Multi-institutional comparison of simulated treatment delivery errors in ssIMRT, manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

Pogson, Elise M; Aruguman, Sankar; Hansen, Christian Rønn; Currie, Michael; Oborn, Bradley M; Blake, S; Juresic, J.; Ochoa, Cesar E.; Yakobi, Jim; Haman, A.; Trtovac, A.; Carolan, Martin G; Holloway, Lois; Thwaites, David

doi:10.1016/j.ejmp.2017.08.008

Cited by 18 publications

(20 citation statements)

References 31 publications

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“…This shows that fine QA is expected in the upper and lower layers of MLC dose and mechanical parts. It has been widely reported that the MLC leaf root mean square (RMS) error was closely linked to maximum leaf speeds 31,32,33,34. The pretreatment QA of ArcCHECK has shown that Halcyon accurately delivers the calculated dose distribution.…”

Section: Discussionmentioning

confidence: 99%

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Li¹,

Chen²,

Jing-ci³

et al. 2019

J. Cancer

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Purpose: Varian Halcyon is a novel machine with dual-layer leaves, single flattening filter free (FFF) energy and an enclosed bore. The purpose of this study was to compare the differences in dosimetry and plan parameters of intensity-modulated radiation therapy (IMRT) plans between the Halcyon and Trilogy accelerators. Methods and Materials: A total of 30 IMRT plans from cervical carcinoma patients were retrospectively analyzed on the Trilogy and Eclipse v13.5 treatment planning systems (TPSs). For each patient, a new plan based on Halcyon was created with the same planning parameters and optimization constraints using the Eclipse Version 15.1 TPS. To compare plan qualities, dosimetry parameters regarding planning target volume (PTV), organs at risk (OARs), monitor unit (MU) efficiency, segment size and treatment time were evaluated. Evaluation of the helical diode array system was performed with gamma-index analysis. Results: The dose distribution of the target volume of the Halcyon and Trilogy plans showed no significant difference (p > 0.05). The mean doses of rectum and both femoral heads for Halcyon plans were significantly reduced compared to those for Trilogy plans (p < 0.05). Compared to Trilogy, Halcyon increased the number of MUs from 1542.9±248.3 MU to 2514.9±328.2 MU (p = 0.00) and decreased the delivery time from 11.28±1.36 min to 3.26±0.26 min (p = 0.00). The average segment areas of Halcyon plans for proximal and distal multileaf collimators (MLCs) were 42.1 ± 31.2 cm 2 and 28.4 ± 23.7 cm 2 , respectively, and that of Trilogy plans was 27.3 ± 16.9 cm 2. The mean gamma index (3 mm/3%) results for the Halcyon and Trilogy plans were 99.41±0.26 and 99.76±0.32 (p > 0.05), respectively. Conclusions: All Halcyon treatment plans were recognized as clinically acceptable and had statistically better OAR sparing with higher delivery efficiency. The Halcyon system exhibited fast treatment delivery of IMRT with good dosimetric agreement using ArcCHECK.

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Section: Discussionmentioning

confidence: 99%

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Li¹,

Chen²,

Jing-ci³

et al. 2019

J. Cancer

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“…If applied, margins around OARs to derive PRVs should be described. 18. Have OAR definitions been described in sufficient detail, with references if possible?…”

Section: Oars and Prvsmentioning

confidence: 99%

Radiotherapy Treatment plannINg study Guidelines (RATING): A framework for setting up and reporting on scientific treatment planning studies

Hansen

Crijns

Hussein

et al. 2020

Radiotherapy and Oncology

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“…The Synergy plans were manifested in the larger segment area and lower MU relative to the Trilogy plans. Furthermore, VMAT auto plans were more sensitive to MLC errors [26].…”

Section: Discussionmentioning

confidence: 99%

Beam complexity and monitor unit efficiency comparison in two different volumetric modulated arc therapy delivery using automated planning

Cheng

Bai

et al. 2020

Preprint

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Background: To investigate the beam complexity and monitor unit（MU）efficiency issues for two different volumetric modulated arc therapy (VMAT) delivery technologies for patients with left-sided breast cancer (BC) and nasopharyngeal carcinoma (NPC). Methods: Twelve left-sided BC and seven NPC cases were enrolled in this study. Each delivered treatment plan was optimized in Pinnacle 3 treatment planning system with Auto-Planning module for Trilogy and Synergy systems. Similar planning dose objectives and beam configuration were used for each site in two different delivery systems to produce clinically acceptable plans. Beam complexity was evaluated in terms of segment area(SA), segment width(SW), leaf sequence variability(LSV), aperture area variability(AAV), modulation complexity score(MCS) based on MLC sequence and MU. Results: With similar plan quality, the average SAs for Trilogy plans were smaller than those for Synergy plans: 55.5 ± 21.3 cm 2 vs. 66.3 ± 17.9 cm 2 (p<0.05) for the NPC cases, and 100.7 ± 49.2 cm 2 vs. 108.5 ± 42.7 cm 2 (p<0.05) for BC cases, respectively. The SW was statistically significant for two delivery systems (NPC: 6.87±1.95cm vs.6.72±2.71cm, p < 0.05; BC: 8.84±2.56cm vs.8.09±2.63cm, p < 0.05). LSV was statistically significant smaller for Trilogy (NPC: 0.84±0.033 vs.0.86±0.033, p < 0.05; BC: 0.89±0.026 vs.0.90±0.26, p < 0.05). The mean AAV was statistically significant larger for Trilogy than Synergy (NPC: 0.18±0.064 vs.0.14±0.037, p < 0.05; BC: 0.46±0.15 vs.0.33±0.13, p < 0.05). The MCS values for the Trilogy were higher than those for the Synergy: 0.14 ± 0.016vs. 0.12 ± 0.017 (p<0.05) for the NPC cases, and 0.42 ± 0.106 vs. 0.30 ± 0.087(p<0.05) for the BC cases. Compared with Synergy plans, the average MU for Trilogy plans were larger: 828.6±74.1MU and 782.9±85.2MU (p>0.05) for the NPC cases, and 444.8±61.3MU and 393.8±75.3MU (p>0.05) for the BC cases. Conclusions: The pinnacle 3 Auto planning system can optimize BC and NPC plans to obtain the same plan quality using Trilogy and Synergy systems. We found that this two systems resulted in different SA, SW, LSV, AAV and MCS. As a result, we suggested that beam complexity should be considered in providing further methodologies while optimizing VMAT auto planning.

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Multi-institutional comparison of simulated treatment delivery errors in ssIMRT, manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

Cited by 18 publications

References 31 publications

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Radiotherapy Treatment plannINg study Guidelines (RATING): A framework for setting up and reporting on scientific treatment planning studies

Beam complexity and monitor unit efficiency comparison in two different volumetric modulated arc therapy delivery using automated planning

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