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. 2015 Nov 10:10:226.
doi: 10.1186/s13014-015-0533-2.

Evaluation of an automated knowledge based treatment planning system for head and neck

Jerome Krayenbuehl  1 , Ian Norton  2 , Gabriela Studer  3 , Matthias Guckenberger  4
Affiliations

Evaluation of an automated knowledge based treatment planning system for head and neck

Jerome Krayenbuehl et al. Radiat Oncol. .

Abstract

Background: This study evaluated an automated inverse treatment planning algorithm, Pinnacle Auto-Planning (AP), and compared automatically generated plans with historical plans in a large cohort of head and neck cancer patients.

Methods: Fifty consecutive patients treated with volumetric modulated arc therapy (Eclipse, Varian Medical System, Palo Alto, CA) for head and neck were re-planned with AP version 9.10. Only one single cycle of plan optimization using one single template was allowed for AP. The dose to the planning target volumes (PTV's; 3-4 dose levels), the organs at risk (OAR's) and the effective working time for planning was evaluated. Additionally, two experienced radiation oncologists blind-reviewed and ranked 10 plans.

Results: Dose coverage and dose homogeneity of the PTV were significantly improved with AP, however manually optimized plans showed significantly improved dose conformity. The mean dose to the parotid glands, oral mucosa, swallowing muscles, dorsal neck tissue and maximal dose to the spinal cord were significantly reduced with AP. In 64 % of the plans, the mean dose to any OAR (spinal cord excluded) was reduced by >20 % with AP in comparison to the manually optimized plans. In 12 % of the plans, the manually optimized plans showed reduced doses by >20 % in at least one OAR. The experienced radiation oncologists preferred the AP plan and the clinical plan in 80 and 20 % of the cases, respectively. The average effective working time was 3.8 min ± 1.1 min in comparison to 48.5 min ± 6.0 min using AP compared to the manually optimized plans, respectively.

Conclusion: The evaluated automated planning algorithm achieved highly consistent and significantly improved treatment plans with potentially clinically relevant OAR sparing by >20 % in 64 % of the cases. The effective working time was substantially reduced with Auto-Planning.

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Figures

Fig. 1
Fig. 1
Mean parotid dose difference as a function of the clinical mean parotid dose. If the values are positive, Auto-Planning reduced the parotid mean dose. If the values are negative, the parotid mean dose was reduced with the clinical plan
Fig. 2
Fig. 2
Mean swallowing muscles dose difference as a function of the clinical mean swallowing muscles dose. If the values are positive, Auto-Planning had a better dose sparing of the swallowing muscles. If the values are negative, the clinical plan had a better dose sparing of the swallowing muscles
Fig. 3
Fig. 3
Mean oral mucosa dose difference as a function of the clinical mean oral mucosa dose. If the values are positive, Auto-Planning had a better dose sparing of the s oral mucosa. If the values are negative, the clinical plan had a better dose sparing of the oral mucosa
See this image and copyright information in PMC

References

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