public static List <List <Structure> > SetConstraints(ref ExternalPlanSetup plan, HNPlan hnPlan, List <List <Structure> > matchingStructures, bool checkOptis = false)
{
StructureSet ss = plan.StructureSet;
//Will be checking if opti structures need to be made. If so, they will be created and used for optimization. So we need a new matching list
//which contains structures (opti or not) that are actually used during optimization.
List <List <Structure> > optimizedStructures = new List <List <Structure> >();
if (!checkOptis)
{
optimizedStructures = new List <List <Structure> >(matchingStructures);
for (int i = 0; i < hnPlan.ROIs.Count; i++)
{
hnPlan.ROIs[i].OptimizationStructures = new List <Structure>(hnPlan.ROIs[i].MatchingStructures);
}
return(optimizedStructures);
}
//Need to set all optimization constraints now. First clear all the current constraints
foreach (var objective in plan.OptimizationSetup.Objectives.OfType <OptimizationPointObjective>())
{
plan.OptimizationSetup.RemoveObjective(objective);
}
foreach (var objective in plan.OptimizationSetup.Objectives.OfType <OptimizationMeanDoseObjective>())
{
plan.OptimizationSetup.RemoveObjective(objective);
}
//Now loop over all constraints and set them
for (int i = 0; i < hnPlan.ROIs.Count; i++) //Loop over all structures
{
if (checkOptis)
{
hnPlan.ROIs[i].OptimizationStructures = new List <Structure>();
optimizedStructures.Add(new List <Structure>());
}
for (int match = 0; match < matchingStructures[i].Count; match++)
{
//Here I want to make sure that the matched structure does not overlap with PTVs, and if it does I want to make an opti structure.
if (checkOptis)
{
if (!hnPlan.ROIs[i].Critical)
{
Structure opti = CheckOverlap_OptiMaker(matchingStructures[i][match], ref ss, false);
optimizedStructures[i].Add(opti);
hnPlan.ROIs[i].OptimizationStructures.Add(opti);
}
else
{
Structure opti = CheckOverlap_OptiMaker(matchingStructures[i][match], ref ss, true);
optimizedStructures[i].Add(opti);
hnPlan.ROIs[i].OptimizationStructures.Add(opti);
}
}
if (hnPlan.ROIs[i].OptimizationStructures[match].Volume < 0.5)
{
continue;
}
for (int j = 0; j < hnPlan.ROIs[i].Constraints.Count; j++) //Loop over all constraints for the current structure
{
plan.OptimizationSetup.AddNormalTissueObjective(80.0f, 0.0f, 100.0f, 40.0f, 0.05f);
string type = hnPlan.ROIs[i].Constraints[j].Type;
string subscript = hnPlan.ROIs[i].Constraints[j].Subscript;
string relation = hnPlan.ROIs[i].Constraints[j].EqualityType;
double value = hnPlan.ROIs[i].Constraints[j].Value;
string format = hnPlan.ROIs[i].Constraints[j].Format;
double volume = hnPlan.ROIs[i].OptimizationStructures[match].Volume;
OptimizationObjectiveOperator constraintType;
if (relation == "<")
{
constraintType = OptimizationObjectiveOperator.Upper;
}
else
{
constraintType = OptimizationObjectiveOperator.Lower;
}
if (type.ToLower() == "d") //if a dose constraint
{
try //subscript is a number
{
volume = Convert.ToInt32(subscript); //need to analyze DVH data if a number.
//convert to cGy (90% of maximum for optimization)
plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match],
constraintType, new DoseValue(value, "cGy"), volume, hnPlan.ROIs[i].Constraints[j].Priority);
}
catch //is a mean or max restriction
{
if (subscript.ToLower() == "mean")
{
double dose = value * 0.9; //take 90 percent of dose constraint dose to start
OptimizationObjective objective = plan.OptimizationSetup.AddMeanDoseObjective(hnPlan.ROIs[i].OptimizationStructures[match],
new DoseValue(dose, "cGy"), hnPlan.ROIs[i].Constraints[j].Priority);
//update subsegment constraints if organ is subsegmented
if (hnPlan.ROIs[i].HasSubsegments)
{
//replace whole organ constraint with subsegment constraints
//plan.OptimizationSetup.RemoveObjective(objective); //uncomment if don't also want the whole organ constraint
foreach (Structure structure in ss.Structures)
{
if ((structure.Name.Contains(hnPlan.ROIs[i].OptimizationStructures[match].Name.Substring(0, 5))) && (structure.Name.ToLower().Contains("subseg")))
{
plan.OptimizationSetup.AddMeanDoseObjective(structure,
new DoseValue(dose, "cGy"), hnPlan.ROIs[i].Constraints[j].Priority);
}
}
}
}
else if (subscript.ToLower() == "max")
{
double dose = value * 0.9; //take 90 percent of constraint dose to start
if (hnPlan.ROIs[i].IsPTV) //if ptv, go halfway between the max dose and prescription dose
{
dose = (value + (double)hnPlan.ROIs[i].PTVDose) * 0.5;
}
OptimizationObjective objective = plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose, "cGy"), 0, hnPlan.ROIs[i].Constraints[j].Priority);
if (hnPlan.ROIs[i].HasSubsegments)
{
//replace whole organ constraint with subsegment constraints
//plan.OptimizationSetup.RemoveObjective(objective); //uncomment if don't also want the whole organ constraint
foreach (Structure structure in ss.Structures)
{
if ((structure.Name.Contains(hnPlan.ROIs[i].OptimizationStructures[match].Name.Substring(0, 5))) && (structure.Name.Contains("subseg")))
{
plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose, "cGy"), 0, hnPlan.ROIs[i].Constraints[j].Priority);
}
}
}
}
else if (subscript.ToLower() == "min")
{
double dose = value * 1.05; //take 110% percent of constraint dose to start
OptimizationObjective objective = plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose, "cGy"), 100, hnPlan.ROIs[i].Constraints[j].Priority);
if (hnPlan.ROIs[i].HasSubsegments)
{
//replace whole organ constraint with subsegment constraints
//plan.OptimizationSetup.RemoveObjective(objective); //uncomment if don't also want the whole organ constraint
foreach (Structure structure in ss.Structures)
{
if ((structure.Name.Contains(hnPlan.ROIs[i].OptimizationStructures[match].Name.Substring(0, 5))) && (structure.Name.Contains("subseg")))
{
plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose, "cGy"), 100, hnPlan.ROIs[i].Constraints[j].Priority);
}
}
}
}
}
}
else if (type.ToLower() == "v")
{
try //in case can't parse the subscript into Int32
{
if (format.ToLower() == "abs") //I assume here that an absolute volume constraint will always be an upper bound OAR consatraint
{
double dose = Convert.ToInt32(subscript); //convert to cGy
//Need to convert to relative volume.
volume = value / volume * 100;
volume *= 0.9; //Make it an even harsher constraint
if (volume <= 0.2)
{
volume = 0;
}
plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose * 0.95, "cGy"), volume, hnPlan.ROIs[i].Constraints[j].Priority);
}
else //if relative, will belong to a PTV
{
double dose = StringOperations.FindPTVNumber(hnPlan.ROIs[i].OptimizationStructures[match].Name.ToLower()) * 100;
volume = value;
volume = 100; //set to 100 to push the optimizer
plan.OptimizationSetup.AddPointObjective(hnPlan.ROIs[i].OptimizationStructures[match], constraintType,
new DoseValue(dose, "cGy"), volume, hnPlan.ROIs[i].Constraints[j].Priority);
}
}
catch
{
}
}
}
}
}
return(optimizedStructures);
}
public static List <string> UpdateConstraints(ref ExternalPlanSetup plan, ref StructureSet ss, ref HNPlan hnPlan, ScriptContext context, List <List <Structure> > optimizedStructures, List <List <Structure> > matchingStructures, int numCycles)
{
List <string> log = new List <string>();
log.Add("<p>");
if (numCycles == 1)
{
log.Add("Preliminary Optimization Iteration Update Log: <br>");
}
else
{
log.Add("Full VMAT Optimization Update: <br>");
}
//Go through all plan types and check all constraints.
PlanSetup p = context.PlanSetup;
p.DoseValuePresentation = DoseValuePresentation.Absolute;
double prescriptionDose = p.TotalDose.Dose;
List <ROI> ROIs = hnPlan.ROIs;
for (int s = 0; s < hnPlan.ROIs.Count; s++) //Gothrough all the different constrained structures
{
for (int match = 0; match < matchingStructures[s].Count; match++) //FOr each structure in ss that matches the hnplan structure
{
for (int i = 0; i < ROIs[s].Constraints.Count; i++) //first go one by one through the constraints.
{
//Get DVH data for structure:
DVHData dvhData = p.GetDVHCumulativeData(matchingStructures[s][match], DoseValuePresentation.Absolute, VolumePresentation.AbsoluteCm3, 0.01);
//Get type of constraint
string type = ROIs[s].Constraints[i].Type;
string subscript = ROIs[s].Constraints[i].Subscript;
string relation = ROIs[s].Constraints[i].EqualityType;
double value = ROIs[s].Constraints[i].Value;
string format = ROIs[s].Constraints[i].Format;
int priority = ROIs[s].Constraints[i].Priority;
int priorityLower = ROIs[s].Constraints[i].PriorityRange[0];
int priorityUpper = ROIs[s].Constraints[i].PriorityRange[1];
if (type.ToLower() == "d")//now subscript can be mean, max, min, median?
{
try
{
double sub = Convert.ToInt32(subscript); //need to analyze DVH data if a number.
VolumePresentation vp = VolumePresentation.AbsoluteCm3;
DoseValuePresentation dp = new DoseValuePresentation();
dp = DoseValuePresentation.Absolute;
double volume = matchingStructures[s][match].Volume;
if (format.ToLower() == "rel")
{
sub = volume * sub / 100;
value *= prescriptionDose / 100;
}
double doseQuant = p.GetDoseAtVolume(matchingStructures[s][match], sub, vp, dp).Dose;
if (p.GetDoseAtVolume(matchingStructures[s][match], sub, vp, dp).Unit == DoseValue.DoseUnit.Gy) //convert to cGy if necessary
{
doseQuant *= 100;
}
//now check the inequality:
if (relation == "<")
{
if (doseQuant < value)
{
//If an OAR, loosen priority if its satisfied by over 7Gy
if ((ROIs[s].Type == "OAR") && (value - doseQuant > 1000))
{
priority = (int)(priority * 0.8);
//Make sure the priority is within the priority range:
priority = Math.Min(priorityUpper, priority);
priority = Math.Max(priorityLower, priority);
hnPlan.ROIs[s].Constraints[i].Priority = priority;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED. Dose (" + doseQuant.ToString() + "cGy) not within 10Gy of constraint - adjusted priority from " + string.Format("{0}", priority) + " to " + ((int)(priority * 0.8)).ToString() + ".");
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED. Dose (" + doseQuant.ToString() + "cGy). Unadjusted.");
}
}
else
{
//By what percentage is the constraint being missed by (as ratio)?
double percentageOff = 1 + (doseQuant - value) / value;
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " FAILED- Updating priority from " + string.Format("{0}", priority) + " to " + string.Format("{0}", (int)(newPriority)));
}
}
else if (relation == ">")
{
if (doseQuant > value)
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED Dose (" + doseQuant.ToString() + "cGy). Unadjusted.");
}
else
{
//By what percentage is the constraint being missed by (as ratio)?
double percentageOff = 1 - (doseQuant - value) / value; //minus because its negative numerator
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " FAILED. Updating priority from " + string.Format("{0}", priority) + " to " + string.Format("{0}", newPriority));
}
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + "- Could not understand the relation given in the constraint.");
}
}
catch //mean median...
{
double dose = 0;
if (subscript.ToLower() == "mean")
{
dose = dvhData.MeanDose.Dose;
}
else if (subscript.ToLower() == "max")
{
dose = dvhData.MaxDose.Dose;
}
else if (subscript.ToLower() == "median")
{
dose = dvhData.MedianDose.Dose;
}
else if (subscript.ToLower() == "min")
{
dose = dvhData.MinDose.Dose;
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + "- Could not understand the relation given in the constraint. ");
break;
}
if (dvhData.MeanDose.Unit == DoseValue.DoseUnit.Gy) //convert to gy if necessary
{
dose *= 100;
}
if (format.ToLower() == "rel")
{
value *= prescriptionDose / 100;
}
//Now check the relation
if (relation == "<")
{
if (dose < value)
{
if ((ROIs[s].Type == "OAR") && (value - dose > 1000))
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED by over 10Gy. Decreasing priority to " + string.Format("{0}", (int)(priority * 0.8)));
priority = (int)(priority * 0.8);
priority = Math.Min(priorityUpper, priority);
priority = Math.Max(priorityLower, priority);
hnPlan.ROIs[s].Constraints[i].Priority = priority;
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED. Unadjusted");
}
}
else
{
//By what percentage is the constraint being missed by (as ratio)?
double percentageOff = 1 + (dose - value) / value;
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
//Also don't want to increase priority by more than 20 at a time:
newPriority = Math.Min(newPriority, priority + 20);
if ((ROIs[s].Type == "OAR") && (ROIs[s].Critical == false))
{
newPriority = Math.Min(newPriority, 70);
}
if (dose - value > 2000) //if constraint is failing miserably, stop trying
{
newPriority = 0;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " Failed by more than 20Gy. Deleting constraint.");
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " Failed. Updating priority from " + string.Format("{0}", priority) + " to " + string.Format("{0}", (int)(priority * 1.1)));
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
}
}
}
else if (relation == ">")
{
if (dose > value)
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED. Unadjusted.");
}
else
{
//By what percentage is the constraint being missed by (as ratio)?
double percentageOff = 1 - (dose - value) / value; //negative because negative numerator
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " Failed. Updating priority from " + string.Format("{0}", priority) + " to " + string.Format("{0}", newPriority));
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
}
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + "-Could not understand the relation given in the constraint.");
}
}
}
else if (type == "V")
{
try
{
double sub = Convert.ToDouble(subscript); //need to analyze DVH data if a number.
double frac = prescriptionDose; //ad hoc fix for ptv string output
VolumePresentation vp = VolumePresentation.Relative;
double volume = matchingStructures[s][match].Volume;
if (format.ToLower() == "abs")
{
value = (value / volume) * 100;
sub = Convert.ToDouble(subscript);
}
//But if PTV, then this is not relative to the prescription dose.
if (ROIs[s].Name.ToLower().Contains("ptv"))
{
frac = StringOperations.FindPTVNumber(ROIs[s].Name.ToLower());
sub = Convert.ToDouble(subscript) * frac / 100; //frac in Gy and subscript percentage, so factor of 100 cancels out
vp = VolumePresentation.Relative;
}
DoseValue dose = new DoseValue(sub, "cGy");
//Need dose in cGy for calculation:
double volumeQuant = p.GetVolumeAtDose(matchingStructures[s][match], dose, vp);
//Now check the inequality:
if (relation == "<")
{
if (volumeQuant < value)
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED.");
}
else
{
//By what percentage is the constraint being missed by (as ratio)?
double percentageOff = 1 + (volumeQuant - value) / value;
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
//Also don't want to adjust any constraint by more than 20 at a time:
newPriority = Math.Min(newPriority, priority + 20);
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " Failed. Updating priority from" + string.Format("{0}", priority) + " to " + string.Format("{0}", newPriority));
}
}
else if (relation == ">")
{
if (volumeQuant > value)
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " SATISFIED.");
}
else
{
double percentageOff = 1 - (volumeQuant - value) / value;
int newPriority = Math.Max((int)(priority * percentageOff), priority + 10);
newPriority = Math.Min(priorityUpper, newPriority);
newPriority = Math.Max(priorityLower, newPriority);
hnPlan.ROIs[s].Constraints[i].Priority = newPriority;
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + " Failed. Updating priority from" + string.Format("{0}", priority) + " to " + string.Format("{0}", newPriority));
}
}
else
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + "-Could not understand the relation given in the constraint.");
}
}
catch
{
log.Add(ROIs[s].Name + ": Constraint " + (i + 1).ToString() + "-Could not understand the relation given in the constraint.");
}
}
}
}
log.Add("</p>");
}
//Now need to delete and reset all constraints
OptObjectivesEditing.SetConstraints(ref plan, hnPlan, optimizedStructures);
return(log);
}
public static void BeamMaker(ref ExternalPlanSetup plan, StructureSet ss, double prescriptionDose, Tuple <string, string, bool> beamParams)
{
//First check if beams already exist
foreach (Beam beam in plan.Beams.ToList())
{
plan.RemoveBeam(beam);
}
string treatmentCenter = beamParams.Item1;
string treatmentArea = beamParams.Item2;
string beamName = "";
int doseRate = 600;
//Get the right beam name
if (treatmentCenter == "BC Cancer - Surrey")
{
beamName = "fv" + treatmentArea.Replace(" ", "") + "TB";
beamName = beamName.ToUpper();
doseRate = 400;
}
else if (treatmentCenter == "BC Cancer - Vancouver")
{
beamName = "Va" + treatmentArea.Replace(" ", "");
}
//need to create two arc beams, and make sure they fit to PTVs.
ExternalBeamMachineParameters ebmp = new ExternalBeamMachineParameters(beamName, "6X", doseRate, "ARC", null);
//First need to find the isocentre, which will be in the main PTV
//find all the ptvs
List <Structure> ptvs = new List <Structure>();
List <Structure> mainPTVs = new List <Structure>();
foreach (Structure structure in ss.Structures)
{
if (structure.Name.ToLower().Contains("ptv"))
{
ptvs.Add(structure);
if (StringOperations.FindPTVNumber(structure.Name) == prescriptionDose / 100)
//Check if receiving prescription dose
{
mainPTVs.Add(structure);
}
}
}
//Check if it's receiving the prescription dose. If so, set isocentre here. If there is more than
//One receiving the prescription dose, set at the average between the two.
VVector isocentre;
if (mainPTVs.Count > 0)
{
double x = 0;
double y = 0;
double z = 0;
//Find average x,y,z
for (int i = 0; i < mainPTVs.Count; i++)
{
x += Math.Round(mainPTVs[i].CenterPoint.x / 10.0f) * 10.0f / mainPTVs.Count;
y += Math.Round(mainPTVs[i].CenterPoint.y / 10.0f) * 10.0f / mainPTVs.Count;
z += Math.Round(mainPTVs[i].CenterPoint.z / 10.0f) * 10.0f / mainPTVs.Count;
}
isocentre = new VVector(x, y, z);
}
else
{
isocentre = new VVector(0, 0, 0);
}
//Create two VMAT beams
//First get the right jaw dimensions:
VRect <double> jaws1 = FitJawsToTarget(isocentre, plan, ptvs, 30, 0);
VRect <double> jaws2 = FitJawsToTarget(isocentre, plan, ptvs, 330, 0);
Beam vmat1 = plan.AddArcBeam(ebmp, jaws1, 30, 180.1, 179.9, GantryDirection.Clockwise, 0, isocentre);
Beam vmat2 = plan.AddArcBeam(ebmp, jaws2, 330, 179.9, 180.1, GantryDirection.CounterClockwise, 0, isocentre);
vmat1.Id = "PC_vmat1";
vmat2.Id = "PC_vmat2";
}
