Automatic treatment planning for VMAT‐based total body irradiation using Eclipse scripting

Abstract

The purpose of this work is to establish an automated approach for a multiple isocenter volumetric arc therapy (VMAT)-based TBI treatment planning approach. Five anonymized full-body CT imaging sets were used. A script was developed to automate and standardize the treatment planning process using the Varian Eclipse v15.6 Scripting API. The script generates two treatment plans: a headfirst VMAT-based plan for upper body coverage using four isocenters and a total of eight full arcs; and a feet-first AP/PA plan with three isocenters that covers the lower extremities of the patient. PTV was the entire body cropped 5 mm from the patient surface and extended 3 mm into the lungs and kidneys. Two plans were generated for each case: one to a total dose of 1200 cGy in 8 fractions and a second one to a total dose of 1320 cGy in 8 fractions. Plans were calculated using the AAA algorithm and 6 MV photon energy. One plan was created and delivered to an anthropomorphic phantom containing 12 OSLDs for in-vivo dose verification. For the plans prescribed to 1200 cGy total dose the following dosimetric results were achieved: median PTV V100% = 94.5%; median PTV D98% = 89.9%; median lungs Dmean = 763 cGy; median left kidney Dmean = 1058 cGy; and median right kidney Dmean = 1051 cGy. For the plans prescribed to 1320 cGy total dose the following dosimetric results were achieved: median PTV V100% = 95.0%; median PTV D98% = 88.7%; median lungs Dmean = 798 cGy; median left kidney Dmean = 1059 cGy; and median right kidney Dmean = 1064 cGy. Maximum dose objective was met for all cases. The dose deviation between the treatment planning dose and the dose measured by the OSLDs was within AE4%. In summary, we have demonstrated that scripting can produce high-quality plans based on predefined dose objectives and can decrease planning time by automatic target and optimization contours generation, plan creation, field and isocenter placement, and optimization objectives setup.

Eclipse web service application programming interface

“…Compared with general software development: it also needs to conduct scientific clinical risk assessment before development; after completing the development, it also needs to design some test cases for preclinical commissioning (Covington et al 2020). Excellent open-source projects in the community (Cardan et al 2019, Teruel et al 2021 can serve as a solid foundation for interface implementation.…”

Implementing failure mode and effect analysis to improve the safety of volumetric modulated arc therapy for total body irradiation

“…In such complicated treatment planning techniques like VMAT‐TBI, it is beneficial and sometimes necessary to use scripting to produce high‐quality plans based on pre‐defined dose objectives and can decrease planning time. In a study by Teruel et al., 39 an automated approach was established for VMAT‐TBI treatment planning. A script was developed to automate and standardize the treatment planning process using the Varian Eclipse scripting API.…”

Automatic planning of the lower extremities for total marrow irradiation using volumetric modulated arc therapy

“…Teruel et al. [ 29 ] developed an ESAPI script that produced high-quality VMAT-TBI plans by automating tasks such as isocenter positioning, placement of plan fields, and target and optimization contours creation. Authors reported time savings of 2–3 h, and up to a full day in case of unnoticed manual errors.…”