Multicriteria plan optimization in the hands of physicians: a pilot study in prostate cancer and brain tumors.
Multicriteria plan optimization in the hands of physicians: a pilot study in prostate cancer and brain tumors.
复制标题
DOI：
10.1186/s13014-017-0903-z
复制
发表时间：
2017-11-06
期刊：
影响因子：
--
通讯作者：
Craft D
中科院分区：
文献类型：
--
作者：
Müller BS;Shih HA;Efstathiou JA;Bortfeld T;Craft D
本研究的目的是通过多标准优化（MCO）治疗计划系统和基于模板的计划优化，证明医生驱动计划在调强放疗（IMRT）中的可行性。利用MCO导航的全部规划潜力，这种替代规划方法旨在提高规划效率和个人规划质量。回顾性对12例脑肿瘤患者和10例前列腺切除术后患者进行MCO-IMRT治疗。对于每位患者，医生都可以使用原始临床计划的光束角度，为其提供基于模板生成的最优计划的帕累托曲面。我们比较了医生制定的计划和临床交付的计划（由剂量师创建）在剂量学差异、医生偏好和计划时间方面的差异。计划质量相似，但医生制定的计划和临床计划在临床目标的优先级上存在差异。医生制定的前列腺计划显示，高剂量的直肠和膀胱区域明显更好地保留(p(D1) < 0.05；D1：相应结构1%的剂量)。医生的脑肿瘤计划显示靶和脑干的剂量更高（p(D1) < 0.05）。在盲法计划比较中，医生更倾向于临床计划（脑部：6:3 / 12，前列腺：2:6 / 10）（无统计学意义）。虽然医生参与前列腺计划的时间相当，但新的工作流程将脑部病例的平均参与时间减少了30%。所有情况下的计划时间都减少了。临床医生通过洞察计划优化和体验剂量权衡，观察到主观益处，例如更好地理解计划情况。我们将医生驱动的MCO作为一种可行的脑和前列腺肿瘤规划工作流程。所提出的方法通过使用特定地点的模板来标准化规划过程，并将医生更紧密地整合到治疗计划中。医生的导航计划质量与临床计划相当。由于减少了计划人员的计划时间，而医生的计划时间相等或更低，这种方法有可能提高部门效率。
The purpose of this study was to demonstrate the feasibility of physician driven planning in intensity modulated radiotherapy (IMRT) with a multicriteria optimization (MCO) treatment planning system and template based plan optimization. Exploiting the full planning potential of MCO navigation, this alternative planning approach intends to improve planning efficiency and individual plan quality. Planning was retrospectively performed on 12 brain tumor and 10 post-prostatectomy prostate patients previously treated with MCO-IMRT. For each patient, physicians were provided with a template-based generated Pareto surface of optimal plans to navigate, using the beam angles from the original clinical plans. We compared physician generated plans to clinically delivered plans (created by dosimetrists) in terms of dosimetric differences, physician preferences and planning times. Plan qualities were similar, however physician generated and clinical plans differed in the prioritization of clinical goals. Physician derived prostate plans showed significantly better sparing of the high dose rectum and bladder regions (p(D1) < 0.05; D1: dose received by 1% of the corresponding structure). Physicians’ brain tumor plans indicated higher doses for targets and brainstem (p(D1) < 0.05). Within blinded plan comparisons physicians preferred the clinical plans more often (brain: 6:3 out of 12, prostate: 2:6 out of 10) (not statistically significant). While times of physician involvement were comparable for prostate planning, the new workflow reduced the average involved time for brain cases by 30%. Planner times were reduced for all cases. Subjective benefits, such as a better understanding of planning situations, were observed by clinicians through the insight into plan optimization and experiencing dosimetric trade-offs. We introduce physician driven planning with MCO for brain and prostate tumors as a feasible planning workflow. The proposed approach standardizes the planning process by utilizing site specific templates and integrates physicians more tightly into treatment planning. Physicians’ navigated plan qualities were comparable to the clinical plans. Given the reduction of planning time of the planner and the equal or lower planning time of physicians, this approach has the potential to improve departmental efficiencies.
登录
查看更多内容
DOI：
10.1016/j.ijrobp.2012.04.015
发表时间：
2013-03-01
影响因子：
7
作者：
Voet, Peter W. J.;Dirkx, Maarten L. P.;Heijmen, Ben J. M.
通讯作者：
Heijmen, Ben J. M.
DOI：
10.1016/j.ijrobp.2016.07.033
发表时间：
2016-11-15
影响因子：
7
作者：
Craft, David;Khan, Fazal;Bortfeld, Thomas
通讯作者：
Bortfeld, Thomas
影响因子：
7.5
作者：
Yu, Y;Zhang, JB;Okunieff, P
通讯作者：
Okunieff, P
影响因子：
5.7
作者：
Kyroudi, Archonteia;Petersson, Kristoffer;Moeckli, Raphael
通讯作者：
Moeckli, Raphael
影响因子：
3.5
作者：
Lahanas, M;Schreibmann, E;Baltas, D
通讯作者：
Baltas, D