Authors: Yu Chang, Mei Chen
Affiliation: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine
Abstract Preview: Purpose: Spot weights optimization, as a critical step in the proton therapy, is often time-consuming and labor-intensive. Deep learning, with its powerful learning and computational efficiency, can e...
Authors: Jiayi Chen, Manju Liu, Ning Wen, Haoran Zhang, Yibin Zhang
Affiliation: Department of Radiation Oncology, Ruijin Hospital, Department of Radiology, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Duke Kunshan University, Department of Radiation Oncology,Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Abstract Preview: Purpose: This study introduces a novel Dual Energy CT (DECT)-Guided Intelligent Radiation Therapy (DEIT) platform designed to streamline and optimize the radiotherapy process. The DEIT system combines...
Authors: Liqin HU, Tao He, Jing JIA, Pengcheng LONG, Wei Meng, Yang Yuan
Affiliation: SuperAccuracy Science & Technology Co. Ltd.
Abstract Preview: Purpose: A multi-criteria optimization method based on reinforcement learning and adaptive boosting(RLAB MCO) has been developed to enhance radiotherapy plan quality by offering reasonable and effecti...
Authors: Christopher L. Deufel, Suman Gautam, William Y. Song
Affiliation: Virginia Commonwealth University, Mayo Clinic
Abstract Preview: Purpose: Direction modulated brachytherapy creates anisotropic dose distribution from an isotropic source. This study aims to develop a truncated conditional value at risk optimization algorithm for D...
Authors: Lili Chen, Ahmed A. Eldib, Chang Ming Charlie Ma
Affiliation: Fox Chase Cancer Center
Abstract Preview: Purpose: Specialized adaptive radiotherapy (ART) systems have been developed and clinically implemented, which are either cost-ineffective such as MR-linacs or inflexible in workflow such as the Ethos...
Authors: Olivier Blasi, Eric Cameron, Brad K. Lofton
Affiliation: CAMP, Colorado Assn in Medical Phys (CAMP)
Abstract Preview: Purpose:
Magnetic Resonance (MR) imaging obtained from external centers for radiation therapy (RT) planning can suffer from suboptimal protocols and geometric distortions. These issues can require ...
Authors: Katja M. Langen, William Andrew LePain, Robert Muiruri, Vivi Nguyen, Mosa Pasha, Roelf L. Slopsema, Alexander Stanforth, Yinan Wang, Mingyao Zhu
Affiliation: Emory Healthcare, Emory University, Department of Radiation Oncology and Winship Cancer Institute, Emory University
Abstract Preview: Purpose: Intensity modulated proton therapy (IMPT) treatment planning for craniospinal irradiation (CSI) is complex and requires extensive effort from the planner. This study aims to enhance planning ...
Authors: David L. Barbee, David Byun, Matt Long, Jose R. Teruel Antolin, Michael J Zelefsky
Affiliation: NYU Langone Health
Abstract Preview: Purpose:
Online adaptive MR-Linac therapy requires contour adaptation, often adding 20 minutes to treatment time and reducing machine throughput. This study introduces a fully automated MR contour ...
Authors: Muhammad Ramish Ashraf, Dixin Chen, Lloyd Emmanuel Kamole Ghomsi, Edward Elliot Graves, Billy W Loo, Stavros Melemenidis, Joseph B. Schulz, Lawrie Skinner
Affiliation: Department of Radiation Oncology, Department of Radiation Oncology, Stanford University School of Medicine
Abstract Preview: Purpose: Precise beam collimation is essential in preclinical radiotherapy studies to ensure accurate dose delivery. Manual design and fabrication of organ-specific collimators usually consist of mult...
Authors: Shane McCarthy, Damodar Pokhrel, William St. Clair, Eddy S Yang
Affiliation: University of Kentucky, Department of Radiation Medicine
Abstract Preview: Purpose: Demonstration of automated stereotactic treatment planning for recurrent head and neck (RHN) cancers using knowledge-based planning, multicriteria optimization (MCO), and dosimetric scorecard...
Authors: Yabo Fu, Yang Lei, Yu Lei, Haibo Lin, Ruirui Liu, Tian Liu, Kenneth Rosenzweig, Charles B. Simone, Shouyi Wei, Jiahan Zhang
Affiliation: Icahn School of Medicine at Mount Sinai, University of Nebraska Medical Center, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York Proton Center
Abstract Preview: Purpose: Beam orientation optimization (BOO) in intensity-modulated radiation therapy (IMRT) is traditionally a complex, non-convex problem tackled with heuristic methods. This study benchmarks global...
Authors: Alyssa Gadsby, William J. Godwin, Daniel G. McDonald, Jean L. Peng, Alek K. Rapchak, Sean A Roles, Austin M. Skinner, Stephanie Tan
Affiliation: Medical University of South Carolina
Abstract Preview: Purpose: To characterize optimal optimization workflow and settings for a single large target utilizing the Leksell GammaPlan Lightning Optimizer.
Methods: An anonymized dataset containing a large ...
Authors: Dylan Yamabe Breitkreutz, Lee Chin, Brige P. Chugh, Mark D'Souza, Brian M. Keller, Anthony Kim, Michelle K. Nielsen, Arjun Sahgal
Affiliation: Sunnybrook Health Sciences Centre
Abstract Preview: Purpose: The Elekta Unity MR-linac delivers highly conformal SBRT treatments using IMRT. These treatment plans require patient-specific quality assurance (PSQA) measurements to detect discrepancies be...
Authors: David L. Barbee, Paulina E. Galavis, Lena Adel Samad, Jose R. Teruel Antolin
Affiliation: NYU, NYU Langone Health
Abstract Preview: Purpose: To validate an automated script that converts treatment plans of varying Varian MLC models
Methods: A C# script was developed using the Eclipse Scripting API to convert treatment plans...
Authors: Xiaoda Cong, Rohan Deraniyagala, Xuanfeng Ding, Xiaoqiang Li, Jian Liang, Peilin Liu, Craig Stevens, Xiangkun Xu, Weili Zheng
Affiliation: Corewell Health William Beaumont University Hospital, Corewellhealth William Beaumont University Hospital, William Beaumont University Hospital, Corewellhealth William Beaumont Hospital, Department of Radiation Oncology, Corewell Health William Beaumont University Hospital
Abstract Preview: Purpose:
Commission a step-and-shoot arc therapy(SPArc-step&shoot) for treating head-neck cancer patients as a desired interim milestone toward full dynamic treatment.
Methods:
An in-house de...
Authors: Gourav Jhanwar, Mojtaba Tefagh, Masoud Zarepisheh
Affiliation: The University of Edinburgh, Memorial Sloan Kettering Cancer Center
Abstract Preview: Purpose:
Radiotherapy treatment planning involves solving computationally-intensive and time-consuming optimization problems. Central to these problems is a large matrix known as the dose-influence...
Authors: William F.B Igoniye, Belema Manuel, Christopher F. Njeh, O Ray-offor
Affiliation: Indiana University School of Medicine, Department of Radiation Oncology, Department of Radiology, University of Port Harcourt Teaching Hospital
Abstract Preview: Purpose: The accurate and efficient categorization of brain tumors is essential for effective treatment planning and improved patient outcomes. Current MRI-based diagnostic methods are time-intensive ...
Authors: Yaspal Badyal, Rabten Datsang, Tianjun Ma, William Song
Affiliation: MVision AI, Virginia Commonwealth University
Abstract Preview: Purpose: Deep learning (DL)-based dose distribution predictions for prostate cancer show significant potential for OAR sparing compared to manually optimized treatment plans. We aim to generate clinic...
Authors: Hamdah Alanazi, Silvia Pella
Affiliation: FAU, Florida Atlantic University
Abstract Preview: Purpose: The appearance of breast cancer in the global list of most common cancers worldwide requires
research for ultimate treatment approaches including radiation therapy to reduce deaths from br...
Authors: Parker Anderson, Elizabeth L. Bossart, Jonathan Cyriac, Nesrin Dogan, Robert Kaderka, Yihang Xu
Affiliation: University of Miami, University of Miami, Sylvester Comprehensive Cancer Center, University of Miami Sylvester Comprehensive Cancer Center
Abstract Preview: Purpose:
Knowledge-based planning (KBP) can enhance the treatment planning process in cancer radiotherapy (RT). By training a KBP model with high-quality treatment plans developed by experts, dose-...
Authors: Aliasghar Rohani, Rui Zhang
Affiliation: Louisiana State University, Baton Rouge, Louisiana, Department of Radiation Oncology, Mary Bird Perkins Cancer Center
Abstract Preview: Purpose: This study aimed to evaluate the impact of simultaneous optimization of multi-photon beam energy and fluence on IMRT and VMAT treatment planning.
Methods: An Elekta linear accelerator (lin...
Authors: Deidre Batchelar, Michael Kudla, Stephanie Merkl, Tony Teke
Affiliation: BC Cancer - Kelowna
Abstract Preview: Purpose: Preplanning 3D-printed templates for cervical and vaginal brachytherapy is an iterative process, often taking hours to for an individual patient.
This study demonstrates an end-to-end auto...
Authors: Ana Laura Burin, Ilca Marli Moitinho Amaral Medeiros, Priscila Santos Rodrigues, Maria Elisa Chuery Martins Rostelato, Sabrina Spigaroli Sgrignoli, Ana Catarina Koka de Souza Silva, Carla Daruich Souza, Cristhian Ferreira Talacimon, Lara El Hajj Teodoro, Carlos Alberto Zeituni
Affiliation: IPEN - USP, IPEN - Instituto de Pesquisas Energéticas e Nucleares
Abstract Preview: Purpose: The uniform distribution of phosphorus-32 (32P) in beta sources is essential to ensure the accuracy of radiotherapy treatments, such as those for paravertebral cancer. This study evaluated th...
Authors: Qiu Tang, Yeqiang Tu, Jiahao Wang, Lu Wang
Affiliation: Women's Hospital School of Medicine Zhejiang University, Hangzhou Women's Hospital
Abstract Preview: Purpose: The BT boost regions were previously delineated and optimized during EBRT planning process. The differences of DVH parameters addition (PA), deformable dose summation (DS) with BT boost regio...
Authors: Min Cheol Han, Hojin Kim, Jin Sung Kim, Hyejin Lee, Sac Lee, Yongdo Yun
Affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine
Abstract Preview: Purpose: Carbon ion radiotherapy (CIRT) is characterized by high relative biological effectiveness (RBE), which must be integrated into the treatment planning process. This study aims to develop a nov...
Authors: Jacob S. Buatti, Mu-Han Lin, Dominic Moon, David D.M. Parsons, David Sher, Justin D. Visak, Hui Ju Wang
Affiliation: Department of Radiation Oncology, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, UT Southwestern Medical Center, UT Southwestern Medical Center, Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX
Abstract Preview: Purpose: Most current adaptive treatment planning systems (TPS) natively utilize static planning goals from the reference plan for online adaptive re-optimization. In complex head-and-neck cancer (HNC...
Authors: Yang Sheng, Qingrong Jackie Wu, Qiuwen Wu, Xin Wu, Dongrong Yang
Affiliation: Duke University Medical Center
Abstract Preview: Purpose:
Treatment planning for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) relies on inverse planning, an iterative and non-intuitive process of adjust...
Authors: Cheng-En Hsieh, Shen-Hao Li, Hsin-Hon Lin, Shu-Wei Wu, An-Ci Yang
Affiliation: Department of Medical Imaging and Radiological Sciences, Chang Gung University, Proton and Radiation Therapy Center, Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Chang Gung Memorial Hospital Linkou
Abstract Preview: Purpose:
The aim of this study is to develop a framework of generating patient-specific phantom tailored for head and neck proton therapy. From these phantoms, digital reference objects based on th...
Authors: Peng Dong, Elizabeth Kidd, Sheng Liu, Thomas R. Niedermayr, Oscar Pastor-Serrano, Lei Xing, Yong Yang, James Zou
Affiliation: Department of Biomedical Data Science, Stanford University, Department of Radiation Oncology, Stanford University, Stanford University
Abstract Preview: Purpose: Radiotherapy treatment planning is a time-consuming and potentially subjective process that requires iterative adjustments of optimization parameters to balance conflicting objectives. In thi...
Authors: Doris Dimitriadis/Dimitriadou, Denisa R. Goia, M. Saiful Huq, Ronald John Lalonde, Noor Mail, Adam Olson, Tyler Wilhite
Affiliation: UPMC Hillman Cancer Center, UPMC Hillman Cancer Center and University of Pittsburgh School of Medicine, UPMC
Abstract Preview: Purpose: The goal of the HyperSight® offline adaptive-workflow is to create a methodical approach to adaptive-radiotherapy (ART) that considers modifications in patient setup and anatomy. Through effi...
Authors: Ara Alexandrian, Sadiki Daniel
Affiliation: Louisiana State University, Mary Bird Perkins Cancer Center
Abstract Preview: Purpose: To develop a learning-to-optimize machine learning model that accelerates optimization in VMAT treatment planning by training on prostate patient data.
Methods: A treatment plan dataset of...
Authors: Fang-Fang Yin, Lei Zhang, Yaogong Zhang
Affiliation: Medical Physics Graduate Program, Duke Kunshan University
Abstract Preview: Purpose: Rotational symmetry is an inherent property of many tomography systems (e.g., CT, PET, SPECT), arising from the circular arrangement or rotation of detectors. This study revisits the image re...
Authors: Nobuki Imano, Daisuke Kawahara, Akito S Koganezawa, Yuji Murakami, Ikuno Nishibuchi, Takuya Wada
Affiliation: Department of Information and Electronic Engineering, Faculty of Science and Engineering, Teikyo University, Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University
Abstract Preview: Purpose: Adaptive radiotherapy (ART) compensates for treatment plans based on anatomical changes while not considering biological effects such as interruptions during treatment. This study aims to dev...
Authors: Ryan Clark, Jon Cornelisse, Kenny Guida, Anthony Magliari, Lesley Rosa, Megan Smith, Shane R Stecklein
Affiliation: Office of Medical Affairs, Varian, A Siemens Healthineers Company, Department of Radiation Oncology, University of Kansas Medical Center
Abstract Preview: Purpose: Post-mastectomy radiation therapy (PMRT) can pose a challenge for planners of all levels of experience. For cases where 3D conformal therapy yields undesirable results (i.e., dose heterogenei...
Authors: James Irrer, Charles K. Matrosic, Martha M. Matuszak, Charles S. Mayo, Kelly C. Paradis, Joann I. Prisciandaro, Benjamin S. Rosen, John Yao, Claire Zhang
Affiliation: University of Michigan, Department of Radiation Oncology, University of Michigan
Abstract Preview: Purpose: To introduce an in-house developed tool, BioDoseUI, designed to calculate and visualize 3D equieffective dose (EQD2Gy) for treatment planning systems (TPS) without such capabilities, to facil...
Authors: Hao Gao, Jiayue Han, Wangyao Li, Yuting Lin, Jufri Setianegara, Aoxiang Wang, Yanan Zhu
Affiliation: Department of Biomedical Engineering, Huazhong University of Science and Technology, Department of Radiation Oncology, University of Kansas Medical Center
Abstract Preview: Purpose: Proton therapy leverages Bragg-peak-based dose delivery to achieve ultra-high-dose-rate FLASH with patient-specific range modulators (PSRM). Current proton FLASH (pFLASH) planning typically i...
Authors: Hassan Bagher-Ebadian, Anthony J. Doemer, Ryan Hall, Joshua P. Kim, Bing Luo, Benjamin Movsas, Humza Nusrat, Kundan S Thind
Affiliation: Department of Physics, Toronto Metropolitan University, Henry Ford Health
Abstract Preview: Purpose: This study investigates the development and feasibility of local LLM-based agents to automate radiotherapy treatment planning, aiming to improve planning efficiency and consistency, while pre...
Authors: Dalton Griner, Kathryn L. Kolsky, Joseph John Lucido, Andrew J. Veres
Affiliation: Mayo Clinic
Abstract Preview: Purpose: This project aimed to automate a complex and time-consuming employee scheduling process. By replacing the traditional manual method with a multi-criteria optimization-based system (MCO), the ...
Authors: Steve B. Jiang, Mu-Han Lin, Yu-Chen Lin, Austen Matthew Maniscalco, Dan Nguyen, David Sher, Xinran Zhong
Affiliation: Medical Artificial Intelligence and Automation (MAIA) Lab & Department of Radiation Oncology, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, UT Southwestern Medical Center, UT Southwestern Medical Center, Department of Radiation Oncology, UT Southwestern Medical Center, UT Dallas
Abstract Preview: Purpose:
Sequential boost radiotherapy (RT) poses a challenge in allocating dose across multiple plans while protecting organs at risk (OARs). Clinicians must decide whether OAR sparing should occu...
Authors: Michael Evan Chaga, Timothy Chen, Darra M. Conti, Shabbar Danish, Jing Feng, Wenzheng Feng, Joseph Hanley, Tingyu Wang
Affiliation: Hackensack Meridian Health, Jersey Shore University Medical Center
Abstract Preview: Purpose: Using mixed fractionation schemes is a common technique in treating CNS lesions. This article describes an innovative plan-and-split approach for more efficient planning on the ZAP-X and thus...
Authors: Michael Bowers, Patrik Brodin, Madhur Garg, Rafi Kabarriti, William P. Martin, Todd R. McNutt, Julie Shade, Wolfgang A. Tomé, Christian Velten
Affiliation: Johns Hopkins University, Oncospace, Inc., Montefiore Medical Center
Abstract Preview: Purpose: Development of an automated planning tool utilizing AI generated patient-specific dose-volume histogram predictions for rapid H&N plan generation.
Methods: Planning best-practices were dev...
Authors: Shifeng Chen, Erica Fisler, Arun Gopal, Mariana Guerrero, Jason Hendershot, Kai Huang, Eric Kusmaul, Adam Schrum, Megan Steinberg, Kai Wang
Affiliation: University of Maryland School of Medicine, Department Radiation Oncology, Kaufman Cancer Center, Upper Chesapeake Medical Center, University of Maryland Medical System Central Maryland Radiation Oncology, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore Washington Medical Center Radiation Oncology, Department of Radiation Oncology, University of Maryland School of Medicine
Abstract Preview: Purpose:
Our goal is to develop and clinically deploy an automated planning tool using multicriteria optimization (MCO) for VMAT in prostate only, whole pelvis radiotherapy treatments.
Methods:<...
Authors: Shahid B. Awan, Harold Li, Aba Lippuner
Affiliation: Department of Radiation Oncology, University of Kansas Medical Center
Abstract Preview: Purpose: QA review is a necessary component of QA management but is often pushed aside owing to time constraints and overreliance on vendor solutions. At our multicenter institution, we designed a 3-s...
Authors: Daisuke Kawahara, Takaaki Matsuura, Yuji Murakami, Ryunosuke Yanagida
Affiliation: Hiroshima High-Precision Radiotherapy Cancer Center, Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima
Abstract Preview: Purpose: In recent years, automation in radiation therapy planning using AI has gained significant attention to reduce the workload of treatment planners. Adaptive Radiation Therapy (ART), as a new fo...
Authors: William T. Hrinivich, Junghoon Lee, Lina Mekki
Affiliation: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Department of Biomedical Engineering, Johns Hopkins University, Johns Hopkins University
Abstract Preview: Purpose: Volumetric modulated arc therapy (VMAT) planning is a computationally expensive process. In this work, we propose a reinforcement learning (RL) framework to automatically optimize dose rate a...
Authors: Matthew Brown, Yushi Chang, Jinhyuk Choi, William Silva Mendes, Lei Ren, Aman Sangal, William Paul Segars, Phuoc Tran, Hualiang Zhong
Affiliation: University of Maryland School of Medicine, Department of Radiation Oncology, University of Maryland School of Medicine, Carl E. Ravin Advanced Imaging Laboratories and Center for Virtual Imaging Trials, Duke University Medical Center, Department of Radiation Oncology, Medical College of Wisconsin
Abstract Preview: Purpose: Digital phantoms like XCAT are essential for imaging and treatment optimization in radiology and radiation oncology. However, the lack of realistic textures (HU distribution) in XCAT limits i...
Authors: Izabella L. Barreto, Benjamin Taylor Heggie, Stephanie M. Leon
Affiliation: University of Florida College of Medicine, University of Florida
Abstract Preview: Purpose: Filament deposition modeling (FDM) 3D printers may utilize proprietary calibration methods inadequate for medical imaging. Proper techniques are necessary to achieve imaging uniformity standa...
Authors: Amanda J. Deisher, Susannah V. Hickling, Shima Ito, Jon J. Kruse
Affiliation: CancerCare Manitoba, Mayo Clinic
Abstract Preview: Purpose:
To date, 11 ocular patients were treated with spot scanning gantry-based gaze-gated ocular proton program at Mayo Clinic, Rochester MN since 2023. Treatments are done in the half-arc gantr...
Authors: Manuel M. Arreola, Hugh Davis, Daniella Fabri, Emily L. Marshall, BC Schwarz
Affiliation: University of Florida
Abstract Preview: Purpose:
This study aims to map procedure names, descriptions, and CPT codes from a Hybrid Angio-CT room to the American College of Radiology (ACR) Common Lexicon. This mapping will support expedit...
Authors: Huixiao Chen, Zhe (Jay) Chen, MinYoung Lee, Sameer Taneja
Affiliation: Yale School of Medicine, Department of Therapeutic Radiology, Yale University School of Medicine
Abstract Preview: Purpose: Superficial radiation therapy uses low-energy x-rays to treat various types of cancers, including non-melanoma skin cancers, and dermatological conditions such as keloid scars, mycosis fungoi...
Authors: Laura I. Cervino, Sharif Elguindi, Yu-Chi Hu, Licheng Kuo, Xiaoning Liu, Jennifer Ma, Pengpeng Zhang
Affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, Radiation Oncology, Memorial Sloan Kettering Cancer Center
Abstract Preview: Purpose:
Quad-shot radiotherapy (QSRT) is an emerging paradigm in palliative cancer treatment. This study aimed to streamline the QSRT workflow using automation to improve efficiency while maintain...
Authors: Lawrence T. Dauer, Yusuf Emre Erdi, Yiming Gao, Dustin W. Lynch, Usman Mahmood
Affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center
Abstract Preview: Purpose: Radiation dose to patients in CT examinations (CTDIvol, DLP) is tracked in dose monitoring solutions. Some solutions push for automatically estimating patient organ doses based on exam images...
Authors: Ana Maria Barragan Montero, John A. Lee, Eliot Peeters, Romain Schyns, Edmond S. Sterpin, Sophie Wuyckens
Affiliation: UCLouvain, Universite Catholique de Louvain
Abstract Preview: Purpose:
Although the likelihood of a point being tumorous decreases with distance from the GTV, CTVs are still defined as binary masks. Recently, the concept of clinical target distribution (CTD),...
Authors: Ryan Burri, Nazanin Hoshyar, Jerry W. McCoy, Yulin Song, Huma Syed
Affiliation: Bay Pines VA Medical Center
Abstract Preview: Purpose: The study aimed to streamline traditionally manual, iterative, and time-consuming VMAT commissioning process. The goal was to identify an optimal set of MLC dosimetric parameters that minimiz...
Authors: Avinash Mudireddy, Nathan Shaffer, Joel J. St-Aubin
Affiliation: University of Iowa
Abstract Preview: Purpose: This work demonstrates preliminary results in training a reinforcement learning (RL) network to perform VMAT machine parameter optimization.
Methods: We implemented a policy gradient RL al...