Toward Fully Automated Multicriterial Plan Generation: A Prospective Clinical Study
Toward Fully Automated Multicriterial Plan Generation: A Prospective Clinical Study
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DOI：
10.1016/j.ijrobp.2012.04.015
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发表时间：
2013-03-01
影响因子：
7
通讯作者：
Heijmen, Ben J. M.
中科院分区：
文献类型：
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作者：
Voet, Peter W. J.;Dirkx, Maarten L. P.;Heijmen, Ben J. M.
目的：为了前瞻性地比较使用iCycle生成的计划，iCycle是一种内部开发的用于全自动多标准调强放射治疗（IMRT）射束轮廓和射束方向优化的算法，与剂量测定师使用临床治疗计划系统手动生成的计划。随机选择20例不同肿瘤部位的头颈部肿瘤患者，（其中13人接受了序贯加强治疗），我们为治疗医生提供了自动生成的iCycle计划和使用标准临床程序手动优化计划之间的选择。虽然iCycle使用了一个固定的“愿望清单”，具有硬约束和优先目标，但剂量师手动选择射束配置并微调每个IMRT计划的约束和目标。未提前告知剂量测定师是否制定了竞争性iCycle计划。这2个计划同时提交给医生，然后由医生选择用于治疗的计划。对于患者组，在规划的目标体积覆盖率和备用的关键tissues.Results的差异进行了量化：在32的33个计划比较，医生选择了iCycle计划进行治疗。对自动生成计划的高度一致的偏好主要是由于对大多数关键结构的改进的备用。使用iCycle，腮腺和下颌下腺的正常组织并发症概率分别降低了2.4% +/- 4.9%（最大值，18.5%，P = 0.001）和6.5% +/- 8.3%（最大值，27%，P = 0.005）。平均口腔剂量减少2.8 +/- 2.8戈伊（最大，8.1戈伊，P = 0.005）。对于吞咽肌肉、食管和喉，平均剂量减少为3.3 +/- 1.1戈伊（最大值，9.2戈伊，P < .001）。20例患者中有15例，目标覆盖率也得到了改善。结论：在97%的情况下，自动生成的计划被选择用于治疗，因为其上级质量。除了提高计划质量外，自动计划生成由于减少了工作量而在经济上具有吸引力。(c)2013 Elsevier Inc.
Purpose: To prospectively compare plans generated with iCycle, an in-house-developed algorithm for fully automated multicriterial intensity modulated radiation therapy (IMRT) beam profile and beam orientation optimization, with plans manually generated by dosimetrists using the clinical treatment planning system.Methods and Materials: For 20 randomly selected head-and-neck cancer patients with various tumor locations (of whom 13 received sequential boost treatments), we offered the treating physician the choice between an automatically generated iCycle plan and a manually optimized plan using standard clinical procedures. Although iCycle used a fixed "wish list" with hard constraints and prioritized objectives, the dosimetrists manually selected the beam configuration and fine tuned the constraints and objectives for each IMRT plan. Dosimetrists were not informed in advance whether a competing iCycle plan was made. The 2 plans were simultaneously presented to the physician, who then selected the plan to be used for treatment. For the patient group, differences in planning target volume coverage and sparing of critical tissues were quantified.Results: In 32 of 33 plan comparisons, the physician selected the iCycle plan for treatment. This highly consistent preference for the automatically generated plans was mainly caused by the improved sparing for the large majority of critical structures. With iCycle, the normal tissue complication probabilities for the parotid and submandibular glands were reduced by 2.4% +/- 4.9% (maximum, 18.5%, P = .001) and 6.5% +/- 8.3% (maximum, 27%, P = .005), respectively. The reduction in the mean oral cavity dose was 2.8 +/- 2.8 Gy (maximum, 8.1 Gy, P = .005). For the swallowing muscles, the esophagus and larynx, the mean dose reduction was 3.3 +/- 1.1 Gy (maximum, 9.2 Gy, P < .001). For 15 of the 20 patients, target coverage was also improved.Conclusions: In 97% of cases, automatically generated plans were selected for treatment because of the superior quality. Apart from the improved plan quality, automatic plan generation is economically attractive because of the reduced workload. (c) 2013 Elsevier Inc.