Hybrid optimization based on non-coplanar needles for brachytherapy dose planning

Purpose An ideal dose distribution in a target is the ultimate goal of preoperative dose planning. Furthermore, avoiding vital organs or tissues such as blood vessels or bones during the puncture procedure is significant in low-dose-rate brachytherapy. The aim of this work is to develop a hybrid inverse optimization method based on non-coplanar needles to assist the physician during conformal dose planning, which cannot be properly achieved with a traditional coplanar template.