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Program Information

Evaluation of PlanIQ Feasibility DVH as Planning Objectives for Skull Base SBRT Patients

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H Wang

W Jiang1 , H Wang2*, P Chi2 , (1) School of Medicine, Qingdao University, Yantai, Shandong, (2) University of Texas, M.D. Anderson Cancer Center, Houston, Texas

Presentations

SU-F-T-419 (Sunday, July 31, 2016) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose: PlanIQ(Sun Nuclear Corporation) can provide feasibility measures on organs-at-risk(OARs) around the target based on depth, local anatomy density and energy of radiation beam used. This study is to test and evaluate PlanIQ feasibility DVHs as optimization objectives in the treatment planning process, and to investigate the potential to use them in routine clinical cases to improve planning efficiency.

Methods: Two to three arcs VMAT Treatment plans were generated in Pinnacle based on PlanIQ feasibility DVH for six skull base patients who previously treated with SBRT. The PlanIQ feasibility DVH for each OAR consists of four zones – impossible (at 100% target coverage), difficult, challenging and probable. Constrains to achieve DVH in difficult zone were used to start plan optimization. Further adjustment was made to improve coverage. The plan DVHs were compared to PlanIQ feasibility DVH to assess the dose received by 0%(D0), 5%(D5), 10%(D10) and 50%(D50) of the OAR volumes.

Results: A total of 90 OARs were evaluated for 6 patients (mean 15 OARs, range 11-18 OARs). We used >98% PTV coverage as planning goal since it’s difficult to achieve 100% target coverage. For the generated plans, 96.7% of the OARs achieved D0 or D5 within difficult zone or impossible zone (ipsilateral OARs 93.5%, contralateral OARs 100%), while 90% and 65.6% of the OARs achieved D10 and D50 within difficult zone, respectively. Seventeen of the contralateral and out of field OARs achieved DVHs in impossible zone. For OARs adjacent or overlapped with target volume, the D0 and D5 are challenging to be optimized into difficult zone. All plans were completed within 2-4 adjustments to improve target coverage and uniformity.

Conclusion: PlanIQ feasibility tool has the potential to provide difficult but achievable initial optimization objectives and therefore reduce the planning time to obtain a well optimized plan.


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