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Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy
BACKGROUND/PURPOSE: Tomotherapy may deliver high-quality whole breast irradiation at static angles. The aim of this study was to implement Knowledge-Based (KB) automatic planning for left-sided whole breast using this modality. MATERIALS/METHODS: Virtual volumetric plans were associated to the dose...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256826/ https://www.ncbi.nlm.nih.gov/pubmed/35814259 http://dx.doi.org/10.1016/j.phro.2022.06.009 |
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author | Esposito, Pier Giorgio Castriconi, Roberta Mangili, Paola Broggi, Sara Fodor, Andrei Pasetti, Marcella Tudda, Alessia Di Muzio, Nadia Gisella del Vecchio, Antonella Fiorino, Claudio |
author_facet | Esposito, Pier Giorgio Castriconi, Roberta Mangili, Paola Broggi, Sara Fodor, Andrei Pasetti, Marcella Tudda, Alessia Di Muzio, Nadia Gisella del Vecchio, Antonella Fiorino, Claudio |
author_sort | Esposito, Pier Giorgio |
collection | PubMed |
description | BACKGROUND/PURPOSE: Tomotherapy may deliver high-quality whole breast irradiation at static angles. The aim of this study was to implement Knowledge-Based (KB) automatic planning for left-sided whole breast using this modality. MATERIALS/METHODS: Virtual volumetric plans were associated to the dose distributions of 69 Tomotherapy (TT) clinical plans of previously treated patients, aiming to train a KB-model using a commercial tool completely implemented in our treatment planning system. An individually optimized template based on the resulting KB-model was generated for automatic plan optimization. Thirty patients of the training set and ten new patients were considered for internal/external validation. Fully-automatic plans (KB-TT) were generated and compared using the same geometry/number of fields of the corresponding clinical plans. RESULTS: KB-TT plans were successfully generated in 26/30 and 10/10 patients of the internal/external validation sets; for 4 patients whose original plans used only two fields, the manual insertion of one/two fields before running the automatic template was sufficient to obtain acceptable plans. Concerning internal validation, planning target volume V(95%)/D(1%)/dose distribution standard deviation improved by 0.9%/0.4Gy/0.2Gy (p < 0.05) against clinical plans; Organs at risk mean doses were also slightly improved (p < 0.05) by 0.07/0.4/0.2/0.01 Gy for left lung/heart/right breast/right lung respectively. Similarly satisfactory results were replicated in the external validation set. The resulting treatment duration was 8 ± 1 min, consistent with our clinical experience. The active planner time per patient was 5–10 minutes. CONCLUSION: Automatic TT left-sided breast KB-plans are comparable to or slightly better than clinical plans and can be obtained with limited planner time. The approach is currently under clinical implementation. |
format | Online Article Text |
id | pubmed-9256826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-92568262022-07-07 Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy Esposito, Pier Giorgio Castriconi, Roberta Mangili, Paola Broggi, Sara Fodor, Andrei Pasetti, Marcella Tudda, Alessia Di Muzio, Nadia Gisella del Vecchio, Antonella Fiorino, Claudio Phys Imaging Radiat Oncol Original Research Article BACKGROUND/PURPOSE: Tomotherapy may deliver high-quality whole breast irradiation at static angles. The aim of this study was to implement Knowledge-Based (KB) automatic planning for left-sided whole breast using this modality. MATERIALS/METHODS: Virtual volumetric plans were associated to the dose distributions of 69 Tomotherapy (TT) clinical plans of previously treated patients, aiming to train a KB-model using a commercial tool completely implemented in our treatment planning system. An individually optimized template based on the resulting KB-model was generated for automatic plan optimization. Thirty patients of the training set and ten new patients were considered for internal/external validation. Fully-automatic plans (KB-TT) were generated and compared using the same geometry/number of fields of the corresponding clinical plans. RESULTS: KB-TT plans were successfully generated in 26/30 and 10/10 patients of the internal/external validation sets; for 4 patients whose original plans used only two fields, the manual insertion of one/two fields before running the automatic template was sufficient to obtain acceptable plans. Concerning internal validation, planning target volume V(95%)/D(1%)/dose distribution standard deviation improved by 0.9%/0.4Gy/0.2Gy (p < 0.05) against clinical plans; Organs at risk mean doses were also slightly improved (p < 0.05) by 0.07/0.4/0.2/0.01 Gy for left lung/heart/right breast/right lung respectively. Similarly satisfactory results were replicated in the external validation set. The resulting treatment duration was 8 ± 1 min, consistent with our clinical experience. The active planner time per patient was 5–10 minutes. CONCLUSION: Automatic TT left-sided breast KB-plans are comparable to or slightly better than clinical plans and can be obtained with limited planner time. The approach is currently under clinical implementation. Elsevier 2022-06-23 /pmc/articles/PMC9256826/ /pubmed/35814259 http://dx.doi.org/10.1016/j.phro.2022.06.009 Text en © 2022 Published by Elsevier B.V. on behalf of European Society of Radiotherapy & Oncology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Article Esposito, Pier Giorgio Castriconi, Roberta Mangili, Paola Broggi, Sara Fodor, Andrei Pasetti, Marcella Tudda, Alessia Di Muzio, Nadia Gisella del Vecchio, Antonella Fiorino, Claudio Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title | Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title_full | Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title_fullStr | Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title_full_unstemmed | Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title_short | Knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
title_sort | knowledge-based automatic plan optimization for left-sided whole breast tomotherapy |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9256826/ https://www.ncbi.nlm.nih.gov/pubmed/35814259 http://dx.doi.org/10.1016/j.phro.2022.06.009 |
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