VMAT

This is a typical case where the PMRT model can improve workflows and yield great results almost instantaneously.  For a left-sided PMRT case with a large separation (>28cm), a switch to VMAT ensured a homogenous dose distribution within the chest wall and nodal regions.  The plan was optimized on the virtual data set with the Flash structure generated (HU = -400).  The model was able to generate accurate predictions for OARs, including the ipsilateral lung, heart, and contralateral breast.  Using no-entry, no-exit on optimization structures for the ipsilateral and contralateral lungs, the planner was able to push low dose away from these structures and create a more horseshoe-like dose cloud to ensure the ideal DVH constraints were met.  For this case, the planner optimized the plan fully then continued the optimization at MR Level 2 to further enhance the dose distribution.  The virtual plan was copied to the TXCT and calculated with and without 0.5cm bolus over the chest wall region.  Dosimetric scorecards yielded scores over 90% for virtual, bolus, and non-bolus plans.

_{Any reference to a "plan study" are simply what the organizers call each case and may not be a "study" in the FDA sense as they may not have been published in a peer reviewed journal.
Varian does not provide medical advice and these are illustrative examples only.
Leading plans by expert planner. Your results may vary.}