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. 2019 Jan-Dec:18:1533033819851763.
doi: 10.1177/1533033819851763.

Can the Student Outperform the Master? A Plan Comparison Between Pinnacle Auto-Planning and Eclipse knowledge-Based RapidPlan Following a Prostate-Bed Plan Competition

April Smith  1 , Andrew Granatowicz  1 , Cole Stoltenberg  1 , Shuo Wang  1 , Xiaoying Liang  2 , Charles A Enke  1 , Andrew O Wahl  1 , Sumin Zhou  1 , Dandan Zheng  1
Affiliations

Can the Student Outperform the Master? A Plan Comparison Between Pinnacle Auto-Planning and Eclipse knowledge-Based RapidPlan Following a Prostate-Bed Plan Competition

April Smith et al. Technol Cancer Res Treat. 2019 Jan-Dec.

Abstract

Purpose: Pinnacle Auto-Planning and Eclipse RapidPlan are 2 major commercial automated planning engines that are fundamentally different: Auto-Planning mimics real planners in the iterative optimization, while RapidPlan generates static dose objectives from estimations predicted based on a prior knowledge base. This study objectively compared their performances on intensity-modulated radiotherapy planning for prostate fossa and lymphatics adopting the plan quality metric used in the 2011 American Association of Medical Dosimetrists Plan Challenge.

Methods: All plans used an identical intensity-modulated radiotherapy beam setup and a simultaneous integrated boost prescription (68 Gy/56 Gy to prostate fossa/lymphatics). Auto-Planning was used to retrospectively plan on 20 patients, which were subsequently employed as the library to build an RapidPlan model. To compare the 2 engines' performances, a test set including 10 patients and the Plan Challenge patient was planned by both Auto-Planning (master) and RapidPlan (student) without manual intervention except for a common dose normalization and evaluated using the plan quality metric that included 14 quantitative submetrics ranging over target coverage, spillage, and organ at risk doses. Plan quality metric scores were compared between the Auto-Planning and RapidPlan plans using the Mann-Whitney U test.

Results: There was no significant difference between the overall performance of the 2 engines on the 11 test cases ( P = .509). Among the 14 submetrics, Auto-Planning and RapidPlan showed no significant difference on most submetrics except for 2. On the Plan Challenge case, Auto-Planning scored 129.9 and RapidPlan scored 130.3 out of 150, as compared with the average score of 116.9 ± 16.4 (range: 58.2-142.5) among the 125 Plan Challenge participants.

Conclusion: Using an innovative study design, an objective comparison has been conducted between 2 major commercial automated inverse planning engines. The 2 engines performed comparably with each other and both yielded plans at par with average human planners. Using a constant-performing planner (Auto-Planning) to train and to compare, RapidPlan was found to yield plans no better than but as good as its library plans.

Keywords: Auto-Plan; KBP; RapidPlan; automation; treatment planning.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A schematic of our innovative study design.
Figure 2.
Figure 2.
Isodose distributions (A, B) and the DVH (C) plots comparing the AP and RP plans on one example patient (patient 3). On the isodose distributions, the targets are shown in color wash (red is PTV 68 and cyan is PTV 56-68). AP indicates Auto-Planning; DVH, dose–volume histogram; PTV, planning target volume; RP, RapidPlan.
Figure 3.
Figure 3.
A comparison of the total PQM scores of the corresponding RP versus AP plans on the 11 test cases. The perfect score is 150 and patient #11 is the Plan Challenge case. AP indicates Auto-Planning; PQM, plan quality metric; RP, RapidPlan.
Figure 4.
Figure 4.
Comparison of the total PQM scores of the AP and RP plans on the Plan Challenge case with the human planner scores from the Plan Challenge. The average scores and score ranges were plotted for all human participants as well as all Pinnacle planners and all Eclipse planners. AP indicates Auto-Planning; RP, RapidPlan.
See this image and copyright information in PMC

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