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Evaluation of a Fully Automated Treatment Planning and Quality Assurance System for HDR Brachytherapy with a Cylinder Applicator

P Klages

P Klages*, Y Zhou , J Tan , K Albuquerque , X Jia , The University of Texas Southwestern Medical Center, Dallas, TX


MO-L-GePD-T-3 (Monday, July 31, 2017) 1:15 PM - 1:45 PM Room: Therapy ePoster Lounge

Purpose: Aiming at eliminating human errors, reducing plan quality variation, and improving workflow efficiency, we have successfully developed a fully automated treatment planning and quality assurance (QA) system for HDR brachytherapy with a cylinder applicator. Starting with a patient CT images, the system automatically segments the applicator, generates a treatment plan, and performs QA checks. The purpose of this study is to perform comprehensive validations of the system using real patient cases treated at our institution.

Methods: We tested the system using 29 cases treated at our institution in 2016. For each case, we first selected input the treatment prescription, depth, and length. The program automatically segmented the CT images using image processing techniques and created a model cylindrical applicator and the corresponding CTV as per the guideline of ABR. Dwell positions were determined and times were calculated using quadratic optimization techniques. For geometrical accuracy, we compared the position of cylinder applicator apex position and orientation in the automatically generated plan with the clinical plan used to treat the patient. For dosimetric accuracy, we studied CTV surface dose homogeneity index (DHI).

Results: Preliminary analysis on 20 cases show agreement between automatically planned and manually planned treatments. Apex positions differ by sub-voxel-sized distances, and orientation angles differ by less than 1 degree. The dose homogeneity in all automatically generated plans were acceptable. Automatic plans achieved less DHI variation than manual plans. QA tests in all cases were passed.

Conclusion: The automated treatment planning program for HDR brachytherapy cylindrical is able to create clinically viable plans. Its clinical implementation is expected to improve plan quality and clinical workflow.

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