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Evaluation of Automated Treatment Planning System for Lung Functional Avoidance

A Yorke

A Yorke1*, J Zhang2 , Y Vinogradskiy3 , E Castillo4 , I Grills5 , C Stevens6 , T Guerrero7 , (1) William Beaumont Hospital, Royal Oak, MI, (2) Beaumont Health System, Royal Oak, MI, (3) University of Colorado Denver, Aurora, CO, (4) Beaumont Health System, Royal Oak, Michigan, (5) Beaumont Health System, Royal Oak, MI, (6) Beaumont Health System, Royal Oak, MI, (7) Beaumont Health System, Roayl Oak, Michigan


SU-H1-GePD-J(A)-1 (Sunday, July 30, 2017) 3:00 PM - 3:30 PM Room: Joint Imaging-Therapy ePoster Lounge - A

Purpose: IMRT and VMAT treatment planning is a tedious and time-consuming process for the planner. Treatment plan quality can vary widely with the dosimetrist’s experience and available time. We perform a retrospective study to evaluate automated treatment planning (AP) v. manual planning for functional avoidance in non-small cell lung cancer cases. The methods are compared on their dosimetric performance in achieving planning criteria and required planning time.

Methods: The treatment planning 4DCT images for 8 cases from an active functional avoidance clinical trial (NCT02528942) were re-planned using the AP techniques created in Pinnacle3 9.14. Two AP techniques were created one each for IMRT and VMAT, using organ at risk (OAR) and planning target volume (PTV) treatment criteria from our institution. AP plans were created using the technique that matched the patient prescription. The OAR objectives analyzed for, Lung-GTV and total vent were V20%, V5%, and mean dose. Other OAR include maximum dose to the great vessels, cord, esophagus, trachea and heart. A Wilcoxon ranked sum test was performed to evaluate the statistical significance between the two plans.

Results: The average planning time for AP was about an hour, which was lower compared to the four hours for manual plans. In each case dose volume histogram analysis revealed that both the clinical plan and the AP plan satisfied the dose constraints criteria. A Wilcoxon ranked sum shows p=0.742 for D95% PTV, p=0.383 for mean dose for total ventilation, and p=0.641, p=0.078 and p=0.547 for max dose of heart, esophagus and trachea respectively.

Conclusion: There was no significant difference in dosimetric values between the clinical plans and the AP plans except for the maximum dose to the cord (p=0.039), proximal bronchial tree (P=0.039) and V60%(p=0.039) of the esophagus. AP plans were faster to generate and easy to adapt in busy clinical workflow.

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