Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Radiother Oncol. 2017 Dec;125(3):500-506. doi: 10.1016/j.radonc.2017.09.021. Epub 2017 Oct 20.
To prospectively investigate the use of an independent DVH prediction tool to detect outliers in the quality of fully automatically generated treatment plans for prostate cancer patients.
MATERIALS/METHODS: A plan QA tool was developed to predict rectum, anus and bladder DVHs, based on overlap volume histograms and principal component analysis (PCA). The tool was trained with 22 automatically generated, clinical plans, and independently validated with 21 plans. Its use was prospectively investigated for 50 new plans by replanning in case of detected outliers.
For rectum D, V, V, anus D, and bladder D, the difference between predicted and achieved was within 0.4 Gy or 0.3% (SD within 1.8 Gy or 1.3%). Thirteen detected outliers were re-planned, leading to moderate but statistically significant improvements (mean, max): rectum D (1.3 Gy, 3.4 Gy), V (2.7%, 4.2%), anus D (1.6 Gy, 6.9 Gy), and bladder D (1.5 Gy, 5.1 Gy). The rectum V of the new plans slightly increased (0.2%, p = 0.087).
A high accuracy DVH prediction tool was developed and used for independent QA of automatically generated plans. In 28% of plans, minor dosimetric deviations were observed that could be improved by plan adjustments. Larger gains are expected for manually generated plans.
前瞻性研究使用独立的剂量体积直方图（DVH）预测工具来检测前列腺癌患者全自动生成治疗计划质量的异常值。
材料/方法：开发了一种计划 QA 工具，用于基于重叠体积直方图和主成分分析（PCA）预测直肠、肛门和膀胱的 DVH。该工具使用 22 个自动生成的临床计划进行了训练，并使用 21 个计划进行了独立验证。使用该工具对 50 个新计划进行了前瞻性研究，如果发现异常值，则重新计划。
对于直肠 D、V、V、肛门 D 和膀胱 D，预测值与实测值之间的差异在 0.4Gy 或 0.3%以内（标准差在 1.8Gy 或 1.3%以内）。检测到 13 个异常值并进行了重新计划，导致适度但具有统计学意义的改善（平均值，最大值）：直肠 D（1.3Gy，3.4Gy）、V（2.7%，4.2%）、肛门 D（1.6Gy，6.9Gy）和膀胱 D（1.5Gy，5.1Gy）。新计划的直肠 V 略有增加（0.2%，p=0.087）。
开发了一种高准确性的 DVH 预测工具，并用于全自动生成计划的独立 QA。在 28%的计划中，观察到了轻微的剂量偏差，可以通过计划调整来改善。对于手动生成的计划，预计会有更大的收益。
