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Using a simulated annealing algorithm, CIMO seeks to minimize differences between the optimized and sequenced intensity maps.

The CIMO algorithm was applied, and the optimized aperture shapes and weights were loaded back into Pinnacle.

On average, the CIMO algorithm provided a 54% reduction in the number of beam segments as compared with Pinnacle's leaf sequencer.

The plans sequenced using the CIMO algorithm also provided improved target dose uniformity and a reduced discrepancy between the optimized and sequenced intensity maps.

For ten clinical intensity maps, comparisons were performed between the CIMO algorithm and the power-of-two reduction algorithm of Xia and Verhey [Med.