Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer

Hansen, Christian Rønn; Nielsen, Morten; Bertelsen, Anders; Hazell, Irene; Holtved, Eva; Zukauskaite, Ruta; Bjerregaard, Jon Kroll; Brink, Carsten; Bernchou, U.

doi:10.1080/0284186x.2017.1349928

Cited by 33 publications

(34 citation statements)

References 23 publications

(50 reference statements)

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“…HN cancer is one of the most challenging sites for treatment planning, and Pinnacle auto‐planning is confirmed as a viable solution in an early study . Other sites, such as prostate, esophagus, lung, and brain, are also investigated by different groups. All studies have confirmed that auto‐planning generates clinically acceptable plans.…”

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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“…A main drawback of the current MRL planning and treatment chain was the lack of automated planning. Inter-planner variation has been shown to decrease, while plan quality and planning efficiency increases, for several indications, including prostate cancers, with automated planning such as PAP [17][18][19][20][21][22]. However, a clinical version of automated treatment planning for localized prostate cancer has been developed and implemented in Monaco, with further development for MRL planning use in mind [23].…”

Section: Discussionmentioning

confidence: 99%

“…The planning time used to create MUPs was considered feasible for clinical use and operator time comparable to that for autoplan setup and re-optimization for other treatment sites such as head and neck [22] and esophagus [19] treatment plans in our clinic. A distinction between the initial treatment planning time, as reported here, and the online adaption of that plan is important.…”

Section: Discussionmentioning

confidence: 99%

“…However, the clinical plans used in the current study were produced by experienced physicists and RTTs using PAP including a post-optimization step to fine-tune the final plan. Although the plans were produced by different planners, this process has been shown to consistently deliver high quality treatment plans both in terms of target coverage and sparing of OAR for several complex treatment sites, including the prostate [17][18][19]22].…”

Section: Discussionmentioning

confidence: 99%

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Plan quality for high-risk prostate cancer treated with high field magnetic resonance imaging guided radiotherapy

Christiansen

Hansen

Dahlrot

et al. 2018

Physics and Imaging in Radiation Oncology

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Background and purpose: Daily radiotherapy plan adaptation facilitated by a high field magnetic resonance linac (MRL) may potentially reduce the treated volume due to a reduction of the setup uncertainty. However, the technology also imposes limitations to the treatment technique compared to a standard linac. This study investigated the clinical quality of MRL treatment plans against current standard plans using identical planning target volume margins for high-risk prostate cancer patients. Materials and methods: Twenty consecutive patients planned with our current clinical standard TPS and treated with single arc VMAT on standard linacs with 78 Gy in the prostate and 56 Gy for pelvic lymph nodes over 39 fractions were included. In addition, IMRT treatment plans for delivery by a 1.5 T MRL, using standard margins and dose objectives, were made in a dedicated TPS. Mean population dose volume histograms (DVH) and dose metrics were analyzed and clinical plan quality was evaluated by an oncologist. Results: All MRL plans were considered clinically acceptable, and DVH analysis showed an overall high similarity to dose distributions of the clinically delivered plans. Mean target coverage was similar (78.0 Gy vs 77.8 Gy). Small but statistically significant differences were seen in doses to organs at risk; on average MRL plans reduced dose to the bladder (46.2 vs 48.3 Gy) compared to standard plans, while dose was higher to the bowel (29.2 vs 26.6 Gy) and penile bulb (16.5 vs 10.8 Gy). Conclusion: MRL treatment plans were clinically acceptable and similar in quality to the current standard.

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“…Its plan quality is comparable with knowledge‐based planning approach employing overlap‐volume histogram . Auto‐Planning was regarded as a useful tool to perform treatment plans automatically . However, its availability for liver cancer is still unknown.…”

Section: Introductionmentioning

confidence: 99%

A knowledge‐based approach to automated planning for hepatocellular carcinoma

Zhang

Xiao

et al. 2017

J Applied Clin Med Phys

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PurposeTo build a knowledge‐based model of liver cancer for Auto‐Planning, a function in Pinnacle, which is used as an automated inverse intensity modulated radiation therapy (IMRT) planning system.Methods and MaterialsFifty Tomotherapy patients were enrolled to extract the dose–volume histograms (DVHs) information and construct the protocol for Auto‐Planning model. Twenty more patients were chosen additionally to test the model. Manual planning and automatic planning were performed blindly for all twenty test patients with the same machine and treatment planning system. The dose distributions of target and organs at risks (OARs), along with the working time for planning, were evaluated.ResultsStatistically significant results showed that automated plans performed better in target conformity index (CI) while mean target dose was 0.5 Gy higher than manual plans. The differences between target homogeneity indexes (HI) of the two methods were not statistically significant. Additionally, the doses of normal liver, left kidney, and small bowel were significantly reduced with automated plan. Particularly, mean dose and V15 of normal liver were 1.4 Gy and 40.5 cc lower with automated plans respectively. Mean doses of left kidney and small bowel were reduced with automated plans by 1.2 Gy and 2.1 Gy respectively. In contrast, working time was also significantly reduced with automated planning.ConclusionsAuto‐Planning shows availability and effectiveness in our knowledge‐based model for liver cancer.

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Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer

Abstract: The AU plans were in general preferred and showed a lower mean dose to the lungs. The automation of the planning process generated esophageal cancer treatment plans quickly and with high quality.

Cited by 33 publications

References 23 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

Plan quality for high-risk prostate cancer treated with high field magnetic resonance imaging guided radiotherapy

A knowledge‐based approach to automated planning for hepatocellular carcinoma

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