The role of a knowledge based dose–volume histogram predictive model in the optimisation of intensity-modulated proton plans for hepatocellular carcinoma patients

Cozzi, Luca; Vanderstraeten, Reynald; Fogliata, A.; Chang, F.L.; Wang, Po-Ming

doi:10.1007/s00066-020-01664-2

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…This work demonstrates that the IMPT plans generated by a KBPP model were able to achieve comparable plan quality to that of the IMPT plans generated by experts. This is consistent with the previous results on the use of the KBPP model for IMPT planning for head and neck cancers and hepatocellular carcinoma [ 20 , 22 , 23 ]. One of the benefits of employing the KBPP system for plan generation is its high efficiency.…”

Section: Discussionsupporting

confidence: 93%

“…Their later publication demonstrated that clinically acceptable IMPT plans can be created using a KBPP system [ 20 , 22 ]. A recently published study by Cozzi et al [ 23 ] showed that the quality of the KBPP plans were at least equivalent to the manually generated expert plans for patients with hepatocellular carcinoma. However, more studies are necessary to both evaluate and validate the KBPP for various treatment sites at this early stage in its use.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Knowledge-Based Planning for Prostate Intensity Modulated Proton Therapy

Brovold

Cyriac

et al. 2021

International Journal of Particle Therapy

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Purpose To assess the performance of a proton-specific knowledge based planning (KBPP) model in creation of robustly optimized intensity-modulated proton therapy (IMPT) plans for treatment of patients with prostate cancer. Materials and Methods Forty-five patients with localized prostate cancer, who had previously been treated with volumetric modulated arc therapy, were selected and replanned with robustly optimized IMPT. A KBPP model was generated from the results of 30 of the patients, and the remaining 15 patient results were used for validation. The KBPP model quality and accuracy were evaluated with the model-provided organ-at-risk regression plots and metrics. The KBPP quality was also assessed through comparison of expert and KBPP-generated IMPT plans for target coverage and organ-at-risk sparing. Results The resulting R2 (mean ± SD, 0.87 ± 0.07) between dosimetric and geometric features, as well as the χ2 test (1.17 ± 0.07) between the original and estimated data, showed the model had good quality. All the KBPP plans were clinically acceptable. Compared with the expert plans, the KBPP plans had marginally higher dose-volume indices for the rectum V65Gy (0.8% ± 2.94%), but delivered a lower dose to the bladder (−1.06% ± 2.9% for bladder V65Gy). In addition, KBPP plans achieved lower hotspot (−0.67Gy ± 2.17Gy) and lower integral dose (−0.09Gy ± 0.3Gy) than the expert plans did. Moreover, the KBPP generated better plans that demonstrated slightly greater clinical target volume V95 (0.1% ± 0.68%) and lower homogeneity index (−1.13 ± 2.34). Conclusions The results demonstrated that robustly optimized IMPT plans created by the KBPP model are of high quality and are comparable to expert plans. Furthermore, the KBPP model can generate more-robust and more-homogenous plans compared with those of expert plans. More studies need to be done for the validation of the proton KBPP model at more-complicated treatment sites.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Assessment of Knowledge-Based Planning for Prostate Intensity Modulated Proton Therapy

Brovold

Cyriac

et al. 2021

International Journal of Particle Therapy

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“…As a tradeoff, the bilateral RPP plans produced a slightly higher hotspot than the expert plans in the body outside of CTVs (1.69 ± 1.39 Gy). In general, our results are consistent with the previous studies illustrating that the RPP plans were at least equivalent to if not better than the expert plans ( 18 , 24 , 25 ).…”

Section: Discussionsupporting

confidence: 93%

“…It has been demonstrated that the quality of VMAT plans for HN cancer created by the RP model was independent of prescription and beam geometry ( 26 ). A study comparing a proton model trained with customized beam number and arrangement to another model trained with standardized beam number and arrangement for hepatocellular carcinoma treatment indicated that two models performed equivalently with no statistically significant difference for almost all dose–volume parameters ( 24 ). However, as the quality of the proton plans is more dependent on the beam arrangement than the photon plans, the impact of employing IMPT plans with different beam arrangements versus standardized beam arrangement in the model should be investigated for HN IMPT model.…”

Section: Discussionmentioning

confidence: 99%

“…One limitation of this study is that the 20 patients included in the validation set consisted of 10 unilateral cases and 10 bilateral cases, which may not be sufficient to confirm the reliability of the model, as it is at early stage for RPP exploration. That being said, many publications on KBP photon and proton models have included small numbers of plans for validation, and the vendor’s recommendation is 10 validation cases to prove the model is working sufficiently ( 12 , 16 , 17 , 24 , 31 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

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Knowledge-Based Planning for Robustly Optimized Intensity-Modulated Proton Therapy of Head and Neck Cancer Patients

Cyriac

Ornelas

et al. 2021

Front. Oncol.

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PurposeTo assess the performance of a proton-specific knowledge-based planning (KBP) model in the creation of robustly optimized intensity-modulated proton therapy (IMPT) plans for treatment of advanced head and neck (HN) cancer patients.MethodsSeventy-three patients diagnosed with advanced HN cancer previously treated with volumetric modulated arc therapy (VMAT) were selected and replanned with robustly optimized IMPT. A proton-specific KBP model, RapidPlanPT (RPP), was generated using 53 patients (20 unilateral cases and 33 bilateral cases). The remaining 20 patients (10 unilateral and 10 bilateral cases) were used for model validation. The model was validated by comparing the target coverage and organ at risk (OAR) sparing in the RPP-generated IMPT plans with those in the expert plans. To account for the robustness of the plan, all uncertainty scenarios were included in the analysis.ResultsAll the RPP plans generated were clinically acceptable. For unilateral cases, RPP plans had higher CTV_primary V100 (1.59% ± 1.24%) but higher homogeneity index (HI) (0.7 ± 0.73) than had the expert plans. In addition, the RPP plans had better ipsilateral cochlea Dmean (−5.76 ± 6.11 Gy), with marginal to no significant difference between RPP plans and expert plans for all other OAR dosimetric indices. For the bilateral cases, the V100 for all clinical target volumes (CTVs) was higher for the RPP plans than for the expert plans, especially the CTV_primary V100 (5.08% ± 3.02%), with no significant difference in the HI. With respect to OAR sparing, RPP plans had a lower spinal cord Dmax (−5.74 ± 5.72 Gy), lower cochlea Dmean (left, −6.05 ± 4.33 Gy; right, −4.84 ± 4.66 Gy), lower left and right parotid V20Gy (left, −6.45% ± 5.32%; right, −6.92% ± 3.45%), and a lower integral dose (−0.19 ± 0.19 Gy). However, RPP plans increased the Dmax in the body outside of CTV (body-CTV) (1.2 ± 1.43 Gy), indicating a slightly higher hotspot produced by the RPP plans.ConclusionIMPT plans generated by a broad-scope RPP model have a quality that is, at minimum, comparable with, and at times superior to, that of the expert plans. The RPP plans demonstrated a greater robustness for CTV coverage and better sparing for several OARs.

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Automation of pencil beam scanning proton treatment planning for intracranial tumours

et al. 2023

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The role of a knowledge based dose–volume histogram predictive model in the optimisation of intensity-modulated proton plans for hepatocellular carcinoma patients

Cited by 8 publications

References 35 publications

Assessment of Knowledge-Based Planning for Prostate Intensity Modulated Proton Therapy

Assessment of Knowledge-Based Planning for Prostate Intensity Modulated Proton Therapy

Knowledge-Based Planning for Robustly Optimized Intensity-Modulated Proton Therapy of Head and Neck Cancer Patients

Automation of pencil beam scanning proton treatment planning for intracranial tumours

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