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S814

ESTRO 36 2017

_______________________________________________________________________________________________

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