A method for <i>a priori</i> estimation of best feasible <scp>DVH</scp> for organs‐at‐risk: Validation for head and neck <scp>VMAT</scp> planning

Ahmed, Saeed; Nelms, Benjamin E.; Gintz, Dawn; Caudell, Jimmy J.; Zhang, Geoffrey; Moros, Eduardo G.; Feygelman, Vladimir

doi:10.1002/mp.12500

Cited by 62 publications

(59 citation statements)

References 42 publications

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“…The f factor is defined as the feasibility factor, with higher feasibility associated with higher f . The estimation is based on a series of energy‐specific dose spread calculations, independent of any particular beam arrangement . For a specific patient, this estimated calculation is based on the heterogeneous dataset along with the geometric relationship between the targets and OARs while taking into account the high‐(penumbra driven) and low (PDD and scatter‐driven) gradient dose spreading.…”

Section: Methodsmentioning

confidence: 99%

“…Allowing flexibility and patient‐specific organ sparing prediction, a commercial product, PlanIQ Feasibility (Sun Nuclear Corp., Melbourne, FL), has been developed. The predicted dose volume histograms (DVHs) are based on energy‐specific dose spread calculation, reflecting the characteristics of photon dose distribution in media . Another approach to robust planning is to create many planning solutions (multicriteria optimization) for a single clinical case so that clinicians can make a decision based on the trade‐off among the dose coverage of the tumor volume and protections of sensitive structures .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of auto‐planning in IMRT and VMAT for head and neck cancer

Ouyang

Shen

Murray

et al. 2019

J Applied Clin Med Phys

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Purpose The purposes of this work are to (a) investigate whether the use of auto‐planning and multiple iterations improves quality of head and neck (HN) radiotherapy plans; (b) determine whether delivery methods such as step‐and‐shoot (SS) and volumetric modulated arc therapy (VMAT) impact plan quality; (c) report on the observations of plan quality predictions of a commercial feasibility tool. Materials and methods Twenty HN cases were retrospectively selected from our clinical database for this study. The first ten plans were used to test setting up planning goals and other optimization parameters in the auto‐planning module. Subsequently, the other ten plans were replanned with auto‐planning using step‐and‐shoot (AP‐SS) and VMAT (AP‐VMAT) delivery methods. Dosimetric endpoints were compared between the clinical plans and the corresponding AP‐SS and AP‐VMAT plans. Finally, predicted dosimetric endpoints from a commercial program were assessed. Results All AP‐SS and AP‐VMAT plans met the clinical dose constraints. With auto‐planning, the dose coverage of the low dose planning target volume (PTV) was improved while the dose coverage of the high dose PTV was maintained. Compared to the clinical plans, the doses to critical organs, such as the brainstem, parotid, larynx, esophagus, and oral cavity were significantly reduced in the AP‐VMAT (P < 0.05); the AP‐SS plans had similar homogeneity indices (HI) and conformality indices (CI) and the AP‐VMAT plans had comparable HI and improved CI. Good agreement in dosimetric endpoints between predictions and AP‐VMAT plans were observed in five of seven critical organs. Conclusion With improved planning quality and efficiency, auto‐planning module is an effective tool to enable planners to generate HN IMRT plans that are meeting institution specific planning protocols. DVH prediction is feasible in improving workflow and plan quality.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of auto‐planning in IMRT and VMAT for head and neck cancer

Ouyang

Shen

Murray

et al. 2019

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…These models are validated with cases other than the ones used for the model building and evaluated against other predictive approaches. [13][14][15] Standardization of targets and critical structures delineation are of utmost importance in the radiotherapy process. Variations in structure delineation are found to be the most significant among all the radiotherapy processes.…”

Section: Iroc Implementation Of the Standardsmentioning

confidence: 99%

NCTN clinical trial standardization for radiotherapy through IROC and CIRO

et al. 2018

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Evidence-based practice is the cornerstone of modern medicine. Randomized clinical trials across multiple institutions are the gold standard for modern evidence collection. National Cancer Trials Network (NCTN) instruments the clinical trials through the new infrastructure for improvements in cancer treatment. Radiation therapy is an integral component of cancer treatment and is involved in many of the NCTN clinical trials. Radiotherapy is experiencing exciting developments in new treatment modalities and multi-modality image guidance. One of NCTN network groups NRG Oncology brings together the research areas of the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG), and the Gynecologic Oncology Group (GOG). The Imaging and Radiation Oncology Core (IROC) and Center for Innovation in Radiation Oncology(CIRO) of NRG Oncology complement each other's functions in development and implementation of the new radiotherapy and imaging technologies in clinical trials with standardization and other strategies for quality. The standardization process is the essential step to make the data collected for clinical trials of high quality, interoperable, and reusable.

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“…One major challenge to treating spine metastases is proximity to the spinal cord and extent of dural involvement (7). Vendors are now developing and releasing advanced treatment planning systems (TPSs) with tools that allow for complex sculpting of dose to create steep dose gradients near critical structures, such as the spinal cord, as well as implementing automation and artificial intelligence to increase planning throughput and consistency based on previous investigations (8,9).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Elements Spine SRS Plan Quality for SRS and SBRT Treatment of Spine Metastases

Träger

Landers

et al. 2020

Front. Oncol.

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Purpose: The Elements Spine Stereotactic Radiosurgery treatment planning system uses automated volumetric modulated arc radiotherapy that can provide a highly conformal dose distribution to targets, which can provide superior sparing of the spinal cord. This study compares the dosimetric quality of Elements plans with the clinical plans of 20 spine stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT) patients treated at our institution. Methods: Twenty spine SRS/SBRT patients who were clinically treated at our institution were replanned using the automated Elements planning workflow with prespecified templates. Elements automatically evaluates the size and shape of the target to determine if splitting the PTV into simplistic subvolumes, each treated by their own arc(s), would increase conformity and spinal cord sparing. The conformity index, gradient index, PTV D 5% , and maximum and mean cord dose were evaluated for the Elements and clinical plans. Treatment delivery efficiency was also analyzed by comparing the total number of monitor units and the modulation factor. Wilcoxon rank-sum tests were performed on the statistics. Results: Elements split the PTV for 50% of cases, requiring four or six arcs. Overall, Elements plans were found to be superior to clinical plans in conformity index, gradient index, and maximum cord dose. The PTV D 5% and cord mean dose for the Elements plans trended higher and lower, respectively. The numbers of monitor units and modulation factor were also higher for Elements plans, although the differences were not significant. Conclusion: Automated Elements plans achieved superior conformity and cord dose sparing compared to clinical plans and PTV splitting successfully improved spinal cord sparing.

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A method for a priori estimation of best feasible DVH for organs‐at‐risk: Validation for head and neck VMAT planning

Cited by 62 publications

References 42 publications

Evaluation of auto‐planning in IMRT and VMAT for head and neck cancer

Evaluation of auto‐planning in IMRT and VMAT for head and neck cancer

NCTN clinical trial standardization for radiotherapy through IROC and CIRO

Evaluation of Elements Spine SRS Plan Quality for SRS and SBRT Treatment of Spine Metastases

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