minimize the value of the objective function. The fields with a low importance value are thereafter iterations are continued until removed. It is also possible to let PGO decide the optimal number of fields in the final plan. the 3D dose distribution is completely calcu- lated in order to fully account for long range scatter effects. each field is separately removed from the plan. can be considered to be less impor- tant. all the fields in the initial field distribution have the same isocenter. a few fluence optimization iterations are calculated. Global optimization mode The global beam angle optimization mode in PGO starts with a large initial number of fields either in a coplanar (2D) or in a non-coplanar (3D) geometry. during which the fluences are optimized and thereafter bad fields removed.” number of fields to be left in the plan. Thereafter. After the optimization of fluences. i.

In order to perform beam angle optimization only for valid fields. If the file already exists. Removing forbidden fields from the initial field distribution The initial field distribution may contain fields which cannot be used in dose cal- culations. there is a possibility to give a limiting value for the elevation angle of the fields from the coplanar plane. In case the non-coplanar field geometry is used. the collimators will not be rotated and are left at zero degree (IEC). Fields with forbidden gantry / couch angle combinations It is possible to define forbidden gantry / couch angle combinations using a config- uration file. This offset is mainly intended for research purposes. 3 | VA R I A N M E D I C A L S Y S T E M S . the information in it is used by PGO. the x-direction of the MLC (the movement direction of the leaves) will coincide with the shortest dimension of the PTV in the BEV. where the couch angles are set to zero. There is a possibility to use an offset for the gantry angles in the co-planar field geometry. or larger. Selecting the non-coplanar geometry creates a 3D initial field distribution. Opposing fields are avoided in the non-coplanar field geometry. Also. This file can be edited in order to give individual specifications for forbidden gantry / couch angle combinations. it is automatically created. It can be used in sensitivity analysis of the algorithm. The amount of the offset (in degrees) can be controlled by a parameter value. If the limiting value for collimator angle separation is set to 180 degrees. The fields are generated equally spaced with an increasing value for the gantry angle. If such a file does not exist when PGO is being run. where the field directions are equally distributed in 3D space so that the angle to the closest field would be approximately the same for all fields. Selecting the coplanar geometry creates a 2D initial field distribution. the fol- lowing fields are excluded from the initial field distribution: Fields going in through the end(s) of the CT stack After the creation of the initial field distribution fields entering the patient through either ends of the CT stack are removed from the initial field distribution. it might be impossible to deliver some fields due to the physical limitations of the treatment machine in creating certain gantry and /or couch rota- tions. The fields in the initial field distribution will not have elevation angle values larger than the specified limit. There is also a possibility to specify a limit value for collimator angle separation in adjacent fields. The maximum initial number of fields is 400. If this value is set to zero. The ini- tial number of fields both in the coplanar and in the non-coplanar field geometry is controlled with a parameter value.

Thus. 1). This procedure is continued until either 1) a decreased value of the objective function is obtained. the global optimization mode in PGO aims at leaving nmin fields in the plan. Thereafter. If the minimum number of fields is less than the maximum number of fields. The final number of fields in the plan The final number of fields which shall be left in the treatment plan after global beam angle optimization is controlled with the following two parameter values: 1. The optimal number of fields is determined from the value of the objective function in the following way: if the value of the objective function increases due to the removal of fields. the beam angle optimization iteration is re-calculated with the reduced field reduction rate. or 2) the removal of the fields is canceled and global beam angle optimization stops. is controlled with a parameter value. It is recommended to use at least three fluence iterations per global geometric iteration. Maximum number of fields If the minimum number of fields equals the maximum number of fields. Minimum number of fields 2. nleft is the number of fields which are currently included in the plan and nmin is the minimum number of fields to be left in the final plan. the final field geometry will have an optimal number of fields which belongs to the specified range. Number of fluence optimization iterations per global geometric iteration The number of fluence optimization iterations. which are run during one beam angle optimization iteration in the global optimization mode. The number of fields to be removed is calculated as nremoved = FRR*( nleft-nmin ). Field reduction The number of fields to be removed at the end of global beam angle optimization iteration is controlled by the Field Reduction Rate (FRR) parameter. The effect of the number of fields on the objective function is adjusted with the field number constraint (see Fig. 4 | VA R I A N M E D I C A L S Y S T E M S . the removal shall be canceled and the value of the field reduction rate shall be reduced to one half of the original value. the specified number of fields will be left in the final plan. (1) where nremoved is the number of fields to be removed. and fields are removed according to the cur- rent field reduction rate.

and its shape is pre- sented in Fig. and a large number of fields would be left in the final plan. The constraint used in restricting the number of fields in the final plan is called the field number constraint. An increase in the value of the objective function would not allow the removal of the fields. 5 | VA R I A N M E D I C A L S Y S T E M S . With the field number constraint. Figure 1. a constraint has been added into the calculation of the objective function.Field number constraint To control the number of fields to be left in the final plan. the number of fields in the final plan is con- strained into values typically below 10. The shape of the field number constraint. the value of the objective function used in flu- ence optimization typically increases. 1. The reason for this is that if fields are removed from the plan. The strength of the constraint is adjusted with a weight parameter.

the importance of the fields located close to removed field is increased with respect to the remaining fields. 2. The values of the objective function (OF) are then updated with the lateral inhibi- tion in the following way: OFnew = OFold + LI. a calculation called lateral inhi- bition is implemented in the algorithm. Lateral inhibition To prevent the algorithm from removing all the fields from a bad direction during the first global beam angle optimization iterations. The shape of the lateral inhibition function. α is the angle to the removed field and std is the standard deviation of the field removal effects. The calculation of lateral inhibition is cumulated in the values of the objective function within one beam angle optimization iteration. Figure 2. 6 | VA R I A N M E D I C A L S Y S T E M S . The effect of lateral inhibition is reset when the next beam angle optimization iteration starts. The shape of the lateral inhibition function with std = 1 is presented in Fig. Due to the inhibition. The shape of the lateral inhibition function (LI) is a linear combination of cosine powers: LI = C* ( cos2. fields located close to removed fields have an increased objective function value and therefore tend to be left in the plan.5 α + cos18 α )*std. Lateral inhibition enhances the values of the objective function near the removed fields. (2) where C is the value of the weight parameter used to control the amount of lateral inhibition. (3) Thus.

is implemented in terms of setting a limiting value for the angle how close the fields are allowed to stay in the final field configuration. a calculation called proximity effect is available in PGO. et al. Therefore. Press. The value for the limiting angle can be controlled by a parameter value. This situation in a final treatment plan is usually regarded as unde- sirable because it can easily produce “hot spots” in the normal tissue. The amount of the proximity effect is then subtracted from the original values of the objective function in order to decrease the importance of fields located close to each other. there are two algorithms available for optimizing of the field parameters: 1) the downhill Simplex method and 2) the Powell method. To avoid closely located fields in the final treatment plan.). The proximity effect is calculated in a similar way as lat- eral inhibition but in this case. Throughout the local optimization mode the information about the best field configuration found so far is stored. Initial field removal effects The values of the field removal effects calculated during the first beam angle opti- mization iteration are preserved for further use. The weight for the proximity effect calculation is adjusted with a parameter value. The collimator angles are also calcu- treatment plan. which are close to one another.Proximity effect Sometimes beam angle optimization results in plans which have fields located close to each other. In the local beam angle optimization mode. These values are assumed to con- tain information about the geometry of the patient. this information is always available if the local optimization mode is stopped at any time. The initial field removal effect values can be included in the following beam angle optimization iterations by adding their weighted value into the current values of the objective function. and the gantry and parameters of an existing the couch angles in the 3D non-coplanar case. The parame- mode modifies the beam angle ters to be optimized are the gantry angles in the coplanar case. the local beam angle optimization mode modifies the beam angle parameters of an existing treat- ment plan. Opposite to the global mode. No fields are added to or removed from the plan. there is a local beam angle opti- mization mode available in PGO.” lated if the limiting value for the collimator angle separation in adjacent fields is larger than zero. α is the angle to the closest field in the plan. the Information about the two optimization methods can be found in Numerical local beam angle optimization Recipes in C: The Art of Scientific Computing (William H. Local optimization mode In addition to the global beam angle optimization. The weight given to the initial field removal effects can be adjusted with a parameter value. 7 | VA R I A N M E D I C A L S Y S T E M S . which is then lost during the following beam angle optimization iterations. “Opposite to the global mode. Minimum field separation angle Another mechanism available for excluding fields.

the corner points are modified according to the algorithm schema. the amount of change applied to each parameter in the construction phase of the simplex. not derivatives. the Simplex algorithm stops. Powell algorithm After initializing the search directions with unit vectors. i. The number of corner points is N + 1 where N is the number of parameters to be optimized. the stopping criteria for the algorithm are checked first. is controlled by a parameter value. the gantry angles in the 2D case and the gantry and couch angles in the 3D case. The search directions are initialized with unit vectors. The distance from each corner point to the start- ing point. the Powell algorithm pro- ceeds according to the algorithm schema by finding so called conjugate search direc- tions. i. Thus. the algorithm continues by finding a new position for the worst corner point in the simplex. the corner points of the original simplex are generated. Powell algorithm The Powell algorithm calculates line minimizations along the specified search direc- tions.. In the beginning of Powell iteration. Initialization phase Simplex algorithm In the initialization phase of the Simplex algorithm. The initial step size is controlled with the same parameter value as is used for the Simplex algorithm. If none of the criteria are met. The procedures included in finding a new cor- ner point for the simplex are called a Simplex iteration. The number of fluence optimization iterations to be run within each local geometric optimization iteration can be controlled by a parameter value. If there is no improvement found in the value of the objective function. in the first Powell iteration each parameter is optimized separately.e. This value is common for gantry and couch angles. In the beginning of a Simplex iteration the stopping criteria for the algorithm are checked first.. The generation of each corner point requires a cal- culation of the objective function.e. Optimization phase Simplex algorithm After the construction of the original simplex. The calculations performed during the line minimizations along the current search directions are called a Powell iteration. The search space for each parameter is expanded until there is a minimum point found between the line end points. 8 | VA R I A N M E D I C A L S Y S T E M S . Number of fluence optimization iterations per local geometric iteration The Simplex and the Powell methods require only objective function evaluations.

these parameters do not belong to the list of PGO input parameters. the number of local optimization iterations. i. The evaluation of the convergence is controlled by two parameter values: the number of Simplex iterations to be included in the evaluation. not during the iteration. the local optimization mode stops. it is not recommended to set a low value for this number since the algorithm may not have reached a minimum point if the execution is stopped too early. Convergence of the algorithm This stopping criterion is used only for the Simplex algorithm. Number of objective function calculations The maximum number of objective function calculations. In the Powell algorithm. This parameter is included in the list of input parameters for PGO.e. the Simplex algorithm shall be stopped. valid field parameters may not be found in generating new field directions in the local optimization mode. there are three addi- tional stopping criteria used in the local optimization mode. However. If valid field parameters cannot be found after a certain number of trials. 9 | VA R I A N M E D I C A L S Y S T E M S . and the limit value for the amount of change in the value of the objective function which determines whether the optimization shall be continued.Additional stopping criteria In addition to the condition discussed in the previous section.. the total number of local optimization iterations may exceed the given input parameter value. These criteria are pre- sented in the following sections. The convergence of the algorithm is checked in the beginning of a Simplex iteration. Currently. Therefore. the number of calculated local optimization iterations is checked only in the beginning of Powell optimization iteration. Invalid field parameters Depending on the properties of the patient geometry and/or on the definition of the valid gantry and couch angles. can be used as a stopping criterion in the local optimization mode. If there are no significant changes detected in the value of the objective function during recent iterations.

The use of NTO with proper parameter values should remove possible “hot physical manner. It was developed in order to take into account the desired decrease in the dose level as the distance from the PTV(s) is increased. Normal Tissue Objective (NTO) Since giving values for the plan goals to be used inside beam angle optimization is crucial for the success of the optimization. this part of the body shall be called normal tissue. NTO is expected to limit dose level in the healthy tissue in a physical man- level in the healthy tissue in a ner.” spots” in the healthy tissue. NTO may be used in fluence optimiza- “NTO is expected to limit dose tion. In addition to beam angle optimization. The new objective is called Normal Tissue Objective (NTO). a new type of objective was developed for the part of the body which is not included in the PTV(s). In this document. NTO shape The shape of NTO is controlled with the following parameters: • Distance from PTV border ( xstart ) • Start dose ( ƒ0 ) • End dose ( ƒ∞ ) • Fall-off ( k ) The shape of NTO ( ƒ(x) ) as a function of the distance from PTV border ( x ) is calculated according to the following formula: (4) 1 0 | VA R I A N M E D I C A L S Y S T E M S .

the NTO is first calculated for each target and at each body point.05. The NTO has no value inside any of the targets in a plan. The shape of NTO presented in Fig. In addition to the four parameters which control the shape of NTO. 3 has been calculated with the following parameter values: xstart = 10 mm.0 (or 100 %) is selected to correspond to the lowest upper objective of the target. 1 1 | VA R I A N M E D I C A L S Y S T E M S . ƒ0 = 1. ƒ∞ = 0. the level 1. An example of the shape of the normal tissue objective. Figure 3.5 and k = 0. the largest of all calculated NTO values is kept to define the total NTO. 3.05 times the highest lower objective of the target.0 (or 100 %) is selected to be 1. A typical shape for NTO is presented in Fig. its relative importance with respect to the other objectives used in optimization can be con- trolled with a priority parameter in a similar way than for the DVH objectives. If no upper objective is set to the target. If there are several targets in the plan. The normalization of NTO is done in the following way: the level 1.0.

1 0.500 40 Initial step size in local optimization [deg] Double 1 .1 0.1 Lateral inhibition weight Double 0 .1 0. Coplanar Non-coplanar.15 9 Maximum collimator variation [deg] Double 0 – 180 0 Coplanar offset angle [deg] Double 0 – 90 0 Maximum elevation angle for non-coplanar fields [deg] Double 0 – 90 90 Fluence iterations per global geometric iteration Int 1 . The table also includes their types. Appendix A: Input parameters for PGO This section contains information about the input parameters which are used in the PGO algorithm to control the execution. Parameter name Type Valid range Default value Initial field distribution String Coplanar. List of PGO input parameters The input parameters for the PGO algorithm are listed in Table 1.20 3 Maximum number of local optimization iterations Int 0 .90 10 Local geometric optimization mode String Simplex.180 10 1 2 | VA R I A N M E D I C A L S Y S T E M S . None Initial number of fields Int 2 .20 3 Field reduction rate Double 0 .4 Minimum field separation angle [deg] Double 0 .4 First global iteration weight Double 0 . Table 1.400 71 Minimum number of fields Int 2 .5 Field number constraint weight Double 0 . None Fluence iterations per local geometric iteration Int 1 .1 0.1 0.4 Proximity effect weight Double 0 . Input parameters for PGO. valid ranges and default values.15 5 Maximum number of fields Int 2 . Simplex Powell.

the field geometry shall be checked before running global optimization. In most cases. Therefore. However. Initial number of fields This parameter shall set the initial number of fields in the field geometry to be cre- ated for global optimization. -90 degrees) and 90 degrees so that the x-direction of the MLC (the movement direction of the leaves) shall coincide with the shortest dimension of the PTV in the BEV. Maximum number of fields This parameter shall set the upper limit for the number of fields to be left in the plan after running global beam angle optimization. the collimator angles of neighboring fields shall stay within the specified limit. Selecting None as the initial field distribution shall skip the global optimization phase. the movement direc- tion of the leaves shall coincide with the shortest dimension of the PTV. Non- coplanar and None. it also results in minimizing the area of healthy tissue inside the collimator jaws. The coplanar and non-coplanar initial field geometries shall be created as explained earlier. Initial field distribution There are three possible choices for the initial field distribution: Coplanar. If a value smaller than 180 degrees is selected. The check includes removing the fields which enter the patient through the end(s) of the CT stack and / or the fields with forbidden gantry / couch angle values. the collimators shall be rotated between 270 degrees (i. In this case. the actual number of fields left in the initial field distribution after the validity check may be less than the number specified by this parameter. If the limiting value for collimator angle separation is set to 180 degrees. This choice aims at the minimum number of carriage groups required for the treatment. the active plan in Eclipse shall be used as the input plan for local optimization. 1 3 | VA R I A N M E D I C A L S Y S T E M S .e. If this value is set to zero. Minimum number of fields This parameter shall set the lower limit for the number of fields to be left in the plan after running global beam angle optimization. Maximum collimator variation This parameter shall control how much the collimator angle values are allowed to vary from one field to the closest neighboring field in the initial field distribution.. the collimators shall not be rotated but are left to zero angle. Within the limit.Use of PGO input parameters This section describes the effect of the input parameter values on the execution of PGO.

First global iteration weight See section Description of PGO – Global optimization mode – Initial field removal effects for description of the use of this parameter.5. See section Description of PGO – Global optimization mode – Field number constraint for further details. Field number constraint weight This parameter shall control the cost for leaving more fields in the final plan. Field reduction rate This parameter shall control the number of fields to be removed from the plan after global beam angle optimization iteration. it is not recommended to increase this value above 0. the offset to the starting gantry angle (default = 0 degrees) can be adjusted with this parameter value. 1 4 | VA R I A N M E D I C A L S Y S T E M S . and the execution of the algorithm shall be faster. If the value is increased. Please note that currently the individual machine limits for collimator angle rotation are not taken into account by PGO. Lateral inhibition weight See section Description of PGO – Global optimization mode – Lateral inhibition for the description of the use of this parameter. Proximity effect weight See section Description of PGO – Global optimization mode – Proximity effect for description of the use of this parameter. Constraining the collimator angle values between 270 and 90 degrees is considered strict enough for most linear accelerators. Coplanar offset angle In case of a coplanar initial field distribution. Maximum elevation angle for non-coplanar fields This parameter shall control the maximum elevation from the coplanar plane in case a non-coplanar initial field distribution is being used. It shall not have any effect on the non-coplanar initial field distribution. the number of fields to be removed is increased. However. Fluence iterations per global geometric iteration This parameter shall set the number of fluence optimization iterations to be run within global beam angle optimization iteration.

or to use Simplex or Powell optimization methods. Local geometric optimization mode This parameter shall set the mode for local beam angle optimization. Maximum number of local optimization iterations This parameter value shall set the upper limit for the number of objective function evaluations to be calculated within the local optimization mode. Possible choices are to skip the local optimization (None). Initial step size in local optimization This parameter value shall set the initial distance between the original and the new (trial) field direction in the local optimization mode. Fluence iterations per local geometric iteration This parameter shall set the number of fluence optimization iterations to be run in local beam angle optimization iteration. Therefore. 1 5 | VA R I A N M E D I C A L S Y S T E M S .Minimum field separation angle This parameter shall control how close to each other the fields are allowed to stay in the final plan after running global optimization. It shall also apply in the local optimization mode. This parameter value shall be used by Simplex optimization and by Powell optimization. it shall control the execution time spent in local beam angle optimization. See section Description of PGO – Local optimization mode – Additional stopping criteria – Number of objective function calculations for further details.

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RA D 7 1 7 6 1 7 | VA R I A N M E D I C A L S Y S T E M S 10/07 (100) .

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