Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study
BackgroundIn radiation oncology, automation of treatment planning has reported the potential to improve plan quality and increase planning efficiency. We performed a comprehensive dosimetric evaluation of the new Personalized algorithm implemented in Pinnacle3 for full planning automation of VMAT pr...
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Frontiers Media S.A.
2021-06-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.636529/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Savino Cilla Carmela Romano Vittoria E. Morabito Gabriella Macchia Milly Buwenge Milly Buwenge Nicola Dinapoli Luca Indovina Lidia Strigari Alessio G. Morganti Alessio G. Morganti Vincenzo Valentini Vincenzo Valentini Francesco Deodato Francesco Deodato |
spellingShingle |
Savino Cilla Carmela Romano Vittoria E. Morabito Gabriella Macchia Milly Buwenge Milly Buwenge Nicola Dinapoli Luca Indovina Lidia Strigari Alessio G. Morganti Alessio G. Morganti Vincenzo Valentini Vincenzo Valentini Francesco Deodato Francesco Deodato Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study Frontiers in Oncology automated planning personalized prostate cancer VMAT (volumetric modulated arc therapy) pinnacle dosimetric analysis |
author_facet |
Savino Cilla Carmela Romano Vittoria E. Morabito Gabriella Macchia Milly Buwenge Milly Buwenge Nicola Dinapoli Luca Indovina Lidia Strigari Alessio G. Morganti Alessio G. Morganti Vincenzo Valentini Vincenzo Valentini Francesco Deodato Francesco Deodato |
author_sort |
Savino Cilla |
title |
Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study |
title_short |
Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study |
title_full |
Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study |
title_fullStr |
Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study |
title_full_unstemmed |
Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric Study |
title_sort |
personalized treatment planning automation in prostate cancer radiation oncology: a comprehensive dosimetric study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-06-01 |
description |
BackgroundIn radiation oncology, automation of treatment planning has reported the potential to improve plan quality and increase planning efficiency. We performed a comprehensive dosimetric evaluation of the new Personalized algorithm implemented in Pinnacle3 for full planning automation of VMAT prostate cancer treatments.Material and MethodsThirteen low-risk prostate (without lymph-nodes irradiation) and 13 high-risk prostate (with lymph-nodes irradiation) treatments were retrospectively taken from our clinical database and re-optimized using two different automated engines implemented in the Pinnacle treatment system. These two automated engines, the currently used Autoplanning and the new Personalized are both template-based algorithms that use a wish-list to formulate the planning goals and an iterative approach able to mimic the planning procedure usually adopted by experienced planners. In addition, the new Personalized module integrates a new engine, the Feasibility module, able to generate an “a priori” DVH prediction of the achievability of planning goals. Comparison between clinically accepted manually generated (MP) and automated plans generated with both Autoplanning (AP) and Personalized engines (Pers) were performed using dose-volume histogram metrics and conformity indexes. Three different normal tissue complication probabilities (NTCPs) models were used for rectal toxicity evaluation. The planning efficiency and the accuracy of dose delivery were assessed for all plans.ResultsFor similar targets coverage, Pers plans reported a significant increase of dose conformity and less irradiation of healthy tissue, with significant dose reduction for rectum, bladder, and femurs. On average, Pers plans decreased rectal mean dose by 11.3 and 8.3 Gy for low-risk and high-risk cohorts, respectively. Similarly, the Pers plans decreased the bladder mean doses by 7.3 and 7.6 Gy for low-risk and high-risk cohorts, respectively. The integral dose was reduced by 11–16% with respect to MP plans. Overall planning times were dramatically reduced to about 7 and 15 min for Pers plans. Despite the increased complexity, all plans passed the 3%/2 mm γ-analysis for dose verification.ConclusionsThe Personalized engine provided an overall increase of plan quality, in terms of dose conformity and sparing of normal tissues for prostate cancer patients. The Feasibility “a priori” DVH prediction module provided OARs dose sparing well beyond the clinical objectives. The new Pinnacle Personalized algorithms outperformed the currently used Autoplanning ones as solution for treatment planning automation. |
topic |
automated planning personalized prostate cancer VMAT (volumetric modulated arc therapy) pinnacle dosimetric analysis |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.636529/full |
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doaj-3ac58529b4d141d68d709bc8b85a73cf2021-06-01T13:34:02ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-06-011110.3389/fonc.2021.636529636529Personalized Treatment Planning Automation in Prostate Cancer Radiation Oncology: A Comprehensive Dosimetric StudySavino Cilla0Carmela Romano1Vittoria E. Morabito2Gabriella Macchia3Milly Buwenge4Milly Buwenge5Nicola Dinapoli6Luca Indovina7Lidia Strigari8Alessio G. Morganti9Alessio G. Morganti10Vincenzo Valentini11Vincenzo Valentini12Francesco Deodato13Francesco Deodato14Medical Physics Unit, Gemelli Molise Hospital–Università Cattolica del Sacro Cuore, Campobasso, ItalyMedical Physics Unit, Gemelli Molise Hospital–Università Cattolica del Sacro Cuore, Campobasso, ItalyMedical Physics Unit, Gemelli Molise Hospital–Università Cattolica del Sacro Cuore, Campobasso, ItalyRadiation Oncology Unit, Gemelli Molise Hospital–Università Cattolica del Sacro Cuore, Campobasso, ItalyRadiation Oncology, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, ItalyDIMES, Alma Mater Studiorum Bologna University, Bologna, ItalyRadiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli–Università Cattolica del Sacro Cuore, Rome, ItalyMedical Physics Unit, Fondazione Policlinico Universitario A. Gemelli–Università Cattolica del Sacro Cuore, Rome, ItalyMedical Physics Unit, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, ItalyRadiation Oncology, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, ItalyDIMES, Alma Mater Studiorum Bologna University, Bologna, ItalyRadiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli–Università Cattolica del Sacro Cuore, Rome, ItalyIstituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, ItalyRadiation Oncology Unit, Gemelli Molise Hospital–Università Cattolica del Sacro Cuore, Campobasso, ItalyIstituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, ItalyBackgroundIn radiation oncology, automation of treatment planning has reported the potential to improve plan quality and increase planning efficiency. We performed a comprehensive dosimetric evaluation of the new Personalized algorithm implemented in Pinnacle3 for full planning automation of VMAT prostate cancer treatments.Material and MethodsThirteen low-risk prostate (without lymph-nodes irradiation) and 13 high-risk prostate (with lymph-nodes irradiation) treatments were retrospectively taken from our clinical database and re-optimized using two different automated engines implemented in the Pinnacle treatment system. These two automated engines, the currently used Autoplanning and the new Personalized are both template-based algorithms that use a wish-list to formulate the planning goals and an iterative approach able to mimic the planning procedure usually adopted by experienced planners. In addition, the new Personalized module integrates a new engine, the Feasibility module, able to generate an “a priori” DVH prediction of the achievability of planning goals. Comparison between clinically accepted manually generated (MP) and automated plans generated with both Autoplanning (AP) and Personalized engines (Pers) were performed using dose-volume histogram metrics and conformity indexes. Three different normal tissue complication probabilities (NTCPs) models were used for rectal toxicity evaluation. The planning efficiency and the accuracy of dose delivery were assessed for all plans.ResultsFor similar targets coverage, Pers plans reported a significant increase of dose conformity and less irradiation of healthy tissue, with significant dose reduction for rectum, bladder, and femurs. On average, Pers plans decreased rectal mean dose by 11.3 and 8.3 Gy for low-risk and high-risk cohorts, respectively. Similarly, the Pers plans decreased the bladder mean doses by 7.3 and 7.6 Gy for low-risk and high-risk cohorts, respectively. The integral dose was reduced by 11–16% with respect to MP plans. Overall planning times were dramatically reduced to about 7 and 15 min for Pers plans. Despite the increased complexity, all plans passed the 3%/2 mm γ-analysis for dose verification.ConclusionsThe Personalized engine provided an overall increase of plan quality, in terms of dose conformity and sparing of normal tissues for prostate cancer patients. The Feasibility “a priori” DVH prediction module provided OARs dose sparing well beyond the clinical objectives. The new Pinnacle Personalized algorithms outperformed the currently used Autoplanning ones as solution for treatment planning automation.https://www.frontiersin.org/articles/10.3389/fonc.2021.636529/fullautomated planningpersonalizedprostate cancerVMAT (volumetric modulated arc therapy)pinnacledosimetric analysis |