Search Submissions 🔎

Results for "prostate seed": 41 found

12 Year Clinical Experience with Low-Tesla MRI for Tumor Progression

Authors: Soon N. Huh, Perry B. Johnson, Jiyeon Park, Ryan Stevens

Affiliation: University of Florida Health Proton Therapy Institute, UF Health Proton Therapy Institute, UFHPTI

Abstract Preview: Purpose:
Low-Tesla MRI (0.23T Panorama MR Scanner, Philips) has been used for tumor progression during proton therapy treatments, and for initial contouring in addition to diagnostic MRI. The pulse...

A Plan Complexity Comparison between Monaco and Eclipse - Meta Analysis of 17,000 Plans and 30,000 Beams

Authors: Christopher Colyer, Leon F Dunn, Jonathan Dunning, Simon Goodall, Andy Schofield

Affiliation: GenesisCare

Abstract Preview: Purpose: Modern radiotherapy is characterized by complex treatment plans utilizing dynamic MLCs, gantry positions and recently, collimator rotations. The purpose of this work was to compare the plan c...

Advancing Post-Radiotherapy Toxicity Extraction: A Novel Privacy-Preserving, Parameter-Efficient Language Model Fine-Tuning

Authors: Hassan Bagher-Ebadian, Indrin J. Chetty, Mohamed Elshaikh, Ahmed I Ghanem, Mohammad M. Ghassemi, Reza Khanmohammadi, Benjamin Movsas, Shayan Siddiqui, Kundan S Thind, Jawad Turfa

Affiliation: Michigan State University, Department of Radiation Oncology,Cedars-Sinai Medical Center, Department of Radiation Oncology, Henry Ford Health-Cancer, Detroit, MI and Alexandria Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Henry Ford Health

Abstract Preview: Purpose: Extracting late radiotherapy-induced toxicities from free-text notes using natural language processing is complicated by negative symptom identification, computational demands, and data priva...

An Efficient Workflow for X-Ray Imaging-Based IGRT/ART

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...

Assessing the Need for Online Adaptive Prostate SBRT Using the MR-Linac

Authors: Awens Alphonse, Nebi Demez, Michael Kasper, Noufal Manthala Padannayil, Shyam Pokharel, Suresh Rana, Samuel Richter, Lauren A. Rigsby, Tino Romaguera, Hina Saeed, Nishan Shrestha, Somol Sunny

Affiliation: Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida

Abstract Preview: Purpose: This study evaluates the necessity and potential benefits of online adaptive stereotactic body radiotherapy (SBRT) for prostate cancer using the ViewRay MR-Linac system. By leveraging real-ti...

Augmenting Histopathology Lymphocyte Detection with Gpt-4 in-Context Visual Reasoning

Authors: Kyle J. Lafata, Casey Y. Lee, Xiang Li, Megan K. Russ, Zion Sheng

Affiliation: Duke University, Department of Radiation Oncology, Duke University, Clinical Imaging Physics Group, Department of Radiology, Duke University Health System

Abstract Preview: Purpose:
Traditional deep learning-based cell segmentation models face limitations, such as the need for extensive training data and retraining when encountering new cell types or domains. This stu...

Automated MR Segmentation for Online Adaptive MR-Linac Therapy Using an in-House Model

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 ...

Can AI Agent be a Good Judge for Online Adaptive Radiotherapy Plan Evaluation?

Authors: Steve B. Jiang, Mu-Han Lin, Dan Nguyen, Beiqian Qi, Daniel Yang, Ying Zhang

Affiliation: Department of Radiation Oncology, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Lab & Department of Radiation Oncology, UT Southwestern Medical Center

Abstract Preview: Purpose:
Online adaptive radiotherapy (oART) is a resource-intensive workflow requiring significant time and effort required from clinicians, particularly for the online evaluation of plan quality....

Clinical Factors Associated with Urinary Morbidity in Men Undergoing Combination Prostate Radiation Therapy

Authors: James Benton, Andrew Dewar, Benjamin C Lee, Ryan Y Lee

Affiliation: Radiotherapy Clinics of Georgia, Urology of Greater Atlanta

Abstract Preview: Purpose:
The purpose of our investigation was to determine if pre-treatment factors could predict urinary morbidity after combination radiation treatment for localized prostate cancer.
Methods:<...

Clonogenic Assays for Three Prostate Cancer Cell Lines with Varying Levels of DNA Repair Mutations Treated with LET-Optimized Pencil Beam Scanning Protons and Evaluation of Dose Rate Effect

Authors: Mark E Artz, Jiyeon Park, Lori Rice, Mohammad Saki, Sanjeev Shukla, Michael Vieceli

Affiliation: University of Florida Health Proton Therapy Institute, Department of Radiation Oncology, University of Florida College of Medicine, UF Health Proton Therapy Institute, Department of Urology, University of Florida College of Medicine

Abstract Preview: Purpose: To investigate how varying levels of DNA repair mutations affect the LET sensitivity of prostate cancer cells.
Methods: The prostate cancer cell lines Du145 (low DNA repair mutations), PC3...

Comparing Planned Vs. Delivered Bladder Dose-Toxicity Associations in Prostate Cancer Radiotherapy: Insights from the Mirage Trial

Authors: Minsong Cao, Amar Kishan, Yi Lao, An Liu, Beth Neilsen, X. Sharon Qi, Kun Qing, Ke Sheng, Michael Steinberg, Luca F Valle, Terence Williams

Affiliation: Department of Radiation Oncology, University of California, Los Angeles, Department of Radiation Oncology, City of Hope Medical Center, Department of Radiation Oncology, University of California, San Francisco, Department of Radiation Oncology, City of Hope National Medical Center

Abstract Preview: Purpose: To investigate the clinical relevance of planned versus delivered doses in toxicity associations utilizing localized assessment of genitourinary (GU) toxicity in bladder subregions among pros...

Convergence Speed Advantages of a Machine Learning Assisted Framework in IMRT Fluence Map Optimization – a Comparison Study Using Multiple Convergence Criteria

Authors: Yang Sheng, Qingrong Jackie Wu, Qiuwen Wu, Xin Wu, Dongrong Yang

Affiliation: Duke University Medical Center

Abstract Preview: Purpose: Convergence speed is crucial for an optimizer. Faster convergence leads to better solutions with fewer iterations and less time. Recently, a machine learning (ML)-assisted framework employing...

Determination of HU Override for Small Metal Implants in Proton Therapy

Authors: Matthew Stephen Andriotty, Taoran Cui, Harold Y Hu, Ke Nie, Tan Phan, Xiao Wang, Ning J. Yue, Chengzhu Zhang

Affiliation: Rutgers Cancer Institute of New Jersey, Basis Scottsdale

Abstract Preview: Purpose: Metallic implants are often non-isocentric, and their exact volumes/orientations/shapes are difficult to capture and contour accurately on CT images even if that information is known beforeha...

Development and Implementation of MRI-Only Simulation, Planning and Treatment Workflow for Pelvic Radiotherapy Using Synthetic CT on MR-Linac

Authors: Peter Balter, Elaine Eunnae Cha, Seungtaek Choi, Yao Ding, Eun Young Han, Yusung Kim, Rajat J. Kudchadker, Belinda Lee, Surendra Prajapati, Reza Reiazi, Ergys D. Subashi, Sarath Vijayan, Jinzhong Yang, Yao Zhao

Affiliation: The University of Texas MD Anderson Cancer Center

Abstract Preview: Purpose: This study evaluates the feasibility of an MR-only simulation, planning, and treatment (MROSPT) workflow for pelvic cancer patients using synthetic CT generated from MRI data. By validating s...

Development of a GPU-Based Dose Calculation Engine for MRI-Guided Proton Therapy

Authors: Yaowen Cao, Haonian Gong, Yue Gu, Meiqi Liu, Hsiao-Ming Lu, Yuxiang Wang, Yidong Yang, Xiaogang Yuan

Affiliation: Hefei Ion Medical Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Department of Engineering and Applied Physics, University of Science and Technology of China

Abstract Preview: Purpose: Magnetic resonance imaging (MRI)-guided proton therapy is an innovative technology that combines superior soft tissue imaging capabilities of MRI with the high dose conformity of proton thera...

Dosimetric Comparison of MR-Linac Vs. Cyberknife for Prostate Stereotactic Body Radiation Therapy

Authors: Awens Alphonse, Nebi Demez, Michael Kasper, Noufal Manthala Padannayil, Shyam Pokharel, Suresh Rana, Lauren A. Rigsby, Tino Romaguera, Hina Saeed, Nishan Shrestha, Somol Sunny

Affiliation: Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida

Abstract Preview: Purpose: Prostate stereotactic body radiation therapy (SBRT) requires precise dose delivery to the target volume and organ-at-risk (OAR) sparing. This study compares MR-Linac (MRL) and CyberKnife (CK)...

Dosimetric Evaluation of a Helical Tomotherapy to L-Shaped Linac Plan Conversion Workflow

Authors: Megan E. Daly, Ryan D. Hernandez, Abriel J. Horak, Soo Kyoung Kim, Peter C. Park, Dwaine O. Spence, Payton H. Stone, Cari L. Wright

Affiliation: UC Davis Cancer Center

Abstract Preview: Purpose: To evaluate a fallback planning workflow used for cross-modality treatment planning and delivery between helical Tomotherapy and volumetric modulated arc therapy (VMAT) using conventional L-s...

Dosimetric Impact of Target Coverage with Inter-Fraction Patient Yaw Setup Error in IMRT/VMAT Prostate Cancer Radiotherapy

Authors: Min Su

Affiliation: Mount Sinai School of Medicine

Abstract Preview: Purpose: To evaluate dosimetric impact of patient setup yaw error to target coverage for pelvis/prostate radiation external beam IMRT-VMAT treatment.
Methods: 9 Pelvis/prostate IMRT-VMAT treatment ...

Effects of Communication with Patients on Bladder Sparing in Photon Beam Prostate Treatments

Authors: Nathaniel Haas, David Pearson

Affiliation: University of Toledo

Abstract Preview: Purpose: For external beam treatments for prostate cancer, we ask patients to attend treatments with their bladders full. A full bladder has been shown to reduce the dose to the bladder and bowels for...

Enhanced Pelvic Organ Segmentation Using LLM-Driven Prompts for Prostate Cancer Low-Dose-Rate Brachytherapy

Authors: Yang Lei, Tian Liu, Ren-Dih Sheu, Meysam Tavakoli, Jing Wang, Kaida Yang, Jiahan Zhang

Affiliation: Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, Emory University

Abstract Preview: Purpose:
The study aimed to improve target and organ at risk (OAR) segmentation in low-dose-rate brachytherapy (LDR-BT) for prostate cancer treatment, by integrating clinical guidelines into deep l...

Evaluating the Impact of Bladder Volume on Small Bowel Dose Constraints in Prostate Cancer Patients with Nodal Involvement: Assessing the Efficacy of a 'half-Full Bladder' Guideline

Authors: Neha Devi, Deon M. Dick

Affiliation: Jaeger Corporation

Abstract Preview: Purpose: To evaluate the impact of bladder volume variation on small bowel dose in prostate cancer patients with nodal involvement and assess the efficacy of a 'half-full bladder' guideline for minimi...

Evaluating the Impact of Spot Spacing on Dosimetric Outcomes in Dynamic Arc Proton Therapy for Prostate SBRT

Authors: Nebi Demez, Michael Kasper, Noufal Manthala Padannayil, Shyam Pokharel, Suresh Rana, Umesh Rana, Hina Saeed, Nishan Shrestha, Somol Sunny

Affiliation: Florida Atlantic University, Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida

Abstract Preview: Purpose: DynamicARC is a novel pencil beam scanning (PBS) proton therapy technique with the potential to provide more conformal dose distributions and reduce treatment time. This study investigates th...

Evaluation of Dose-Rate Metrics in Intensity Modulated Proton Therapy for Prostate Cancer Treatments

Authors: Stella Flampouri, Edgar Gelover, William Andrew LePain, Roelf L. Slopsema, Alexander Stanforth, Mingyao Zhu

Affiliation: Emory Healthcare, Emory University

Abstract Preview: Purpose: Little consideration was given to the change in dose rate (DR) observed when moving to pencil beam scanning (PBS). This study reports on DR in clinical prostate PBS plans. While dose distribu...

Impact of Patient Setup Errors on the MR Linac-Based SBRT Treatment for Prostate Cancer

Authors: Awens Alphonse, Nebi Demez, Michael Kasper, Noufal Manthala Padannayil, Shyam Pokharel, Suresh Rana, Lauren A. Rigsby, Tino Romaguera, Hina Saeed, Nishan Shrestha, Somol Sunny

Affiliation: Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida

Abstract Preview: Purpose: In radiation therapy, patient setup errors have been a primary concern impacting dose delivery accuracy. A robust treatment plan is essential to mitigate these errors. This study aimed to eva...

Implementing a Learning-to-Optimize Machine Learning Framework to Accelerate VMAT Treatment Planning Optimization for Prostate Cancer

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...

Incorporating Physicians’ Contouring Style into Auto-Segmentation of Clinical Target Volume for Post-Operative Prostate Cancer Radiotherapy Using a Language Encoder

Authors: Steve B. Jiang, Chien-Yi Liao, Dan Nguyen, Daniel Yang, Hengrui Zhao

Affiliation: Medical Artificial Intelligence and Automation (MAIA) Lab & Department of Radiation Oncology, UT Southwestern Medical Center

Abstract Preview: Purpose:
Post-operative radiotherapy for prostate cancer requires precise contouring of the clinical target volume (CTV) to account for microscopic disease that is invisible in the image. However, ...

Influence of Intrafraction Motion on the Dosimetry of Prostate Treatments

Authors: María Fernández, Inés Flores, Nuria Montero, Manuel Ruiz, Francisco San Miguel

Affiliation: Hospital Central de la Defensa 'Gómez Ulla', Hospital Central de la Defensa "Gomez Ulla", CSVE, Hospital Central de la Defensa 'Gómez Ulla', CSVE

Abstract Preview: Purpose:
During external radiotherapy treatments in the prostate, there can be PTV movements between fractions and during each treatment fraction. In a typical prostate treatment in our institution...

Introduce a Novel Spot-Scanning Proton Arc(SPArc) Optimization Algorithm for Single Energy Extraction(SEE) Synchrotron-Accelerator-Based Proton Therapy System (PTS)

Authors: Xiaoda Cong, Xuanfeng Ding, Gang Liu, Peilin Liu, Jiajian Shen

Affiliation: Department of Radiation Oncology, Mayo Clinic, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Corewellhealth William Beaumont University Hospital

Abstract Preview: Purpose: This study aims to develop the first SPArc optimization algorithm based on the Dynamic Programming (SPArc-DP), to improve the treatment delivery efficiency for synchrotron-accelerator-based P...

Micro-Ultrasound Guided Focal Prostate Radiotherapy: Development and Testing of a Novel Device.

Authors: Kevin Barker, David Jeffrey Contella, Chandima Edirisinghe, Aaron Fenster, Douglas A Hoover, Elizabeth Huynh

Affiliation: Robarts Research Institute, University of Western Ontario, London Health Sciences Center, Department of Radiation Oncology, London Health Sciences Centre

Abstract Preview: Purpose: We aim to develop a system that integrates micro-ultrasound into focal prostate cancer radiotherapy. This requires developing a mechatronic stepper capable of performing motorized rotation of...

Modernization of the NIST Air-Kerma Strength Standard for LDR Brachytherapy Seeds

Authors: Michael G. Mitch, Csilla I. Szabo-Foster

Affiliation: National Institute of Standards and Technology

Abstract Preview: Purpose: The U.S. air-kerma strength standard for low-dose-rate (LDR) low-energy photon-emitting brachytherapy sources provides measurement traceability for calibrations at the AAPM Accredited Dosimet...

Modified Dehazenet for Scatter Correction in Triggered Imaging: Enhancing Visibility and Alignment Precision for Radiation Therapy

Authors: Hyosung Cho, Dae Yup Han, Duhee Jeon, Jiwon Park, Hyesun Yang

Affiliation: Department of Therapeutic Radiology, Yale University School of Medicine, Yonsei University

Abstract Preview: Purpose: Scatter in X-ray imaging degrades image quality, hindering the visibility of critical anatomical features and complicating patient alignment in radiation therapy. This study aims to improve s...

Noise Sensitivity of Benchmark Whole-Body CT Segmentation Models: Totalsegmentator and Vista3D Performance on an Independent Dataset

Authors: Samuel L. Brady, Shruti Hegde, Alexander Knapp, Usman Mahmood, Joseph G. Meier, Elanchezhian Somasundaram, Zachary Taylor

Affiliation: Cincinnati Children's Hospital Medical Ctr, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, Cincinnati Children's Hospital Medical Center, Cincinnati Childrens Hospital Med Ctr

Abstract Preview: Purpose:
To assess how two benchmark multi-organ CT segmentation models respond to varying image noise levels.
Methods:
This study utilized the pediatric CT dataset from The Cancer Imaging Ar...

Oncoseed: Automated Workflow Generation for Pre-or and or-Plan Comparison in Prostate Seed Implants

Authors: Jaehee Chun, Jin Sung Kim, Siddhant Sen, James J. Sohn, Ethan D. Stolen

Affiliation: Department of Radiation & Cellular Oncology, University of Chicago, Department of Radiation and Cellular Oncology, University of Chicago, Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Department of Psychology, University of Illinois Urbana-Champaign, Oncosoft Inc

Abstract Preview: Purpose: In LDR brachytherapy for prostate cancer, anatomical changes between pre-planning and implantation require adjustment of needle and seed configurations. Currently, clinics spend significant t...

Prostate Brachytherapy Training – a Virtual Approach

Authors: Fahad Alam, Douglas A Hoover, Raffi Karshafian, Andrew Loblaw, Lucas Mendez, Lucas Mendez, Gerard Morton, Humza Nusrat, Moti R. Paudel, Mackenzie Smith, Amandeep Tagger, Anton Varlukhin

Affiliation: Odette Cancer Center, Sunnybrook Health Sciences Center, Department of Anesthesiology, Temerty Medicine, University of Toronto, Department of Physics, Toronto Metropolitan University, Department of Radiation Oncology, Temerty Medicine, University of Toronto, Department of Radiation Oncology, London Health Sciences Centre

Abstract Preview: Purpose: Prostate brachytherapy utilization has declined, due in part to limitations seen with in-person training including time and space constraints in the operating room. Virtual reality addresses ...

Quantifying the Impact of Tissue Inhomogeneities on Calculated Dosimetry within LDR Brachytherapy

Authors: Fatemeh Akbari, Deidre Batchelar, Luc Beaulieu, Nathan E. Becker, Juanita Crook, Dakota Mckeown, Matthew Jonathan Muscat, Rowan M. Thomson

Affiliation: Département de physique, de génie physique et d'optique, Université Laval, BC Cancer Agency, UBC, Carleton University, BC Cancer - Kelowna, BC Cancer

Abstract Preview: Purpose:
To study the effects of inter-seed attenuation and tissue inhomogeneities on dose-volume metrics of critical structures in prostate low-dose-rate (LDR) permanent seed implant brachytherapy...

Real-Time 3D Dose Verification for MR-Guided Online Adaptive Radiotherapy (ART) Via Geometry-Encoded Deep Learning Framework

Authors: Steve B. Jiang, Dan Nguyen, Chenyang Shen, Fan-Chi F. Su, Jiacheng Xie, Shunyu Yan, Daniel Yang, Ying Zhang, You Zhang

Affiliation: Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, UT Southwestern Medical Center, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Lab & Department of Radiation Oncology, UT Southwestern Medical Center, Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology, UT Southwestern Medical Center, The University of Texas at Dallas

Abstract Preview: Purpose: Fast dose verification is essential for the safety and efficiency of MR-guided adaptive radiotherapy (ART) as patients anxiously waiting on the treatment couch. Conventional tools often requi...

Real-Time Fully Automated IMRT Planning without Optimization Process Using a Two-Step AI Framework

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...

Robustness Evaluation of Dynamic Arc Proton Therapy: A Comparative Analysis of Small and Large Spot Sizes in Lung and Prostate Cancer Planning

Authors: Awens Alphonse, Nebi Demez, Michael Kasper, Noufal Manthala Padannayil, Shyam Pokharel, Suresh Rana, Hina Saeed, Gagandeep Saini, Nishan Shrestha, Somol Sunny

Affiliation: Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida

Abstract Preview: Purpose: This study evaluates the robustness of DynamicARC proton therapy plans for lung and prostate cancer, comparing small spot size (SS) and large spot size (LS) plans under nominal and worst-case...

Salvage High-Dose-Rate Brachytherapy for Locally Recurrent Prostate Cancer Treating Whole Gland with Focal Boost in Two Fractions

Authors: Elizabeth K. Butker, Cara Cimmino, Jenna L. Fair, David Matthew Giles, Bruce Hershatter, Shadab Momin, Sagar Patel, John Pattaras, Kamran Salari Salari, Aaron Weiss

Affiliation: Department of Radiation Oncology and Winship Cancer Institute, Emory University, Emory University School of Medicine

Abstract Preview: Purpose: Prostate cancer patients may experience a local-only failure after radiation. While high-dose-rate (HDR) brachytherapy may have more favorable toxicity profile and cancer control compared to ...

Towards Real-Time Marker-Less Prostate Tracking on Standard Radiation Therapy Systems

Authors: Freeman Jin, Paul J. Keall, Alistair MacDonald, Adam Mylonas, Chandrima Sengupta

Affiliation: Image X Institute, Faculty of Medicine and Health, University of Sydney, Image X Institute, Faculty of Medicine and Health, The University of Sydney, Image X Institute, School of Health Sciences, University of Sydney

Abstract Preview: Purpose: During radiation therapy, tumours in the prostate may move from the planned treatment position, leading to significant dose deviations above clinical tolerances Surveys have indicated the nee...

Using a-Si 1200 Epid Portal Dosimetry for VMAT Commissioning

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...