Department of Radiation Oncology, Tane General Hospital, 1-12-21 Kujo-minami, Nishi, Osaka 550-0025, Japan.
Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, 377-2 Ohno-higashi, Osaka-sayama, Osaka 589-8511, Japan.
Phys Med. 2019 Nov;67:132-140. doi: 10.1016/j.ejmp.2019.10.032. Epub 2019 Nov 6.
This study aimed to clarify the inter-planner variation of plan quality in knowledge-based plans created by nine planners.
Five hypofractionated prostate-only (HPO) volumetric modulated arc therapy (VMAT) plans and five whole-pelvis (WP) VMAT plans were created by each planner using a knowledge-based planning (KBP) system. Nine planners were divided into three groups of three planners each: Senior, Junior, and Beginner. Single optimization with only priority modification for all objectives was performed to stay within the dose constraints. The coefficients of variation (CVs) for dosimetric parameters were evaluated, and a plan quality metric (PQM) was used to evaluate comprehensive plan quality.
Lower CVs (<0.05) were observed at dosimetric parameters in the planning target volume for both HPO and WP plans, while the CVs in the rectum and bladder for WP plans (<0.91) were greater than those for HPO plans (<0.17). The PQM values of HPO plans for Cases1-5 (average ± standard deviation) were 41.2 ± 7.1, 40.9 ± 5.6, and 39.9 ± 4.6 in the Senior, Junior, and Beginner groups, respectively. For the WP plans, the PQM values were 51.9 ± 6.3, 47.5 ± 4.3, and 40.0 ± 6.6, respectively. The number of clinically acceptable HPO and WP plans were 13/15 and 11/15 in the Senior group, 13/15 and 10/15 plans in the Junior group, and 8/15 and 2/15 plans in the Beginner group, respectively.
Inter-planner variation in the plan quality with RapidPlan remains, especially for the complicated VMAT plans, due to planners' heuristics.
本研究旨在阐明 9 位规划师创建的基于知识的计划中计划质量的规划师间差异。
每位规划师使用基于知识的计划（KBP）系统分别为 5 个前列腺单纯症（HPO）部分容积调强弧形治疗（VMAT）计划和 5 个全骨盆（WP）VMAT 计划进行优化。9 位规划师分为高级、中级和初级三个 3 人小组。仅对所有目标进行优先级修改的单次优化以保持在剂量限制内。评估了剂量学参数的变异系数（CV），并使用计划质量指标（PQM）评估综合计划质量。
HPO 和 WP 计划的计划靶区的剂量学参数的 CV 较低（<0.05），而 WP 计划的直肠和膀胱的 CV 较高（<0.91），高于 HPO 计划（<0.17）。病例 1-5 的 HPO 计划的 PQM 值（平均值±标准差）分别为高级组 41.2±7.1、中级组 40.9±5.6 和初级组 39.9±4.6。WP 计划的 PQM 值分别为 51.9±6.3、47.5±4.3 和 40.0±6.6。高级组的临床可接受 HPO 和 WP 计划数量分别为 13/15 和 11/15，中级组分别为 13/15 和 10/15，初级组分别为 8/15 和 2/15。
由于规划师的启发式方法，RapidPlan 中的计划质量仍然存在规划师间差异，尤其是对于复杂的 VMAT 计划。
