Full automation of spinal stereotactic radiosurgery and stereotactic body radiation therapy treatment planning using Varian Eclipse scripting

Abstract

The purpose of this feasibility study is to develop a fully automated procedure capable of generating treatment plans with multiple fractionation schemes to improve speed, robustness, and standardization of plan quality. A fully automated script was implemented for spinal stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT) plan generation using Eclipse v15.6 API. The script interface allows multiple dose/fractionation plan requests, planning target volume (PTV) expansions, as well as information regarding distance/overlap between spinal cord and targets to drive decision‐making. For each requested plan, the script creates the course, plans, field arrangements, and automatically optimizes and calculates dose. The script was retrospectively applied to ten computed tomography (CT) scans of previous cervical, thoracic, and lumbar spine SBRT patients. Three plans were generated for each patient — simultaneous integrated boost (SIB) 1800/1600 cGy to gross tumor volume (GTV)/PTV in one fraction; SIB 2700/2100 cGy to GTV/PTV in three fractions; and 3000 cGy to PTV in five fractions. Plan complexity and deliverability patient‐specific quality assurance (QA) was performed using ArcCHECK with an Exradin A16 chamber inserted. Dose objectives were met for all organs at risk (OARs) for each treatment plan. Median target coverage was GTV V100% = 87.3%, clinical target volume (CTV) V100% = 95.7% and PTV V100% = 88.0% for single fraction plans; GTV V100% = 95.6, CTV V100% = 99.6% and PTV V100% = 97.2% for three fraction plans; and GTV V100% = 99.6%, CTV V100% = 99.1% and PTV V100% = 97.2% for five fraction plans. All plans (n = 30) passed patient‐specific QA (>90%) at 2%/2 mm global gamma. A16 chamber dose measured at isocenter agreed with planned dose within 3% for all cases. Automatic planning for spine SRS/SBRT through scripting increases efficiency, standardizes plan quality and approach, and provides a tool for target coverage comparison of different fractionation schemes without the need for additional resources.

An Automated Treatment Planning Framework for Spinal Radiation Therapy and Vertebral-Level Second Check

“…Teruel et al automated various parts of the treatment planning process using Eclipse for stereotactic spine but their approach requires completed structure delineation 43 . BrainLab offers advanced auto-segmentation and treatment planning tools (Elements Spine SRS), but to our knowledge, only for stereotactic spine 34 .…”

Deep learning tools for the cancer clinic: an open-source framework with head and neck contour validation

“…By using an internal computer to act as a server, a single configuration of the framework would be available to all clinical personnel through their web browsers without requiring the end users to interface with Python. Alternatively, some vendors of treatment planning software offer scripting application programming interfaces that can integrate customized capabilities into the treatment planning workflow [ 27 – 29 ]. Work is underway at our clinic to incorporate a more robust framework, based in concept on the work presented here, to enable clinicians with various levels of technical expertise to access deep learning research tools.…”

Large-scale dose evaluation of deep learning organ contours in head-and-neck radiotherapy by leveraging existing plans

“…To make our automated program, a four-step script [23] , [24] , [25] was created which uses manually defined beam settings and objective weights from the clinical plan (more details in Supplementary Material C ). This approach is also referred as robot process automation (RPA) [26] , a process wherein a program emulates a human.…”