Shared data for intensity modulated radiation therapy (IMRT) optimization research: the CORT dataset
 David Craft†^{1}Email author,
 Mark Bangert†^{2},
 Troy Long†^{3},
 Dávid Papp†^{1} and
 Jan Unkelbach†^{1}
DOI: 10.1186/2047217X337
© Craft et al.; licensee BioMed Central. 2014
Received: 14 July 2014
Accepted: 19 November 2014
Published: 12 December 2014
Abstract
Background
We provide common datasets (which we call the CORT dataset: common optimization for radiation therapy) that researchers can use when developing and contrasting radiation treatment planning optimization algorithms. The datasets allow researchers to make onetoone comparisons of algorithms in order to solve various instances of the radiation therapy treatment planning problem in intensity modulated radiation therapy (IMRT), including beam angle optimization, volumetric modulated arc therapy and direct aperture optimization.
Results
We provide datasets for a prostate case, a liver case, a head and neck case, and a standard IMRT phantom. We provide the doseinfluence matrix from a variety of beam/couch angle pairs for each dataset. The doseinfluence matrix is the main entity needed to perform optimizations: it contains the dose to each patient voxel from each pencil beam. In addition, the original Digital Imaging and Communications in Medicine (DICOM) computed tomography (CT) scan, as well as the DICOM structure file, are provided for each case.
Conclusions
Here we present an open dataset – the first of its kind – to the radiation oncology community, which will allow researchers to compare methods for optimizing radiation dose delivery.
Keywords
IMRT Optimization Radiation therapy Beam angle optimization VMAT Treatment plan optimizationBackground
The goal of radiation therapy for cancer treatment is to irradiate the tumorous regions of the body with sufficiently high levels of radiation while sparing nearby healthy tissues as much as possible. In the mid 1990s a technique known as intensity modulated radiation therapy (IMRT) emerged which further enables tailoring of the 3D dose distribution inside the patient. Along with this extra freedom comes the need for mathematical optimization, and over the last 20 years a large amount of research has produced over of 600 papers (a conservative estimate based on a PubMed search for the words “IMRT” and “optimization” in the title or abstract) revolving around this topic.
A deficiency in the field has been the lack of common datasets for researchers to test their algorithms on. As such, most new algorithm papers simply state the algorithm and demonstrate it, but the reader is left to wonder how this algorithm compares with other approaches to the same problem. Furthermore, the raw data that was used for a specific study is never provided as part of the publication, for reasons such as data size, involvement of commercial software products, and protection of data privacy for individual patients.
With this paper, we want to address these issues and provide the basis for meaningful benchmarking of IMRT optimization algorithms. Specifically, our initiative aims at resolving the following shortcomings:

Patient cases used in different papers differ greatly in the geometry of their targets and critical structures. A technique that works on an “easy” patient may not work as well on a “challenging” patient and vice versa.

Research papers make different assumptions when deriving plan optimization data from the patient’s planning computed tomography (CT) scan. This includes the dose calculation method, spatial resolution of the dose and beamlet grid, planning goals, delivery modality, etc. These data are generated inhouse and are not shared with the research community.

New researchers in the field may not have access to clinical patient datasets.
Data description
Here, we present datasets comprising three anonymized cancer patient cases and one standard IMRT phantom. For each of the four cases, we include the original DICOM CT image as well as the DICOM RTStruct file containing the contours of targets and organs at risk. These files are made available for viewing results, although they are not necessary for optimization. In addition, the DICOM files give researchers the opportunity to replan these patients in a commercial treatment planning system. All further data is derived from the DICOM data.
Voxel grid
For dose calculation, the original CT image is downsampled to a lower resolution. The final resolution and size of the dose grid in three dimensions is stored in a text file named CTVOXEL_INFO.txt. Each voxel in the 3D dose grid is assigned a voxel index, which is used in optimization data described below. The coordinate system and the conversion of voxel indices to spatial location is described in Methods. For standard optimizations, voxel positions are not needed. However, they are required for visualization of the dose distribution, and are useful for implementing objective functions which require spatial information, for example a dose penalty which depends on the distance from a normal tissue voxel to the patient’s tumor. This file also contains the isocenter location. The isocenter denotes the point in space about which couch and gantry rotate to achieve different beam orientations.
Beamlet grid
The incident fluence is discretized into a rectangular grid of beamlets. We use a beamlet size of 1cm × 1cm for all cases except for the head and neck case, for which we use 0.5 cm × 0.5 cm. The isocenter is identical for all beam directions and is located in the center of mass of the union of all target volumes. The set of beamlets for which dose is calculated is based on an isotropic 2.5 mm expansion of the union of all targets. A beamlet is included in the fluence map if its central axis intesects the enlarged target. In a postprocessing step, we ensure that the beamlet grid is consecutive. If beamlets are missing from the fluence map, causing a hole across a multileaf collimator (MLC) row, these beamlets are added and their dose distribution is calculated. This issue arises for example in the head and neck case with disconnected targets on either side of the neck. Missing beamlets could be problematic for sliding window IMRT and VMAT optimization approaches, where the MLC leaves would potentially slide over those beamlets. The beamlet grid coordinate system is described in Methods.
Optimization data
All binary formatted data are saved from Matlab as *.mat files (we have used Matlab version 7.14.0.739, R2012a)^{a}. In this way, data can either be read into Matlab, Octave or Python using the scipy package. Instructions for reading in the data are given in the Methods section. For treatment plan optimization, we provide the following files for each patient.
Voxel lists
The voxel list files contain the indices of the voxels which are inside each geometrically contoured structure. The information is stored as a list of integers in the files {structure name}_VOILIST.mat. The format thus allows for overlapping structures, in other words a given voxel index can be contained in multiple voxel lists.
Beamlet information
For each (gantry angle, couch angle) pair, a beam information file with the file name Gantry{gantry angle}_Couch {couch angle}_BEAMINFO.mat is provided. The file contains the following information:

couch angle

gantry angle

number of beamlets

number of nonzeros in the doseinfluence matrix (see the next section; this value is helpful for preallocating memory to store these matrices)

A vector of the x position of each of the beamlets (using the gantry head coordinate system, see Figure 2).

A vector of the y position of each of the beamlets (see Figure 2).
Geometric beamlet information is not necessary for the most primitive type of IMRT optimization, but when a fluence map smoothing term is to be included, for example, see [23, 24] or for VMAT and DAO (where “apertures” are created by combining adjacent beamlets), it is necessary to know the geometric location (x, y) of each of the beamlets. See also Figure 2(a). Although a nonzero collimator angle can be useful for VMAT delivery and standard IMRT where delivery time is of high concern, for simplicity we have only used a collimator angle of 0 for these datasets and so do not include collimator angle as a field in the BEAMINFO files.
Doseinfluence matrix
The dose influence matrix D _{ ij } is the main entity used for optimization. It contains the dose delivered to each voxel i per unit intensity of beamlet j. We provide the dose influence matrix in units of Gray per monitor unit (Gy/MU)^{b}. The doseinfluence matrix is stored in separate files for each (gantry angle, couch angle) pair in files named Gantry{gantry angle}_Couch{couch angle}_D.mat. The beamlet order (index) is as they are ordered in the (x, y) data in the corresponding BEAMINFO file. Each of the doseinfluence files contains a single matrix called D, which is a Matlab sparse matrix ^{c}. We use CERR version 4.4 (Computational Environment for Radiotherapy Research) [25] to produce the dose influence matrices for each case. CERR uses a pencil beam type dose calculation algorithm referred to as the quadrant infinite beam (QIB) model [26, 27]. This method uses pretabulated integration values to allow for a fast computation of D _{ ij }. We use the default values in the CERR IMRT GUI regarding the specifics of the dose computation (Gaussian primary and scatter radiation, exponential scatter method, 6 Megaelectronvolts beams).
where x _{ j } is the fluence value of the j th beamlet.
Hints for CERR users
Summary of patient characteristics
TG119  Prostate  Liver  Head and neck  

Number of beam angles  5  180  56  1983 
Total number of beamlets  418  25,404  3678  2,257,507 
Noncoplanar  no  no  yes  yes 
Beamlet size [cm]  1 ×1  1 ×1  1 ×1  0.5 ×0.5 
Voxel resolution (LR,AP,SI) [mm]  (3.0, 3.0, 2.5)  (3.0, 3.0, 3.0)  (3.0, 3.0, 2.5)  (3.0, 3.0, 5.0) 
Voxel grid size (LR,AP,SI)  (167,167,129)  (184,184,90)  (217, 217,168)  (160,160,67) 
Number of target voxels  7429  9491  6954  25,388 
Number of voxels in patient  599,440  690,373  1,927,357  251,893 
dataset size  25 MB  1.9 GB  560 MB  64 GB 
The four cases
TG119 dataset
The first case we use is a phantom provided by the American Association of Physicists in Medicine Task Group 119 for use in institutional IMRT commissioning (i.e. readying a clinic for IMRT treatments) [28]. This phantom has several sets of contours for various IMRT treatment planning tests, but we only use three of the contours: a Cshaped target (called “OuterTarget”), an OAR that the target wraps around (“Core”), and the external contour of the phantom itself (“BODY”).
For this case we provide five equispaced coplanar beams (coplanar refers to beams where the couch angle is fixed at 0°) at gantry angles 0°, 72°, 144°, 216°, and 288°. This serves as our small dataset. The total number of beamlets at each respective angle is 98, 70, 90, 90 and 70, for a total of 418 beamlets.
Prostate
The prostate case serves as one of our two medium size datasets. We generate 180 equispaced coplanar beams, thus this data set serves as a test case for VMAT algorithms. Using a beamlet resolution of 1 cm × 1 cm, the total number of beamlets is 25,404. There are two targets for the prostate case. The highest prescription dose target, PTV_68, is a geometric expansion of the prostate. The lower dose target, PTV_56, is an expansion around the prostate and the lymph nodes.
SBRT liver case
This is the first noncoplanar case we present. We originally generate 162 (gantry, couch) angle pairs such that the entry angles are evenly scattered over a sphere corresponding to an average angular spacing of 16°. This was done using a Matlab routine called GridSphere available from the File Exchange portion of the MathWorks website. We then eliminate beams that have either entrance or exit doses through the first slice of the CT since if this is the case, the full dose deposit of the beam is not properly accounted for. This leaves 56 beams in the dataset, with a total of 3678 beamlets. Note that given a particular linac, some gantry/couch angle combinations may not be allowed due to mechanical collisions. Since this is linac specific, we have not attempted to eliminate such beams, and instead leave it to the reader to keep this in mind if modeling an actual clinical delivery situation.
Head and neck
Analyses
Dose statistics for all cases, for two selected structures, for the ones solution (all beams), i.e. ${d}_{i}=\sum _{j}\mathit{\text{Dij}}$
Case  Structure name  Minimum dose  Mean dose  Maximum dose 

TG119  Core  0.026798  0.050724  0.053313 
OuterTarget  0.049379  0.051067  0.052702  
Prostate  PTV_56  1.3015  1.3631  1.4089 
Bladder  0.66549  1.2753  1.3863  
Liver  Heart  0.0003963  0.093117  0.4388 
PTV  0.37532  0.41629  0.48094  
Head and Neck  PTV_70  19.5394  21.0998  23.1338 
PAROTID_LT  8.7997  20.3354  23.7127 
Optimization demonstration and results
Description of the IMRT optimization problem
Here we describe what is known as the fluencebased IMRT optimization problem. This an idealized version of the actual IMRT treatment planning problem, but is commonly used to develop algorithms and indeed is possible to use in clinical settings (e.g., [30]).
A specific example that would give rise to a linear program would be to choose as f(d) the mean dose to a critical structure, and to invoke upper bounds for all voxels and additional lower bounds for the target voxels via the constraint set C. A typical quadratic formulation would set goals for every voxel (e.g., prescription dose to all target voxels and 0 to all other voxels) and minimize the squared deviation from those levels.
BAO, DAO and VMAT formulations put additional restrictions on the x vector. For example for BAO, one might restrict that a total of five beams are used at most, and thus integer variables could be added to this formulation to control the maximum number of active beams/beamlets.
Examples of linear programming formulations
Linear programming formulation and solution statistics for the TG119 case, all five beams used
Objective  min (mean Core + mean BODY) 

Constraints  OuterTarget >= 1 
OuterTarget <= 1.2  
Core <= 1.2  
Results  mean Core = 0.2489 
mean BODY = 0.1021 
Linear programming formulation and solution statistics for the Prostate case, using the five beams at gantry angles 0°, 72°, 144°, 216°, and 288°
Objective  min (mean Rectum + 0.6*mean Bladder+ 0.6*mean BODY) 

Constraints  PTV_68 >= 1 
x <= 50  
Results  mean Rectum = 0.2842 
mean Bladder = 0.4035  
mean BODY = 0.0905 
Linear programming formulation and solution statistics for the Liver case, using the seven beams at (gantry, couch) angles (58°, 0°), (106°, 0°), (212°, 0°), (328°, 0°), (216°, 32°), (226°, 13°), (296°, 17°)
Objective  min (mean Liver + mean Heart+ 0.6*mean entrance) 

Constraints  PTV >= 1 
x <= 25  
Results  mean Liver = 0.1771 
mean Heart = 0.1258  
mean Entrance = 0.0186 
Linear programming formulation and solution statistics for the head and neck case, using five gantry angles at couch = 0° (0°, 72°, 144°, 216°, and 288°) as well as five gantry angles at couch = 20° (180°, 220°, 260°, 300°, 340°)
Objective  min (mean Left Parotid + mean Right Parotid) 

Constraints  All PTVs >= 1 
spinal cord <= 0.5  
brainstem <= 0.5  
x <= 25  
Results  mean Left Parotid = 0.4959 
mean Right Parotid = 0.3437 
Discussion
We provide four datasets for radiotherapy treatment plan optimization. The datasets are meant to serve several purposes:

We provide datasets for researchers in the optimization community who may not have access to patient data.

Advanced problems like BAO, DAO and VMAT represent nonconvex or combinatorial problems which typically cannot be solved to optimality. Thus, solution approaches are heuristics, and different methods can only be compared meaningfully based on common datasets, where differences due to patient geometry and dose calculation are eliminated.

The datasets can serve as benchmark cases for the development of fast and efficient solvers customized to fluence map optimization and its variants. This development may also benefit other radiotherapy planning problems such as robust optimization in proton therapy and adaptive replanning in online image guided radiotherapy. Our datasets do not per se support these specific problems. However, such applications rely on very fast optimization methods that can handle large instances of optimization problems of the form (2).
Solution reporting
We recommend that researchers share results in the maximally transparent and reproducible manner. This includes the statement of the full optimization problem that was solved. In addition, the solution should be shared in the form of fluence maps, from which the dose distribution and all dose measures can be derived. The details of the solution reporting may depend on the application:

For IMRT fluence map optimization, the solution is the vector of beamlet intensities x at each beam (gantry/couch pair) that is used in the solution. As such, we recommend the following file format for users to report and share solutions. The file name should match the name of the Dij file (replacing the “_D.mat” with “_beamletSol.mat”), and should consist of fluence values stored as a vector called beamx. The beamlet solution files for the linear programs solved above are included in the data download.

For DAO applications, the solution can be reported through an effective fluence map for each individual aperture, using the same format. Similarly, VMAT algorithms that represent extensions of DAO algorithms can report the solution in the form of effective fluence maps for all control points.
Fluence map optimization
We have presented results for the ones solutions and for simple linear programs for the purpose of data testing and consistency. We have not included solution times since the purpose of this paper is not to present methods for fast/quality solutions to the IMRT problem, but rather to provide a set of data for the community to do such things. We used the Matlab linear programming solver (linprog) to solve the TG119, the prostate, and the liver case, but switched to CPLEX’s Matlab interface (cplexlp) to solve the head and neck case, due to its size. All cases finished in under two minutes, except for the head and neck case which took about 8 minutes.
The optimization formulation given in formulation (2) involves the linear mapping from the fluence values x to the voxel doses d as given in Equation (1). As such, provided the function f(d) is convex and the constraint set C is convex, the problem is a convex optimization problem. Hardware considerations, such as determining MLC positions to directly form the desired fluence maps (DAO), make the problem nonconvex, as do dosevolume constraints which specify for example that only a certain number of voxels of a structure can exceed a certain dose level. The discrete form of the beam angle optimization problem, where candidate beams are preselected and the optimization problem is to find a subset of the beams (for example, the seven best beams) and their beamlet fluences to optimize a given objective, is a combinatorial problem, and thus is also nonconvex.
DAO and VMAT applications
In modern clinical treatment planning systems, fluence based optimization is done (at most) as an initial step. Final plan optimization involves determining aperture shapes (specified by the positions of MLC leaves) and weights. To that end, many modern planning systems apply DAO methods.
Once a segment shape is computed, the dose is linear in the segment weight. To a first approximation, the dose contribution from a segment is the sum of the contributions from the individual beamlets that constitute that segment (i.e., the information stored in the D _{ ij } matrix). But better accuracy is obtained by doing a dose computation for each individual aperture shape, which involves scatter terms that can only be computed once the aperture shape is known. Using the datasets provided herein, dose calculation for an aperture is limited to approximations based on the D _{ ij } matrix. Despite this limitation, this dataset can be used for DAO algorithm design. Indeed, most DAO algorithms heavily utilize the D _{ ij } matrix concept for generating promising apertures [22] or for approximating gradients with respect to MLC leaf positions [20, 31]. Only a more accurate final or intermittent recalculation of an aperture’s dose distribution cannot be performed using this dataset.
Similarly, VMAT treatments need to consider MLC leaf positions in order to emulate a clinical VMAT optimizer. VMAT solvers typically strive to find a solution where the beam rotates completely around the patient on the order of minutes. As such, complete fluence modulation cannot be achieved at every angle, and MLC leaf positions must be tracked to make sure neighboring apertures are similar so that the gantry does not need to slow down excessively to move the leaves far across the treatment field. Because this dataset involves beamlet position information and couch and gantry positions, it can be used for VMAT optimization research. To include delivery time in VMAT planning optimization one must specify a dose rate. A typical value is 600 MU/min.
Conclusion
We provide the first open dataset to the radiation oncology community, thus allowing researchers to compare methods for optimizing radiation dose delivery. The dataset comprises four patient cases from different sites. Besides CT data and structure sets, we also include dose calculation data in order to enable a onetoone comparison of novel and existing optimization strategies for intensity modulated radiation therapy, beam angle optimization, direct aperture optimization, and volumetricmodulated arc therapy.
Methods
Demonstration code
Availability of supporting data
The data supporting this article are available in the GigaScience repository, GigaDB, [32].
Endnotes
^{a} Note that, if one were to use a more recent version of Matlab to save data for reading into Python etc, one should use the Matlab toggle v7 during the save command.
^{b} The unit of beamlet intensity (MU) is defined such that 100 MU yields a dose of 1 Gy in 10 cm depth in water in the center of a 10 cm × 10 cm radiation field. We choose the units of Gy/MU for the doseinfluence matrix in order to facilitate studies where treatment delivery time and/or variable dose rates are of interest.
^{c} The dose influence matrix can by read directly into Matlab, Octave and Python as a sparse matrix (see the Methods section). Note however that Python is 0based whereas Matlab and Octave are 1based. The voxels indices stored in the {structure name}_VOILIST.mat files are 1based, i.e., the lowest voxel index is 1, as depicted in Figure 5. Thus the user has to perform the appropriate shift when using Python.
Notes
Abbreviations
 AP:

Anteriorposterior
 BAO:

Beam angle optimization
 CERR:

Computational environment for radiotherapy research
 CORT:

Common optimization for radiation therapy
 CT:

Computed tomography
 DAO:

Direct aperture optimization
 DICOM:

Digital imaging and communications in medicine
 Gy:

Gray
 IMRT:

Intensity modulated radiotherapy
 LR:

Leftright
 MLC:

Multileaf collimator
 MU:

Monitor unit
 OAR:

Organatrisk
 PTV:

Planning target volume
 QIB:

Quadrant infinite beam
 SBRT:

Stereotactic body radiation therapy
 SI:

Superiorinferior
 VMAT:

Volumetric modulated arc therapy.
Declarations
Authors’ Affiliations
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