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The next step: more than one re-optimization,
dose accumulation, probabilistic planning
planning
CT
IMRT
plan
1 cm margin
around CTV
CT
…
Fx
5
Fx
1
…
Fx
6
Fx
N
…
CT
model motion of each voxel, this
enables calculation of average
‘expected’ dose-per-voxel
deformable registration,
dose warping,
dose accumulation
probabilistic
IMRT
plan
new plan
optimizes the expected
dose-per-voxel
one feedback loop
Birkner et al. 2003
(Med. Phys. 30(10))
versus
ESTRO IMRT course 2016
Adaptive Radiotherapy
London April 7th, 2016
-29-
planning
CT
IMRT
plan
1 cm margin
around CTV
CT
…
Fx
5
Fx
1
…
Fx
6
Fx
N
…
CT
prob.
IMRT
plan
CT
prob.
IMRT
plan
Fx
7
CT
prob.
IMRT
plan
…
continuous
adaptive feedback