Automated IMRT planning in Pinnacle

Kusters, J.M.A.M.; Bzdusek, Karl; Kumar, Prashant; Kollenburg, P.G.M. Van; Kunze-Busch, Martina; Wendling, M.; Dijkema, Tim; Kaanders, J.H.A.M.

doi:10.1007/s00066-017-1187-9

Cited by 33 publications

(24 citation statements)

References 20 publications

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“…There are many studies in the literature which have clinically implemented commercial and in-house implementations of PB-AIO, KBP, and MCO automated planning. [42][43][44][45][46][48][49][50][51][52][53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][70][71][72][73][74][75][76][77][78][79][81][82][83][89][90][91][92][93][94][95][96][97][99][100][101][102][103][150][151]…”

Section: Clinical Evaluation and Implementation Of Automated Planningmentioning

confidence: 99%

Automation in intensity modulated radiotherapy treatment planning—a review of recent innovations

Hussein

Heijmen

Verellen

et al. 2018

The British Journal of Radiology

181

187

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Radiotherapy treatment planning of complex radiotherapy techniques, such as intensity modulated radiotherapy and volumetric modulated arc therapy, is a resource-intensive process requiring a high level of treatment planner intervention to ensure high plan quality. This can lead to variability in the quality of treatment plans and the efficiency in which plans are produced, depending on the skills and experience of the operator and available planning time. Within the last few years, there has been significant progress in the research and development of intensity modulated radiotherapy treatment planning approaches with automation support, with most commercial manufacturers now offering some form of solution. There is a rapidly growing number of research articles published in the scientific literature on the topic. This paper critically reviews the body of publications up to April 2018. The review describes the different types of automation algorithms, including the advantages and current limitations. Also included is a discussion on the potential issues with routine clinical implementation of such software, and highlights areas for future research.

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Section: Clinical Evaluation and Implementation Of Automated Planningmentioning

confidence: 99%

Automation in intensity modulated radiotherapy treatment planning—a review of recent innovations

Hussein

Heijmen

Verellen

et al. 2018

The British Journal of Radiology

181

187

View full text Add to dashboard Cite

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“…The AP-BF plan was optimized using Pinnacle 3 AP algorithm. In summary, it is a fully integrated module in the TP system which uses a progressive optimization algorithm to continually adjust the optimization objective list set by the user to meet or further decrease OARs doses and related DVH parameters with minimal compromise to PTV coverage, thus simulating the decision-making process of an experienced human planner [ 21 ]. Indeed, the AP algorithm iteratively fine-tunes the target coverage and OAR sparing by creating multiple additional structures based both on the relative geometry of originally segmented ROIs and on transient dose distributions.…”

Section: Methodsmentioning

confidence: 99%

“…This issue has been addressed by the recent introduction of automated engines in treatment planning (TP) systems in order to create an optimized plan with minimal user interaction. They have proved able to generate IMRT plans of non-inferior or even higher clinical quality compared to human driven plans for many different tumour sites, such as head and neck [ 21 ], prostate [ 22 , 23 ]and lung [ 24 ]. To the best of our knowledge, however, no study investigated the Auto-Planning (AP) algorithm applied to VMAT for supradiaphragmatic HL (SHL) patients.…”

Section: Introductionmentioning

confidence: 99%

Auto- versus human-driven plan in mediastinal Hodgkin lymphoma radiation treatment

et al. 2018

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BackgroundTechnological advances in Hodgkin lymphoma (HL) radiation therapy (RT) by high conformal treatments potentially increase control over organs-at-risk (OARs) dose distribution. However, plan optimization remains a time-consuming task with great operator dependent variability. Purpose of the present study was to devise a fully automated pipeline based on the Pinnacle3 Auto-Planning (AP) algorithm for treating female supradiaphragmatic HL (SHL) patients.MethodsCT-scans of 10 female patients with SHL were considered. A “butterfly” (BF) volumetric modulated arc therapy was optimized using SmartArc module integrated in Pinnacle3 v. 9.10 using Collapsed Cone Convolution Superposition algorithm (30 Gy in 20 fractions). Human-driven (Manual-BF) and AP-BF optimization plans were generated. For AP, an optimization objective list of Planning Target Volume (PTV)/OAR clinical goals was first implemented, starting from a subset of 5 patients used for algorithm training. This list was then tested on the remaining 5 patients (validation set). In addition to the BF technique, the AP engine was applied to a 2 coplanar disjointed arc (AP-ARC) technique using the same objective list. For plan evaluation, dose-volume-histograms of PTVs and OARs were extracted; homogeneity and conformity indices (HI and CI), OARs dose-volume metrics and odds for different toxicity endpoints were computed. Non-parametric Friedman and Dunn tests were used to identify significant differences between groups.ResultsA single AP objective list for SHL was obtained. Compared to the manual plan, both AP-plans offer comparable CIs while AP-ARC also achieved comparable HIs. All plans fulfilled the clinical dose criteria set for OARs: both AP solutions performed at least as good as Manual-BF plan. In particular, AP-ARC outperformed AP-BF in terms of heart sparing involving a lower risk of coronary events and radiation-induced lung fibrosis. Hands-on planning time decreased by a factor of 10 using AP on average.ConclusionsDespite the high interpatient PTV (size and position) variability, it was possible to set a standard SHL AP optimization list with a high level of generalizability. Using the implemented list, the AP module was able to limit OAR doses, producing clinically acceptable plans with stable quality without additional user input. Overall, the AP engine associated to the arc technique represents the best option for SHL.

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“…Both automated treatment planning methods and knowledge-based optimisation engines are now available within most commercial treatment planning systems [9][10][11], and have demonstrated improvements in planning efficiency and plan quality compared to current practice [12,13]. Multiple institutions have investigated the efficacy of automated treatment planning for head and neck [14][15][16][17][18][19], oesophageal [20], and prostate cancers [21][22][23][24], and found the automatically generated plan to be noninferior and often superior to manual planning quality, while significantly reducing treatment planning times. Additionally, previously complex and time-consuming stereotactic treatments for liver cancer have had automatic treatment plans developed [25], while quantitative tools have been constructed to automatically identify poorer quality treatment plans [26,27].…”

Section: Introductionmentioning

confidence: 99%

Adapting automated treatment planning configurations across international centres for prostate radiotherapy

Roach

Wortel

Ochoa

et al. 2019

Physics and Imaging in Radiation Oncology

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Background and purpose: Automated configurations are increasingly utilised for radiotherapy treatment planning. This study investigates whether automated treatment planning configurations are adaptable across clinics with different treatment planning protocols for prostate radiotherapy. Material and methods: The study comprised three participating centres, each with pre-existing locally developed prostate AutoPlanning configurations using the Pinnacle 3 ® treatment planning system. Using a three-patient training dataset circulated from each centre, centres modified local prostate configurations to generate protocol compliant treatment plans for the other two centres. Each centre applied modified configurations on validation datasets distributed from each centre (10 patients from 3 centres). Plan quality was assessed through DVH analysis and protocol compliance. Results: All treatment plans were clinically acceptable, based off relevant treatment protocol. Automated planning configurations from Centre's A and B recorded 2 and 18 constraint and high priority deviations respectively. Centre C configurations recorded no high priority deviations. Centre A configurations produced treatment plans with superior dose conformity across all patient PTVs (mean = 1.14) compared with Centre's B and C (mean = 1.24 and 1.22). Dose homogeneity was consistent between all centre's configurations (mean = 0.083, 0.077, and 0.083 respectively). Conclusions: This study demonstrates that automated treatment planning configurations can be shared and implemented across multiple centres with simple adaptations to local protocols.

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Automated IMRT planning in Pinnacle

Abstract: The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality.

Cited by 33 publications

References 20 publications

Automation in intensity modulated radiotherapy treatment planning—a review of recent innovations

Automation in intensity modulated radiotherapy treatment planning—a review of recent innovations

Auto- versus human-driven plan in mediastinal Hodgkin lymphoma radiation treatment

Adapting automated treatment planning configurations across international centres for prostate radiotherapy

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