Assessment of Plan<scp>IQ</scp> Feasibility <scp>DVH</scp> for head and neck treatment planning

Fried, David; Chera, Bhishamjit S.; Das, Shiva K.

doi:10.1002/acm2.12165

Cited by 31 publications

(23 citation statements)

References 11 publications

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“…PlanIQ may also be used before treatment planning to help guide the planning process. Fried et al show that with the knowledge of PlanIQ predictions before HN planning, significant reduction in doses to contralateral parotid and larynx is achieved …”

Section: Discussionmentioning

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

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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: Discussionmentioning

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

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“…In our practice, we used a radiotherapy plan analysis program (Plan IQ™, Sun Nuclear co, Melbourne, FL, USA) to generate scores for these dosimetric goals according to the PQM. The scores were based on the constraints and dose-volume histograms of the planning results and assigned to each evaluation object according to the calculated dose [21, 22]. The quality scores for each objective are shown in Table 1.…”

Section: Methodsmentioning

confidence: 99%

Combining deep-inspiration breath hold and intensity-modulated radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma: Dosimetric evaluation using comprehensive plan quality indices

et al. 2019

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Background Although there have been many attempts to increase the therapeutic ratio of radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma (MALToma), only a few planning studies have reported the efficacy of the modern radiotherapy technique till date. Therefore, we performed the dosimetric comparison among 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) plans, using deep-inspiration breath hold (DIBH) or free-breathing (FB) techniques, to determine the most optimal plan for gastric MALToma. Methods We evaluated 9 patients with gastric MALToma for whom 3D-CRT, step-and-shoot IMRT ( S IMRT), volumetric-modulated arc therapy (VMAT), and tomotherapy plans with identical prescribed doses were generated using DIBH or FB computed tomography (CT). Planning target volume (PTV) coverage and non-target doses were calculated for each plan and compared with plan quality metric (PQM) scores. Results All 72 plans of 9 patients satisfied our dosimetric goals, and the IMRT plans and 3D-CRT plans had similarly good conformity index values with no differences related to respiratory movement. IMRT plans yielded significantly better doses to the organs-at-risk, and DIBH plans yielded significantly lower liver, heart, and lung D mean and spinal cord D max with smaller irradiated volumes compared to FB plans. For the mean PQM scores, VMAT-DIBH and S IMRT-DIBH yielded the best scores, whereas 3D plans provided reduced beam monitor unit values. Conclusion Our findings demonstrate that modern RT technologies (DIBH with VMAT or S IMRT) could potentially provide excellent target coverage for gastric MALToma while reducing doses to organs-at-risk. However, the relevance of the most optimal plan considering clinical outcomes should be confirmed further in a larger patient cohort. Electronic supplementary material The online version of this article (10.1186/s13014-019-1263-7) contains supplementary material, which is available to authorized users.

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“…These comparisons are valuable because all of the plans evaluated within PlanIQ have been previously achieved through manual planning alone whereas this study now looks to refine and advance the process of planning re-irradiation through the use of AP and feasibility software. As previously noted by Fried et al, 13 Dosimetry contouring was minimal and consisted primarily of segmenting OAR based on previously delivered doses which would then be exported to PlanIQ. These optimization target volumes, generated to account for direct overlap with previously irradiated critical structures, were used in two (2/20) cases to achieve a plan of equal quality with the manual plan.…”

Section: Purposementioning

confidence: 99%

“…12 Considered a highly valuable and validated tool for dosimetric planning, Plan IQ utilizes a priori estimation of each clinical goal, returning a feasibility score that planners can interpret, mitigating historical uncertainties, and optimization backtracking. 13,14 More specifically, PlanIQ returns users' optimization objectives as values along a feasibility dose-volume histogram (FDVH) that can be examined and/or manipulated to achieve ideal sparing of proximal tissues through Pinnacle optimization. 15 Recently, this has become a seamless process, as Pinnacle autoplan now offers direct export and import options for PlanIQ.…”

mentioning

confidence: 99%

Refining complex re‐irradiation dosimetry through feasibility benchmarking and analysis for informed treatment planning

Duffy

Zheng

Muenkel

et al. 2020

J Applied Clin Med Phys

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Purpose/Objectives The purpose of this study is to dually evaluate the effectiveness of PlanIQ in predicting the viability and outcome of dosimetric planning in cases of complex re‐irradiation as well as generating an equivalent plan through Pinnacle integration. The study also postulates that a possible strength of PlanIQ lies in mitigating pre‐optimization uncertainties tied directly to dose overlap regions where re‐irradiation is necessary. Methods A retrospective patient selection (n = 20) included a diverse range of re‐irradiation cases to be planned using Pinnacle auto‐planning with PlanIQ integration. A consistent planning template was developed and applied across all cases. Direct plan comparisons of manual plans against feasibility‐produced plans were performed by physician(s) with dosimetry recording relevant proximal OAR and planning timeline data. Results and Discussion All re‐irradiation cases were successfully predicted to be achievable per PlanIQ analyses with three cases (3/20) necessitating 95% target coverage conditions, previously exhibited in the manually planned counterparts, and determined acceptable under institutional standards. At the same time, PlanIQ consistently produced plans of equal or greater quality to the previously manually planned re‐irradiation across all (20/20) trials (P = 0.05). Proximal OAR exhibited similar to slightly improved maximum point doses from feasibility‐based planning with the largest advantages gained found within the subset of cranial and spine overlap cases, where improvements upward of 10.9% were observed. Mean doses to proximal tissues were found to be a statistically significant (P < 0.05) 5.0% improvement across the entire study. Documented planning times were markedly less than or equal to the time contributed to manual planning across all cases. Conclusion Initial findings indicate that PlanIQ effectively provides the user clear feasibility feedback capable of facilitating decision‐making on whether re‐irradiation dose objectives and prescription dose coverage are possible at the onset of treatment planning thus eliminating possible trial and error associated with some manual planning. Introducing model‐based prediction tools into planning of complex re‐irradiation cases yielded positive outcomes on the final treatment plans.

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Assessment of PlanIQ Feasibility DVH for head and neck treatment planning

Cited by 31 publications

References 11 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

Combining deep-inspiration breath hold and intensity-modulated radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma: Dosimetric evaluation using comprehensive plan quality indices

Refining complex re‐irradiation dosimetry through feasibility benchmarking and analysis for informed treatment planning

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