Development and Clinical Implementation of Applications for Guiding Linac-Based Stereotactic Radiosurgery Planning

Mann, Thomas David

Development and Clinical Implementation of Applications for Guiding Linac-Based Stereotactic Radiosurgery Planning

dc.contributor.advisor	Thind, Kundan S.
dc.contributor.advisor	Moazzen-Ahmadi, Nasser
dc.contributor.author	Mann, Thomas David
dc.contributor.committeemember	Ploquin, Nicolas P.
dc.contributor.committeemember	Pierce, Greg David
dc.contributor.committeemember	Loewen, Shaun
dc.date	2023-11
dc.date.accessioned	2023-08-18T19:55:25Z
dc.date.available	2023-08-18T19:55:25Z
dc.date.issued	2023-08
dc.description.abstract	Stereotactic Radiosurgery (SRS) is a well-established treatment technique for brain lesions that uses a high dose of radiation delivered in a single fraction. Studies have shown improved cognitive outcomes with SRS for the treatment of brain metastases compared to whole brain radiation therapy. While effective, SRS planning is a complex and time-consuming process due to non-coplanar beam angles, multiple metastases, and proximity to organs-at-risk within the brain. Scripting can be used to automate complex planning processes and analyze patient data through a treatment planning system application programming interface. Applications developed using scripting can help inform planner decision-making and improve clinical efficiency. This thesis investigates the design and clinical implementation of two scripting applications developed to assist SRS planning at the Tom Baker Cancer Centre. The use of non-coplanar beam angles in SRS increases the risk of collision between the linac gantry and the patient or treatment table. We developed the Clearance Check application to predict possible collisions in radiation treatment plans using patient CT body contours and accurate models of the gantry and immobilization. The collision prediction algorithm uses oriented bounding boxes and binary tree hierarchies to improve algorithm efficiency. Algorithm accuracy was assessed using a calibration phantom and several simulated treatment positions. Initial results from clinical implementation are reported and a follow-up summary after five years of use is also included. Collision prediction, beam angle optimization and automated plan creation were combined to create the Stereotactic Optimized Automated Radiotherapy (SOAR) application. SOAR planning was compared to manual SRS planning and found to achieve similar plan quality with a significant increase in plan creation efficiency. SOAR was then benchmarked against the commercial SRS planning solution HyperArc. SOAR showed improved target conformity, better organ-at-risk sparing, and lower plan complexity. The SOAR application provides greater versatility in SRS planning, straightforward integration with the treatment planning system, and is not restricted to a specific immobilization device. Initial improvements in SRS planning efficiency using SOAR are reported. Overall, this thesis presents novel applications of scripting to improve the SRS planning process, enhancing clinical efficiency while maintaining plan quality.
dc.identifier.citation	Mann, T. D. (2023). Development and clinical implementation of applications for guiding linac-based Stereotactic Radiosurgery planning (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.uri	https://hdl.handle.net/1880/116868
dc.identifier.uri	https://dx.doi.org/10.11575/PRISM/41710
dc.language.iso	en
dc.publisher.faculty	Graduate Studies
dc.publisher.institution	University of Calgary
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subject	Collision Prediction
dc.subject	Beam Angle Optimization
dc.subject	Stereotactic Radiosurgery
dc.subject	Eclipse Scripting API
dc.subject	Treatment Planning
dc.subject	Radiation Therapy
dc.subject.classification	Physics--Radiation
dc.title	Development and Clinical Implementation of Applications for Guiding Linac-Based Stereotactic Radiosurgery Planning
dc.type	doctoral thesis
thesis.degree.discipline	Physics & Astronomy
thesis.degree.grantor	University of Calgary
thesis.degree.name	Doctor of Philosophy (PhD)
ucalgary.thesis.accesssetbystudent	I require a thesis withhold – I need to delay the release of my thesis due to a patent application, and other reasons outlined in the link above. I have/will need to submit a thesis withhold application.