{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:16:22Z","timestamp":1790640982310,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,7,27]],"date-time":"2018-07-27T00:00:00Z","timestamp":1532649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007210","name":"Varian Medical Systems","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2018,9]]},"abstract":"Purpose<\/jats:title>Although volumetric modulated arc therapy (VMAT<\/jats:styled-content>) is a well\u2010accepted treatment technique in radiotherapy using a coplanar delivery approach, VMAT<\/jats:styled-content> might be further improved by including dynamic table and collimator rotations leading to dynamic trajectory radiotherapy (DTRT<\/jats:styled-content>). In this work, an optimization procedure for DTRT<\/jats:styled-content> was developed and the potential benefit of DTRT<\/jats:styled-content> was investigated for different treatment sites.<\/jats:p><\/jats:sec>Methods<\/jats:title>For this purpose, a dedicated optimization framework for DTRT<\/jats:styled-content> was developed using the Eclipse Scripting Research Application Programming Interface (ESRAPI<\/jats:styled-content>). The contours of the target and organs at risk (OAR<\/jats:styled-content>s) structures were exported by applying the ESRAPI<\/jats:styled-content> and were used to determine the fractional volume\u2010overlap of the OAR<\/jats:styled-content>s with the target from several potential beam directions. Thereby, an additional weighting was applied taking into account the relative position of the OAR<\/jats:styled-content> with respect to the target and radiation beam, that is, penalizing directions where the OAR<\/jats:styled-content> is proximal to the target. The resulting two\u2010dimensional gantry\u2010table map was used as input for an A* path finding algorithm returning an optimized gantry\u2010table path. Thereby, the process is also taking into account CT<\/jats:styled-content> scan length and collision restrictions. The A* algorithm was used again to determine the dynamic collimator angle path by optimizing the area between the MLC<\/jats:styled-content> leaves and the target contour for each gantry\u2010table path leading to gantry\u2010collimator paths. The resulting gantry\u2010table and gantry\u2010collimator paths are combined and serve as input for the intensity modulation optimization using a research VMAT<\/jats:styled-content> optimizer and the ESRAPI<\/jats:styled-content> resulting in dynamic trajectories. This procedure was evaluated for five clinically motivated cases: two head and neck, one lung, one esophagus, and one prostate. Final dose calculations were performed using the Swiss Monte Carlo Plan (SMCP<\/jats:styled-content>). Resulting dose distributions for the DTRT<\/jats:styled-content> treatment plans and for the standard VMAT<\/jats:styled-content> plans were compared based on dose distributions and dose volume histogram (DVH<\/jats:styled-content>) parameters. For this comparison, the dose distribution for the VMAT<\/jats:styled-content> plans were recalculated using the SMCP<\/jats:styled-content>. In addition, the suitability of the delivery of a DTRT<\/jats:styled-content> treatment plan was demonstrated by means of gafchromic film measurements on a TrueBeam linear accelerator.<\/jats:p><\/jats:sec>Results<\/jats:title>DVH<\/jats:styled-content>s for the target volumes showed similar or improved coverage and dose homogeneity for DTRT<\/jats:styled-content> compared with VMAT<\/jats:styled-content> using equal or less number of dynamic trajectories for DTRT<\/jats:styled-content> than arcs for VMAT<\/jats:styled-content> for all cases studied. Depending on the case, improvements in mean and maximum dose for the DTRT<\/jats:styled-content> plans were achieved for almost all OAR<\/jats:styled-content>s compared with the VMAT<\/jats:styled-content> plans. Improvements in DTRT<\/jats:styled-content> treatment plans for mean and maximum dose compared to VMAT<\/jats:styled-content> plans were up to 16% and 38% relative to the prescribed dose, respectively. The measured and calculated dose values resulted in a passing rate of more than 99.5% for the two\u2010dimensional gamma analysis using 2% and 2\u00a0mm criteria and a threshold of 10%.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>DTRT<\/jats:styled-content> plans for different treatment sites were generated and compared with VMAT<\/jats:styled-content> plans. The delivery is suitable and dose comparisons demonstrate a high potential of DTRT<\/jats:styled-content> to reduce dose to OAR<\/jats:styled-content>s using less dynamic trajectories than arcs, while target coverage is preserved.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.13086","type":"journal-article","created":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T02:32:26Z","timestamp":1531276346000},"page":"4201-4212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Part 1: Optimization and evaluation of dynamic trajectory radiotherapy"],"prefix":"10.1002","volume":"45","author":[{"given":"Michael K.","family":"Fix","sequence":"first","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Frei","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Volken","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Terribilini","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvan","family":"Mueller","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olgun","family":"Elicin","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Hemmatazad","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Aebersold","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Manser","sequence":"additional","affiliation":[{"name":"Division of Medical Radiation Physics Department of Radiation Oncology Inselspital, Bern University Hospital University of Bern CH\u20103010 Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/40\/9\/004"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597345"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2818738"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.12.033"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.09.043"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2013.02.002"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.09.028"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-014-0239-x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4917165"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.04.034"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2013.10.031"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.03.004"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2006.09.004"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/60\/13\/5179"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/58\/22\/8163"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.07.014"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4914863"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(88)90059-4"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v14i1.4035"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.08.056"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12648"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.10.016"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12270"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/52\/19\/N01"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/53\/19\/N01"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2010.10.010"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(15)30382-0"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zemedi.2018.03.002"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1109\/TSSC.1968.300136"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2000.898024"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmp.13086","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.13086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T09:25:09Z","timestamp":1695029109000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.13086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,27]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1002\/mp.13086"],"URL":"https:\/\/doi.org\/10.1002\/mp.13086","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,27]]},"assertion":[{"value":"2018-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}