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Plan Quality: Analyzing and Quantifying Plan Quality as a Key Component of a Total Quality System


B Nelms

B Nelms
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R McInturf

V Feygelman
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G Robinson







B Nelms1*, R McInturf2*, V Feygelman3*, G Robinson4*, (1) ,Merrimac, WI, (2) Cancer Care Centers of South Texas, San Antonio, TX, (3) H. Lee Moffitt Cancer Center, Tampa, FL, (4) Radiation Oncology Resources, Goshen, IN

SA-C-Salon AB-1 Saturday 1:30:00 PM - 3:30:00 PM Room: Salon AB

In the medical physics realm, the mention of “Quality Assurance” (QA) is often associated with topics such as system commissioning or per-patient verification of TPS dose calculations and machine delivery. However, in reality, a total quality system has many more components. One vital upstream component is the quantification and assessment of the actual “Plan Quality,” i.e. the abilities of the TPS, modality, and treatment planner to create high quality plans that meet clinical needs and are robust with respect to potential errors.

The quantification and study of plan quality across many TPS, modalities, and treatment planners has been the major point of study for a group of clinicians and researchers for the past few years. They will describe the methods, experiences, and lessons learned. Scientific studies of plan quality variation (and the root causes) will be presented, and a dedicated “Plan Challenge” on a challenging SBRT case will be performed just for this meeting. Another topic will introduce plan quality measures as a key component in a Maintenance of Certification (MOC) project at a large clinic. Yet another talk will concentrate on the role of plan quality measures in the evolving recommendations for TPS commissioning and will provide a glimpse into the upcoming TG 244 report. The session will close with discussions of practical implementation, automation, application to commissioning new auto-planning software tools, plus other future directions to further improve radiation plan quality and safety going forward.
The learning objectives for this session include:
1. To learn the history and methodology to create comprehensive and customizable plan quality algorithms.
2. To learn the measured variations in plan quality based on: treatment planner, TPS, and delivery modality
3. To understand the difficulty to achieve any/all physician’s objectives prior to planning (but post-contouring) and realistic expectations prior to plan optimization. To learn how to do patient-specific adjustments, or normalizations, of plan quality scores.
4. To learn a comprehensive plan quality metrics for a MOC project
5. To discuss standard sets of clinical plans (patient data) for TPS QA along with a clear list of aggressive, multi-criteria plan objectives, with the goal to be to quantify and benchmark.
6. To learn the results of the Plan Challenge planned and dedicated specifically for this AAPM meeting.


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