Dose-volume histogram evaluation scheme for beam orientations in intensity-modulated radiation therapy

Beam orientations in intensity-modulated radiation therapy (IMRT) is an important, but difficult NP-hard optimization problem. A considerable part of this difficulty is due to the essential prerequisite of defining, appropriately, counter-intuitive criteria for a mathematical plan evaluation that coincides with the clinical judgment of the considered plan. Moreover, the quality of beam directions depends heavily on their intensities. Usually a stochastic selector is utilized for optimizing beam orientations, and the intensities are thus calculated many thousands of times, each time for a different selection of beam directions, resulting in excessive time complexity. Therefore, selecting an appropriate set of beam directions in IMRT is still a time-consuming manual trial-and-error search procedure that depends on intuition and empirical knowledge. To overcome these difficulties, this work utilizes the concept of dose-volume histogram (DVH), which is one of the main recognized quantitative measurement tools used for plan judgment, and presents a DVH evaluation scheme that parallelizes plan evaluation with clinical plan judgment. This scheme is then utilized to optimize the intensities of each individual beam, enabling it to be represented by its DVHs, produced for the different irradiated volumes. Finally, an evolutionary algorithm is employed to search for the best combination of those DVHs reflecting the clinical optimal. The presented methods have been applied to three real clinical examples. In comparison to the standard equally spaced beam plans, improvements were reported in all three cases. In comparison with the greedy algorithm, improvements were reported in those examples requiring more than five beam directions.