  High-dose-rate brachytherapy is a tumor treatment method where a highly
radioactive source is brought in close proximity to the tumor. In this paper we
develop a simulated annealing algorithm to optimize the dwell times at
preselected dwell positions to maximize tumor coverage under dose-volume
constraints on the organs at risk. Compared to existing algorithms, our
algorithm has advantages in terms of speed and objective value and does not
require an expensive general purpose solver. Its success mainly depends on
exploiting the efficiency of matrix multiplication and a careful selection of
the neighboring states. In this paper we outline its details and make an
in-depth comparison with existing methods using real patient data.
