1. Clinical Implementation of Knowledge-Based Automatic Plan Optimization for Helical Tomotherapy
- Author
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Paola Mangili, Antonella del Vecchio, Roberta Castriconi, Piergiorgio Esposito, Andrei Fodor, Claudio Fiorino, Giovanni Mauro Cattaneo, Chiara Lucrezia Deantoni, Nadia Di Muzio, Cesare Cozzarini, Sara Broggi, Castriconi, R., Cattaneo, G. M., Mangili, P., Esposito, P., Broggi, S., Cozzarini, C., Deantoni, C., Fodor, A., Di Muzio, N. G., Vecchio, A. D., and Fiorino, C.
- Subjects
Male ,Organs at Risk ,medicine.medical_specialty ,medicine.medical_treatment ,Knowledge Bases ,Planning target volume ,Plan (drawing) ,Tomotherapy ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Dosimetry ,Pelvic node ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radiation treatment planning ,Radiometry ,business.industry ,Radiotherapy Planning, Computer-Assisted ,External validation ,Prostatic Neoplasms ,Radiotherapy Dosage ,Training cohort ,Oncology ,030220 oncology & carcinogenesis ,Radiotherapy, Intensity-Modulated ,business - Abstract
Purpose To implement knowledge-based (KB) automatic planning for helical TomoTherapy (HTT). The focus of the first clinical implementation was the case of high-risk prostate cancer, including pelvic node irradiation. Methods and Materials One hundred two HTT clinical plans were selected to train a KB model using the RapidPlan tool incorporated in the Eclipse system (v13.6, Varian Inc). The individually optimized KB-based templates were converted into HTT-like templates and sent automatically to the HTT treatment planning system through scripting. The full dose calculation was set after 300 iterations without any additional planner intervention. Internal (20 patients in the training cohort) and external (28 new patients) validation were performed to assess the performance of the model: Automatic HTT plans (KB-TP) were compared against the original plans (TP) in terms of organs at risk and planning target volume (PTV) dose–volume parameters and by blinded clinical evaluation of 3 expert clinicians. Results KB-TP plans were generally better than or equivalent to TP plans in both validation cohorts. A significant improvement in PTVs and rectum–PTV overlap dosimetry parameters were observed for both sets. Organ-at-risk sparing for KB-TP was slightly improved, which was more evident in the external validation group and for bladder and bowel. Clinical evaluation reported KB-TP to be better in 60% of cases and worse in 10% compared with TP (P Conclusions The fully KB-based automatic planning workflow was successfully implemented for HTT planning optimization in the case of high-risk patients with prostate cancer.
- Published
- 2021