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. 2013 Feb;40(2):021714.
doi: 10.1118/1.4788671.

Using overlap volume histogram and IMRT plan data to guide and automate VMAT planning: a head-and-neck case study

Binbin Wu  1 , Dalong Pang, Patricio Simari, Russell Taylor, Giuseppe Sanguineti, Todd McNutt
Affiliations

Using overlap volume histogram and IMRT plan data to guide and automate VMAT planning: a head-and-neck case study

Binbin Wu et al. Med Phys. 2013 Feb.

Abstract

Purpose: To investigate whether an overlap volume histogram (OVH)-driven planning application using an intensity-modulated radiation therapy (IMRT) database can guide and automate volumetric-modulated arc therapy (VMAT) planning for head-and-neck cancer.

Methods: Based on comparable head-and-neck dosimetric results between planner-generated VMAT and IMRT plans, an inhouse developed, OVH-driven automated planning application containing a database of prior clinical head-and-neck IMRT plans is built into Pinnacle(3) SmartArc for VMAT planning. Double-arc VMAT plans of four oropharynx, four nasopharynx, and four larynx patients are generated and compared with corresponding clinical IMRT plans.

Results: Each VMAT plan is automatically generated in two optimization rounds, while the average number of optimization rounds in generating a clinical IMRT plan is 43. In VMAT plans, statistical superiority (p < 0.01) in sparing of the cord+4 mm, brainstem, brachial plexus, larynx, and inner ear is observed with a slight degradation in low-dose-level planning target volume (PTV) coverage. On average, D(0.1 cc) to the cord+4 mm, brainstem and brachial plexus is reduced by 3.7, 4.9, and 1.6 Gy, respectively; V(50 Gy) to the larynx is reduced by 5.3%; mean dose to the inner ear is reduced by 4.4 Gy; V(95) of low-dose-level PTV coverage is reduced by 0.3% with p = 0.25.

Conclusions: IMRT-data-driven VMAT planning offers a potential method for generating VMAT plans that are comparable to IMRT plans in terms of dosimetric quality.

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