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Title: Automatic planning on hippocampal avoidance whole-brain radiotherapy

Abstract

Mounting evidence suggests that radiation-induced damage to the hippocampus plays a role in neurocognitive decline for patients receiving whole-brain radiotherapy (WBRT). Hippocampal avoidance whole-brain radiotherapy (HA-WBRT) has been proposed to reduce the putative neurocognitive deficits by limiting the dose to the hippocampus. However, urgency of palliation for patients as well as the complexities of the treatment planning may be barriers to protocol enrollment to accumulate further clinical evidence. This warrants expedited quality planning of HA-WBRT. Pinnacle{sup 3} Automatic treatment planning was designed to increase planning efficiency while maintaining or improving plan quality and consistency. The aim of the present study is to evaluate the performance of the Pinnacle{sup 3} Auto-Planning on HA-WBRT treatment planning. Ten patients previously treated for brain metastases were selected. Hippocampal volumes were contoured on T1 magnetic resonance (MR) images, and planning target volumes (PTVs) were generated based on RTOG0933. The following 2 types of plans were generated by Pinnacle{sup 3} Auto-Planning: the one with 2 coplanar volumetric modulated arc therapy (VMAT) arcs and the other with 9-field noncoplanar intensity-modulated radiation therapy (IMRT). D{sub 2%} and D{sub 98%} of PTV were used to calculate homogeneity index (HI). HI and Paddick Conformity index (CI) of PTV as wellmore » as D{sub 100%} and D{sub max} of the hippocampus were used to evaluate the plan quality. All the auto-plans met the dose coverage and constraint objectives based on RTOG0933. The auto-plans eliminated the necessity of generating pseudostructures by the planners, and it required little manual intervention which expedited the planning process. IMRT quality assurance (QA) results also suggest that all the auto-plans are practically acceptable on delivery. Pinnacle{sup 3} Auto-Planning generates acceptable plans by RTOG0933 criteria without time-consuming planning process. The expedited quality planning achieved by Auto-Planning (AP) may facilitate protocol enrollment of patients to further investigate the hippocampal-sparing effect and be used to ensure timely start of palliative treatment in future clinical practice.« less

Authors:
; ; ; ; ; ; ; ;
Publication Date:
OSTI Identifier:
22685184
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 42; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; EFFICIENCY; HIPPOCAMPUS; IMAGES; MANUALS; METASTASES; PATIENTS; PERFORMANCE; PLANNING; QUALITY ASSURANCE; RADIATION DOSES; RADIOTHERAPY; QUALITY MANAGEMENT

Citation Formats

Wang, Shuo, E-mail: shuo0220@gmail.com, Zheng, Dandan, Zhang, Chi, Ma, Rongtao, Bennion, Nathan R., Lei, Yu, Zhu, Xiaofeng, Enke, Charles A., and Zhou, Sumin. Automatic planning on hippocampal avoidance whole-brain radiotherapy. United States: N. p., 2017. Web. doi:10.1016/J.MEDDOS.2016.12.002.
Wang, Shuo, E-mail: shuo0220@gmail.com, Zheng, Dandan, Zhang, Chi, Ma, Rongtao, Bennion, Nathan R., Lei, Yu, Zhu, Xiaofeng, Enke, Charles A., & Zhou, Sumin. Automatic planning on hippocampal avoidance whole-brain radiotherapy. United States. doi:10.1016/J.MEDDOS.2016.12.002.
Wang, Shuo, E-mail: shuo0220@gmail.com, Zheng, Dandan, Zhang, Chi, Ma, Rongtao, Bennion, Nathan R., Lei, Yu, Zhu, Xiaofeng, Enke, Charles A., and Zhou, Sumin. Sat . "Automatic planning on hippocampal avoidance whole-brain radiotherapy". United States. doi:10.1016/J.MEDDOS.2016.12.002.
@article{osti_22685184,
title = {Automatic planning on hippocampal avoidance whole-brain radiotherapy},
author = {Wang, Shuo, E-mail: shuo0220@gmail.com and Zheng, Dandan and Zhang, Chi and Ma, Rongtao and Bennion, Nathan R. and Lei, Yu and Zhu, Xiaofeng and Enke, Charles A. and Zhou, Sumin},
abstractNote = {Mounting evidence suggests that radiation-induced damage to the hippocampus plays a role in neurocognitive decline for patients receiving whole-brain radiotherapy (WBRT). Hippocampal avoidance whole-brain radiotherapy (HA-WBRT) has been proposed to reduce the putative neurocognitive deficits by limiting the dose to the hippocampus. However, urgency of palliation for patients as well as the complexities of the treatment planning may be barriers to protocol enrollment to accumulate further clinical evidence. This warrants expedited quality planning of HA-WBRT. Pinnacle{sup 3} Automatic treatment planning was designed to increase planning efficiency while maintaining or improving plan quality and consistency. The aim of the present study is to evaluate the performance of the Pinnacle{sup 3} Auto-Planning on HA-WBRT treatment planning. Ten patients previously treated for brain metastases were selected. Hippocampal volumes were contoured on T1 magnetic resonance (MR) images, and planning target volumes (PTVs) were generated based on RTOG0933. The following 2 types of plans were generated by Pinnacle{sup 3} Auto-Planning: the one with 2 coplanar volumetric modulated arc therapy (VMAT) arcs and the other with 9-field noncoplanar intensity-modulated radiation therapy (IMRT). D{sub 2%} and D{sub 98%} of PTV were used to calculate homogeneity index (HI). HI and Paddick Conformity index (CI) of PTV as well as D{sub 100%} and D{sub max} of the hippocampus were used to evaluate the plan quality. All the auto-plans met the dose coverage and constraint objectives based on RTOG0933. The auto-plans eliminated the necessity of generating pseudostructures by the planners, and it required little manual intervention which expedited the planning process. IMRT quality assurance (QA) results also suggest that all the auto-plans are practically acceptable on delivery. Pinnacle{sup 3} Auto-Planning generates acceptable plans by RTOG0933 criteria without time-consuming planning process. The expedited quality planning achieved by Auto-Planning (AP) may facilitate protocol enrollment of patients to further investigate the hippocampal-sparing effect and be used to ensure timely start of palliative treatment in future clinical practice.},
doi = {10.1016/J.MEDDOS.2016.12.002},
journal = {Medical Dosimetry},
number = 1,
volume = 42,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}