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. 2018 Dec;129(3):494-498.
doi: 10.1016/j.radonc.2018.03.025. Epub 2018 Apr 5.

Functional-guided radiotherapy using knowledge-based planning

Austin M Faught  1 , Lindsey Olsen  2 , Leah Schubert  3 , Chad Rusthoven  3 , Edward Castillo  4 , Richard Castillo  5 , Jingjing Zhang  4 , Thomas Guerrero  4 , Moyed Miften  3 , Yevgeniy Vinogradskiy  3
Affiliations

Functional-guided radiotherapy using knowledge-based planning

Austin M Faught et al. Radiother Oncol. 2018 Dec.

Abstract

Background and purpose: There are two significant challenges when implementing functional-guided radiotherapy using 4DCT-ventilation imaging: (1) lack of knowledge of realistic patient specific dosimetric goals for functional lung and (2) ensuring consistent plan quality across multiple planners. Knowledge-based planning (KBP) is positioned to address both concerns.

Material and methods: A KBP model was created from 30 previously planned functional-guided lung patients. Standard organs at risk (OAR) in lung radiotherapy and a ventilation contour delineating areas of high ventilation were included. Model validation compared dose-metrics to standard OARs and functional dose-metrics from 20 independent cases that were planned with and without KBP.

Results: A significant improvement was observed for KBP optimized plans in V20Gy and mean dose to functional lung (p = 0.005 and 0.001, respectively), V20Gy and mean dose to total lung minus GTV (p = 0.002 and 0.01, respectively), and mean doses to esophagus (p = 0.005).

Conclusion: The current work developed a KBP model for functional-guided radiotherapy. Modest, but statistically significant, improvements were observed in functional lung and total lung doses.

Keywords: Functional-guided radiotherapy; Knowledge-based planning.

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Figures

Figure 1
Figure 1
A regression plot of the geometric distribution principal component score is presented for the functional contour. The plot can be used to assess the consistency of the plans included in the KBP model.
Figure 2
Figure 2
An example of a typical ventilation contour is presented in axial (left), coronal (center), and sagittal (right) planes. The distribution of the contour is unique to each patient and can appear diffuse and speculated in some patients and more evenly distributed in others.
See this image and copyright information in PMC

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