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Purpose: Respiratory motion and the interplay effect cause the dose delivered to a patient with spot-scanned proton therapy to differ from the dose planned for during optimization. A new 4D robust optimization methodology was developed…

Purpose: Pencil beam scanning proton therapy is sensitive to respiratory motion, leading to potential dose inhomogeneities due to interplay effects. We developed and validated a predictive framework to assess interplay and motion robustness…

Robust optimization is a commonly employed method to mitigate uncertainties in the planning of intensity-modulated proton therapy (IMPT). In certain contexts, the large number of uncertainty scenarios makes the robust problem impractically…

Medical Physics · Physics 2025-04-22 Ivar Bengtsson

Robust treatment planning algorithms for Intensity Modulated Proton Therapy (IMPT) and Intensity Modulated Radiation Therapy (IMRT) allow for uncertainty reduction in the delivered dose distributions through explicit inclusion of error…

Medical Physics · Physics 2025-10-15 Remo Cristoforetti , Jennifer Josephine Hardt , Niklas Wahl

Objective: Intensity-modulated radiation therapy (IMRT) beam angle optimization (BAO) is a challenging combinatorial optimization problem that is NP-hard. In this study, we aim to develop a personalized BAO algorithm for IMRT that improves…

Medical Physics · Physics 2023-03-08 Peng Bao , Gong Wang , Ruijie Yang , Bin Dong

When treating moving tumors, the precise delivery of proton therapy by pencil beam scanning (PBS) is challenged by the interplay effect. Although several 4D-optimization methods have been proposed, what is the most beneficial motion…

Medical Physics · Physics 2025-01-29 Ivar Bengtsson , Anders Forsgren , Albin Fredriksson

Intensity-modulated proton therapy (IMPT) offers superior dose conformity with reduced exposure to surrounding healthy tissues compared to conventional photon therapy. Improving IMPT delivery efficiency reduces motion-related uncertainties,…

Medical Physics · Physics 2025-04-15 Ya-Nan Zhu , Nimita Shinde , Bowen Lin , Hao Gao

Distributionally robust optimization (DRO) is an effective framework for controlling real-world systems with various uncertainties, typically modeled using distributional uncertainty balls. However, DRO problems often involve infinitely…

Optimization and Control · Mathematics 2025-10-22 Yuma Shida , Yuji Ito

Purpose: Patient-specific ridge filters can modulate proton energy to obtain a conformal dose. We describe a new framework for optimization of filter design and spot maps to meet the unique demands of FLASH radiotherapy. We demonstrate an…

Stochastic and (distributionally) robust optimization problems often become computationally challenging as the number of scenarios or data points increases. Scenario reduction is therefore a key technique for improving tractability. We…

Optimization and Control · Mathematics 2026-03-10 Kevin-Martin Aigner , Sebastian Denzler , Frauke Liers , Sebastian Pokutta , Kartikey Sharma

Intensity-modulated radiation therapy (IMRT) allows for the design of customized, highly-conformal treatments for cancer patients. Creating IMRT treatment plans, however, is a mathematically complex process, which is often tackled in…

Optimization and Control · Mathematics 2022-03-18 Danielle A. Ripsman , Thomas G. Purdie , Timothy C. Y. Chan , Houra Mahmoudzadeh

Background: Intensity-modulated proton therapy (IMPT) using pencil beam technique scans tumor in a layer by layer, then spot by spot manner. It can provide highly conformal dose to tumor targets and spare nearby organs-at-risk (OAR). Fast…

Medical Physics · Physics 2024-11-28 Aoxiang Wang , Ya-Nan Zhu , Jufri Setianegara , Yuting Lin , Peng Xiao , Qingguo Xie , Hao Gao

We present a method to include robustness into a multi-criteria optimization (MCO) framework for intensity-modulated proton therapy (IMPT). The approach allows one to simultaneously explore the trade-off between different objectives as well…

Medical Physics · Physics 2015-06-03 Wei Chen , Jan Unkelbach , Alexei Trofimov , Thomas Madden , Hanne Kooy , Thomas Bortfeld , David Craft

Carbon-ion radiotherapy provides high dose conformity for lung cancer, but its benefit is limited by two sources of uncertainties: interplay between scanned beam delivery and tumor motion, and dose modulation from heterogeneous lung tissue.…

Medical Physics · Physics 2026-02-18 Maria Chiara Martire , Lennart Volz , Marco Durante , Christian Graeff

High dose-rate brachytherapy (HDRBT) is widely used for gynecological cancer treatment. Although commercial treatment planning systems (TPSs) have inverse optimization modules, it takes several iterations to adjust planning objectives to…

Medical Physics · Physics 2021-09-14 Huan Liu , Chang M Ma , Xun Jia , Chenyang Shen , Peter Klages , Kevin Albuquerque

Purpose: The presence of respiratory motion during radiation treatment leads to degradation of the expected dose distribution, both for target coverage and healthy-tissue sparing, particularly for techniques like pencil-beam scanning proton…

The interplay between the beam delivery time structure and the patient motion makes 4D dose calculation (4DDC) important when treating moving tumors with intensity modulated proton therapy. 4DDC based on phase sorting of a 4DCT suffers from…

Medical Physics · Physics 2023-10-13 Ivar Bengtsson , Erik Engwall , Albin Fredriksson , Lars Glimelius

Treatment planning uncertainties are typically managed using margin-based or robust optimization. Margin-based methods expand the clinical target volume (CTV) to a planning target volume, generally unsuited for proton therapy. Robust…

Distributionally Robust Optimization (DRO), which aims to find an optimal decision that minimizes the worst case cost over the ambiguity set of probability distribution, has been widely applied in diverse applications, e.g., network…

Machine Learning · Computer Science 2022-12-20 Yang Jiao , Kai Yang , Dongjin Song

A central problem in the field of radiation therapy (RT) is how to optimally deliver dose to a patient in a way that fully accounts for anatomical position changes over time. As current RT is a static process, where beam intensities are…

Medical Physics · Physics 2019-09-04 Rodney D. Wiersma , Xinmin Liu
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