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Fully automated, multi-criterial planning for Volumetric Modulated Arc Therapy – An international multi-center validation for prostate cancer
Reported plan quality improvements with autoplanning of radiotherapy of the prostate and seminal vesicles are poor. A system for automated multi-criterial planning has been validated for this treatment in a large international multi-center study. The system is configured with training plans using a...
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Published in: | Radiotherapy and oncology 2018-08, Vol.128 (2), p.343-348 |
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creator | Heijmen, Ben Voet, Peter Fransen, Dennie Penninkhof, Joan Milder, Maaike Akhiat, Hafid Bonomo, Pierluigi Casati, Marta Georg, Dietmar Goldner, Gregor Henry, Ann Lilley, John Lohr, Frank Marrazzo, Livia Pallotta, Stefania Pellegrini, Roberto Seppenwoolde, Yvette Simontacchi, Gabriele Steil, Volker Stieler, Florian Wilson, Stuart Breedveld, Sebastiaan |
description | Reported plan quality improvements with autoplanning of radiotherapy of the prostate and seminal vesicles are poor. A system for automated multi-criterial planning has been validated for this treatment in a large international multi-center study. The system is configured with training plans using a mechanism that strives for quality improvements relative to those plans.
Each of the four participating centers included thirty manually generated clinical Volumetric Modulated Arc Therapy prostate plans (manVMAT). Ten plans were used for autoplanning training. The other twenty were compared with an automatically generated plan (autoVMAT). Plan evaluations considered dosimetric plan parameters and blinded side-by-side plan comparisons by clinicians.
With equivalent Planning Target Volume (PTV) V95%, D2%, D98%, and dose homogeneity autoVMAT was overall superior for rectum with median differences of 3.4 Gy (p |
doi_str_mv | 10.1016/j.radonc.2018.06.023 |
format | article |
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Each of the four participating centers included thirty manually generated clinical Volumetric Modulated Arc Therapy prostate plans (manVMAT). Ten plans were used for autoplanning training. The other twenty were compared with an automatically generated plan (autoVMAT). Plan evaluations considered dosimetric plan parameters and blinded side-by-side plan comparisons by clinicians.
With equivalent Planning Target Volume (PTV) V95%, D2%, D98%, and dose homogeneity autoVMAT was overall superior for rectum with median differences of 3.4 Gy (p < 0.001) in Dmean, 4.0% (p < 0.001) in V60Gy, and 1.5% (p = 0.001) in V75Gy, and for bladder Dmean (0.9 Gy, p < 0.001). Also the clinicians’ plan comparisons pointed at an overall preference for autoVMAT. Advantages of autoVMAT were highly treatment center- and patient-specific with overall ranges for differences in rectum Dmean and V60Gy of [−4,12] Gy and [−2,15]%, respectively.
Observed advantages of autoplanning were clinically relevant and larger than reported in the literature. The latter is likely related to the multi-criterial nature of the applied autoplanning algorithm, with for each center a dedicated configuration that aims at plan improvements relative to its (clinical) training plans. Large variations among patients in differences between manVMAT and autoVMAT point at inconsistencies in manual planning.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2018.06.023</identifier><identifier>PMID: 29970259</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Automated multi-criterial treatment planning ; Knowledge-based planning ; Multi-center validation ; Prostate ; VMAT</subject><ispartof>Radiotherapy and oncology, 2018-08, Vol.128 (2), p.343-348</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5531458d8848ce4e8fb574030fe1f2bebe5ae37f05e39422ec2f675f6c6c4b173</citedby><cites>FETCH-LOGICAL-c474t-5531458d8848ce4e8fb574030fe1f2bebe5ae37f05e39422ec2f675f6c6c4b173</cites><orcidid>0000-0002-9889-2697</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29970259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heijmen, Ben</creatorcontrib><creatorcontrib>Voet, Peter</creatorcontrib><creatorcontrib>Fransen, Dennie</creatorcontrib><creatorcontrib>Penninkhof, Joan</creatorcontrib><creatorcontrib>Milder, Maaike</creatorcontrib><creatorcontrib>Akhiat, Hafid</creatorcontrib><creatorcontrib>Bonomo, Pierluigi</creatorcontrib><creatorcontrib>Casati, Marta</creatorcontrib><creatorcontrib>Georg, Dietmar</creatorcontrib><creatorcontrib>Goldner, Gregor</creatorcontrib><creatorcontrib>Henry, Ann</creatorcontrib><creatorcontrib>Lilley, John</creatorcontrib><creatorcontrib>Lohr, Frank</creatorcontrib><creatorcontrib>Marrazzo, Livia</creatorcontrib><creatorcontrib>Pallotta, Stefania</creatorcontrib><creatorcontrib>Pellegrini, Roberto</creatorcontrib><creatorcontrib>Seppenwoolde, Yvette</creatorcontrib><creatorcontrib>Simontacchi, Gabriele</creatorcontrib><creatorcontrib>Steil, Volker</creatorcontrib><creatorcontrib>Stieler, Florian</creatorcontrib><creatorcontrib>Wilson, Stuart</creatorcontrib><creatorcontrib>Breedveld, Sebastiaan</creatorcontrib><title>Fully automated, multi-criterial planning for Volumetric Modulated Arc Therapy – An international multi-center validation for prostate cancer</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>Reported plan quality improvements with autoplanning of radiotherapy of the prostate and seminal vesicles are poor. A system for automated multi-criterial planning has been validated for this treatment in a large international multi-center study. The system is configured with training plans using a mechanism that strives for quality improvements relative to those plans.
Each of the four participating centers included thirty manually generated clinical Volumetric Modulated Arc Therapy prostate plans (manVMAT). Ten plans were used for autoplanning training. The other twenty were compared with an automatically generated plan (autoVMAT). Plan evaluations considered dosimetric plan parameters and blinded side-by-side plan comparisons by clinicians.
With equivalent Planning Target Volume (PTV) V95%, D2%, D98%, and dose homogeneity autoVMAT was overall superior for rectum with median differences of 3.4 Gy (p < 0.001) in Dmean, 4.0% (p < 0.001) in V60Gy, and 1.5% (p = 0.001) in V75Gy, and for bladder Dmean (0.9 Gy, p < 0.001). Also the clinicians’ plan comparisons pointed at an overall preference for autoVMAT. Advantages of autoVMAT were highly treatment center- and patient-specific with overall ranges for differences in rectum Dmean and V60Gy of [−4,12] Gy and [−2,15]%, respectively.
Observed advantages of autoplanning were clinically relevant and larger than reported in the literature. The latter is likely related to the multi-criterial nature of the applied autoplanning algorithm, with for each center a dedicated configuration that aims at plan improvements relative to its (clinical) training plans. 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A system for automated multi-criterial planning has been validated for this treatment in a large international multi-center study. The system is configured with training plans using a mechanism that strives for quality improvements relative to those plans.
Each of the four participating centers included thirty manually generated clinical Volumetric Modulated Arc Therapy prostate plans (manVMAT). Ten plans were used for autoplanning training. The other twenty were compared with an automatically generated plan (autoVMAT). Plan evaluations considered dosimetric plan parameters and blinded side-by-side plan comparisons by clinicians.
With equivalent Planning Target Volume (PTV) V95%, D2%, D98%, and dose homogeneity autoVMAT was overall superior for rectum with median differences of 3.4 Gy (p < 0.001) in Dmean, 4.0% (p < 0.001) in V60Gy, and 1.5% (p = 0.001) in V75Gy, and for bladder Dmean (0.9 Gy, p < 0.001). Also the clinicians’ plan comparisons pointed at an overall preference for autoVMAT. Advantages of autoVMAT were highly treatment center- and patient-specific with overall ranges for differences in rectum Dmean and V60Gy of [−4,12] Gy and [−2,15]%, respectively.
Observed advantages of autoplanning were clinically relevant and larger than reported in the literature. The latter is likely related to the multi-criterial nature of the applied autoplanning algorithm, with for each center a dedicated configuration that aims at plan improvements relative to its (clinical) training plans. Large variations among patients in differences between manVMAT and autoVMAT point at inconsistencies in manual planning.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>29970259</pmid><doi>10.1016/j.radonc.2018.06.023</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9889-2697</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Automated multi-criterial treatment planning Knowledge-based planning Multi-center validation Prostate VMAT |
title | Fully automated, multi-criterial planning for Volumetric Modulated Arc Therapy – An international multi-center validation for prostate cancer |
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