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@ARTICLE{Wahl:130810,
      author       = {N. Wahl$^*$ and M. Bangert$^*$ and C. P. Kamerling$^*$ and
                      P. Ziegenhein$^*$ and G. H. Bol and B. W. Raaymakers and U.
                      Oelfke$^*$},
      title        = {{P}hysically constrained voxel-based penalty adaptation for
                      ultra-fast {IMRT} planning.},
      journal      = {Journal of applied clinical medical physics},
      volume       = {17},
      number       = {4},
      issn         = {1526-9914},
      address      = {Reston, Va.},
      publisher    = {ACMP},
      reportid     = {DKFZ-2017-05888},
      pages        = {172 - 189},
      year         = {2016},
      abstract     = {Conventional treatment planning in intensity-modulated
                      radiation therapy (IMRT) is a trial-and-error process that
                      usually involves tedious tweaking of optimization
                      parameters. Here, we present an algorithm that automates
                      part of this process, in particular the adaptation of
                      voxel-based penalties within normal tissue. Thereby, the
                      proposed algorithm explicitly considers a priori known
                      physical limitations of photon irradiation. The efficacy of
                      the developed algorithm is assessed during treatment
                      planning studies comprising 16 prostate and 5 head and neck
                      cases. We study the eradication of hot spots in the normal
                      tissue, effects on target coverage and target conformity, as
                      well as selected dose volume points for organs at risk. The
                      potential of the proposed method to generate class solutions
                      for the two indications is investigated. Run-times of the
                      algorithms are reported. Physically constrained voxel-based
                      penalty adaptation is an adequate means to automatically
                      detect and eradicate hot-spots during IMRT planning while
                      maintaining target coverage and conformity. Negative effects
                      on organs at risk are comparably small and restricted to
                      lower doses. Using physically constrained voxel-based
                      penalty adaptation, it was possible to improve the
                      generation of class solutions for both indications.
                      Considering the reported run-times of less than 20 s,
                      physically constrained voxel-based penalty adaptation has
                      the potential to reduce the clinical workload during
                      planning and automated treatment plan generation in the long
                      run, facilitating adaptive radiation treatments.},
      cin          = {E040},
      ddc          = {530},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27455484},
      doi          = {10.1120/jacmp.v17i4.6117},
      url          = {https://inrepo02.dkfz.de/record/130810},
}