Automated Closed- and Open-Loop Validation of Knowledge-Based Planning Routines Across Multiple Disease Sites
Automated Closed- and Open-Loop Validation of Knowledge-Based Planning Routines Across Multiple Disease Sites
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DOI：
10.1016/j.prro.2019.02.010
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发表时间：
2019-07-01
影响因子：
3.3
通讯作者：
Moore, Kevin L.
中科院分区：
文献类型：
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作者：
Kaderka, Robert;Mundt, Robert C.;Moore, Kevin L.
目的：基于知识的规划（KBP）临床实施需要大量的前期工作，即使是在一个单一的疾病部位。本研究的目的是为临床医生提供一种有效的方法，以评估KBP在多个疾病部位的非劣效性，并估计实施后的任何系统剂量学差异。我们试图在多个既往接受过治疗的患者中确定这些终点（验证集），具有两个闭环（训练集与验证集重叠）和开环（独立训练集）KBP例程。方法和材料：我们确定了53个前列腺，24个前列腺窝，54个低分割肺，在我们诊所广泛采用RapidPlan（Varian Medical Systems，Palo Alto，CA）之前的一年中，52名头颈部患者接受了体积调制弧治疗。使用Varian Eclipse Scripting API，我们的程序将患者列表作为输入，然后执行半自动结构匹配、全自动RapidPlan驱动优化和计划比较。所有计划均标准化为计划靶体积（PTV）D-95% = 100%。计算各疾病部位标准PTV和危及器官（OAR）剂量-体积直方图参数的剂量度量差异（Delta D-x = D-x，D-clinical = D-x，D-KBP）。双尾配对t检验定量统计学显著性（P
Purpose: Knowledge-based planning (KBP) clinical implementation necessitates significant upfront effort, even within a single disease site. The purpose of this study was to demonstrate an efficient method for clinicians to assess the noninferiority of KBP across multiple disease sites and estimate any systematic dosimetric differences after implementation. We sought to establish these endpoints in a plurality of previously treated patients (validation set) with both closed-loop (training set overlapping validation set) and open-loop (independent training set) KBP routines.Methods and Materials: We identified 53 prostate, 24 prostatic fossa, 54 hypofractionated lung, and 52 head and neck patients treated with volumetric modulated arc therapy in the year directly preceding our clinic's broad adoption of RapidPlan (Varian Medical Systems, Palo Alto, CA). Using the Varian Eclipse Scripting API, our program takes as input a list of patients, then performs semiautomated structure matching, fully automated RapidPlan-driven optimization, and plan comparison. All plans were normalized to the planning target volume (PTV) D-95% = 100%. Dose metric differences (Delta D-x = D-x,D-clinical = D-x,D-KBP) were computed for standard PTV and organ-at-risk (OAR) dose-volume histogram parameters across disease sites. A 2-tailed paired t test quantified statistical significance (P