TU-E-BRB-02：一种使用可搜索剂量体积直方图数据库进行立体定向体部放疗计划的决策支持工具。

TU-E-BRB-02: A Decision Support Tool for SBRT Planning Using a Searchable DVH Database.

作者信息

Lewis J, Mak R, Molodowitch C, Mannarino E, Baldini E, Chen A, Kozono D, Sher D, Hacker F, Killoran J

机构信息

Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA.

Rush University Medical Center, Chicago, IL.

出版信息

Med Phys. 2012 Jun;39(6Part24):3908. doi: 10.1118/1.4735951.

DOI:10.1118/1.4735951

PMID:28518686

Abstract

PURPOSE

Develop a decision support tool that aids dosimetrists, physicians, and physicists in assessing and improving plan quality through comparison to plans previously used in similar clinical situations.

METHODS

Software was developed to capture and store DVHs and other clinically relevant treatment plan characteristics in a database. In addition to the plan DVH, the database contains a total of 24 plan characteristics including fractionation, prescribed dose, treatment volume, prior surgery, tumor position, and smoking history. DVH and other plan data was captured from the treatment planning system via exported dicom RT files. Structures in the plan were automatically matched by name to a list of standard structures using a system of regular expressions. Additional fields were entered manually using a simple java interface. As a support tool, a plan under development can be quickly compared to similar plans in the database based on selected plan characteristics. A plot displaying the current and historical DVHs provides an easy visual comparison. Our interface also provides statistics for comparison for each dose/volume level such as average, minimum, maximum and standard deviation.

RESULTS

DVHs from 111 lung SBRT plans treated from 2009-2011 were imported in accordance with an approved IRB protocol. As an example of data comparisons that can be easily performed to guide plan evaluation, we examined plans prescribing 5400cGy in 3 fractions and found that tumors >7.5cc (n=34) had an average PTV coverage of 94.2% (range: 73.5-95.0%), and tumors =7.5cc (n=35) had an average PTV coverage of 94.9% (range: 81.6-99.6%).

CONCLUSION

A searchable DVH database was constructed to provide planners, physicists, and physicians with a straightforward means of comparing plans against historic distributions of DVHs. In the future, outcome data will be included in the database to strengthen its functionality as a decision support and research tool.

摘要

目的

开发一种决策支持工具，帮助剂量师、医生和物理学家通过与先前在类似临床情况下使用的计划进行比较，来评估和改进计划质量。

方法

开发了软件，用于在数据库中捕获和存储剂量体积直方图（DVH）及其他临床相关治疗计划特征。除了计划DVH外，数据库总共包含24个计划特征，包括分割方式、处方剂量、治疗体积、既往手术、肿瘤位置和吸烟史。DVH及其他计划数据通过导出的DICOM RT文件从治疗计划系统中捕获。计划中的结构通过正则表达式系统按名称自动与标准结构列表匹配。使用简单的Java界面手动输入其他字段。作为一种支持工具，正在制定的计划可以根据选定的计划特征与数据库中的类似计划快速进行比较。显示当前和历史DVH的图表提供了直观的视觉比较。我们的界面还提供每个剂量/体积水平的比较统计数据，如平均值、最小值、最大值和标准差。

结果

根据批准的机构审查委员会（IRB）方案，导入了2009年至2011年治疗的111个肺部立体定向体部放疗（SBRT）计划的DVH。作为可轻松进行以指导计划评估的数据比较示例，我们检查了处方剂量为5400cGy分3次分割的计划，发现肿瘤体积>7.5cc（n = 34）的计划靶体积（PTV）平均覆盖率为94.2%（范围：73.5 - 95.0%），而肿瘤体积 =7.5cc（n = 35）的计划PTV平均覆盖率为94.9%（范围：81.6 - 99.6%）。