{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:18:42Z","timestamp":1761110322070},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,4,16]],"date-time":"2010-04-16T00:00:00Z","timestamp":1271376000000},"content-version":"vor","delay-in-days":46,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:p>Commercially available intensity\u2010modulated radiation therapy (IMRT) inverse treatment planning systems (ITPS) typically include a smoothing function which allows the user to vary the complexity of delivered beam fluence patterns. This study evaluated the behavior of three ITPSs when varying smoothing parameters. We evaluated four cases treated with IMRT in our clinic: sinonasal carcinoma (SNC), glioblastoma multiforme (GBM), base of tongue carcinoma (BOT), and prostate carcinoma (PST). Varian Eclipse v6.5, BrainLAB BrainScan v5.31, and Nomos Corvus v6.2 ITPSs were studied for the SNC, GBM, and PST sites. Only Eclipse and Corvus were studied for BOT due to field size constraints of the BrainLAB MM3 collimator. For each ITPS, plans were first optimized using vendor\u2010recommended default \u201csmoothing\u201d values. Treatment plans were then reoptimized, exploring various smoothing values. Key metrics recorded included a delivery complexity (DC) metric and the Ian Paddick Conformality Index (IPCI). Results varied widely by vendor with regard to the impact of smoothing on complexity and conformality. Plans run on the Corvus ITPS showed the logically anticipated increase in DC as smoothing was decreased, along with associated improved organ\u2010at\u2010risk (OAR) sparing. Both Eclipse and BrainScan experienced an expected trend for increased DC as smoothing was decreased. However, this increase did not typically result in appreciably improved OAR sparing. For Eclipse and Corvus, and to a much lesser extent BrainScan, increases in smoothing decreased DC but eventually caused unacceptable losses in plan conformality. Depending on the ITPS, potential benefits from optimizing fluence smoothing levels can be significant, allowing for increases in either efficiency or conformality. Because of variability in smoothing function behavior by ITPS, it is important that users familiarize themselves with the effects of varying smoothing parameters for their respective ITPS. Based on the experience gained here, we provide recommended workflows for each ITPS to best exploit the fluence\u2010smoothing features of the system.<\/jats:p><jats:p>PACS numbers: 87.56.bd, 87.56.N\u2010<\/jats:p>","DOI":"10.1120\/jacmp.v11i2.3035","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T22:13:16Z","timestamp":1488233596000},"page":"33-61","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of fluence\u2010smoothing feature for three IMRT planning systems"],"prefix":"10.1002","volume":"11","author":[{"given":"Christopher J.","family":"Anker","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Tobler","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Chapek","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis C.","family":"Shrieve","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying J.","family":"Hitchcock","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bill J.","family":"Salter","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology. Huntsman Cancer Hospital University of Utah  Salt Lake City UT USA 84112"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,4,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1895545"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1477415"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2006.04.010"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/47\/10\/303"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/43\/10\/008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1713279"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/45\/5\/403"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.11.034"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2409749"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2889703"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1406522"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(03)00165-8"},{"key":"e_1_2_7_14_1","volume-title":"Reference Guide for Eclipse Algorithms; Vision Eclipse \u2013 External Beam Planning v6.5","author":"Varian Medical Systems. 1","year":"2004"},{"key":"e_1_2_7_15_1","first-page":"179","volume-title":"Software Guide Rev 1.1: BrainScan Ver 5.31","year":"2005"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597961"},{"key":"e_1_2_7_17_1","unstructured":"RomesbergM aCORVUS Computational Physicist [E\u2010mail]; February 2009."},{"key":"e_1_2_7_18_1","unstructured":"RomesbergM BartelsJ.Controlling the tradeoff between delivery efficiency and dosimetric fitness in IMRT.Presented at the 44thAnnual Meeting of the American Association of Physicists in Medicine Montreal Canada 14\u201318 July2002."},{"key":"e_1_2_7_19_1","volume-title":"United States patent U.S patent 7,266,175","author":"Romesberg M","year":"2007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.supplement_3.0219"},{"key":"e_1_2_7_21_1","unstructured":"BarthJ aVarian Application Specialist[E\u2010mail]; July2006."},{"key":"e_1_2_7_22_1","first-page":"24","volume-title":"Eclipse IMRT\u2010 A Practical Treatment Planning Guide","author":"Mayo C","year":"2004"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v11i2.3035","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v11i2.3035","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1120\/jacmp.v11i2.3035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T14:56:32Z","timestamp":1694876192000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1120\/jacmp.v11i2.3035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,3]]}},"alternative-id":["10.1120\/jacmp.v11i2.3035"],"URL":"https:\/\/doi.org\/10.1120\/jacmp.v11i2.3035","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3]]}}}