planning:userguide:tutorials:finding_optimal_plan
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planning:userguide:tutorials:finding_optimal_plan [2017/02/28 22:38] – [Running the Optimizer] kerhart | planning:userguide:tutorials:finding_optimal_plan [2021/07/29 18:28] (current) – external edit 127.0.0.1 | ||
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- | ====== Astroid Optimization ====== | + | ====== Astroid Optimization |
- | With intensity modulated treatment plans the variety of possible dose distributions is quite large. Typically if a physician does not like a plan they will request it to be re-run. This requires the planner to input new constraints and objectives and a new plan to be run from the beginning of the optimization process. This is a time consuming process. Astroid eliminates this cycle using a Multi-Criteria Optimization (MCO) approach that allows planners and physicians to visualize the trade-offs of target volume coverage vs reduced dose to the OAR's in real time. MCO treatment planning is based on a set of Pareto optimized plans, where a plan is considered Pareto optimal if it satisfies all the constraints and none of the objectives can be improved without worsening at least one of the other objectives. So instead of creating just one plan, Astroid creates a set of optimal plans that satisfies the treatment plan constraints and puts an interactive exploration of the objectives at the planners and physicians fingertips via a unique, highly intuitive, solution navigation slider bar system. | + | With intensity modulated |
// | // | ||
+ | | ||
+ | ===== Optimizer Algorithm Selection ===== | ||
+ | |||
+ | The user is able to select the MCO optimization algorithm from a list defined in the site configuration settings. The default option is the first algorithm in this site level list of pluggable_functions designated with the mco_optimizer key. | ||
+ | |||
+ | As of Planning 2.3.2 the available optimizers are Art3+O and Nymph. Both optimizers use the same constraints and objectives. However Nymph does not use a separate feasibility stage and has it built in to the optimization step. | ||
+ | |||
+ | {{ : | ||
+ | |||
+ | ===== PBS Fraction Groups ===== | ||
+ | |||
+ | {{page> | ||
+ | |||
+ | ===== Optimization Constraints ===== | ||
+ | |||
+ | ==== About Constraints ==== | ||
+ | |||
+ | // | ||
+ | |||
+ | It should be noted that all constraints are considered "hard limits" | ||
+ | |||
+ | The following constraint types are available. Note certain constraints are available only for //Target// type structures. | ||
+ | * **Min**: The minimum dose the structure must receive | ||
+ | * **Max**: The maximum dose the structure may receive | ||
+ | * **Min Mean**: The minimum mean dose a structure must receive | ||
+ | * This will drive the dose up across the structure | ||
+ | * **Max Mean**: The maximum mean dose a structure may receive | ||
+ | * This will limit the mean dose across the structure | ||
+ | * **Overdose**: | ||
+ | * This will limit the total volume-weighted overdose (dose above a given threshold) that a structure receives, driving down hot spots | ||
+ | * **Underdose**: | ||
+ | * This will limit the total volume weighted underdose (dose below a given threshold) that a structures, driving up cold spots | ||
+ | * **Hot Spot Vol**: The maximum mean dose to the hottest portion of a structure (//not available for ART3+O optimizer// | ||
+ | * This will keep the mean dose to the hottest portion of a structure below the given limit; portion is set as a % vol and the limit is the max mean dose allowed to that portion of the structure | ||
+ | * **Cold Spot Vol**: The minimum mean dose to the coldest portion of a structure (//not available for ART3+O optimizer// | ||
+ | * This will keep the mean dose to the coldest portion of a structure above the given limit; portion is set as a % vol and the limit is the min mean allowed to that portion of the structure | ||
+ | |||
+ | The user can choose to apply one or multiple of these constraints to any number of structures. | ||
+ | |||
+ | ==== Working with Constraints ==== | ||
+ | |||
+ | === Working with Fraction Group and Target/Beam Set Constraints === | ||
+ | |||
+ | |||
+ | // | ||
+ | |||
+ | - Select the //Fraction Group// if it has been created or create a new one by clicking //Create New Fraction Group// | ||
+ | - Choose the prescription, | ||
+ | - Choose the type of treatment (SFO, IMPT, Advanced) and target {{ : | ||
+ | - Choose the //Beams// to be treated | ||
+ | - Choose the //Target// to be treated | ||
+ | - Assign the dose constraints to the //Target// | ||
+ | - The assigned constraint doses at this level will be divided evenly among the //Beams// to the //Target//, which allows for quick creation of SFO treatments {{ : | ||
+ | |||
+ | |||
+ | |||
+ | === Working with Plan Constraints === | ||
+ | // | ||
+ | - Open the // | ||
+ | - Choose from the drop down the structure or structures to which constraints should be added | ||
+ | - Define what constraint(s) should be applied to each structure by choosing the constraint and entering the dose | ||
+ | - Follow this and enter the constraints for all applicable structures. {{ : | ||
+ | - When finished click the //OK// button. | ||
+ | - Once all the Constraints have been set the user can either start the Feasibility by choosing // | ||
| | ||
===== Feasibility and Constraints ===== | ===== Feasibility and Constraints ===== | ||
- | After the // | + | After the // |
The user also needs to be aware of the impact of // | The user also needs to be aware of the impact of // | ||
+ | ===== Optimization Objectives ===== | ||
+ | // | ||
+ | The following objective selections are available in Astroid: | ||
+ | * **min_max**: | ||
+ | * **max_min**: | ||
+ | <WRAP 1000px center>< | ||
+ | * **min_mean**: | ||
+ | * **max_mean**: | ||
+ | * **min_overdose**: | ||
+ | * Dose will be driven down only until the specified limit is reached (this is often more relevant that min_max, since it may not be beneficial to continue minimizing beyond a certain dose level) | ||
+ | * **min_underdose**: | ||
+ | * Dose will be driven up only until the specified limit is reached (this is often more relevant that max_min, since it may not be beneficial to continue maximizing beyond a certain dose level) | ||
+ | <WRAP 920px center>< | ||
+ | * **min_hot_spot**: | ||
+ | * The mean dose to the hottest portion of a structure will be driven down (i.e. the tail dose on the DVH); portion is set as a % vol of the structure | ||
+ | * **min_cold_spot**: | ||
+ | * The mean dose to the coldest portion of a structure will be driven up (i.e. the shoulder dose on the DVH); portion is set as a % vol of the structure | ||
+ | |||
+ | ==== Working with Objectives ==== | ||
+ | - Open the // | ||
+ | - Choose a structure to which you wish to apply objectives | ||
+ | - Check the boxes to activate the desired objectives for the structure and then set the dose level if applicable | ||
+ | <WRAP center> | ||
+ | |||
+ | Once all the // | ||
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===== Dose Normalization and Display ===== | ===== Dose Normalization and Display ===== | ||
- | The user has many options for how the dose is displayed. The options for controlling the display of the dose are on the right hand side of the display under //Dose Options//. The //Dose Options// provide controls over the DVH type (relative or absolute volume), the colors and scaling of the display dose, and the type of dose display shown (colorwash, isolines, or isobands). | + | The user has many options for how the dose is displayed |
==== Dose Volume Histogram (DVH) ==== | ==== Dose Volume Histogram (DVH) ==== | ||
- | The planner has the option of viewing the dose for the DVH in relative volume (dose per percentage of the volume) or in absolute volume (dose per cc of the structure) using the //Absolute DVH// option. The user may also hover over any area of the DVH curve to obtain the dose and percentage of a given structure or click on a line to obtain | + | === Relative and Absolute DVH === |
+ | |||
+ | The planner has the option of viewing the dose for the DVH in relative volume (dose per percentage of the volume) or in absolute volume (dose per cc of the structure) using the //Absolute DVH// option. The user may also hover over any area of the DVH curve to obtain the dose and percentage of a given structure or click on one or more lines to start tracking the cursor value for the lines. | ||
<WRAP center box> | <WRAP center box> | ||
- | {{: | + | {{: |
+ | === Dual Dose DVH === | ||
+ | The planner has the option of viewing the original MCO dose and the currently navigated MCO dose in the DVH graph. By selecting the //Show Secondary Doses// option under the Dose Options, the DVH graph will display the following doses: | ||
+ | * **Dotted Line:** Original un-navigated dose. | ||
+ | * **Solid Line:** Current navigated dose based on the position of the MCO sliders. | ||
+ | |||
+ | With the //Show Secondary Doses// option disabled, only the current navigated dose will be displayed within the DVH graph. | ||
+ | |||
+ | {{ : | ||
==== Dose Display Normalization ==== | ==== Dose Display Normalization ==== | ||
As in the DVH the user has multiple options for displaying the dose. The user may change the percentage isodose line and its corresponding Gy they would like displayed. This is done by entering the appropriate numbers in the boxes under //Levels//. The user may turn on and off specific levels by clicking on the //X// to the left of the line. | As in the DVH the user has multiple options for displaying the dose. The user may change the percentage isodose line and its corresponding Gy they would like displayed. This is done by entering the appropriate numbers in the boxes under //Levels//. The user may turn on and off specific levels by clicking on the //X// to the left of the line. | ||
- | The user also can choose to view the isodose | + | The user also can choose to view the dose as either isobands, isolines, color wash or combinations of these. The user may use the sliders to set the opacity for each of these as well. They may choose the line width and whether it is solid, dashed or dotted for isolines. |
+ | {{ : | ||
- | {{ : | + | In the case of a plan with multiple //Fraction Groups// the user may choose to view the dose: |
+ | - In a composite dose- //Full Plan//- which will take into account all //Fractions groups// | ||
+ | - For a particular //Fraction Group// or | ||
+ | - For an individual beam | ||
+ | To pick one of the above the user must choose from the dropdown list under //Scope//. The //Scope// automatically defaults to //Full Plan// | ||
- | Note: When in a sliced image display containing dose, slice scrolling will be based on the smallest voxel size of the calculation grid. For any sliced image displays that do not show dose scrolling positions will be based on the CT image slices | + | Note: When in a sliced image display containing dose, slice scrolling |
- | === Isobands === | + | ==== Isobands |
Isobands are an interpolation of dose from isodose line to isodose line. Isobands take a range of interpolated dose and fills it in with color. | Isobands are an interpolation of dose from isodose line to isodose line. Isobands take a range of interpolated dose and fills it in with color. | ||
{{ : | {{ : | ||
- | === Isoline === | + | ==== Isoline |
- | Isoline | + | Isolines |
{{ : | {{ : | ||
- | === Color Wash === | + | ==== Color Wash ==== |
- | Color Wash demonstrates | + | Color Wash shows the raw dose across |
{{ : | {{ : | ||
- | === Combination === | + | ==== Combination |
- | The user does have the ability to combine multiple representations. Below shows a combination of Isobands and Isolines | + | The user does have the ability to combine multiple representations. Below shows a combination of Isobands and Isolines. |
{{ : | {{ : | ||
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Once the plan has been calculated the // | Once the plan has been calculated the // | ||
- | The Navigation Sliders should provide an intuitive process for finding the optimal plan, but by gaining a complete understanding of the Navigation Sliders users will be better equipped to quickly reach their plan goals. On each slider there are two vertical bars. The thick white bar is the user controlled slider handle and it represents the worst value of an objective that the user wants to allow (note sliders for minimize objectives will slide to the left and sliders for maximize objectives will slide to the right). Simply stated, the objective will not go past this limit. The thin blue bar denotes the actual current value of the objective. Astroid calculates this value by balancing the solution over the available ranges of each objective. It should now be clear that moving a slider does **not** directly set an objective, but rather it places limits on the allowable range of an objective. It is this feature that makes navigating the solution space very clear and effective. | + | The Navigation Sliders should provide an intuitive process for finding the optimal plan, but by gaining a complete understanding of the Navigation Sliders users will be better equipped to quickly reach their plan goals. It should also be noted that sliders for minimize objectives will slide to the left and sliders for maximize objectives will slide to the right. On each slider there are two vertical bars. The thick white bar is the user controlled slider handle and it represents the worst value of an objective that the user wants to allow. Simply stated, the objective will not go past this limit. The thin blue bar denotes the actual current value of the objective. Astroid calculates this value by balancing the solution over the available ranges of each objective. It should now be clear that moving a slider does **not** directly set an objective, but rather it places limits on the allowable range of an objective. It is this feature that makes navigating the solution space very clear and effective. |
{{ : | {{ : | ||
- | The blue and white numbers to the upper right of each slider correlate to the objective value for the current plan and the objective limit based on the slider position, respectively. The numbers at the end of each slider bar denote the overall range for the objective value (i.e worst and best possible values). The main slider horizontal bar is also separated into two sections. The thicker, lighter grey horizontal bar is the range or window that the objective is currently limited to stay within (it is limited due to the positioning of the other sliders by the user). The user will notice as they drag the slider handle (white bar) on one objective, this light grey area will change on some of the other sliders. This allows the user to know the limits they have to work in and the impacts (trade-offs) that one objective is having on the others. | + | The blue and white numbers to the upper right of each slider correlate to the objective value for the current plan and the objective limit based on the slider position, respectively. So in the image above, it can be seen that the top slider has been set such that allowable maximum dose to the CTVbreast_L is 10.46 Gy(RBE), but the current value is 10.33 Gy(RBE). The numbers at the end of each slider bar denote the overall range for the objective value (i.e worst and best possible values). The main slider horizontal bar is also separated into two sections. The thicker, lighter grey horizontal bar is the range or window that the objective is currently limited to stay within (it is limited due to the positioning of all sliders by the user). The user will notice as they drag the slider handle (white bar) on one objective, this light grey area will change on some of the other sliders. This allows the user to know the limits they have to work in and the impacts (trade-offs) that one objective is having on the others. Sliders should be adjusted such that all physician goals are achieved and the best balance of target coverage and normal tissue doses are realized for the unique patient at hand. |
- | FIXME Add some details of how to adjust and why (need to discuss with MGH??) | ||
All of these adjustments are able to be done without running a new plan as would needed to be done in traditional treatment planning systems. This allows the user to look at many different solutions in a short amount of time. | All of these adjustments are able to be done without running a new plan as would needed to be done in traditional treatment planning systems. This allows the user to look at many different solutions in a short amount of time. | ||
- | If the user does not like the adjustments | + | If the user likes the adjustments |
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planning/userguide/tutorials/finding_optimal_plan.1488321507.txt.gz · Last modified: 2021/07/29 18:24 (external edit)