  Purpose: To develop a multi-criteria optimization framework for image guided
radiotherapy. Methods: An algorithm is proposed for a multi-criteria framework
for the purpose of patient setup verification decision processes. Optimal
patient setup shifts and rotations are not always straightforward, particularly
for deformable or moving targets of the spine, abdomen, thorax, breast, head
and neck and limbs. The algorithm relies upon dosimetric constraints and
objectives to aid in the patient setup such that the patient is setup to
maximize tumor dose coverage and minimize dose to organs at risk while allowing
for daily clinical changes. A simple 1D model and a lung lesion are presented.
Results: The algorithm delivers a multi-criteria optimization framework
allowing for clinical decisions to accommodate patient target variation make
setup decisions less straightforward. With dosimetric considerations, optimal
patient positions can be derived. Conclusions: A multi-criteria framework is
demonstrated to aid in the patient setup and determine the most appropriate
daily position considering dosimetric goals.
