Computer-implemented medical method for radiation treatment (RT) planning for treating multiple lesions of a patient

A non-transitory computer readable storage medium comprising instructions which, when executed by at least one processor, cause the at least one processor to:

• determine for at least one or more lesion of a patient, one or more conformal apertures to be used during radiation treatment;
• perform a treatment optimization based on conformal shapes for the one or more lesions of the patient using a dynamic conformal arc (DCA) optimizer thereby calculating a first irradiation treatment;
• use the calculated first irradiation treatment as initialisation of a volumetric intensity modulated arc therapy (VMAT) optimizer;
• perform an optimization for the one or more lesions of the patient using the initialized VMAT optimizer;
• and
• wherein the VMAT optimizer keeps all determined conformal apertures conformal during the optimization.

A medical system, comprising:

• at least one processor;
• at least one electronic data storage device storing at least patient data describing multiple lesions of a patient;
• and
• a medical device for carrying out a medical procedure on the patient, wherein the at least one processor is operably coupled to:
• the at least one electronic data storage device for acquiring, from the at least one electronic data storage device, the patient data describing the multiple lesions of the patient, the at least one processor operable to:
• perform an optimization for the multiple lesions of the patient using an initialized volumetric intensity modulated arc therapy (VMAT) optimizer;
• and
• wherein the VMAT optimizer keeps all determined conformal apertures conformal during the optimization;
• and
• issuing a control signal to the medical device for controlling an operation of the medical device on a basis of a result of the optimization.