Optimizing beam weights and wedge filters with the concept of the super-omni wedge.

This study introduces a new concept, the super-omni wedge, and proposes an algorithm for optimizing beam weights, wedge angles, and wedge orientations on the basis of this new concept. The super-omni wedge is a generalization of the omni wedge. Instead of combining one open beam and two orthogonal wedged beams, it uses two orthogonal pairs of nominal wedged beams to generate a wedged dose distribution with an arbitrary wedge angle and an arbitrary wedge orientation. The orientations of a pair of nominal wedges are opposite each other. In this way, the effective wedge orientation can vary from 0 degrees to 360 degrees rather than being restricted to one quadrant. When the concept of the super-omni wedge is used, the optimization of beam weights, wedge angles, and wedge orientations for J beams is transformed into the optimization of beam weights for 4J beams. A quadratic dose-based objective function is defined, and the method of sequential quadratic programming is used to find the 4J beam weights that minimize it. After the weights of the nominal wedged beams have been determined, the beams can be delivered in one of four methods: Directly, by using the omni wedge technique, by using the universal wedge technique, and by using the virtual wedge technique. When tested with two clinical cases, the algorithm achieved homogeneous dose distributions in target volumes while meeting the constraints to the organs at risk. A prominent feature of the algorithm is that there is no need to manually preselect the orientations of nominal wedges.