Session Item

The current state-of-the-art multicriteria optimization (MCO) algorithms promise significantly better brachytherapy dosimetric treatment plans for complex multi-catheter configurations relative to either manual planning or commercially available inverse planning [1]. They do so by providing the end-users with hundreds if not thousands of Pareto optimal plans, exploring various compromises between all of the clinical objectives in seconds. This approach is highly efficient timewise and allows the brachytherapy team to concentrate on selecting the plan(s) that meet all the required quantitative (dose metrics) and more qualitative (isodose shapes, …) planning objectives of the treating physician.  

In this talk, we will review the strategies for plan optimization and extracting the Pareto front as implemented in brachytherapy. The change in planning paradigm that is enabled by MCO will be explored. Various implementation of MCO will be discussed and multi-catheter prostate HDR brachytherapy will served as a test case. Since a very large number of plans are generated, options pertaining to plan navigation and plan selection will be touch upon.

A sneak peek into the latest application of this approach to more complex cases such a GYN interstitial brachytherapy with applicators offering numerous combinatorial options (namely parallel applicator needles, angulated applicator needles and template interstitial needles in addition to the standard applicator channels) will illustrate how the MCO approach could be integrated in the clinical setting as a fast pre-planning or inter-fraction planning tool.

[1] Beaulieu L, Al-Hallaq H, Rosen BS, Carlson DJ. Multicriteria Optimization in Brachytherapy. Int J Radiat Oncol Biology Phys. 2022;114(2):177-180.