Inverse planning in brachytherapy from radium to high dose rate192iridium afterloading

Lahanas, M; Karouzakis, K; Giannouli, S; Mould, RF; Baltas, D

dc.contributor.author	Lahanas, M	en
dc.contributor.author	Karouzakis, K	en
dc.contributor.author	Giannouli, S	en
dc.contributor.author	Mould, RF	en
dc.contributor.author	Baltas, D	en
dc.date.accessioned	2014-03-01T11:45:51Z
dc.date.available	2014-03-01T11:45:51Z
dc.date.issued	2004	en
dc.identifier.issn	0029540X	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/37660
dc.relation.uri	http://www.scopus.com/inward/record.url?eid=2-s2.0-2942597562&partnerID=40&md5=1e2b4345cffe426ce7376dbb52f5cf2a	en
dc.subject	Brachytherapy	en
dc.subject	Inverse planning	en
dc.subject.other	iridium 192	en
dc.subject.other	radium	en
dc.subject.other	algorithm	en
dc.subject.other	brachytherapy	en
dc.subject.other	computer assisted radiotherapy	en
dc.subject.other	human	en
dc.subject.other	radiation dose	en
dc.subject.other	radiobiology	en
dc.subject.other	review	en
dc.subject.other	three dimensional imaging	en
dc.subject.other	treatment planning	en
dc.title	Inverse planning in brachytherapy from radium to high dose rate192iridium afterloading	en
heal.type	other	en
heal.publicationDate	2004	en
heal.abstract	We consider the inverse planning problem in brachytherapy, i.e. the problem to determine an optimal number of catheters, number of sources for low-dose rate brachytherapy (LDR) and the optimal dwell times for high-dose rate brachytherapy (HDR) necessary to obtain an optimal as possible dose distribution. Starting from the 1930s, inverse planning for LDR brachytherapy used geometrically derived rules to determine the optimal placement of sources in order to achieve a uniform dose distribution of a specific level in planes, spheres and cylinders. Rules and nomograms were derived which still are widely used. With the rapid development of 3D imaging technologies and the rapidly increasing computer power we have now entered the new era of computer-based inverse planning in brachytherapy. The inverse planning is now an optimisation process adapted to the individual geometry of the patient. New inverse planning optimisation algorithms are anatomy-based that consider the real anatomy of the tumour and the organs at risk (OAR). Computer-based inverse planning considers various effects such as stability of solutions for seed misplacements which cannot ever be solved analytically without gross simplifications. In the last few years multiobjective (MO) inverse planning algorithms have been developed which recognise the MO optimisation problem which is inherent in inverse planning in brachytherapy. Previous methods used a trial and error method to obtain a satisfactory solution. MO optimisation replaces this trial and error process by presenting a representative set of dose distributions that can be obtained. With MO optimisation it is possible to obtain information that can be used to obtain the optimum number of catheters, their position and the optimum distribution of dwell times for HDR brachytherapy. For LDR brachytherapy also the stability of solutions due to seed migration can also be improved. A spectrum of alternative solutions is available and the treatment planner can select the solution that best satisfies the clinical constraints. The inverse planning now can be extended to include characteristics of the radioactive sources that can be used for further improving the dose distributions that can be obtained leading to a generalized inverse planning. The computer-based inverse planning provides solutions that protect the OARs and the normal tissue better than by empirical methods. We present computer-based inverse planning algorithms used for LDR brachytherapy and currently also for HDR brachytherapy.	en
heal.journalName	Nowotwory	en
dc.identifier.volume	54	en
dc.identifier.issue	3	en
dc.identifier.spage	195	en
dc.identifier.epage	218	en