Treatment planning appears to be one of the recurring themes at this year's AAPM, with BrainLAB of Germany among those highlighting the latest and greatest in radiotherapy planning software. On show at the company's booth were the latest releases of its iPlan packages: iPlan RT image, for contouring and target definition, and iPlan RT Dose, for treatment dose planning.
"From the imaging perspective, the version 4 software integrates a couple of new things: 4D CT integration and the head-and-neck Atlas," iPlan project manager David Brett told me.
The head-and-neck Atlas provides a nifty way to perform automatic segmentation of pre-treatment CT or MRI scans. The Atlas - a series of around 50 predefined anatomical objects - is fused onto the patient data set using elastic image fusion. And it's fast: iPlan takes less than a minute to find these 50 objects, after which the user can tweak the outlines manually, if required.
"There's a lack of consistency in contouring; studies of five doctors will give five different results," Brett said. "The benefit of Atlas-based segmentation is that within one minute you get a consistent outline. BrainLAB's software team works closely with clinical partners to get the ideal contours that fit the greatest percentage of patients".
On the dose planning side, BrainLAB's big announcement is the FDA clearance of its Monte Carlo dose calculation algorithm - an integral part of iPlan RT Dose version 4.
David Brett extols the benefits of BrainLAB's Monte Carlo dose engine
Brett explained that although Monte Carlo algorithms have been used before for treatment planning, clinical implementation tended to be limited by extreme calculation time requirements, or restrictions to planning for a single machine or treatment modality.
"Monte Carlo is considered the gold standard, especially for extra-cranial treatments, because it considers inhomogeneities," he said." With our Monte Carlo algorithm, we can create a complex IMRT case in less than five minutes."
Such a feat, which Brett claims would previously have taken 20 computers running over night to perform, was enabled by designing a Monte Carlo algorithm specifically for radiotherapy needs. What's more, BrainLAB's algorithm supports a multitude of treatment plans, including conformal beam, static and dynamic arc, and IMRT.
"We believe that the release of the BrainLAB Monte Carlo dose calculation algorithm will have a great impact on the field of radiosurgery," said Brett. "We continue to develop software that extends clinicians' treatment precision to cover more extra-cranial cancers, as well as advanced dose calculation possibilities for lung and head-and-neck tumours."