1. A treatment planning code for hadrontherapy,ANCOD++.
Faiza Bourhaleb Dipartimento di Fisica sperimentale
TERA Fondation University Med 1st -Morocco
Introduction
ANCOD ++ Main features.
ANCOD++ structure.
Making an optimized treatment plan,
Example of a TP.
Verification with GEANT3.
Perspectives.
PTCOG. Catania -29- May 2002

2. Acknowledgment Alberto Boriano Faiza Bourhaleb Roberto Cirio
Jamal Derkaoui
Marco Donetti
Flavio Marchetto
Cristiana Peroni
Camilo Sanz Freire

3. Optimization and treatment planning
Steps before treatment
CT and 3D definition of the global
volume for treatment.
Doctors prescription and beam info.
Planning of the treatment.
Treatment planning techniques:
Forward planning (experience!?)
Monte Carlo simulation (Time!?)
Inverse planning
ANCOD++ !??

4. Main features: C++ Version =>ANCOD++ Characteristics:
Fortran Version
C++ Version =>ANCOD++
Characteristics:
Voxels scanning.
Inverse planning =>kinetic Energies.
3D optimization => fluence values.

5. ANCOD++ structure Voxel CT Target Accelerator Field Energy Optimize
Dose

6. CT Target? Interface to different CT format: DICOM CART format.
Voxelplan (Heidelberg).

7. Target Volume extraction is done in two steps : Angles methode.
Propagation methode.

8. Field Total volume Source Field Direction. Beams directions.
Beams intersections with voxels.

9. Field Convertion to Lenght water equivalent. Source21 22 23 24 25 19 20 7 8 9 17 18 4 5 6 15 16 1 2 3 10 11 12 13 14
Source
lwe(9,18)
Lwe at the peak position.
Voxels ordering :
(i,j,k) n .

10. Energy
Table of data input :
GSI .
Simulation GEANT3

11. Experimental data of energy deposited of carbon ions in water.
Bilinear interpolation of the data input to extract the desired data for a specific beam.
Experimental data of energy deposited of carbon ions in water.
dE/dz Z
Interpolated curve for a specific beam. Ec

12. Optimize Iterative method used in ANCOD:
Dose required, in a specific voxel, is modified in each iteration.
We start our calculation of weight of a given beam without considering any correlation with the other beams, then the weight of the following beam is calculated taking into account the precedent one.
Once we have the first set of the fluence values, it is necessary to iterate many times to find the fluence values satisfying the best to requirements and prescriptions.

13. Cutting off the non-realistic fluence values:
Setting to zero negative values.
Defining an upper limit on possible fluence values.
Re-initialization.
Iterating till an objective
function defined reach the minimum.

15. Dose
The final three dimensional dose calculation is an important step since it allows to see the results of our optimization, and to see also the finale isodose superimposed to the CT slices.
The extraction of DVHs for the target volume as well the DVHs for the surrounding volume is necessary to have an overview on the whole 3D distribution in only one plot.

16. TP example
Dose
100 40 Y X

19. DVH inside target
DVH outside target

20. Verification with GEANT3
The simulation using GEANT3, for the moment, is the unique way to verify our results.
For carbon ions.
For protons and other heavy ions.
In different materials.

21. Example
Simulation of dose distrution of four orthogonal fields in the case of a tumor in the head.

22. ANCOD++
Simulation with GEANT3

23. 100 80
ANCOD++ 60 40 20
Simulation with GEANT3

24. Perspectives and Future planning: To define error margins.
Simultaneous optimization.
Field direction optimization.
Target
OAR

25. Biological optimization.

26. {Thanks for your attention }

27. CT Target Dose Field Optimize Energy
Accelerator
Target
Dose
Field
Optimize
Energy