S814
ESTRO 36 2017
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further investigation of the correlation between particular
MC-scores and dosimetric accuracy can be the basis for the
definition of tolerance criteria to identify potentially
problematic
plans.
EP-1534 Automate the Complex Stuff: Pathways,
Pitfalls and Results of Planning Automation in
Raystation
B. Archibald-Heeren
1,2
, M. Byrne
1
, Y. Wang
1
, Y. Hu
3
1
Radiation Oncology Centres, Wahroonga, Sydney,
Australia
2
University of Wollongong, Clinical Medical Physics,
Wollongong, Australia
3
Radiation Oncology Centres, Gosford, Sydney, Australia
Purpose or Objective
Automation provides the real possibility of providing
exceptional plan quality to an enormous population of
patients where time constraints or staffing levels may
form a barrier. It is thus the authors hope that by openly
sharing the constructed methodologies incorporated at
Radiation Oncology Centre, Sydney, they may in some way
expedite adoption of automation across the greater
community. The work will focus on prostate and breast
deliveries, but touch on other areas and solutions
Material and
Methods
Atlas Based Segmentation (ABS) was utilized for automatic
volume delineation. Volume metrics and DICE coefficient
scores were compared between multiple manual
delineation, ABS and ABS with post processing.
Automatic planning was achieved by python code in the
Raystation treatment planning environment. Initial
optimization objectives were determined by a min-
difference optimization of database entries from previous
clinical plans.
Plan evaluation checks against both standard guidelines
and previous plan quality scores are produced through
python code and inbuilt look up tables. Non-linear scoring
systems are incorporated for total plan scores that provide
score weighting to crucial structures.
Adaptive planning and dose tracking is achieved in a
Varian-Mosaiq-Raystation
environment.
In all case time measurements were use to provide
comparisons between manual and automated processing
of typical radiotherapy planning tasks.
Results
Contouring of DICE scores showed strong agreement (over
0.90) for the vast majority of regions of interest, with an
average DICE coefficient of 77.7 for breast patients and
81.8 for prostate. Results were improved with post
processing.
Breast and prostate plans show comparable plan quality
with manual planning for both simple single phase and
advanced 3-4 target volume techniques with dose volume
histogram differences consistently within 5% TD
Point to point comparisons between automatic
deformation matches and manual user deformations
showed varying results highlighting the current need for
visual QA of deformable
registrations.
Time improvements over manual processes are recoreded
for both breast and prostate patients in all areas of testing
Conclusion
The possibility of automation to provide efficiency and
consistency on a departmental and larger scale is
demonstrated. The work represents a step in the correct
direction rather than a finished produce to radiotherapy
automation and the current limitations and problems are
opened to the audience for responses and questions.
EP-1535 knowledge based planning for lung cancer
patients with stereotactic ablative radiotherapy
S. Smith
1
, P. Houston
1
, G. Currie
1
1
NHS Greater Glasgow & Clyde, Radiotherapy Physics,
Glasgow, United Kingdom
Purpose or Objective
To determine whether a knowledge based treatment
planning system can efficiently produce VMAT plans for
lung cancer patients treated with SABR and to assess plan
quality in relation to different training plan data and
model parameters.
Material and Methods
Three Lung SABR models were developed using the Varian
RapidPlan™ DVH estimation algorithm.
1.
Model A was trained using 60 plans calculated
with both standard and HD MLCs, 6MV flattened
/10 MV flattening filter free (FFF) utilising one
algorithm (AAA version 10.0.28) with no plans
excluded.
2.
Model B included data from model A and a
further 40 plans; 22 plans with statistical
outliers were excluded.
3.
Model C included the data from model B. A
further 78 plans calculated with a new algorithm
version (AAA version 13.6.23) were added to the
model. Statistical outliers were excluded.
The resulting models were then used to
generate plans for ten patients who had not
been included in the model training process.
Comparisons of plans generated by each
RapidPlan model with corresponding clinical
plans were performed against clinical
objectives. Clinical plans were generated by an
experienced physicist using 10MV FFF, HD MLC
and AAA (version 13.6.23).
Results
All of the plans generated by each model met the clinical
objectives. The PTV V99 (Volume of the PTV receiving at
least 99% of the prescription) was comparable between
all three model plans and the plan generated by the
experience physicist (p>>0.05). The R50 (Ratio of the 50%
prescription isodose volume to the PTV) and D2cm (the
maximum dose at 2cm from the PTV) values were
significantly reduced when using the RapidPlan (p<0.05)
for all three models. Model B gave the best results and
was statistically better than model A (p<0.05). Model B
also gave better results for the R100 (Ratio of the 100%
prescription isodose volume to the PTV) than the
experienced planner (P<0.05). This may be due to the
differences in the out of field dose calculation between
versions of AAA. OAR doses were comparable between all
models and the experienced planner (p>0.05)
Conclusion
The RapidPlan™ system was able to generate clinically
acceptable VMAT treatment plans for lung SABR patients,
in a single optimisation, with comparable OAR sparing and
equal or better plan conformity than the original clinically
acceptable plans. allowing for improved consistency and
efficiency in the treatment planning process.
EP-1536 The advantages of Collimator Optimization for
Intensity Modulated Radiation Therapy
S. Pella
1
, B. Brian Doozan
2
1
21st Century Radiation Oncology- Florida Atlantic-
Univeristy and Advanced Radiation Physics Inc.,
Radiation Oncology/Physics, Boca Raton, USA
2
Florida Atlantic University, Physics/Medical Physics,
Boca Raton, USA
Purpose or Objective
The goal of this study was to improve dosimetry for
pelvic, head and neck and other cancer sites with
aspherical planning target volumes (PTV) using a new
algorithm for collimator angles optimization for intensity
modulated radiation therapy (IMRT).
Material and Methods
A retroactive study on the effects of the collimator
optimization for 20 patients was performed by comparing
the dosimetric effects, number of monitor units (MU), and