Three IMRT advanced planning tools: A multi‐institutional side‐by‐side comparison

Lu, Lihua; Yang, Sheng; Donaghue, J; Shen, Zhongzhou; Kolar, M.; Wu, Qiuwen; Xia, Peng

doi:10.1002/acm2.12679

Cited by 6 publications

(10 citation statements)

References 30 publications

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“…However, no statistically significant difference was found among the three kinds of plans, indicating that the KBP method can produce comparable or even better plans than the traditional manual way. This observation was consistent with previously published studies ( 15 , 28 , 29 ).…”

Section: Discussionsupporting

confidence: 94%

“…By introducing estimated DVHs, patient-specific optimization objectives rather than general templates were generated for each individual patient in the KBP method, based on the patient anatomy and prior knowledge. This helped offer a clearer directionality for the planner to refine the optimization objectives and achieve a high quality plan, which would be particularly useful for some complicated disease sites such as cancer of the head and neck ( 28 ). Our results showed that the EXP method provided the best trade-off between target dose coverage and normal tissue protection, acquiring the highest quality assessment scores among the three kinds of IMRT plans.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative Comparison of Knowledge-Based and Manual Intensity Modulated Radiation Therapy Planning for Nasopharyngeal Carcinoma

Liu

Xie

et al. 2021

Front. Oncol.

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Background and purposeTo validate the feasibility and efficiency of a fully automatic knowledge-based planning (KBP) method for nasopharyngeal carcinoma (NPC) cases, with special attention to the possible way that the success rate of auto-planning can be improved.Methods and materialsA knowledge-based dose volume histogram (DVH) prediction model was developed based on 99 formerly treated NPC patients, by means of which the optimization objectives and the corresponding priorities for intensity modulation radiation therapy (IMRT) planning were automatically generated for each head and neck organ at risk (OAR). The automatic KBP method was thus evaluated in 17 new NPC cases with comparison to manual plans (MP) and expert plans (EXP) in terms of target dose coverage, conformity index (CI), homogeneity index (HI), and normal tissue protection. To quantify the plan quality, a metric was applied for plan evaluation. The variation in the plan quality and time consumption among planners was also investigated.ResultsWith comparable target dose distributions, the KBP method achieved a significant dose reduction in critical organs such as the optic chiasm (p<0.001), optic nerve (p=0.021), and temporal lobe (p<0.001), but failed to spare the spinal cord (p<0.001) compared with MPs and EXPs. The overall plan quality evaluation gave mean scores of 144.59±11.48, 142.71±15.18, and 144.82±15.17, respectively, for KBPs, MPs, and EXPs (p=0.259). A total of 15 out of 17 KBPs (i.e., 88.24%) were approved by our physician as clinically acceptable.ConclusionThe automatic KBP method using the DVH prediction model provided a possible way to generate clinically acceptable plans in a short time for NPC patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Quantitative Comparison of Knowledge-Based and Manual Intensity Modulated Radiation Therapy Planning for Nasopharyngeal Carcinoma

Liu

Xie

et al. 2021

Front. Oncol.

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“…A recent study [ 23 ] by Lu et al compared plan quality for four sites using three different advanced planning tools including AP. They showed that AP could improve plan quality, but the statistical power was limited by the small sample size-five patients for each site.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Automated Treatment Planning and Organ Dose Prediction for Lung Stereotactic Body Radiotherapy

Ouyang

Zhuang

Marwaha

et al. 2021

Cureus

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Purposes: To evaluate whether the auto-planning (AP) module can achieve clinically acceptable treatment plans for lung stereotactic body radiotherapy (SBRT) and to evaluate the effectiveness of a dose prediction model.Methods: Twenty lung SBRT cases planned manually with 50 Gy in five fractions were replanned using the Pinnacle (Philips Radiation Oncology Systems, Fitchburg, WI) AP module according to the dose constraint tables from the Radiation Therapy Oncology Group (RTOG) 0813 protocol. Doses to the organs at risk (OAR) were compared between the manual and AP plans. Using a dose prediction model from a commercial product, PlanIQ (Sun Nuclear Corporation, Melbourne, FL), we also compared OAR doses from AP plans with predicted doses.Results: All manual and AP plans achieved clinically required dose coverage to the target volumes. The AP plans achieved equal or better OAR sparing when compared to the manual plans, most noticeable in the maximum doses of the spinal cord, ipsilateral brachial plexus, esophagus, and trachea. Predicted doses to the heart, esophagus, and trachea were highly correlated with the doses of these OARs from the AP plans with the highest correlation coefficient of 0.911, 0.823, and 0.803, respectively. Conclusion: Auto-planning for lung SBRT improved OAR sparing while keeping the same dose coverage to the tumor. The dose prediction model can provide useful planning dose guidance.

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“…Many studies on the auto‐planning without FDVH guidance has shown improved or similar plan quality in comparison with the plans generated manually or using other automation algorithms. 16 , 17 , 19 , 21 , 22 Nonetheless, the auto‐planning algorithm required users to set planning dose goals, thus introducing subjectivity. Based on the skills and preferences of the planners, the planning dose goals entered by planners might be too loose or too stringent.…”

Section: Discussionmentioning

confidence: 99%

“…The plan qualities produced from these automation methods were reported to be comparable. 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

Using feasibility dose–volume histograms to reduce intercampus plan quality variability for head‐and‐neck cancer

Ahmed

Liu

LaHurd

et al. 2022

J Applied Clin Med Phys

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The purpose of this work is to objectively assess variability of intercampus plan quality for head‐and‐neck (HN) cancer and to test utility of a priori feasibility dose–volume histograms (FDVHs) as planning dose goals. In this study, 109 plans treated from 2017 to 2019 were selected, with 52 from the main campus and 57 from various regional centers. For each patient, the planning computed tomography images and contours were imported into a commercial program to generate FDVHs with a feasibility value ( f ‐value) ranging from 0.0 to 0.5. For 10 selected organs‐at‐risk (OARs), we used the Dice similarity coefficient (DSC) to quantify the overlaps between FDVH and clinically achieved DVH of each OAR and determined the f ‐value associated with the maximum DSC (labeled as f ‐max). Subsequently, 10 HN plans from the regional centers were replanned with planning dose goals guided by FDVHs. The clinical and feasibility‐guided auto‐planning (FgAP) plans were evaluated using our institutional criteria. Among plans from the main campus and regional centers, the median f ‐max values were statistically significantly different ( p < 0.05) for all OARs except for the left parotid ( p = 0.622), oral cavity ( p = 0.057), and mandible ( p = 0.237). For the 10 FgAP plans, the median values of f ‐max were 0.21, compared to 0.37 from the clinical plans. With comparable dose coverage to the tumor volumes, the significant differences ( p < 0.05) in the median f ‐max and corresponding dose reduction (shown in parenthesis) for the spinal cord, larynx, supraglottis, trachea, and esophagus were 0.27 (8.5 Gy), 0.3 (7.6 Gy), 0.19 (5.9 Gy), 0.19 (8.9 Gy), and 0.12 (4.0 Gy), respectively. In conclusion, the FDVH prediction is an objective quality assurance tool to evaluate the intercampus plan variability. This tool can also provide guideline in planning dose goals to further improve plan quality.

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Three IMRT advanced planning tools: A multi‐institutional side‐by‐side comparison

Cited by 6 publications

References 30 publications

Quantitative Comparison of Knowledge-Based and Manual Intensity Modulated Radiation Therapy Planning for Nasopharyngeal Carcinoma

Quantitative Comparison of Knowledge-Based and Manual Intensity Modulated Radiation Therapy Planning for Nasopharyngeal Carcinoma

Evaluation of Automated Treatment Planning and Organ Dose Prediction for Lung Stereotactic Body Radiotherapy

Using feasibility dose–volume histograms to reduce intercampus plan quality variability for head‐and‐neck cancer

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