Quantitative comparison of automatic and manual IMRT optimization for prostate cancer: the benefits of DVH prediction.
Abstract
A recent publication indicated that the patient anatomical feature (PAF) model was
capable of predicting optimal objectives based on past experience. In this study,
the benefits of IMRT optimization using PAF-predicted objectives as guidance for prostate
were evaluated. Three different optimization methods were compared.1) Expert Plan:
Ten prostate cases (16 plans) were planned by an expert planner using conventional
trial-and-error approach started with institutional modified OAR and PTV constraints.
Optimization was stopped at 150 iterations and that plan was saved as Expert Plan.
2) Clinical Plan: The planner would keep working on the Expert Plan till he was satisfied
with the dosimetric quality and the final plan was referred to as Clinical Plan. 3)
PAF Plan: A third sets of plans for the same ten patients were generated fully automatically
using predicted DVHs as guidance. The optimization was based on PAF-based predicted
objectives, and was continued to 150 iterations without human interaction. DMAX and
D98% for PTV, DMAX for femoral heads, DMAX, D10cc, D25%/D17%, and D40% for bladder/rectum
were compared. Clinical Plans are further optimized with more iterations and adjustments,
but in general provided limited dosimetric benefits over Expert Plans. PTV D98% agreed
within 2.31% among Expert, Clinical, and PAF plans. Between Clinical and PAF Plans,
differences for DMAX of PTV, bladder, and rectum were within 2.65%, 2.46%, and 2.20%,
respectively. Bladder D10cc was higher for PAF but < 1.54% in general. Bladder
D25% and D40% were lower for PAF, by up to 7.71% and 6.81%, respectively. Rectum D10cc,
D17%, and D40% were 2.11%, 2.72%, and 0.27% lower for PAF, respectively. DMAX for
femoral heads were comparable (< 35 Gy on average). Compared to Clinical Plan (Primary
+ Boost), the average optimization time for PAF plan was reduced by 5.2 min on average,
with a maximum reduction of 7.1min. Total numbers of MUs per plan for PAF Plans were
lower than Clinical Plans, indicating better delivery efficiency. The PAF-guided planning
process is capable of generating clinical-quality prostate IMRT plans with no human
intervention. Compared to manual optimization, this automatic optimization increases
planning and delivery efficiency, while maintainingplan quality.
Type
Journal articleSubject
HumansProstatic Neoplasms
Radiotherapy Planning, Computer-Assisted
Radiometry
Automation
Male
Radiotherapy, Intensity-Modulated
Organs at Risk
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https://hdl.handle.net/10161/19400Published Version (Please cite this version)
10.1120/jacmp.v16i2.5204Publication Info
Yang, Yun; Li, Taoran; Yuan, Lunlin; Ge, Yaorong; Yin, Fang-Fang; Lee, W Robert; &
Wu, Q Jackie (2015). Quantitative comparison of automatic and manual IMRT optimization for prostate cancer:
the benefits of DVH prediction. Journal of applied clinical medical physics, 16(2). pp. 5204. 10.1120/jacmp.v16i2.5204. Retrieved from https://hdl.handle.net/10161/19400.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
W. Robert Lee
Professor of Radiation Oncology
Prostate cancer, Intensity-modulated radiation therapy (IMRT), Image-guided radiation
therapy (IGRT), Stereotactic Body Radiation Therapy (SBRT), Prostate HDR and LDR Brachytherapy,
Quality of Life, Educational Technology
Qingrong Wu
Professor of Radiation Oncology
Fang-Fang Yin
Gustavo S. Montana Distinguished Professor of Radiation Oncology
Stereotactic radiosurgery, Stereotactic body radiation therapy, treatment planning
optimization, knowledge guided radiation therapy, intensity-modulated radiation therapy,
image-guided radiation therapy, oncological imaging and informatics
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