{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:11:26Z","timestamp":1778778686733,"version":"3.51.4"},"reference-count":13,"publisher":"IOP Publishing","issue":"9","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2023,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    Delineating and planning with respect to regions suspected to contain microscopic tumor cells is an inherently uncertain task in radiotherapy. The recently proposed\n                    <jats:italic>clinical target distribution<\/jats:italic>\n                    (CTD) is an alternative to the conventional\n                    <jats:italic>clinical target volume<\/jats:italic>\n                    (CTV), with initial promise. Previously, using the CTD in planning has primarily been evaluated in comparison to a conventionally defined CTV. We propose to compare the CTD approach against CTV margins of various sizes, dependent on the threshold at which the tumor infiltration probability is considered relevant.\n                    <jats:italic>Approach.<\/jats:italic>\n                    First, a theoretical framework is presented, concerned with optimizing the trade-off between the probability of sufficient target coverage and the penalties associated with high dose. From this framework we derive conventional CTV-based planning and contrast it with the CTD approach. The approaches are contextualized further by comparison with established methods for managing geometric uncertainties. Second, for both one- and three-dimensional phantoms, we compare a set of CTD plans created by varying the target objective function weight against a set of plans created by varying both the target weight and the CTV margin size.\n                    <jats:italic>Main results.<\/jats:italic>\n                    The results show that CTD-based planning gives slightly inefficient trade-offs between the evaluation criteria for a case in which near-minimum target dose is the highest priority. However, in a case when sparing a proximal organ at risk is critical, the CTD is better at maintaining sufficiently high dose toward the center of the target.\n                    <jats:italic>Significance.<\/jats:italic>\n                    We conclude that CTD-based planning is a computationally efficient method for planning with respect to delineation uncertainties, but that the inevitable effects on the dose distribution should not be disregarded.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/acc77b","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T18:34:16Z","timestamp":1679682856000},"page":"095005","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Implications of using the clinical target distribution as voxel-weights in radiation therapy optimization"],"prefix":"10.1088","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2365-3867","authenticated-orcid":true,"given":"Ivar","family":"Bengtsson","sequence":"first","affiliation":[{"name":"KTH Royal Institute of Technology"},{"name":"RaySearch Laboratories AB"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-7815","authenticated-orcid":false,"given":"Anders","family":"Forsgren","sequence":"additional","affiliation":[{"name":"KTH Royal Institute of Technology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albin","family":"Fredriksson","sequence":"additional","affiliation":[{"name":"RaySearch Laboratories AB"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"266","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"pmbacc77bbib1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.radonc.2005.09.005","type":"journal-article","article-title":"Robust treatment planning for intensity modulated radiotherapy of prostate cancer based on coverage probabilities","volume":"78","author":"Baum","year":"2006","journal-title":"Radiother. 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Published on behalf of Institute of Physics and Engineering in Medicine by IOP Publishing Ltd","name":"copyright_information","label":"Copyright Information"},{"value":"2022-10-14","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2023-03-24","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2023-04-17","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}