A fully flexible joint lattice position and dose optimization method for LATTICE therapy

TL;DR

This paper presents a novel flexible planning method for LATTICE radiotherapy that optimizes vertex placement and dose distribution jointly, improving treatment precision and sparing healthy tissues.

Contribution

It introduces a fully flexible joint optimization approach for vertex positioning and dose planning in LATTICE therapy, surpassing traditional rigid pattern methods.

Findings

Plans with the new method showed better optimization scores.

Improved peak-to-valley dose ratios were achieved.

Enhanced target conformity and organ sparing were demonstrated.

Abstract

Lattice radiotherapy (LATTICE) is a form of spatially fractionated radiation therapy (SFRT) designed to deliver high doses to tumor regions while sparing surrounding tissues. Traditional LATTICE uses rigid vertex patterns, limiting adaptability for irregular tumors or those near critical organs. This study introduces a novel planning method with flexible vertex placement and joint optimization of vertex positions and dose distribution, enhancing treatment precision. The method integrates vertex positioning with other treatment variables within a constrained optimization framework, allowing dynamic adjustments. Results showed that plans generated with the new method (NEW) demonstrated superior or comparable quality to conventional LATTICE plans, with improvements in the optimization objective and peak-to-valley dose ratio (PVDR). This approach offers significant improvements in target dose conformity and OAR sparing, providing an enhanced LATTICE technique.