1
|
Scaggion A, Cavinato S, Dusi F, El Khouzai B, Guida F, Paronetto C, Rossato MA, Sapignoli S, Scott ASA, Sepulcri M, Paiusco M. On the necessity of specialized knowledge-based models for SBRT prostate treatments plans. Phys Med 2024; 121:103364. [PMID: 38701626 DOI: 10.1016/j.ejmp.2024.103364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/21/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE Test whether a well-grounded KBP model trained on moderately hypo-fractionated prostate treatments can be used to satisfactorily drive the optimization of SBRT prostate treatments. MATERIALS AND METHODS A KBP model (SBRT-model) was developed, trained and validated using the first forty-seven clinically treated VMAT SBRT prostate plans (42.7 Gy/7fx or 36.25 Gy/5fx). The performance and robustness of this model were compared against a high-quality KBP-model (ST-model) that was already clinically adopted for hypo-fractionated (70 Gy/28fx and 60 Gy/20fx) prostate treatments. The two models were compared in terms of their predictions robustness, and the quality of their outcomes were evaluated against a set of reference clinical SBRT plans. Plan quality was assessed using DVH metrics, blinded clinical ranking, and a dedicated Plan Quality Metric algorithm. RESULTS The plan libraries of the two models were found to share a high degree of anatomical similarity. The overall quality (APQM%) of the plans obtained both with the ST- and SBRT-models was compatible with that of the original clinical plans, namely (93.7 ± 4.1)% and (91.6 ± 3.9)% vs (92.8.9 ± 3.6)%. Plans obtained with the ST-model showed significantly higher target coverage (PTV V95%): (97.9 ± 0.8)% vs (97.1 ± 0.9)% (p < 0.05). Conversely, plans optimized following the SBRT-model showed a small but not-clinically relevant increase in OAR sparing. ST-model generally provided more reliable predictions than SBRT-model. Two radiation oncologists judged as equivalent the plans based on the KBP prediction, which was also judged better that reference clinical plans. CONCLUSION A KBP model trained on moderately fractionated prostate treatment plans provided optimal SBRT prostate plans, with similar or larger plan quality than an embryonic SBRT-model based on a limited number of cases.
Collapse
Affiliation(s)
- Alessandro Scaggion
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
| | - Samuele Cavinato
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Francesca Dusi
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Badr El Khouzai
- S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Federica Guida
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Chiara Paronetto
- S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | - Sonia Sapignoli
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | - Matteo Sepulcri
- S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Marta Paiusco
- S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| |
Collapse
|
2
|
Sasaki M, Nakaguchi Y, Kamomae T, Tsuzuki A, Sawada S, Shibuya K, Oita M, Tominaga M, Tominaga Y, Ikushima H. Comparative analysis of two dose-volume histogram prediction tools for treatment planning in volumetric-modulated arc therapy: A multi-planner study. Med Dosim 2024; 49:271-275. [PMID: 38556402 DOI: 10.1016/j.meddos.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/21/2024] [Accepted: 02/24/2024] [Indexed: 04/02/2024]
Abstract
The increase in high-precision radiation therapy, particularly volumetric-modulated arc therapy (VMAT), has increased patient numbers and expanded treatment sites. However, a significant challenge in VMAT treatment planning is the inconsistent plan quality among different planners and facilities. This study explored the use of dose-volume histogram (DVH) prediction tools to address these disparities, specifically focusing on RapidPlan (Varian Medical Systems) and PlanIQ (Sun Nuclear). RapidPlan predicts achievable DVHs and automatically generates optimization objectives. While it has demonstrated organ-at-risk (OAR) dose reduction benefits, the quality of the plan used to build its model significantly affects its predictions. On the other hand, PlanIQ offers ease of use and does not require prior model-building. Five planners participated in this study, each creating two treatment plans: one referencing RapidPlan and the other using PlanIQ. The planners had the freedom to adjust parameters while referencing the DVH predictions. The plans were evaluated using "Plan Quality Metric" (PQM) scores to assess the planning target volume excluding the rectum and OARs. The results revealed that RapidPlan-referenced plans often outperformed PlanIQ-based plans, with less interplanner variability. PlanIQ played a pivotal role in the construction of the RapidPlan model. This study is the first to compare plans generated by multiple planners using both tools. This study provides insights into optimizing treatment planning by considering the characteristics of both RapidPlan and PlanIQ.
Collapse
Affiliation(s)
- Motoharu Sasaki
- Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Tokushima 770-8503, Japan.
| | | | - Takeshi Kamomae
- Radioisotope Research Center, Nagoya University, Nagoya, Aichi 466-8550, Japan; Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Akira Tsuzuki
- Department of Radiological Technology, Kakogawa Central City Hospital, Kakogawa, Hyogo 675-8611, Japan
| | - Soma Sawada
- School of Health Sciences, Tokushima University, Tokushima, Tokushima 770-8503, Japan
| | - Koki Shibuya
- School of Health Sciences, Tokushima University, Tokushima, Tokushima 770-8503, Japan
| | - Masataka Oita
- Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University
| | - Masahide Tominaga
- Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Tokushima 770-8503, Japan
| | - Yuki Tominaga
- Department of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic, Osaka, Osaka 554-0022, Japan
| | - Hitoshi Ikushima
- Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Tokushima 770-8503, Japan
| |
Collapse
|
3
|
Masumoto N, Sasaki M, Nakaguchi Y, Kamomae T, Kanazawa Y, Ikushima H. Knowledge-based model building for treatment planning for prostate cancer using commercial treatment planning quality assurance software tools. Radiol Phys Technol 2024; 17:337-345. [PMID: 37938420 DOI: 10.1007/s12194-023-00759-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023]
Abstract
This study devised a method to efficiently launch the RapidPlan model for volumetric-modulated arc therapy for prostate cancer in small- and medium-sized facilities using high-quality treatment plans with the PlanIQ software as a reference. Treatment plans were generated for 30 patients with prostate cancer to construct the RapidPlan model using PlanIQ as a reference. In the context of PlanIQ-referenced treatment planning, treatment plans were developed, such that the feasibility dose-volume histogram of each organ-at-risk fell within F ≤ 0.1. For validation of the RapidPlan model, treatment plans were formulated for 20 patients using both RapidPlan and PlanIQ, and the differences were evaluated. The results of RapidPlan model validity assessment revealed that the RapidPlan-produced treatment plans exhibited higher quality in 11 of 20 patients. No significant differences were found between the treatment plans. In conclusion, high-quality treatment plans formulated using PlanIQ as reference facilitated efficient implementation of RapidPlan modeling.
Collapse
Affiliation(s)
- Nagi Masumoto
- Medical Research Institute Kitano Hospital, PIIF Tazuke-kofukai, Osaka, Osaka, 530-8480, Japan
| | - Motoharu Sasaki
- Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan.
| | - Yuji Nakaguchi
- Toyo Medic Co., Ltd, Shinjyukuku, Tokyo, 162-0813, Japan
| | - Takeshi Kamomae
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
| | - Yuki Kanazawa
- Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Hitoshi Ikushima
- Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| |
Collapse
|
4
|
Panizza D, Faccenda V, Arcangeli S, De Ponti E. Treatment Optimization in Linac-Based SBRT for Localized Prostate Cancer: A Single-Arc versus Dual-Arc Plan Comparison. Cancers (Basel) 2023; 16:13. [PMID: 38201441 PMCID: PMC10778084 DOI: 10.3390/cancers16010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to comprehensively present data on treatment optimization in linac-based SBRT for localized prostate cancer at a single institution. Moreover, the dosimetric quality and treatment efficiency of single-arc (SA) versus dual-arc (DA) VMAT planning and delivery approaches were compared. Re-optimization was performed on twenty low-to-intermediate-risk- (36.25 Gy in 5 fractions) and twenty high-risk (42.7 Gy in 7 fractions) prostate plans initially administered with the DA FFF-VMAT technique in 2021. An SA approach was adopted, incorporating new optimization parameters based on increased planning and clinical experience. Analysis included target coverage, organ-at-risk (OAR) sparing, treatment delivery time, and the pre-treatment verification's gamma analysis-passing ratio. The SA optimization technique has consistently produced superior plans. Rectum and bladder mean doses were significantly reduced, and comparable target coverage and homogeneity were achieved in order to maintain a urethra protection strategy. The mean SA treatment delivery time was reduced by 22%; the mean monitor units increased due to higher plan complexity; and dose measurements demonstrated optimal agreement with calculations. The substantial reduction in treatment delivery time decreased the probability of prostate motion beyond the applied margins, suggesting potential decrease in treatment-related toxicity and improved target coverage in prostate SBRT. Further investigations are warranted to assess the long-term clinical outcomes.
Collapse
Affiliation(s)
- Denis Panizza
- Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (E.D.P.)
- School of Medicine and Surgery, University of Milan Bicocca, 20126 Milan, Italy;
| | - Valeria Faccenda
- Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (E.D.P.)
| | - Stefano Arcangeli
- School of Medicine and Surgery, University of Milan Bicocca, 20126 Milan, Italy;
- Radiation Oncology Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Elena De Ponti
- Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (E.D.P.)
- School of Medicine and Surgery, University of Milan Bicocca, 20126 Milan, Italy;
| |
Collapse
|
5
|
Yuan K, Yao X, Liao X, Diao P, Xin X, Ma J, Li J, Orlandini LC. Comparing breath hold versus free breathing irradiation for left-sided breast radiotherapy by PlanIQ™. Radiat Oncol 2023; 18:200. [PMID: 38098106 PMCID: PMC10722777 DOI: 10.1186/s13014-023-02386-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Breast cancer is the most widespread cancer in women and young women worldwide. Moving towards customised radiotherapy, balancing the use of the available technology with the best treatment modality may not be an easy task in the daily routine. This study aims to evaluate the effectiveness of introducing IQ-feasibility into clinical practice to support the decision of free-breathing (FB) versus breath-hold (BH) left-sided breast irradiations, in order to optimise the technology available and the effectiveness of the treatment. METHODS Thirty-five patients who received 3D radiotherapy treatment of the left breast in deep-inspiration BH were included in this retrospective study. Computed tomography scans in FB and BH were acquired for each patient; targets contoured in both imaging datasets by an experienced radiation oncologist, and organs at risk delineated using automatic segmentation software were exported to PlanIQ™ (Sun Nuclear Corp.) to generate feasibility dose volume histogram (FDVHs). The dosimetric parameter of BH versus FB FDVH, and BH clinical dataset versus BH FDVH were compared. RESULTS A total of 30 patients out of 35 patients analysed, presented for the BH treatments a significant reduction (p < 0.05) in the heart mean dose ([Formula: see text]), volume receiving 5 Gy ([Formula: see text]) and 20 Gy ([Formula: see text]), of 35.7%, 54.5%, and 2.1%, respectively; for the left lung, a lower reduction was registered and significant only for [Formula: see text] (21.4%, p = 0.046). For the remaining five patients, the FDVH cut-off points of heart and lung were superimposable with differences of less than 1%. Heart and left lung dosimetric parameters of the BH clinical plans are located in the difficult zone of the FDVH and differ significantly (p < 0.05) from the corresponding parameters of the FDVH curves delimiting this buffer area between the impossible and feasible zones, respectively. CONCLUSION The use of PlanIQTM as a decision-support tool for the FB versus BH treatment delivery modality allows customisation of the treatment technique using the most appropriate technology for each patient enabling accurate management of available technologies.
Collapse
Affiliation(s)
- Ke Yuan
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Xinghong Yao
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Xiongfei Liao
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China.
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China.
| | - Pen Diao
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Xin Xin
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Jiabao Ma
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Jie Li
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| | - Lucia Clara Orlandini
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University and Electronic Science and Technology of China, Chengdu, China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Chengdu, China
| |
Collapse
|
6
|
Sato D, Sasaki M, Nakaguchi Y, Kamomae T, Kawanaka T, Kubo A, Tonoiso C, Kanazawa Y, Oita M, Kajino A, Tsuzuki A, Ikushima H. Differences between professionals in treatment planning for patients with stage III lung cancer using treatment-planning QA software. Rep Pract Oncol Radiother 2023; 28:671-680. [PMID: 38179286 PMCID: PMC10764038 DOI: 10.5603/rpor.97511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/18/2023] [Indexed: 01/06/2024] Open
Abstract
Background The quality of treatment planning for stage III non-small cell lung cancer varies within and between facilities due to the different professions involved in planning. Dose estimation parameters were calculated using a feasibility dose-volume histogram (FDVH) implemented in the treatment planning quality assurance software PlanIQ. This study aimed to evaluate differences in treatment planning between occupations using manual FDVH-referenced treatment planning to identify their characteristics. Materials and methods The study included ten patients with stage III non-small cell lung cancer, and volumetric-modulated arc therapy was used as the treatment planning technique. Fifteen planners, comprising five radiation oncologists, five medical physicists, and five radiological technologists, developed treatment strategies after referring to the FDVH. Results Medical physicists had a higher mean dose at D98% of the planning target volume (PTV) and a lower mean dose at D2% of the PTV than those in other occupations. Medical physicists had the lowest irradiation lung volumes (V5 Gy and V13 Gy) compared to other professions, and radiation oncologists had the lowest V20 Gy and mean lung dose. Radiological technologists had the highest irradiation volumes for dose constraints at all indexes on the normal lung volume. Conclusions The quality of the treatment plans developed in this study differed between occupations due to their background expertise, even when an FDVH was used as a reference. Therefore, discussing and sharing knowledge and treatment planning techniques among professionals is essential to determine the optimal treatment plan for each facility and patient.
Collapse
Affiliation(s)
- Daisuke Sato
- Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
| | - Motoharu Sasaki
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Takeshi Kamomae
- Department of Radiology, Graduate School of Medicine, Nagoya University Nagoya, Japan
| | - Takashi Kawanaka
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Graduate School, Tokushima University Tokushima, Japan
| | - Akiko Kubo
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Graduate School, Tokushima University Tokushima, Japan
| | - Chisato Tonoiso
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Graduate School, Tokushima University Tokushima, Japan
| | - Yuki Kanazawa
- Department of Medical Image Informatics, Institute of Biomedical Sciences, Graduate School, Tokushima University, Tokushima, Japan
| | - Masataka Oita
- Division of Radiological Technology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Akimi Kajino
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akira Tsuzuki
- Department of Radiological Technology, Kakogawa Central City Hospital, Kakogawa, Japan
| | - Hitoshi Ikushima
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| |
Collapse
|
7
|
Olch AJ, Gopalakrishnan M, Murphy ES, MacDonald SM, Hua CH. Toward Systematic Assessment and Improvement of Radiation Therapy Plan Quality of Cooperative Group Trial Submissions: A Report From the Children's Oncology Group. Pract Radiat Oncol 2023; 13:e374-e382. [PMID: 37037758 PMCID: PMC11163894 DOI: 10.1016/j.prro.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE This study evaluates the quality of plans used for the treatment of patients in the Children's Oncology Group study ACNS1123. Plan quality is quantified based on a scoring system specific to the protocol. In this way, the distribution of plan quality scores is determined that can be used to identify plan quality issues for this study and for future plan quality improvement. METHODS AND MATERIALS ACNS1123 stratum 1 patients (70) were evaluated. This included 50 photon and 20 proton plans. Digital Imaging and Communications in Medicine (DICOM) structure and dose data were obtained from the Children's Oncology Group. A commercially available plan quality scoring algorithm was used to create a scoring system we designed using the protocol dosimetric requirements. The whole ventricle and boost planning target volumes (PTVs) could earn a maximum of 70 points, whereas the organs at risk could earn 30 points (total maximum score of 100 points). The scoring algorithm adjusted scores based on the difficulty in achieving the structure dose requirements, which depended on the proximity of the PTVs and the dose gradients achieved relative to the organs at risk. The distribution of plan scores was used to determine the mean, median, and range of scores. RESULTS The median adjusted plan quality scores for the 20 proton and 50 photon plans were 83.3 and 86.9, respectively. The range of adjusted scores (maximum to minimum) was 50 points. The average score adjustment was 7.4 points. Photon and proton plans performed almost equally. Average plan quality by individual structure revealed that the brain stem, PTV boost, and cochlea lost the most points. CONCLUSIONS This report is the first to systematically analyze overall radiation therapy plan quality scores for an entire cohort of patients treated in a cooperative group clinical trial. The methodology demonstrated a large variation in plan quality in this trial. Future clinical trials could potentially use this method to reduce plan quality variability, which may improve outcomes.
Collapse
Affiliation(s)
- Arthur J Olch
- Department of Radiation Oncology, University of Southern California and Children's Hospital Los Angeles, Los Angeles, California.
| | | | - Erin S Murphy
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Shannon M MacDonald
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Chia-Ho Hua
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
8
|
Aoyama T, Shimizu H, Koide Y, Kitagawa T, Tachibana H, Suzuki K, Kodaira T. Estimation of the risk of secondary cancer in rectum and bladder after radiation therapy for prostate cancer using a feasibility dose-volume histogram. Phys Imaging Radiat Oncol 2023; 27:100468. [PMID: 37520638 PMCID: PMC10384607 DOI: 10.1016/j.phro.2023.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
We investigated the risk of secondary cancers in rectum and bladder for prostate cancer radiotherapy using a feasibility assessment tool. We calculated the risk of secondary cancer by generating a dose-volume histogram based on an ideal dose falloff function (f-value). This study found a smaller f-value was associated with a lower secondary cancer risk in the rectum but a higher risk in the bladder. The study suggests setting the f-value at 0-0.1 as the optimization goal for the rectum and 0.4 for the bladder is reasonable and feasible for reducing the risk of secondary cancer and other adverse events.
Collapse
Affiliation(s)
- Takahiro Aoyama
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| | - Hidetoshi Shimizu
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| | - Yutaro Koide
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| | - Tomoki Kitagawa
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| | - Hiroyuki Tachibana
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University, 1-1 Yazako-karimata, Nagakute, Aichi 480-1195 Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681, Japan
| |
Collapse
|
9
|
Zhang Y, Huang Y, Lin J, Ding S, Gong X, Liu Q, Gong C. Multi-isocenter VMAT craniospinal irradiation using feasibility dose-volume histogram-guided auto-planning technique. JOURNAL OF RADIATION RESEARCH 2023:7150737. [PMID: 37141634 DOI: 10.1093/jrr/rrad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/07/2022] [Indexed: 05/06/2023]
Abstract
This study aims to propose a novel treatment planning methodology for multi-isocenter volumetric modulated arc therapy (VMAT) craniospinal irradiation (CSI) using the special feasibility dose-volume histogram (FDVH)-guided auto-planning (AP) technique. Three different multi-isocenter VMAT -CSI plans were created, including manually based plans (MUPs), conventional AP plans (CAPs) and FDVH-guided AP plans (FAPs). The CAPs and FAPs were specially designed by combining multi-isocenter VMAT and AP techniques in the Pinnacle treatment planning system. Specially, the personalized optimization parameters for FAPs were generated using the FDVH function implemented in PlanIQ software, which provides the ideal organs at risk (OARs) sparing for the specific anatomical geometry based on the valuable assumption of the dose fall-off. Compared to MUPs, CAPs and FAPs significantly reduced the dose for most of the OARs. FAPs achieved the best homogeneity index (0.092 ± 0.013) and conformity index (0.980 ± 0.011), while CAPs were slightly inferior to the FAPs but superior to the MUPs. As opposed to MUPs, FAPs delivered a lower dose to OARs, whereas the difference between FAPs and CAPs was not statistically significant except for the optic chiasm and inner ear_L. The two AP approaches had similar MUs, which were significantly lower than the MUPs. The planning time of FAPs (145.00 ± 10.25 min) was slightly lower than that of CAPs (149.83 ± 14.37 min) and was substantially lower than that of MUPs (157.92 ± 16.11 min) with P < 0.0167. Overall, introducing the multi-isocenter AP technique into VMAT-CSI yielded positive outcomes and may play an important role in clinical CSI planning in the future.
Collapse
Affiliation(s)
- Yun Zhang
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| | - Yuling Huang
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| | - Jiafan Lin
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| | - Shenggou Ding
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| | - Xiaochang Gong
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| | - Qiegen Liu
- Department of Electronic Information Engineering, 999 Xuefu Dadao, Honggutan District, Nanchang 330031, China
| | - Changfei Gong
- Department of Radiation Oncology, Jiangxi Cancer Hospital, 519 East Beijing Road, Qingshanhu District, Nanchang 330029, China
| |
Collapse
|
10
|
Scaggion A, Fusella M, Cavinato S, Dusi F, El Khouzai B, Germani A, Pivato N, Rossato MA, Roggio A, Scott A, Sepulcri M, Zandonà R, Paiusco M. Updating a clinical Knowledge-Based Planning prediction model for prostate radiotherapy. Phys Med 2023; 107:102542. [PMID: 36780793 DOI: 10.1016/j.ejmp.2023.102542] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 01/15/2023] [Accepted: 02/02/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Clinical knowledge-based planning (KBP) models dedicated to prostate radiotherapy treatment may require periodical updates to remain relevant and to adapt to possible changes in the clinic. This study proposes a paired comparison of two different update approaches through a longitudinal analysis. MATERIALS AND METHODS A clinically validated KBP model for moderately hypofractionated prostate therapy was periodically updated using two approaches: one was targeted at achieving the biggest library size (Mt), while the other one at achieving the highest mean sample quality (Rt). Four subsequent updates were accomplished. The goodness, robustness and quality of the outcomes were measured and compared to those of the common ancestor. Plan quality was assessed through the Plan Quality Metric (PQM) and plan complexity was monitored. RESULTS Both update procedures allowed for an increase in the OARs sparing between +3.9 % and +19.2 % compared to plans generated by a human planner. Target coverage and homogeneity slightly reduced [-0.2 %;-14.7 %] while plan complexity showed only minor changes. Increasing the sample size resulted in more reliable predictions and improved goodness-of-fit, while increasing the mean sample quality improved the outcomes but slightly reduced the models reliability. CONCLUSIONS Repeated updates of clinical KBP models can enhance their robustness, reliability and the overall quality of automatically generated plans. The periodical expansion of the model sample accompanied by the removal of the unacceptable low quality plans should maximize the benefits of the updates while limiting the associated workload.
Collapse
Affiliation(s)
- Alessandro Scaggion
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy.
| | - Marco Fusella
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Samuele Cavinato
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy; Dipartimento di Fisica e Astronomia 'G. Galilei', Università degli Studi di Padova, Padova, Italy
| | - Francesca Dusi
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Badr El Khouzai
- Radiation Oncology Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Alessandra Germani
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Nicola Pivato
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Marco Andrea Rossato
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Antonella Roggio
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Anthony Scott
- The Abdus Salam International Centre for Theoretical Physics, Strada Costiera 11, 34151 Trieste, Italy
| | - Matteo Sepulcri
- Radiation Oncology Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Roberto Zandonà
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| | - Marta Paiusco
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padova, Italy
| |
Collapse
|
11
|
Sasaki M, Nakaguchi Y, Kamomae T, Ueda S, Endo Y, Sato D, Ikushima H. Predicting the complexity of head-and-neck volumetric-modulated arc therapy planning using a radiation therapy planning quality assurance software. Rep Pract Oncol Radiother 2022; 27:963-972. [PMID: 36632304 PMCID: PMC9826646 DOI: 10.5603/rpor.a2022.0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/18/2022] [Indexed: 12/31/2022] Open
Abstract
Background/Aim The more complex the treatment plan, the higher the possibility of errors in dose verification. Recently, a treatment planning quality assurance (QA) software (PlanIQ) with a function to objectively evaluate the quality of volumetric-modulated arc therapy (VMAT) treatment plans by scoring and calculating the ideal dose-volume histogram has been marketed. This study aimed to assess the association between the scores of ideal treatment plans identified using PlanIQ and the results of dose verification and to investigate whether the results of dose verification can be predicted based on the complexity of treatment plans. Materials and methods Dose verification was performed using an ionization chamber dosimeter, a radiochromic film, and a three-dimensional dose verification system, Delta4 PT. Correlations between the ideal treatment plan scores obtained by PlanIQ and the results of the absolute dose verification and dose distribution verification were obtained, and it was examined whether dose verifications could be predicted from the complexity of the treatment plans. Results Even when the score from the ideal treatment plan was high, the results of absolute dose verification and dose distribution verification were sometimes poor. However, even when the score from the ideal treatment plan was low, the absolute volume verification and dose distribution verification sometimes yielded good results. Conclusions Treatment plan complexity can be determined in advance from the ideal treatment plan score calculated by PlanIQ. However, it is difficult to predict the results of dose verification using an ideal treatment plan.
Collapse
Affiliation(s)
- Motoharu Sasaki
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Takeshi Kamomae
- Department of Radiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Shoji Ueda
- Department of Radiological Technology, Yawatahama City General Hospital, Ehime, Japan
| | - Yuto Endo
- Graduate School Medical Sciences, Tokushima University, Tokushima, Japan
| | - Daisuke Sato
- Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
| | - Hitoshi Ikushima
- Department of Therapeutic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| |
Collapse
|
12
|
Level Ib CTV delineation in nasopharyngeal carcinoma based on lymph node distribution and topographic anatomy. Radiother Oncol 2022; 172:10-17. [DOI: 10.1016/j.radonc.2022.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/07/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022]
|