Rx: 21Gy+18Gy/1fx

Five brain mets, three on the same plane


Simple DVH Metrics

Name (ID): P3Brain, P3Brain (P3Brain)
Plan or PlanSum ID: HyperArc

Structure ID Structure Code Patient Structure DVH Objective Evaluator Variation Priority Met Achieved
4GyBrain_noPTV   BRAIN_PTV V4Gy[cc]         157.13 cc
12GyBrain_noPTV   BRAIN_PTV V12Gy[cc]         15.69 cc
21GyBrain_noPTV   BRAIN_PTV V21Gy[cc]         0.86 cc
Brain_noPTV   BRAIN_PTV Mean[Gy]         2.680 Gy
PTV1   1PTV_LP_21 V100%[%] >=99     Goal 99.80 %
GTV1   1GTV_LP Max[%]         135.2 %
GTV1   1GTV_LP Max[Gy]         28.387 Gy
GTV1   1GTV_LP Min[Gy]         25.003 Gy
GTV1   1GTV_LP V100%[cc]         0.22 cc
GTV1   1GTV_LP Volume[cc]         0.22 cc
PTV2   2PTV_LPG_21 V100%[%] >=99     Goal 99.00 %
GTV2   2GTV_LPG Max[%]         125.0 %
GTV2   2GTV_LPG Max[Gy]         26.248 Gy
GTV2   2GTV_LPG Min[Gy]         22.435 Gy
GTV2   2GTV_LPG V100%[cc]         1.15 cc
GTV2   2GTV_LPG Volume[cc]         1.15 cc
PTV3   3PTV_RP_21 V100%[%] >=99     Goal 99.35 %
GTV3   3GTV_RP Max[%]         133.1 %
GTV3   3GTV_RP Max[Gy]         27.949 Gy
GTV3   3GTV_RP Min[Gy]         23.127 Gy
GTV3   3GTV_RP V100%[cc]         1.36 cc
GTV3   3GTV_RP Volume[cc]         1.36 cc
PTV4   4PTV_RF_21 V100%[%] >=99     Goal 100.00 %
GTV4   4GTV_RF Max[%]         147.5 %
GTV4   4GTV_RF Max[Gy]         30.975 Gy
GTV4   4GTV_RF Min[Gy]         27.539 Gy
GTV4   4GTV_RF V100%[cc]         0.07 cc
GTV4   4GTV_RF Volume[cc]         0.07 cc
PTV5   5PTV_RT_18 V18Gy[%] >=99     Goal 99.48 %
GTV5   5GTV_RT Max[%]         111.7 %
GTV5   5GTV_RT Max[Gy]         23.454 Gy
GTV5   5GTV_RT Min[Gy]         20.145 Gy
GTV5   5GTV_RT V100%[cc]         1.76 cc
GTV5   5GTV_RT Volume[cc]         1.92 cc
Brainstem   Brainstem Max[Gy]         9.908 Gy
Chiasm   Chiasm Max[Gy]         6.743 Gy
OpticNerve_L   OptNrv_L Max[Gy]         3.419 Gy
OpticNerve_R   OptNrv_R Max[Gy]         6.115 Gy
Eye_L   Eye_L Max[Gy]         2.922 Gy
Eye_R   Eye_R Max[Gy]         2.904 Gy
Technical Plan Comments

HyperArc was utilized for this case which means it used a very simplified workflow for planning and delivery.  First the immobilization device is added as a structure model to the patient.  Then, creating a new HyperArc plan walks the user through the process of placing the isocenter of the predefined HyperArc beam set and identifying the target structures and their desired Rx dose.  At that point the Photon Optimizer can be launched automatically which includes preset lower objectives for each target with 100 priority and the HyperArc exclusive SRS NTO (also with 100 priority) which is tuned specifically to enforce a sharp dose falloff and prevent dose bridging of adjacent disparate targets.

Eclipse 15.5+ also features the Automatic Lower Dose Objective (ALDO) which, when enabled in the Photon Optimizer, in the background automatically adjusts dose/priority to keep dose converge on targets near 98%.  Enabling ALDO thereby balances dose received by each target prescribed to the same dose level during optimization.

The plan presented here was created with no user interaction during optimization.  ALDO was enabled and optimization was started.  The Photon Optimizer calculation option Convergence Mode was set to Extended.


3rd party software plan report



DICOM patient export        


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