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KMID : 1038720190300040094
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Progress in Medical Physics
2019 Volume.30 No. 4 p.94 ~ p.103
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Volumetric-Modulated Arc Radiotherapy Using Knowledge-Based Planning: Application to Spine Stereotactic Body Radiotherapy
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Jeong Chi-Young
Park Jae-Won
Kwak Jung-Won
Song Si-Yeol
Cho Byung-Chul
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Abstract
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Purpose: To evaluate the clinical feasibility of knowledge-based planning (KBP) for volumetric-modulated arc radiotherapy (VMAT) in spine stereotactic body radiotherapy (SBRT).
Methods: Forty-eight VMAT plans for spine SBRT was studied. Two planning target volumes (PTVs) were defined for simultaneous integrated boost: PTV for boost (PTV-B: 27 Gy/3fractions) and PTV elective (PTV-E: 24 Gy/3fractions). The expert VMAT plans were manually generated by experienced planners. Twenty-six plans were used to train the KBP model using Varian RapidPlan. With the trained KBP model each KBP plan was automatically generated by an individual with little experience and compared with the expert plan (closed-loop validation). Twenty-two plans that had not been used for KBP model training were also compared with the KBP results (open-loop validation).
Results: Although the minimal dose of PTV-B and PTV-E was lower and the maximal dose was higher than those of the expert plan, the difference was no larger than 0.7 Gy. In the closed-loop validation, D1.2cc, D0.35cc, and Dmean of the spinal cord was decreased by 0.9 Gy, 0.6 Gy, and 0.9 Gy, respectively, in the KBP plans (P<0.05). In the open-loop validation, only Dmean of the spinal cord was significantly decreased, by 0.5 Gy (P<0.05).
Conclusions: The dose coverage and uniformity for PTV was slightly worse in the KBP for spine SBRT while the dose to the spinal cord was reduced, but the differences were small. Thus, inexperienced planners could easily generate a clinically feasible plan for spine SBRT by using KBP.
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KEYWORD
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Radiotherapy, Intensity-modulated, Radiotherapy planning, computer-assisted, Machine learning, Radiosurgery
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